Help - Should I Work or Wait?

1 hour ago, kat1822 said:

 Can I use my orientation packet from last year - I checked off loads of skills.

Those skills typically have to be checked off yearly, if not more frequently than that.

If you were planning to return to the same position after maternity leave, and you had the spousal support and childcare means to do so, my answer would be find any job you love.

Since that's not the case, I would only accept a position that requires no experience, critical thinking, or long term commitment- like administering covid vaccines.  You're clinically a new grad, so any acute care job worth taking would spend those 3 months on your orientation.  It's really not good to pay a nurse for 3 months just to have her quit before she ever counts as staffing.  (Technically, you're a little more of a risk than a true new grad. You have a new grad level of experience, but a lot of time has passed since your education,  so you may have forgotten skills/knowledge that are fresh in a true new grad's mind.)

As someone who has taught undergraduate nurses in multiple programs and worked as an educator in the hospital setting orienting new grads, I can tell you that no matter how many undergraduate clinical hours you obtained, those aren't RN experience.  School clinicals don't translate to independent RN practice.

You're already going to have an iffy resume because of large time gaps between school and work and lacking experience.  Don't make it worse by filling it up with 3 month hospital jobs you didn't keep.  It'll look like wow, this lady never works, and when she does, she quits right away.  On the other hand, if you accept something like a vaccine position, your resume can say something like Vaccine RN (Temporary Position) to show that the position was meant to be short term all along.

Don't get me wrong. I think staying home to raise your babies is the best choice you can make! Employers just don't share that sentiment.

Alternatively, what about finding a job where you consistently work Saturdays or Sundays? (Not both)  It would give you all week with your children, all evenings with your husband, and one weekend day together as a family.  Your job choices may be limited, but I'll bet with something like home health or private duty nursing this could be a good option!  Best of all, it would keep your resume current and open doors a couple of years from now when (and if) you're ready to really launch your career. 

1 hour ago, Closed Account 12345 said:

If you were planning to return to the same position after maternity leave, and you had the spousal support and childcare means to do so, my answer would be find any job you love.

Since that's not the case, I would only accept a position that requires no experience, critical thinking, or long term commitment- like administering covid vaccines.  You're clinically a new grad, so any acute care job worth taking would spend those 3 months on your orientation.  It's really not good to pay a nurse for 3 months just to have her quit before she ever counts as staffing.  (Technically, you're a little more of a risk than a true new grad. You have a new grad level of experience, but a lot of time has passed since your education,  so you may have forgotten skills/knowledge that are fresh in a true new grad's mind.)

As someone who has taught undergraduate nurses in multiple programs and worked as an educator in the hospital setting orienting new grads, I can tell you that no matter how many undergraduate clinical hours you obtained, those aren't RN experience.  School clinicals don't translate to independent RN practice.

You're already going to have an iffy resume because of large time gaps between school and work and lacking experience.  Don't make it worse by filling it up with 3 month hospital jobs you didn't keep.  It'll look like wow, this lady never works, and when she does, she quits right away.  On the other hand, if you accept something like a vaccine position, your resume can say something like Vaccine RN (Temporary Position) to show that the position was meant to be short term all along.

Don't get me wrong. I think staying home to raise your babies is the best choice you can make! Employers just don't share that sentiment.

Alternatively, what about finding a job where you consistently work Saturdays or Sundays? (Not both)  It would give you all week with your children, all evenings with your husband, and one weekend day together as a family.  Your job choices may be limited, but I'll bet with something like home health or private duty nursing this could be a good option!  Best of all, it would keep your resume current and open doors a couple of years from now when (and if) you're ready to really launch your career. 

I really truly appreciate your perspective. Thank you for sharing all of this with me.

Let me say this: I worked on a stepdown telemetry unit only part time for orientation for my first job. I was taking 5 patients by the time I left... I felt pretty comfortable for the most part unless I had impossible assignments (like argatroban or a heparin drip and lots of high BPs all at the same time and a new blood transfusion order- that happened once and was not a fun day). My preceptor was letting me fly on my own and would come in when I needed help like the scenario I described. All that to say, I’m looking at a position on a swing bed unit. After talking to some people about acuity levels on swing bed units and the type of care needed, I do feel quite confident that I could get off of orientation in less than 3 months. I’m a very quick learner and hard worker (and I’ve done very hands-on clinicals while heavily pregnant). It’s in the same health system, so the charting is all the same. The career coach said the manager is very flexible and they are looking for a PRN associate - she’s talking to her for me.  I would be happy to do orientation 2 days a week if they’ll take me and then go down to 1 day a week or whatever is required for PRN. Then go back to work indefinitely after maternity leave.
Thoughts? Thanks if you read this far ?

34 minutes ago, kat1822 said:

Thoughts?

Respectfully, I am concerned that you don't know what you don't know. 

It is frightening that a new grad with 3 months of part-time RN experience under her belt (occurring 6 months ago and while on orientation with a preceptor) considers herself competent to jump right into independent practice with a speedy orientation in a new role. 

I don't say that to be ugly, but even experienced nurses aren't interchangeable between specialties without a good orientation. No decent new grad orientation can be completed in a few shifts.  Frankly, I think over-confidence in this situation really endangers patients' lives. 

Even top of their class, #1, shining star new grads who start working full time right out of school and go through wonderful residency programs are still new grads. They still critically think like new grads when dealing with new situations.  They still get overwhelmed.  They're still learning to prioritize when all of their patients decide to go downhill at once.  They're still learning the ropes.  That's not a bad thing; it's just the reality at first! 

Competence comes from experience- first with a preceptor, and then over time while practicing independently.  You didn't have time to practice independently at your last job (even though you felt confident about your orientation), and 3 months won't be enough time to gain adequate experience in a new job.

Before taking any new position, make sure you and your manager are on the same page about length of orientation,  understanding that you need to be oriented as a new grad instead of an experienced RN, the length of your maternity leave, and your very limited availability upon returning.  If all of that checks out, ask yourself "Why does this manager need to hire an inexperienced nurse who is about to take a long break and will have minimal availability after maternity leave?" Is there a toxic culture in the unit where they just need a warm body? Are there red flags? Maybe not! Maybe it really is just an ideal situation for your circumstances... Just tread carefully.

18 hours ago, Closed Account 12345 said:

Respectfully, I am concerned that you don't know what you don't know. 

It is frightening that a new grad with 3 months of part-time RN experience under her belt (occurring 6 months ago and while on orientation with a preceptor) considers herself competent to jump right into independent practice with a speedy orientation in a new role. 

I don't say that to be ugly, but even experienced nurses aren't interchangeable between specialties without a good orientation. No decent new grad orientation can be completed in a few shifts.  Frankly, I think over-confidence in this situation really endangers patients' lives. 

Even top of their class, #1, shining star new grads who start working full time right out of school and go through wonderful residency programs are still new grads. They still critically think like new grads when dealing with new situations.  They still get overwhelmed.  They're still learning to prioritize when all of their patients decide to go downhill at once.  They're still learning the ropes.  That's not a bad thing; it's just the reality at first! 

Competence comes from experience- first with a preceptor, and then over time while practicing independently.  You didn't have time to practice independently at your last job (even though you felt confident about your orientation), and 3 months won't be enough time to gain adequate experience in a new job.

Before taking any new position, make sure you and your manager are on the same page about length of orientation,  understanding that you need to be oriented as a new grad instead of an experienced RN, the length of your maternity leave, and your very limited availability upon returning.  If all of that checks out, ask yourself "Why does this manager need to hire an inexperienced nurse who is about to take a long break and will have minimal availability after maternity leave?" Is there a toxic culture in the unit where they just need a warm body? Are there red flags? Maybe not! Maybe it really is just an ideal situation for your circumstances... Just tread carefully.

 

 

 

Wow you don’t mince words do you! I respect that. And you have reminded me that I did feel a little on my own in my first job... which is one reason among many why I left. One of the things that did scare me was exactly what you said - I didn’t know what I didn’t know. My preceptor wasn’t very good - she didn’t explain to me that the hospital expected a very specific way of charting on a suicidal patient. If the oncoming charge nurse hadn’t told me about it, who knows when I would have found out I should have been doing that.

I’m understanding that if I take this part time position, I will be working 2 days under orientation which would be “dependent” on my “progression”. That gives me hope that they will be supportive if I feel I need a longer than normal orientation. Hopefully by the time baby comes in 5 and a half months I will be off of orientation or close to it. I’m setting up to shadow on the unit before interviewing. I want to know what I’m in for before committing that way I can hold the job consistently for a long period of time (even if I’m not working “a lot”). 
 

1 hour ago, kat1822 said:

Wow you don’t mince words do you!

No, but I also really don't mean for anything to sound offensive- just truthful and helpful!

OK, just to clarify... Your previous post says you would do 2 days per week for orientation.  That could be OK if you're given 2 days of orientation a week for 8-12 weeks.

Your last post says 2 days of orientation with the potential for an extension.  If it's the second, RED FLAG! A pole full of red flags!

You've described the unit as a swing unit for patients going from acute care to skilled nursing facilities. 

Think about these factors: elderly, patients recovering from acute illnesses so possibly on antibiotics or treatments that must be done on time, folks with new acute mobility issues who are prone to falling and don't yet know how to assist you in their transfers, possible pain management issues, possible disorientation from transitioning to a new unit, the emotional struggle of loss of independence as they move to SNF, people with multiple comorbidities, many of whom probably require assistance with ADLs and transfers, many patients needing finger sticks or breathing treatments, most folks with  polypharmacy, probably ridiculous nurse to patient ratios from dubbing these patients no longer "acute"... At the end of two days, you won't know the unit's policies and procedures yet. You won't know the providers. You won't know where supplies are located. You won't know the flow. You likely won't have all access codes or keys.  You won't know how to file an incident report. You won't know your peers and who is a safe resource. At this moment, are you 100% independently proficient in trach care, tube feeds, wound care, orthopedic nursing, neuro checks, IV therapy, oxygen therapy, medication administration, catheterizations, being able to QUICKLY scan charts for abnormal labs, knowing what those mean and how to respond, PICC lines, understanding monitoring parameters for many meds, etc.? If you're not, there is a ZERO percent chance you will be in 2 shifts.  (I've been a nurse 14 years in a broad variety of roles. *I* could not safely practice in that kind of unit without a 6 week orientation because it's so unlike the acute care units I've worked in and probably lacks the on-site resources I'm used to from hospitals.)

It is nightmarish to think that a unit like this would even CONSIDER two days with a preceptor an adequate orientation for a new grad, even with the possibility of an extension. See 95% of SNF posts on this website to see how they promised orientation extensions were never granted, and in fact how people find themselves the only RN in the building by day 2 or 3.

How many RNs are staffed per shift? If 2 of 3 RNs call in, how is staffing addressed? Are nurses ever mandated to stay over due to call ins? If you have 12-20 patients, when will you have time to pump in a private clean area if that's your desire? If you choose to breastfeed and are mandated to stay over for an extra 8 hrs, how will that affect supply? Will your husband be able to call in to cover that required extra time?  How many techs work each shift? You don't need to be transferring and catching a 300 lb patient alone at 8 mos prego.

Signed, Your fellow mama who believes raising children ALWAYS comes first, has a heart for new nurses (and experienced nurses learning new things), and believes everyone deserves the training needed to be SAFE

P.S. I know this post is a bunch of jumbled word mess. I typed it on my phone with freezing cold fingers as I sit on back porch watching my own littles run around before bed. Forgive typos and grammar fails.  ?

On 3/18/2021 at 7:24 PM, Closed Account 12345 said:

No, but I also really don't mean for anything to sound offensive- just truthful and helpful!

OK, just to clarify... Your previous post says you would do 2 days per week for orientation.  That could be OK if you're given 2 days of orientation a week for 8-12 weeks.

Your last post says 2 days of orientation with the potential for an extension.  If it's the second, RED FLAG! A pole full of red flags!

You've described the unit as a swing unit for patients going from acute care to skilled nursing facilities. 

Think about these factors: elderly, patients recovering from acute illnesses so possibly on antibiotics or treatments that must be done on time, folks with new acute mobility issues who are prone to falling and don't yet know how to assist you in their transfers, possible pain management issues, possible disorientation from transitioning to a new unit, the emotional struggle of loss of independence as they move to SNF, people with multiple comorbidities, many of whom probably require assistance with ADLs and transfers, many patients needing finger sticks or breathing treatments, most folks with  polypharmacy, probably ridiculous nurse to patient ratios from dubbing these patients no longer "acute"... At the end of two days, you won't know the unit's policies and procedures yet. You won't know the providers. You won't know where supplies are located. You won't know the flow. You likely won't have all access codes or keys.  You won't know how to file an incident report. You won't know your peers and who is a safe resource. At this moment, are you 100% independently proficient in trach care, tube feeds, wound care, orthopedic nursing, neuro checks, IV therapy, oxygen therapy, medication administration, catheterizations, being able to QUICKLY scan charts for abnormal labs, knowing what those mean and how to respond, PICC lines, understanding monitoring parameters for many meds, etc.? If you're not, there is a ZERO percent chance you will be in 2 shifts.  (I've been a nurse 14 years in a broad variety of roles. *I* could not safely practice in that kind of unit without a 6 week orientation because it's so unlike the acute care units I've worked in and probably lacks the on-site resources I'm used to from hospitals.)

It is nightmarish to think that a unit like this would even CONSIDER two days with a preceptor an adequate orientation for a new grad, even with the possibility of an extension. See 95% of SNF posts on this website to see how they promised orientation extensions were never granted, and in fact how people find themselves the only RN in the building by day 2 or 3.

How many RNs are staffed per shift? If 2 of 3 RNs call in, how is staffing addressed? Are nurses ever mandated to stay over due to call ins? If you have 12-20 patients, when will you have time to pump in a private clean area if that's your desire? If you choose to breastfeed and are mandated to stay over for an extra 8 hrs, how will that affect supply? Will your husband be able to call in to cover that required extra time?  How many techs work each shift? You don't need to be transferring and catching a 300 lb patient alone at 8 mos prego.

Signed, Your fellow mama who believes raising children ALWAYS comes first, has a heart for new nurses (and experienced nurses learning new things), and believes everyone deserves the training needed to be SAFE

P.S. I know this post is a bunch of jumbled word mess. I typed it on my phone with freezing cold fingers as I sit on back porch watching my own littles run around before bed. Forgive typos and grammar fails.  ?

 

SORRY!! I should have been clearer in my communication - it would be 2 days per week for 8-12 weeks with the possibility of extending orientation if I need it. After that, I'll go down to one day a week! I think that's quite generous.
I don't think I'm overconfident, but apart from being familiar with medication parameters, being comfortable with trach care, and breathing treatments - the rest of it I'm fairly comfortable with believe it or not. I'm not "fast" at labs but I can interpret ABGs no problem and I think I'm moderately quick at analyzing other lab values. I worked in an assisted living facility for nearly two years that was run basically like a nursing home, so I'm comfortable with transfers, dementia, disorientation, and total care.

On the first floor I worked on, many if not most of my 5 patients were FSBS ac/hs and I could usually handle that alright unless for example I had 2 or 3 BPs that needed IV push meds.

As far as I'm aware, this is a 12 bed unit. Having said that, I don't know how many RNs or techs are staffed per shift. I'm going to shadow on Friday from 0630-1030 to get a feel for the place! Honestly I feel very optimistic about this opportunity. It's a part of the health system that I worked for before, which I have always admired because the staff genuinely cares (well, most of them - the ones who make it very far, anyway!). It's corporate, so that has some intrinsic downsides... but overall, people stay there. I have spoken to multiple nurses who have been there 15-30 years!

Thank you for hearing me out, giving me some things to consider when I go shadow, and also for being realistic with me ?

9 hours ago, kat1822 said:

SORRY!! I should have been clearer in my communication - it would be 2 days per week for 8-12 weeks with the possibility of extending orientation if I need it. After that, I'll go down to one day a week! I think that's quite generous.

Yes, now THAT sounds good! ?

Enjoy your shadowing day!

One more thing to pay attention to this year- availability of PPE! You'll have an infant to be cautious with and don't want to take home all the gross things.

I don't see a point in you trying to get a job now if your plan is to just quit in a few months. That actually looks worse than a gap in the resume (which can easily be explained with a pregnancy and staying at home), especially since you already have a stint on your resume right now.

Also, is this going to be your last one? I know someone who, after a few years of experience and even going to NP school, went PRN at the bedside (didn't bother with an NP career) and is happy with the flexibility being PRN affords. Unfortunately for you, you don't have enough experience to work PRN.

I suggest you either a) have all your babies, stay home and wait until the youngest is in preschool before taking on nursing (all though you may not be hire-able at this point) or b) suck it up and get that year or two of experience so that you can go PRN in the very near future, even though it is hard. I do know of women who do work full-time with multiple small children, so it is possible.

On 3/18/2021 at 12:54 AM, Closed Account 12345 said:

Respectfully, I am concerned that you don't know what you don't know. 

It is frightening that a new grad with 3 months of part-time RN experience under her belt (occurring 6 months ago and while on orientation with a preceptor) considers herself competent to jump right into independent practice with a speedy orientation in a new role. 

I don't say that to be ugly, but even experienced nurses aren't interchangeable between specialties without a good orientation. No decent new grad orientation can be completed in a few shifts.  Frankly, I think over-confidence in this situation really endangers patients' lives. 

Even top of their class, #1, shining star new grads who start working full time right out of school and go through wonderful residency programs are still new grads. They still critically think like new grads when dealing with new situations.  They still get overwhelmed.  They're still learning to prioritize when all of their patients decide to go downhill at once.  They're still learning the ropes.  That's not a bad thing; it's just the reality at first! 

Competence comes from experience- first with a preceptor, and then over time while practicing independently.  You didn't have time to practice independently at your last job (even though you felt confident about your orientation), and 3 months won't be enough time to gain adequate experience in a new job.

Before taking any new position, make sure you and your manager are on the same page about length of orientation,  understanding that you need to be oriented as a new grad instead of an experienced RN, the length of your maternity leave, and your very limited availability upon returning.  If all of that checks out, ask yourself "Why does this manager need to hire an inexperienced nurse who is about to take a long break and will have minimal availability after maternity leave?" Is there a toxic culture in the unit where they just need a warm body? Are there red flags? Maybe not! Maybe it really is just an ideal situation for your circumstances... Just tread carefully.

 

 

 

This. My manager actually hired someone with similar work experience (a few months in a different specialty months ago no less!) as a contingent...even gave her six weeks (!) of full-time training and she did not last three months out because she became overwhelmed and quit. 

OP, PLEASE get that year or two of experience before considering going PRN. You will absolutely need it.

You are potentially in a bit of a bind depending on the job market in your area. I am assuming with a family to consider moving for a job is not an option for you if you live in a locale with a tight job market.

The primary barrier I see is your extremely limited experience as a licensed nurse compounded with another planned long absence. 

If you take a job now it won't add much to your resume in terms of nursing experience and may even hurt future prospects as employers won't care why you have such long gaps between employment. The computer algorithms or person that screens initial applications will see a three month job, a long gap then another three month job followed by another long gap and toss the application to the garbage pile without asking for clarification on your work history. 

Add to that you are essentially a new grad and a gap of a couple of years between graduation and steady employment makes you an old new grad which will make it even harder to find employment.

Hopefully the potential job you are looking into pans out for you and it is something you will be willing to return to after maternity leave so you can have at least one steady employer on your resume. 

Congratulations on your pregnancy by the  way.  I am in total agreement with you wanting to take extended time at home with your newborn. I just want you to be aware that it might make job opportunities a little harder for you.  It's sad but true that this country doesn't value a mothers commitment to her family in employment decisions.