Here I go again on my own

jjjoy, LPN · Jul 13, 2007

Tough situation, I agree. It's important to recognize a bad situation and get out. Perhaps those places that couldn't see it that way aren't good places to work to begin with.

I'm interested to hear others' perspective and what kind of advice they may have.

Keep on keeping on!

bigsyis · Jul 13, 2007

I would suggest that you have a frank talk with your Manager, and ask her to extend your orientation on the unit that you are currently on. Then, after a year or so, after you have some experience and confidence, begin to look around if you still want to.

jamonit · Jul 13, 2007

Thanks. In both places I felt like my license was in jeopardy--the PICU for obvious reasons and the tele floor (for the above reasons). I just listened to my gut and trusted my instincts that neither place was a good fit. I'm upset right now, as I want to find my way and I feel like a failure.

mer_RN · Jul 13, 2007

give yourself a chance. it definitely takes at least a year to feel confident of what you are doing. maybe try a teaching hospital, they seem to have good orientation programs. best of luck!

Trauma Columnist · Jul 13, 2007

I would be honest with yourself first: what do you want to do? You are not expected to be completely comfortable immediately after orientation. You should still have someone to "go to" that can help you prioritize care. However, I hate to say this, but you really do have to give these places a chance - two jobs in 5 months didn't even allow you to get off of orientation, did it? If prioritizing your care is the issue, maybe a longer orientation would be appropriate and help you out to not feel so frustrated. I wish you the best. Being a new grad isn't easy.

llg, PhD, RN · Jul 13, 2007

If you haven't actually resigned your current job, I would definitely try to find a way to make it work for at least a while longer. I like bigsyis's recommendation of having a sit-down talk with your manager and asking for an extension to your orientation. Explain to her that the Charge Nurse was not able to help -- but don't be too critical of her and don't blame her or anyone else. Blaming someone will only make you look bad. If at all possible, stay until you have another job lined up. You also might find that things will improve a bit as you develop more skills. Many new nurses feel overwhelmed at first -- but feel much more comfortable as they become more competent in their roles.

My second choice would be to try to arrange a transfer to another unit in the same hospital. That switch will look less bad on your resume than an outright resignation. Also, you might have an easier time finding a position in the same institution than a totally different one as the orientation you have already received will be somewhat applicable.

Finally, if you have already burned your bridges at your 2nd job ... then I would do a thorough assessment of yourself and identify what went wrong with your first 2 attempts to find a job that suits you. How is it that you made 2 decisions to accept jobs that you soon came to regret? Review your job hunting process, the types of questions you asked, the types of things you looked for in a job, etc. You'll want to avoid making the same mistakes again -- and the only way you will avoid making them again is to identify what they were.

Also, by thoroughly understanding where/how you went wrong in your first 2 attempts, you will be better able to answer questions about it when you interview for your 3rd position. You'll want to be able to talk about it calmly and demonstrate that you have resolved those issues and will not be making the same mistakes again -- thus making you a "safer" person to hire.

Good luck to you. I hope you can sort things out and get back on track.

jamonit · Jul 13, 2007

I think the first couple of jobs came easily. That's why I decided to take them. Also, you are right, llg, I didn't ask enough questions before accepting the jobs. I didn't know to ask about the staffing matrix and the charting systems, etc.

In Phoenix, they are really nurse-hungry. The shortage is definitely visible--however, many hospitals are not hiring 'new grads' because they are inundated with them and not enough experienced nurses.

I know it's supposed to be hard in the beginning, and I expect(ed) that. However, I really felt like the hospital where I am currently employed is for-profit and is not very nurse-friendly. I should have realized that before I signed on.

jjjoy, LPN · Jul 13, 2007

To the OP - I agree with the others that if you haven't yet quit your second job to see if there's any way to make that work or if you can try a different shift or work with a different preceptor or try another unit. However, I know that some hospitals aren't very accomodating with a "take it or leave it" attitude to staff.

If you've already quit the second job do what you need to do to build your confidence and to get exposure to different work environments so that you can have a better idea of what will work for you. If there's a local nurse refresher course nearby, they might let you join in on the clinical experience. That would allow you to work on your skills without the pressure to assume a full work load ASAP. Now that you've had the experience in the RN position and have an idea of your strengths and weaknesses, you might be better able to utilize the "student experience" as well as have the opportunity to work in some different settings and get an insider's view before hiring on somewhere again.

If you want this, you CAN make it work. If you don't want it, that's okay, too. You've got some big choices and challenges ahead, and you will learn a lot in the process no matter how it turns out.

Now I'm going to diverge a bit, but it's related to the topic at hand...

I just don't get how a new nurse is *supposed* to know what they can handle and what to look for in a job. No one is going to say "We don't support our staff" or "it's okay if your time management skills are weak" or "We say we'll extend your orientation if needed but in reality we're going to pressure you into getting off orientation as soon as possible."

Nursing instructors and nurse recruiters encourage new nurses that even though they don't feel ready that the work place will train them and support them. Some places do offer great support but places that are good to work don't have such the demand for nurses and not everyone can get those choice positions. Others will be stuck at places that don't offer good support of their nurses and have to make do.

And yes, it does take time to get the experience needed to feel comfortable as a nurse and to be able to work both safely and quickly. However, how does the new nurse function during that time? I hear people say new nurses aren't expected to know everything and be able to do everything, but in many places the new nurses are scolded for taking for too long as they try to be safe and learn new things. As the new nurse is being pushed to be faster and faster and do more and more, they may fear that can't do that AND be safe. So the new nurse chooses better safe than sorry. And gets told again and again that they're not fast enough and see their colleagues frustrated with their performance. How is the new nurse not to conclude that they can't work safely in that environment? How is the new nurse to want to keep coming back to that day after day, week after week waiting for the magical transition to competency? Especially if it seems like the only way to get everything done is to compromise safety?

This is something I haven't yet gotten my head around so I'm not very articulate.

Obviously, many are successful in their transition from student to professional practice. But there is little recourse for the new nurses who have trouble with that transition. I can't see how a new nurse who doesn't have any basis real basis of comparison or knowledge of what's reasonable to be expected can be held fully responsible for not finding a good fit out of school. While there will always be some degree of "sink or swim" in any kind of transition, if we need nurses so badly (and we do) I would think there would be some place for those who aren't "strong swimmers."

jamonit · Jul 13, 2007

Thank you jjjoy for eloquently articulating my current condition. I think that this is yet another hiccup in solving the nursing shortage and establishing nursing as a profession. New Graduate nurses are often not welcomed, let alone oriented to competency. For example, in both situations I was told that I would be allowed ample time to adjust to a full patient load and the expectations of safe practice. However, in both situations the orientation was not enough for me and in both situations I was thrown into the deep end in a staffing pinch. I voiced my concerns about my competence and confidence to both employers, preceptors and management. I discussed my feelings and asked for assistance. In both cases, I was told that I "seemed" ready and that the only way to learn is to do. Well, I did. I found myself compromising my ethics about safe practice in a time shortage and feeling incompetent and behind due to not-quite honed time management skills. I know that I want to be a nurse, that I feel honored to be a part of this profession. That's not the issue. The issue is what jjjoy pointed out, that as a new nurse I feel that I was not given what I needed or what was promised by management, instructors, and educators. I don't think it was a mistake to end my affiliation with either facility. I just hope I won't be punished in the future for being unwilling to compromise patient safety . In the mean time, I sit here and hope that the next go-around will be a better fit and that I will feel that I am more prepared to fulfill the obligations of being a new nurse.

jamonit · Jul 14, 2007

any other thoughts, you guys?

jjjoy, LPN · Jul 15, 2007

How about asking about shadowing a nurse at different facilities and in different units before applying for another job? Some places don't allow it, but others do, so it's worth asking. You know probably have a better idea of what to notice that's important to you. You can observe how the staff interacts with each other, if everyone looks like they're stressed out all shift, ask the nurse questions about how he/she made the transition from a student and how he/she manages the time and juggles the priorities. After shadowing at several different places, you might have a better idea of which places you'd prefer to work at and which ones you'd rather avoid.

Another possibility to check out is registry work. Some have contracts with a few "lower pace" facilities that might work for you while you're deciding what kind of position to apply for next. Then you avoid signing onto another contract until you're more sure about what you're getting into.

Again, ask at your old school and at local programs if there are any clinical programs for licensed nurses to brush up on their clinical skills. As I mentioned before, that can be a way to get some more on floor experience without the full responsibility for the patients and without the expectations of a new hire.

The way I see it is that there's no reason to jump into another job that you might end up just wanting to bail on again. So if you can, you might do well to take your time before deciding where to apply next. Just some thoughts.

Let us know what you do and how it goes for you!!