I can’t get past orientation and want to be an aid instead

[Bjessica]

Look I’m just going to be honest and blunt here. I was given 3 months of orientation and I failed it. The hospital isn’t to blame, my preceptors aren’t to blame. I just could not do the patient load. I was ok with 4 patients, maybe 5, struggled with 6, and couldn’t do all 7. When I got to 7 my preceptor had to always do something for me, whether it was take care of a transfer or admission or help give medication or contact a physician about a problem etc.

so now I don’t know what to do. I thought about going back to being an aid because I loved it and was good at it. If I do that, I’ll have to revoke my nursing license. I hate all my hard work and money for nursing school to end with me revoking it.

People have told me what about a nursing home? But in a nursing home, you get an even higher patient load. And I’m too new to be a home health nurse.

Being asked to leave the hospital and turn in my badge felt so shameful and I feel like a failure. I wish I could have been successful. They even asked me if I really passed my nclex. Of course I have. I tried hard, the best I could.

Do you think I could take my chances to work as an aid without revoking my RN license? I just don’t want to do that. I know it’ll eventually be lost but I can’t bring myself to revoke it yet.

[CommunityRNBSN, BSN, RN]

Was this your first job? It seems pretty drastic to go from “I wasn’t successful at this one job” to “I have to forfeit my license and never be a nurse again.” If you’ve failed at 3 or 4 jobs then maybe I’d be coming around to that line of thinking. Otherwise: Apply somewhere else. Either a different specialty in the hospital, or a totally different field. I work in an outpatient clinic (my first nursing job). There are a million types of nursing job. Go try one of those before you decide to be an aid forever! An aide is certainly a respectable thing to be, but you spent money and time to become a nurse.

[Bjessica]

It was my first job as an RN. I can’t work for that hospital anymore since it was a residency. I really couldn’t do the patient load, after 3 months. I’m terrified to go through that again. Every day I messed up. No mistakes like medication error, but can you imagine if I had a code? I felt drowning every day, and honestly felt like I failed every single day I worked.

I appreciate you trying to encourage me to stick in nursing, I really do, but I do feel like nursing is out of my league. Maybe if I go back to an aid for a little while, maybe I’d want to try nursing again. I’m not sure.

[DeLana_RN, BSN, RN]

It's sad to see that apparently even preceptors in residencies eat their young.

Op, don't give up. 7 patients is a huge load for a new grad. They didn't give you a fair chance. There are much more reasonable employers out there. No one will hold this against you.

Best of luck to you!

[TheLastUnicorn]

Honestly, given SAR a try. Even LTC. Maybe even psych.

I started in SAR. It was a LTC/SAR facility but they mostly keep their RNs on the SAR units. I drowned in LTC (the 11-7 wasn't terrible, but anything else was too much stress for me).

I am actually happy I started in SAR. Sure, the patient load can be a bit much. Mine was a 20 bed unit with an average of 12-16 at any given time. I started on the 11-7 shift, picking up a lot of 3-11's just so that I could get more hands on with skills, disease processes, and learn who some of the doctor's were and best times to contact them, what protocols they had, and if I ever needed to call them, what information I'd know they would ask me for. 16 patient's in SAR, was an easier load then my 6 patient med/surg, or my 4 patient PCU loads. These are patients who, for the most part are stable, and are there for rehab (ortho's, weaknesses, post-strokes), or for long term ABT. Some are CHF management, and some of COPD. A few were palliative and hospice. SAR is a mixed bag now days. I still enjoy it and work PD at a sister facility to the one I began my nursing career at. You learn a lot about meds, a lot of skills, and one most important things I took from SAR was time management. After 8 months, I transitioned to a PCU/tele-step down unit. I didn't care for critical care and left there after 18 months. Too much stress. Too many bad nights. I work float pool now and I love it.

Honestly. You don't really know what you might want or like until you try it. The hospital setting is often made to be this golden palace of nursing, but really... your golden palace is where you find yourself. There are so many nurses that come out of school and they want ICU, ED, or L&D and they get there and.. they are miserable, and they quit, or have to resign, or just don't fit.. and they end up someplace else they never thought they would.. and they love it. Find the place you love. So you can't go back to this hospital, there are plenty of others. You will find someplace and I assure you there are plenty to pick from. If you don't like it, thank them, resign, and move on. I interviewed and oriented at 5 different SAR's before I found the one I started in. None of them are on my resume. I resigned from them during orientation or shortly thereafter. Even so, if ever I needed, there are still 2298137 (exaggerating) SAR facilities in a 45 minute radius of me that I could have applied to. There are also about 6 different hospitals. This is not even considering dialysis, psych facilities, assisted livings, and various others. You will find where you fit in.

[Sour Lemon]

A lot of us have rough starts and do eventually find our footing. I came close to getting let go from my first job, but was able to talk my way out of it somehow.

You're feeling low right now, and that's understandable, but I think you deserve another chance. Most people can succeed in the right area with the right support system.

[GilligansPlace]

7 patients is beyond ridiculous and unsafe. I’ve been a nurse for 14 years and I can’t do 7 patients and keep my head above water. You absolutely are wrong is thinking it is anything you lack.

[JKL33]

On 1/28/2020 at 9:36 PM, Bjessica said:

When I got to 7 my preceptor had to always do something for me, whether it was take care of a transfer or admission or help give medication or contact a physician about a problem etc.

You sound like every other RN. I don't know who can take excellent care of 7 acute care patients without a little help and teamwork. I'm sure there are areas for improvement, yes--you are a novice. It's good that you aren't trying to lay all the blame on someone else but at the same time you aren't judging yourself against a realistic standard.

On 1/28/2020 at 9:36 PM, Bjessica said:

They even asked me if I really passed my nclex.

Well that answers a few questions.

**

Apply for other RN positions. This will end up being a useful experience in the end, even though painful now.

[ruby_jane, BSN, RN]

SEVEN???? Sweet baby moses.

It's flu season right now. Find an agency that does flu shots and temp there for a minute.

Look around for some time management CEs and take those classes (not that I think your time management is faulty - I could not manage seven!)

Start again. Enough of us are shocked/saddened by this pt ratio for you to understand that it's not this way all the time. Best of luck!!

[Just me.]

I feel the pain! I struggled on days with 5 or 6. It takes one thing not going right, a post op pt, "direct admit"...etc. I was a nurse for more than 7 years at my breaking point.

Many times I had to ask for help. I remember once asking the charge to give a pt her am meds because I couldn't keep up. The pt was admitted for migraine, years ago...and kept calling for pain meds and her daily meds. It took the charge nurse an hour to give the meds...I was done with Med-surg after that. I did it for 7 years in the float pool. The charge was mad at me, and I thanked her thinking how was I supposed to get this done with all these other people!

Today, I know locally that admitted patients have to be really, really sick to qualify for admission. The floors are probably even heavier than when I left.

It takes a while to develop a rhythm. Night shifters used to get up to 10 at night, no way!

[RNperdiem, RN]

Seven patients is a lot.

When I had six in my med-surg days, I could give ok care if my aide was helpful (aides were a mixed bag- some excellent, some poor), and nothing unusual happened during shift. OK care was as good as it got for me, forget excellent care. Now if that load was increased, corners would have to be cut. Nobody likes to talk about this in nursing, but time is a zero-sum game. Charting would become minimal, conversations cut short on lonely but talkative patients, lunch skipped, leaving late. I lasted a year in that job.

I hope you find a better job. Don't give up on nursing entirely; your first experience was a bad one.

[Just me.]

@RNperdiem I agree that tech help can make or break you sometimes.