I feel like an illegitimate nurse

[Laura Polifka]

Half way through nursing school, I started to have serious doubts about whether this was the right career choice for me. I never felt comfortable or confident in clinicals and I kept waiting for someone to collar me and say "there's no way you're ready to be a nurse". But I graduated, passed N-CLEX and told myself I'd try nursing for two years given the massive time, energy and money invested.

I'm at my first job at an assisted living. I do tons of paperwork, organizing, managing meds and labs and almost no nursing skills. No catheders, no trachs, no ostomies. Nothing. Maybe clean and dress a wound. Part of me thinks: Great! I don't have to do any of that stuff I don't feel comfortable with and think, frankly, is gross. Part of me thinks: Someone is going to figure out I have no idea what I'm doing and I'll be outed.

Should I be happy with my sanitary, gross-free, basically desk job? Or should I push myself and move on to a TCU or otherwise where I can learn and practice and gain some confidence? How do other new nurses build their experience? I never worked in health care before nursing school, so I only have this first job. I've been there five months.

[NOADLS]

Depends on what you want to do with your career. I've heard a lot of nurses say "I don't want to do LTC because I don't want to lose my skills" and in all honesty, if they choose to stay in LTC, changing a catheter once in a blue moon and needing guidance the first few times isn't the end of the world. It sounds like you're in a position that sounds "too good to be true." IMO hold onto it while it lasts. Since graduating, I've went 9 months without changing a catheter and 4 months before doing my first "complex" dressing. The nurse in charge on both of those shifts understood my situation and helped me through those procedures.

Edit: I guess I forgot to mention that if you aren't doing ADL's, that's another plus in my book for that job you currently have. That job's a keeper

[pookyp, LPN]

Depends on what you want to do with your career. I've heard a lot of nurses say "I don't want to do LTC because I don't want to lose my skills" and in all honesty if they choose to stay in LTC, changing a catheter once in a blue moon and needing guidance the first few times isn't the end of the world. It sounds like you're in a position that sounds "too good to be true." IMO hold onto it while it lasts. Since graduating, I've went 9 months without changing a catheter and 4 months before doing my first "complex" dressing. The nurse in charge on both of those shifts understood my situation and helped me through those procedures. Edit: I guess I forgot to mention that if you aren't doing ADL's, that's another plus in my book for that job you currently have. That job's a keeper [/quote']

What's your situation?

[Been there,done that, ASN, RN]

Hope that's not your real life name, if so please change it .

You ARE using nursing skills. The ones that really matter. Assessment, disease management , organization and prioritization.

Trachs, ostomies, etc, are simply tasks that needed to be taught in nursing school.

Enjoy your current position, learn and grow in it. Consider a future in case management !

[amoLucia]

You can try to seek out something part-time that would allow you to do some more skills. Don't knock LTC because today's LTC environment provides LOTS of chances to do those skills you seek. If you don't like it, you can quit.

You'll then have some baseline experiences with which to compare to your more "desk" job. You can then make a more informed decision.

[TheCommuter, BSN, RN]

What do you want to do with your career? That's the real question here.

Personally, I couldn't care less if I never learned another procedural skill ever again. I'm not a hands-on person, nor do I need to 'feel needed' by patients. Your job sounds like a dreamy gig to me.

Then again, if your dream is to work at a hospital or teach nursing skills someday, you might want to start taking actions that will result in the future you seek. Good luck to you!

[ceebeejay]

Agreed. I feel like this sometimes with my job. I feel like I am supposed to be freaking out and feeling inadequate or overwhelmed. I don't, but maybe that's a good thing. If you feel comfortable with what you are doing, then why question why you don't feel uncomfortable. If that makes any sense. And, you are using nursing skills as mentioned previously.

[TiffyRN, BSN, PhD]

Doing technical skills is only one part of nursing; that's why there are lots of others out there that think they are nurses just because they can do a., b., or c. Being a nurse is providing and coordinating care to meet the needs of your patients. Do you want to learn certain skills? If you are happy in your position, feel you are providing a legitimate service to your patients, then find happiness in that.

Do you suffer from "imposter syndrome"? Read about it and think about it a little.

The Imposter Syndrome | Psychology Today

[jadelpn, LPN, EMT-B]

Assisted living is usually not clinical in nature, although some assisted living facilities do push that now and again. You are doing what many other nurses who are in acute care are doing--charting.

What this job is allowing you to do is to really know the entire case of the resident. A good overview, what is needed, what the goal is. That is a huge part of nursing.

If you are feeling you want to do more clinical skills, see if you can get a per diem job that would allow you to do this. Even home health would allow you to practice your skills. Otherwise, a med/surg floor, urgent care....You could also see about getting a wound care certification, IV therapy certifications, whatever you think you may need going forward.

There are lots of things you could do with the experience you are getting. Case management, quality assurance, to just name a couple. There is so much of nursing tied up in compliance at this point, that over time you will have a great deal of experience that will benefit you in the long run.

[chevyv, BSN, RN]

Well go ahead and be happy doing something it sounds like you like to do! My first job was psych and I felt somewhat the same. No iv's, a few caths but not many, no serious physical stuff. Part of me wondered if I was right in my choice. Then I realized that I love psych nursing and it's a completely different use of skills. So be happy and know that you are honing skills that bedside nurses won't have right out of school. I wouldn't want a charge role right now and it sounds like you're doing just that. Relax and enjoy. Learn all that you can! Sometimes when you're good at something, it just clicks and seems easy. Good luck!

[sallyrnrrt, ADN, RN]

laura, please change your "screen name to something other than your real name, enjoy what you are doing, you have been given some very good advice by the other posters

[BrandonLPN, LPN]

Yeah, the Commuter hit it on the head when she said the real question is "Is this what you want to do?"

If performing tasks like cathers, trach care, IV therapy, whatever are what's important to you then, yeah, I guess you aren't in the right job. But you said yourself you have no burning desire to do these things anyway, so....

You don't need to worry about "losing" these skills. The handful of times you performed them in clinicals or the skills lab don't really make you "skilled". I wish nursing students and brand new nurses would realize that they don't have any skills TO lose. I know saying that might offend some new grads, but accepting it sure would save a lot of them some grief. :)

If you do move on to acute care at some point, you can learn these tasks as you go. No one will say "Oh my God, she doesn't know how to start an IV!". That's why hospitals have orientation periods.

And don't worry about being an "illegitimate" nurse, or "not a real" nurse. "Real nurse" is as much a nonsense term as "real American" All Americans are real Americans and all nurses are real nurses.

In a nutshell, it seems to me that if you enjoy assisted living and you like your job then you are exactly where you should be.