I want to quit first RN job after a few weeks.

[newgradrn2016]

Hello,

I've been working at a sub-acute facility for about three weeks now and quite frankly, am having anxiety about the job. I have a high patient load of about eighteen to twenty patients. Many of them are complex patients with GTubes, trachs, and blood sugars. I didn't realize how different of an environment it is in a nursing home. I feel like I spend all my time passing meds and then I have to stay 2-3 hours after to document. I only had one week orientation and don't feel adequately trained to take on this much at a time. I'm really considering leaving and finding another place to work, but I would like to get some insight on other options or hear what other people's stories are. Employment at this place is "employment at will" so I believe that means I don't have to give notice?

[caliotter3]

Your feelings of anxiety are normal. The one week orientation is about par for such a facility, in fact, many people receive less than that. That number of patients is about normal for the RN working in the Medicare section (G tubes, trachs, and blood sugars are not considered complex). You could just as easily have been placed on the floor with the responsibility of 80 or more residents. As a rule of thumb, you should start to feel better about your time management skills and ability to handle what comes up after about a year or so on the job. You want to avoid looking like a "job hopper". Moving on to another place that is similar will more than likely just get you into the same boat again.

You can decide to start looking for a new job when you have been at this one long enough that you don't have to explain your short tenure. Strive for the one year mark. You can learn a lot in that amount of time that will help you to do better at your next place of employment.

[djh123]

Hmmmmm, well, I've been at a LTC/rehab place for 4 years. I got very little training (and was also a new grad) too. I wouldn't call blood sugars unusual - I've had anywhere from say, 3, to 8-9-10 (on a similar-sized unit to yours), but 'lots' of g-tubes and trachs? - I've had anywhere from zero to 3-4 g-tube/PEG people, sometimes colostomies, sometimes PICC lines. As some others have suggested, making up a 'cheat sheet' to help you get organized can help quite a bit.

[Been there,done that, ASN, RN]

I agree you have not had a decent orientation, especially as a new grad. They hired you, because they cannot keep staff. These sub-acute facilities run on minimal staffing to boost their for-profit bottom line.

At one time, I had 28 years of experience, started with a one week orientation in a joint like that, and quit the next week. That assignment was not doable , even for an oldie-moldie.. it WAS my license on the line for corporate profit.

I see in your next post you are leaving. Give your notice in writing to your immediate supervisor.

The fact that you have resigned should remain confidential. If management makes it known, you will have to deal for 2 weeks. Better now than later.

Best wishes, let us know how it's going.

[calivianya, BSN, RN]

In the end, what you have to remember is leaving so early is going to look bad. It's going to be a red flag to future employers. If you quit your first job this quickly, others may think if they hire you, they're going to be wasting their money orienting you because you're just going to jump ship.

Since you are a new grad, it is my advice NOT to quit your job until you have another one in hand. Many new grads have trouble finding jobs in the first place, and a new grad job hopper is at a double disadvantage. I'm assuming you probably have bills to pay, and it's awfully hard to do that with no job at all.

So - give notice, and don't give notice until you have another job lined up - with a written offer in your hand, not just someone saying they're going to hire you.

[Angry LPN]

In my state the department of nursing thinks your employer is God, so when the work you to death, always threaten you, and those lazy managers that like to sit in the cozy offices and watch TV or tinker on the computer rather than help the floor nurses out when you are short and refuse to help you, when you reach a point where your back is so sore from running up and down hard floors and staying over for hours to get that never ending paperwork done and you quit because you can't take it anymore without giving the slave drivers notice, they will get even with you by giving you a bad reference. I think my state has a standard for hiring where you have to have 2 positive letters of reference, which means they are actively siding with management over labor and should be taken to court over it. No matter how badly they treat you, harass you. discriminate against you, you had better smile and take it or give them the 2 weeks notice. 20 years of busting my backside off and the nursing homes are all the same. Constant threats and intimidation, people who get those office or management jobs once worked the floor and dread the idea that they might actually have to do some work, then they come out and threaten you. If you miss your break (which you never get to take), we'll write you up. If you get 3 write ups, suspended or terminated. Then the government seems to be on a mission to make our jobs even more impossible. More regulations, paperwork this is totally unnecessary and then the dreaded state inspections that prompts the facility to start cleaning the floors and carpets, painting the walls, etc. Used to be you had a pretty good idea of when they were coming, and they always came on the day shift. Now they zig zag across the state, come in at 2am or these odd hours trying to sneak attack the place so they can steal money from these petty "infractions" to get revenue for the budgets that are broken all over the country. The owners lose money and get pissed off, they jump on the administrator and he gets mad, so he pounces on the DON and she gets stressed out, so she goes after the unit managers and the tortured floor nurses. We are supposed to pick on the CNAs but I refused to do that. When they were short, a took a set, gave them showers, helped them to the bathroom, fed them, etc That left me with a hernia and a severely damaged back. I am so glad I got into homecare. Give them 2 weeks notice and try homecare. It's one on one, minimal management, no government inspectors, etc

[jaderook01, BSN, RN]

In my state the department of nursing thinks your employer is God, so when the work you to death, always threaten you, and those lazy managers that like to sit in the cozy offices and watch TV or tinker on the computer rather than help the floor nurses out when you are short and refuse to help you, when you reach a point where your back is so sore from running up and down hard floors and staying over for hours to get that never ending paperwork done and you quit because you can't take it anymore without giving the slave drivers notice, they will get even with you by giving you a bad reference. I think my state has a standard for hiring where you have to have 2 positive letters of reference, which means they are actively siding with management over labor and should be taken to court over it. No matter how badly they treat you, harass you. discriminate against you, you had better smile and take it or give them the 2 weeks notice. 20 years of busting my backside off and the nursing homes are all the same. Constant threats and intimidation, people who get those office or management jobs once worked the floor and dread the idea that they might actually have to do some work, then they come out and threaten you. If you miss your break (which you never get to take), we'll write you up. If you get 3 write ups, suspended or terminated. Then the government seems to be on a mission to make our jobs even more impossible. More regulations, paperwork this is totally unnecessary and then the dreaded state inspections that prompts the facility to start cleaning the floors and carpets, painting the walls, etc. Used to be you had a pretty good idea of when they were coming, and they always came on the day shift. Now they zig zag across the state, come in at 2am or these odd hours trying to sneak attack the place so they can steal money from these petty "infractions" to get revenue for the budgets that are broken all over the country. The owners lose money and get pissed off, they jump on the administrator and he gets mad, so he pounces on the DON and she gets stressed out, so she goes after the unit managers and the tortured floor nurses. We are supposed to pick on the CNAs but I refused to do that. When they were short, a took a set, gave them showers, helped them to the bathroom, fed them, etc That left me with a hernia and a severely damaged back. I am so glad I got into homecare. Give them 2 weeks notice and try homecare. It's one on one, minimal management, no government inspectors, etc

That sounds like a nightmare. I'm glad you got a better job! Is home care really the best place for a new nurse, though? I figure there needs to be more time to develop decent nursing and assessment skills before doing something like that.

[cyc0sys]

@Angry LPN, I think you won the internet. This should be required reading.

[Angry LPN]

The blood sugars are not "unusual" but get a hand full of brittle diabetics who either had their food tray stolen or the CNAs didn't feed them from the shift before (a frequent occurrence) and protocol calls for you to call the physician, break the instant glucose out of the people proof med box, administer it, fill out the forms so they pharmacy can charge for it, put the tags back on the people proof med box that was like trying to steal gold from Fort Knox trying to get into, and you used up probably 20 minutes of your time. Then the G-tubes. Meds have to be crushed, and some dimwitted physician always writes out some order to give some elderly patient that has had osteoporosis for decades those bunk, lunky green calcium pills that never fully crush and plug up the G-tube and doesn't do anything to reverse the osteoporosis. Then you are being almost constantly called off the floor, family members wanting to know about their loved ones during your med pass, lab results, the pharmacy wanting to clarify orders, and physicians that can't write legibly get pissed off when you call them because you can't read their hieroglyphics, etc All that eats away at your time. Toss in a few fall risks and a new admit or two and you have the makings of a long and stressful day

[aidoglobe]

Always give at least a minimum of a two week notice before leaving, sometimes its longer depending on the situation. Always try and leave, if possible on good terms with any place of employment; you never know who you will have to work with again. The assignment as you describe it sounds like a decent one to learn with. It takes time to gain speed and proficiency. Ltc/snfs are not bad places to start as they help to find a routine and a system that works for you. It also helps you to learn time management skills.

The orientation period sounds short, in my area the minimum would be a couple weeks. I started in the same type of setting than moved onto med-surg/tele and then moved into critical care. Best advice is to remember you are brand new and need time to learn the process.

[Esme12, ASN, BSN, RN]

At the end of my orientation I have brought it up with my supervisor that I would like more orientation time, but it was denied because we're short staffed and they need an RN to start working ASAP. During orientation, I have noticed some of the nurses start passing meds right away after receiving report or will prepare them an hour early and leave the meds in the med-cart for when it's time. But that to me seems high-risk for med errors. I want to do things properly, especially since I'm a new grad, but it's hard when all the nurses tell me I should start prepping early because I'll run out of time (which is incredibly true). The EMR system won't even let us document we've passed meds until an hour before the scheduled time.

But everyone's advice on giving notice two weeks early does seem the right thing to do. I'll email my employer thanking them for the opportunity of course. I am worried though that word will get out that I'm quitting. And co-workers will stop helping, judge me, or shut me off completely.

I am so sorry......nursing is not an easy profession to break into ((HUGS)) and sub-acute/long term are horribly understaffed, under paid with poor orientation for new grads. Try to look for a LTACH/LTAC (long term acute care hospital) they offer better orientation and slightly better staffing.

Employment at will means there is no contract and they can fire you whenever they want for whatever reason they want. Nursing is an incestuous profession....everyone knows everyone else and they ALL gossip about each other. If you really can't stick it out until you are off probation, or getting that one year experience, do not leave one job until you have another. It is ALWAYS easier to get a job when you already have one.

No matter where you work your first year or so stinks. I wanted to quit at least once a week when I started out. You are perfectly normal...((HUGS))

[Angry LPN]

Another thing to keep in mind is burning too many bridges. When these nursing homes were profitable many of the independently owned ones are concentrating in the hands of a few large for profit corporations. Some of them have a hit list of do not hires. I was at this one place where I worked on the midnight shift and this sweet, little old lady would want to get up around 3am and have a cigarette outside. I was quite fond of that lady, should would tell about her life, the Great Depression, etc while I sat out there with her for like 5 minutes. Not a problem. Then this mean spirited social worker there took it upon herself to establish smoking times, with the cut off being like 7pm. Now they drill it into us that this place is their home, respect their rights, etc and I always have. The employees, including some of the nurses can go out and smoke as often as they want. So I figured chuck it I am not going to pay that any attention. The day crew there. Talk about a seething cauldron of witches, they would make nurse Ratchett look like an angel. They would bring in their boxes of doughnuts and coffee and sit down for an entire hour cursing and complaining about all the other shifts over their caffeine and sugar orgies. I was always by myself on the MN shift and never got to sit down. Here I am writing out their schedule for them and all this other stuff they dumped on the MN shift so they could come in and sit down. This one particular nurse who was very vile and nasty assumed the role of the manager although neither the DON or the admin gave her that position. She would take it upon herself to ask me anyone took my friend out for a cigarette last night. What I wanted to say is what business is that of yours, you are not the administrator here so don't ask me again. Get this. They kept the nice ladies cigs locked up in the med room and this vile witch was taking it upon herself to actually count the ladie's cigarettes. I will admit I hated the day crew there, and I didn't have the heart to tell my friend that she couldn't have her nicotine at night, one of the few things she had left. So between that and my hatred of the day crew there I just couldn't bring myself to go back. It was a PT job anyways. So wouldn't you know, they went out of their way to put me on the hit list. All of their facilities are horrible, they pay way less than other companies, so are always hiring. I went to apply at 3 places, the DON acted like she wanted me to start the next day, and then the silent treatment. Call the receptionist up, "may I ask whose calling", then you get the voice mail (you know she is standing right there screening her calls). Leave a message and they don't call back. 3 places owned by this cheap company where I could have ran circles around the best nurses but apparently I made the hit list. Just as well, but don't burn too many bridges

[guest52816]

When you gave your notice, I think you made the correct decision. As a recent graduate, leaving a job after a few weeks won't be looked upon poorly. It would be different if you had a long nursing history, and all of your jobs were short-term, let's say eight months or less.

Because you are a new graduate, you can always handle interview questions regarding your short tenure by stating that it wasn't the right fit. Please choose your next position carefully. I would stay away from LTC.

Remember, it is YOUR nursing license on the line. You worked hard for it. Protect it, because nobody else will. Also remember that with each job, you are building a career. So again, choose carefully.

Good luck. I believe you will find a place to work that better suits you. You obviously have a lot to offer.