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?

[Mavrick, BSN, RN]

I'll assume you are taking this opportunity to vent and aren't really ready to hear any solutions. Newbies have that right in my book.

However, while you are assessing the situation take your time before you act rashly. This is your first job so you have nothing to compare it to except your EXPECTATIONS of what a job SHOULD be. Your nursing school education does not prepare you for this so you really have no way of knowing that you are woefully unprepared for the real world of employment.

You are working in a vacuum of book learning. You don't know your basic nursing that well. You have not established any work routines or habits that make your work flow more easily. Kinda like learning to drive, at first it takes a lot of mental energy to get all the basic steps right. Steering, looking at mirrors, speed control, signs, lights, pedestrians etc. Soon enough that stuff becomes routine and doesn't require near so much concentration so it becomes possible to add all sorts of non essential tasks, tuning the radio, eating a sandwich, applying make up etc.

Your nursing develops similarly. At first it is terribly time consuming to check and check again that you are practicing safely. Everything is new. Nothing is "routine". Soon enough you get to know what you can and cannot take shortcuts with and what efficiencies work for you. Setting up meds or pre charting will never be condoned by any policy but you will learn what is necessary to get the job done. An employer will only be so patient with you taking hours to chart after your shift ends whether you clock out or not.

I would highly recommend checking out any alternative employment prior to dumping and running. Depending on the market in your area it may be hard for a new grad to get anything but a LTC job and you will still have to climb that learning curve of skill development. Only now you will have to explain why you are an even riskier employee to an employer who is reluctant to take on a new grad that is more expense than value. Unfortunately, to them you don't bring much to the workforce other than a pulse.

You are certainly not alone and are following in a long line of of seasoned experts that were all once novices.

[MsQueensRN, LPN, LVN]

honestly it sounds like you are going through the new grad blues where everything feels overwhelming. It can be difficult to truly judge what is or isn't complex when you have nothing to reference it to. I agree with the advice of some of the other nurses as far as developing time management skills, give yourself time to get used to doing these tasks and you will start to realize how much faster and easier it becomes for you, also are you utilizing delegating appropriate tasks to the nursing aides or are you attempting to do everything alone. When i first began as a med surg nurse years ago, I found where I would often attempt to do every single task myself, I did not know how to prioritize, and I had no time management skills which left me staying at work an hour later each day trying to catch up with documentation. Give yourself some time to catch up. If you feel like your license is at risk and you truly feel as though you and the patients are not safe, then I suggest seeking other employment and giving your current employer notice. I'm a firm believer in never burning bridges, and honestly as a professional it is just good practice to give some type of notice.

[Junebug903, LPN]

Very standard situation in a nursing home. Pill pushes and documentation...not much of anything else and when you do, it throws of your whole routine. It takes times to get things together and figure out how to manage it all. I have been doing it for 10 years and I still get anxious at work sometimes. The job isn't "hard", but it can be very stressful and overwhelming. Good luck...if you stick with it, you will be just fine...eventually :)

[Kooky Korky, BSN, RN]

If you do quit, you absolutely must give at least 2 weeks' notice. I don't know what to say because others here have already said the things I would also say. Here's wishing you all the best.

[SMcLpn]

Do not Jepordize your license I would get out of that faciity as fast as I can you are over worked and insufficietly oriented you should never have this type work load as a new nurse.

[middleagednurse]

Give it more time. LTC is difficult work, even for experienced nurses. Your skills will improve with time. Ask the other nurses for time saving tips.

[TheCommuter, BSN, RN]

Do not Jepordize your license

The "jeopardizing my license" mantra is extremely exaggerated. Most nurses who have had their licensure censured or revoked were involved in diversion, theft, intemperate use of drugs and/or alcohol, impaired practice, and other issues surrounding substance abuse and addictions.

Nurses in the LTC/subacute setting rarely, if ever, have action taken against their licensure due to patient care mistakes. Moreover, after years of reading the disciplinary action pages published by the board of nursing in the state where I practice, the vast majority of nurses who have had licensing censures (e.g. formal warning, suspension, probation, remedial education, fines, limited licensure, revocation) had been employed at hospitals, not LTC facilities.

Peoples' fears of jeopardizing their nursing licensure are disproportionate to the reality of the situation.

[srercg6]

I had a similar experience. All they wanted to do was make sure I knew how to chart so that Medicaid/medicare would pay. They don't train on patient care at all. Too many facilities and hospitals assume you learned all that in nursing school. Uh, no. Not really. Some will even give you weeks of training, but do exactly the same thing - a quick "book" overview of what you learned in school, check you off on the ridiculously easy stuff like checking a blood sugar and changing a bandage, then its all computer and charting charting charting. The preceptor I had sat and checked my charting all night, every night. When I asked "can you actually go into some of the rooms with me?" she asked "why?, what do you need to work on?" - that's kind of a loaded question. We're not sure until we're faced with it - but I felt like she should have been going into the rooms with me the whole time and giving me tips, and tricks of the trade, and best ways to answer patients concerns - more hands on. It was night after night of discussing her travel plans with her boyfriend, and checking my charting.

That was at a hospital. Most hospitals that are learning hospitals (i.e. the local university has a lot of students that train there) provide good training - the one I was at sort of did, but not on the real stuff. Like my preceptor didn't even get "real" assignments. She was always on an easy assignment because she'd been there a long time - they give the harder assignments to the newbies. which makes no sense. I'm not talking about step up patients - but like grunt work - and the kind that keep you running the whole time so you can't chart. She never got that. I got it as soon as I was done precepting though.

[srercg6]

leaving a long term care facility - unless your going to another one - due to lack of training, and recognizing the need for proper training - will NOT look bad to your next employer. This is a common story they hear when dealing with facilities - they won't think you did anything wrong.

[desertace]

Hang in there, it is worth it, there are tough times and good times, and each place you work at will be slightly differnet, it is worth it to stay in.

[Wlaurie, RN]

Welcome to ltc. This was my first rn job. I received no training. They just put me on the floor and showed me a few times how to document on the mar. What I learned was a lot of people did work arounds (ie putting meds in cups early etc ). Also people documented that procedures were done when clearly they werent. It's not the best place to work when you're trying to stick to the right way things should be done. I am working home health now which I much prefer to ltc. 1 patient instead of 30 and pay is the same. Best to you, Laurie

[atrn4887]

I completely understand. My first nursing job was on a sub acute rehab floor. I received very little training and was left in charge at times! I was completely overwhelmed and had little to no support. I lasted 6 months. I left and went to an acute rehab floor and have been there for about 3 years now. Much better environment. Good luck, don't stress yourself out to death. It isn't worth it. Next time you interview and tour a unit I'm sure you will be able to tell what type of environment it is. Make sure you ask about the orientation you will receive as well.