If You Can't Handle the Heat, Get Out of the Kitchen!

[GreenApplesauce]

Hi all,

I am a new grad-ish, I have been working the hospital for 6 months on a med floor. I am run ragged on a daily basis and hardly get my breaks. I know this is normal. If I get one break I consider that a success just as the other nurses do on my floor.

I got a written warning a couple months ago because of a documentation error, no patient harm. Just a bad day, so stressed I forgot to document.

I love caring for patients, hey I even had a couple cool moments with patients that made me think "Hey I have something to hold onto that makes this job worth while.'

But sometimes I feel my days are numbered at my job. At weak moments I desperately search and apply for non-hospital jobs looking for a way out. But when potential employers call, I don't respond...because by the time they do i have pepped talked myself back in staying at my job...."Just hold on for one more day..." Wilson Philips

Even though I keep my patients safe, I am just not going fast enough for management, I am expected to put up with poor staffing conditions, and abusive patients with a smile...welcome to nursing.

That's cool, I get it...the term "If you can handle the heat, get out of the kitchen!" slaps me in the face every time when I want to complain to myself about my job. Millions of nurses see the BS and they still do it. When I reflect upon my career path...lol...Scrubs some how deceptively guided me, foolish me.Too much day dreaming. Hospital nursing is like scrubs but with out the cool docs like Elliot or Turk. Just Dr.Cox with no charm and humor. Truth be told that is nursing, if you can't handle it you better get out because things are not going to change any time soon. Big fish eat little fish and keep it moving. Things move so fast, no one has time to mourn your untimely termination if it happens...on to the next one. The well of mercy in this world is desolate and barren.

I knew when i went into nursing it was not going to be easy...but I did not think it was going to be this hard and though squeezing a tear out of me is like squeezing blood out of a rock...I have a had moments on the floor in which the lump in my throat threatened to push the tears gates open. But with many deep breaths I have pulled my self together.

I want to be an ICU nurse, I know I am still very new to this game. I was elated when getting this job on the medical floor....my first step towards ICU then CRNA... I wanted to put in my years in med and serve my time but now I just want to get mine and ditch this place now that I have 6 months experience. I was willing to give them 1-2 years....but

The heat in the kitchen is hot and it is not my patients that concern me, it is management. I feel like I am a dime a dozen. If they fire me, there are a 1000 other willing applicants eager and ready to take my place. The world will un-remorsfully keep turning. Just another nurse who could not hack it. Sure they lose a little cash with the money they invested training me but they will be fine...but what about me? Start from the bottom again..?

I don't know if i will be fired but darn...I rather not wait to find out. A written warning...I have a feeling my supervisor has it out for me. She exaggerated everything in our meeting. That's fine, they got me. I take responsibility. But I don't think it needed to goto this extent. I am over medical. Documentation trumps patient care any day.

Sorry for the ramble but I need some answers...should i just start applying for ICU jobs and try and get out ASAP or try and tough it out some more and gamble not to be fired. Jumping to another medical job would be like starting at the bottom. I am okay at medical but i think with the right training I would be great in ICU. Many new grads do residency in ICU and succeed...Can't I as well with my med experience with a good icu training program?

I figure let me use this job as my leaping ground to get to ICU fast. I am not normally this cold. But I don't see why I should give my best years and energy to a place where the rewards are so few. They don't care if they suck me dry...."just work faster...harder...but go home on low census so we don't have to pay you' It does not seem like a good deal. This job is sucking me dry with no mercy. I might as well get what I can and get out with no remorse.

It is a doggy dog world in the hospital I work in.

Your thoughts....

[Anna Flaxis, BSN, RN]

"Out of the frying pan and into the fire" comes to mind.

[GreenApplesauce]

LOL,I know it will be hot in ICU...but with the right training I know I can do it. I would only be willing to goto ICU if they had a solid training program.

[iluvivt, BSN, RN]

You seem ambivalent. You apply for non-nursing employment and then want to go to the ICU. Any kind of hospital nursing has it challenges and it is very demanding both physically and mentally so accept that up front. Many of these positions may be complicated by interpersonal conflicts with either coworkers and /or the particular management team. Then you have your own goals and personal needs for success, job satisfaction and gainful employment. You will need to do some soul searching and apply some thought to how to meet your goals and most importantly how you can be fulfilled day in and day out while at work.

Yes..Many can go into ICU or ED right out of the gate...others want to have a little more experience under their belt. Instead of being spread thin over a number of patents and keeping track of lots of data about a lot of patients in the ICU you are heavily concentrated on 1 to 3 patients that need intense rapidly changing at times care. You are every bit as exhausted in ICU! Some like the advanced skill and intensity and the decreased number of patients but it is intense and you do have to like it IMO. My praise to all the wonderful ICU nurses out there that I interact with every day.

Nursing can be way too punitive. I find it ironic we are entrusted with medications.to monitor someones every breath and heartbeat and save your life BUT we are dragged into the office and written up for the silliest of things and for even a disagreement of opinion with management. I find that this leads to job dissatisfaction,squelches creativity and desire to participate and it unprofessional at times. Had I been your manager I would have asked you a few questions about the day and helped to identify your stressors and together we could have come up with some suggestions to help you to find a way to not forget. Then I would have immediately set up another appointment with you to see if the strategies and ideas that we came up with worked for you and we can modify if necessary and or see if they were successful. NOW tell me does that not work better and make you want to keep trying and contribute. Nursing has Always gotten this WRONG!

So really think about this and what your needs and goals are and make a decision that is right for you and one you can fully commit to and not one that is an escape.

[jadelpn, LPN, EMT-B]

The first year as a nurse are the hardest. There's lots of information coming at you at once, and you need to find your own groove and what works. Very different than your clinicals in school, it takes time to feel successful.

I also am of the opinion that there is no real non- monetary investment on good nurses that are loyal to a facility. You are correct, there are many, many applicants for one position at any given moment.

When you were written up, was an improvement plan made? If not, I would check in again with the NM and say that it has been 2 months since the write up. That you are mindful and careful, and would like some feedback. 6 months is usually the probationary period. (check your facility policy to be sure). If you have passed your 6 month mark, you can look at job opportunities within your facility. Make an appointment with the ICU NM and discuss where you are, where you want to be, and what you would need to do to get there.

If you feel as if your NM "has it out for you" I think that a written warning in a probationary period would have meant termination. That did not happen. It is 2 months later. I think that you need to take a deep breath, focus, and really determine where you want to be, and all the ways you can get there.

With all due respect, passive-aggressive/all over the place thinking serves no purpose than to drive you mad. Focus. Determination. Start focusing on what it is that you need to learn in your current positon. You need a firm foundation to build a firm career. Being in the ICU and onto CRNA needs focus. Start that process now. Mean people stink, but they are everywhere. Just focus on your patients, your skills, your nursing character, your nursing practice. Be mindful of what you know, but even more mindful of what you don't know and take initiative to find out using references and policies on hand.

And do make that appointment to discuss goals with the ICU NM. You may find most want 1-2 years of experience. Some want also a year of ER experience. The time to start the process of goal making is now.

[RNperdiem, RN]

I was where you were when I was a new grad. After 6 months, the honeymoon is over, the newness is gone and the daily slog has to be faced and your morale sinks.

Part of your misery is just being new and dealing with big responsibilities, it could happen on any floor or department. It is that Reality Shock they taught us in school. So yes, it is going to be hard, but things do get better.

Every shift you survive, you are learning and growing.

If it helps you feel better, start planning your escape.(I smiled at your "doing time" phrase-so prison like) What jobs in ICU are available in your area? Does your hospital have and ICU you might be interested in, and what are the requirements for a transfer? Talk to a few nurses ICU nurses. Have their units hired anyone without ICU experience recently? Any units about to expand and need more staff? etc.

Last of all, take care of yourself outside of work.

[lisajtrn]

I went from medical to ICU after 10 years of being an RN and I can honestly say that you will not be any more appreciated or any less worked there. I have found some new grads want to work in ICU because they feel there is some prestige associated with it. I can tell you ICU is very similar to medical nursing but with more equipment. Yes, you will have fewer patients but the pace can be very fast and you are expected to keep up. There is lots to do and if not done quick enough some doctors will let you know without delay and they will do it loudly. I feel that new grads need medical experience. Working on acute medicine, learning everything you can there and acquiring the organizational skills required to do that job will give you a very good foundation wherever you may go. Master one thing at a time.

[Been there,done that, ASN, RN]

It's a dog EAT dog world.

The current goal to boost the corporate bottom line.. work the nurses to death.. environment will not improve.

Go with your gut.. GO TO THOSE INTERVIEWS.

Run ,don't walk away from the hospital.

[morte, LPN, LVN]

Maybe the kitchen is on fire....

[nurseprnRN, BSN, RN]

I am willing to bet that in another six months on your medical floor you will look back at this and acknowledge how far you have come. Six months seems like forever to a youngster like you, but trust me on this, you will have to lose that perspective and learn to take a longer view if you want any sort of career, whether or not you move from area to area with a specific defined plan or just job-hop around until you meet your lowest common denominator.

As to the idea of "ICU and then CRNA school," well, this is the dreeeaaaammmmm of so many new grads. It pains me to tell you that if even a fraction of them were able to pull it off we would see an immense explosion of unemployed CRNAs returning to bedside nursing. Besides, if you want a work milieu to see overtime, heavy documentation requirements, demands for excellence in critical assessment and communication skills, and great care given to medications, you'll love ICU. Translation: Probably not a good idea right now.

Do not give up the idea if you can't bear to do so, but it would be prudent to allow for the possibility that in the next year or two on your medical floor-- when you will no longer be the new girl on the block and you will have your feet much more firmly underneath you-- you may find another interest within your extant patient population or a related field. You haven't begun to scratch the surface. Look actively for that other interest(s) right now; so doing doesn't invalidate the dreeeaaammmm thing but it does keep you focused on the here and now, where your attention rightfully belongs.

[GreenApplesauce]

You are right, I don't want to escape or run away...that is why I am still here. But I want a fair shot. If I know I have a fair shot at staying, i could tough it out. Heck I can see myself getting better and better every day...but it is not worth it if I am on the chopping block. If they are going to be breathing down my neck and looking for a reason to fire me....then it is better for me to leave.

[nurseprnRN, BSN, RN]

You are right, I don't want to escape or run away...that is why I am still here. But I want a fair shot. If I know I have a fair shot at staying, i could tough it out. Heck I can see myself getting better and better every day...but it is not worth it if I am on the chopping block. If they are going to be breathing down my neck and looking for a reason to fire me....then it is better for me to leave.

You might not see it this way, but that sure sounds like an excuse to me. You can be better than that. I agree c the PP that if they wanted to fire you they'd have done so already. No fair making it a self-fulfilling prophecy. Go forth and do good.