In over my head and don't know what to do!

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I am a new nurse. I took my NCLEX in July and passed. I did not start looking for a position until August. I applied and interview for several but did not hear anything. After a long story, I started a job in December. Unfortunately, I don't feel I was given the full job description before I started. Now I am not sure what to do. The job is in a small rural hospital on the night shift, charging the floor and ER. My orientation lasts for 3 months. I did not realize that I would be the ONLY RN on this shift with one LPN and 2 CNA's. I don't feel I have the experience or education for this position. A doctor is on call at all times but may or may not come to see the patients in the ER. The RN is responsible for making the assessment, calling the Dr. on call, and receiving verbal orders over the phone (the doctor never sees the patient). I have heard from others that there have been times the nurse has actually done surtures. There also have been babies delivered in this ER by the RN because there is no doctor on the premises. The closest hospital that delivers babies is 30-50 miles away. I don't have any experience in OB. I am afraid of not finding another job, or it looking bad that I quit after a month. More importantly, I am worried that I will jeopardize my license. As a new nurse I don't know how to handle the situation. Does anyone have any suggestion on how or what to say when I quit and what to say to my potential next employer on why I quit?

Sure, many nurses do stay in such unsafe situations and manage to make the best of it. If they're still there after a year or two, then you know that they learned to do what they needed to do or else they would've quit or been fired by that time. Those folks who make it are either extremely lucky, extremely talented (natural clinicians), or most likely some of each - lucky AND talented. Just because some nurses CAN make it in such conditions doesn't mean that such conditions should be condoned or that new nurses should be encouraged to take on such a big risk (so much responsibility so soon with so little experience) - risk both to themselves & their career and to the patients they are responsible for.

Talk about sink or swim!! Some situations may demand this kind of risk-taking - I'm thinking of war-time battle-field conditions where the alternatives are no care vs. inexperienced care. I guess some might view rural areas as being that desparate; that it is a question of no care vs. inexperienced care. I'd hope there would be better solutions than this kind of sink or swim experience.

In regard to this specific case, I think it's terrible that the facility would knowingly hire an inexperienced new grad for this type of position! I know that it does happen, though. At this point, it's up to the individual to decide for themself what they are comfortable with. Personally, I wouldn't be comfortable with that situation.

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Specializes in Cardiac, Maternal-child, LDRP, NICU.

heyheyhey35, which state rural/area do you live in? I really would like to know that. I have never heard of such a thing at all in our nurse practice act in state of nj/ny. What does your state practice act qualifies an RN to do? I would love to know this:confused:

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Specializes in Psych.

I have just come in from a long walk and it is a hot sunny day. I'm thinking that I may have heat stroke and I should go to the nearest ER. I could have sworn the OP wrote she was a new nurse and is running a rural hospital on the night shift.

[Falls off chair and onto floor]

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Specializes in Emergency Room.

i would tell them exactly how i feel. trust me they KNOW that they are taking a risk hiring you. it appears that they are desperate and i have a feeling the last nurse that had your job left for the same reasons you want to. good luck with your decision, if you can....quit tomorrow.

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Specializes in Medical Surgical.

Absolutely quit! I have almost 20 years experience and I would NOT take a job, anywhere, where I was the only RN, at least not without a lot of orientation with stable patients. This is so nuts. Don't worry about explaining to your next employer. This would be easier than explaining to the board of nursing why you knowingly put patients at risk by acccepting a job for which you were definitely not qualified.

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Specializes in ER,OR, PACU, Corrections.

This sounds exactly like my first job- they do have a hard time staffing many rural hospitals. I would check with your board of nursing to make sure you are not practicing outside your scope of practice. I would also speak with the DON and make sure they were aware of your concerns. If you feel so uncomfortable in this job you should look for another position. It must be so stressful for you. Hang in there- you will find a job that is right for you. Perhaps you could do agency work until the right job presents itself? I would not worry about your resume. If you tell future employers the job conditions I am sure they will understand. Good luck!

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Specializes in M/S, Travel Nursing, Pulmonary.

Go ahead and look for a new job I would say. And certainly stop working there. No need for a 2 week notice IMO. You are leaving because you have deemed the work environment dangerous for someone with your experience. Not like its a fight over salary or something. Protect your license.

Just cause they hired you for the position doesnt mean you should be able to do it. Since you are just training, your absence wont hurt anyone else. Not like they have to cover the shifts or anything.

This is how I see it:

Its a well known fact, part of the housing crisis we are in is due to banks lending to borrowers who were obvious poor risks. Part of the reason for this is (as I understand it from the books I've read on buying a house) that borrowers dont understand one simple fact. When a bank OK's a loan, it doesnt mean you can afford the loan. It just means, under their policies, they are allowed to loan you (fill in the blank with a number)_________.

Same thing seems to happen with jobs. People think just because the institution hires you, then you are qualified for it. Not the case. Just as it is a borrowers responsibility to decide what is an acceptable monthly payment to make on a house for themselves, a job seeker must decide for themselves if they can perform the job or not. If something happens, HR is not going to throw themselves in front of the bullet and declare "It was us, we told her she was qualified to do the job. We knew she wasnt." They will produce documentation to counter that in fact.

The responsibility to recognize that this is not the right situation for you lies with you. Dont let them give you any other impression.

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Do any nurses ever rise to the challenge when faced with these types of situations? Everytime these questions come up on all nurses a bunch of people say run. But do nurses always have to run from challenges?? I'm guessing this is how the role of NP came about in the first place - because some people didn't run.

This is a general question - not specific to OP's situation.

As a new grad this is not a challenge I would rise to... To put patients and myself at risk so the hospital can save a few bucks is ludicrous. If you aren't qualified for a job you just aren't... nursing is not a "fake it til you make it" profession.

As nurses we are faced with many challenges... some are worth rising to and others are not. If patients are going to benefit, I say buck up and fight, but if it comes down to hospital buearocracy at its best... if we do rise to these challenges then the powers that be come up with an even more ludicrous challenge next time. My point being that CEO's of healthcare do what's best for the corporation to make money... not always what is best for patient care, ie... hiring a new grad with no experience to be the only RN in the hospital all night.

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Specializes in NICU, Post-partum.

This is scary. I am sure you are a very intelligent person but the real Hallmark of intellect is knowing when you are over your head, and I COMMEND you for realizing that.

Everyone else is so right. I can't believe that they have put you in that position.

Honestly? You would be quitting not only for your protection but for THEIRS!

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Specializes in NICU, Post-partum.
Do any nurses ever rise to the challenge when faced with these types of situations? Everytime these questions come up on all nurses a bunch of people say run. But do nurses always have to run from challenges?? I'm guessing this is how the role of NP came about in the first place - because some people didn't run.

This is a general question - not specific to OP's situation.

I'm all for rising to a challenge, just as long as I don't put someone's life at risk while I'm learning.

There is no comparison of the education/clinical hours/level of training in an RN vs an NP. If there was they would just hand you an NP name tag after so many years of experience as an RN. They only "rise to the challenge" when they have the training in order to do it.

The OP is very correct and SMART in recognizing the situation as dangerous. She is new herself in assessment skills, new a pharmaceuticals, learning how to refine her decisions herself...and leading a staff that ultimately, needs to turn to her for direction?

It's hard to make decisions when probably 85% of the situations, you have never experienced as a new grad.

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Specializes in Med surg, Critical Care, LTC.

Man, I would LOVE to find a position like this!! It would be awesome!

However, if you have little to no experience, you will find yourself stuck in quick sand and not able to get out. So, I agree with the other posters, RUN fast and don't look back.

Blessings

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Thanks for the responses. It is nice to hear from those experienced. I should do some clarifying. Some of the medical providers do come in. But several of them don't. These are the ones that do the verbal orders. So far as a new employee, I have not done anything outside of my scope. I was only asked once to do something that made me uncomfortable and I refused. I will probably stay for the rest of the week as I am on the floor more than the ER and am still in training.

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