Insecure new grad and urgent care orientation. Your thoughts please?

[MissBrittanyRN]

Sorry this is soooo long, but please help!: It is probably premature to start this thread before my interview, but I am very concerned about what my orientation may be like. I am a new grad and I have my first interview scheduled with an urgent care facility. From my understanding they see a wide variety of illnesses, including issues that patients should probably present to the emergency department for. My orientation is only 30 days, and of course during my interview I will ask about the possibility of an extension if I am not ready. I do not think they have employed many new grad nurses in the past. Ideally I would have started my career in a hospital setting. The urgent care center pays well, but I would prefer to work for minimum wage in the hospital setting for my first year, in an RN residency program, or a thorough orientation. My last clinical experience was almost 5months ago, and although I did well in clinicals, and I was as comfortable with my assessments as a student could be, I feel out of practice, and I feel like I have forgotten my theory and about a lot of pathophysiology! I feel like I don't know the answers to things that I should that my friends/family ask me. The new grad programs in my area hospitals have thorough orientations varying from 3-12 months. The new grads in the hospitals work with a preceptor for several months, each shift doing their assessments and interventions together, classroom time in place of one clinical shift per week, workshops, etc. Again, I will inquire more about the orientation during my interview, but if the staff at this urgent care center are not used to new grads, what are they going to think about having to do assessments with me, which is a basic of the nursing process? I will be honest that I do not feel confident in myself yet, as a new grad. I did well in clinical and passed my NCLEX first time with 75 questions, but I do not feel like an RN. I know that in most settings people often have questions after orientation, and I am not afraid to ask for help when I am uncertain about things, but I do not want to put the patient OR my license at risk. When you enter a specialty, they reinforce teaching of the common dx, but in the E.D or urgent care, you don't know what you will see! There are so many different diseases out there, and I feel like I need to understand all of them! 30 days just seems to be so much shorter than the several months orientation offered in other settings. Well I can go on and on with my insecurities, but this has been long enough lol. Any thoughts?

[PostOpPrincess, BSN, RN]

I think that getting a job in the hospital would be the best way for you, being so new.

I am concerned that you will be missing very subtle things that only come with experience.

Personally, I do not think this is the right route.

[Sparrowhawk]

I would agree..urgent care's probably not best and they may likely not hire you based on experience...I'd go with hospital.

[MikeyBSN]

I don't think 30 days is enough time to orient a new grad, and I think you would be better in a hospital setting. You would learn a lot more and have more support. The orientation program in a hospital would almost certainly be better.

[MissBrittanyRN]

I agree, and oh my the truth hurts. I do appreciate everyone's honesty, so thank you so much for replying - and so quickly! My true concern from the beginning has been what JoPACURN said about missing subtle things that come with experience. It is extremely difficult to get a hospital position right now for a new grad in my area. I have applied for about 46 positions, mainly hospital, a few in other settings. Some other new grads in my area have applied to more! There are so many nursing schools around here, including large reputable universities. I have even tried getting volunteer positions in hospitals. I am fortunate to have financial support from family, and I do not have children, so I am willing to take an unpaid position for learning! I just want to learn to be the best nurse I can be! Thanks for the advice, and for the chance to vent :-)

[Sparrowhawk]

Try nursing homes too..you get a good amount of good experience there too.

[MissBrittanyRN]

I have considered long term care, but I have been told that I probably would not get good experience. I should look into it though, as that is one of the few types of facilities that I have not applied to, only because I have been seeking out the best learning opportunities, but if I can learn in LTC, great! I have applied mostly to hospitals in various departments, but many L&D units, because I have almost 3 years experience as an L&D patient care tech, and was highly involved in direct care. As an ADN prepared new grad, I seem to be unqualified in today's competitive market, but at least I have L&D experience (not nursing), but I will try not to turn this thread another whining about not having a job thread, because trust me, I'm definiately participating in those in their respective forums!

[PostOpPrincess, BSN, RN]

Good luck to you, you sound like a very level-headed person. I think it is just a matter of time. Keep going!

[Sparrowhawk]

You won't get a lot of patient care experience no..but a lot of good charge experience, assements those things.

[jjjoy, LPN]

Sometimes there's a frustrating gap between what might be the most advisable route and the opportunity to take said route. It's not like you're turning down great new grad job offers in order to pursue an ill-advised course of action.

First off, is relocating a possibility? I don't know of anywhere with guaranteed opportunities, but some areas might be better.

For LTC, if you have a choice in the matter, I'd recommend a sub-acute facility or a sub-acute unit in a larger facility.

As to what non-hospital job you might be willing to take so that you're not working as a nurse at all for a year or more, a lot depends upon the exact job description, the work environment (eg severely understaffed?), the supportiveness of colleagues, what orientation and expectations are for inexperienced nurses, etc. The best you can do is ask a lot of questions at the interview, ask for an opportunity to observe, and talk to the other nurses there. If it seems do-able to you, then go for it. And be prepared to resign if you later feel it's not a good place for you.

Best wishes!

[retiredlady]

I would say take a deep breath and try the urgent care if offered. Do the orientation and then decide if you like it. It's probably just minor things that they come in with. Would you be the only nurse? If not you would have back up. I think that it would be better than LTC at that hectic pace. Good Luck!!!!