Is my (50K) BSN worthless?

[boxofrain]

Long, sad story. I graduated from BSN program as a second-career nurse in December, 2017. Passed NCLEX in 75 questions in Feb. of 2018; secured first job in ICU at a Level I trauma unit in a residency program summer 2018. Was asked to leave program after 2.5 months on that job, with management saying that ICU is too difficult for a new grad nurse. Took psych job at small, poorly run standalone facility and worked 50+ hours/week, was assaulted, had 20+ patients at times. Was offered and accepted dream job at a highly reputable rehab hospital in the specialty I've always wanted. Did not make it through orientation here either. Manager and one of the preceptors stated that maybe I'm just not cut out for floor nursing.

I came into this job with almost no bedside experience. I arrived for 6:30 a.m. shift at 6:00 a.m. every day. I lived, ate and breathed this job, spending all non-working time reading about disease pathophysiology, watching YouTube videos on suctioning and IVs (just to name two, there are many skills with which I had no experience) designing shift report form and tightening up med pass procedure. For many of these, I actually acted out the processes just to get some muscle memory. All to no avail. One preceptor remarked that I was "passionate" and "the most hard-working person I ever met," but, something just wasn't "clicking" and I wasn't "making connections." She also said that she loved my inquisitive nature, hinting maybe I should try research.

Here's my question. Are there really some people who just can't do bedside nursing? I don't want to appear as bitter arrogant, but, come on, this isn't rocket science. This most recent dismissal happened a week ago and I'm working hard to gain some perspective and insight. I would definitely look to other areas of nursing, but it seems most want at least 1-3 years bedside experience. Where do I go if I can't manage that?

Any guidance would be much appreciated.

[beekee]

I’m guessing you are very book smart? Book smart gets you through nursing school and the NCLEX. It sounds like you focused on the technical side, but not so much the human side.

[JKL33]

Agree. ^

You haven't described anything about developing working rapports with colleagues and patients/families. How would you categorize your experiences in that area?

[llg, PhD, RN]

Can you give us some information about why you have been fired for these jobs? You've described how hard you have worked and tried ... but not told us what reasons your employers have stated as the reason you have been fired. What weaknesses have they identified?

For example:

1. Are you unable to use/manipulate the technical equipment and/or do the technical skills correctly? Do you have a problem with physical coordination?

2. Are you having trouble assess and diagnosis what is happening with your patients? Can you analyze the information and make a good decision about what to do in situations?

3. Are you having trouble "fitting in" with the staff and/or getting along with them (or your patients)?

4. Do you keep forgetting details about how to do procedures correctly, how to document things, etc.?

5. Do you have trouble with time management? Do you take a lot longer to do tasks that other nurses do quickly?

6. Do you lack confidence and hesitate to do things that a nurse needs to do?

Each of the questions represents a different realm of nursing practice that can be a problem for a new grad. Which -- if any -- are the ones that your former employers have said are your weak areas?

Only when you have identified your specific weak areas, will you be able to make a plan to deal with them.

[CommunityRNBSN, BSN, RN]

It is so hard to know without seeing you face to face. Are there any nurses in your life— either from school or from your jobs— that you are close enough to that they could give you some insight? Off the clock, at a coffee shop. You could say “I know no one likes to say things that could hurt someone’s feelings. But my career is at risk here and this is Hail Mary time, so I need your honesty. What can you tell me about my nursing that might help me improve?”

[MrNurse(x2), ADN]

Your BSN gives you greater access to the non bedside opportunities you are looking for. Not a waste at all.

[boxofrain]

1 hour ago, JKL33 said:

Agree. ^

You haven't described anything about developing working rapports with colleagues and patients/families. How would you categorize your experiences in that area?

Actually, that was another piece of positive feedback that I received. I was told that I was very good at developing relationships with patients and family. And, yes, probably most people would describe me as "book smart."

[Wuzzie]

2 minutes ago, boxofrain said:

Actually, that was another piece of positive feedback that I received. I was told that I was very good at developing relationships with patients and family. And, yes, probably most people would describe me as "book smart."

Okay then what was the issue? It's really hard for us to help without an idea of where things went wrong. We don't need explicit details but a general idea. For instance, if they said "you aren't a good fit" that's code for they didn't like you (which may or may not be your fault.)

[JKL33]

1 minute ago, boxofrain said:

Actually, that was another piece of positive feedback that I received. I was told that I was very good at developing relationships with patients and family. And, yes, probably most people would describe me as "book smart."

Well, that's good. So are you having trouble effectively translating knowledge into practice then? Or what do you believe the problem is?

[Susie2310]

How much student clinical experience on live patients did you have during your nursing program?

What student clinical rotations did you have? How many patients were you assigned to as a student to care for?

[boxofrain]

51 minutes ago, llg said:

Can you give us some information about why you have been fired for these jobs? You've described how hard you have worked and tried ... but not told us what reasons your employers have stated as the reason you have been fired. What weaknesses have they identified?

For example:

1. Are you unable to use/manipulate the technical equipment and/or do the technical skills correctly? Do you have a problem with physical coordination?

2. Are you having trouble assess and diagnosis what is happening with your patients? Can you analyze the information and make a good decision about what to do in situations?

3. Are you having trouble "fitting in" with the staff and/or getting along with them (or your patients)?

4. Do you keep forgetting details about how to do procedures correctly, how to document things, etc.?

5. Do you have trouble with time management? Do you take a lot longer to do tasks that other nurses do quickly?

6. Do you lack confidence and hesitate to do things that a nurse needs to do?

Each of the questions represents a different realm of nursing practice that can be a problem for a new grad. Which -- if any -- are the ones that your former employers have said are your weak areas?

Only when you have identified your specific weak areas, will you be able to make a plan to deal with them.



First, thank you for taking the time to put together this response. I know the questions are meant to elicit personal reflection, but thought I'd throw the answers out there:

1. YES! I had trouble with the med scanner, getting med packages open, coordinating movements when suctioning, etc. These were the things that I practiced at home. Also, time sucks like dropping meds on the floor (and having to go back and replace them) really seemed to sabotage my time management.

2. My assessment skills were actually pretty good. Biggest problem (I know this will come as a shock) was that I did tend to overthink (and thus overcomplicate) some of the cases.

3. This is a good question. As stated above, I did very well establishing rapport w/patients and families. I thought I was doing okay w/peers, but in retrospect, starting to wonder. In all honest, I've never really fit into big groups of women, but I felt I was doing okay here.

4. YES. Probably my biggest problem, therefore, I put together a number of "cheat sheets" and practiced procedures at home. I was making much progress at these things, but apparently not enough.

5. YES. I had every day planned in advance, but the things I mention above reared their ugly heads. Additionally, I'd get sucked into a patient room (say to take them to the bathroom) and end up spending 15-20 minutes there since they couldn't be left alone. With regard to this, it's not like I just went blindly into each day...I had a definite plan, but was seemingly thwarted. I was racked with anxiety every day, in a constant race with the clock to get everything done. I still don't understand how the other nurses did it. I was often told, "that comes with experience."

6. I probably do lack confidence, but I never hesitated. I always asked to do the things I needed work on. For example, I let the PCTs know that I wanted to do all of the lift transfers or all of the straight caths just to get the experience.

Having lost two jobs before the end of orientation has been very demoralizing. I know it must be something I'm doing wrong. Admittedly, the school I went to was sadly lacking in skills education. It was an accelerated BSN program that was only 16 months start to finish. Many of clinical experiences were either abbreviated or barely qualified as clinical (ie had to supplement short Peds rotation w/observation at a day care center.) So I guess my question is, do I try for another bedside position (which would probably be pretty difficult to obtain) and continue to hone my skills (which had come a long way; I'd hate to lose all the ground I gained...) or look elsewhere, like research? Research appeals to me, but most of the jobs I've seen require bedside experience. Also considering ambulatory or school nursing. On the upside, all of these have great hours. On the flip side, I really loved direct care. Thanks for listening.

[JBMmom, MSN, NP]

First I would say that no education is worthless. And you have clearly been successful in certain areas so you can find your niche in the nursing realm.

We are challenged here to comment after having only one side of the story and not ever seeing you in action. I have no doubt that you are very smart and have some very good attributes that could help in nursing. However, there must be something else that isn't coming through in your post. If you're that knowledgeable and good at working with people, where is the connection you're missing? Did you get any feedback on specifics? You may have all the information from A to Z in your head, but if you're presented with a change in patient condition and you can't translate that into the appropriate action to take or questions to ask, that could be part of it.

Some workplaces aren't that good. The ICU could be very challenging for a new grad. Maybe they hadn't hired many new grads and realized it just wasn't going to work out. Yes, there are facilities where you have an unsafe patient assignment, and the psych facility you were at may have been poorly managed. However, three workplaces in two years that let you go points to something that is related to the common denominator, you. Not to offend you, but you need to figure out how you can look more objectively at your performance and find the similarities that might be causing you trouble. I hope that you can find something that will work out for you! Good luck.