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.

[boxofrain]

17 minutes ago, Susie2310 said:

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?

I did an accelerated BSN program (16 months) with no prior medical experience. That was probably my first mistake. A program like this is fine for the student who previously worked as a PCT or EMT, but not so much for someone like me. Because the program was accelerated, the rotations were only seven weeks, sometimes not even that long. For my community health rotation, I went to a senior housing complex and sat around waiting for residents to wander in. I got really good at manual blood pressures and accuchecks though. Wondering if a nursing refresher course (like one for nurses reentering the field after hiatus) would be helpful or if I just lack some basic quality needed for the bedside.

[boxofrain]

11 minutes ago, JBMmom said:

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.

Just, fyi, I left the psych facility of my own accord to take this most recent job, which I thought was my dream job. And it was, in many ways. This is why the loss of the job is so difficult for me. I think the earlier part of the post may be one component of the problem. Applying knowledge to real life situations. Hence, the comment from the preceptor about not "making connections." So, now I'm trying to figure out how to get there from here.

[JBMmom, MSN, NP]

3 minutes ago, boxofrain said:

Just, fyi, I left the psych facility of my own accord to take this most recent job, which I thought was my dream job. And it was, in many ways. This is why the loss of the job is so difficult for me. I think the earlier part of the post may be one component of the problem. Applying knowledge to real life situations. Hence, the comment from the preceptor about not "making connections." So, now I'm trying to figure out how to get there from here.

I completely understand the disappointment of being told you're not going to work out at a job that you were happy to get. It can really shake your confidence. But, now that you think you've got an idea of where the potential disconnect is, you can work on it. When you find another position, and you will, take the time to talk things through with your preceptor, or other coworkers, so you can start making those connections. You're right, it's not rocket science. You will get there. If you can apply for a new grad residency program that might be perfect. Because you don't have more than a year in acute care, you may find facilities that would hire you for that even though you're not technically a new grad. Good luck!

[boxofrain]

2 minutes ago, JBMmom said:

I completely understand the disappointment of being told you're not going to work out at a job that you were happy to get. It can really shake your confidence. But, now that you think you've got an idea of where the potential disconnect is, you can work on it. When you find another position, and you will, take the time to talk things through with your preceptor, or other coworkers, so you can start making those connections. You're right, it's not rocket science. You will get there. If you can apply for a new grad residency program that might be perfect. Because you don't have more than a year in acute care, you may find facilities that would hire you for that even though you're not technically a new grad. Good luck!

I would welcome an opportunity like a new grad residency and some of my friends have suggested it as well. Although technically not a new grad, I guess it can't hurt to try. Thank you so much for your response.

[Wuzzie]

Just wanted to tell you that your attitude is great and will really help you recover from this blow. Best wishes as you find your nursing niche...and you will.

[MunoRN, RN]

One downside to BSN programs these days, particularly accelerated BSN programs, is that you finish the program with a long way yet to go in terms of being able to handle a full patient assignment.

What portion of a 'normal' patient load were you taking in clinicals by the end of the program?

[boxofrain]

37 minutes ago, Wuzzie said:

Just wanted to tell you that your attitude is great and will really help you recover from this blow. Best wishes as you find your nursing niche...and you will.

Aw, thanks! Something I needed to hear...

[boxofrain]

25 minutes ago, MunoRN said:

One downside to BSN programs these days, particularly accelerated BSN programs, is that you finish the program with a long way yet to go in terms of being able to handle a full patient assignment.

What portion of a 'normal' patient load were you taking in clinicals by the end of the program?

Hmmm...trying to remember almost two years ago now. Role transition was on a general med surg floor with a few tele pts thrown in. Want to say maybe three or four? I don't remember what the regular patient load was for those nurses. Probably four or five. Standard pt load on my most recent floor was six, which I understand is true of most rehab facilities. One nurse who had been there for more than 30 years told me it had changed a lot. Patients are sicker; much more like a med surg floor.

RE: Accelerated program. I agree. As I state above, probably fine for people with previous medical experience or even people transferring in after two years of university, but for me, out of college for 20+ years, not a good way to go.

[Golden_RN, MSN]

I wish you had more specifics on why you were told you weren't "making connections" & things weren't "clicking". It could be taken that you weren't connecting the dots in clinical scenarios, and perhaps the critical thinking aspect was lacking?

[Koshea61, BSN]

Some hospitals have year long nursing internships. It's hard coming out as a new grad. I did med surg my first 5 years. It was before preceptors and I was just thrown in to five complete care patients. I cried every day for a while all the way home. I had migraines. All of the sudden you organize yourself out of pure necessity and it clicks. Nursing is very hard. Maybe they didnt work with you long enough or give you a real chance.

Each time you have to start over it's more and more nerve wracking.

I lost a job do to someone else's error. But they wanted me off their payroll as I had a lot of experience and was making too much money. Each time I got a different job it was like the anxiety was crippling.

Maybe think about how your anxiety makes it worse.. do you need a way to destress and not be so hard on yourself? Nurses are a tough crowd.

[MunoRN, RN]

2 hours ago, boxofrain said:

Hmmm...trying to remember almost two years ago now. Role transition was on a general med surg floor with a few tele pts thrown in. Want to say maybe three or four? I don't remember what the regular patient load was for those nurses. Probably four or five. Standard pt load on my most recent floor was six, which I understand is true of most rehab facilities. One nurse who had been there for more than 30 years told me it had changed a lot. Patients are sicker; much more like a med surg floor.

RE: Accelerated program. I agree. As I state above, probably fine for people with previous medical experience or even people transferring in after two years of university, but for me, out of college for 20+ years, not a good way to go.

That's actually not bad for BSN programs these days, we've been getting BSN new grads who were taking a half-load at best by graduation, when we've brought this up with their programs we've been told essentially that their goal is no longer to prepare their graduates to be prepared for bedside nursing, that's the hospital's job, yet it's not an easy sell to hospital administrators to spend 6 months or more doing what their nursing school should have done.

As a result, there's an initial leap that has to occur as a new grad between nursing school and a direct care nursing job, and many employers aren't interested in helping new grads make that leap, which isn't your fault.

You sound as though you've got the right foundation and competence for this to work out for you, it just may take some time.

[Vanessa Fillop, BSN]

Can I ask what made you want to be a nurse? Since this was an accelerated program I assume you got an undergrad degree in an area of study you liked. I am just assuming here mostly because I see and hear this a lot. People getting nursing degrees as a second career choice because the jobs are plentiful and typically stable. Unfortunately that is not a great reason to enter this field. Nursing is hard physically and emotionally and you often do not get a lot of support from your coworkers especially when you are new. This is an unfortunate aspect if nursing. You work long hours and miss out on weekends and holidays especially if you choose a career in the hospital which to many is the pinnacle of graduating and passing your NCLEX.
So what to do now.... lots of people suggesting your BSN opens doors to other areas and it does. Although, often those jobs do require you to still have clinical experience or at least having it helps with success and satisfaction in those jobs. It sounds like aside from being smart you now have anxiety about job performance Which becomes a vicious cycle. Let’s just say there are some less stressful areas of nursing that patient loads are more manageable. For example, home health or occupational health. Although, I do think hospital floor experience is invaluable to these jobs, but it’s possible to do them well without it. I did home health early in my career and I had no hospital experience. It was great learning experience and it developed my IV and lab drawing skills because you are it. I will say after moving on to the ED and ICU I do think that if I had the later experience prior to former it would have been helpful. There is also case management and Utilization management but once again experience helps, but that doesn’t mean you couldn’t obtain a position. There is also school nursing. I don’t know how you obtained that 50,000 but I am going to guess it was the way the most of us do- student loans so I know pay is of importance so school nursing might be the least attractive from a pay stand point, but it could be rewarding. I wish you all the luck.