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.

[Susie2310]

3 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.

How much of the care for those three or four patients were you providing? Under your clinical instructor's supervision were you doing assessments, admissions, discharges, administering medications including IV meds, clinical procedures, keeping track of I&O, assisting patients with hygiene and with ambulation as ordered, and documenting your care?

I'm trying to understand how much actual hands-on care you gave to your patients as a student.

[MjHudd]

Try the OR. Being a circulating nurse, especially in a trauma center or a complex specialty team such as neuro or cardiothoracic surgery, can be exciting, rewarding and very fulfilling. It takes minimal interaction with patients while still helping them. You have to work closely with surgeons and anesthesiologists but not as close as you’d think. Look into it.

[Crystal P, BSN]

I would suggest all new nurses go into a generic area such as Med-Surg and not a specialty. You need to get the basics down before moving on to a specialty

[MjHudd]

1 minute ago, Crystal P said:

I would suggest all new nurses go into a generic area such as Med-Surg and not a specialty. You need to get the basics down before moving on to a specialty

Yeah well that’s fine for most but some people just aren’t cut out for floor nursing as the OP is saying she was told. I went to the OR straight out of nursing school. I knew I would hate Med-surg and had no desire to do it. I’ve done homecare and dialysis as well but eventually found my way back to the OR and I’m a damn good OR nurse! Ask any nurse, scrub tech or doctor I work with.... never worked a day in med-surg. Sometimes specialties are the way to go.

[dream'n, BSN, RN]

It sounds perhaps like you are having issues with critical thinking? Are you mostly task oriented?

[JeaniB]

Not every BSN graduate is cut out to work the floor. This doesn’t mean your education is worthless, but you may need to look at other nursing opportunities. Find a hospital that offers a good internship for new nurses. (For example, the Air Force has a six month internship for all baby nurses). Explain your school didn’t offer many clinical hours and you have found that to be to your detriment.

What, exactly do you want to do? What is your passion in nursing? Determine that and then do what you need to get there.

I've mentored many baby nurses. 75% of the ones with little clinical time didn’t make it through. 25% just couldn’t translate their book knowledge to actual patient care. None got out of nursing, they all evaluated themselves and found their niche.

[CATclaimRN]

There are 100s of ways to be an excellent nurse. There is Case management, UR, physician offices. Explore non hospital options and you might find your niche!

[quirkycuriousity]

I want to commend you on your attitude and clear passion to do the job well.

Based on comments you’ve made I wanted to ask a few questions (and if not comfortable answering I understand):

1. you mention anxiety a good deal, have you talked to a counselor/PCP/Psychiatrist about this?

2. have you considered if you may have adhd? Hyper focus combined with prioritization and distractedness (I.e. clumsiness with meds, losing time) makes me wonder if that’s a possibility.

You sound intelligent and self aware as well as driven. Untreated mental health issues can really exacerbate the difficulties of finding your footing in nursing.

best of luck to you!!

[L-ICURN, BSN, RN]

I'm sorry this is happening to you. Like others said, it looks like you have self awareness and you are trying to figure out how to fix it. I think the accelerated BSN short-changed you in clinical experience. I was a returning student and went through a traditional BSN program. At the end, we had ~500 clinical hours done, and those hours were very hands on.

I know what it's like to have your pride damaged when someone says you just can't do the job. Like others have also said, maybe floor nursing isn't your niche. 50k is a lot of money for school. Maybe try to find something outside the traditional realm of nursing. Ambulatory, OR, clinic? Good luck to you, whatever you do!

[boxofrain]

7 hours ago, quirkycuriousity said:

I want to commend you on your attitude and clear passion to do the job well.

Based on comments you’ve made I wanted to ask a few questions (and if not comfortable answering I understand):

1. you mention anxiety a good deal, have you talked to a counselor/PCP/Psychiatrist about this?

2. have you considered if you may have adhd? Hyper focus combined with prioritization and distractedness (I.e. clumsiness with meds, losing time) makes me wonder if that’s a possibility.

You sound intelligent and self aware as well as driven. Untreated mental health issues can really exacerbate the difficulties of finding your footing in nursing.

best of luck to you!!

Yes and yes. I know I have at least moderate anxiety and I'm pretty sure I have ADHD (my son, brother, a niece and a nephew have all been diagnosed too.) I have considered medicating for the ADHD and will at least consult w/someone about it. I'm very leery of anxiety meds. I used xanax about 10 years ago as a "rescue" drug when I was going through extreme stress. It did the job at the time, but it was awful. I felt groggy, slow-moving. The benzo route is a can of worms I really don't want to open. Maybe ADHD meds can help w/anxiety too...or exacerbate. I'm willing to try at this point.

[AuntieNurse1013]

I will admit, I didn't read through all of the comments. So if any of my opinions are redundant, please excuse.

I did read someone mention a new grad residency program may be suited, and that sounds like a wonderful idea. I think my hospital calls it Academy for certain specialities like OR, ED, or ICU... But the similar none-the-less. Longer orientation times, individualized classes for that speciality and so forth. May be worth looking into.

Without being your preceptor and being on the floor with you and seeing how you work, organize, interact, prioritize, execute, delegate, assess, communicate, etc it's hard to say why you have had such a difficult time as a new grad.

In some of your descriptions I think you lack what most new grads do.... Prioritization. A big part of that is delegation. I understand that taking a patient to the bathroom is an important part of our job, but until you have honed in your skills in orientation that should be delegated, and is something I would myself delegate. I've also had a few preceptees who were very book smart and detail oriented who would get hung up on making sure they got every step of a procedure right, memorizing each step (even had one who would correct other seasoned nurses while observing) while forgetting to see the big picture. Yes, take those caths from the techs... But after 2 or 3, delegate it. You have the rest of your career to perfect your cathing skills. Work on the more important ones while you have someone with you, seek out opportunities to learn harder things and do things you haven't done. Ok, done with the ICU preceptor encouragement.

Idea... Maybe try floor nursing at a very small community hospital. They tend to have fairly not sick patients. That way you get your bedside experience, work on delegation prioritization and skills, then go get your dream job... Or even decide in the mean time that you don't want to do bedside anyway and that your dream is something else. I never thought in a million years I would end up where I have during my career, but each experience has been valuable in its own way. It's finding the value that's important. I hate you've had a rough start at it, but don't ever think you wasted your education.

[quirkycuriousity]

1 hour ago, boxofrain said:

Yes and yes. I know I have at least moderate anxiety and I'm pretty sure I have ADHD (my son, brother, a niece and a nephew have all been diagnosed too.) I have considered medicating for the ADHD and will at least consult w/someone about it. I'm very leery of anxiety meds. I used xanax about 10 years ago as a "rescue" drug when I was going through extreme stress. It did the job at the time, but it was awful. I felt groggy, slow-moving. The benzo route is a can of worms I really don't want to open. Maybe ADHD meds can help w/anxiety too...or exacerbate. I'm willing to try at this point.

As someone with ADHD I went I medicated until I became a floor nurse. Once medicated I did great.

I definitely wouldn’t go the benzo route. There are so many maintenance medications for anxiety that are taken daily and not sedating.

I highly recommend you see about addressing these issues prior to attempting another job.