Is my (50K) BSN worthless?

jbudrick, MSN · Oct 13, 2019

On 10/10/2019 at 10:40 AM, boxofrain said:
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 t beenursing? 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.

Hello Box of Rain,

I understand your situation and how you feel. I have experienced something similar. Not all people have the personality and/or temprament to work the floor. Some nuses lives do not allow for the flexibility to work the floor. You have tried three jobs and havent been able to make it work.

You can have a successful career in nursing by trying a job that matches your strengths. Home care, doctor office, school nursing, OR training programs, research, are all areas to look at. Say to employers: I now have hospital and floor nursing experience and realize my strengths and where I can best provide patient care and be successfull.

You can make a good career once you understand that not every nurse is suited to working the floor in an inpatient setting. I hope you realize that all people have strengths and weaknesses. You should not have to take drugs and change your personality for a job.

Best wishes,

Jbudrick

FullGlass, BSN, MSN, NP · Oct 13, 2019

Like you, I changed careers to nursing mid-life and graduated from an ABSN program, but I went straight into an NP program.

What I found was that many employers would consider me for jobs like case management and research, given my maturity and prior experience. My previous career as a business executive gave me skills that were transferable to these jobs, such as good organization, analytical, and writing skills. I was offered some Director level management jobs upon graduation.

Bedside nursing in an acute care facility may just not be your cup of tea. That's okay. There are a lot of options for nursing. I would suggest a slower-paced, lower stress job. LTC might be an option, as well as home care. School nursing might also be worth considering, and with 2 years experience, you are qualified. Psych is also an option, in a well-run facility. One of my favorite clinical rotations was in a pediatric psych day hospital - very nice environment and low-acuity patients. There are also RNs who work in primary care. You've gotten a lot of of other good suggestions from other posters, too. Go for a lower stress job now - you can always go for a higher stress job in the future, if you want. I think right now you need to gain confidence and feel secure. Good luck!

You don't have to have 2 years of med surg experience to get other nursing jobs. There are many places in the country that have a nursing shortage and will offer jobs to RNs with less experience. Some of our RN grads went into school nursing right out of school.

tiddles · Oct 13, 2019

15 hours ago, FullGlass said:
LTC might be an option, as well as home care.

I would definitely not recommend either LTC or home care as slower paced or less stressful.

MOmama · Oct 13, 2019

I can relate. I, too, am a second career nurse. Tried hospital nursing... 2 different jobs in one year. I hated both of them. I was miserable, which made my family miserable. It wasn't until I looked in the mirror and admitted to myself that I am not a floor nurse. This idea gets drilled into our heads in nursing school by professors. One year of med/surg and you can go anywhere. Well, I'm here to tell you that I did not last 1 year in med/surg. I lasted about 5, maybe 6 months tops. I was ready to throw in the towel on this entire career. It wasn't until I applied and subsequently was offered a job as a pre/post op nurse at a surgery center that my outlook on nursing changed. In a last-ditch effort to give this career a go, I took the job and I have absolutely loved it from day one. I found my home. Never in a million years did I think this type of nursing (I also circulate in the OR) would be a good fit for me. And never did I think I would actually love a nursing job.

Just wanted to tell you that you're not alone. Like others have suggested, try applying to jobs that maybe you wouldn't have considered in the past, as they aren't hospital nursing jobs. You may be surprised that sometimes what we want is not always what we need. I wish you well!

FullGlass, BSN, MSN, NP · Oct 13, 2019

1 hour ago, tiddles said:
I would definitely not recommend either LTC or home care as slower paced or less stressful.

RNs that go to a patient's home care for only that patient while in that home. They don't have to simultaneously care for 6-8 patients. I'm not saying home care is easy, but in certain respects it is less stressful than floor nursing in a hospital.

LTC is generally viewed as less stressful than many hospital jobs and this has been discussed a lot elsewhere on this forum.

glasgow3 · Oct 13, 2019

On 10/10/2019 at 4:49 PM, MunoRN said:
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

But, but, but how could that possibly be true? For years I've been hearing from those same folks that BSN preparation should be the minimum for entry into professional nursing practice. Where else will nursing students learn to think critically? .......and to embrace evidence based nursing practice? ........ and to differentiate between Benner from Orem? With this news I fear that an epidemic of "failure to rescue" is inevitable with the attendant negative morbidity and mortality outcomes.

Katie82, RN · Oct 14, 2019

On 10/12/2019 at 8:47 PM, BraveLego said:
Man, I am about to commit to an ABSN program and hope it is not the same one as you mentioned where they provided minimum clinical hours. What state did you go to school if you don't mind me asking and how many hours is considered little for new grads?

I don't think any nursing education program provides you with enough clinical hours prior to graduation. BSN gives you even less than ASN. That's why the current trend is Orientation Programs that will provide concentrated hands-on clinical time before they turn you loose.

FullGlass, BSN, MSN, NP · Oct 14, 2019

Can anyone provide any actual evidence of nursing schools lowering clinical hours and expected nursing student performance?

I graduated from my ABSN program in 2014 and was expected to care for up to 6 patients on clinical rotations at the end of the program.

As for required clinical hours, this is public information that should be on each school's website. So if someone has actual proof that these hours have declined, please provide it. I had 996 clinical hours on completion of a 16 month ABSN program. Given that a full time job is about 2,000 hours a year, I had almost 1,000 hours of clinical time in a little more than year, and that's about as much as anyone can reasonably expect from a full time nursing student who also has didactic responsiblities.

I will say that my ABSN clinical instructors said they felt the ADN (2 year RN programs) did a better job of teaching skills than most BSN programs. However, skills are only one part of being an RN. Many hospitals will now only hire BSN RNs, so I'm not trying to stir up a debate here.

No one coming fresh out of school is 100% prepared to be anything, in any profession, and that includes MDs. The best hospitals have extensive training programs for new grad RNs.

Susie2310 · Oct 14, 2019

1 hour ago, FullGlass said:
Can anyone provide any actual evidence of nursing schools lowering clinical hours and expected nursing student performance?
I graduated from my ABSN program in 2014 and was expected to care for up to 6 patients on clinical rotations at the end of the program.
As for required clinical hours, this is public information that should be on each school's website. So if someone has actual proof that these hours have declined, please provide it. I had 996 clinical hours on completion of a 16 month ABSN program. Given that a full time job is about 2,000 hours a year, I had almost 1,000 hours of clinical time in a little more than year, and that's about as much as anyone can reasonably expect from a full time nursing student who also has didactic responsiblities.
I will say that my ABSN clinical instructors said they felt the ADN (2 year RN programs) did a better job of teaching skills than most BSN programs. However, skills are only one part of being an RN. Many hospitals will now only hire BSN RNs, so I'm not trying to stir up a debate here.
No one coming fresh out of school is 100% prepared to be anything, in any profession, and that includes MDs. The best hospitals have extensive training programs for new grad RNs.

Number of clinical hours and number of patients is not a complete measure by itself. One could have a relatively large number of clinical hours but it is important how much of that clinical time is spent providing actual hands on bedside nursing care under the supervision of one's clinical instructor/preceptor and also what types of nursing activities are performed.

I doubt that anyone would disagree that no-one is 100% prepared coming fresh out of school and that isn't the focus of this discussion.

Those "skills" are a lot more than just step-by-step actions; many require considerable knowledge of not just the procedure but relevant aspects of the patient's medical condition, involve significant clinical decision making to perform correctly and safely, and incorporate using the Nursing Process.

MunoRN, RN · Oct 14, 2019

1 hour ago, FullGlass said:
Can anyone provide any actual evidence of nursing schools lowering clinical hours and expected nursing student performance?
I graduated from my ABSN program in 2014 and was expected to care for up to 6 patients on clinical rotations at the end of the program.
As for required clinical hours, this is public information that should be on each school's website. So if someone has actual proof that these hours have declined, please provide it. I had 996 clinical hours on completion of a 16 month ABSN program. Given that a full time job is about 2,000 hours a year, I had almost 1,000 hours of clinical time in a little more than year, and that's about as much as anyone can reasonably expect from a full time nursing student who also has didactic responsiblities.
I will say that my ABSN clinical instructors said they felt the ADN (2 year RN programs) did a better job of teaching skills than most BSN programs. However, skills are only one part of being an RN. Many hospitals will now only hire BSN RNs, so I'm not trying to stir up a debate here.
No one coming fresh out of school is 100% prepared to be anything, in any profession, and that includes MDs. The best hospitals have extensive training programs for new grad RNs.

It's not the number of clinical hours that varies, that's fairly standardized, it's the rate of progression that occurs.

Some programs expect their students be taking a full load with a preceptor only observing them by graduation, some programs have students only taking a portion of a regular patient load.

At least in my area, this a result of differences in the ratio of students to clinical opportunities between ADN and BSN programs. The main BSN program has it's own affiliated medical center which as almost twice as many beds as the hospital the ADN program uses, but the BSN program has just over 10 times as many students. As a result, while the ADN students are paired 1:1 with a precepting nurse at their clinical rotations and are starting to provide care 'independently' in their first year of the program, the BSN students are 8 students to 1 preceptor for most of their first year and don't get anywhere near as much opportunity to progress to becoming and independently practicing nurse.

As far as skills go, it's actually a completely different issue than skills. Knowing how to place a foley or start an IV is an extremely small part of learning how to manage multiple competing patient priorities and needs through hands on experience.

J.C.fan · Oct 14, 2019

On 10/10/2019 at 12:06 PM, 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.

I hope you moonlight as a consultant/advisor.

To the OP, do NOT give up! Find a mentor! The field needs you!

I signed up just to join this thread. I am heartened by the responses.

Wuzzie · Oct 14, 2019

8 hours ago, FullGlass said:
However, skills are only one part of being an RN. Many hospitals will now only hire BSN RNs, so I'm not trying to stir up a debate here.

You do realize that skills are not taught in a vacuum?