I started at a large prestigious hospital ICU unit 4 months ago. Previously I have worked at a small community hospital ICU for about a year. I had no issue at my prior job and I made the change because I was young and wanted the "big hospital, high acuity" experience. For the first two months, there had been no concern about me, everyone on the unit was saying how fast I would adopt to this environment. Then an incident occurred where there were questions about my critical thinking ability. I won't go into details due to patient privacy but I have fully taken responsibility for it and there were no harm done to the patient. I met with the educators, debriefed over the incident and discussed what had went wrong.
The orientation since then had been quite rocky since I felt like I was being watched over all the time and i was not too sure if my preceptor had ever really trusted my ability since then. Fast forward to this week, I was called into a meeting with my manager regarding my progress, apparently my preceptor had significant concerns about me and this was documented in a very detailed journal. I was not aware of a lot of concerns she had and i felt like even things that I have said (unrelated to patient care) was documented. I was surprised but maintained myself during the meeting. The manager said they would extend my orientation and if it doesn't work out then she will ask me to resign. My question is that I still work per diem at my old place, and there will be a temp full time position opening, I havent technically been let go yet at this new place. However I felt like thats the direction we are gonna go into. I am wondering if I should call it quit now or give it a try? My coworkers at the old place are aware the orientation aren't working at this new job and they are quite supportive of me returning. My family and friends said I should not quit this new job and this is a prestigious hospital and I wont be able to be re-hired. They told me its practically a career suicide. Any suggestions? I would appreciate any help!
P.S this new job had been a 1.5 hr commute each way plus I get very minimal break at work so I am constantly tired, having trouble sleeping. My old job is a 5 mins commute and my work life balance then was much better.
Get out. Who cares about the prestige of the hospital name when the staff are not supportive of their own? Leave on your own terms and trust your instincts.
Specializes in public health, women's health, reproductive health.
I would be gone, gone, gone. There is no way I'd stay in such an environment when I had another, closer, (and better for my quality of life) job available. Wouldn't give it a second thought and wouldn't care about what others were saying. You are the one who has to go to work each shift under those circumstances. Not them. I do not believe leaving will be career suicide for you. It looks like they are gunning to get rid of you. Go with your head held high and move on with your life.
Specializes in med-surg, IMC, school nursing, NICU.
As for this being a "prestigious hospital" unless you are in a unit doing cutting edge research or treatment, it really doesn't matter. I worked many years at a "world renowned" medical institution and in most every way it wasn't much different than any other hospital I ever worked at.[/quote']
THIS. So many people I have spoken to (mostly very young/new grads) have this idea that a big name medical center is going to be better work experience. I, like dream'n left a VERY large and prestigious hospital for my current job. The day-to-day wasn't any different than the smaller hospital where I worked previously. Some of the patients were a bit more complex since they were transferred to us from smaller community hospitals but really, the differences stopped there.
Work where you think you will be happy. Work where you can still have a life. Don't worry about what your family and friends say. They aren't living your reality.
It sounds like you know what you want to do. You want to resign and take the FT position at your per diem place, and it sounds like you are wanting validation.
Anyway, on to my opinion....run from this place, professionally, of course. Put your notice in NOW. I cannot imagine from what you have told us, them NOT firing you. I have no idea why. Clearly you've established yourself as a good employee in the other ICU. This to me is a "take your extra orientation and shove it," kind if situation. They want you out. Their loss.
My very first job was in pediatric open hearts at a big teaching hospital. Looking back, I am amazed I never harmed a patient (that I am aware of). About 6 months in I was called in to the manager's office, who I had only met once, and a list of complaints was presented to me. This included things like pt was prescribed 21 cal/ounce formula, and the nurse following me thinks I must have given 23 cal/ounce formula because the patient had runny bowel movements, even though I specifically documented 120ml of 21 cal/ounce formula in my feeding note. I simply asked her "If all of these things were a concern, why weren't they brought up to me at the time, instead of collecting them and presenting them 6 months later?" The manager agreed, and back to work I went, never trusting them day ******* again (credit Laura Gasparus for the term). In the end I think your old job sounds WAYYYYYY better, prestigious teaching hospitals are overrated anyway.
I'm sorry it's been so rough! A new place is tough enough without an increased acuity in patients!
However to be brief and simple, your last paragraph-the P.s portion is a clear indicator of what you want to do. You basically did a "should I go here or there? Oh btw there I am happy, here I am not".....
Follow your gut. I personally wouldn't quit (assuming the facility is tolerable). It's the nature of the field, sometimes the going gets really rough but you have to keep going. You can't be scared of what you do not know and use it as a stepping stone to be a better nurse. I wouldn't let it destroy me I would let it cultivate me. But that's just me and speaking as someone NOT In your shoes, I can only speak minimally. Best of luck.
Thanks everyone for your comment. but like SleeepyRN said, I cant imagine right now what 4 weeks is going to change anything. The meeting was rough I think my manager appeared supportive but it seems she doesn't have any faith that I can make it. She even said she can give me a neutral reference if it doesn't work out at any point. I am humiliated to go back to work on Monday. and of course during the meeting, the incident was bought up again and referred to multiple times. Even a thermometer malfunction back in september was documented and discussed. I emailed my manager at my old job to set up a meeting, not sure how forgiving she would be to someone who pretty much ran back. I am planning to just be honest and say it wasn't a good fit and i miss the atmosphere and working with the team here.
Specializes in NICU, PICU, Transport, L&D, Hospice.
If it were me I would stay where the balance is better and healthier for me...but I am old, have been doing this for several decades, and I understand that I much prefer to work where I am appreciated, supported, and can practice my profession without worrying about that individual who is trying to make a case to get rid of me.
The situation that you describe sounds hostile and punative to me. I wouldn't stay.
Another month of orientation might work, but I would ask for a new preceptor. I had a 3-month orientation with one preceptor when I started in my department, but it wasn't enough. I was given a different preceptor for an additional month, with new goals and harder assignments, and honestly, a week or so in I almost flunked out! The difference was that my preceptor really wanted me to succeed and took me to the woodshed for several meetings where we debriefed after tough cases. I never felt that she wanted me gone, and I managed to get through the rest of that month with her. I've now been there 3 years and am doing quite well.
I owe a lot to both of my preceptors. Both of them and my manager supported me 100%. I guess my point is that sometimes extra time is a good thing IF it is not some weird punitive witch hunt. Let us know what you decide to do, and good luck!
So your question is: should I stay at a job that makes me exhausted, anxious, and miserable or should I go back to a job where I felt appreciated, competent, and happy?
When you put it that way, is it really such a hard choice?
I don't like the journal either, but I did train for a preceptor program that required we write 3 items for improvement & 3 items that the preceptor found that the orientee did very well. It was due weekly....we had to review our answers with the orientee & give a plan of improvement once discussed with the manager.
Had the program been utilized as it was designed, I think it would have been great for graduate nurses. I don't think seasoned nurses found it beneficial. We had to give them specific patients every week, which was challenging. Who knew there would be NO lap chole pt for 2 weeks on a post-open floor?
At that facility, journals were known to everyone. We spent about 15 minutes per shift on them. Usually during my unpaid lunch break!
It was very handy once. I had documented on my journal page that the orientee had struggled with pushing IV meds, constantly asking how slow to give them. This went on for 6 weeks. One night, I told the other nurses our "assignment" was giving all the IV meds, scheduled OR a PRN. We only had 15 patients, so no one minded an extra pt (she had only taken 3 at one time).
I had tried having her write them down as a list once she looked them up....she told me we were mean. Well, writing she had looked up the rate to give Lasix IV push 4 times in 30 minutes & had asked 3 times if she could mix Morphine & Phenegan in a syringe to give IV (yep!), was why she got shown the door. She had been given the answer & sources for the answers more times than was reasonable. Really? Our IV antibiotics had the rate ON the label....
I just wanted to post a similar experience I had. I was an experienced nurse, but new to a specialty. I actually moved out of my home state for this job, and had everything riding on it. I had received some feedback that I wasn't efficient, but it was buffered with "it will come with time". I hadn't received any other negative feedback, but my orientation was extended a couple of times. The second time, I asked what I could improve, and was given the same response as before. A week before my orientation was to end, I was asked to a meeting where I was offered a different position. More feedback was given, and I was floored. Long story short, I started job hunting, and ended up at a different organization. I can't (and won't) say anything bad about the previous organization. I should have pushed more and kept my personality quirks to myself until people knew me better. Live and learn.
My point is that sometimes the culture of an organization doesn't mesh well with an employee. I think that's what happened to me. Just as it's important to have an employee who works well with the organization, it's also important that the organization works well for the employee. Hospital culture will be long established before a nurse takes a position. It won't change because of an individual nurse (unless it impacts patient care), and a nurse shouldn't have to change or hide his/her personality to fit in. I understand wanting a "prestigious" hospital job. But you also have to consider how much you'll like going to work. A good team of coworkers can make all the difference. I agree with PPs that it sounds like you made up your mind. It sounds like a good choice to me. Either way, my best to you. You're not alone. :)
LV3677
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Get out. Who cares about the prestige of the hospital name when the staff are not supportive of their own? Leave on your own terms and trust your instincts.