7 months in...not what I expected

[sleepyjane]

I've been a nurse for nearly 7 months now. After months of searching and countless resumes sent out, I reluctantly took the first job offered to me at and acute rehabilitation hospital on a general rehab/musculoskeletal unit. As a new grad, I really wanted to work in med surg or telemetry to gain as much experience as possible and then decide if I wanted to go into a specialty. But do to such a high influx of new grads and recent requirements (Jan 2008) made by area hospitals that all new hires have a minimum of a BSN (I have an AD with BA in another field, graduated May 2008, go figure!), my options were limited. I was promised that I would get the med surg experience that I needed on this unit. Definately not the case.

Our patients are stable for the most part, post surgical, burns, trauma and amputees mostly. I had 6 weeks of orientation (including 2 weeks classroom, so only 4 on the floor) with my preceptor who had only been a nurse herself for only a year. She quit my last day of orientation. I work days with an average of 6-7 patients who are in 3 hours of therapy on my shift. My time management skills have improved tremendously since the patients are on the floor such a limited amount of time. I am great at dressing changes, pain management, passing meds and teaching. I have only had one patient with a trach (which came out the day after he was admitted), one G-tube and one NG tube. No chest tubes, no vents, occassional catheterizations and IV medications. RNs need to take a class before they can start IVs and the class has not been offered since I started. RNs don't give IV push meds or piggyback infusions on my facility. There is no telemetry. I have yet to hang blood. The primary diagnoses are almost always the same thing (hip, knee, amputee) and I have the same patients for 2 or 3 weeks. RNs are not valued members of the team...theraists and MDs see us as only passing meds and wiping butt and to be quite honest there are more days where I feel like this IS all I do.

To sum it up, I am clearly unhappy at my present job and have been looking for something else. My biggest concern is that because I am 7 months in to the profession I have already missed out on a really good new grad experience. This first year is where the most learning takes place. Now I'm not saying that I haven't learned anything...I just haven't been exposed to much. So I wonder if hospitals will still consider me a new grad and offer me the same orientation, or if they will see me as an experienced RN and expect me to be at a certain level (in which case I will probably fall flat on my face). I expect to be honest with potential employers of course and I don't know if this will help or hurt my chances. I am really discouraged and kind of depressed about all this. I was so excited to get in the profession and now I feel like I have missed out and can expect to encounter more roadblocks looking for a new job.

Has anyone else had a similar experience?

[Miami NightNurse]

With a Nursing shortage like it is they are requiring BSN only or higher??? I don't know what part of the world you are in. Want a job in Miami? My hospital would hire you in any area you wanted and even train you for it, ICU, ER, wherever

http://tbe.taleo.net/NA2/ats/careers/jobSearch.jsp?org=BAPTISTHEALTH&cws=1 Plus they have a $5000 sign on bonus- might even be more now

[MelBel]

We just hired a nurse on my unit who has been a nurse for about a year, but mostly in long term care. She is entitled to the same length orientation as the new grad we just hired. But that has to do with our union contract....so I'm sure it depends on the facility!

[kimberlydsrn]

I am right there with you. I had wanted to either work ER or OR, but I applied later than my peers with the thinking that since there is such a shortage......long story short, after 20 or more applications sent out I took the first full time job offered to me. It is on a rehab/ortho floor. I graduated in May of 2007, started there in June. We have mostly stable patients also. Post ops (hips and knees) and rehab for amputees and strokes. I access and pass meds, thats about all. I work midnights and pass pain meds almost all night long. I do hang IV bulks and piggybacks and do PCA's but other than that, I have only placed 2 foleys, 5 IV's (only 2 of which I got), Ive never been through a patient death (I know this is a good thing but Ive never done CPR or post mortem care), no trachs, no chest tubes. At times I am the only RN during the night if we only have a few patients. I dont like that either, its kinda scary. I have quite a few peers who started as a new grad in an ER and love it, and the experience they are getting.......well, that ER they hired into is again, beginning to hire new grads. I am really thinking about applying and have the same concerns, will they hire me as a new grad (Id prefer this so I could get the intense orientation), and will my lack of experience hurt my chances? Try and keep in touch and let me know what you are deciding to do. I will do the same. I live in Michigan, where do you live? Anyone else in the same situation?

[labrador4122, RN]

With a Nursing shortage like it is they are requiring BSN only or higher??? I don't know what part of the world you are in. Want a job in Miami? My hospital would hire you in any area you wanted and even train you for it, ICU, ER, wherever

http://tbe.taleo.net/NA2/ats/careers/jobSearch.jsp?org=BAPTISTHEALTH&cws=1 Plus they have a $5000 sign on bonus- might even be more now

that is a good place to work. but what I do not like about that hospital is that you don't have a lot of resources.

I have an IV nurse, phlebotomist and LPN..........oh yes, and what I definitely HATE HATE HATE about that hospital is that PAPER CHARTING. Its 2008 and they are STILL using paper charting!!

[Miami NightNurse]

Its 2008 and they are STILL using paper charting!!

Yeah really. Can you believe that?? When I came to Baptist 11 years ago I came from a hospital in Richmond, Va. where we were charting on computers. I've been waiting for Baptist to get that for 11 yrs. Where do you work, sounds good?

[llg, PhD, RN]

This first year is where the most learning takes place.

Not necessarily. There is no law (scientific or otherwise) that says you can't learn more in your 2nd year ... or in your 22nd year for tha matter! Learning is not limited to a set standard time frame. Think about it: people graduate from nursing school at all different ages and coming from all sorts of backgrounds -- and they manage to learn what they need to know -- at different paces and in different settings.

You will have one set of experiences this first year that will teach you certain things. You will have another set of experiences that will teach you other things next year. etc. etc. etc. You can continue to learn if you want to. Your career path may take a few turns that you did not expect, but that doesn't mean you are doomed to some terrible fate. Just keep moving forward and keep learning along the way.

Don't let yourself stagnate. Find things to learn wherever you are -- and continue to look for opportunities that suit your interests.

[LauraMT]

My hospital would be in HUGE trouble if they demanded a BSN! On my shift I think I'm the only one with a BSN right now. Everyone else is an ADN, one person working on her BSN. Anyway, can you move? If you don't have a mortgage and a family you should go on an adventure! Go somewhere where you're appreciated and you like your job. I work telemetry in eastern washington. We have about 5 openings (even though there are better adventures elsewhere)!

[PMFB-RN, RN]

To sum it up, I am clearly unhappy at my present job and have been looking for something else. My biggest concern is that because I am 7 months in to the profession I have already missed out on a really good new grad experience. This first year is where the most learning takes place. Now I'm not saying that I haven't learned anything...I just haven't been exposed to much. So I wonder if hospitals will still consider me a new grad and offer me the same orientation, or if they will see me as an experienced RN and expect me to be at a certain level (in which case I will probably fall flat on my face). I expect to be honest with potential employers of course and I don't know if this will help or hurt my chances. I am really discouraged and kind of depressed about all this. I was so excited to get in the profession and now I feel like I have missed out and can expect to encounter more roadblocks looking for a new job.

Has anyone else had a similar experience?

*** Sounds like you need to get a job in an ICU. I have been off orientation for 11 months now. I recover CABG patients with chest tubes, NG, Swan lines (PA catheters), Art line, IV, sometimes itra-aortic baloon pumps, always vented and on 3 - 6 vaso active dips. I also do Neuro surg patients with ventricular drain and inter cranial pressure monitoring. We (ICU nurses) are on the code and trauma teams. We respond to codes all over the hospital. I have done all the ACLS roles and have run half dozen coded by myself. I have responded to the ER for every sort of trauma you can think of. I have pumped 38 units of PRBC into a trauma patient in an hour and a half with the rapid infuser. I have ridden the gurney into the while doing CPR on a trauma patient. ALso do CRRT (continuous renal replacement therapy), twice have had CV surgeons crack a patients chest IN THE ROOM. I have assisted in all sort of bedside procedures and am PICC line certified, on the rapid response team and on a special diabetic "super users" team. Also coordinate organ donation after brain and cardiac death.

All of those jobs can only be done by staff nurses, not travelers. With half or our staff made up of travelers means that on some shifts all I do is place PICCs, and respond to codes, traumas, and requests for the diabetic team (the "team" being me alone) and rapid response team.

Of course some shifts I just take my two patients and have a quiet shift. I am also the VAPs (ventilator associated pneumonia) nurse for the ICU.

I make over $32/hour in an area where we purchased a 9 year old 4 BR, 2 bath, house with 3 car garage on 23 acres in the country for $110K in Jan 08.

We are very short of RNs and nobody cares at all whether you have and diploma, ADN, BSN or MSN.

The down side? I live in Wisconsin and winters are long and cold.

If you want to do the cool - high speed stuff come to St. Joseph's Hospital in Marshfield (connected to the Marshfield Clinic) Wisconsin.

We have a very good 7 month training program for new grads or nurses from other fields wanting to go directly into the ICU.