New grad: I've failed at my first two RN jobs

[Lemon Bars]

My nursing career is off to a rough start. After unsuccessfully applying to a local new grad program, I grabbed a job at a rehab/SNF. This first job promised me extensive training and support, and I accepted it with the understanding that I would be working mostly with patients in short-term rehabilitation. Instead, they placed me on the long term care side of their facility, with just two weeks training, and assigned me 23 patients to care for and chart on, with additional supervisory responsibilities and responsibility for administering IV medications on night shift throughout the facility. Medication pass alone took me six hours, and then I was expected to do extensive charting on patients that I had spent no time with. I thought this was unsafe, so I resigned.

My second job was on a Telemetry/PCU Unit at a hospital. I had only four patients, but they were mostly severely ill with CHF, COPD on BiPaP, and end stage kidney failure patients with heparin and cardizem drips. There were also patients experiencing withdrawal from meth, alcohol and heroin. There were no admit/discharge nurses, no resource nurses, no break nurses, and oftentimes no nurse aides either. I was learning a lot at this job and I wanted to keep at it, but there was too much work and I could not work fast enough to get it all done. I could not get the work done without a preceptor, so I could not get off orientation after three months, and I had to resign.

I'm not lazy. I coffee up, hustle and try to be efficient, but this is just not working out so far. So, where can I get a job in nursing where the pace and the workload are not INSANE? Should I look at small rural hospitals? Should I try for a clinic job? Should I become a school nurse or a public health nurse? What about an ICU job with only two patients? Psyche maybe? I've just spent five years and lots of money getting a BSN degree. There's got to be a job for me out there somewhere, right?

[llg, PhD, RN]

I think you should focus on less acute and/or slower paced work environments --not ICU (with fewer patients, but a LOT more complexity) -- not school nursing (which requires you to work independently, using expert judgement, without many close peers to support you), etc.

You need a slower pace and less complex patients -- preferably in an environment where you will have peers easily available to help you when needed. What types of facilities exist in your area with those characteristics?

[pedsrn1027]

I feel for you. Finding the right job can be hard. But once you find it, you will love it! I would definitely go the clinic route or to a smaller hospital. You need patients that are not terribly complex. I understand that most places are understaffed and I remember being a new grad... those were rough rough rough days. I'm pretty sure I cried on my way to work, throughout my shift, and on the way home for a solid 6 months. I hope you find something soon that is the perfect fit for you!

[Lemon Bars]

On 2/15/2019 at 8:58 AM, llg said:

I think you should focus on less acute and/or slower paced work environments --not ICU (with fewer patients, but a LOT more complexity) -- not school nursing (which requires you to work independently, using expert judgement, without many close peers to support you), etc.

You need a slower pace and less complex patients -- preferably in an environment where you will have peers easily available to help you when needed. What types of facilities exist in your area with those characteristics?

You are absolutely right that I would do better at a slower pace and with less complex patients. The problem is: I don't know where that situation can be found. Med-Surg would be less complex patients, but there would be five instead of four. ICU would be only two patients, but they'd be much more complex. There is an LTAC in town, but I've heard that each nurse cares for ten to twelve patients there! Outpatient surgery might be a better environment, but they want two or more years of experience for new hires. Do you have any suggestions of facilities that typically have a slower, less complex environment?

[BamaLady]

That's one reason I love postpartum/nursery/mom/baby. Some areas keep L&D with postpartum, but if you live in an area like mine, they're separated. Yes there is still plenty to look out for, but for the most part my patients are healthy and self sufficient. If I do have one that hemorrhaging or having BP issues then it's usually just 1 out of 5 vs 5/5 on med/surg.

Only problem is, I sometimes get bored. I recently picked up a float pool position at another hospital PRN just so I wouldn't lose my skills ?.

[Persephone Paige, ADN]

If you are a think, feeling human being, which it sounds like you are, these are growing pains. Some nurses are plain AI, and I'm in awe. I was never one of those. I stopped and felt, pondered, etc... and I had a rough start, also. You are not deficient, you just haven't yet found your niche'. You will, keep at it.

[FaithHopeLove333]

Have you considered hospice nursing?

[TAKOO01, BSN]

Yes, there is a job for you. Now you know about two jobs that aren't right for for you : SNF and Tele. Fine. There are a hundred others out there.

Is it too late to apply for a new grad residency in some area that interests you? Or, as you say, you can try psych or school nursing. A lot depends on how much support you have in a new position, what sort of work background (even non nursing work can help) you have and your ability to adapt. Keep at it.