New grad job advice

Wolf at the Door, BSN · Jan 29, 2017

I guess OR..Nobody from OR take this the wrong way. I am only suggesting OR because OR RN's don't give meds, don't do assessments, there is not taking or charting vitals, no charting I&O, no care plans, you won't need a sitter or restraint orders. patient is probably unconscious so that takes care of them needing to talk to you..

Do you believe you are incompetent?

HouTx, BSN, MSN, EdD · Jan 30, 2017

I am concerned about the comment from your instructor. I think you should arrange some time to discuss the basis for her opinion of the fact that you don't seem to be *minimally competent*. You certainly don't want any surprises at then end of the semester - if her opinion doesn't change, you may not receive a passing grade.

In the real world, staff nurses don't have the time to do any in-depth chart reviews prior to assuming care for their assigned patients. They have to hit the ground running based on information provided by the preceding shift. If they're lucky, they'll have time to do some review at some point in the shift when they're charting or taking off new orders, but that may be a rarity. I know that this sounds grim, but -- it WILL get better with experience. As time goes on, you will become very familiar with the majority of meds you administer, so you won't need to look them up any more. This also applies to disease processes, treatments, etc.

Your curiosity and desire to learn may cause you more angst at first because of time constraints. But eventually caring for *routine* patients will not be so time consuming and you'll be able to explore the new and unusual things that come your way. IMO, your *happy learner* personality is very well suited to nursing & may very well keep you engaged and positive about your career in years to come.

Nichole__ · Feb 1, 2017

Thank you very much for your insightful response :) What you've said makes complete sense; I'm not sure why I also myself to get so discombobulated over everything, especially since I'm brand new to this world (and will continue to be new for quite a while!). The experience and familiarity will come with time. Truly, thank you.. Sometimes I think it just takes me sitting down and reading what advice someone else could give me. I realize that I need to just relax a tad. The instructor said that quite frankly she had only seen me in clinical once, and it had been a few semesters ago. I guess I was hoping for less hurtful type statements, though. She could have been a little bit more therapeutic I believe.

Anywho..Thanks again!

LessValuableNinja · Feb 3, 2017

I find it strange that someone who saw you once in clinicals more than a semester ago would comment on your current clinical competence. Perhaps it would be more useful to solicit the advice of someone who is more familiar with your current level of competence. They may be able to better guide you towards imptovement.

renblis · Mar 2, 2017

I will be graduating this May and have already submitted some applications. I was told recently by an instructor that I didn't seem minimally competent, and therefore definitely not competent for the areas in which I requested as my "top areas" for new grad residencies (which were NICU, PICU/peds, L&D, and adults critical care.)
My question is, what IS a good first nursing job for someone who's seemingly incompetent? I have been on mostly med-surg clinical floors, and I know I am not suitable for those jobs. I cannot handle having 6 patients, nor do I feel safe practicing with 6 patients. I know I wouldn't be a good fit there because I am more meticulous with everything (meds, looking through history/notes, etc) and it's going to take me much more time to do things. I've been told over and over that I need to be more assertive (to my dismay, I am not able to "become assertive" overnight or after having someone tell me "you need to be more assertive!" In fact, it only worsens my nonexistent self-esteem and confidence.
The thing is, I'm not very good at anything nurse-wise, other than being super attentive and intuitive to my surroundings and details. I'm not the greatest multi-tacker (i'm much better and focusing on one thing at a time), I'm not speedy with meds (I look in depth at everything; I want to become familiar with what i'm giving, me being a SAFE nurse is more important to me than giving a pt their tylenol and protonix "on time". I recognize the medications that DO need to be given at a certain time (abx, more critical type meds, etc.) , I'm extremely introverted in a large field of extroverts, I'm not good at running around like a chicken with my head cut off (which is how I see every med-surg nurse) I know I would fail miserably, I would not be timely enough for everything.
I like to go into pts chart in depth and read their history, why they came in, and start piecing things together. I chose those specialties because of the ratio of nurse:pt. I just want to be the best nurse I can be. I have everything to work on, I know that. It's hard enough having to change my personality/behavior, but I also have to work on nurse related skills. I'm sorry for this novel of a post, but I'm very concerned for myself. I have no idea the best first nursing job for me. I'm very slow on the whole learning curve thing, and I don't want to be absolutely miserable for 18-24 months.

You sound just like me which makes me feel like I have grounds to reply :)

Don't be so hard on yourself. In your post you speak about how your qualities are all negative pertaining to being a nurse. Start looking at how they are positives as well as how they can benefit you in your career and stand out from the crowd.

Also, don't allow what one instructor (who doesn't even have much experience working with you) says to hold so much weight. Their job isn't supposed to be to discourage students - it's to prepare them. To add to that, not all students are made equal! Brush it off, continue to work toward your goals, and also work on confidence. Trust me, I know just gaining confidence is not easy. It's an everyday battle, but just start with trying your best to turn negative thoughts to positive thoughts. It might sound corny, but thoughts are powerful.

Good luck!!