New Grad ready to quit...

sunnyjohn · Jun 13, 2005

When I first started reading your post, I thought I had written this and forgotten about it!

You haven't had a proper orientation! If they were counting you as staff, they threw you in the deep end from your second week. Experienced employee or not! No wonder you are ready to walk!

A proper orientation would do wonders for you. If it where me I would find a hospital or Long-term care facility willing to give me the weeks of orientation I needed to get up to speed.

I certainly understand the depression and anxiety. I would do outstanding in school, but the depression and anxiety was so bad I could rarely function for a long periods of time. Then I got counseling and medication and I felt like a different person. I think it is the depression that is really making you feel so helpless and undermining your confidence. It killed mine.

There is hope. :)

RyanAaronsmom · Jun 13, 2005

You have heart, you care, and you are honest about your mistakes...which, by the way, everyone makes, even the best nurses, but unfortunately not everyone is honest about that! I would hate for you to be nursing my family member if you were not caring and honest!

No one can answer you question about suffering from depression and pursuing a career in nursing, but you. However, I can tell you that EVERY career has successful people who suffer from depression. But you do have a responsibility to have it treated, as much as if it was any other type of illness, for yourself and your patients. Then just take each day, each patient and each nursing procedure one at a time, and stay in the moment, to decrease the chance of error. And do not be a typical nurse by neglecting yourself while caring for others. Take care of yourself, so you CAN continue to care for others!

nelligolitely · Jun 18, 2005

To those that gave me advice, thank you so much. To RyanAaronsMom, thank you especially for that "staying in the moment" advice. It got me through last Monday and Tuesday.

Unfortunately, I lost it on Wednesday and had to call in sick. I couldn't stop crying and I felt exhausted...Calling in during your probation is a BIG no-no at our place, so I went to my psychiatrist the next day for many reasons including needing "a note."

My doc said I needed time off. I had to agree b/c I'm afraid of making more mistakes. He signed a sick-leave notice. Of course, I feel extremely guilty about getting out this way. I carried over sick days from whence I worked in the Recreation dept. at this facility, so I will not lose pay. However, I have to start my probation over when I go back.

I went in on Friday to talk to personnel dept. and hand in my doc's paperwork. They were so supportive and told me not to give up. They said they didn't care that I'd be out for a little while, and told me to feel better. A trusted colleague, director of a special care unit, suggested I come back in my Recreation capacity until my family stressors and mental health get better. She can make this happen - there are precedents. She said people will talk, but I can just say "I'm entering Nursing more slowly" - maybe work per diem someplace else at same time.

I said I'd think about it. Friends and family want me to think about nothing for the next few days. (Stress obviously took a toll on my body). What does everybody think? Is this a good idea or a horrific one? Has anybody ever done this? Will it destroy my RN chances? I know I will make the ultimate choice, but I just want to research it.

military spouse · Jun 19, 2005

I graduated in 1995 and went to work on an understaffed med/surg unit and used to get physically sick on the way to work. Lasted a handful of months. Perhaps a different setting with a better and more reasonable orientation would help. Don't give up!

CritterLover, BSN, RN · Jun 19, 2005

while i think it is nice of them to let you go back in to your recreation dept role for a while, that is really just a temporary fix.

what you need is a proper orientation!!!! without one, you will never feel competent.

it is a good thing that you will be starting your probationary period over again. it needs to come with a new orientation period, where you are precepted as you should have been to begin with.

when i was a preceptor, the first few days i was with a new-grad orientee, the patients were mine, all mine. my orientee moslty watched, looked up meds, learned the equipment, and the like. slowly, after a day or so, we would start giving the orientee tasks -- they became a "helper." after a few weeks, they would begin to take their own patients, but it was many weeks before they would have a full load. and i always watched them. (i could often be found sitting on the counter in the patient's room. not very professional, granted, but we worked night shift and not very many people were around.) many of my collegues disagreed with me about this (watching everything), but it was ultimately my license, and that is the way i did it.

now, i was a preceptor in acute-care, and a very complex icu environment at that; and i have no idea how new nurses should be precepted in ltc. however, i do know that as a new nurse you need a slow intruduction to your new responsibilities, and you were given a raw deal in the orientation department.

so, unless the facility you are currently at is willing to give you an appropriate orientation, i would look for a new job somewhere else. and be certain to ask about what kind of orientation you will have. get the response in writing, too.

good luck to you. it sounds as though you have the makings of a wonderful, caring and compassionate nurse.

nelligolitely · Jun 19, 2005

Thanks for advice. I don't feel like a wonderful nurse... I had made those errors, and feel like there's so much I don't know. I'm pretty sure facility will put me back on probation, but orientation is over. The way they see it, I had 6-8 wks, and even if I wasn't watched, I should know the system by now. I think I kind-of do and wouldn't gain much more knowledge, just confidence. I don't think any facility can TEACH me that.

Charity, RN, APRN · Jun 19, 2005

You must really love this place to put your license, your career, and most importantly your patients' safety on the line in order to continue working there! Some nurses need to take things more slowly than others. ALL nurses need a proper orientation, and that orientation ends when the nurse is prepared, NOT on some arbitrary date on a schedule.

I worked for a year and a half as an extern on a floor before starting there as an RN. It was a difficult transition. I had been doing everything but passing meds. But the CNAs had not had to help me care for my patients, and they had trouble adjusting to my suddenly being charge nurse the second day I got my license. Sometimes it is better to start fresh in a new place. Always it is better to have a place that orients properly. It is your duty and there is NOTHING WRONG with insisting on a proper orientation.

C

ZASHAGALKA, RN · Jun 19, 2005

Howdy,

You gave the right dose from the wrong blister pack? That's not a med error; it's an accounting error (and one easily fixed the next night by compensating between blister packs). And you gave another narc late?? If you ever get around to working a busy med/surg unit, you'll quickly realize that med pass times more often than not are just 'suggestions'.

It sounds to me like you are trying to talk yourself out of being a nurse. Instead of telling yourself that you can do this, you've been too busy telling yourself that you can't do it. If that's the case, either you must change that, or you will not be a nurse for much longer.

Repeat after me: "I can do this".

When I was first in nursing, I used to overanalyze and overcriticize everything I did. I couldn't sleep thinking, 'did i do this', or 'what will my relief think of me cause i did that'.

Eventually, when I was at my breaking point, I made a deal with myself: At the end of each shift, I would spend a few minutes thinking about my day with each patient. I would analyze the care I gave, the charting I did, and the interventions I made as to whether they were truly patient advocating decisions on my part. AND FINALLY, I would evaluate whether I thought my patients were better or worse after my shift, and if they were worse, what did i do about it. This process usually still takes me about 10 minutes. At that point, I either make the proper phone calls to correct what I evaluate as deficits in my care, or per the prior agreement with myself, I agree to put the shift behind me and not think about it any longer. I'll even admit to, after a few very stressful shifts, purposely limiting my self-evaluation to: 'nobody died or will die as a result of my care today'.

It took some time, but now my time away from work is mine. After my end-of-shift self-evaluation, my work time is no longer allowed to infringe upon my personal time.

You can talk yourself into nursing just as easily as you are now talking yourself out of it. That choice is yours, but make no mistake, IT IS A CHOICE.

Buck up and choose wisely.

~faith,

Timothy.

fulwood · Jun 19, 2005

Nelligolitely, I wanted to thank you for writing your email. Like you I have extremely low self-esteem, have suffered from depression and do not always handle stress well. I am over-cautious as I doubt my own judgment so double check everything! When I lock my house at nite to go to bed I will check 3-4 times that I have locked doors that I know I have already locked! I think for me a lot of it has do to with not having as a young child anyone in my corner giving me positive reinforcement. Unlike you though I am a coward and have never pursed a nursing degree even though I would love to. I love the variety, the sciences, the people and am well-educated on pros and cons of current nursing conditions. But for all of the above reasons I do not pursue nursing as a career.

I KNOW you have what it takes. I agree with all others that your orientation/preceptorship was less than desirable. Take some time for yourself and do not put all blame on yourself for errors made. Perhaps you need to look for another job. I have taken meds before for depresson and it helped me. I am not advocating it but something to consider...There are probably many places that will accept and give you the proper orientaiton that you require. Don't knock yourself - you hve come this far. Take time off and look at your options...Good luck

CritterLover, BSN, RN · Jun 19, 2005

thanks for advice. i don't feel like a wonderful nurse... i had made those errors, and feel like there's so much i don't know. i'm pretty sure facility will put me back on probation, but orientation is over. the way they see it, i had 6-8 wks, and even if i wasn't watched, i should know the system by now. i think i kind-of do and wouldn't gain much more knowledge, just confidence. i don't think any facility can teach me that.

no, no, no!! there should be so much more to new grad orientation than "learning the system."

you do not learn everything you need to know in order to take care of patients in school. that would be impossible. there are many things that you still need to learn once you get out of school. there are so many disease processes out there, that you could not possilby have covered it all in enough detail. in addition, nursing school is very poor at teaching you time-management skills, organizational skills, and skills to deal with family and physicians. how can they possibly teach good time-management skills when a nursing student rarely has more than 2 or 3 patients? and as for being in ltc, when did you do your ltc roatation in school? mine was in the 2nd semester. i hadn't learned enough at that point to do much patient care or to get the "big picture" about what was going on with the patient.

of course you don't feel like a good nurse right now. you received a crappy orientation and were then thrown to the wolves. but even new nurses who receive a good orientation usually take a year or so to feel competent. and i agree with the previous poster, your errors wern't that serious. as far a the ambien belonging to the wrong patient, if it was the right drug and right dose, i wouldn't think twice about it. and as far as the narcotic being given late, while i realize that med administration times are more strictly enforced in ltc than in acute care, sometimes you have to prioritize other things over med administration. so take a big deep breath and let both of those go, ok?

i understand why you want to stay at your current facility. you know the employees and probably are very attached to some of the residents. and it is scary starting someplace new. but really, you need to repeat your orientation, and if they won't let you -- and do it right -- then you need to seriously think about going elsewhere.

nelligolitely · Jun 20, 2005

Part of my reason for staying at this nursing home is because I'm a civil servant. I get free health,dental, and prescriptions, and I pay into a great pension plan. Most people here are "lifers". I know, this breeds mediocrity but I always rose above it.

I admit I'm scared to move on. Being on sick leave now, I'm losing $$$ rapidly. I'm also glad I had carryover sick and vacation days as it is. If I was new somewhere, I wouldn't have these... It's a double-edged safety net!

I am considering moving on. I had an offer from a friend of a friend, to run an Adult Day Care Program. I KNOW school didn't prepare me for this, and I would be the general manager! They said my Alzheimer's Association background, and my RN and Activity Director certification is a great combo for this. The money is actually less but I think I need to bite the bullet and try it. I'll let you know how the interview goes...