New RN Questioning Leaving Hospital Setting

[BabyTurtle2k11]

Hello,

I am a new RN (graduated in August, 2020) who completed a StaRN program at an HCA facility. Therefore, I am in a contract that requires me to work full-time for two years or pay back $10,000... I've heard that they go after some people to pay, but don't for others. But I hate my job. I don't use this as an excuse, but I already have anxiety/depression and have previously been on medication for it before becoming an RN. So being a new nurse on top of that doesn't help. I work on a busy med-surg unit. I dread going into work. I cry almost every time before having to go back. I feel this dark cloud over me. I feel so badly about myself and have struggled with low self-esteem for years. I have talked to plenty of nurses and they say this anxiety is normal, but my anxiety and overthinking cripples me. Some anxiety is good, but mine makes me make mistakes and question everything I do. I have another post about making mistakes on here. I made one last night that is a pretty big one. No harm was done to the patient and it was definitely a miscommunication error in a busy area of the hospital in ER holds, but I take full responsibility. I fantasize about having chosen a different career, to be honest. I enjoy helping people, but I don't think that I'm smart enough or can handle stress well to be in this job. I did very well in school, but I'm book smart and think that I just can't access the knowledge like others can. I feel like an idiot. I honestly don't know what to do at this point. I don't know if I should try to stick it out even though I'm miserable or to try a different area of nursing. I'm a thorough thinker. I like to follow steps, know a lot about my patients, tackle things one at a time. But that isn't how nursing is. You have to be able to think quickly and adapt to changes, multitask, etc. I have already taken the steps to getting back on anxiety/depression medications and have looked into counseling. I've been telling myself that if I can handle my mental health, that I will do better. But I'm thinking that hospital nursing is just not for me. I need something that is less stress and slower paced. Any words of wisdom would be helpful at this point. I'm unsure of what to do. All I want to do is cry and hide from the embarrassment I feel for the mistakes I've been making. I'm wondering if nursing altogether is just not for me. 

[BabyTurtle2k11]

@LibraNurse27

Thank you for your reply!!

[AdobeRN]

On 1/7/2021 at 12:49 PM, BabyTurtle2k11 said:

@nursy

The pay isn’t too much of a concern for me as long as it’s decent. I don’t have kids (unless you count dogs) ? So a pay cut wouldn’t be too bad for me. But I haven’t found any school nurse positions online. How did you go about getting your job? Thank you for your reply. 

Look up the local school districts in your area.  Contact HR to see if they need substitute nurses and start there to see if you like it.  Alot of times school nurse jobs are hard to come by - jobs will not be posted and if they are it is not for long.  Our district tends to hire from our sub list before taking outside applications.

I have been a school nurse for over 10 years now, it was the best decision for me - mental, physical and for my family.  Yes when comparing hospital pay to school nurse pay - it will be lower but not by much when you consider the amount of time off.  In the district I work in I am on the teachers pay scale and make decent money for what I do, paid all through the year for 187 day contract, no weekends, holidays, no call, leave my office daily at 3:20pm. 

There are some downsides - the work can be boring some days, see the same kids day by day for the same issues, sometimes get tired of passing out bandaids and icepacks, some parents are hard to deal with etc, but I wouldn't trade my job for another.  

[TheMoonisMyLantern, ADN, LPN, RN]

Word for the wise, HCA is about as widespread as the coronavirus, and working for them is about as much fun as having the coronavirus. They are notorious for operating with just enough nursing staff to avoid getting sued... often. In my area they go through all of their management at all levels about every 2 years, when the new bunch comes in they say "Oh we're going to change everything!" and over the course of 2 years they slowly either quit from frustration or get fired for trying to change things. I will say that in my area they pay very well and the benefits are quite good, it's just the working conditions that are terrible.

Now HCA has the StarRN program that's akin to making a deal with the devil. I would advise trying to stay there at least 1 year, as I've said in other threads, when you work on a hell floor long enough you can tolerate and handle working anywhere afterwards. If it is intolerable though, then I would advise giving med/surg another go at different hospital system, and if that too is intolerable then certainly look at your options outside of the hospital which are plentiful. 

Good luck to you!

[subee, MSN, CRNA]

If the other new grads aren't miserable second guessing themselves all day, then I would guess there is something wrong with THEM.  First year sucks; it just sucks when you are trying to be perfect or not.  I'm not sure you are hirable with so little experience.  Please sign up for some talk therapy - it got me through school:)

[dogmombyday, RN]

Baby Turtle,

First of all, can I just say good job on being brave enough to try out the hospital as a new nurse during this crazy time?! The first year is rough in general but add a pandemic on top of it? Oof. I do not envy you. When I was a new grad, I was in a program that sounds like it was similar to what you are currently a part of. I landed a job in the ICU of this hospital and I was so excited. I signed on for a two year contract and would have to pay $10k back if I left prior to the two year mark. Well, guess what? I left within the first year. And no one said a peep to me about paying anything back. It was explained to me by someone in HR that they couldn’t really uphold the contract, because 1 they had let others go and not made them pay and 2 I had not accepted any money from them...other than my pay checks. Basically, if they had paid it out at the start it as a bonus it would have been different but they couldn’t really enforce it otherwise. That was the best decision I’ve made career wise. The hospital itself was not run particularly well. They went through a buy out right when I started and were already going through another when I left. The director of my department, who had hired me, left. And there were just some very odd things going on there in general. Plus, I had a manager speak to

me in a way that in my 30ish years of life, no one else has ever come close to. Yelling, insulting my character, etc. Now, I realize that despite what my mom thinks, I am not perfect. However, no one should speak that way to others and certainly not in a professional setting...especially because what she accused me of, another manager immediately told her was not accurate and vouched for me. But I digress. I left for a position in an ICU elsewhere. This year, I moved across the country with my family and accepted a position in a very busy unit where we take level 1 traumas and all sorts of other fun things. I say that because I was in a similar position as you are in now. I was scared to leave, both because of the money thing and also because I don’t like failing and it seemed like a failure at the time. But the day I put in my two weeks was one of the best days ever. I’m very happy in my new job now. It’s still ICU but I’ve yet to run into a unit with a culture as horrific as that first one. I have been given new opportunities to learn things I never even considered. That’s the awesome thing with nursing. If one job doesn’t fit, there are certainly others out there! Best of luck finding the right fit for you! Try not to let fear keep you from doing what is best for you!

[CommunityRNBSN, BSN, RN]

I work in a federally-qualified health center. If you go to one of the job sites and type in “community health”, you will see listings in your area. I’ve really enjoyed working here. It is slower paced than most hospital jobs. Also, I have my own little area— by which I mean a cubicle with a desk, computer, phone. As someone with anxiety too, it makes me feel more secure to have a “spot” to do my paperwork, instead of spending the whole shift out in the open, in patient rooms and the nursing station. 

[turtlesRcool]

On 1/10/2021 at 4:41 PM, BabyTurtle2k11 said:

I feel like I'm struggling while others aren't...The mistakes I've made, others haven't made I don't think. And I know I look stupid. 

Other people are struggling.  They aren't broadcasting their mistakes, but that doesn't mean they don't make them.  And I doubt you look stupid.  Just as you are too busy with your own assignment to notice other people's mistakes, they are too busy with their assignments to notice where you mess up. 

If you go into this with the expectation that you will reach a point where you are a flawless nurse, you are setting yourself up for failure. You are a human being, and humans make mistakes. Can you accept that and give yourself grace? Small flaws magnified into great failings are the clutter of the soul.

Ask yourself this: if you knew another nurse made a mistake, would you think s/he is stupid? Or would you think s/he had a heavy assignment and messed up? Can you grant yourself the grace you probably extend to others?

 

I guess I just don't feel like I'm smart enough. I constantly ask myself if I'm qualified to be an RN.  And I know I look stupid. I've also struggled with low self-confidence for years and am trying to work on that. Any suggestions for feeling more confident? 

To start feeling more confident, stop with some of the negative talk. You're psyching yourself out.  I bet you can do 20 things right, and one thing wrong, and you'll obsess over the one wrong thing instead of the twenty perfect ones.  Am I right?  

Start noticing what you do well. Focus on that. Pat yourself on the back for it. At the end of the day, take a minute to think about something you did well.  Did you catch a mistake? Intervene at the right time? Just get through a really concise, efficient provider phone call? How was your dressing change?  Did you establish rapport with a cranky patient or coax a patient with dementia to take her pills?

Then think of what you learned today.  This means there was something that you didn't know or realize when you started. Maybe it was something you knew or you should have known, but now it's really seared into your brain. It might have started as a mistake. If you focus on the mistake itself, it's easy to feel worthless, stupid, etc.  If you focus on what you learned, the mistake becomes an opportunity to grow.  It's not forgetting it or ignoring it, but reframing it.

Example: the other day, the off-going nurse told me the patient's IV was outdated, and she put in a new one, but didn't pull the old one yet.  So like a conscientious nurse, what do I do when I go in and see fluids running through one IV and the other IV saline locked? I pull the saline locked IV, so we're compliant with hospital policy. As I was giving report at the end of my shift, I looked at my brain sheet and realized something: I pulled the wrong IV.  Patient had fluids running through the 5-day-old one, and I pulled the new one. So after my "oh-crap" moment, and feeling like an idiot, I fessed up to the oncoming nurse, and after report went back in and put in a new IV.  Now, I could have felt like an idiot, and left it there, but I didn't.  What I learned: 1) triple check before pulling something (yes, I knew this, but was in a hurry and assumed.)  2)take the time to date your IV on the dressing, not just in the computer (neither of the patient's IVs were dated, so I made sure my new one was. Often the mistakes we make start with something someone else did/didn't do) 3) set the new nurse up for success (I switched the fluids to the new one - and TOLD my replacement exactly what I'd done).  And two more things: 1) the on-coming nurse didn't judge me; he really didn't care b/c the old IV worked 2) I put an IV in a 103-year-old!  I'm usually only so-so at IVs, so I was nearly giddy at getting a nice one in someone so elderly (patient was unresponsive, moving towards comfort measures, and didn't even flinch, so I wasn't hurting her with the insertion.)  I made a mistake, but that doesn't mean I'm a failure.  You will make mistakes, but that doesn't mean you're not qualified to be a nurse. Don't drive yourself crazy holding yourself to impossible standards that no one else is holding you to.

[BabyTurtle2k11]

@turtlesRcool

You’re right with me focusing on the things I do wrong and not acknowledging the things I’ve done right. I’m working on reframing my thoughts. I’m trying to be more positive and am looking into CBT to change the way I think about myself and situations. I’m trying to be more positive. I go back into work tonight and have a three night stretch. I’m trying to not become negative and anxious. Currently at the gym to work off some stress. And thank you for sharing your experience. That helps a ton! I made a small mistake Sunday night, but I caught it. I asked another nurse for help, but I feel comfortable with her and knew she wasn’t judging me. I caught the mistake before it got to the patient. So no harm done. Just was working too fast. I’m trying to work on that. Working slower even when I’m stressed.