Nursing is not what I thought...hate my job...need ur opinion

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Hi, I'm a 36 y/o new nurse. Graduated 12/2008. I work for a major hospital in St. Louis on the telemetry floor. I've been working there since March 09. I am not happy with my job as this is not what I thought nursing to be. I was taught in school to listen to my patients concerns, cultural concerns, and treating the patient as a whole, including mind, body, and spiritual needs. Well, on my floor, it's always so busy that I barely have time to say more than 2 extra sentences to the patient. It's so stressful. They equip us with a cordless phone that is with us everywhere we go. So, either the phones is ringing with doctors, family, or techs on the phone or the patients are on the call lights. There is so much monitoring and I am constantly getting admissions and discharges. Admissions really take a long time. Plus, I am more behind than anyone else because I'm always have so many questions. I feel as if I'm constantly being pulled in 50 different directions and even if I get to work early to get prepared for my patients, I still end up leaving late. Which results me working in 14 hr. shifts, instead of 12. I am always so exhausted and even on off days, I cannot enjoy my off days because it takes me several days to feel energized again. Since I've been working, Ive been so stressed out and I just don't feel like myself anymore. I'm always crabby and never feel like going out and doing anything. I feel so bad because I can tell that my patients need a little extra attention and loving care and I only have time to push meds, change dressings, and run out the room. This is not the way I thought nursing to be. I worked so hard to get through nursing school with the motivation that I would have a job that I love doing. But, I hate it. I feel nauseated every morning when I wake up and get ready to go to work. I want a job that I'm busy, but, not crazy busy, and where I still have time for my patients. I know I can't sit in the patient's room all day and lolly gag, but I wanna at least be in touch with their feelings and needs. I don't want a lazy job, either, where I'm not using many of my skills. A lot of friends of mine suggested working at a nursing home may be better, but, some people say it's the same or worse. Do you think I feel the way about my job because I'm still a new nurse and still trying to find my way...such as time management, and etc. or can you suggest a position that you would think is better suited for me? I welcome your opinion. Thank you.:heartbeat

Specializes in med/surg, telemetry, IV therapy, mgmt.

i remember you posting on the student nurses forums.

i worked on a stepdown (telemetry) unit for many years. i have always been very opposed to new grads working on these kinds of units and i would not have recommended this as a first job for you. i criticize any nurse manager who hires new grads for these units because i feel the manager should know better. they do it because they have an empty spot to fill and they don't care about the welfare of who they get to fill it. and, there you are, dtermineddenise, you filled an empty spot for your unit manager and are now suffering for it. i'm amazed you have lasted this long at it and not mentioned being written up or put on probation. you are probably doing a pretty good job as a nurse, a feather in your cap.

my recommendation for new grads (and i was a supervisor and nurse manager for some time) is to work on a unit that has a lot more routine patients and not this constant turmoil that a telemetry unit has. look at your hospital policy to see exactly when you are able to put in for a transfer to another unit. then start looking (shopping around) at the different medical or surgical units in the facility that you are currently working and approach the unit manager(s) of them and inquire what kind of patients they have, what happens on their unit and ask if they have any open positions. keep things vague because you don't want it to get back to your current nurse manager. when the time comes, immediately approach the unit you want to go to, talk to the unit manager there and tell him or her you would like to transfer there, that telemetry was a mistake and you feel it is way over your head and you need to find another home. you would like them to consider you. have their approval first before you put in the actual transfer request. let the transfer be a surprise to your telemetry manager.

if none of that is feasible then start looking for another hospital job on a medical or surgical unit. do not let your current job or manager know you are job hunting.

going to a nursing home will only guarantee that you will never be able to work in a hospital setting again. acute hospitals do not consider nursing home work experience to be relevant to what is done in the hospital and as a general rule will not hire nurses with nursing home experience to work in acute hospitals.

one thing that some telemetry patients have going for them that may ease your mind a bit is that some of them are too sick to talk--that was my experience. also, over time you learn to multi-task. as you master skills you learn to do multiple things at one time. while doing assessments and a physical skill you are also engaging a patient in some quality listening of their concerns. it is doable, but it takes practice. when i worked on a stepdown (telemetry) the only time i sat down was when i had to do my stint at the ekg monitors. i never passed a room without looking into it and often would ask, "how is everything? is there anything you need?" the trick is to head problems off before they happen. i had one bout of plantar fasciitis as well during my 5 years on the unit. every day when i got home my ankles were killing me.

Specializes in Critical Care, Orthopedics, Hospitalists.

Don't give up on nursing! One of the best things about being a nurse is that there are SOOO many different types of nursing out there. Why don't you try out the PRN pool for a bit so that you can see if there are other areas of hospital nursing that you do enjoy? If that doesn't work out, start looking for nursing jobs outside of the hospital (consultant, case manager, home health, hospice...).

Good luck. :)

Specializes in Cardiac Telemetry, ED.

I think what you're experiencing is a combination of factors. Reality shock is extremely common in new grads, when you take that first job and realize that nursing school did not prepare you for this; being a new nurse, time management is a struggle; telemetry is its own animal, and can be a tough place for a new nurse to start.

Here are my suggestions:

Reality shock: The only cure for this is the tincture of time. You will either adapt, change jobs, or get out of nursing.

Time management: Triage your care. Prioritize the interventions that you MUST accomplish, and if you have time left over, then do things that aren't as critical. The next nurse coming on will gripe/be *****, but too bad. You are new, and it will take time to get your feet on the ground. Every nurse was new at one point in time, and don't let the next nurse's attitude be your problem. It is theirs.

Telemetry: I went into tele as a new grad, and I have no regrets. At two years, I can see that I am an asset to our floor, and have critical thinking skill beyond many of the long time nurses on our unit. I would never make a blanket statement that new grads should not start on tele, but I would agree that *most* new grads probably should not. I was once told by a veteran nurse that "If you can handle (our floor), you can handle anything." This kind of nursing experience can be a lot to handle for a new nurse. Maybe a different, lower acuity unit might be a better place for you.

As far as the therapeutic communication piece, as someone else mentioned, you can squeeze a lot of therapeutic communication into your routine. I do a lot of this while I'm doing my assessments, taking vitals, passing meds, changing dressings, and other interventions. But the fact is that on tele, our job is to move em in and move em out. We turn over rooms quickly, and therapeutic communication is not on the top of the priority list when it comes to our primary purpose within the organization. Giving one patient extra TLC means that another one of my patients will get less. So, if the touchy feely part is what you went into nursing for, then tele may not be where you will find the most job satisfaction. Maybe oncology? That patient population needs a TON of TLC.

one of my best friends said this exact same stuff (as the original post) when she was an RN (BSN). She recently graduation with her MSN and says the patient ratio and time is so much better. She suggested I get my masters as quickly as possible... I know this isn't an option for everyone but just thought I'd mention it...

Specializes in Oncology.

Telemetry units are notoriously difficult. I floated to tele one day from my med/surg unit and was flabbergasted. I had a new-found respect for all you tele nurses :bow: I work in oncology, but really wasn't happy on the inpatient side. I moved to outpatient oncology after two years. I am now extremely happy in the profession, but actually MISS inpatient nursing! Ha...ya just can't win! It WILL get better once you gain the experience and the confidence. Trust me. But tele may not be right for you.

Luvbugg... I did the same thing. I was inpatient oncology for 18 months and now I'm outpatient... and I miss inpatient!

Specializes in ER, TRAUMA, MED-SURG.
hospital nursing sucks, you are over worked like crazy and all your managers care about is if you r getting high customer service ratings and steadily trying to increase the nurse patient ratios and cuting your cna's any chance they get. I have been a nurse for many years and we all run around like chickens with our heads cut off b/c the work load is just too much.

lady is right, hospital nsg just sucks. I've been a nurse for 19 years now, and waited to get the heck out of Dodge until I ended up with serious cardiac disease as well as other health concerns. Woulda shoulda coulda ... I should have gotten out before I did.

I live in Louisiana and where my hubbie who is also an RN works, the ratio is HORRIBLE!!! He is a nsg supervisor, so he isn't on the floor day after day. But where we work, the ratios are -

ICU 1 to 3 or 4

ER 1 to 3 or 4, but up to 5

Tele 1 to 6 at least

Med surg 1 to 12 to 15, and you may be the only RN there and giving all the LPNs IVPs

The med surg staffing is enough to give you a stroke!

Anne

I just wished that all the states can pass the legislation to mandate the nurse patient ratio. I'm glad that I'm now working in California and the nurse patient ratio for ICU is 1:2, telemetry 1:4, Med Surg, 1:5. We should all collaborate and sign a petition to the legislation.

All these years I thought there was something wrong with me when I couldn't handle a med/tele/PCU unit with a day ratio of 1:8 (yes, eight), admits/discharges all day long - it wasn't unusual to have to chart on 12 pts! I was a new grad with the orientation method of "throw them to the wolves" - a little bit of classroom, then put them on the floor with one "preceptor" for all four new grads who was occasionally available, but the basic training method was "increase their pt load weekly". Need I add that it nearly did me in? I lasted 11 months out of sheer desperation (needed a job)....

Twelve hour shifts, no breaks (except I always took a 30 minute lunch or I couldn't have made it); no IV team; trachs; drips to be monitored, calculated, sometimes mixed (heparin, Cardizem, Dopamine, etc.), direct admits, tube feedings, codes... 12 hours turned into 14, 15, 16 and on a really bad day (did I mention the drunk agency tech who told my black pts I was a racist? Because I had dared to ask her politely to do her job?) even 17 hours as I rarely had time to do any (computer) charting except for brief notes during my shift. It was pure insanity, even the conscientious seasoned nurses stayed over for hours. 1:8 - this was 1999 - they were insane!!!

With reasonable ratios (1:4 sounds about right) and a decent orientation with a real preceptor/mentor new grads could probably do well on a tele floor. But not in such a nuthouse!!!

Just my :twocents:

DeLana

Specializes in Neuroscience/Neuro-surgery/Med-Surgical/.

One of the posters had a great idea of shadowing on another unit to get an idea of your interest. Medical-surgical is the ideal place to start for new grads, and you would be surprised at how many of the other speciality units have consistent med-surg overflow. This too would be beneficial.

I'm in awe of how much has changed for new grads orientation; 8 years ago, my first RN job required 3 months of orientation which included class time and on floor time; we worked 8 hour shifts, 5 days a week. We also had to work all 3 shifts on the floor to get experience of the differences.

Now a days, the new grads at our hospital are lucky to have 6 weeks, with the first 2 weeks being in class, and the next 4 weeks on the floor. In my opinion this just isn't enough when they only work 12 hour shifts, 3 days a week.

Specializes in ER, TRAUMA, MED-SURG.
I just wished that all the states can pass the legislation to mandate the nurse patient ratio. I'm glad that I'm now working in California and the nurse patient ratio for ICU is 1:2, telemetry 1:4, Med Surg, 1:5. We should all collaborate and sign a petition to the legislation.

I agree, Diaper!!! And our old nurse manager would walk through the station, call lights going crazy, staff running around like chickens, and ... just keep on walking. And, don't dare make the comment that you don't have time for something.(to another staff, not to the patient.)

It's a shame when the almighty buck is more important than patient safety, ect...

Anne, RNC

Sometimes I think nurses get blinders on and believe that if they don't work in a hospital, they are not a "real nurse" or something. Open yourself up to options other than the usual. I know that it's a goofy piece of baloney to tell people to think outside of the box, but do it. I found myself unhappy working for, quite frankly, people who are a lot dumber than I am! Now I am an entreprenuer, running my own business, (consulting and training) and am very satisfied with my new nursing career. Think of Hospice, home care, school nurse, office nurse, working for attorneys, pharmacies,etc. Don't give up and don;t beat yourself up, you just have to find your groove.

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