jennsrn

Hi everyone, I’m an RN of almost 3 years, and all two jobs of mine have consisted of skilled nursing/LTC, and subacute rehabilitation. The hospital setting was never my thing so I don’t have too much regret not taking that step, but I feel as though MAYBE my outlook would be a bit different had I taken that route. I graduated with my Associate’s in 2019, right before Covid hit. I had about maybe 6 months experience (in a SNF/LTC) before Covid took over and it completely burned me out. I think in many ways this has made me a stronger nurse in some senses, and has taught me to be resilient with my learning and gaining experience, however at the same time, I am just so over nursing, particularly bedside nursing. I left my LTC job after a year due to short staffing, feeling stressed and overwhelmed with no support, and feeling like I was working a job that was not beneficial to my growth and learning as a new nurse. I started BSN school online and found a new job (my current job) in 2020. I work as a subacute nurse, working on the floor. It was doable in the beginning, I didn’t feel as though I was completely overwhelmed. Staffing was better and my nurse to patient ratios were much more feasible. Fast forward to a couple of months ago. Our census has gone up tremendously (not even Covid patients), my facility takes anyone and everyone because it’s more $ in their pockets, and the overwhelming stress of taking this on is just too much. I am now lacking motivation, I am now feeling forced to take on a supervisor role on my weekends and a desk position during the week because the facility cannot find anyone else interested in doing it and I am the only nurse qualified to take on the position. I worked my first supervising shift last weekend and felt completely unsupported, stressed and overwhelmed by my bosses and their expectations of everything I needed to get done in 8 hours after the facility received 10 admissions the night prior (and the bosses literally saw nothing wrong with calling nurses on their days off to come in and help). I called out Monday because I was incredibly tired and not feeling well after my weekend, and literally my scheduler was calling me and blowing my phone up with texts at 2pm asking if I could come in 3-11 to help with admissions. After I called out 7-3 because I didn’t feel good?? The boundaries are just not existent and/or maintained and it’s a huge lack of disrespect towards nurses who are treated like robots rather than individuals. I hate to say this, but I’m starting to feel trapped and I don’t want to look bad for just upping and leaving, but I don’t know how much more I can do this. I spend many of my days off dreading the next day. I have anxiety and I just don’t want to feel this way. I don’t know if I should request to change shifts? Maybe step away from 7-3 for a while? I’m now looking for more outpatient jobs. Any advice on what I should look in to? I want something that will keep me involved and busy but not overwhelmed to the point I want to scream or go into the bathroom and have a breakdown. I just received my BSN and I am actively looking but many outpatient jobs I feel are hard to come by. Does anyone have any advice on MDS? Informatics? Case management? I just need to take a step back from bedside. Any advice would be appreciated!

I am a nurse with just about a year and half experience as a working RN. My first position was working LTC/skilled nursing, and I absolutely hated it. I felt I didn't learn much and I was overwhelmed more and more everyday. I left and found a subacute RN position and so far I've been there a little over 6 months. I think it's a good job to get some decent experience, but I still feel like I have not progressed. I still feel as though I lack many critical thinking skills and I have many stupid moments that I look back at and ask myself why I didn't catch that or think of that. I have great support from my nurse managers and DON, but my self-esteem has greatly been affected. I find myself comparing myself to other nurses, and am amazed on how well they are able to catch on to changes in a patient's status and know the steps to take. Doing this makes me feel stupid. There are days I still have crazy anxiety going into work, but then there's days I feel like I can conquer the day and what comes with it. My primary issue that I feel like I'm struggling with is critical thinking. Nursing school does not teach you how to critically think, and I know it sometimes takes longer for some, but as a nurse for a year and a half already, am I just slower, or is this something that will never come to me? I work on a subacute floor, where I can have up to about 16 patients if the unit is filled. I find it incredibly hard to keep eyes on all patients, know patient hx, background, etc. My med passes can sometimes be heavy, then having to deal with wound tx and doctor's orders, I end up feeling extremely overwhelmed at times, where I'm begin to rush to just get everything done. I work 8 hour shifts and I feel myself a lot of the times rushing to get it all time that I forget what the purpose of me being there and why I became a nurse in the first place. I feel as though if I were to work in a setting where the ratio is smaller, I would be able to take the time, learn my patients, and actually work on my nursing skills. Many of the times, I walk into the room, introduce myself, get vitals, do a quick look over, and move on to the next patient. Some of the patients, as sad as it is, I only see a few times in an 8 hour shift. It sometimes leaves me feeling unaccomplished and disappointed. Regarding critical thinking, I had a patient the other day where I walked in and got vitals. I got a BP of 204/80, and an oral temp of 102.5. I rechecked manually and got 190/76. Looking at her diagnosis, she was admitted for septic arthritis, and was being treated with IV ABT. I assessed for pain, gave her her IV ABT, scheduled Coreg, oxycodone for pain, and Tylenol for pain. I figured her BP was raised because she was running a fever and was in severe pain, and after looking at her BP trends, she did usually run on the higher side. But seeing this high number put me in panic mode. I quickly notified my supervisor and told her we should contact the doctor. Granted she was on BP medications, but it was a relatively small dose, so I felt it was right to reach out to the doctor. The supervisor told me to recheck the BP, and temp in two hours before reaching out to the doctor. What is your take on this? I also feel like because I go into panic mode, my first reaction is to call the doctor instead of critically thinking and asking myself why this may be happening. Sometimes I jump at it before looking at PRN orders, or the patient's background and medical hx. I am also scared to make myself look like an incompetent idiot if I were to call the doctor unnecessarily. Thankfully her BP did decrease to the 130s, and her fever did break, but was I overreacting? I am scared to make a mistake, not take initiative, and feel like an idiot. I also still struggle with identifying situations that warrant a doctor's call versus me working through the problem myself. I feel as though I need to just stop, take a breath and critically think problems through. Any advice on this? I need to work on my self-esteem and not be so nervous.

Hi everyone! So I just passed my one year mark of being an RN, and although I feel as though I have made progress, and am getting into the groove of things, I feel like I am still lacking a lot of nurse qualities. My first nine months I worked in a LTC facility caring for up to 30 patients... it was very overwhelming, hard to learn in a setting like this, I received little to no support from colleagues, and it was just overall not a good experience. I left and am currently at a sub-acute rehab facility. I like it there much better, but am still having a lot of doubt and anxiety about my abilities as a nurse. Tomorrow is my first day off orientation, and I will be on my own. I am very comfortable with passing medications, administering treatments, putting in orders, and the basic skills that nurses do. What I have severe/crazy anxiety about is critical thinking, communicating with doctors and NPs, expressing concerns with them, and fearing they will ask me questions and I'll look at them dumbfounded. Don't get me wrong, a lot of the doctors who work at my facility, are very welcoming and easy to approach, but I still get scared. I know that the more I put myself in scary, uncomfortable situations, the faster I will get used to it, and become more confident in doing it. Yes I know people say critical thinking takes time, but I feel as though I should SOMEWHAT feel a bit more comfortable talking to doctors, etc. I am afraid to sound and look like an idiot, and I feel as though I literally know nothing related to nursing. I am so consumed with my busy, daily tasks, that I may easily overlook important things. I am usually able to determine if something is wrong with my patient, but it's the actions after that, that I freeze up with. What is causing the problem? What warrants a call to the doctor? Am I overreacting over something that isn't important? My mind goes into overdrive. This is one of my biggest struggles. I'm hoping as I get more and more experience under my belt, I will become more comfortable, but it's a serious lack of self-esteem that is bringing me down, and doubting my abilities. Some days I tell myself I am not cut out to be a nurse, which makes me even more upset because I know I am capable. Does anyone have any advice for me? People say fake it until you make it, but it's easier said than done!

Newer nurse here. I have about 11 months of nursing experience. For my first 10 months of being a nurse I worked in a skilled nursing facility 4 days a week. I was considered "full time" and received benefits. I got a per diem job working at a LTC facility for extra money in May and have worked about 2 shifts/month there as that's their requirement. It's OK but I'm not entirely crazy about it. There was a sign on bonus which was a plus and it contracted me to work for them for at least 90 days to receive the full amount. (August 6th marks my 90 days). I recently just changed my status from full-time to per diem at my full-time job for a new job at a subacute facility, which I start next week. I felt like the environment for me to learn will be much better, etc. With this company, I am eligible to work the minimum of 3 days/week to receive benefits, which I need. They are paying me very well, so that's not an issue. I'm trying to decide if I should approach my DON in regards to my schedule and ask if I could start out at 3 days/week (8hr shifts), instead of the four we initially discussed, as I do have two other per diem jobs and am currently in school for my next degree. I figured if I work the three days at my full-time job I can work more at my per diems, and give them availability and compensate with the extra money. but I know that no hours are guaranteed at per diem and I could be potentially cut if not needed. It was not my plan to have two per diem jobs, but the company offered and I accepted because I felt bad I was leaving at such a stressful time, I was an employee of 9 years, and they were short-staffed. I'm conflicted whether I should approach the DON at my new job about my schedule change, or if I should stay at the 32 hrs/week we discussed initially and quit one of my per diems? I obviously make more money at my per diem jobs, so staying at 3 days/week at my full-time wouldn't be a concern, but I don't want to make a bad impression with my new boss, nor do I want to hand in a two week notice to a company I have only been working for 90 days and quitting once I receive my bonus (it will make me look like I was only working for the sign on bonus and that's not true). I don't want to burn any bridges, as I would want to keep my options open in the future with any nursing facility. But I feel as if I were to put my notice in, I may be burning some bridges? My family says to wait and see how I like my job before quitting any of my per diems, but I'm not sure what to do.

This is another fear of mine. Leaving my current job to go to another job that's just as bad. It's hard making that decision, because I can be just as miserable at my next job. I also think part of the problem is that I started in a facility that has no new nurses. No new grad residency, no other nurses I can express concerns with, and talk about my feelings with. I was given a very short orientation time and felt I was not properly trained on certain things, which I also think hasn't helped my self-esteem and confidence in my abilities. Management never checks up on me, asks how I am, never gives me feedback on what I'm doing good, bad, or what needs improvement, and it bothers me. Unfortunately there are many companies out there that have corrupt and unorganized management. Thanks for your advice!

Thank you!! I really needed to hear that. I am trying to work on the whole self-confidence issue, especially when speaking with doctors, NPs, etc. I just feel because I am so new, I'll say something stupid or look incompetent. But then I tell myself I rather look stupid than risk a patient's health and/or life, and my license. But I realize I won't be the nurse I aspire to be in month's time. The only thing I can do is keep looking for employment elsewhere, and in the meantime make the best of my current situation. Go into work with a positive attitude, ask questions, and also be open to learning. I think part of my issue is that I started in a SNF that had no "new grad residency", so I was kind of just given a short one month orientation and told to figure it out, so not feeling supported and comfortable in my current environment hasn't helped my anxiety, fear, and incompetency. I have made it 9 months so far though, and I'm sure I have made progress, and I need to give myself at least a little more credit! Thanks for your advice and help!!

I applied at the facility... management there is terrible I'm finding. No call back, no interview. I figure it's because they don't want me working in the same building as my sister even though I was told that's not a legitimate reason not to hire someone. Which is unfortunate because I really think I'd benefit well in a strict subacute setting, where it's similar to a hospital setting, but not as extreme. I'm going back and forth on the hospital setting. I'm not sure if I'll like it, but I can't imagine not TRYING, even if it's only a couple years to get some med/surg experience. My problem is I worry too much about what others say and think. I don't want people looking down on me because I have no hospital experience, or desire to work in a hospital. My overall goal is to find a nice job outpatient, I do have interests in forensics and case management. I did apply to some hospitals in my area, so hopefully I get a call back. In the mean time I'm trying to stick out my current job until the 1 year mark, and look for other sub-acute jobs with better hours. Thanks for your input and advice!!

I am a "recent" new grad, I graduated last May with my associate's degree in nursing and started my first RN job at a SNF. I've been unhappy there almost as long as I've been there (9 months), and it's really starting to affect my thoughts, and feelings regarding my ability to be the nurse I want to be and know I can be. It also is not helping that I am a new, unexperienced nurse in the middle of a pandemic. I didn't necessarily want to start in a SNF, because everyone says the hospital is the best place for a new grad. I was feeling a lot of pressure from my peers about "you need hospital experience, go to the hospital", but this has been a company I've been working for, for a long time (9 years), and they were willing to offer me very good money. They weren't able to offer me a position at their subacute facility which is where I wanted to go, but they transferred me to their LTC/SNF facility, so I decided to take the position because I thought it would be OK. Also, with my associate's degree in my state (NJ), it's almost impossible to land a new grad residency without having a BSN. Spots are highly competitive, unless you already have an "in" in the hospital, like as a CNA/PCT at their hospital. I did put a few applications out for just a regular med-surg position, but so far nothing, and it's really starting to eat at me! I feel as though I am not learning at my current job. I have had some experience with wound vacs, IVs, wounds, trachs, catheters, but I feel as though I am all along to figure it out - no guidance, no encouragement from my coworkers, and I just feel they look at me and see "RN", therefore I should know what to do. I am having a really hard time developing my assessment and critical thinking skills because my nurse:patient ratio is WAY too high (1:29), that I can barely think about WHAT it is I'm doing, and WHY. I have improved on my time management, that I'm proud of, but I am scared to ask questions sometimes, in fear I will look like an idiot, I question what situations warrant me to call the doctor or not to call the doctor, and whenever I have to call the doctor I get so scared because I don't want to say the wrong thing, and don't want to look like an incompetent nurse (even though the doctors are VERY nice). I am completely overwhelmed and it's not getting better. I work 3-11, and it also has made me even more upset and depressed that I barely see friends and family. I struggle with anxiety and self-confidence, something I've been aware of since before starting nursing school, but ever since starting my first job, it's been at an all-time high. I am medicated and speaking with a doctor regarding my anxiety and depression, but I am so completely burnt out and feel like I am never going to make progress as an RN and I feel like I am failing. I am so worried that by the time I get my BSN (I am in school now, and should graduate by September 2021), that no hospital will want me because I have no acute care experience and will no longer be eligible for a residency. But at the same time, I don't even know if the hospital setting is for me, and is somewhere I want to be long-term. Almost all nice outpatient jobs require acute care experience, or just nursing experience in general. Since I do have 9 months experience now, I am in the process of looking for a job elsewhere. I thought maybe a sub-acute/post-acute job may be a good place to start, and the setting will help with my self-confidence. I really do truly believe my problem is my job, NOT nursing. My job is very demanding, and that's also taking a toll on me. Also I tend to compare myself to others, and I hate it. My sister is an RN, with two years of experience, and I feel as though I have an expectation to live up to. I am on vacation this week, and I am still being bothered by my scheduler, asking I can work a 16 hour day in the middle of my vacation, because they have no staff. It made me so upset, that even on my vacation I can't be left alone. My family is really encouraging me look elsewhere and think it will help my mental health and happiness to get out of the toxic environment. Anyone have any advice for a new grad dealing with burnout? I think it's important to work for a facility that really supports and guides their nurses (especially new ones), and I am not receiving it at my current job. I feel as though I am just a body to get the job done. I don't even want to go into work anymore, I am feeling a great disconnect. Any advice for a overwhelmed, sad, burnt out, new RN? Thanks!

I agree. I would go with the Dialysis. I am also a (recent) new grad with only 9 months of experience. I currently work in SNF and although in my area, it pays MUCH more than the hospitals, dialysis clinics, and outpatient settings, I kind of regret not going a different route, especially for my first job. You will get some experience in SNF though. I've had patients with trachs, colostomies, urinary catheters, wound vacs, IVs, wounds, among many other things, but many people say once you take a position in LTC/SNF, it's harder to get away from it if you were to choose to move on. I was also looking into dialysis, it's a great specialty to learn I think. You can work in outpatient clinics, or even go work on a dialysis unit in the hospital. Especially if they are looking to provide extensive training, I would go that route. I don't know your area, but in my area, Davita and Frensenius hire new grads without experience. In fact one of my friends who I graduated nursing school with started in a dialysis clinic about a few months ago, and so far she loves it. But also, many people say you kind of get "pigeon-holed" into the dialysis speciality and limits your nursing opportunities in the future. Maybe start there, and try to get a per diem in the hospital so you can keep up with your med-surg skills? If you don't like it, just move on! Good luck.

I am not an experienced LTC nurse, but I've started my nursing career in LTC in September, so I have about 9 months experience. It's a lot of work, and I'd be lying if I said I didn't go to the bathroom and cry on multiple occasions. The patient load is high, as well as the med pass, but as you get more and more used to it, it becomes repetitive. The facility I work at considers themselves as a "SNF", so we do get some rehab patients from the community, so I have had some experience with wound vacs, IVs, colostomies, catheters, trachs, wound care, etc, but caring for these individuals is tough when you have many others as well. Sometimes I rather go work in an acute care setting and take my 5 acute patients. You would be surprised on how many LTC residents are acutely ill. I'm looking to leave to possibly go to another LTC facility and/or subacute facility, because staffing is an issue, but that is usually how it is in LTC. One nurse to 20-40 patients. No wonder they have a high turnover rate. 9 months in, and I'm already burnt out. You'll realize that many of the residents are on many common meds, like Lasix, Eliquis, Metoprolol, Coumadin, Synthroid, psych meds, Insulin, etc, so you get used to them (like to give metoprolol with a meal). If unsure about a medication, just look it up! I wouldn't be so worried about the meds.

New grad currently working LTC/SNF. I now have 9 months experience. I wouldn't say I dislike LTC, but I would definitely say I hate my job. I'm trying to tell myself that not all LTC's are the same. LTC comes with a lot of stress, especially if you are a new grad like you and I. Time management is key. In the nine months of working, I have greatly improved in this area. My problem is assessing and recognizing when something and/or someone needs intervention, because in LTC you are usually always running around like a chicken without its head, trying to do a million things at once. Patient load is usually very high in LTC, and in some places, usually short-staffed (high turnover rates). Hours are typically 8 hour shifts/5 days a week which can be difficult for family and social life (especially if you work 3-11 like I do). BUT at the same time, if you start out in hospital, most likely 7p-7a will be the shift you work, which I also hear is tough. You do see some acuity in a SNF, so I wouldn't necessarily be worried about losing skills (trachs, foley catheter insertions/removals, colostomies, wound care, gtubes, etc), but like someone mentioned, if you are an RN, get some experience and leave. That's my plan. I'm already burnt out between the constant stress I'm under at work, feeling unappreciated, and receiving no help or guidance. The only good thing that comes out of it is the paycheck. Most LTC's will pay more than the hospital settings (at least in my area), but I'm not that type of nurse and I don't WANT to be that type of nurse that just works for a paycheck. I became a nurse because I want to help people! I do like LTC though, and am currently looking for work elsewhere in this area. I don't think LTC is bad specialty to get into, I think it can be very rewarding. Working for an organized company that has a strong, upper management that supports and guides you can make all the difference. Make sure you are getting an adequate orientation, proper training, and make sure to ask questions, do not be afraid, and ask for help. I got a month of improper training, and basically thrown to the wolves. You just have to weigh the pros and cons, and don't let other people tell you LTC is not "real nursing". I can't even begin to tell you how many people I've come in contact with that say "Oh you're a new RN? Why are you here? Go to the hospital." In a sense I understand, but do what you feel is right, and where you are happy. Try it out, and if you don't like it, put in your time and move on. Good luck!

I am a current "new grad", I started out in LTC/SNF in September, so I only have about 9 months experience. I was debating this same exact question, I was looking to start out in a strictly sub-acute facility, that probably would have provided me better training, and experience, but the pay this LTC/SNF facility was offering was so much more than the sub-acute place, so ultimately I started my career in LTC. It's an OK job, but I am having regrets and anxiety about losing my skills, and never having the opportunity to transfer to a hospital if I want to down the road. People say if you start in LTC, you are "pigeonholed" into this specialty, so this is also why I am worried. It is a lot of work, and from what I hear, COMPLETELY different from other healthcare settings. LTC has its own regulations, etc. I am looking to leave for a variety of reasons (burnt out, no help from management, shift hours). Most LTC's are 8 hour shifts, and if going full time, that's usually 5 days/week, whereas other settings can offer 3 12's, which usually allows for more time to get stuff done. It is stressful. I currently work 3-11 because they cannot offer me 7-3 and I absolutely dread it because I am a morning person and rather get home from work at a decent hour. I have close to no social life, and rarely get to spend time with family. The nurse:patient ratio is also a lot different. Most LTC units have a lot of beds, and it's sometimes only 1 nurse caring for them. It is insane, but at the same time, as you get more and more used to it, you develop a routine. But at the same time, as you develop a routine, you begin to feel more like a babysitter who is just there to pop and administer meds and not like a nurse. Med passes are usually very heavy, except if you work 11-7. As people mentioned, LTC does have a high turnover rate, hence why so many LTC facilities are constantly hiring. It is a lot of stress, between med pass, treatments, doctor's orders, dealing with families, emergences, fall risks, etc. I have only been working 9 months at this current LTC facility, and I'm burnt out and ready to leave. I personally believe that the burn out is not only because of the workload, but because I get no help from upper management, and staffing is an issue. In most places, the pay is much better than what you would get in a hospital (at least in my area), but you really have to weigh the pros and cons.

I have been an RN for about 9 months now, working in a LTC/SNF. I am burnt out! Any area or specialty of nursing is sure to bring stress, especially as a new nurse, but it's to the point where I get extreme anxiety about going into work. I don't like the hours, management is extremely unhelpful, staffing is an issue, and the nurse:patient ratio is just too much. As much as I hate my current job, looking back to September, I see progress in myself. I still have a lot to learn, but time management, especially in LTC, is something that I greatly improved on. What I'm worried about, especially in the setting I am in, is my critical thinking skills, and my basic nursing skills. I am sometimes SO overwhelmed in my patient load that I just feel as though all I'm there for is popping pills, and that important things such as a change in a resident's status is easily overlooked because I am so caught up in everything else. I can't spend any more than a few minutes with my patients, I get no help, guidance/assistance from my supervisors/managers, and it's weighing on me heavily. I do not know if I'm doing a good job, or bad job, I've been given no feedback by my employer and, and I feel as though I am just a body that fills their schedule. I feel like I am a "fake" nurse, who is just there to get the job done. I am a perfectionist, and that's also part of the problem. I know I need to leave, I have been looking elsewhere for employment, but due to COVID-19 it's been a bit difficult. I have some friends who work in hospital settings, and all I hear are horror stories, the stress, the hours, and especially with this virus, it's only gotten worse. I have been considering the hospital setting, but I am very nervous. I know deep down I am capable (I graduated nursing school, passed NCLEX, so I think I am pretty capable), but I struggle with anxiety and fear of doing something wrong, or looking stupid when speaking with a physician, another nurse, patient's family, etc. I know that time will only boost my confidence, as I grow more comfortable in the job, but I am also hesitant about going into the hospital because I already know I will not like night shift, and that's most likely what I'll be given. Many hospitals in my area also require BSN to even be considered, which I am currently in school for. I just recently started a per diem job at another LTC facility, which I can already tell is MUCH better than my current one, and I am hoping maybe a full-time position opens there. But the whole "get the hospital experience" is weighing heavily on me. Even the nurse educator told me I should go into the hospital to get some experience. I just feel like I am being pressured, and that only "real" nurses work in the hospital, which is why I should do it. At the end of the day, I don't know if my hesitancy is caused by me just having no desire to work in a hospital, or because I'm genuinely scared. I did do a preceptorship in the hospital before I graduated nursing school, and I didn't have many feelings about it, because at the end of the day, I had someone to fall back on, and it wasn't all my responsibility. I'm just looking for some advice! I do plan on graduating with my BSN by the end of next year. I honestly don't know what to do. I get paid great at my two current jobs (more than what the hospitals around me are paying), but there are many cons (work hours, poor management, poor guidance/assistance). I am currently looking for another job in LTC, and/or maybe sub-acute, with better hours, where I can use and develop my nursing skills without being in a hospital. Does anyone have any opinions? I am just in fear that if I don't get hospital experience now, I'll never get it, and it will be a missed opportunity.

I think the anxiety and the feeling of being overwhelmed comes not only from the staffing issue but also because I’m taking care of so many people. The unit I work on is a mixture of acute patients (some have trachs, gtubes, catheters), and residents who are just there to live (LTC) and need someone to just administer medications to them. My problem/issue is not acuity. I know med surg is no walk in the park - I have done school clinicals and have witnessed these floors. Like I mentioned no nursing job is easy... but I feel as though LTC is just WAY too much, especially for a brand new nurse who still needs to develop skills. I sometimes feel like I don’t even have time to think because I need to accomplish SO much in an 8 hr period. I also work the floor alone - I do have a supervisor but she rarely will help with orders, labs and won’t touch meds. I have no other nurse that I can work alongside. There’s no teamwork, no communication, no consistency. Acuity is not my problem. I can learn in a fast paced environment and could utilize and build on the skills I learned in nursing school if I had 1/2 the patients I’m taking care of now.

I am a new grad RN (graduated May ‘19) and have been working at my current job as a floor nurse at a LTC/SNF for just about 4 months now. I absolutely hate it! I understand whatever area of nursing I get myself in to it will be stressful. I also understand that the first year of nursing is always the hardest... and to just give it time before I feel more comfortable and confident. But I’m starting to think it’s the job that’s giving me anxiety not being a new nurse overall! I feel very overwhelmed. I’ve been caring for a lot of residents (all on my own, I am the only floor nurse on my unit) my highest census being 27 at the moment. I am not comfortable with taking on that big responsibility... something goes wrong it’s MY license at risk. I also feel as though LTC is not for me. I’ve done all my clinicals in a hospital setting so I feel I could benefit better from either a hospital setting or in a subacute setting. Geriatrics is not my issue, but when I’m the only nurse on the floor with help from only 2 CNA’s, it becomes very overwhelming to the point where I lose patience, I lose compassion and I just want to walk out and never come back. And people tell me once I lose the compassion, it’s nursing burnout. It’s very hard walking into work with a positive attitude but I really just hate my job. I hate the hours as well. The facility is very short handed and I find it very difficult to do my job. Most of my residents have end stage dementia, fall risks. About 95% of them have bed alarms and don’t understand their limitations. I can’t even begin to tell you how many times I’ve had to stop med pass to run down the hallway because there are bed alarms constantly going off. Or when I really need to concentrate while putting in doctor’s orders and I have to babysit my fall risks residents. It’s just too much and I feel like I’m not making progress here. Also all the RNs who work at the facility are supervisors, doing admissions and discharges. And LPNs work on the floor. I have yet to shadow an RN doing those tasks. I feel out of place and I feel taken advantage of. I spoke with the corporate nurse at the company recently and expressed my desire to learn more RN tasks and to transfer to their sub acute facility for more acute care; where I have a smaller ratio, I work with other nurses on the floor. She said I wouldn’t be eligible for transfer until 6 months (March), but in the mean time she will try working on me getting some morning hours and working with the supervisors to learn more of the RN’s job and if I feel like a transfer is better suited for me come March, she'll "work out a transfer". I spoke to her almost 3 weeks ago, and securing morning hours, working alongside an RN has yet to happen. I’m trying to hold out until March, but I can’t depend nor trust the nurse to actually secure me a job there. She could have just been saying that to shut me up. Back in July, before my NCLEX, I applied for their subacute facility. I was told no full time positions were available there at the time. Hence why they transferred me to their LTC/SNF facility. The problem is, is that I worked for this particular company for over 8.5 years, so just walking away is difficult for me. And other facilities in my area are paying NO where near close to what I am currently making at my current job. So leaving would definitely result in a significant pay cut. But I don’t wait to wait around until March to be told there aren’t any positions for me at their sub acute facility, and I'm back at square one. I am starting to feel hopeless, depressed, and unsure of my abilities to handle the tasks of a nurse, and I don't know if I should just start looking now for a job, or stick this out to March if she can really work me out a transfer. She has told me that the company would not want to lose me as an employee, that I have great potential, but I also can't continue working at a facility that makes me feel this way. All in all, this is about what benefits me and my career, not what is best for the company! Any opinions on what I should do? I have started a job search... hospitals, subacute facilities, outpatient centers like a physicians practice. This is just weighing heavily on me. It’s very important to me as a new nurse to make sure I’m comfortable in an environment where I feel like I’m learning and making progress as an RN. Any feedback would be appreciated!