Many, many thanks for all of your thoughtful suggestions and insights.
In answer to the question about clinical rotations, again, my education was woefully inadequate. Technically, the number of required hours was attained, it's what passed as "clinical" hours that is lacking. I think I stated earlier that I only actually went to the hospital three times during my OB rotation. One of those times we were sent home earlier because there was nothing going on. That rotation was supplemented with sim lab hours. In peds, the entire rotation was more like observation since we weren't allowed to pass meds. This was at one of the top hospitals in my area (also in the entire nation.) I was determined to make the most of it, so I attached myself to the preceptors hip and spent much time chasing her down when she disappeared. I was actually very proactive in all of my placements in this regard. At one point, I asked another preceptor if I could observe a procedure. The instructor happened to be there and she yelled at me, saying, "you don't ask her; you ask me." I just apologized and said it wouldn't happen again, when I knew full well it would happen again. There's no way I would have gotten even the small experience I did without being assertive on the floor. One more thing I will say about clinicals. I know that the school needs some kind of metric on which to grade students, but I feel that way too much time is spent on care plans. The time I spent copying information, since I couldn't print anything out, was precious floor time I could have spent honing my skills.
I did voice my concerns when I was still in school, saying that I didn't feel like I knew what I was doing. My instructors told me "oh, those are things you'll learn on the floor." Not sure if I believed them even then.
Regardless of what got me here, I have to press forward with what skills and knowledge (and hopefully, at least a little wisdom) I do have. I'm trying to pursue some ambulatory care positions and considering school nursing. Also wondering if the universe is telling me it's time to pursue my NP. Again, many, many thanks for all of your thoughts. Keep them coming if so inclined.