Bailey Jones

I have recently graduated with my doctorate and my dissertation is on this very topic. Not only in the U.S., but globally 33% of new nurses quit the profession within the first year because they blame themselves on not being able to be a good nurse. Reasons for quitting their profession mirrored yours in feeling overwhelmed, not prepared to transition to the hospital work environment, not having support by administration, and not having an adequate preceptorship. Specialty areas such as they ER should have a minimum of a 12-week internship. During this time you should also be receiving classroom time for, in your case, ER standing orders, nurse safety, ER medication, and common procedures. You do not say how long your new residency was a a new graduate. I need graduate should not be expected to take the normal patient load of an experienced nurse who has been working 10 years. New nurse should start with one patient and build up their confidence and skill set and work with their preceptor to build up time management and skills to take care of multiple patients and to learn how to critically think and triage the needs of multiple patients. if you did not receive this type and length of an internship, and were expected to care for four patients in the ER, that is unrealistic. This mistake the hospital made would definitely decrease your confidence and make it difficult to work on any unit the changes you to and on any shift. I would look around to other hospitals that follow the American Association of Colleges of Nursing guidelines in Nurse Residency programs. You will have an entirely different experience, and a positive one. Here are hospitals participating in the AACN Nurse Residency program by state https://www.aacnnursing.org/Portals/42/AcademicNursing/NRP/Nurse-Residency-Participants-by-State.pdf I was fortunate and was hired by a hospital that provided a two-year nurse residency program in CVICU. The entire first year I had to work days To become familiar with administration, physicians, new orders, new admits, and all the busy work that does occur on days. My second year was in nights. I now have an appreciation for how busy it was on days and try to get as much as possible done at night to help the nurses on dayshift. Yet I felt more qualified and experienced to be able to handle emergencies with less personnel and staff at 0300 versus 1500. Please do not give up on your dream if it was in ER, there are many factors that you did not share such as how long of an orientation you received, but there are so many new nurses that are unfortunately feeling nursing must not be for them and they cannot provide adaquate and safe nursing care and quit the nursing profession. This is on the hospital’s lack of a standard residency program not you!! Hang in there!!

Since I have been in academic administration for 10 years I have just been doing informal research. Those questions are not the reason they are in nursing school. I am sure there are plenty of people who has a nurse in their family or loved one that suffered through an illness that do not choose to go through nursing school. New graduate retention is a huge problem with 33% quitting the nursing profession within one year of graduation. My research is just trying to figure out the rationale for students going into nursing school and if that makes a difference in staying in the profession. What I found is people that have had a loved one battling an illness or on hospice they have seen the nurse do all different types of care including non-glamorous care. They are well aware of what they are seeking to be a nurse. The same goes for people that have a nurse in the family. My mom tried to talk me out of going into nursing, but people with the nurse in the family tells them the good the bad and the ugly about the profession so they go in as wide open. The student that tells me they are here because they are tired of getting laid off as a computer programmer does it tell me they are prepared to be a compassionate, empathetic, good communicator professional nurse. This is not always the case, but in my research it is true and verified by their PSB entrance exam that has a components to measure compassion and if they will be a good fit for nursing on the vocational aptitude test. In nursing school the faculty have to be in charge or have a significant say in the policies. In our nursing school the student affairs committee pics the students that our admit it based on the spreadsheet with the highest points given to the highest GPA, the Math and reading part of the PSB, and if they repeated any classes. I wish they would luck at potential students more holistically because there are probably a lot of B students that would make an excellent bedside nurse. Hospital send us a survey of new graduates they hire so I know the students who have a job and are doing well versus the students that have a hard time finding a job, was terminated, or a struggling not wanting to do certain parts of nursing. You can’t become a nurse only wanting to do certain parts of the job. I’m saying we need to do a better job in nursing school too cover real life nursing job duties. A nursing school can lose their accreditation if the first time NCLEX-RN pass rate is below 80%. Most schools like to be above 95%. So all there is an emphasis on being successful on the NCLEX-RN, more real world expectations of professional nurse would probably be helpful.

I will accept the fact that a large part of this is their nursing education. My first semester teaching in a clinical setting students were using an automated blood pressure cuff. I cut that out immediately. When they complained I said what if you don’t have one or it’s during a code and the automated BP is not picking up an accurate reading and you have to take it manually. If you do not practice manuals outside the lab you won’t be able to do it in a crisis situation. So my students always took manual blood pressure’s. I also caught them using patient care assistant to do glucose checks, change the sheets, bathing, denture care, etc and I stopped that nonsense immediately. When they complained that nurses don’t do that stuff I laughed. Many times PCA’s are short staffed or the unit may not have any that shift. This semester the students only have two patients at this point, and students need to learn total patient care. If a PCA is not there for a shift does that mean the patient does not get a bath, oral hygiene, or their sheets changed? No it means the nurse needs to pick up the slack. All of my students always thank me at graduation and the floor nurses or more willing to help the students when they saw the work they were doing. The PCAs are more helpful to nurses who help them. They have 10 patients and if a nurse offers to do total patient care on one or two it makes their life easier and they do not get paid near enough. Unfortunately, nursing schools have a faculty shortage and use a lot of adjunct faculty. This means the person has a full-time nursing job and works one day a week for the college to do a 12 hour clinical group. There is a combination of not having the training to be an educator, and just collecting a big paycheck but very few of them demand the same expectations from student nurses. Some students go all the way through nursing school only having adjunct faculty as a clinical instructors. When they get to the real world, they are whining because they are being asked to do some thing they should have done in nursing school but did not. There are some students that just feel that it is beneath them, and I tell these students the first day during orientation a nurse is expected to give total patient care and if they are not ready to be vomited on, clean up diarrhea, and do oral care or the non-glamorous jobs of a nurse they do not need to be in nursing. In summary, I wanted to be a nurse...my mom was a nurse...I felt the calling to be empathetic, compassionate, and provide excellent care. The very first day I always ask the incoming students in orientation how many are in this program because a family member is a nurse and probably 40% of the class raises their hand. Then I ask how many of you are in the nursing school because a loved one battled a chronic illness and you saw the difference a nurse made and want to give back? Again another 40%. That 80% the students are going into nursing for the right reasons. My final question is how many of you are here going through nursing school because it’s a recession proof job and make good money and that is 20% of the class. They do not have the compassion and they lack complete empathy and they are the ones that are complaining constantly. You also have very smart textbook students that are able to get into nursing but have terrible bedside skills and communication skills and that probably makes 10% of new grads. So basically 30% of new grads are not capable of showing compassion and are not capable of putting themselves in the patient’s shoes and treating them with the respect, and have poor to non existent communication skills. When one of my students would call a patient by their first name I would flip out. After we got out of the room I said you will address them by Mr. or Mrs. or their appropriate title unless they specifically ask you to call them by their first name. And do not ever call them sweetie, honey or any pet names. These 30% of new graduates are dangerous because they think they know everything and will not ask for clarification. These are the ones that make huge mistakes and are the ones that have the entitlement attitude.

Please be aware that most colleges want to do everything they can to help students be successful. If you do not want to take Microbiology from this professor, go to the dean and ask to be placed in another class. I know it says the other sections are all full, but the dean has the power to overload the class and it is done quite frequently. All you have to do is make an appointment with a Dean and just tell him that time will not work with your schedule and you really need to take Microbiology on a different day and tell the dean what section you would like to be in, also known as a CRN (course record number). The dean will overload a class to help a student, I always have to help!