newgradRN001

My preceptor is one of my floors absolute best nurses. He has been on our unit for over ten years. My preceptor told me about how when he was done with his new grad orientation he was a disaster. He would shake like a leaf d/t anxiety, was always behind, and frequently had to have other nurses step in to help with his patient load. He went back onto orientation to get the extra time and help he needed. He was never given up on, he was never "forced to resign," no one made him feel stupid, lazy, or inadequate. No one mentioned that he wasn't cut out for the ICU. He got the support that he needed and eventually thrived in the ICU. Having a new grad be forced to resign should be a rare occurrence not the epidemic that it is these days with the hospitals that act as if they don't have the time, money, or staff to properly give new grads in these facilities a chance. Its incredibly disheartening.

I'm a new grad in an ICU setting and while its been stressful and tough I absolutely love it and have done fairly well with a ton of support and lots of training. So I disagree with posters that say new grads don't belong in ED or ICU's. You have to get a job in a hospital willing to put the time and commitment into training new grads in these high-acquity environments. So many hospitals these days have taken cuts, are desperate for the nurses to be on par as quickly as possible and so they'll give new grads an unrealistic amount of time to get their poop in a group and if they're not they just let them go or "force resign" them which seems to be quite an epidemic right now.

Which unit seems like you'll get the most support from? Which unit has the nurse manager that you meshed well with? Was there a unit where the nurses seemed particularly happy and helpful? What is your gut telling you? With these type of decisions the gut is always a good one to go with. Also, do you know the turnover on these floors? A floor with high turnover can be a red flag. You have to decide this one for yourself but asking yourself these questions can help with making a decision. Congratulations and good luck to you.

I would love to get the report sheet as well. Do you mind emailing it to me? Thanks so much!

GO to UH Manoa!!!! It has some minor headaches as well but its a great school. I cannot stress this enough...GO TO UH Manoa!! Good luck and congratulations!

Move!!!-that is my biggest and best suggestion. I moved from San Francisco to Idaho. Not my ideal spot at first but let me tell you I found an amazing job, in an amazing hospital, and I've never been happier. It was the best decision I ever made. Plus I can move back to San Fran anytime I want now. I just looked and UCSF has 5 openings in my specialty all of which I now qualify for since I went and got experience instead of sitting around and waiting in SF for a new grad job to open up, not that I want to move because I love where I work. Some people can't move-they have families and other difficult situations. But if you can move-when you have hospitals paying for your relocation and hiring lots of new grads in specialty areas no less-how can you not move? I don't understand the people that just refuse to leave the bay area. Good luck in SF...

That is so heart-breaking. I had this happen to a girlfriend that got a job in an LA-area hospital so it can happen anywhere. About the legality of what they did-unfortunately with new grads because we are entering training/orienting positions its not the same as offered experienced nurses. They have us sign contracts that say that anytime in the first 60, 90, or 120 days they can fire us for any reason with no recourse or they can dissolve the training program. I held my breath hard for those 120 days. So they can dissolve the program at anytime or fire you at anytime with no explanation or no recourse basically. It makes life as a new grad incredibly distressing. You're pinning all your hopes, dreams, and saving on the fact that your new grad program will remain solvent in the recession and that you won't be let go. If it makes you feel any better we are all in it together and we are all feeling the stress and pain of this. The best I can do is say how incredibly sorry I am. This was certainly undeserved and just incredibly short-sided of that hospital. I am impressed with your fortitude and willingness to go anywhere for that all important first job. I moved away, thousands of miles away, and spent a lot of money to move for my first job and I was incredibly lucky, it worked out. And I think it could work for you to. I hope that an even better job comes your way. You certainly deserve it. (Feel free to send me a private message and I will let you in on where I work. Extremely new grad friendly, the program isn't going anywhere anytime soon, and my unit alone hired 8 new grads for the summer so they are definitely hiring, and they give you money for relocation and pay for moving expenses, but they do fire within those first 120 days if you're not a good fit, we lost one that way). I wish you all the luck in the world and hope that you can put this awful experience behind you and mov eon the bigger and better things!!!

We had a 23 weeker on our unit and an MD prescribed two rounds of Indomethacin as a prophylais for IVH for this kiddo. I read the research that was done in 1988 and I wasn't completely convinced by the research article on the validity of Indocin as prophylaxis for IVH. I certainly did not feel that is showed enough evidence to base clinical practice on. Of course the kid that got the multiple rounds of Indocin perfed, but I have to say, hasn't had IVH. Does anyone else use Indomethacin on their unit as prophylaxis for IVH? Does anyone know of more research or has a more solid understanding of why Indocin should be used a prophylaxis for IVH? The research article did mention that Indocin causes reduced blood flow to the brain, there-by reducing pressures and decreasing risk and incidence of IVH. But at what cost and really how effectively? Effectively enough to risk perfing? Thoughts????

Its really really hard in Hawaii to get a job as a new grad. Its become a basically who do you know game. I suggest getting a home health RN job. I know Wilson Home Health is good for new grads. Then keep applying for jobs, RN and otherwise (CNA, patient care coordinators, etc) at your top choice hospitals and see if you can get your foot in the door. I know some people who got jobs at Kap and Kaiser after working for 6-9 months as as CNA. I worked at Queens for a year as a CNA and had friends on the floor who has worked for a year as a CNA with their RN license and still didn't have a job as an RN on the horizon so I think Queen's is pretty near impossible. I know one new grad that got a job at Tripler after volunteering on a peds floor. Also volunteer at some of the medical non-profits in town. I made some great connections doing so. I opted to move to the mainland for my first acute care job but if that's not an option hopefully the above suggestions might help. Good luck!

I am 4 weeks in, starting on my 5th week of my first nursing job in an icu unit and I am definitely having problems with anxiety. I feel the acute responsibility I have to my patients, aware of the multitudes of areas I can mess up that has severe consequences. On top of that, I still feel like I'm learning where things are, who people are, what is expected of me, while acquiring and honing my skills. I get overwhelmed easily. I get frustrated with myself easily because I feel like I have such a short time to get my act together, because I want so badly to be a good nurse, and because I want to show my preceptor and educators that I can do this and do it well. But my anxiety and frustration has led to some bad shifts and a very tense conversation with my preceptor. I can't believe that we're expected to not have high levels of anxiety for at least the first year. I've had a number of nurses tell me, don't worry it takes one to two years to really get your feet under you as a nurse and then on the same day by the same nurse I am asked why I was so nervous or so frustrated. They also scared the bejesus out of us in nursing school where I was hyper aware of everthing I was doing during clinical so afraid that I was going to make one mistake and get kicked out. I still can't shake that feeling that I am one mistake from either being fired or hurting a patient or worse, both. Its nice to come to this page and see that others are experiencing this. I hope these feelings go away soon and that I hit my stride because I know it is negatively affecting my performance and making my orientation a lot more difficult than it probably has to be. I keep telling myself during my shift, chill out, put the alarms out of your mind and just go through the steps, its ok you've got this...Hopefully this is just a phase for us all that will soon pass.

I got an interview with a hospital in Colorado Springs fairly quickly so I would check out the hospitals in that area and apply, even when it says experience preferred. Also Texas definitely has availability. Just be sure that you adequately explain that you are willing and happy to move. My advice is to apply, apply, apply. I wish you the best!

P.S. one really important thing I had to learn was don't take everything so personally. She is not attacking you personally. Don't get defensive. Think of it as a boot camp where you are willing to do anything to be the best nurse possible and she is your drill sargeant who is going to pick you apart at every chance she gets because in the long run she knows that it will make you a better nurse. If she doesn't think you're ready it doesn't mean that you don't have the potential to be an awesome nurse. It means that your unit is especially challenging for new grads and you need some extra support and guidance before you are cut looose to the very stressful and challenging situation of being on your own. Start each day as a challenge-saying I will not let her find anything wrong with my charting...and someday you will...

A step-down ICU med/surg unit has got to be one of the hardest places for a new grad to start. So first off, bravo for jumping into the deep end of the pool and just realize that its going to take awhile before you feel totally comfortable. A 6 week orientation sounds way too short to me so if I were you I would welcome some extra orientation time. Even though your preceptor isn't very supportive I'd rather have someone to lean back on and mandated to be available to my questions than to be off-orientation in a sink-or-swim situation. It sucks that your preceptor isn't able to give you accolades along with constructive criticism but having someone so hard on you right off the bat will probably only make you a better nurse later on. The poster above is right. Nurses are anal for a reason-the little things matter and blowing off the not dotting the i's and crossing the t's is a sign that maybe you aren't ready just yet. If an experienced nurse is telling you you aren't doing something right don't blow it off as she's being too critical: write-it down, remind yourself of it, and be sure to have it covered with every patient so that you are building good habits and covering your bases. As you get experienced later down the line you have the clinical knowledge and experience to know how safely to cut corners but as a new grad its just bad habits and does not reflect well on you (we all go through this just make a habit of keeping on your toes of not making the same oversights every time, showing that your making this effort goes a long way). All new grads hope and dream of having the perfect preceptor that guides us through the horrendous first year or two of nursing with compliments and constructive criticism but most of us just don't get this. I'd rather have a preceptor who is a hard ass than someone who doesn't care and isn't giving me any feedback or who gives me way too much rope (in which to hang myself). I think what you are going through is just realizing how hard the first year is (esp. in med/surg). I am so sorry its not going better for you. Keep your head up and just keep showing up. It should get better. Also extend your orientation time and ask for a different preceptor if you think it will help. Good luck to you. You are not alone in feeling this way!

I worked as a home health RN while filling out as many applications as possible for positions all over the country and...whamo two months later I had a job. I had to move cross country...but it was so worth it! So my piece of advice is...TO MOVE!!! Trying to get a job in one geographical area-especially if it's a very slammed area such as Cali, Portland, Seattle, NYC, Boston, Philly, Miami, Chicago-is incredibly tough and so limiting. If you want a job and STAT then adopt the attitude I will move anywhere for the right job. Worked for me and I hope it works for you. Good luck!

The Bay Area is ridiculously tough right now but still send out your applications to those medical centers hiring new grads-UCSF, Oakland Children's (if peds) , Stanford, SF VA, UC Davis, etc. Other areas in Cali hire from time to time-UCLA hires a big new grad class, Loma Linda, Cedars, Fresno hospitals hire new grads. Portland is tighter than the bay area right now so I don't know who told you that but I think that's one of the hardest markets to get a job in at the moment. Texas is indeed a good place to look, there's also some availability in places like North Carolina, Colorado, Idaho, Upstate NY, at times DC. The trick is to have good timing. Stalk the hospital websites of these areas. Know the minute they open up their new grad applications and submit asap. Make sure in essays and in cover letter you are stating that you are willing and happy to relocate and stay at least 2 years. Make sure you are tailoring your resume and application to each medical center and each specialty. I think being willing to relocate (especially if you are living in the Bay AREA) is key to finding a job right now. I relocated for mine and it was the best decision I ever made while all my other friends are holding out in their hometown jobless.