claddagh

Milieu, I can relate to your story on multiple levels. I work in an ER with a high volume of mental health and substance abusing patients. As we know, the two often overlap. Many of these patients bounce between our ER, the psych unit, detox, jail and homelessness. It can be very discouraging for both patients and nurses to try to navigate such a broken system. While I often find myself saying, "If only there were better services for these people," I also continually watch my patients burn any bridge that may be built for them. I mostly shrug it off and accept that there are things that are not in my power to fix, but deep down it breaks my heart to know that many of these patients will be trapped in this cycle until they die. Every week I see the mugshots of multiple former patients of mine. I also see them when the local jail sends them to us as patients. Most of them are convicted of petty crimes. Most come low socioeconomic backgrounds. Most will never have the resources or the opportunities that allow people to achieve recovery from addiction and mental illness. Every week, often several times a week, the ER staff, EMS and the police will spot a mugshot of one of our "frequent fliers" and we'll have a chuckle about their latest antics and joke that it is the jail's "turn" to put up with them. It's easier than crying about the very broken system we work in, a system where our clientele bounce between psychiatric and police custody as matter of routine. Only one mugshot of a former patient has shocked me. Only one mugshot of a patient has ever made my stomach churn. It was the mugshot of a man named "Andrew" who I treated over the winter. Andrew presented to the ER with the complaint of a panic attack. After Andrew had calmed down we began to chat about life after college and its challenges. I could tell Andrew and I were from similar backgrounds. We both came from supportive middle class families where our parents made sure we had great educational opportunities and expected us to go on to successful careers. We were close in age and had several acquaintances in common. After what I thought would just be a few minutes of pleasant and therapeutic small talk, I began to get an uncomfortable feeling in my stomach. I no longer desired to speak to Andrew or even be in the same room as him. He never said anything inappropriate or rude. He was not the slightest bit threatening, but there was just something about the way Andrew presented himself that was strange. Something in my gut told me that this guy was, for lack of a better term, not right in the head. Andrew was discharged shortly afterward. He pleasantly thanked me for my help and went on his way. Several months later I saw his picture on the news. He had stabbed a stranger to death after a brief verbal altercation at a traffic light. My gut feeling was right and it turned out he was more than just a bit "off." I felt a little disgusted and a little angry, but I mostly didn't know what to feel. I wished that odd feeling I'd had during our brief encounter would somehow have turned into an action that would have prevented that horrible crime from happening. Objectively, I know that's impossible. Andrew gave no indication that he had any tendency towards violence. He made a horrible choice because he could not control his anger. He went from just another kid with an anxiety disorder to a murderer. There was absolutely nothing I could have done. I still don't really know how to feel about the whole ordeal. I attribute it to just another thing I'll never understand about life. But it does make wonder. I don't have any helpful advice for dealing with what you're feeling, but I hope you can feel a little better just knowing you're not alone. Nursing is raw and complicated. Sometimes the only comfort I can find when dealing with its many harsh realities is knowing that I've got my team behind me and knowing that even in the darkest and most challenging moments of my job, I'm there to help and I'm a positive force. I feel fortunate to work with people on the fringes of society because it reminds me how blessed and fortunate I am. I try to make a difference in what little way I can. I know haven't stopped a whole lot of bad things from happening, but I have done my best to replace some of the bad with good.

I had the wonderful opportunity during my BSN program to take course at Trinity College during their winter session. For three weeks, my classmates and I learned about nursing in Ireland. We even shadowed at several major Dublin hospitals. It is one of my most treasured memories from nursing school. Things were so different, but still so similar. I was jealous of the amount of clinical hours student nurses received. Since I was not practicing as an RN yet, it is hard to say that we have more autonomy in the US, but I can say that both general nurses, well as nurses in the fields of mental health, intellectual disabilities, midwifery and children's nursing seemed to really know and love what they were doing. Overall, it seemed that nurses in Ireland were really able to focus on their jobs rather than tedious, unnecessary charting and minor complaints from patients, family and management. I did not see that sense of entitlement from patients and families that we deal with constantly in the US. Maybe I was just there on a good day, but it really seemed like nurses were almost always respected as health professionals, rather than providers of narcotics and snacks. The sightseeing and night life in Ireland wasn't too bad either .

53 miles/ 1 hour. I'm a new grad in a bad market; it's a means to an end. Better opportunities will come with time and experience!

Thanks to everyone who shares their experiences on AN! I'm a new grad who starts orientation on Monday and I feel like I've learned almost as much on AN as I did in school. School is of course important for learning basic skills and theory, but AN helped prep me for the real side of nursing. No one in school told us that the job market in NY sucks and that I should expect to have a hard time getting a job. Now I have a job that's low-paying and an hour away, but I am able to accept that this is the reality for new grads. And you what, I'm excited and grateful to be starting at this job. It's not my dream job, I'm not going to put down roots, but it's been great to hear that there are others in the same boat and I'm not some unique sort of failure. I plan to start this job with a positive attitude and use remind myself that every day there is a step towards where I want to be. School gave me an idealistic view of nursing where I thought I would stroll into a great job right after graduation, but AN helped me see that this isn't the case, but not to give up and to keep fighting for my goals because no one else is going to fight for me. Thanks for helping me develop thicker skin!

Thanks for the support! :). Definitely looking forward to getting the last few weeks of school and then NCLEX behind me so I can really focus on the job hunt! If any lurkers have any advice I'd love to hear it, especially if you experienced something similar.

Thanks for your response Willimina! Did your interviewer seem impressed by your outside experience? Obviously, you got hired, but do you think that you might recommend even emphasizing that hiring someone from a non-healthcare background might bring someone with refreshing skills to a team. I don't want to downplay the value of previous healthcare experience, but I think it might be valuable to spin my other skills as something equally important in nursing. I also don't want to come off as desperate to get hired because of my lack of experience, but that might be worth a separate discussion.

Hawkesbe, I dread the question, "tell me about yourself." What does an interviewer like you like to hear in an answer?

Shenanigans- thanks! And I hope you find what you're looking for in a job soon. Amanduh, I have pretty much the same plan of attack! I'm going to move back home for financial reasons, but I plan to apply far and wide in my region. Did you apply for just med/surg or did you try for specialties too? Did you have previous work experience that you played up?

I was secretly hoping all your troubles were caused by living in CA lol. I'm from NY, but outside the city so I may have a better chance (and not from Long Island either). Did employers ever give you any answers as to why you weren't hired or was it more of an issue of just not hearing back from them?

Thanks for responding! Sounds like a long road. You must live in an area in a very saturated market. I'm lucky to live in an area where new grads have an easy enough time getting jobs in an acute care hospital, especially if they are flexible on hospital and position. I just feel like going to school outside of the region and not having my foot in the door anywhere could put impede me getting a job. Do you feel like not doing an externship hurt your prospects or is it just tough getting a job in altogether in your area?

Hi there. I was wondering if anyone has any advice for an almost new grad who has never been an NA or an extern/intern. I did well as a student and I am comfortable in the clinical setting, but each summer I chose to return to my other passions: coaching, swim instruction and lifeguarding. I was wondering if anyone had any tips for spinning these jobs into positive experience in the eyes of a prospective employer. Cheers!

I graduate in 1.5 mos. Your article is great. Hoping to get hired sometime in July and I'm definitely looking for all the advice I can get.