peggyon

I don't think Nursing, particularly bedside nursing, is set up to maintain high standards. Many very nice people do cut corners somewhat in order to survive. I 'survived' 38 years but I paid the price for my perfectionism, I did it because I couldn't not do it. For example, some nurses don't get their patients up everyday, nor do they reposition them enough, etc. I could not do that. Re: Case Mgment: I wouldn't send my patients to substandard SNFs even though those facilities may have had the only opening. I would find work-arounds or drive myself nuts to find an alternative. I was constantly bending the truth to management. Many perfectly wonderful colleagues chose not to go that far-they would transfer a patient to the place I wouldn't etc. I am not a better person, I just didn't want that on my conscience. I paid a high price with stress. I never recommend young people go into nursing-there is a reason there is a shortage. So, what I will say to the OP, is Nursing is not set up to give you the support you need to maintain high standards and the majority of nurses will cut corners to survive. I would recommend another field that gives one time to maintain higher standards-and where the stakes aren't has high. Most

I don't think Nursing, particularly bedside nursing, is set up to maintain high standards. Many very nice people do cut corners somewhat in order to survive. I 'survived' 38 years but I paid the price for my perfectionism, I did it because I couldn't not do it. For example, some nurses don't get their patients up everyday, nor do they reposition them enough, etc. I could not do that. Re: Case Mgment: I wouldn't send my patients to substandard SNFs even though those facilities may have had the only opening. I would find work-arounds or drive myself nuts to find an alternative. I was constantly bending the truth to management. Many perfectly wonderful colleagues chose not to go that far-they would transfer a patient to the place I wouldn't etc. I am not a better person, I just didn't want that on my conscience. I paid a high price with stress. I never recommend young people go into nursing-there is a reason there is a shortage. So, what I will say to the OP, is Nursing is not set up to give you the support you need to maintain high standards and the majority of nurses will cut corners to survive. I would recommend another field that gives one time to maintain higher standards-and where the stakes aren't has high. Most

I have been an RN for 38 years and don't think I spent one day in that lengthy career cutting corners. However, it will be exhausting and frustrating for you. Many good RN's drop their standards somewhat, just to survive. My most recent job was as an inpatient Case Manager for a very large, 'not-for-profit', bottom-line oriented institution who often discharged patients prematurely. We had to meet with our managers everyday to justify a patient's level of care or answer as to why they hadn't been discharged yet. To be honest, I learned to bend the truth or out-right lie to keep them off my back. Had to do same with MDs who were trying to obtain Partnership by playing by the rules which were --reduce length of inpatient stay. I don't think I compromised by standards but I worked way too hard in a system that is not set up for decent patient care. I think I would agree with Felix for a different reason. As a Radiology Tech or Physical Therapist you work with one patient at a time. As a nurse you will have few boundaries and be expected to juggle too many competing demands and will work very very hard to maintain your standards. I would seriously suggest you not invest more energy and time into nursing.

Some of these comments are too harsh. This is not your fault and your 'Preceptor' was out of line sitting @ a desk while you needed help. Unfortunately, it is very common for hospitals, LTAC's experienced nurses to treat new grads very poorly. It is the main reason there is a nursing shortage. Try to hang in there so you have a record of employment and as soon as possible, leave.

I would say the only folks who benefit from 'training hard' in an inner city level one Trauma Center are surgical/trauma residents. If they can hang with the gunshot/knife wounds, the rapid bleeding-out, the extreme behavior, the MVA's, the unrelenting trauma and chaos, then they will be ahead of the game when they return to the 'normal' world.

You are not crazy. You are working in the worst environment possible-a public, under-funded hospital with the most challenging patient population. Try to complete one year and then apply to an ER in a private hospital. It will be better funded and the patient population will be less needy. You seem bright and capable-how about adult ICU? ICU nursing will place you on another level clinically. You will work closely with intensivists and other specialists. It can be stressful but it is more controlled than ER. You will not have more than 2 patients. I worked in ICU for 10+ years and was then able to transfer into PACU (my favorite job) and lastly Case Management where my clinical knowledge afforded confidence when I needed to advocate with MDs for patient's needs.

I worked in ICU for 15+ years primarily because the staffing was better. Looking back, I would say my temperament was not suited to the ICU. It is my experience that ICU/ER nurses who are comfortable for the long-run in those environments are wired a bit differently; a bit more like race horses who like "drips, drugs and lines." Some of the procedures are very invasive and need to be accomplished quickly; crash intubation, resuscitation, line insertions, etc. One must be self-confident and knowledgeable talking with Intensivists as well. You need to trust your gut and assessment skills as you are advocating for very ill/fragile patients. My knowledge of pathophysiology increased dramatically and I was very comfortable with the MD's but I struggled with some of the invasive procedures. I also developed a bit of OCD from needing to move quickly without the time to properly double-check, ie., grabbing bags of highly potent drugs or IV's such as dopamine/ lidocaine/norepinephrine etc. I don't discourage RN's from working in ICU, just know it is called Intensive Care for a reason. Secret...Once you have ICU experience you can work in PACU which I LOVED.

Yes, I agree with giving yourself time. You will need @ least one year to be able to show experience. My point is that though you may master hospital nursing, it is not a good fit for many nurses, hence the nursing shortage. Even on good days, it is a stressful gig. Non-hospital jobs are not as plentiful, though the exist. I would not recommend an LTAC as it will be more of the same. (a grind) Clinic jobs appeal to some; home health, hospice, nursing education. I loved working in the PACU (recovery room) but one needs ICU experience. ICU can be very rewarding. Your patient load usually does not exceed 2, you have an Intensivist on site and you will learn incredible assessment skills. There is a learning curve though. Try not to internalize or beat yourself up. Exercise is helpful and try to find people you can confide in.

I just re-read your fear about your 2 year contract. I would talk to an attorney to see if it legally binding. Somehow, I don't think so. You sound like a wonderful person; I'll be thinking about you. I know how you feel. Hospitals can have an authoritarian feel, almost para-military. You will find your way.

My heart goes out to you. I agree with the previous poster to double-check your gut feelings with an experienced RN with a generous heart. You sound very conscientious and please give yourself some room to grow. Even experienced nurses make mistakes. One thing I wish I would have known is that there are many types of positions in nursing and some of them are not as stressful as hospital work.

Bravo Julie! I just cannot understand why nurses across the country do not stand together and unionize. it is not fair for Julie to have to do this alone!! Hospitals cannot operate without nurses. You may have to strike for a period, but the outcome is so worth it. I practice in California and am protected by CNA. They have to seen to it that we are the highest paid nurses in the nation. (Dues are high but it is worth it). Our hospital continue to pull "fast ones" regularly ( usually around staffing) and it is so gratifying to see CNA go after them. Please see your worth.