Quitting the StaRN program?

Alex Egan, LPN, EMT-B · Nov 8, 2018

A sign on bonus is the company betting you that you won't stay. Seriously.

Have a lawyer look over your employment contract and advise you of your options.

beekee · Nov 8, 2018

Sign on bonuses and contracts like yours are usually bad omens, in my experience. But what's done is done. You can talk to a lawyer to see if there's any way to get out of the contract. But, honestly, most new grads have the same feelings you do. Just browse AN and you'll find post after post about how awful new grads feel.

As for your charge nurse, she or he may be burnt out too. If there are a lot of new grads on your floor, she is getting your questions plus the same number of questions from every other nurse on the floor. It can be exhausting. In other words, she may not be thinking you are an idiot, she just may be drowning herself.

Same with your preceptor. The general rule of thumb is that it takes a year to feel comfortable. Or at least not feel like a complete idiot. So if your preceptor is already precepting at the one year mark, that's got to be pretty overwhelming too.

Chances are, if you go to another hospital, you will experience these same feelings.

The lack of equipment is concerning. Do you not have computers in the room when you are giving meds? That would worry me. I worked at a place that had 2 vitals machines for 30 patients. The nursing assistants would detach a cord from "their" machine and carry it in their pocket so no one else could use it. That was fun when you had a crashing patient and you couldn't get their vitals because the cord was no where to be found.

My advice: stay put for at least six months and reevaluate. Come up with a brain sheet that works for you (ask your coworkers, search in AN). Keep a notebook and write down the answers to questions. After I tell you the phone number for the pharmacy, I better not have to tell you again. But, I will never get annoyed if you ask, "hey, patient has this background, this assessment, and I'm thinking I should do a, b and c because of x, y and z. What do you think?" Don't be afraid to delegate to your nursing assistants, but don't dump on them. Ask your coworkers for tips on how they manage.

Good luck.

JKL33 · Nov 8, 2018

Hi all. I am a new grad on Med Surg Tele in a small town doing the StaRN program at an HCA hospital. I have a 10,000 contract for 2 years. 8000 for the cost of the didactic training, and a 2,000 bonus (which I have no received).

So you're in for $8K as a result of simply having received whatever they deem to be appropriate didactic training.

Under the circumstances (no contract negotiation, no experience with which to judge a job offer, no real promises regarding what you will receive in return other than the privilege of being allowed to show up at their place when they tell you to, etc.) this is a horrible deal. How many people would sign up for it if it were structured so that you had to lay down $8K in cash up front to pay someone to orient you however they see fit? Because that's how it should be looked at.

This is not to criticize you, Goinmyownway, I wrote it because other new grads will surely read your post, and I think someone should tell them this type of deal stinks for the aforementioned reasons; primarily not having enough control over what you are to receive in return for putting yourself on the hook for this kind of money.

I'm not sure your license is on the line; that tends to be the case less than people think. But if you can't provide prudent nursing care to patients, then I wouldn't say you have nothing to worry about. Either way it doesn't make a person feel good/safe.

I agree have a lawyer advise you. In the meantime, stick with the basics of solid patient care. Make sure you are doing your best with the things that you know have to happen for the safe and effective care of patients. Be mindful/conscientious.

Getting cold feet or feeling very unsure and similar emotions involved in big life transitions seem to be very common, but that doesn't mean that unacceptable scenarios don't exist. Still, you can think this through carefully and try to be clear in your mind about what is a problem with the workplace and what is probably more related to the emotions of this life transition. That way you don't do anything rash as a result of the emotions of the situation.

Best wishes ~

EllaBella1, BSN · Nov 8, 2018

I worked for a different hospital system as a new grad, but it was also one that had its shortcomings, especially on certain floors. I myself was on a tough floor, but I stuck it out through my residency. I went home crying regularly for my first month or two, but then I started to get the hang of things and it got way better.

I will say that a few people in my residency cohort did quit within the first few months, and none of them were pursued by the hospital for repayment. Most of them put together a list of safety issues that they saw on the floor they were on and basically told the hospital to shove it, and the hospital backed off. You could always try something like that, but I'm not familiar with how HCA operates when it comes to stuff like that though.

Goinmyownway · Nov 8, 2018

I actually got offered to apply at a better hospital with fairer ratios.

Goinmyownway · Nov 8, 2018

Tele unit with 6:1 instead of MedSurg 7:1 most nights.

Swellz · Nov 8, 2018

I worked at an HCA on a travel contract where they went up to 8; fortunately I was on days so I never had more than 6. I could never understand how the nurses had such positive attitudes, but they did. By the end of it I'd learned that the trick is to focus on the care you are able to give, not the care you want to give. In my region of Florida, I've heard from other nurses that the local HCAs don't even come after the money when people break their contract. That's a gamble you could make, but it's an expensive gamble and you'd never be able to work at one of their facilities again. That might not mean something to you now, but you may live in a region that has a lot of HCA hospitals and it could limit your options.

It's probably hard for you to look at it objectively while you are so stressed. I struggled coming off orientation on what I now appreciate was a really, really good floor in a really, really good hospital. It's a rough transition wherever you start. I'd keep talking to coworkers or colleagues in the area that you trust to gauge how they view the hospital. If you do decide to leave, have a new job offer in hand first.

Sour Lemon · Nov 9, 2018

Tele unit with 6:1 instead of MedSurg 7:1 most nights.

That's not actually any better. Six in tele is a lot.

I started out really rough with a 1:8 ratio and an LVN with 8 patients to cover. I also had to do the LVNs admissions and take report on all 16 patients so I could be blamed if anything went wrong. This was acute care med/surg. It was a very heavy unit.

With those ratios, you learn to work in survival mode ...your own survival and your patients' survival. It's not even about doing a "good" job.

There's a reason why they're hiring new grads and there's a reason why the other place is hiring a new grad who can't even make it through a few months at their first job. These are probably both places that experienced nurses with options would choose not to work.

The grass may not get greener until you have more experience. I can say that I feel very capable of handling most things after surviving two years at my first job. My coworkers worry about things that would never faze me.

AngelKissed857, BSN, RN · Nov 10, 2018

I read about these ratios that y'all throw out the and it's scary. Why aren't all we all-inclusive every state, joining forces to pass safe ratios in every nursing environment across the board? When we work together we have ALL the power.

BZ2SCS · Nov 11, 2018

Hello my dear,

I think I can help you with this one because I went through the same process as a new grad and it was the StarRN program for an HCA hospital in Florida. It was horrible and every day I felt like quitting and yes some days I felt like My license was at risk but I did not quit. I never started a day without praying because that was very important to me. The contract I signed was for the same amount of money as yours and many of the new nurses quit before the two years and they never pursue them for repayment (not even one of them) I remember some people quit after 3 months and did not have to repay. I stayed for one year until I got something better , I did not repay a penny and no one called me for reimbursement. Instead, the director was begging me to stay per diem and I said no. The contract is just to scare you, you don't even need a lawyer to sort this out. I can bet you they are paying you less than other people who were not part of that program and during the training they only pay $15/hour which is very unfair( so that's their reimbursement). As far as the charge nurse don't let her scare you keep asking her questions or find more experience nurses to help you. NEVER do something if you are unsure ALWAYS ask first. The first thing I did when I started as a new nurse, I got a malpractice insurance with the NSO and I still have it. I would say don't quit , try to give it one year or at least six months because it will look good on your resume , don't worry about the contract. Just let me know if you have more questions. Good luck!

BedsideNurse · Nov 11, 2018

I read about these ratios that y'all throw out the and it's scary. Why aren't all we all-inclusive every state, joining forces to pass safe ratios in every nursing environment across the board? When we work together we have ALL the power.

A) Because nurses as a group are a herd of idiots that constantly take the sword for admin instead of looking out for our own profession and ultimately the patients.

Take the nurse ratio law in MA that just failed. The ANA didn't support it, all sorts of nursing organizations rallied against it. The ONLY group that put out anything pro ratio law that I saw was the MNA, and I thought their effort was mediocre at best. We were inundated with ads from the NO camp/hospitals, lobbyist groups, etc...But we saw almost nothing in the way of support for the nurse-patient ratio law on social media, TV, in the mail, etc...I did see craploads of nurses on TV and on flyers and billboards telling me I should vote NO on the ratio law because nurses need to keep their flexibility and rigid government numbers are dangerous. Anyone who works at bedside knows that is complete and utter nonsense.

As I said, the MNA said they supported it, to their credit they did put some effort with a postcard in the mail, and a few commercials right before election day, but actually disgruntled, overworked, overwhelmed, and understaffed nurses are their bread and butter, so it probably behooves them for nurse-patient ratios not to exist. So who knows? At least they pretended to support it.

Most nurses where I work told me they were voting NO. (This just pisses me off so bad I can't even stand it). We had a real opportunity to make a significant change for the good, improving working conditions and improving patient care, and we turn it down. Whatever...Another reason I'll be glad to get out of this profession. Other professions look out for themselves! Not nursing.

As a side note, before the election the hospital higher ups came around threatening the staff that if the ratio law passed the hospital could very well have to close it's doors and we'd be out of a job. Now the ratio law failed, and just the next week on, surprise, looks like we are shutting down after all anyway. So at my hospital nurses voted no so they could keep their jobs, but I guess it's like "J/K." Jokes on us!

Like I said; a herd of idiots.