Removed from Nurse Residency Program-Should I Try Psych?

Nurses New Nurse

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Sadly, I became a member of the club no one wants to join two days ago. "Removed from Nurse Residency Program" club.

I'm an older nurse, graduated from an accelerated (16 mnths) BSN program in December of '17. Took NCLEX and passed on first try in March. Accepted spot in a pilot Nurse Residency program in June. Hospital is Level 1 Trauma unit in a large city. My position was in SICU. I really loved critical care and I was learning in leaps and bounds. Unfortunately, I was told on my eighth day on the floor that my basic nursing skills were not sufficient for the fast pace of an ICU. Shadowed in Stepdown/Tele and was told the same thing. Also told there was nothing available in general med/surg. Oddly, even though I was told there was no place for me within the facility, the ICU director wanted me to work the following day and one day the following week. Went home, thought about it, checked out many threads on this site and decided that it would be best to resign, rather than be terminated.

I was surprised at how supportive the ICU director was at this meeting. She gave some suggestions for new employment and said she will give me a good letter of recommendation. She also had high praise for my energy, personality and leadership abilities. She emphasized that it is my basic skills that are lacking and encouraged me to contact my school to see if I can get some remediation. I knew throughout nursing school that I wasn't getting the experience I needed to solidify my basic skills. I made this clear to many instructors and administrators and always got the same reply: "you'll learn those skills on the floor." Not so. I did much continuing education on my own. I got in 45 minutes before my shift every day in order to read my patient's history and familiarize myself with the (pretty antiquated) charting system, I asked many, many questions, I lived, ate and breathed nursing at home. Nurse Sarah RN became my new best friend. YouTube nursing videos became my only form of entertainment. I wrote education articles on disease processes for future use in new nurse orientation. I acted out processes such as blood draws just to build muscle memory. Unfortunately, this wasn't enough.

All of that to ask this question: I've seen some openings for psych and will apply for them. I entered nursing school originally with the goal of becoming a psych NP, but I wanted to get a year of general nursing experience to solidify my skills before considering that route. If I do get an offer (the facility where I did my psych rotation would probably hire me), should I take it? Some nurses have told me that if I make that jump, I won't be able to reenter general nursing. I loved my psych rotation as a student; most of it just consisted of talking to the patients and I really enjoyed it. However, it looked to me like the nurses mostly passed meds and had very little interaction with the patients.

In the meantime, I am looking into nursing skills refresher courses in order to further my basic skills and definitely plan to see what my school can offer me in the way of remediation. I would really like to try psych nursing, but worried it will lock me into that role permanently if I do it now. Any input would be much appreciated.

I just want you to know that I looked up this thread today, while on my break at work. A coworker saw the headline, and that started a discussion. Thank you for that.

This is the same old psych nurses "are not real nurses" debate that has gone on...forever.

You may have strong nursing skills for the psychiatric population. Apply and see what happens?

Thank you. The fact that you wrote the above makes me think I'm preaching to the choir, but for anyone else out there: if there's a new person on the floor, and you're ordering out for lunch, make sure you include that person. More than once, my coworkers decided to get food delivered, went through long conversations about what to get, called people who had been floated to other floors to get input, and never asked me to join in. I'm a big girl, I can take it. Certainly wasn't going to make or break my experience, but it would have gone a long way toward making me feel welcome if I had been included.

It sounds like you're better off without this place. You'll find something you like better and will be happy this has happened soon enough.

Specializes in PICU.

[ More than once, my coworkers decided to get food delivered, went through long conversations about what to get, called people who had been floated to other floors to get input, and never asked me to join in. I'm a big girl, I can take it. Certainly wasn't going to make or break my experience, but it would have gone a long way toward making me feel welcome if I had been included.

Wow. This is pretty telling. So sorry incidents such as this happened. This situation explains a lot more about what I suspect happened that any "perceived lack of skill" Your preceptor should be helpignyou "socialize" and become adapted to the unit, not made to feel isolated. My guess, it was more on their end than anything you did or said. All RNs were a new grad at some point, fumbled with IVs, skills, etc.

Most new grad programs I know would be more inclusive thatn the behavior your precptor exhibited. Ouch, sorry.

Truly best of luck with Psych.

[ More than once, my coworkers decided to get food delivered, went through long conversations about what to get, called people who had been floated to other floors to get input, and never asked me to join in. I'm a big girl, I can take it. Certainly wasn't going to make or break my experience, but it would have gone a long way toward making me feel welcome if I had been included.

Wow. This is pretty telling. So sorry incidents such as this happened. This situation explains a lot more about what I suspect happened that any "perceived lack of skill" Your preceptor should be helpignyou "socialize" and become adapted to the unit, not made to feel isolated. My guess, it was more on their end than anything you did or said. All RNs were a new grad at some point, fumbled with IVs, skills, etc.

Most new grad programs I know would be more inclusive thatn the behavior your precptor exhibited. Ouch, sorry.

Truly best of luck with Psych.

Thanks! Yeah, I don't get it. Why wouldn't someone want to be inclusive? I always figure I'm meeting a potential new friend. I guess not everyone sees it that way.

Thank you. The fact that you wrote the above makes me think I'm preaching to the choir, but for anyone else out there: if there's a new person on the floor, and you're ordering out for lunch, make sure you include that person. More than once, my coworkers decided to get food delivered, went through long conversations about what to get, called people who had been floated to other floors to get input, and never asked me to join in. I'm a big girl, I can take it. Certainly wasn't going to make or break my experience, but it would have gone a long way toward making me feel welcome if I had been included.

Those are the kind of floors where you get written up for a patient getting bad care on your day off. You're not one of them. If you stayed, your life would have been hell until you were fired. Tons of us, especially a lot of us that work as aides, have been through it. We're not part of the group, but somehow, no matter how great we do, it's never enough for what the unit expects, while the princess party half-asses their entire job, has patient injuries, and you'll never see them get in trouble. But your first mistake, you'll be on your way to being fired.

The problem wasn't you. You were the scapegoat.

Wow. This is pretty telling. So sorry incidents such as this happened. This situation explains a lot more about what I suspect happened that any "perceived lack of skill" Your preceptor should be helpignyou "socialize" and become adapted to the unit, not made to feel isolated. My guess, it was more on their end than anything you did or said. All RNs were a new grad at some point, fumbled with IVs, skills, etc.

Most new grad programs I know would be more inclusive thatn the behavior your precptor exhibited. Ouch, sorry.

Truly best of luck with Psych.

Thanks! Yeah, I don't get it. Why wouldn't someone want to be inclusive? I always figure I'm meeting a potential new friend. I guess not everyone sees it that way.

Let bygones be bygones.

Apply to a psych residency.

Or a great hospital with good training.

Make sure you research the reviews of the hospital.

I have feeling we will get a good update from you.

Good luck, I'm sure your future is bright.

I'm doing private duty. Not for everyone but I like it. Get to do trach vents caths suctioning Hoyer lifts etc on one person so you get good at those at a slower pace. Also you can usually have more flexibility with your schedule, like no holidays.

I left the hospital some 25 years ago, resigned because I figured I was about to be fired. I got into home care and eventually realized psych was my calling. Now I am a Psych NP. I probably couldn't start an IV if my life depended on it, but I have a completely different skill set.

As I recall, we did almost nothing in our clinicals, only observed. Your experience was not unique.

Bed making? You're kidding I hope.

Rejection is direction, as they say.

I left the hospital some 25 years ago, resigned because I figured I was about to be fired. I got into home care and eventually realized psych was my calling. Now I am a Psych NP. I probably couldn't start an IV if my life depended on it, but I have a completely different skill set.

As I recall, we did almost nothing in our clinicals, only observed. Your experience was not unique.

Bed making? You're kidding I hope.

Rejection is direction, as they say.

"Rejection is direction." Never heard that before...but I love it!

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