I'm a new grad who just recently found a job in the east coast. It's in an acute psychiatric facility- my title--- Charge Nurse. The patient ratio here is 20:1. Upon the hiring, they said they will train me for 12 solid days on the unit. I am floating to all units of the hospital. I will be the only nurse on the unit who is responsible for CNA,LVN, all 20 patients who are acutely ill.
During orientation, they suddenly told us they're giving us five training days. =/ and i'm already almost done, i feel 25% competent by day 5. I am learning as fast as I can but in no way or shape, I can do what do in the next two days to be on my own. to make matters worst, you are literally the ONLY RN on the unit, and no other RN.
on weekends, no supervisors are around. no managers, no body. no doctors, no pharmacy. nothing. and my first shift alone, is going to be a weekends.
during orientation, the focus was $$$. you guessed, they are for-profit. Talking nonstop about how much the hospital is making. never once said the nurses are being treated well. Throughout orientation, i heard the words "how you can lose your license" almost 100 times. This is how you can lose your license, and if you do this, you can lose your license.. now if you do this, you can get reported, suspended.
this hospital has a history of firing 30 nurses in the last year- for god knows what reason. nurses are extremely burned out. all sounding like they want to quit and don't know how to manage to survive day by day. Only 1 nurse gave me a smiling face that he is doing fine. Today I got screamed at by one of the nurses who said " i refuse to let u draw up meds" because you've never been trained, and how can you be on your own after 1 day. management got involved, and told her its the new policy to just let the new orientees to "just do it" without training. and it was chaos.
of course all of us orientees went to management and spoke our concerns. they dismissed it and pulled out the schedule sheet. They said you're fine! don't worry! you wont get your license suspended! just be confident! here look, a supervisor is floating around (mind you this supervisor is in charge of the ENTIRE building), and she can just like look over you once in awhile. and if you really need help, just ask another nurse on another unit! they'll help you! =/ permission denied. another unit...??? i dont even know where the medicine bin is! GOODNESS!
the unit is chaos. the hospital is chaos. everyone is in the midst of chaos. the patients are crazier than the next, with kids cutting their wrist bleeding, and hitting the staff. The other, we just did several codes. I'm scared of the patients assaulting me here,, and sadly that's the least of my concerns for now.
i'm stressed out, i'm tired. this is not what i pictured it to be. any advice/ encouragement would be helpful.
i can easily say JUST LEAVE, but jobs are sooooo scarce in this part of the country. Half of my classmates didnt even find jobs yet. and i've waited a year and a half. sadly, i turned down 3 other interviews for this job and 2 wonderful without pay training programs. i regret it so much right now,i thought the real way of getting experience was just to get a job, and do it. no more holding your hands and guiding your, but this reality just too harsh. the sad part is, i am using zero nursing skills. i barely get a good glance at them before i have to start my charting for the day. there is nothing such as therapeutic communication or anything. its about making sure they don't kill themselves while on your care, and make sure you chart like crazy so you "cover your ass".
I know you guys probably is thinking, why did I even agree to this in the first place.
I have chronic back problems. I'm scared that med-surg may not be the right place for me. I am trying hard to finish that one year of "acute hospital" experience without re-straining my back..I thought "toughing" it out was the way to go at first... until first- i learned that most patients are VERY suicidal, and patients are VERY psychotic. the mix of both just give you a very chaotic unit.
I am with family and friends.
the money is the highest paying area in the country.
but i understand, no amount of perks will make this job worthwhile
they just hired in MASSES recently due to recently "firings".
the management is new. everyone is new. i suppose even the management team quit!
the nurses are all 3 months brand new. the oldest nurse is 6 years. and shes about to bounce too
When the house has been cleaned, that doesn't mean new fresh air with sparkles in it and extra oxygen was let in the doors and windows. Mass firings, or quitting of personnel, is a sure sign of a place on the brink of disaster. This is no place for anyone, much less a new grad. Go back to the other possibilities and look for others. Good luck.
I could have written that exact same description for the job I was in fifteen years ago. I mean completely identical story. And yes, I had seriously begun to fear for my license. Chronic low staffing to increase profits permeated every aspect of the organization and compromised safety. Two things tipped the scale for me......
Protocol was this.....once Admitting received authorization to admit they called the nurse on the unit with report and to arrange a time to bring the patient to the unit. One evening I was quite busy managing a very unstable detox and the assistant was keeping an eye on the others. WHen she came out of a room and back to the station she found an older man in a wheelchair in the hallway slumped over and unconscious and began screaming for me. Admitting had come up earlier, didn't see us so just left him and planned to phone the report to me later. So now I had an unconscious man with absolutely no history whatsover. I always stressed to everyone that the first few hours after a patient walks in the door for detox are dangerous as most have swallowed, chewed , drank or smoked any and everything they can get their hands on their way in.
No too long after that I was the only person on the unit with the patients. I was in room with detox patient who became horribly combative and unsafe. I had to call to one of the other patients and instructed him how to go the station and call a code. I will say this, the people did come running as they all knew there were no male staff working the unit and it was male voice calling the code - figured I was getting pummeled. Not too long after, I left clinical nursing. I loved working with the patients but couldn't tolerate the culture.
I promise you, no ammount of training will make it better. It is not a situation that will EVER improve. Get out quickly, as in yesterday. I'm so sorry this happened to you. All my best.
Specializes in Occupational health, Corrections, PACU.
Very good advice from several who mentioned that more training will likely not make a difference. Simply tell them nicely and professionally that you feel that your skills that you have to offer at this time are not a "good fit" for their environment. That way you have not insulted them, and it is a graceful way out. May I offer one piece of advice re: another job? If you are willing to take on this type of job, may I suggest you check out correctional nursing? It is MUCH, MUCH safer! Psych patients have correctional officers with them, anyone dangerous is in cuffs and sometimes leg irons. The rest of the inmates are respectful (usually-not always). You always have back up. Lots of opportunity to use your medical knowledge and nursing training, and you can really, really make a difference. And the best part is...corrections nursing is the best kept secret in the industry-there are ALWAYS jobs available in institutions. If you don't like it after a while, you can always leave. But I promise you, if you are willing to take on a job such as this nightmarish situation, you will find it easier. Hope that helps. Just don't think you HAVE to work in a hospital!
I work in LTC. I've been at the same place almost 9 years, since I was a 19 year old CNA. I decided I wanted to try some other jobs. I worked at a dr's office; didn't really care for it. Then I went to another LTC because it's so hard to get any kind of LPN job in a hospital. One way in was to work LTC for the Catholic Health Care System for 6 months, then transfer. I decided to do that, figuring after so much LTC experience it would be a snap. I work for the leading LTC company in my area. They are truly fantastic. This other place was HORRIBLE. 5 minutes into my "orientation" (which consisted of this woman telling me how much she hated her job and she was telling me I needed to sign stuff the nurses in the shifts before me had forgotten about) and alarm bells were sounding. I decided to tough it out because I really wanted hospital experience. The next night I worked the night shift with someone who hadn't worked nights in 5 years, also hated her job, wouldn't help me with anything and left 2 hours into the shift. There were other things. I was alone halfway through my second night with 50 residents. A lot had bed sores (the nurse the first night told me she didn't bother doing treatments because "the other shifts do it". She also said she didn't see a problem when I noticed half the meds were missing - "days will give them out." There was nowhere for me to sign a narc sheet....on and on. Also a girl I went to LPN school with who had failed out was one of my aides - talk about awkward!!!! On the second night after the nurse left I was alone someone sliced their arm open. I took care of it and was looking for the A & I papers and couldn't find them. The supervisor refused to come to the unit and said she had "faith in me and I could take care of it." I WAS DONE!!!! Toughing it out for those 6 months wasn't worth it to me at all. I felt sorry for the residents and I was terrified I was risking my license. I talked to the RN supervisor at the LTC place I'd worked at for years and she agreed that I needed to quit ASAP so I quit over the phone. They said I had to fax a written statement saying I quit. They didn't even sound surprised, which makes me think that happens frequently. They called me at the beginning of what would have been my next shift because they weren't aware I had quit! The whole place was so disorganized!!!
A couple of months later, there was a huge story in the paper about how badly they had done on their state survey. I'm so glad I left!!!!
Follow your gut. A nurse follows her (or his!) instinct. It's part of the job. Run!!! You WILL find another job. But if you lose your license you are outta luck. Good luck!!!!
I am so sorry this has happened to you as a new nurse and your first job. As others have stated, RUN!! No amount of money or benefits will make up for the stress you are under with this job. You will burn out in a matter of weeks regardless and could possibly lose your license. This place does not care about you and you can bet, if it came right down to it, if anything happened on your watch, they would blame you.
Keep looking out there. I am from the Midwest and nursing positions may be a bit easier to find here but keep looking. Do you have to have a year of med/surg experience? I also have a bad back and I've worked an oncology/med/surg unit for the past 12 years. Have you thought of home nursing or a sub-acute facility? At the hospital I work at, new grad nurses or experienced nurses new to our hospital get THREE MONTHS of precepting. These new nurses cannot be floated to another unit for 6 months after their hire date. Needless to say, morale and job satisfaction is very high. Listen to your instincts. They are screaming at you! Good luck. There is a job out there that is better suited to you.
Like most everyone said you absolutely do need to trust your gut however please make sure your expectations are realistic and you aren't just getting nervous which is very natural as a new grad. I am not saying this is the place for you but keep in mind that many places do not take their new graduates delicately by the hand and offer 6 months worth of orientation! My first job as a new grad was a "sink or swim" for profit psych hospital and although it was a real challenge and continues to be one I still work there part-time and for the most part like my job. The pay is great, my coworkers and the residents incredible, the staffing remains poor at best but we manage to work together to get things done. If for some reason you decide to stay do make friends with your LPNs and techs because they were a tremendous help in my baby nurse days. Good luck with whatever you decide.
I was in your situation very recently. I don't want to say too much, but I was on my own after 3 days. I had a feeling my license was at risk, but I didn't want to be a quitter. Everyone I talked to told me to stick it out. I lasted 5 weeks, and was in the process of lining up another job, when I was suspended, then fired.
Don't worry about lack of other job opportunities right now. Just get out, because not having a job is much better than not having a license! You'll find something.
i said to his face, I feel 30% competent. and i'm on my own this week. He ignored me and looked away.
now the whole nursing building has gone mad. The nurses are fed up because the new hires will have lack of training therefore hindering everyone else's work, risking everyone else' license.
this hospital isnt unionized but the nurses are ALLLL pretty fed up with the situation.
the funny thing was, he used the words, "you're lucky to be hired as a new grad here", and used it as a you should be thankful to have a job, cause I personally gave YOU a chance. i threw in the words, i am concerned for patient safety. he ignored. I said i don't feel ready. he ignored.
guess whats funny, DON is quitting himself, in fact in a couple of weeks. how ironic.
my coworker said today, i look like i can really use an ativan lol
can you guys tell me what is the normal training period for a new nurse at a regular hospital without training programs? what about an experienced nurse going into a completely new field like medsurg? how many weeks do you guys get? any in class orientation?
This depends so much on the facility and the unit. For example, at the hospital I work prn for, med surg orientation is 2 months (or less if new grad feels ready and is bored).
What is most important is that orientation be organized (ex- some type of plan for what skills you should practice/perform, what types of patients you take, ensuring you know policy and documentation, etc) and that your mentor really wants to be a mentor and is not just "stuck" doing it. Also, you will know when you are ready. The hospital should be flexible within reason. For example, if you are bored a week prior to the end of orientation and really want more patients, they should allow that with support. Or, if you know you need an extra week or so, that should be an option, as long as you don't request several more months, lol.
How will you know you are ready? When you're ready, you will still have plenty of nerves, but will know who your resources are and where to go when you have questions. When you're ready, you will feel reasonably comfortable with "the system", for example, what to do if a med doesn't arrive on time from pharmacy, how to order another tray, understand your schedule, etc. Don't expect to feel 100% confident, you often won't for at least a year. But you SHOULD NOT feel what you seem to be feeling now- a gut instinct that this is not a good idea, that your license and your patients will be endangered. I've been doing this for years, and while most things are old hat, it's best to never be complacent. We never know it all, and can never be perfect. Just make it a goal to learn as much as you can and DON'T beat yourself up on the days when you did your best but still don't feel you will ever be that "perfect nurse" you learned about in school. Some day, you can and will be a great nurse, but none of us are perfect. If you hold yourself to that standard, it will make your job harder than necessary.
Also, try hard not to operate out of fear. By this I mean don't let the current economy scare you into taking "just any job." Hard work brought you to this point, and the right job will come in time. You may not start out in the area you love best, but you should feel safe on your unit. A dangerous job isn't worth it. The consequences are too severe.
And no, I don't think anyone looks down on you for taking this job. The more you learned about it, the more you realized things were wrong. It was not an easy thing to find out, I'm sure. Just don't let fear keep you there.
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i threw in the words, i am concerned for patient safety. he ignored. I said i don't feel ready. he ignored.
nurse441
143 Posts
I know you guys probably is thinking, why did I even agree to this in the first place.
I have chronic back problems. I'm scared that med-surg may not be the right place for me. I am trying hard to finish that one year of "acute hospital" experience without re-straining my back..I thought "toughing" it out was the way to go at first... until first- i learned that most patients are VERY suicidal, and patients are VERY psychotic. the mix of both just give you a very chaotic unit.
I am with family and friends.
the money is the highest paying area in the country.
but i understand, no amount of perks will make this job worthwhile