Something Has to Change

Wuzzie · Nov 8, 2019

8 minutes ago, AlmostThere19 said:
If you're a nurse not working in a hospital, could you tell me what your job is like so I can weigh my options? I've never considered anything besides bedside nursing because I always thought that's where I wanted to be.

Most of those types of jobs require a minimum of 1 year at the bedside. There are always outliers of course but as a rule your non-bedside options as a new grad may be limited.

Ella26, BSN, RN · Nov 8, 2019

Hi AlmostThere19,

Sorry you are having a rough go of it!

You're correct about nursing school teaching us nothing. Nursing school teaches us only how to pass NCLEX! Not how to be fully functioning nurses on the floor, that only comes with time...unfortunately....

You have brought up some very real concerns. Hospital management does expect a lot from floor nurses with not much support in return. It’s an awful way to practice. And unfortunately, the patients suffer the most! But, they don’t care! They only care about their satisfaction scores and the bottom line! Oh... and their magnet status!

Anyhow, glad you’re reflecting on where you want to go in the next phase of your career. It’s not easy to admit that your are not cut out for something. But, I commend you!

Now... to answer your question... a little history on my 10 year nursing career...

I started out as a CNA, I strongly disliked it... too hard physically. Not enough time to spend with the residents providing proper care. I once got reprimanded because I was “too thorough” in my care, by that, I took too long washing their face, helping them comb their hair, brushing their dentures, stuff like that. I was late getting them to breakfast all the time because I wanted them to... uh...you know...feel like a real person! The other aides told me they “never” brushed their residents dentures/teeth or did any of that other stuff because it took “too much time”. I was appalled! Management kinda just looked the other way...

My goal was always to be a “clinic nurse”, I never wanted to be a hospital nurse.

I went and got my LPN. Nursing clinical was hard. We did rotations at LTC and hospitals. I did OK in LTC, but in the hospital, I struggled with time management too! Being too thorough and cautious=too dang slow....which was not good!

My first job as an LPN was at an alcohol detox facility. That was intense! It was hard to rehab the patients, they were far too gone in their disease process and they treated our facility like a bed and breakfast. They weren’t interested in getting better. We had many “frequenters“. I did patient intake(going over med, vitals, history) med pass, wound treatments, insulin injections, stuff like that. They were 12hr shifts on weekends. It was a 50 bed unit (40 males/10 females). I did that on-call for a year or so in addition to the clinic job.

The specialty clinic job I worked at was M-F , 8-5pm. I did patient histories, vital signs, giving allergy shots, allergy testing, phone triage, Rx refills, prior authorizations (for meds not covered by insurance), neb treatments, pulmonary function testing, blood draw, injections for asthma and eczema.

I liked the variety of skills, (different than hospital skills, but still skills). The pace was very manageable. I stayed there for 8 years. I climbed the ranks to nursing supervisor after obtaining my RN and then BSN (I worked there full-time while getting my RN and BSN). Don’t ask me how I managed that, those years were a blur! Lol.

Being a supervisor is not my strong suit. It’s against my nature. I’m not assertive or bossy one bit, so although I was supervisor to only 4 LPNs, it became a difficult role in mostly “conflict management” in addition to my other duties. Which became extremely overwhelming! Everyday it was something new to resolve!

Now, presently, I moved out of state. I work at another specialty clinic in Immunology doing the same things as above (even being a BSN nurse). I am not in a leadership role. I have decided, I never want to be again either.

In the future, I would be interested trying other clinic specialties like GI, cardiology, or OB. But, for now, I’m content.

Like others have mentioned it might be harder to come by a clinic job as many do require some hospital experience. Perhaps, you can stick it out for a year and see if that helps your future prospects!

Anyway, sorry so long. Hope this helps.

Good luck!

NightNerd, MSN, RN · Nov 9, 2019

I work outside of the hospital currently, in research. The amount and kind of nursing experience you need varies through different kinds of research, but I know where I am they didn't need a lot at all to be considered. The downside is that you don't practice any skills or critical thinking, and I have found it to be extremely boring and unfulfilling.

Based on the little I've seen in clinicals, clinic and home health nursing may be a little more fast-paced with better variety. However, you also probably won't have as many resources or enough time to learn the skills you are using every day in the hospital. As I understand it, those are jobs where you need to come in somewhat prepared and independent already.

I know it's not what you want to hear, but you may want to strongly consider staying at this job for a little longer. If the thought of staying a full year gives you hives, maybe 10 months would feel a little better - or if not that, at least six months. I can empathize with the issue of the commute, so if there is a hospital closer to home that you are able to work at, that might be a better option.

Chin up! I know it is so discouraging to realize the reality of bedside care. You're right, we often don't have the staff and resources to do everything we want to for our patients, and it doesn't feel good. But the fact that you are there doing everything you can is still meaningful! I think if you stick it out in the hospital a little longer, you will start finding joy and pride in the little things that you are able to do - and realize that they're not so little.

Good luck in whatever you choose to do!

carti, BSN, RN · Nov 9, 2019

private duty nursing. I would also look into psych, but I don't have experience in that so I would wait until a psych nurse would say about new grads joining that area. But PDN has its challenges but I feel like a new grad would like it assuming the agency gives you a normal case.

Horseshoe, BSN, RN · Nov 9, 2019

23 hours ago, AlmostThere19 said:
I'm a new grad 3 months into my orientation on a med/surg floor. I am feeling very discouraged and defeated. I feel like nursing school taught me NOTHING. I don't like that I can't spend the time I want with each individual patient because we are expected to take so many. We seem to always start out with 5 patients, and then it never fails that we're getting an admit right after we get report and are trying to start assessments and meds. I feel like patients in the hospital don't get enough attention due to understaffing, and I'm having a harder time dealing with that than I thought I would. I'm learning that I'm a horrible multitasker that would do better in a slow-paced environment. I also live over an hour away from my job so I spend at least 2 hours driving to and from work. I think I'd cope better working closer to home. I want to explore Nursing Jobs outside the hospital setting, but I'm afraid of it looking bad for me to quit this job before I'm even off orientation (even though I'd give my 2 weeks notice). If you're a nurse not working in a hospital, could you tell me what your job is like so I can weigh my options? I've never considered anything besides bedside nursing because I always thought that's where I wanted to be.

You are a new nurse. Of COURSE you feel like you can't multi task. It takes time to get down time management and everything else that nursing requires. It usually takes one to two years for a nurse to gain the competency that gives them justified confidence in their practice. If a new grad of 3 months told me he was completely comfortable with his expertise, I'd be very very concerned that he was dangerous- because he demonstrated an inability to realize that he has so much to learn before his confidence could be backed up by reality.

My advice is to buck up and stick it out. The first year of nursing is hard for everyone. We can all tell stories of crying on the way to or from work that first year, of getting up with dread every morning before we head off, of feeling that sick feeling in the pit of your stomach as you drive in. There's no getting around it, but it does get better with each month you put in the time and effort to learn.

If I were hiring, I'd see leaving this soon as a red flag...

I think you are too new to nursing to really know that you don't have the ability to handle it.

JMO of course.

7 minutes ago, carti said:
private duty nursing. I would also look into psych, but I don't have experience in that so I would wait until a psych nurse would say about new grads joining that area. But PDN has its challenges but I feel like a new grad would like it assuming the agency gives you a normal case.

Private duty nursing, which requires the nurse to be able to work very independently, seems like a bad idea for someone fresh out of school.

AlmostThere19, BSN, RN · Nov 9, 2019

On 11/8/2019 at 9:28 AM, Wuzzie said:
Most of those types of jobs require a minimum of 1 year at the bedside. There are always outliers of course but as a rule your non-bedside options as a new grad may be limited.

That's very true, I'm definitely going to try my best to stick it out with this job.

AlmostThere19, BSN, RN · Nov 9, 2019

23 hours ago, Ella26 said:
Hi AlmostThere19,
Sorry you are having a rough go of it!
You're correct about nursing school teaching us nothing. Nursing school teaches us only how to pass NCLEX! Not how to be fully functioning nurses on the floor, that only comes with time...unfortunately....
You have brought up some very real concerns. Hospital management does expect a lot from floor nurses with not much support in return. It’s an awful way to practice. And unfortunately, the patients suffer the most! But, they don’t care! They only care about their satisfaction scores and the bottom line! Oh... and their magnet status!
Anyhow, glad you’re reflecting on where you want to go in the next phase of your career. It’s not easy to admit that your are not cut out for something. But, I commend you!
Now... to answer your question... a little history on my 10 year nursing career...
I started out as a CNA, I strongly disliked it... too hard physically. Not enough time to spend with the residents providing proper care. I once got reprimanded because I was “too thorough” in my care, by that, I took too long washing their face, helping them comb their hair, brushing their dentures, stuff like that. I was late getting them to breakfast all the time because I wanted them to... uh...you know...feel like a real person! The other aides told me they “never” brushed their residents dentures/teeth or did any of that other stuff because it took “too much time”. I was appalled! Management kinda just looked the other way...
My goal was always to be a “clinic nurse”, I never wanted to be a hospital nurse.
I went and got my LPN. Nursing clinical was hard. We did rotations at LTC and hospitals. I did OK in LTC, but in the hospital, I struggled with time management too! Being too thorough and cautious=too dang slow....which was not good!
My first job as an LPN was at an alcohol detox facility. That was intense! It was hard to rehab the patients, they were far too gone in their disease process and they treated our facility like a bed and breakfast. They weren’t interested in getting better. We had many “frequenters“. I did patient intake(going over med, vitals, history) med pass, wound treatments, insulin injections, stuff like that. They were 12hr shifts on weekends. It was a 50 bed unit (40 males/10 females). I did that on-call for a year or so in addition to the clinic job.
The specialty clinic job I worked at was M-F , 8-5pm. I did patient histories, vital signs, giving allergy shots, allergy testing, phone triage, Rx refills, prior authorizations (for meds not covered by insurance), neb treatments, pulmonary function testing, blood draw, injections for asthma and eczema.
I liked the variety of skills, (different than hospital skills, but still skills). The pace was very manageable. I stayed there for 8 years. I climbed the ranks to nursing supervisor after obtaining my RN and then BSN (I worked there full-time while getting my RN and BSN). Don’t ask me how I managed that, those years were a blur! Lol.
Being a supervisor is not my strong suit. It’s against my nature. I’m not assertive or bossy one bit, so although I was supervisor to only 4 LPNs, it became a difficult role in mostly “conflict management” in addition to my other duties. Which became extremely overwhelming! Everyday it was something new to resolve!
Now, presently, I moved out of state. I work at another specialty clinic in Immunology doing the same things as above (even being a BSN nurse). I am not in a leadership role. I have decided, I never want to be again either.
In the future, I would be interested trying other clinic specialties like GI, cardiology, or OB. But, for now, I’m content.
Like others have mentioned it might be harder to come by a clinic job as many do require some hospital experience. Perhaps, you can stick it out for a year and see if that helps your future prospects!
Anyway, sorry so long. Hope this helps.
Good luck!

It's definitely sad how many patients nurses are expected to care for. And it sounds like you've had a very interesting and diverse career - thanks for giving me some insight into possible options to look into! I'm going to try my best to stick it out and give this job a chance. I feel bad that I'm taking so long to get the hang of it, but I know that's probably common with new grads.

AlmostThere19, BSN, RN · Nov 9, 2019

2 hours ago, NightNerd said:
I work outside of the hospital currently, in research. The amount and kind of nursing experience you need varies through different kinds of research, but I know where I am they didn't need a lot at all to be considered. The downside is that you don't practice any skills or critical thinking, and I have found it to be extremely boring and unfulfilling.
Based on the little I've seen in clinicals, clinic and home health nursing may be a little more fast-paced with better variety. However, you also probably won't have as many resources or enough time to learn the skills you are using every day in the hospital. As I understand it, those are jobs where you need to come in somewhat prepared and independent already.
I know it's not what you want to hear, but you may want to strongly consider staying at this job for a little longer. If the thought of staying a full year gives you hives, maybe 10 months would feel a little better - or if not that, at least six months. I can empathize with the issue of the commute, so if there is a hospital closer to home that you are able to work at, that might be a better option.
Chin up! I know it is so discouraging to realize the reality of bedside care. You're right, we often don't have the staff and resources to do everything we want to for our patients, and it doesn't feel good. But the fact that you are there doing everything you can is still meaningful! I think if you stick it out in the hospital a little longer, you will start finding joy and pride in the little things that you are able to do - and realize that they're not so little.
Good luck in whatever you choose to do!

Thank you for your advice! Your response is one of many on this thread that has encouraged me to stick it out with this job.

1 hour ago, carti said:
private duty nursing. I would also look into psych, but I don't have experience in that so I would wait until a psych nurse would say about new grads joining that area. But PDN has its challenges but I feel like a new grad would like it assuming the agency gives you a normal case.

That's an option but especially to be on my own I would need more experience than I currently have.

AlmostThere19, BSN, RN · Nov 9, 2019

1 hour ago, Horseshoe said:
You are a new nurse. Of COURSE you feel like you can't multi task. It takes time to get down time management and everything else that nursing requires. It usually takes one to two years for a nurse to gain the competency that gives them justified confidence in their practice. If a new grad of 3 months told me he was completely comfortable with his expertise, I'd be very very concerned that he was dangerous- because he demonstrated an inability to realize that he has so much to learn before his confidence could be backed up by reality.
My advice is to buck up and stick it out. The first year of nursing is hard for everyone. We can all tell stories of crying on the way to or from work that first year, of getting up with dread every morning before we head off, of feeling that sick feeling in the pit of your stomach as you drive in. There's no getting around it, but it does get better with each month you put in the time and effort to learn.
If I were hiring, I'd see leaving this soon as a red flag...
I think you are too new to nursing to really know that you don't have the ability to handle it.
JMO of course.
Private duty nursing, which requires the nurse to be able to work very independently, seems like a bad idea for someone fresh out of school.

Great advice! I want to stick it out and give myself time, I just hope my managers will give me time!

Krks · Nov 10, 2019

Hi... I am a new grad also and I'm into about a month-and-a-half of my orientation on a med-surg floor.. It was not my intended job but it was only one really that called me back for a position.. my goal was women's health and every hospital obviously has their new graduate nurse residency program and all that seem to be open for positions that I was available to apply to was med-surg.. and I remember in nursing school being told that it's good to have at least a year med-surg experience.. but like I said this was not my intended position to start out with..

however because of the hospital I am in that I used to work as a medical assistant years ago, is a great Hospital a magnet hospital and the way their floors are set up specially med-surg you have pods that have 10 patients on each unit.. that makes it so much more less chaotic and better able to handle your patients.. although the ratio is 1 to 5 but these are not critical care patients and less invasive type of treatment they need... I could not ask for a better crew to work with...I will probably stick with this job because it's not too far away and it's a little better than what I thought and it does pay pretty decent.. however with that being said I think all nurses even new grads especially, need to be very selective of where you work or start off with....if you are not happy where you are at then I would not feel bad to put in my notice if you dread getting up and going in.... You can easily get burned out on it just like with any job that you're not happy with and start off on the wrong foot and then feel like you don't want to be in the profession any more...I'm not trying to be negative nor am I the type of person that says give up on something.. but if you are a young grad nurse you have many years of head of you in the nursing profession and if you are able to to look at something different to start out your nursing career then just do it.....I know probably most replies to your comment are saying stick it out and only you know if you're able to stick it out and want to... I feel like as new graduates we need to have a good job start that we don't mind going to enjoy it and we can handle it and therefore have time to learn our nursing skills....

Since you say you have an hour to and from your job that's a negative right there and if you are able to find something closer to home and something that you can better handle and you enjoy just a little bit better than what you're doing now I would say go for it... Life is short and you want to get off on a good foot as a new RN grad....every person and every nurse even a new grad nurse is different and unique and only you know in your heart what you want and what you don't want what you can handle and what you can't handle...

2BS Nurse, BSN · Nov 10, 2019

In response to this post:

"Based on the little I've seen in clinicals, clinic and home health nursing may be a little more fast-paced with better variety. However, you also probably won't have as many resources or enough time to learn the skills you are using every day in the hospital. As I understand it, those are jobs where you need to come in somewhat prepared and independent already."

Clinic jobs may be hard to come by in some areas, but where I live inpatient experience is not required. Your starting salary will be lower, however, the salaries have risen in the past 4 years. You do need to keep yourself up to date in the clinic setting. I've done a lot of self-study. If I don't remember how to do a skill/etc. I go to a reputable YouTube channel to refresh my memory. I never started IVs before the clinic setting and I'm great at placing them now.