Something Has to Change

Published

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.

The problem as many have highlighted is that you need atleast a year to move away from bedside nursing. I'm not even sure that bedside nursing is for me but I know I'm going to have to stick it out for a year before being able to move on.

2
Up Vote Up Vote ×

I'm tired of hearing "a new grad shouldn't be working in the ER", "a new grad shouldn't be working in the ICU", "a new grad shouldn't be working in the clinic", "A new grad shouldn't be working in urgent care". The fact is... they are! Rather than judging, we need to figure out how to provide adequate training and work on retaining new grads! It's sad that they are holding on and counting down the days only 2 months into their first jobs!

4
Up Vote Up Vote ×
1 hour ago, 2BS Nurse said:

I'm tired of hearing "a new grad shouldn't be working in the ER", "a new grad shouldn't be working in the ICU", "a new grad shouldn't be working in the clinic", "A new grad shouldn't be working in urgent care". The fact is... they are! Rather than judging, we need to figure out how to provide adequate training and work on retaining new grads! It's sad that they are holding on and counting down the days only 2 months into their first jobs!

So true! I've applied to an ER position very close to my house. I want to have a backup plan incase they do let me go at my current job. The worst they can do is say no.

1
Up Vote Up Vote ×
On 11/9/2019 at 9:21 AM, Horseshoe said:

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.

I'm a new grad working in PDN. Like I said, it honestly depends on the cases you get. My agency is really supportive towards new grads and I currently have a (relatively) easy case. I have my reasons as to why I don't want to work at a hospital, but if OP is looking for a nonstressful environment, then there is definitely PDN cases that feel like glorified babysitting. (just don't do trach/vent)

Up Vote Up Vote ×

I'm also a new grad three months into orientation. Are you working days or nights? I've found that once I transitioned from days to nights after orienting on days for two months, I am able to time manage better. The perfect time to reflect, learn, read doctor's notes, etc is in the middle of the night when everyone is asleep/have less meds to give.

2
Up Vote Up Vote ×
24 minutes ago, lex06 said:

I'm also a new grad three months into orientation. Are you working days or nights? I've found that once I transitioned from days to nights after orienting on days for two months, I am able to time manage better. The perfect time to reflect, learn, read doctor's notes, etc is in the middle of the night when everyone is asleep/have less meds to give.

I'm on nights and still having trouble with time management ? I do fine once things slow down, but it's the beginning of the shift when I'm having to do assessments and meds as well as taking admits all at the same time that gets me.

1
Up Vote Up Vote ×

I will be on nights....hoping I have just 2 more weeks of days orienting ?..I am not a day person and 12 hrs are an adjustment...especially at 57!..time management is not too much of a problem for me right now as I have been in nursing as an LPN for 15 years..... it's just been a while since I've been on the clinical floor.. but it has not been too bad of an adjustment it's just the 12 hours..... My greatest focus and concern is obviously addjusting to the role of the RN and being able to spot and know signs and symptoms of various disease processes and interventions for that.. As well as knowing procedure and protocol for admissions and obviously getting used to the EMR my hospital has..it is not very visually appealing and a little difficult for me but I'll get a handle on it.... My goal is to be a case manager or patient care coordinator by two years time frame?... Best of luck in your nursing career!

2
Up Vote Up Vote ×
Specializes in Emergency.

"Time Management" is trying to complete all tasks, care, documentation, call lights, AND make the patient feel like a cared for human being. I don't think it's truly possible in the modern inpatient setting.

1
Up Vote Up Vote ×
3 hours ago, AlmostThere19 said:

I'm on nights and still having trouble with time management ? I do fine once things slow down, but it's the beginning of the shift when I'm having to do assessments and meds as well as taking admits all at the same time that gets me.

I struggle with the beginning of the shift too! I feel like I'm drowning until 11 PM but I'm working on finding the right routine for me. I've noticed everyone starts their shifts differently. Some people do a few assessments while waiting for the time to give 9 PM meds then do some assessments and pass meds then circle back. Some people do all their assessments and then meds after. We just have to figure out what works best for us! On my floor, we have to take vital signs within 10 min of the patient arriving to the floor. I know it's hard when it's everything is coming up due, but the nurses on my floor always try to help. Maybe it's something you can implement. If a new patient comes, multiple nurses and the tech will go to the room and ask you what can they do, what can they grab for you, help transfer them to the bed, etc. It helps tremendously to have a team there and no matter how long you've been a nurse, it is still hard getting a new admit when you have a billion other things to do. Teamwork is key!! I'll scratch your back if you scratch mine, you know? lol

2
Up Vote Up Vote ×
On 11/8/2019 at 11:58 AM, 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!

Thank you for your transparency. I never intended to be a bedside nurse either. I've had a rough time finding a job period. But through word of mouth and family, I've had a couple of Private Duty assignments, which lead to some Flu clinics. I've developed some confidence. Always thought I'd be a clinic nurse - applied to many with no responses. I enjoy the senior population. Giving serious thought to Nursing homes now. I still like Surgical service, Endoscopy particularly was my favorite rotation. Unfortunately, I wasn't taught how to draw blood or start an IV. Which has been a huge road block. But I still believe there is something special for me in nursing.

2
Up Vote Up Vote ×

Your concerns were my concerns when I was a new grad, too.

I had dreams as a nursing student to provide the utmost compassionate care to each and every one of my patients, including sitting with them and talking with them in depth about their diagnoses, new meds, etc, like they teach us to in nursing school. I found that as a bedside nurse I could almost NEVER accomplish this without being interrupted by a request for pain meds, toileting need, patient needs fresh ice, etc.

I remember seeing a bladed razor (not electric) sitting on the sink of one of my patients who had just started taking Coumadin for a-fib. I asked him, "has anyone gone over the lifestyle changes you'll need to consider on this medication?" He said no one had ever had the time to do so.

This is what I hate most about healthcare...something I wish I'd been given at least some clue about while in school.

Anyway, I work in public health now and find that this gives me a much better opportunity to educate the way I've always wanted to. I did have to put in my "mandatory 1 year at the bedside" but I truthfully think that did give me the tools I needed to practice in an independent position like I am now.

Best of luck!

2
Up Vote Up Vote ×

?best of luck to all of you out there!

1
Up Vote Up Vote ×
+ Join the Discussion