The Right Decision

[purplegal]

Three months ago, I got an exciting call--I had landed my first nursing position, on a cardiovascular progressive care unit. For the hospital I work at, it's considered a step-down unit, but for other hospitals, it would be considered an ICU. Orientation started out well. I attended classes, passed the required examinations and got my ACLS certification. However, things got rocky when I started spending more time on the clinical floor. It became obvious that my skills were lacking, due to not having used them for a year (I graduate with my Associate's degree in 2014, and, while attending school for my Bachelor's, I worked as an ECG technician).

As time has gone on, I have made slight improvements, but it has become obvious that I would not be ready to come off of orientation for a long time. As my manager said, if orientation could last six or nine months, I probably could be successful, but we simply don't have that time. My coworkers have made it known to management that they do not feel that this is the right department, because of my struggles to keep up with the fast paced, busy environment. It doesn't help that, at right about the time I started, another orientee also started. I have been constantly compared to him, because he is well loved by the people on the floor and is obviously what they are looking for. Now, I have met him and he is a very nice person. I'm sure he is an excellent nurse, so I don't want to discredit him or bring him down. At the same time, it hasn't been easy for me to hear how other people are impressed with him, while it seems like my coworkers primarily have negative things to say about me. In the past three months, I have to say that I have never felt comfortable with the people I am working with or a connection to the unit, possibly because of the constant comparison of me to this other person.

Needless to say, my manager and NES had to sit down and have some very hard conversations. I do have the option of continuing orientation, but I would have to go through a formal process, and would only have three weeks to meet their expectations. My other choice, which is the one that I have gone with, is contacting placement office about other positions, as well as having them contact my previous supervisor about possibly moving back to the ECG department, where I was very successful and well liked. I was wondering if this was the right thing to do, because I don't want to give up on this position either. However, my manager and NES have acknowledged that none of this is due to a lack of effort on my part. They said that I gave 150% every time I came into work, was receptive to feedback, and tried to incorporate that feedback into my practice. They acknowledged that I was very determined, and admired me for sticking with this for as long as I have, and realized that this feedback and this outcome was hard to hear. However, they also said that for my sake, and the sake of my license, and, of course, the sake of the patient's, a lower acuity nursing job or my former position are better options.

Additionally, I also have to say that I have never felt so worthless in my life. It's been a long time since I've gone a day without crying or without wanting to. It's also been at least two months since I've looked forward to going into work. I've even wished that I wouldn't wake up in the morning. This has been a very emotional rollercoaster, and I'm tired of it. I know that there's never going to be a job where I want to go to every shift I'm assigned to, but I feel that this is different. In my previous position, there were days like that, but it was because of every day annoyances, not because I felt worthless.

What are your thoughts? Is this the right decision? Or does transferring to another department show a sign of a lack of commitment, quitting or even failure?

[MrNurse(x2), ADN]

So sorry to hear how rough things are. Your ownership of the situation will help you no matter where you end up. You basically answered your own question. You are holding on because the job market is tight and you at least have a job here, I get it, would probably do the same. Are they willing to give you an in house position in a less acute area? You may feel horrible now, but take some time and do a self analysis of your good points. Take these strengths to your employer and highlight that you already have the hospital systems down and they and you have invested resources to your employment. Not everyone is cut out for hospital nursing, maybe home care, sub acute, etc. Good luck on your decision.

[nutella, MSN, RN]

Why not look into a position where it is less acute ?

Not everybody can just jump right in and not everybody is a good fit for every position, not to mention that sometimes integration into a team can be hard.

What about a regular tele floor or one with focus on cardiology?

I have one suggestion : If there is a float pool in your hospital perhaps you can ask the manager/supervisor if it is possible to go with a float nurse to some floor for half a shift or so to see some other areas. That way you would get a feeling for where you would like to go or which place would be a good fit.

The other idea is that if you feel drawn to the technical aspect of nursing to look into options like acute dialysis, OR or outpatient departments.

I need to say that I think 3 months is not a long time to train if you are basically somewhat of a new graduate but you need to progress into the right direction. If you decide to stay and take a chance but do not progress miracle like you may be totally without a job. Transferring out may be better. There is nothing wrong with going to a different area, people change dept all the time. I know nurses who really wanted to go to the ER but once there found that they were not able to keep up with the pace and acuity and transferred out again. Instead of looking at it as a failure try to look at it as an opportunity that probably taught you something but just is not a good fit for you and move on. With a positive attitude you will be able to move more and better.

I took a manager position at some point in the past but found that I did not like it after all. I looked for something else with direct patient contact and left. I do not think I am a failure but that it was not a good fit for me as I realized that I did not want to get grind up in middle management and be more concerned about money as opposed to patient care.

[llg, PhD, RN]

You've made the right decision. And you were very lucky to have a manager that treated you fairly. He/she is giving you a chance to land on your feet in a position better-suited to your current abilities and you were right to take that opportunity. To stay on the step-down unit when it wasn't a fit would only bring you down further.

Find a position that will fit you better and move forward with a positive attitude. Be grateful the step-down management isn't trashing your career. They are helping you move to a better place.

[AceOfHearts<3]

I know the stress you are going through. I went through it with my previous career before switching to nursing. The great thing about nursing is the versatility (my other career didn't have that). I say switch to a different unit if you can. There is no shame in it. Maybe you can get into a different unit with a lower acuity and different atmosphere- one where you feel supported by your colleagues. That and a different acuity might be all you need to feel and be successful again. Then once you have things down and feel confident in a year or two you can decide if you want to stay or maybe try out new challenges (like giving a higher acuity another shot). To me life is too short to be stuck in a job that you absolutely hate. Good luck!

[TheCommuter, BSN, RN]

What are your thoughts? Is this the right decision? Or does transferring to another department show a sign of a lack of commitment, quitting or even failure?

Moving to a less acute area of nursing might be the best decision at the present time. The beauty of nursing is rooted in the fact that there's something for almost everyone.

Good luck to you.

[runner502]

I am so sorry to hear how difficult it's been for you. I truly can relate to your pain because I fear that when I finally do get my first nursing job, I might not measure up either. I've been out of school since May and my confidence in my skills drops even more as time goes by. But like the others have said, don't beat yourself up about it. Everybody has their own unique gifts and talents and you just have to find the right environment for you to use them and then you will see how much you can accomplish! I have to tell myself the same thing, but I can tell you are a good person with a lot to give. I am cheering you on and will keep you in my prayers.

[LadyFree28, BSN, LPN, RN]

Moving to a less acute area of nursing might be the best decision at the present time. The beauty of nursing is rooted in the fact that there's something for almost everyone.

Good luck to you.

This.

I worked in Critical Care as a new grad and felt I needed to transition more slowly, so I picked a job outside of acute care as a supervisor in LTC-I learned many skills, such as assessing without a monitor, leadership skills and soft skills such as talking to challenging families and patients; I moved to a post acute Pediatric facility and was able to handle the higher acuity, and then moved into a Level I Trauma Pediatric ER and have been successfully in this position for 11 months.

My most takeaway from my first position was the high acuity and the learning experience and my own insecurities as well; I knew what type of RN (was a LPN for 7 years prior) I wanted to be and identified what I needed to be successful, as well as a supportive educational and working environment.

You may not know what path you want to pursue, but there are many avenues; seek out an opportunity to see other units if you can, OR go back to the unit you were in where you were supported; it doesn't mean that you or a failure, nor will it stunt your nursing career-remember we have many options and are diverse enough; the key is knowing what you want the most out of your career, and having a supportive work environment.