It has been six months since I started my job as a new grad on a busy med/surg floor. I have been on my own for four months, and I have to say that I feel myself growing stronger clinically. My IV skills have improved immensely (which has always been my weakness), and my time management skills are amazing (I usually have six patients, sometimes seven). Charting is a breeze, and I find myself becoming more assertive with difficult patients, doctors, etc. However, I still am struggling with being task-oriented and am trying to learn how to see the "big picture" (any advice would be greatly appreciated!).
Although I am thriving at my present unit, I just can't see myself staying here. My heart is with the little babies, and my work environment is just so dangerous. The number of falls on my unit is outrageous, the staff is still expected to sit with patients (which contributes to falls) while taking on a full load, and now the emergency department is no longer required or expected to give us report.
I ache to be with the babies and to work in the NICU. I have made some necessary steps towards that goal, however, my residency program doesn't end for another seven/eight months. According to my hospital's policy, employees are eligible for transfers at six months. However, I am not sure if that applies to me as a new grad.
Should I stick it out until the end of the residency program or should I see if I am eligible for a transfer now? What pros and cons do you see in sticking it out vs transferring and vice versa?
And for the more seasoned nurses, do you have any stories in which the grass was NOT greener on the other side or the merits of delayed gratification?
When I first started many years ago I worked a renal/diabetic floor. It would be me and a lpn to 17 patients. It was a large unit. Over 60 patients. Although the LPN was awesome and she had half our patient load I still had to assess everyone once a shift and hang all Ivpb and give all ivp. There would be one code every weekend. I lasted nine months and transferred to peds at the sister hospital. Better working numbers.
p.s. How can the ED NOT give a report?! Talk about unsafe practices!
I seen places that used EPiC or another EMR to get by with this. Basically they say read the EMR once you get the assignment and if you have questions call. Problem is they often send the patient up before you get a chance to sit down and read. Like floor nurses have nothing better to do. It isn't right, but that is the argument I have heard.
My first hospital didn't have the ER give report either. AND, they wouldn't scan given medications..or, at least they didn't show up on the MAR I could see. I would be told I was getting a patient, maybe 5 min before they were sent up..and there would be past due meds in the MAR, some were given, some were not. So I'd have to chase them down in the ER to find out what was or wasn't given. Such an unsafe practice. I LOVE that my current hospital makes ER nurses give report. I still don't always get enough notice, but at least I can glance at the system & history while taking report..and ask pertinent questions.
The hospital I work at now doesn't require ED report. Pisses me OFF. I get a voicemail on Vocera that says, "The depart's in, call me at extension blah-blah if you have questions." Then there's no one at the extension or the name they gave me isn't on Vocera. And it's these people who have a stat antibiotic and/or bolus and/or aspirin and/or rescue med that they haven't given. Do they not know that their name is on the charting and I have a list of the ED managers, complete with phone numbers?
I've gotten a couple of people written up repeatedly.
ThePrincessBride, I've heard a few of your horror stories and I'm surprised you haven't already transferred or reported your hospital to CMS. I hate that you have to put up with that baloney.
My advice would be to transfer as soon as they'll let you. Find out who is the manager of the department you want. Email that person and ask them what you need to do to get transferred. Get your PALS out of the way and any other certification they want while you're waiting to transfer. Build a rapport with the management of the other unit and they will figure out a way to get you there.
The reason I say get out of Dodge, stat, is because you are going to be a new grad all over again. Kids are completely different. Your current experience isn't going to do you any good, except for seasoning. You will have a lot of adult treatment habits to correct once you get over there.
I am concerned about some of the safety problems you mentioned, though. How can you take a full load of patients but sit with one? That doesn't even make sense. No report from ER? Whaaat?
Thats how it is where I work too. Were expected to babysit one or two and provide full customer service to the others.
Ask your manager when you are eligible for transfer. You don't have to go into every reason--just say you really want to do NICU.
Which is not the easiest specialty, mind you. I loved PICU, but it was qualitatively different from NICU--I don't think I could have done the itty-bits. It's also quite qualitatively different from everything else--other than general things like time management, for example, if your heart is really set on NICU, staying longer in adult med-surg really won't benefit you at all. NICU is its own little field, full of conditions and procedures you see nowhere else.
That is my thought process too. Adult med/surg isn't really going to help me with the itty bitty babies.
I am planning on calling HR tomorrow to see where I stand in terms of being able to transfer. *Crosses finger* My heart really is set in the NICU. I am afraid of asking/telling my manager, especially this soon in the game.
ThePrincessBride, I've heard a few of your horror stories and I'm surprised you haven't already transferred or reported your hospital to CMS. I hate that you have to put up with that baloney.
My advice would be to transfer as soon as they'll let you. Find out who is the manager of the department you want. Email that person and ask them what you need to do to get transferred. Get your PALS out of the way and any other certification they want while you're waiting to transfer. Build a rapport with the management of the other unit and they will figure out a way to get you there.
The reason I say get out of Dodge, stat, is because you are going to be a new grad all over again. Kids are completely different. Your current experience isn't going to do you any good, except for seasoning. You will have a lot of adult treatment habits to correct once you get over there.
Thank you for the advice! I will look taking an NRP course through my job.
I honestly don't know how I have managed to survive this place as long as I have, and when they instituted the new rule that ED can drop patients off on the floor without report, I was very tempted to call the BoN. Wouldn't it be considered patient abandonment to leave a pt without handing off any sort of report to another nurse? Your situation sounds nearly identical to mine. :/
I have definitely gotten in contact with the manager after I had tried to get into the NICU earlier this year after graduation. I have been following her advice to a "T", and I hope to get in contact with her after the holidays.
I do agree that I will end up being a new grad over again b/c NICU is its own little world.
I transferred to a CVICU after seven months on a tele unit. I've never regretted it for a second.
I was a little worried about making people mad, but there was so much turn over in my unit I don't think anyone really even noticed.
It'll probably take you a little bit to find a NICU job anyway, and there's absolutely no harm in seeing what's out there, and seeing what options you have. Go ahead and make your resume, so if you see a position you can jump on it.
Try to stick it out at least a year and then try to transfer out. Thats what I did.. Or at least planned on it. I loved my floor, but the staffing got too much and turnover rate was ridiculous. I was planning on waiting and tranferring at least a year and a half but then the opportunity presented itself (by me coaxing the nm for an interview lol). I was on the surgical unit a little over one year and then transferred to surgical icu. I couldn't be more happier with the decision. And now I have two weeks left of orientation before I'm on my own! I hope it works out for you, good luck!
Specializes in Neurosurgery, Stroke, Trauma, NICU.
I struggled with my first few months off orientation on a neuro/trauma floor. I eventually got the hang of it with time though. I learned to prioritize better, I figured out how to cluster my care better, and I developed ways that worked best for me - i.e. creating my own report sheets, learning how to delegate and when, etc. I eventually knew I wanted to transfer after my yearlong residency ended and transfer to a NICU so I started applying 3-4 months prior to my residency ending. Once I got hired into a NICU, I just made the most of my time left on the floor and continued to gain as much experience and exposure as I could with adults while I could.
I would stick it out. It got better with time for me, especially knowing I had another job secured in a unit I truly wanted to work on.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
AHHHHHHHHHHH!!!!
It has been six months since I started my job as a new grad on a busy med/surg floor. I have been on my own for four months, and I have to say that I feel myself growing stronger clinically. My IV skills have improved immensely (which has always been my weakness), and my time management skills are amazing (I usually have six patients, sometimes seven). Charting is a breeze, and I find myself becoming more assertive with difficult patients, doctors, etc. However, I still am struggling with being task-oriented and am trying to learn how to see the "big picture" (any advice would be greatly appreciated!).
Although I am thriving at my present unit, I just can't see myself staying here. My heart is with the little babies, and my work environment is just so dangerous. The number of falls on my unit is outrageous, the staff is still expected to sit with patients (which contributes to falls) while taking on a full load, and now the emergency department is no longer required or expected to give us report.
I ache to be with the babies and to work in the NICU. I have made some necessary steps towards that goal, however, my residency program doesn't end for another seven/eight months. According to my hospital's policy, employees are eligible for transfers at six months. However, I am not sure if that applies to me as a new grad.
Should I stick it out until the end of the residency program or should I see if I am eligible for a transfer now? What pros and cons do you see in sticking it out vs transferring and vice versa?
And for the more seasoned nurses, do you have any stories in which the grass was NOT greener on the other side or the merits of delayed gratification?
Thanks!
You have a residency program, which makes me believe you made a promise of some kind to stay where you are for a specified length of time. You're not even halfway through. Stick it out. Seven or eight months may seem like forever when you're in your 20s; but it's just a tiny speck of time. And you made a commitment to the manager who took a chance on a new grad and hired you. If you leave now, you're sticking it to those who took a chance on you.
The grass is not always greener; trust me. The baby unit probably has staffing issues, management issues and other issues of which you are not now aware and probably could not be until you started working there. I've gotten a ton of PMs from members who left their first job in their first year to take "their dream job" and have regretted it since. Stay where you are for as long as you promised you would be. Learn all you can from your present job -- at six months, you've barely scratched the surface of what there is to learn. Become competent in taking care of your present patient population. And then look for your "dream job." You'll reap the benefits for the rest of your career.
The first year of nursing is difficult. It's going to be difficult no matter where you do it. You're learning so much, the responsibility is so overwhelming. But quitting now and taking another job just prolongs the agony of that first year. The only way to GET through it is to GO through it.
and provide full customer service to the others.
Dacatster, ADN
97 Posts
When I first started many years ago I worked a renal/diabetic floor. It would be me and a lpn to 17 patients. It was a large unit. Over 60 patients. Although the LPN was awesome and she had half our patient load I still had to assess everyone once a shift and hang all Ivpb and give all ivp. There would be one code every weekend. I lasted nine months and transferred to peds at the sister hospital. Better working numbers.