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?
Specializes in Nurse Leader specializing in Labor & Delivery.
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.
If I recall correctly, she worked for a few years as a tech in that department. No point in mentioning that, other than to say that she's probably pretty aware of any staffing and management issues that are going on there.
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!
I would do just as you are. Ask HR when you are eligible to transfer. You've already spoke with the NM of NICU and have already begun following the steps they suggested. I would start looking for openings when you become eligible to transfer. I wouldn't say a word to my own NM until there was an opening I planned on applying to. Good luck!
I am a new RN, and like you, I have seen myself growing. I am generally a good time manager, but, I have gotten better with my patients. Because I work the night shift, I often have 16 to 20 patients, as there are only 2 other RNs, and the supervisor, on the unit.
If I were you, I would first, find out the facts. Are you eligible to transfer or request a transfer after 6 months or not? Once you have an answer to this question, I think you will have more clarity about your options.
Don't be afraid to follow your passion. If the NICU is where you ultimately want to be, go for it! If you can't transfer just yet, then yes, finish out the rest of this term, and learn all that you can. I still quote one of my professors, "You can do any nursing job for at least 1 year, even if it's not your first choice. You should be able to learn and take away something from that assignment and use it in the next position; and it's always good to have a good attitude because you never know who/how you will get to your 'dream' job."
One last thing: before you leave this current assignment, try to come up with a fall reduction plan that can be easily implemented on the unit. Maybe your unit staff are not aware of some possible items that can be implemented; maybe you could speak with your nurse manager. Whether or not your suggestions are implemented, it will be known that you at least had the heart, mind, and courage to advocate for your patients and your colleagues safety. Make sure you document what you suggest (Who, what, when, where, why, how).
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.
You are right. It does feel like forever. And when I do look at positions, I feel like I am cheating on my manager. Right now, there are a few NICU positions opened up. Some are posted every month, it seems.
As for the residency program, they made us sign a contract to finish the residency program. I'm not sure if it said anything about having to stay in our particular unit (I will have to double check).
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.
I worked as a tech for the women and infant department (not NICU though), so I am familiar with some of the drawbacks, but short staffing, dangerous working conditions, noncompliant/rude patients doesn't happen in the NICU to which I want to apply.
A couple weeks ago, the ED tried to drop off a suicidal pt on my unit without any report (we already had other sitter cases and did not have the staffing for another). Had I not had time to browse the chart, my unit would have been in serious trouble. This scares me. My hospital has a bad reputation of extremely high turnover.
I would be inclined to agree with you if I wanted to continue to work with adults. But NICU is such a specialized field that I don't think it really matters if I leave now, next year or two years from now. Regardless, I would end up being a new grad all over again in a world where nothing in adult care applies.
I am not at the point where I completely dread going to work, however. I like my coworkers (generally), night shift is actually not as bad as I thought it was going to be, and I am picking up specialized skills to add to the resume. Given the poor working conditions (travelers and very experienced nurses tell me that this is such a poorly managed to unit) and the fact that adult care is nothing like NICU, I wonder if I am just "wasting" my time here and feel that none of my skills are applicable to where I want to be.
So apparently I am eligible for a transfer, but the person I talked to highly encouraged me to stick it out for a year as HR won't look at my application favorably if I wanted to transfer so soon. So, six more months it is. :/
And that's ok. 6 months is 6 months. 24 weeks. In the meanwhile, start by getting your hands on a NICU certification book. Find out what you need to do to become certified. Look at the fine print on those NICU positions. What are they requiring as far as past experience?
I would ask to make an appointment with the NICU nurse manager. Discuss your goals, and ask for specifics as far as what you need to do in the next 6 months to prepare yourself.
In the meanwhile, adults and kids and babies are all different. What I would do is to think about other parts of nursing and refine them.
As an example, take any difficult IV stick that you can. Really know and feel for those veins. It will get you sensitive to how you would then go about starting an IV on a bitty baby. Same with things like cathing--know your few clinical skills that can refine your practice.
Really think about difficult dynamics and how to deal with them methodically. NICU is a highly charged area of nursing. You are talking about parent's whole heart being so ill. Sometimes there are no answers to the question "what happened here". Sometimes, you can deal with Mom's whose errors in judgment, whose medical history, whose whatever resulted in the patient that you have before you. Sometimes you are talking about parents who have waited years with extreme challenges to have a baby. Sometimes your patients will be in drug withdrawal. A multitude of issues.
So then you talk about how you are to multi-task to see the whole picture. How to use your resources effectively. How to communicate constructively with a patient who needs crisis interventions. Because the whole picture goes far beyond what you see in front of you. Learn to advocate effectively. Focus on educating your patient. Focus on discharge planning. And I can not stress enough--know your resources and how to use them. These will serve you well going forward.
NICU is a specialty, but an exceedingly difficult one. So although you don't love M/S take the next six months and refine a few clinical skills, but most importantly refine those intangibles that you can not see.
Be sure that you are at a place where you do not and can not get emotionally entangled in other people's poop. Suicidal patient, no report, and drop and dump? That is where you go right to charge nurse for a plan that is going to work. Don't waste your time getting po'ed about it. Hyperfocus. If you have 3 other people to medicate--can the charge nurse medicate while you do an admission? Can the charge nurse get social work in so that a risk assessment can be done with possible 15 minute checks? Who was watching this patient in the ED? Can they come to the unit and continue? Thinking outside of the box will benefit your practice in the long run.
Because going forward in a NICU unit you can and will have one baby whose parents longed for them and the baby is clinging to life, and in the next bed a baby who has 10 brothers and sisters at home to a parent who had no prenatal care, and said parent has ineffective coping skills, and a run and fetch me some ginger ale, can I apply for SSDI for this baby now kind of attitude.
Specializes in Palliative, Onc, Med-Surg, Home Hospice.
Though I'm still in nursing school and am about to take Med-Surg... I would stick it out for the time, so that you can continue to learn... wait 2-3 years, then do the transfer, when you're more seasoned.
One problem with this is that NICU and adult med-surg are as different as night and day. Becoming "seasoned" isn't going to help her when it comes to caring for fragile newborns. And if one is miserable in their current unit, they will burn out fast.
In my opinion, OP should go for it. Especially if she is allowed to transfer now. If she doesn't get the position, keep trying.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
So apparently I am eligible for a transfer, but the person I talked to highly encouraged me to stick it out for a year as HR won't look at my application favorably if I wanted to transfer so soon. So, six more months it is. :/
Specializes in Palliative, Onc, Med-Surg, Home Hospice.
So apparently I am eligible for a transfer, but the person I talked to highly encouraged me to stick it out for a year as HR won't look at my application favorably if I wanted to transfer so soon. So, six more months it is. :/
At least it's only 6mos. I can't transfer for another year. I had applied for a couple of positions then got written up so have to wait a year. We can support each other while we wait to transfer. Best of luck to you!
klone, MSN, RN
14,857 Posts
If I recall correctly, she worked for a few years as a tech in that department. No point in mentioning that, other than to say that she's probably pretty aware of any staffing and management issues that are going on there.