Traumatized by nursing - advice needed

[kcsun3]

Hi all,

I apologize in advance for the long post, but I am devastated right now and need some guidance. While I have never been a big poster here, I have been an avid reader of this forum for over 5 years. Those who know me will appreciate the irony of my story.

I am a new grad (May, 2004). Nursing was a dream of mine for as long as I can remember. When my children were old enough, I started to consider nursing school. I read everything I could, made a web site to share the information I found and sought to encourage others. I even wrote a book and was hired to write a weekly advice column for nursing students and potential nursing students (very ironic...). Once in nursing school, I set up a mentoring program, pairing alumni with interested students. I organized a peer tutoring program. I held game show challenges to help junior students through the bewildering first semester. I coordinated the junior-senior "buddy" program. I was passionate about nursing and wanted to support others on the same journey however I could.

I did very well in school, but knew that the real learning was to be had after I graduated. Great grades do not automatically equal "great nurse." Great nurses become so only with experience. Knew all about the stages of reality shock, nurses eating their young, yadda, yadda, yadda. But the idealist in me held out hope that a positive attitude, a willingness to ask questions, a willingness to jump in and try, and a desire to learn would be...well...helpful at least.

First job out of school: I went to a large metropolitan teaching hospital and worked on the pediatrics unit weekend nights. Horrid. While I was blessed to have a great mentor/preceptor, I dreaded going in every shift. I spent most of the week recovering physically and emotionally before heading back in again. It was so stressful, I had six MS attacks in 6 months. Never called in sick until the end...just carried on as best as I could.

My second day off orientation, I was floated to the NICU - the NICU! "Oh, they'll only give you feeders and growers - you'll be fine." Yeah...no orientation to the unit AT ALL - we did computer charting, they did paper charting. Their equipment was different. Their protocols were different. Their patient acuity was higher (obviously). I asked the charge nurse for a brief tour of the unit at least before diving in...but she was busy. I was stuck in a side section separated by a WALL from the rest of the unit by myself - no other staff there - with 3 NICU babies getting complicated (to me) drips. Again I asked for help - charge nurse said she would be over in a minute. She came over 6 HOURS later, and of course I had done everything wrong, not having the first clue about NICU. I just thank God the babies didn't suffer any harm. Scared the crap out of me.

Anyway, the rest of my stay at that hospital was horrible. More floating to NICU, with a devastating near-miss. I did not have the option to NOT float, so I started calling in sick on nights when I was going to be floated. On my own unit, I was given patients whose care needs were way above what I felt comfortable or even remotely competent with (i.e., chemo patients without having had any chemo classes, etc.). My self-confidence dropped and dropped and dropped. Each week was worse than the last and every day my license was on the line.

Then, out of the blue in December, I received an e-mail from the manager of a hospice where I had done a clinical rotation. Hospice has always been my nursing dream - I love everything about it. She wanted to hire me on, said they loved me during my rotation and that I had a great future there. I was so excited - here was a way out of the hospital and into a job where I could be the nurse I had always hoped to be. I called my preceptor from that rotation to tell her the great news. She told me that she no longer worked there, and said, "Don't do it...That hospice will use you, burn you out and drop you." Did I listen to my mentor? No...

So, I quit my hospital job - didn't even work out my notice, which I have never done before - but I was terrified that I would lose my license - so unsafe there! On I went to hospice, heart filled with joy and elation. I should have listened.

I received all of 2 days of orientation, riding around with another nurse, and then was handed my caseload and sent out on my own. On my own, out in the field, with just 6 months of nursing experience under my belt. Can you see the disaster waiting to happen? I asked for support, help, guidance - anything - but my supervisor, manager and peers were all perpetually swamped and not available. I tried my very best, worked as hard as I could, researched every diagnosis, all the appropriate interventions and tried to expand my knowledge fast enough to be able to meet the needs of my families. It just wasn't enough.

Friday, my supervisor called me in for an afternoon meeting. I asked what was up - she said, "I would rather talk to you in person." Not good...not good at all. As I feared, I was being asked to voluntarily resign. She said she knew I had tried really hard, but I didn't yet have the confidence or strong personality needed for being out alone on home visits with no support. She felt bad that I hadn't received a decent orientation, but they just didn't have the time to do that. They needed experienced nurses who could hit the ground running. Of course this makes sense - obviously! But then why did they seek me out and hire me in the first place? I should have seen the red flags, but I was so excited about hospice...

I am devastated. What do I do now? Where do I go? I shudder at the thought of going back to a hospital setting - I am still traumatized from my first job. In fact, my confidence in my nursing abilities is so low right now, I am terrified to start again. I cannot get a reference from my first nursing job, and I am not so sure on the second, either. Any guidance or suggestions would be greatly appreciated. I just don't know what to do, and I am broken-hearted.

Steph

[BETSRN]

Hi all,

I apologize in advance for the long post, but I am devastated right now and need some guidance. While I have never been a big poster here, I have been an avid reader of this forum for over 5 years. Those who know me will appreciate the irony of my story.

I am a new grad (May, 2004). Nursing was a dream of mine for as long as I can remember. When my children were old enough, I started to consider nursing school. I read everything I could, made a web site to share the information I found and sought to encourage others. I even wrote a book and was hired to write a weekly advice column for nursing students and potential nursing students (very ironic...). Once in nursing school, I set up a mentoring program, pairing alumni with interested students. I organized a peer tutoring program. I held game show challenges to help junior students through the bewildering first semester. I coordinated the junior-senior "buddy" program. I was passionate about nursing and wanted to support others on the same journey however I could.

I did very well in school, but knew that the real learning was to be had after I graduated. Great grades do not automatically equal "great nurse." Great nurses become so only with experience. Knew all about the stages of reality shock, nurses eating their young, yadda, yadda, yadda. But the idealist in me held out hope that a positive attitude, a willingness to ask questions, a willingness to jump in and try, and a desire to learn would be...well...helpful at least.

First job out of school: I went to a large metropolitan teaching hospital and worked on the pediatrics unit weekend nights. Horrid. While I was blessed to have a great mentor/preceptor, I dreaded going in every shift. I spent most of the week recovering physically and emotionally before heading back in again. It was so stressful, I had six MS attacks in 6 months. Never called in sick until the end...just carried on as best as I could.

My second day off orientation, I was floated to the NICU - the NICU! "Oh, they'll only give you feeders and growers - you'll be fine." Yeah...no orientation to the unit AT ALL - we did computer charting, they did paper charting. Their equipment was different. Their protocols were different. Their patient acuity was higher (obviously). I asked the charge nurse for a brief tour of the unit at least before diving in...but she was busy. I was stuck in a side section separated by a WALL from the rest of the unit by myself - no other staff there - with 3 NICU babies getting complicated (to me) drips. Again I asked for help - charge nurse said she would be over in a minute. She came over 6 HOURS later, and of course I had done everything wrong, not having the first clue about NICU. I just thank God the babies didn't suffer any harm. Scared the crap out of me.

Anyway, the rest of my stay at that hospital was horrible. More floating to NICU, with a devastating near-miss. I did not have the option to NOT float, so I started calling in sick on nights when I was going to be floated. On my own unit, I was given patients whose care needs were way above what I felt comfortable or even remotely competent with (i.e., chemo patients without having had any chemo classes, etc.). My self-confidence dropped and dropped and dropped. Each week was worse than the last and every day my license was on the line.

Then, out of the blue in December, I received an e-mail from the manager of a hospice where I had done a clinical rotation. Hospice has always been my nursing dream - I love everything about it. She wanted to hire me on, said they loved me during my rotation and that I had a great future there. I was so excited - here was a way out of the hospital and into a job where I could be the nurse I had always hoped to be. I called my preceptor from that rotation to tell her the great news. She told me that she no longer worked there, and said, "Don't do it...That hospice will use you, burn you out and drop you." Did I listen to my mentor? No...

So, I quit my hospital job - didn't even work out my notice, which I have never done before - but I was terrified that I would lose my license - so unsafe there! On I went to hospice, heart filled with joy and elation. I should have listened.

I received all of 2 days of orientation, riding around with another nurse, and then was handed my caseload and sent out on my own. On my own, out in the field, with just 6 months of nursing experience under my belt. Can you see the disaster waiting to happen? I asked for support, help, guidance - anything - but my supervisor, manager and peers were all perpetually swamped and not available. I tried my very best, worked as hard as I could, researched every diagnosis, all the appropriate interventions and tried to expand my knowledge fast enough to be able to meet the needs of my families. It just wasn't enough.

Friday, my supervisor called me in for an afternoon meeting. I asked what was up - she said, "I would rather talk to you in person." Not good...not good at all. As I feared, I was being asked to voluntarily resign. She said she knew I had tried really hard, but I didn't yet have the confidence or strong personality needed for being out alone on home visits with no support. She felt bad that I hadn't received a decent orientation, but they just didn't have the time to do that. They needed experienced nurses who could hit the ground running. Of course this makes sense - obviously! But then why did they seek me out and hire me in the first place? I should have seen the red flags, but I was so excited about hospice...

I am devastated. What do I do now? Where do I go? I shudder at the thought of going back to a hospital setting - I am still traumatized from my first job. In fact, my confidence in my nursing abilities is so low right now, I am terrified to start again. I cannot get a reference from my first nursing job, and I am not so sure on the second, either. Any guidance or suggestions would be greatly appreciated. I just don't know what to do, and I am broken-hearted.

Steph

NO ONE can have confidence unless they are given the chance to build it. You have had two inexcusably LOUSY experiences and neither of them were your fault at all.

Just hospital shop a bit and talk to the nurse managers of the units you are considering. Tell them what has happened to you in the past. You have nothig to be ashamed of. You were the victim of poor management both times.

Be VERY specific about what you need and accept nothing less. You will find a job where you will be able to use your skills and grow your confidence. If you think you find a specific position to your liking, ask to shadow a nurse there and ask a lot of questions. Meet all three shifts. Talk to as many staff as possible and briefly recount your past experiences. They'll understand. If they do not, don't work there.

Good luck.

[Tweety, BSN, RN]

Good luck in whatever you do. Believe in yourself.

[gerilou]

Hi Steph,

I am sorry that you have had such disappointing experiences in nursing SO FAR. I am 42 and have been a nurse for 20 years. There are times since I graduated that I fantasized about being a florist, Walmart greeter or a professional giftwrapper at the mall. The hospitals you have worked at have done you an injustice by not properly training you to do what it is they are asking of you. You need to find a facility with a good PRECEPTOR program. Not only orientation, but someone who actually goes to the unit with you and assists you in learning the skills you need to know on the actual unit and not only in a classroom. Unfortunately with the shortage of nurses, less and less facilities are offering this...but I personally think experiences such as yours are common and contribute to the nursing shortage we are experiencing. The nurse who graduated top of my class works at Walmart. When you are asked to float to a unit that you have not been trained to work on, notify the nursing administration dept and jot down who you spoke with, the date and time. Try to have someone else witness the call and jot their name down too. Keep this log AT HOME and if anything negative should happen, you have documentation of your objection to the assignment and the name of who you spoke with. Also, if you belong to a nursing union, notify your union rep right away. Most importantly, do not give up. You need to get a little moxie Steph and advocate for yourself. that self confidence will come back when you find a job that fits. As much a I admire Hospice nurses, I think any new grad needs to get some good med-surg training under their belt no matter what aspect of nursing they chose to specialize in later. Think about it...i did it to work in Psych, and it was an invaluable three years. Hone up those skills, build up a solid base of self confidence and moxie, then find the right match, and 20 yrs from now, you will find yourself writing this same type of encouraging letter to some new grad, just out of school , in need of some encouragement and support. Feel free to e-mail me any time...

gerilou

[BETSRN]

Hi Steph,

I am sorry that you have had such disappointing experiences in nursing SO FAR. I am 42 and have been a nurse for 20 years. There are times since I graduated that I fantasized about being a florist, Walmart greeter or a professional giftwrapper at the mall. The hospitals you have worked at have done you an injustice by not properly training you to do what it is they are asking of you. You need to find a facility with a good PRECEPTOR program. Not only orientation, but someone who actually goes to the unit with you and assists you in learning the skills you need to know on the actual unit and not only in a classroom. Unfortunately with the shortage of nurses, less and less facilities are offering this...but I personally think experiences such as yours are common and contribute to the nursing shortage we are experiencing. The nurse who graduated top of my class works at Walmart. When you are asked to float to a unit that you have not been trained to work on, notify the nursing administration dept and jot down who you spoke with, the date and time. Try to have someone else witness the call and jot their name down too. Keep this log AT HOME and if anything negative should happen, you have documentation of your objection to the assignment and the name of who you spoke with. Also, if you belong to a nursing union, notify your union rep right away. Most importantly, do not give up. You need to get a little moxie Steph and advocate for yourself. that self confidence will come back when you find a job that fits. As much a I admire Hospice nurses, I think any new grad needs to get some good med-surg training under their belt no matter what aspect of nursing they chose to specialize in later. Think about it...i did it to work in Psych, and it was an invaluable three years. Hone up those skills, build up a solid base of self confidence and moxie, then find the right match, and 20 yrs from now, you will find yourself writing this same type of encouraging letter to some new grad, just out of school , in need of some encouragement and support. Feel free to e-mail me any time...

gerilou

You go, Gerilou!

I laugh about the Walmart thing ............ I know we all mention becoming WalMart greeters at times! I work on a wonderful unit (16 years in the same hospital) and we all have trying days and consider the WalMart challenge!

You've gotten wonderful advice here Steph! You'll be fine in the long run!

[stidget99]

QUOTE: Your solid advice is the gold standard, I know...but I really did not like working in a hospital setting, and there's the rub. Can I do anything without 1 year of hospital experience? Thanks again...I value the input.

The way I look at things is this.........if you think of working a year in the med/surg setting as a continuation of your schooling.....something that you really don't like doing but you know that in the long run, you will reap the benefits. Don't you wish you could paid for all of the clinical hours put in while in school??????

I think that the best way to approach new employers is to be up front and honest. "I did not receive adequate orientation at my two previous jobs. What kind of orientation program do you have?"

Good luck to you.

[UM Review RN, ASN, RN]

The title of your post is close, but not quite accurate. I doubt that you were traumatized by nursing. You still love nursing, don't you? Otherwise, you wouldn't have been such a proactive student.

Would you have loved your job if you had had the proper orientation? I think you would have.

I'm only being nitpicky because you're (rightfully) upset and because you have just learned something about nursing that nurses have been trying to fight for many years now--management sets the goals, management dictates the numbers.

It hurts us. It hurts the patients. And nurses have no power over it. It's thrown us into an adversarial relationship with our employers. We have to fight for our patients. We don't have time to fight for ourselves.

All I know is, we at the bedside need nurses like you. You're green. Your post proves to me that you are not incapable nor incompetent!

You're green.

And there's hope.

Pretend you're developing another clinical skill--it takes a couple of times to get certain skills right, as you know. Make it a challenge. Trust me, it's like riding a horse. This is not the time to go back to school. This is the time to declare war on your inexperience and become the nurse you were meant to be.

Call this clinical skill--Survival. It's a complex one, involving several of your competencies.

Your research skills are needed to get you into the best possible clinical setting. Look for nurse longevity. Some nurses stay due to inertia, but if you see a pattern of many nurses staying for years, it's probably because they love where they work.

Usually, you'll find the types of problems that you encountered with for-profit facilities. So a non-profit might be better.

Try hospitals with Magnet status.

Be assertive, as someone else said. Don't accept less than you were promised, and get those promises in writing. Float to another unit? You can't refuse?

Yes you can! It might mean your job, but it won't mean your license. My first job tried to float me from Med-Surg to Tele without orientation or experience. I went. Duh. It took another new grad to talk to our manager and get us out of that.

So look where I work today! That's irony. But I chose to make war on my inexperience, and got the orientation that I needed. I was on orientation for a few weeks, then preceptored for a couple of months, and now, we have a mentoring program that rocks. So getting all this stuff is not impossible, ok?

In reviewing your post and seeing all you have accomplished up to this point, I'd like to add a couple of other things.

I'm not the best nurse in the world or even on my unit. There are many others on my unit that are clinically more capable, more intelligent, and have a better personality. That doesn't mean that I can't have the goal of doing my best, whatever my clinical level of expertise is at the time.

You've been dreaming about this for too many years to let it go. You had different ideas about some things than you actually encountered. So you now have a choice--to remain Nurse-Ideal, or get real and be Nurse-Beginner.

I'm here on the other side to tell you that Nurse-Ideal always looked good to me--until my first successful Code. Then I was hooked. Still scared s***less, but hooked, and ready to deal with the realities of nursing.

You'll never be more involved in a job--body, mind, emotion. You'll never imagine how far you can stretch, physically, mentally, spiritually. But it can be done.

Yes it can.

And if ever there was a new nurse who I really believed could do it, my dear, it would be you.

Best wishes, whatever your decision.

[traumaRUs, MSN, APRN]

Your experience sounds like an absolute nightmare. Please insist on an 8-16 week orientation for positions. I work in a level one ER and our orientation for new grads is 16 weeks and for experienced nurses 8-12 weeks. This is the minimum to be expected to perform at a safe level.

[Mommy2Katiebaby]

I did home hospice for a number of years, and my best advice to you would be to start in an inpatient hospice if you can get hired. You'll have a chance to learn in a more supported environment than being tossed into the field (something you shouldn't do until you've got SEVERAL years experience, if you ask me) and have the opportunity later to do fieldwork.

Good luck, and don't panic - there's something out there for you, you just haven't found it yet.

[cpomb]

Dear Steph,

Reading your letter brought back memories of fear and trauma for me also. There is hope!!! I went to nursing school when my kids were 12 and 9. I always wanted to be a nurse and was also passionate during school. I even wanted to wear my nursing cap!!!!! I hated clinicals...I became nauseated at the thought. Loose stools the morning off clinicals and sweaty palms. Heart pounding dread. The nurses where mean, some of my instructors could be just as bad...After graduating with a 3.4 I thought I was ready. Wrong....I was eaten alive by the nurses. I was so naive...I thought everyone was in nursing to help each other and share in the experience of helping others get well. Irritable bowel set in.....I quit and took a very safe job in a clinic for emotional disturbed youngsters.. I was becoming board but also ill and developed Graves Disease. I THINK IT WAS ALL BECAUSE OF THE 3 YEARS OF STRESS. I took about 6 months off to get well. I was approached by a former class mate to take a job in a small pediatric unit. I was scared but did...and i had a great preceptor. I watched her and used her as a role model. I began to have confidence again and did a great job. Then I decided I needed a challenge and went to a tele floor and then to the emergency room. Mistake...or maybe not!!!! What does not kills you toughens you. They were evil and very political. While I was there my husband at the time was having an affair with a nurse on his unit....the whole event was devastating....I got caught up in crisis after crisis in my life. I felt I had to leave for my sanity and self preservation...physically, mentally, and professionally. I took a job at a nursing home. I fell in love with the elderly...and had a great time and learn alot and again regained my confidence, but was following a seriers of bad relationships which affected my self esteem....I finally got my personal life and professional life in order. Then I had a major auto accident and was in a major trauma hospital for 3 weeks...I was ready to met my maker and was ok with that...but here I am....Happy, healthy (maybe) and working in a small community emergency room and I am respected and my confidence is the highest it has been in years. I have survived the eaten of the young, divorce and illness. It has all made me a better nurse and a preceptor for nusing students. I promised I would help new nurses and employees to feel welcomed and valued. Take your experience and turn it around. Find what fits you as a nurse, your philosophy, and a place FEELS RIGHT. Always follow your gut and your intuition. There are a multiple of nursing roles. Best of luck to you and stay in touch and let me know if this helped..

cheryl(cpomb)

Hi all,

I apologize in advance for the long post, but I am devastated right now and need some guidance. While I have never been a big poster here, I have been an avid reader of this forum for over 5 years. Those who know me will appreciate the irony of my story.

I am a new grad (May, 2004). Nursing was a dream of mine for as long as I can remember. When my children were old enough, I started to consider nursing school. I read everything I could, made a web site to share the information I found and sought to encourage others. I even wrote a book and was hired to write a weekly advice column for nursing students and potential nursing students (very ironic...). Once in nursing school, I set up a mentoring program, pairing alumni with interested students. I organized a peer tutoring program. I held game show challenges to help junior students through the bewildering first semester. I coordinated the junior-senior "buddy" program. I was passionate about nursing and wanted to support others on the same journey however I could.

I did very well in school, but knew that the real learning was to be had after I graduated. Great grades do not automatically equal "great nurse." Great nurses become so only with experience. Knew all about the stages of reality shock, nurses eating their young, yadda, yadda, yadda. But the idealist in me held out hope that a positive attitude, a willingness to ask questions, a willingness to jump in and try, and a desire to learn would be...well...helpful at least.

First job out of school: I went to a large metropolitan teaching hospital and worked on the pediatrics unit weekend nights. Horrid. While I was blessed to have a great mentor/preceptor, I dreaded going in every shift. I spent most of the week recovering physically and emotionally before heading back in again. It was so stressful, I had six MS attacks in 6 months. Never called in sick until the end...just carried on as best as I could.

My second day off orientation, I was floated to the NICU - the NICU! "Oh, they'll only give you feeders and growers - you'll be fine." Yeah...no orientation to the unit AT ALL - we did computer charting, they did paper charting. Their equipment was different. Their protocols were different. Their patient acuity was higher (obviously). I asked the charge nurse for a brief tour of the unit at least before diving in...but she was busy. I was stuck in a side section separated by a WALL from the rest of the unit by myself - no other staff there - with 3 NICU babies getting complicated (to me) drips. Again I asked for help - charge nurse said she would be over in a minute. She came over 6 HOURS later, and of course I had done everything wrong, not having the first clue about NICU. I just thank God the babies didn't suffer any harm. Scared the crap out of me.

Anyway, the rest of my stay at that hospital was horrible. More floating to NICU, with a devastating near-miss. I did not have the option to NOT float, so I started calling in sick on nights when I was going to be floated. On my own unit, I was given patients whose care needs were way above what I felt comfortable or even remotely competent with (i.e., chemo patients without having had any chemo classes, etc.). My self-confidence dropped and dropped and dropped. Each week was worse than the last and every day my license was on the line.

Then, out of the blue in December, I received an e-mail from the manager of a hospice where I had done a clinical rotation. Hospice has always been my nursing dream - I love everything about it. She wanted to hire me on, said they loved me during my rotation and that I had a great future there. I was so excited - here was a way out of the hospital and into a job where I could be the nurse I had always hoped to be. I called my preceptor from that rotation to tell her the great news. She told me that she no longer worked there, and said, "Don't do it...That hospice will use you, burn you out and drop you." Did I listen to my mentor? No...

So, I quit my hospital job - didn't even work out my notice, which I have never done before - but I was terrified that I would lose my license - so unsafe there! On I went to hospice, heart filled with joy and elation. I should have listened.

I received all of 2 days of orientation, riding around with another nurse, and then was handed my caseload and sent out on my own. On my own, out in the field, with just 6 months of nursing experience under my belt. Can you see the disaster waiting to happen? I asked for support, help, guidance - anything - but my supervisor, manager and peers were all perpetually swamped and not available. I tried my very best, worked as hard as I could, researched every diagnosis, all the appropriate interventions and tried to expand my knowledge fast enough to be able to meet the needs of my families. It just wasn't enough.

Friday, my supervisor called me in for an afternoon meeting. I asked what was up - she said, "I would rather talk to you in person." Not good...not good at all. As I feared, I was being asked to voluntarily resign. She said she knew I had tried really hard, but I didn't yet have the confidence or strong personality needed for being out alone on home visits with no support. She felt bad that I hadn't received a decent orientation, but they just didn't have the time to do that. They needed experienced nurses who could hit the ground running. Of course this makes sense - obviously! But then why did they seek me out and hire me in the first place? I should have seen the red flags, but I was so excited about hospice...

I am devastated. What do I do now? Where do I go? I shudder at the thought of going back to a hospital setting - I am still traumatized from my first job. In fact, my confidence in my nursing abilities is so low right now, I am terrified to start again. I cannot get a reference from my first nursing job, and I am not so sure on the second, either. Any guidance or suggestions would be greatly appreciated. I just don't know what to do, and I am broken-hearted.

Steph

[Town & Country]

To the original poster: please don't blame yourself!

The hospital here where I live gives a three-month orientation on Med/Surg.

The same thing happened to me...you are correct about "book knowledge" not being enough. You need some good solid experience and Med/Surg is the best place to get that, IMO.

It is the facilities' fault, NOT YOURS, that these positions did not work out!

Don't blame yourself at all.....they never should have floated you like that.

Shop around for a good orientation program...you will be amazed at how much you will learn, and alot of it from CNAs!!!

[VeryPlainJane]

I just live down the street from you KCK. Keep your head up! You sound like a great nurse. You know there are many many jobs here...maybe try a smaller hosp. like up north or one of the North or South St. Lukes?

[joyful nurse]

Hi all,

I apologize in advance for the long post, but I am devastated right now and need some guidance. While I have never been a big poster here, I have been an avid reader of this forum for over 5 years. Those who know me will appreciate the irony of my story.

I am a new grad (May, 2004). Nursing was a dream of mine for as long as I can remember. When my children were old enough, I started to consider nursing school. I read everything I could, made a web site to share the information I found and sought to encourage others. I even wrote a book and was hired to write a weekly advice column for nursing students and potential nursing students (very ironic...). Once in nursing school, I set up a mentoring program, pairing alumni with interested students. I organized a peer tutoring program. I held game show challenges to help junior students through the bewildering first semester. I coordinated the junior-senior "buddy" program. I was passionate about nursing and wanted to support others on the same journey however I could.

I did very well in school, but knew that the real learning was to be had after I graduated. Great grades do not automatically equal "great nurse." Great nurses become so only with experience. Knew all about the stages of reality shock, nurses eating their young, yadda, yadda, yadda. But the idealist in me held out hope that a positive attitude, a willingness to ask questions, a willingness to jump in and try, and a desire to learn would be...well...helpful at least.

First job out of school: I went to a large metropolitan teaching hospital and worked on the pediatrics unit weekend nights. Horrid. While I was blessed to have a great mentor/preceptor, I dreaded going in every shift. I spent most of the week recovering physically and emotionally before heading back in again. It was so stressful, I had six MS attacks in 6 months. Never called in sick until the end...just carried on as best as I could.

My second day off orientation, I was floated to the NICU - the NICU! "Oh, they'll only give you feeders and growers - you'll be fine." Yeah...no orientation to the unit AT ALL - we did computer charting, they did paper charting. Their equipment was different. Their protocols were different. Their patient acuity was higher (obviously). I asked the charge nurse for a brief tour of the unit at least before diving in...but she was busy. I was stuck in a side section separated by a WALL from the rest of the unit by myself - no other staff there - with 3 NICU babies getting complicated (to me) drips. Again I asked for help - charge nurse said she would be over in a minute. She came over 6 HOURS later, and of course I had done everything wrong, not having the first clue about NICU. I just thank God the babies didn't suffer any harm. Scared the crap out of me.

Anyway, the rest of my stay at that hospital was horrible. More floating to NICU, with a devastating near-miss. I did not have the option to NOT float, so I started calling in sick on nights when I was going to be floated. On my own unit, I was given patients whose care needs were way above what I felt comfortable or even remotely competent with (i.e., chemo patients without having had any chemo classes, etc.). My self-confidence dropped and dropped and dropped. Each week was worse than the last and every day my license was on the line.

Then, out of the blue in December, I received an e-mail from the manager of a hospice where I had done a clinical rotation. Hospice has always been my nursing dream - I love everything about it. She wanted to hire me on, said they loved me during my rotation and that I had a great future there. I was so excited - here was a way out of the hospital and into a job where I could be the nurse I had always hoped to be. I called my preceptor from that rotation to tell her the great news. She told me that she no longer worked there, and said, "Don't do it...That hospice will use you, burn you out and drop you." Did I listen to my mentor? No...

So, I quit my hospital job - didn't even work out my notice, which I have never done before - but I was terrified that I would lose my license - so unsafe there! On I went to hospice, heart filled with joy and elation. I should have listened.

I received all of 2 days of orientation, riding around with another nurse, and then was handed my caseload and sent out on my own. On my own, out in the field, with just 6 months of nursing experience under my belt. Can you see the disaster waiting to happen? I asked for support, help, guidance - anything - but my supervisor, manager and peers were all perpetually swamped and not available. I tried my very best, worked as hard as I could, researched every diagnosis, all the appropriate interventions and tried to expand my knowledge fast enough to be able to meet the needs of my families. It just wasn't enough.

Friday, my supervisor called me in for an afternoon meeting. I asked what was up - she said, "I would rather talk to you in person." Not good...not good at all. As I feared, I was being asked to voluntarily resign. She said she knew I had tried really hard, but I didn't yet have the confidence or strong personality needed for being out alone on home visits with no support. She felt bad that I hadn't received a decent orientation, but they just didn't have the time to do that. They needed experienced nurses who could hit the ground running. Of course this makes sense - obviously! But then why did they seek me out and hire me in the first place? I should have seen the red flags, but I was so excited about hospice...

I am devastated. What do I do now? Where do I go? I shudder at the thought of going back to a hospital setting - I am still traumatized from my first job. In fact, my confidence in my nursing abilities is so low right now, I am terrified to start again. I cannot get a reference from my first nursing job, and I am not so sure on the second, either. Any guidance or suggestions would be greatly appreciated. I just don't know what to do, and I am broken-hearted.

Steph

Please don't give up. I have been a nurse for over 25 years, and have been involved in developing orientation programs and preceptorships for the last ten. Also I have done a lot of hiring and interviewing and counseling of new nurses. Anyway, my point is I feel qualified to honestly assure you that things will be different somewhere else. My current unit orients new grads from 3 to 6 months, not counting classroom time. Experieneced nurses who are not kind to the new nurses in our unit are written up, we just don't tolerate it. However I've seen units with hight acuity that put new grads in charge after only 4 weeks! Ridiculous! You need to look around, interview until you find a manager and/or educator that you "click" with. The difference between different units is night and day. It may be that a smaller hospital would benefit you better. Look for a unit that has had a manager for a long time, manager turnover is a red flag for the whole nursing dept. Also, you can find units that don't pull except under very controlled circumstances. Believe me, I've seen many nurses with false starts still become very successful and happy in their jobs.