Traumatized by nursing - advice needed

kcsun3 · Apr 11, 2005

Everyone's advice is so excellent. I wanted to add a slight twist. from your OP, you showed yourself to be an expert as a nursing student. transfering from expert to novice "new nurse on the floor" is really hard, not only clinically, but in so many other ways. Know this from a 9 yr. ICU nurse who took a float pool position and caught a baby from a crack head screaming she was a month pregnant and miscarrying, took off the pants, caught the baby... had my own heart attack and screamed for help like a wild banshee.
I've been acoustomed to being the expert... it's a very hard transition to novice.. but it can be hell and fun too. you've got a good plan. With your history in our profession, you'll get through this bump just fine.

Heart Queen,

Very good points, and as I think about it, probably very true. I never considered myself an "expert" as a nursing student by any means...I struggled as much as anyone else. But I felt comfortable in the school setting and felt my strengths were valued there; I felt encouraged to use my strengths to define my own success, to expand and grow, to share as much as I could with others. In the nursing world, my strengths are not so much valued, at least at the novice level. More emphasis is placed on skills - and rightfully so...

You are right...it IS hard. You have to work hard to turn your weaknesses into strengths to have enough collateral to get your bigger strengths a platform to be noticed. I have no idea if that even made sense to anyone but me LOL But, I understand what you were saying - you are right and I appreciate the guidance and support. Thank you, Heart Queen...

Steph

cardiacnurse33 · Apr 11, 2005

Hello kcsun,

From Topeka, Ks here. If at all possible the hospital i work for has at least a 4 week orientation for new nurses. Im not sure where meriam is at but if anywhere near Topeka, I think you would be pleasantly surprised. I am fairly new, ive been on the cardiac floor for 5 years and there were nurses who would try and intimidate, but as long as you know what your doing you would do fine. Hang in there and good luck.

lady_jezebel · Apr 11, 2005

You're so gracious & thoughtful in all of your replies to opinions on this board. Very classy. I think that alone is going to get you far in this field!

Good luck to you in all that you do!

kcsun3 · Apr 11, 2005

Hello kcsun,
From Topeka, Ks here. If at all possible the hospital i work for has at least a 4 week orientation for new nurses. Im not sure where meriam is at but if anywhere near Topeka, I think you would be pleasantly surprised. I am fairly new, ive been on the cardiac floor for 5 years and there were nurses who would try and intimidate, but as long as you know what your doing you would do fine. Hang in there and good luck.

Hi Cardiacnurse33,

Merriam is an older suburb of the KC metro area. Topeka is about an hour away - not too far, really. I think I will look here first, but I appreciate the tip. It never hurts to keep one's options open :)

Thanks for the scoop and the moral support!

Steph

kcsun3 · Apr 11, 2005

You're so gracious & thoughtful in all of your replies to opinions on this board. Very classy. I think that alone is going to get you far in this field!
Good luck to you in all that you do!

Lady Jezebel,

Thank you :icon_hug: - I'm at a loss for words...that was a really nice thing to say and it really made my day :icon_hug:

Steph

Da Monk · Apr 11, 2005

Hi kcsun3. Maybe this idea is erroneously based, but if you feel so down about all of this, perhaps it would be a good thing for you to seek psychotherapy regarding your issues. I know this sounds like something a psych nurse would say, but I myself have utilized this approach in the past on several occasions and except for one disasterous run in with a guy who must have been the worst marriage therapist in North America, I remember my sessions as helpful and I never failed to learn something about myself about which I was unaware. Be happy.

jeepgirl, LPN, NP · Apr 11, 2005

not only do you need a better orientation, but you must learn to stick out a place. you should have gone to your manager at your FIRST job to have them address the gaps you felt you had... asked for more education, etc. did you think that maybe they were giving you the "hard" patients on your home floor so you could learn?

Thats exactly what we did on my floor! it increased my exposure and my threshhold. now, on the NICU, I can see your problem! A peds nurse, however, should be able to feed (nipple and gavage), assess and maintain a stable (feeder / grower) baby's IV and administer some meds. Other than that, it might be pushing it.

I think you are going out of your way to say what a good student you were. That's great... really, it is. But you're right, it doesn't make an excellent nurse. Those take a few years go grow! Just because you're not perfect now doesn't mean there's no hope for you. You've got to step outside your comfort zone.

I think you did a not so smart thing by leaving your first job within six months.... but you did a BAD, BAD thing by not working out your notice. It is not going to look good... companies that want to give a nurse a competitive job look at those things. It shows a lot about character when someone does that. Remember, you won't be eligible for rehire at that hospital or any affiliated clinic, hospital, etc either. You probably won't have any references either. So, if you can't get a reference from the first hospital, and probably not any from the hospice, where are you going to get them from? From the school? If I were looking at this... I would wonder why a nurse with one year of experience has no work references, just school references. It will raise a red flag. You're just really going to have to work to minimize it.

Trauma1 · Apr 11, 2005

I agree. You should definitly try a med-surg unit to get good background experience before you jump into critical care or community health. Those experiences will help form a foundation for your nursing knowlegde. Many hospitals (in the southeast) have new nurse orientation programs for nurses. The orientation is between 6 and 12 weeks with no floating for 6 months to a year. (depending on your hospital) Look into these programs and listen to staff that work on the unit. Are they happy, friendly etc? Teamwork is essential in nursing so try to find a place where you see the team working well. Maybe do an internship or shadow for a day before you accept a job offer. I was a medsurg nurse for several years before going into critical care and the knowledge/time management skills I gained were invaluable. Don't give up...there's a niche for all of us...you just have to find yours.

Hummmm, you have yourself in a pickle now, don't you? Do you think you can get a decent reference from the hospice since they seem to be aware of the problem being you did not have the experience needed. Maybe a nurse refresher course or an internship would be available. I would hate to see you continue to spiral downhill on the self esteem ladder. Your story is exactly why I always advise new grads to do at least a year of general med surg. Specialty units are just that....special, and require special knowledge for special situations. While med-surg is not easy by any means, you will have the opportunity to see a wide variety of situations both acute and non acute, and will be handle the specialities later. It gives you a chance to see how the flow of the floor goes, learn the lingo, fine tune your skills, learn to prioritize, etc. without so much pressure.
I think if you are honest with a recruiter, come with some good references from school, some of the things you did in school and ask for a chance to gain some confidence and skills, you will be well accepted. Good luck. Nursing is tough, I will not discount that, but you can do it if you have the will to do so.

mydesygn · Apr 12, 2005

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

It sounds like a horrble experience. I started as a new grad in pediatrics also. I had the usual 3 month orientation and an excellent preceptor. I enjoy pedi and have remained exclusively in pediatrics for 14 years. I see 2 huge problems -- you should never be asked to float from a floor to an ICU enviroment ---period... If you have had no ICU experience , don't accept the float. I am not sure of the Board procedures in your state, but you do have rights. Secondly, I would consider alternative enviroment, you have some nursing background. Why not consider school nursing or public health or possibly research nursing? It would be great to boost your morale by providing you an enviroment where you have more control over your practice and less stress and constant change. I truly beleive you should not cahin yourself to bedside care. Also, if there is a dedicated pediatric facility in your city, that would be better choice for pediatrics, much more supportive enviroment.

drscepura, BSN, DNP, RN · Apr 20, 2005

No one promised you that being a nurse was going to be easy! The reality is young nurse that you have graduated during a time of great nursing shortage where resources for education, preceptorship are very scarce.

My best advice would be to change your graduation date on your resume (as dishonest as it may seem so that you can get a job) and try getting yourself into an acute medical surgical unit for adults for a minimum of one to two years. This will help you build confidence which after reading your post seems as if you are very short on. No matter how much you hate it or feel scared or grossed out you have to stick it out. Try to find a position that isn't nights also so you are not killing yourself, a rotating day/eve position would be good. Try to go to a teaching hospital where you will have more monitoring/mentoring. But don't expect all the nurses to be nice to you at first, that is not reality. Nurses are tired of teaching younger nurses and not being rewarded in anyway for it, harsh as it seems.

After you have a solid acute care experience under your belt, then feel obliged to try different things. No one says you have to stay in the same job forever. You are free to move about the cabin, remember that.

I think you made poor job choices as a new grad. Pediatrics is very demanding for a new grad, and then to float to a NICU! Unimaginable! And then to go to the opposite extreme, doing Hospice! In order to do hospice you need to have the specific qualities to deal with death and dying issues which only a seasoned nurse has. So: my best advice: THINK AGAIN! And do things right in the logical order of progression.

Still if you are afraid or traumatized to the extreme regarding hospital work and can't bring yourself to work on a medical surgical unit then go apply for a job selling pharmaceuticals, or work for an insurance company, etc etc. There are other options out there for you. Don't devalue yourself so much!

Katillac, RN · Apr 20, 2005

"No one promised you that being a nurse was going to be easy! The reality is young nurse that you have graduated during a time of great nursing shortage where resources for education, preceptorship are very scarce."

Wow. That's pretty harsh. So she should just suck it up and deal? Zero points for that helpful advice.

" My best advice would be to change your graduation date on your resume (as dishonest as it may seem so that you can get a job) and try getting yourself into an acute medical surgical unit for adults for a minimum of one to two years. This will help you build confidence which after reading your post seems as if you are very short on. No matter how much you hate it or feel scared or grossed out you have to stick it out. Try to find a position that isn't nights also so you are not killing yourself, a rotating day/eve position would be good. Try to go to a teaching hospital where you will have more monitoring/mentoring. But don't expect all the nurses to be nice to you at first, that is not reality. Nurses are tired of teaching younger nurses and not being rewarded in anyway for it, harsh as it seems."

Can't begin to say what bad advice this is. So, she lies about when she graduates, then gets found out and fired. But, she had the job to begin with. That's what's important???? And no, you don't have to "stick it out" no matter how bad it is. Her being floated to the NICU was UNSAFE. That's her license and reputation on the line.

"After you have a solid acute care experience under your belt, then feel obliged to try different things. No one says you have to stay in the same job forever. You are free to move about the cabin, remember that."

Ummm. . . I think she knows that, as she IS trying different things. What in God's name makes you think she is OBLIGED to???? Or that she has to wait until she has solid acute care behind her before she does? I'm eternally grateful for my Med/Surg experience, but where is it written that you must have it?

"I think you made poor job choices as a new grad. Pediatrics is very demanding for a new grad, and then to float to a NICU! Unimaginable! And then to go to the opposite extreme, doing Hospice! In order to do hospice you need to have the specific qualities to deal with death and dying issues which only a seasoned nurse has. So: my best advice: THINK AGAIN! And do things right in the logical order of progression."

According to the Great and Powerful You, yes? I advise YOU to THINK AGAIN. Her choice of peds as a new nurse is not necessarily bad, and neither was hospice. Many new nurses go directly to specialties and do well. I'm a hospice nurse, and not all good hospice nurses were seasoned nurses when they arrived at the door. Where do you get these ideas?

"Still if you are afraid or traumatized to the extreme regarding hospital work and can't bring yourself to work on a medical surgical unit then go apply for a job selling pharmaceuticals, or work for an insurance company, etc etc. There are other options out there for you. Don't devalue yourself so much!"

:angryfire Good Lord, after what you had to say to her, you now suggest she don't devalue herself? Let's see, she makes poor choices, she needs to lie to get a job, she's so dim she needs to be reminded that she can change jobs, but now she can loose her bad self on an insurance company or selling pharmaceuticals? SHE isn't devaluing herself, YOU ARE!

nurseinlimbo · Apr 20, 2005

I have had similar experiences. My confidence and learning are also suffering. I have been out of school since Dec. '04 and have worked 3 months in psychiatric rehab (too slow and the nurses were just there for the paycheck, no pt contact or very little), then went to 2 long term care facilities, one of which had a reputation for chasing their nurses away. I lasted from May to December but got tired of the games and gossip, nothing that I did was ever right and the nurse manager wanted to own me even though they didn't have enough shifts to keep me exclusive. The other Long term job is ok, but I had worked there as a PCA for 8 yrs prior to school and came back as an undergrad and grad nurse. They try to bully me occasionally but it's different because I already have been through the pecking order. I also worked for about 6 months in a Rural 16 bed hospital, with an ER. I didn't get to do much ER (it was slow) and the hospital side was mostly LTC waiting placement, with the occasional palliative or acute situation. I found it appalling how they treated their patients (especially anyone with dementia) and they were awful to me. One nurse would ridicule me on every shift change, not show up for an hour for her night shift and made up a situation where I supposedly didn't give a patient a narcotic (I did). I was a nervous wreck and hated going to work.

Right now I work in a facility for severely disabled adults with various problems, several have feeding tubes but it is a fairly stable environment. The unit has a 4 bed "Community Service Bed" ward where patients from our small town can come for convalesence, infirmary or palliative care. I enjoy the palliative care aspect but do find it very emotionally draining ( I just had 2 palliative cases back to back). We can manage IV's but not initiated them. My other job is LTC at the place where I worked for years, not very many shifts there though. I like them both, but don't feel that I am gaining the vital acute experience that I really need in order to expand to other areas. I am working on my degree by correspondence to keep my mind fresh, and would like to eventually take the OR nursing course, but I have no desire to go back to acute care. Our city hospital has a horrible reputation for treating new grads like crap.

Sometimes it feels like a no win situation, but as long as I do the best that I can, that's all I can do.

It sounds like the hospice is willing to help you out, which to me says that they must have recognized that it is your lack of experience not your lack of ability that has limited you. I would take that as a positive and go from there. I have really had to learn not to take anything personally, if you don't in this field they will chew you up and spit you out.