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What if I'm not meant to be a bedside nurse?

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I graduated w/ my BSN last Spring and ended up on starting a tele-turned-COVID floor last fall. I felt very fortunate that I got a hospital job, but 2 months in, I was starting to realize how things weren't making any sense. It wasn't just me that noticed my lack of knowledge or piecing things together, but I could tell my preceptor was getting frustrated with me too. She said I had no sense of urgency for things; I struggled to think critically, I was always so task oriented (nursing is a second career for me). I didn't struggle with the hands on skills, I felt like that was my strength and I knew from my friends who are nurses that you can't be so hard on yourself so much. I took every little victory on the floor as a win for me (like putting in an IV on my own), and there were days I felt so stupid, I'd drive home after my shift crying. 

I also thought my educator was there to support me, but I was belittled over things I didn't realize would be thrown in my face. During one meeting with her, she spoke negatively of the fact that I took multiple attempts to get an IV in on a mannequin arm and draw blood from a PICC line. This was during the first week of orientation, and I had never done either in nursing school. From the beginning, I didn't feel supported, but I pushed through. Fast forward weeks later, and she was belittling me again over the same thing. I don't know if the combo of my educator and preceptor together contributed to my lack of success on a 6:1 tele/covid floor, but I so badly wanted to succeed. At 10 weeks, I was told to go to nights, and I had to say no because I have epilepsy and bc of the nature of my condition, I couldn't put myself at risk.

I got transferred to an outpatient neuro clinic, and now I'm basically at a desk all day helping out the doctors, answering "triage" calls and doing med refills. I don't feel like a nurse anymore, I feel like a failure almost every day now, to the point where I cry about it. I don't feel like I know anything, and I didn't feel like I would be a safe nurse on the floor because I didn't know how to pick up on things on my own after 10 weeks. I didn't know how to critically think, I was still working on it. 

Overall, I feel like a failure. I can't be the only one who has felt like this. I question myself constantly about that experience. I had so much faith in myself that I would succeed. I feel so stupid that I couldn't manage the chaos, the ratios, and learn how to do my job. 

Edited by jms01

FolksBtrippin, BSN, RN

Specializes in Psychiatry, Pediatrics, Public Health.

 

Please don't beat yourself up!

You became a nurse at the most stressful possible time!

You are succeeding in a neuro clinic.

Please don't feel like a failure. You are a nurse. Be the best nurse you can be in the position you are in. There is a lot to learn where you are. 

Use this experience to develop your skills (including critical thinking) and think about what you want to do next. 

You are a success, not a failure. 

Sour Lemon

Has 9 years experience.

4 hours ago, jms01 said:

I graduated w/ my BSN last Spring and ended up on starting a tele-turned-COVID floor last fall. I felt very fortunate that I got a hospital job, but 2 months in, I was starting to realize how things weren't making any sense. It wasn't just me that noticed my lack of knowledge or piecing things together, but I could tell my preceptor was getting frustrated with me too. She said I had no sense of urgency for things; I struggled to think critically, I was always so task oriented (nursing is a second career for me). I didn't struggle with the hands on skills, I felt like that was my strength and I knew from my friends who are nurses that you can't be so hard on yourself so much. I took every little victory on the floor as a win for me (like putting in an IV on my own), and there were days I felt so stupid, I'd drive home after my shift crying. 

I also thought my educator was there to support me, but I was belittled over things I didn't realize would be thrown in my face. During one meeting with her, she spoke negatively of the fact that I took multiple attempts to get an IV in on a mannequin arm and draw blood from a PICC line. This was during the first week of orientation, and I had never done either in nursing school. From the beginning, I didn't feel supported, but I pushed through. Fast forward weeks later, and she was belittling me again over the same thing. I don't know if the combo of my educator and preceptor together contributed to my lack of success on a 6:1 tele/covid floor, but I so badly wanted to succeed. At 10 weeks, I was told to go to nights, and I had to say no because I have epilepsy and bc of the nature of my condition, I couldn't put myself at risk.

I got transferred to an outpatient neuro clinic, and now I'm basically at a desk all day helping out the doctors, answering "triage" calls and doing med refills. I don't feel like a nurse anymore, I feel like a failure almost every day now, to the point where I cry about it. I don't feel like I know anything, and I didn't feel like I would be a safe nurse on the floor because I didn't know how to pick up on things on my own after 10 weeks. I didn't know how to critically think, I was still working on it. 

Overall, I feel like a failure. I can't be the only one who has felt like this. I question myself constantly about that experience. I had so much faith in myself that I would succeed. I feel so stupid that I couldn't manage the chaos, the ratios, and learn how to do my job. 

Things are always tough as a new grad, but I think they've been 100 times worse for recent new grads in heavy-hit-by covid places. A lot of people have horrible first job experiences. I had to fight to not get fired from my first job, in fact.

If you're interested in getting back to a hospital setting, put out some applications and see who calls back. And of course, think about the what you've been told so far and what improvements you might be able to make.

Not everybody needs to be a bedside nurse! It's OK. You're still a nurse. Nurses are needed in a very wide variety of roles. Frankly, I hated bedside nursing and am much happier not being there. I am thankful every day that there are nurses who love it. You're not a failure.

JBMmom, MSN

Specializes in Long term care; med-surg; critical care. Has 9 years experience.

Nurses are needed in a variety of roles, there aren't "nursier" nurses out there than you are right now. If you're happy in the role you're doing, an important one for the patients you're serving, then you're going to have to figure out how to get past the feelings of failure. Because really, they're all coming from you. It sounds like you're doing well and you can be proud of that. 

If, however, you do want to get back to a bedside position because you think that's what you would enjoy more, then don't give up. You can find a way to get back to it and be successful. As others have pointed out, anyone that started in the past year has had a really rough start of it. And it sounds like the unit you were on was not the most supportive. Don't give up if you want to get back to bedside, but don't beat yourself up if you find something else in nursing that works for you. You will be valuable to patients in any role!

RN1485, BSN

Specializes in Public Health, Case Management, Psych, Medsurg. Has 7 years experience.

My first nursing job on the floor I left after 3 months because it was a toxic work environment without much support. I didn’t even put in my notice. I ran out of there screaming!! Tried other nursing positions (psych) until I decided to try the floor again and the support was so much better. It can seriously make or break you! Also nursing roles build on top of each other. The meds you are calling in refills on eventually you’ll know all about those and why they are given. You can really learn a lot from the doctors as well on different neurological conditions. Everything you learn in a nursing position, you take with you to your next position. I knew right away bedside wasn’t where I thrived because I don’t like feeling rushed. It felt like a waitressing job and I didn’t thrive when I was a waitress either. I don’t like codes or emergency situations. I like to build a report with patients and take my time. That’s just me. Do what makes you happy! Don’t worry about what other people think you “should” be doing. You’ll be miserable if you do! 

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 19 years experience.

My very 1st nursing job was in L&D and the hospital spent a ton of money to send me (a new grad) to an 8 week training. I did all this as an interim permitee (no license yet).

About 1 month out of training I was doing a cervical exam and was absolutely confident that my patient was at 9 cm and fully effaced. I called the doctor who was known to be a bit of a prima donna and he came as he was in the facility. After checking the patient he took me out of the room and asked. Why did you think the patient was 9 CM and fully effaced? I just looked at him and probably turned all kinds of red. He told me to wait one hour and check patient again. "Put your finger up in there and feel for the edge of the cervix and don't call me again unless she is at 10 cm or there is fetal distress!"  He told my co-worker/preceptor that I coulndn't tell a cervix from a rubber band!.

I took all kinds of flack for that and really wanted to quit - but my daddy didn't raise no quitters so I perservered. You can bet I made sure I was sure of my assessments from then on out.

As a BSN you are uniquely positioned to enter several different roles , Floor nurse, school nurse, any number of specialties. So take your time and look around for where you think you want to be. Practice skills any time you can and take a course in critcal thinking. Some folks are born with this talent. Others have to learn it.

Don't be so hard on yourself. 

Hppy

Are you upset because you WANT to be on the floor or are you upset because you feel like you SHOULD want to be on the floor?  Do you miss the actual experience of being on the floor or are you mostly stung by the feeling of failure?  If you were able to keep up with a COVID med-surg floor, is that a place you would LIKE working? 

I think there's this myth that hospital nursing is the only kind of nursing that counts.  That hospital nurses are "better" than other nurses.  And that's not true.  Like, at all.

Being able to juggle multiple patients in a med-surg environment is undoubtably valuable, and thank goodness some nurses do that well. But nurses who slow down, and focus on one patient at a time are also important.  A community health nurse who gives excellent diabetic education or a home health nurse who is meticulous with wound care is just as important because that nurse keeps patients OUT of the hospital.  When my mom was dying, the hospice nurse was there for me as much as she was there for my mom.  On a med-surg floor, patients know the nurses are pulled in 5 directions at once; in hospice, the nurse is able to really focus on the patient and family. School nurses are doing way more than giving out ice packs and bandaids these days.  They're doing a bit of public health, and a bit of mental health, and education, and managing medically complex kids, and being first responders, and a bunch of other things rolled into one.

So I guess my question is do you think med-surg is where your talent and interests lie, or is med-surg a job that you want to know you *can* do?  Because if you want to do med-surg because floor nursing is intrinsically interesting to you, then we can probably give some advice on getting back in there.  But if you just want to go back to med-surg to erase the sting of failure, then maybe your time would be better spent looking around at other areas of nursing to see what might be a a better fit for you.  It's not a failure to seek your niche elsewhere.

I would like to go back to floor nursing because I want to understand what I'm doing and bring that knowledge with me for when I go back to school for my FNP. I feel like I never got the grasp of what to look out for if something goes wrong, when to call RRT, why a medication is being prescribed, how to anticipate orders, etc. I was thrown into a pool of sharks and didn't feel ready enough to practice safely. I didn't feel like I knew enough to be safe. Even after 10 weeks, I felt beyond stupid and like I truly wasn't cut out for the floor, but I really do like bedside nursing. I don't know if I make any sense, but basically I feel like because things don't come to me quickly, I struggled and failed on a tele floor.

laflaca, BSN, RN

Specializes in School Nursing. Has 7 years experience.

47 minutes ago, jms01 said:

I would like to go back to floor nursing because I want to understand what I'm doing and bring that knowledge with me for when I go back to school for my FNP. I feel like I never got the grasp of what to look out for if something goes wrong, when to call RRT, why a medication is being prescribed, how to anticipate orders, etc. I was thrown into a pool of sharks and didn't feel ready enough to practice safely. I didn't feel like I knew enough to be safe. Even after 10 weeks, I felt beyond stupid and like I truly wasn't cut out for the floor, but I really do like bedside nursing. I don't know if I make any sense, but basically I feel like because things don't come to me quickly, I struggled and failed on a tele floor.

You know, there's a whole bunch of hospital/bedside nurses out there who are *dying* to get into 9-5 clinic jobs!  Search "leaving the bedside" on this forum, and you'll see. 

If you want to be an FNP you're probably going to work in a clinic, anyway.  You have a great opportunity to learn how clinics work:  what to look out for, when patients need to be seen urgently, why medications are prescribed, how to hone your triage skills, the pathophys of different disorders, and how to anticipate orders and understand treatment plans.  Maybe you're stuck doing insurance auths or med refills, but you can still open your eyes and ears, and learn a lot. (WHY is this med prescribed?)

With experience in this clinic, you could likely transfer to a family practice clinic in the future - and you'd likely learn even more there, as well as meeting people in your future field.

The skills you learn in hospitals can be handy, but they're often quite specific to the environment.  I left the ED to become a school nurse, thinking it would be an easy step down, and I was *shocked* at how much I didn't know.  How do continuous glucose monitors and insulin pumps work - because now someone expects me to trouble shoot one!  How do you manage an injured person by yourself, with no medical equipment or physicians, and panicked adults all around? You can't just CT every head injury....so which ones should you worrry about?  I don't put in IVs or manage really sick patients anymore, but I've learned a ton and I'm definitely still a nurse.

If you're a more contemplative person who takes time to absorb information, the hospital might not be the right spot.  Maybe with the right support you *could* learn it, but that doesn't mean you *need* to.  personally I worked a tele floor for about four months - I could kinda-sorta manage the six million competing demands, but it just seemed like unnecessary suffering to me.  I hated it.

You might be in a better situation than you think!  It kinda seems like you just want to work in the hospital because they made you feel like you couldn't/shouldn't....if that makes sense. 

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

On 2/21/2021 at 8:59 PM, jms01 said:

I graduated w/ my BSN last Spring and ended up on starting a tele-turned-COVID floor last fall. I felt very fortunate that I got a hospital job, but 2 months in, I was starting to realize how things weren't making any sense. It wasn't just me that noticed my lack of knowledge or piecing things together, but I could tell my preceptor was getting frustrated with me too. She said I had no sense of urgency for things; I struggled to think critically, I was always so task oriented (nursing is a second career for me). I didn't struggle with the hands on skills, I felt like that was my strength and I knew from my friends who are nurses that you can't be so hard on yourself so much. I took every little victory on the floor as a win for me (like putting in an IV on my own), and there were days I felt so stupid, I'd drive home after my shift crying. 

I also thought my educator was there to support me, but I was belittled over things I didn't realize would be thrown in my face. During one meeting with her, she spoke negatively of the fact that I took multiple attempts to get an IV in on a mannequin arm and draw blood from a PICC line. This was during the first week of orientation, and I had never done either in nursing school. From the beginning, I didn't feel supported, but I pushed through. Fast forward weeks later, and she was belittling me again over the same thing. I don't know if the combo of my educator and preceptor together contributed to my lack of success on a 6:1 tele/covid floor, but I so badly wanted to succeed. At 10 weeks, I was told to go to nights, and I had to say no because I have epilepsy and bc of the nature of my condition, I couldn't put myself at risk.

I got transferred to an outpatient neuro clinic, and now I'm basically at a desk all day helping out the doctors, answering "triage" calls and doing med refills. I don't feel like a nurse anymore, I feel like a failure almost every day now, to the point where I cry about it. I don't feel like I know anything, and I didn't feel like I would be a safe nurse on the floor because I didn't know how to pick up on things on my own after 10 weeks. I didn't know how to critically think, I was still working on it. 

Overall, I feel like a failure. I can't be the only one who has felt like this. I question myself constantly about that experience. I had so much faith in myself that I would succeed. I feel so stupid that I couldn't manage the chaos, the ratios, and learn how to do my job. 

I don't think you should feel stupid or feel like a failure. This is a bump, a hurdle, something you can learn from. Some jobs are not good fits and not being a good fit on one unit of the hospital doesn't mean you won't be a good fit on another unit of the hospital.

I will say that a 6:1 ratio on a tele floor sounds about right unless you're in one of the few states with a strong union presence  or in California with mandated ratios. One think that jumped out at me was your preceptor saying you lacked a sense of urgency. I think you should really reflect on that because that can be an important issue to address. Was it a problem of prioritization or a problem with attending to issues that needed to be addressed? Sometimes it can be difficult for new grads to transition from the mindset of "I need to tell someone this" to "I need to deal with this." 

As others have said, inpatient environments are very stressful especially right now for the obvious reasons, many would be envious of your clinic position as those type of positions for RN's are becoming rarer. If you really feel it tugging at your soul to try a more acute environment then you ought to go ahead and apply for other hospital jobs in your area. I would also encourage you to consider SNF/LTC, a lot of new grads snurl their nose at the thought but it can be a great place to learn how to be a nurse with patients are typically more stable than hospital patients but still require management of acute illnesses. It is fast pace and the ratio often sounds impossible, but it's pretty task oriented and might be a good fit for your personality.

I think the biggest challenge you'll have isn't that your tele job didn't work out, but that you are unable to do night shift. It can be really hard to nab a dayshift job as a new grad depending on where you are. You have a bigger chance of being able to get a dayshift or evening shift position with LTC/SNF.

Good luck to you.

Thank you all for your feedback! I appreciate it so so much! I’ve definitely been hard on myself since leaving tele because I saw my peers succeed and me falling behind constantly, despite my best efforts. I’m eager to go back because I don’t want to give up on myself, I’ve only been a nurse for about 4 months, but I’m not sure what floor what be a good fit for me.
 

With the neuro experience I’m gaining, I’ve been doing a lot of triage and getting to help the doctors with their new patient visits, which I enjoy. I’m learning how to do H&Ps, something I thought I wouldn’t get to do until I became an NP. I’m just wondering where these skills would be transferable in acute care though. I’ve always wanted to try working in the ICU, esp neuro ICU, but I find that my lack of experience would not help me land a job like that. 

I think I’m really missing the hands on skills the most. Would trying wound care or infusion be a jump for me given my experience?

Edited by jms01

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

28 minutes ago, jms01 said:

Thank you all for your feedback! I appreciate it so so much! I’ve definitely been hard on myself since leaving tele because I saw my peers succeed and me falling behind constantly, despite my best efforts. I’m eager to go back because I don’t want to give up on myself, I’ve only been a nurse for about 4 months, but I’m not sure what floor what be a good fit for me.
 

With the neuro experience I’m gaining, I’ve been doing a lot of triage and getting to help the doctors with their new patient visits, which I enjoy. I’m learning how to do H&Ps, something I thought I wouldn’t get to do until I became an NP. I’m just wondering where these skills would be transferable in acute care though. I’ve always wanted to try working in the ICU, esp neuro ICU, but I find that my lack of experience would not help me land a job like that. 

I think I’m really missing the hands on skills the most. Would trying wound care or infusion be a jump for me given my experience?

You can certainly try for a wound care or infusion nurse position. Typically these types of jobs require experience particularly infusion companies, they want people who are already really good with establishing, maintaining, and managing vascular access. Your best bet would be to look for wound or treatment nurse positions at LTC/SNF or at a wound care clinic. 

martymoose, BSN, RN

Specializes in PCCN. Has 18 years experience.

Quote

 I got transferred to an outpatient neuro clinic, and now I'm basically at a desk all day helping out the doctors, answering "triage" calls and doing med refills.

I would give a million bucks (if I had it LOL) to have this opportunity handed to me. 

It doesnt make you less of a nurse. Your knowledge is valuable. 

I don't have any opportunities where I live to have a job as such, and I would jump on it first thing after being a "floor nurse" for over 10 years , stupidly thinking things would get better . Ahahaha. 

anyhow, good luck, sorry it's not what you wanted. I have to tell myself this everyday too; this is NOT what I "signed up for".

Edited by martymoose

Been there,done that, ASN, RN

Has 33 years experience.

Your preceptor and nursing ED did not support you. Nursing education is there to teach, not belittle.

"I got transferred to an outpatient neuro clinic, and now I'm basically at a desk all day helping out the doctors, answering "triage" calls and doing med refills." Realize that, this is a dream job for many nurses. You will learn how to prioritize with your triage practice. 

Best wishes

I know being a nurse doesn’t just mean being at the bedside, but I feel that having that bedside experience opens the door for many opportunities, such as the ones I’m interested in. I think that’s why I’m worried that having clinic experience isn’t enough if I try to go into a different area of nursing. 
 

Am I overthinking this? Could someone talk about their acute care or outpatient  experience and how they made the jump to another specialty? Would love to hear more about it! I don’t want to feel discouraged, I like what I’m doing but I know I’m capable of so much more. 

martymoose, BSN, RN

Specializes in PCCN. Has 18 years experience.

I'll tell you this. Acute care is for the birds right now. Keep this other job as long as you can. I'm sure there will be plenty of openings for acute care nurses since so many are jumping ship. Most companies right now just want a warm body.

laflaca, BSN, RN

Specializes in School Nursing. Has 7 years experience.

19 hours ago, turtlesRcool said:

So I guess my question is do you think med-surg is where your talent and interests lie, or is med-surg a job that you want to know you *can* do?  Because if you want to do med-surg because floor nursing is intrinsically interesting to you, then we can probably give some advice on getting back in there.  But if you just want to go back to med-surg to erase the sting of failure, then maybe your time would be better spent looking around at other areas of nursing to see what might be a a better fit for you.  It's not a failure to seek your niche elsewhere.

I still think Turtles has a really important point....do you actually LIKE acute care nursing, though? Or do you want to feel like you COULD do it (even though you'd rather do something else)?

Some people love acute care, but in most places it's pretty much the way you experienced it.  Experience and pattern recognition make you faster and more confident, but it doesn't ever become a job where you have time to spend in-depth time with patients. With 6 patients, you will always be hustling and wishing you could do more. 

As others have pointed out, the world needs nurses with that hustle who can run all day and confidently manage a thousand important details at once, but we also need nurses who are suited for the longer-term work of assessment and care in nonacute settings

The other thing is this: you can't be as much of a mess as you think.  To be frank, they could have easily gotten rid of you.  Still on orientation, a new grad, presumably not in a union contract - they didn't even need a reason to fire you!  But they offered you nights first, and when you turned that down they offered you a clinic job.

They must think you have some value as a nurse, and you should too!