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

[jms01]

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. 

[TheMoonisMyLantern, ADN, LPN, RN]

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]

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".

[Been there,done that, ASN, RN]

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

[jms01, BSN]

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]

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.

[guest464345]

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!

 

[LibraNurse27, BSN, RN]

If your end goal is to be an FNP I think clinic experience is more valuable, especially if you're able to transfer to primary care. I worked in an FQHC and did hands on and triage. Swabs for flu and strep, wound care, IVs for hydration, blood sugar checks, meds, IMs, vaccines, UAs, pregnancy tests, hemoglobin checks, EKGs, fetal non stress tests, news. It was busy and we had a lot of emergencies due to our pt population not always understanding the difference between urgent care and the ER. I met great people from all over the world. Would have stayed long term if pay was enough to survive in the Bay Area!

If there are FQHCs near you, try it! Hope the pay is not too low. Some of the pts were medically complex. I learned SO much and many RN coworkers went on to FNP. We would work pts up, let the provider know what was up and let them make the dx/tx plan. Almost like being an NP but with the need for a provider to finish the visit. But you get to see what they diagnose and how they treat it, which is what you will do as an FNP. 

As others said, 2020 was a REALLY hard year to be a new grad. I trained someone during covid and it was hard to teach everything while still learning the covid protocols myself and keeping up with covid developments. Part of your problem sounds like the poor teaching and negative/not encouraging environment. It's hard to learn when you're stressed about being judged and when no one has time to teach. If you really want to go back to bedside, try applying! Covid is improving. See if you can get info on which hospitals have good environments and training. As someone who just left bedside, in my opinion you're not missing out! I am glad I did it for 5 years though, learned a lot, then learned I would die if I kept working there LOL maybe you need to satisfy your curiosity and prove to yourself you can do it, and that's fine, but you should only do it if you also actually enjoy bedside nursing. Otherwise it can be pretty miserable =( I'm glad you have a job! And you can learn something no matter where you are. Good luck!

[jms01, BSN]

Because of ADA laws, they had to offer me an alternative. A clinic job was an accommodation due to the fact I couldn’t work nights. 
 

I do like the bedside because I believe I can still learn a lot there. I didn’t like the chaos, but I was looking forward to learning and thriving in a place that would provide me a good foundation for graduate school. In a perfect world, I would’ve learned just a quickly as everyone else, but prioritizing was my weak point. Critical thinking is something I’m still working on. I want to go back and try because I would like the experience under my belt before I transition to another area. I also would like to really try infusion, but it seems out of reach with the experience I have right now. I don’t know, I’m still a new nurse 

[hppygr8ful, ASN, RN, EMT-I]

2 hours ago, jms01 said:

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. 

While I am working my dream job in Psych I did not start there nor did I start in Med/Surg (Acute). My very first job out of nursing school with an ADN from a CC was in L&D (obstetrics) where I was trained as a LDRP nurse. I actually really loved that job and did it for 2 years- but it was nights and I had a 2 y/o and home and when I realized how much I was missing and wanted to have my evenings to play with my son. I did my research on what jobs 8/hr shifts had and decided to try psych. Remember I had no actual experience (Unless you count having a psychotic condition) When the DON interviewed me she asked "Do you have any psych experience?" I said "If you count helping a woman push an 8 pound watermelon through a 10 CM whole - with the relatives there like Master Piece Theatre then the answer is yes.” She hired me on the spot (8 hour days, no weekends and up to three holidays off per year). I loved that job and learned so much but after 6 years I was pretty much suffering from burn-out and switched to another specialty (Group home, RN consultant) again no prior experience except for the psych, I did that job for 6 years. I had an ethical conflict due to the amount of fraud in the industry and I quit.

Next I went to SNF/rehab for 2 years on days. I ran into my old DON from Psych at Walmart and she basically offered my another position at the psych facility which is where I am today

I have a BA in English and ancient languages and have thought about pursuing a BSN but at 58 with retirement just around the corner. I'm happy where I am and make a good income in a facility that values my skills and allows for input and independent problem solving. 

OF course most of this happened back when you could actually win people over with a smile and winning personality. Now days it's all apply on line and they might call you. 

I 'm not sure where this is going except to answer your question. Which I hope I did Good luck with your endeavors.

Hppy

 

[CommunityRNBSN, BSN, RN]

I just want to join the chorus of people saying you are still a nurse, you don’t have to be bedside!  I have not set foot in a hospital since the day I graduated from nursing school. I LOVE working in my outpatient clinic. If you want to work in the hospital, those opportunities will come up— they really will. Keep doing a great job where you are and you can transition to hospital. But just don’t fall into the trap of thinking you HAVE to be in a hospital in order to be a “real nurse.”

[Hannahbanana, BSN, MSN]

On 2/24/2021 at 9:37 PM, 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.

If I understand you correctly, you are task-oriented after your schooling and feel inadequate at putting together the big picture so you can make decisions about priorities based on in-depth knowledge.

You're not going to be there in ten weeks. Most new nurses will tell you that it takes three or four years to feel that level of confidence in their expertise. Don't even think about proceeding to being a prescriber-level provider (FNP) without that. A FNP has to know a LOT about the whys and hows of conditions, far more than tasks. If you don't feel confident about tht at a new-grad level, that's appropriate, though. Don't expect to be close to pre-NP level for a good while. Meanwhile, every setting has knowledge there for the taking. You might find out you have a gift for talking to people with serious life-changing neuro conditions, and find yourself drawn to being a neuro CNS, for example. Or not. But waaaaay too soon to tell. Let it play out.

[RNrhythm, BSN, RN]

When I look back at my first few years, I realize the large role anxiety played in my challenges. I may not have looked anxious, but I dreaded going to work and had trouble sleeping. Having unsupportive, cliquish coworkers and constantly changing managers and educators didn't help either! But I got my acute care experience and eventually got a better job. I am perfectly happy now and love my unit and my job. 

How does someone improve their critically thinking? No one has ever explained that to me. I think I am smart but maybe a little too task focused and often I am impressed by the critical thinking leaps done by others, including students I precept. That being said, I know my own strengths and know I am an above average bedside nurse that people like working with.

Give yourself a break! You have a good job and are building skills, experience, and connections. You have so much success ahead of you.