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. 

[hppygr8ful, ASN, RN, EMT-I]

1 hour ago, RNrhythm said:

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.

I'm leaving this thread with a quote from one of my favorite sources of inspiration, Ralph Marston........"If you cannot connect what you’re doing to a good, personally meaningful reason, you’re simply not going to be able to focus on it or be truely happy doing it."

Go be you and don;t let others deter you!

Hppy

[PsychNurse24, BSN, RN]

I live in Colorado and some of the Denver hospitals offered 12 week or 16 week classes for OR or ICU Nurses.  It did not sound like you had to be employed there to take the classes; I think they were offering them for new grads or for Nurses who wanted to switch specialties.  You might look into something like that if you can take the time to attend.  I think Covid ended those classes for now, but they will probably start up again. 

And I agree with everyone’s advice to do what you want without worrying what others think. I worked one year on a surgical floor and then moved to psychiatric mental health nursing. A lot of nurses thought I was nuts because being a psych nurse doesn’t really count, but I love it.

[jms01, BSN]

Thank you all for your positive feedback! I truly appreciate it. I think I'm realizing day to day that I'm definitely comfortable with patient education and overall patient interaction. I love getting to help the doctors with visits. What I really need to brush up on is learning the ins and outs of the neuro pharm and reading about the neuro disorders the docs treat. I'm hopeful that I will feel confident enough in this role to jump back onto the floor, hopefully a neuro floor. I'm really confident interviewing, so I hope I can find something neuro related soon. 

[MelEpiRN]

You could consider inpatient rehab nursing too. You'd probably see a good bit of neuro- TBI, spinal cord injury, strokes, etc. It's not acute care, but these patients still experience a lot of the ongoing concerns from hospitalization and their transition to integration back into the community/ functional independence. I think you'd learn a ton about neuro conditions and give you the experience to manage these concerns as an FNP. IPR nurses are huge assets to these patients and are (in my opinion) in a better place to educate the patients than the acute care nurse...it's been shown time and time again that patients don't remember things we teach them in the hospital.

[RNNPICU, BSN, RN]

From what I have read in your posts you are thriving in your position. Acute Care is not the be all do all end all of nursing.  Why stress yourself out and feel awful everyday you go in to work just to say you are working at the bedside.  Do you really want to run around all day, get critiqued by co-workers, physicians, familiy members, the patient because you aren't fast enough, good enough, etc... all just to say you worked bedside? 

You are using your nursing skills, assessment skills as a nurse.  It is just different. Bedside nursing is always chaos, it always changes.

I have always wanted to do ER nursing and IV nursing.. however I am terrible at IV starts no matter how many classes, attempts, etc.  The ED seems interesting because of the teaching aspect and critical thinking, however, I can't move that fast. I would never succeed no matter how much I wanted it or how great a preceptor there was.  I would not choose to work there at all

There truly is a place for everyone.   

Let me ask you this.... Do you want to embrace the fast pace chaos knowing that there is a very finite timeline before you get off orientation?

 

Do you want the bedside because someone said you have to do bedside to be a nurse?

 

Your current job is just as important at the bedside, perhaps more because you are dealing with outpatient and limited resources.

[Lovethenurse2b25, ASN, BSN, CNA, LPN, RN]

Don’t be so hard on yourself! 
 

Im going through a similar experience. I started nursing in a long term care facility in 2019 almost 2 years ago. And recently went onto a oncology/tele/med surg unit in a local hospital. It is a big learning curve for me because I had no experience with chemo, IV drips, picc, blood transfusions, central lines etc. My LTC facility didn’t except patients with complex care. 3 days into my orientation my supervisor told me she didn’t think I was a good fit because I was quiet. 

I started on nights and I currently have a hard time sleeping. I don’t get any sleep before a night shift so by the time I work im up for 24 hours at a time. And after my shift I get about 4 hours of sleep. The ratio is 1:3 with adequate staffing but because I am the newbie last week I received 6 patients while the other two nurses I worked with had one patient each. We also did not have a tech on that night. My supervisor felt that it would help me think critically by giving me a heavier assignment. 

Since working for the past 3 months I have also received complaints about not answering the call bells fast enough etc. 

Don’t feel bad about experiencing a learning curve. I would love to be given an opportunity in another department at my hospital. 
 

[jms01, BSN]

Realistically, I only want to be at the bedside because I’ve hard time and time again that you need that experience to be an FNP. I have every intention of applying to an FNP program in the next year, but my concern is if I’d be able to succeed in that role without the bedside experience. Could anyone here explain what the pros and cons are? I’d like to transition to a different role in the next year. Maybe I’d feel more comfortable at the bedside with the experience I’m getting now. 

[LibraNurse27, BSN, RN]

12 hours ago, Lovethenurse2b25 said:

Don’t be so hard on yourself! 
 

Im going through a similar experience. I started nursing in a long term care facility in 2019 almost 2 years ago. And recently went onto a oncology/tele/med surg unit in a local hospital. It is a big learning curve for me because I had no experience with chemo, IV drips, picc, blood transfusions, central lines etc. My LTC facility didn’t except patients with complex care. 3 days into my orientation my supervisor told me she didn’t think I was a good fit because I was quiet. 

I started on nights and I currently have a hard time sleeping. I don’t get any sleep before a night shift so by the time I work im up for 24 hours at a time. And after my shift I get about 4 hours of sleep. The ratio is 1:3 with adequate staffing but because I am the newbie last week I received 6 patients while the other two nurses I worked with had one patient each. We also did not have a tech on that night. My supervisor felt that it would help me think critically by giving me a heavier assignment. 

Since working for the past 3 months I have also received complaints about not answering the call bells fast enough etc. 

Don’t feel bad about experiencing a learning curve. I would love to be given an opportunity in another department at my hospital. 
 

They each had one patient and you had 6??? that is so unfair. I've never seen an assignment like that. I hope they helped you at least =/

[LibraNurse27, BSN, RN]

7 hours ago, jms01 said:

Realistically, I only want to be at the bedside because I’ve hard time and time again that you need that experience to be an FNP. I have every intention of applying to an FNP program in the next year, but my concern is if I’d be able to succeed in that role without the bedside experience. Could anyone here explain what the pros and cons are? I’d like to transition to a different role in the next year. Maybe I’d feel more comfortable at the bedside with the experience I’m getting now. 

I think experience in a family practice or urgent care clinic would be more relevant to becoming an FNP. I have worked in acute care and in a community clinic, and the critical thinking/knowledge I learned in both settings would be helpful if I went back to school, but as an FNP you're not managing vents, IV pumps, putting in Foleys, giving critical meds, cleaning people, etc. Assessing patients and assisting in the clinic I saw all of the common things people come to see a provider for, how a visit goes, what an FNP actually does, etc. I learned how to do ear and throat exams, saw them drain abscesses, do Pap smears, etc.

Any time you're doing assessments and caring for patients you are learning. But, in my opinion acute care skills don't have much to do with FNP job duties/skills. So if that's the reason you want to do acute care, I wouldn't worry about it! If you enjoyed what you saw in acute care and would like to try it again, then that's a good reason to apply for other acute care jobs ?

[Lovethenurse2b25, ASN, BSN, CNA, LPN, RN]

1 hour ago, LibraNurse27 said:

They each had one patient and you had 6??? that is so unfair. I've never seen an assignment like that. I hope they helped you at least =/

Nope, instead they went to the supervisor and complained that I was not fast enough. 

[jms01, BSN]

I wish I could work in an urgent care but that requires ER or really any bedside experience. The only thing about my current job that I dislike is that I don’t get to assess patients. I don’t want to lose that. I do intakes for new patients (eg asking about their hx, PMH, etc), and I’ve become more comfortable doing that, but I don’t get to assess anyone. Does doing triage on the phone count? IDK. I remembering assessing patients head to toe on the floor constantly and now, I’m realizing I may be losing that. Any suggestions on how to not lose that?  

[RNNPICU, BSN, RN]

OP:

I think you are looking at it from the opposite anlge.  You never truly lose anything, only gain.  Assessing triage on the phone is absolutely assessing.  You are looking at it from a loss persepective.  You are gaining so many skills that many of us cannot do.  Do you ask patients questions, listen to them, educate, try to understand any issues?  Do you provide answers, feedback, etc?  Not all assessments are with a stethoscope.  Think about all of the telehealth appointments, are they not assessing?  

You have lost nothing.