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. 

[LibraNurse27, BSN, RN]

Assessing on the phone is a valuable and difficult skill. In rural areas and areas where patients have trouble with transportation, phone triage is super important, so you can quickly determine the need for emergency transport, whether patient can safely come to the clinic, or provide home care advice. All nurses are important!

[jms01, BSN]

Should I consider taking the CNRN exam once I have a year of experience in this setting? I would like to get a certification, I think it would be relevant given my experience, or does this need to be bedside neuro experience? 

[Hannahbanana, BSN, MSN]

Check the specific requirements for sitting the exam. Most certifications require more than one year of verified experience in a specialty area. Certifications are evidence of actual expertise, so it’s unlikely that you will have enough to qualify. But check. 

[RN1485, BSN]

If you want to be an FNP, clinic nursing is the way to go! I work in a public health clinic as a nurse case manager. However, there are times when I have to help the nurse practitioner with  physicals, pap smears, and std treatments-as in I do them all by myself. I can order select medications via nurse protocol without a doctors order. I’ve gotten very comfortable doing an H&P. The only reason I am able to do this is because I work as an expanded role RN. Some states have this because there is such a shortage of practitioners in public health. I feel like being in the clinic would better suit your career goals. Plus, you could get hired in the clinic if they know you are planning to go back to get your FNP. 

[RNNPICU, BSN, RN]

20 hours ago, jms01 said:

Should I consider taking the CNRN exam once I have a year of experience in this setting? I would like to get a certification, I think it would be relevant given my experience, or does this need to be bedside neuro experience? 

If you are interested in the CNRN, check out the 

https://abnncertification.org/cnrn/about

 

[jms01, BSN]

is anyone here an FNP with or without bedside experience? Doubt it. either way, I'd like to get some insight as to why I should or shouldn't go back to the bedside. Really afraid of failing again. I want to go back because I want to prove to myself I can do it. 

[RNNPICU, BSN, RN]

I don't think you need to prove anything, if anything, you have proved that you are successful at your job and your role.

[jms01, BSN]

Thank you for that, I feel like I'm doing better at my job every day. The only thing is that I'd like to get the bedside experience and I'm worried that once I put my year in at a neurology clinic, no one will want to hire me in a hospital. I'm also afraid of failing at the bedside again, I was not the brightest at the bedside at times and I wish I had more time to learn but unfortunately the reality is you sink or swim after orientation and I sank. With my epilepsy too, I'm afraid it'll be near impossible to find a bedside job on days with 2 mo of floor experience. Clinic jobs are far rare around here, I'm looking to move in the next year because of the cost of living around me being too high. I just don't want to make it more difficult for myself to find a bedside job if I have 2 months of bedside experience.

I'm letting my anxiety get the best of me right now, I'm just note very hopeful lately.

[Hannahbanana, BSN, MSN]

Earth to JMS01: there are a bazillion ways to be a nurse that don’t involve setting foot in a hospital. Students get next to no exposure to them, but ya gotta believe me, there are many, many ways to use your education and the intelligence that made you succeed at it as an RN. 
I had been in critical care for >20 years and thought my life was over when that job ended. But no! 
Keep your eyes and ears open. Peruse the nursing specialties boards, all of them, even if you don’t think you’re the least bit interested before you open up all the threads. Something might catch your eye, something pique your interest that you might be curious to learn more about.

I would be a liability to any self-respecting ICU but I am a recognized expert in another field now.
You have a long career ahead; in what, I dunno — you have to find it. I promise you that you will. 

[jms01, BSN]

What do you recommend for someone like me gaining experience in one specialty that wants to go to the bedside in a year? I wouldn’t know where to start, and I’m getting discouraged that a hospital wouldn’t take me.

[LibraNurse27, BSN, RN]

14 hours ago, jms01 said:

is anyone here an FNP with or without bedside experience? Doubt it. either way, I'd like to get some insight as to why I should or shouldn't go back to the bedside. Really afraid of failing again. I want to go back because I want to prove to myself I can do it. 

I know tons of FNPs who never worked at the bedside. Many who FNP was their first job because they did programs where if you already had a bachelor's in something else you got your RN during first year then went straight to FNP. Some said it was tough because only 2 years of school and expected to be a fully functioning provider, and that they wished they had gone MD route or had some type of RN experience. But many settled in and now love their jobs!

Almost all said the brief hospital experience they got during clinical didn't help them much as FNPs, other than assessments and critical thinking, which you can learn outside the hospital. Those RNs who I worked with at the community clinic while they were in FNP school say they graduated feeling very prepared, usually more so than their colleagues who worked inpatient. One who worked in ER felt prepared because ER is a lot of primary care in addition to emergent care, so they had the background plus additional skills at responding to emergencies in the clinic. 

If the only reason you want to go back to bedside is to prove yourself, I don't think it's necessary, especially if it exacerbates your anxiety and could affect your seizure disorder. As an FNP you will not use IV pumps, put in NG tubes, do incontinent care, restrain people, etc. I recommend if you move to look for a job in a community clinic. You will see what FNPs do and learn a ton! But if you think you will love working bedside, give it another shot! In some areas where the nursing shortage is real, hospitals will hire and train you regardless of your other orientation. The orientation might not be great though if they want you to start working quickly for staffing reasons. Good luck! We all find our nursing path eventually = )

[Hannahbanana, BSN, MSN]

On 2/25/2021 at 9:29 AM, jms01 said:

 

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?

These are interesting tasks requiring a good amount of psychomotor skills, but they are not what makes a person a nurse. We teach them to lay people to do at home, but that doesn’t make those people nurses. Never confuse what tasks nurses do with what nurses are.
You ARE a nurse— you can be a lot more with that as a base. Go forth.