Where do I belong??

Trauma Columnist · Jan 19, 2008

First - don't beat yourself up about this - it wasn't a good fit so you need to find a unit that will be. Second, what did you like and not like about the onc unit? Too many patients, too little interaction with other nurses to guide you thru your treatment decisions? Too little input as to how you were

doing during orientation? Too many preceptors?

Once you find that out, then you sit down and put it on paper so that you can reheorifice for your next interview:

"The floor that I was on wasn't a good fit for me because I had six preceptors in a two week period of time and the amount of feedback I got regarding my performance wasn't specific. I know now that I must be more assertive in requesting consistent preceptors and I must ask for constructive criticism. This will help me to be a success on your floor."

That way, you are taking ownership of this past job and the poor outcome but you are also being honest and upfront with your short-comings.

Good luck - it will get better and you will find your niche.

lorabel · Jan 19, 2008

thanks! It was a combination of things actually..yes, 3 [preceptors in 6 weeks that all did things differently. The only feedback was negative. The unit was very high acuity. I got mixed messages..told to ask questions and when I did was told I didnt take ownership of responsibility. I had limited skills when I was hired and had to learn so many things, down to their IV system......I came from a community college program and didnt have as much clinical time as hospital based programs and my clinical was at a community hospital where I never had a pt with a JP or IJ or bilibag, etc......so I can honestly say I got off to a rough start...I asked for longer on orientation and was told I couldnt be kept on indefinately and was given 1 more day.....I loved the patients but it was such a busy unit.......fresh post-ops almost daily, Chest tubes, bilibags, NGs, PEGs, JPs, IJs, all kinds of stuff. Nurse pt ratio was 6-7/1. 5 patients was ideal for me, 6 was a little too busy, but manageable with a little OT, and I never had 7. I was told when I was hired that I would learn my skills on the job, it wasnt a problem and they expect that. Also told I could be on orientation for as long as it took!!! Very poor management. After my second week on my own, all my support just disappeared! Nurses who had answered questions before now told me to figure it out or would get irritated. I was told I was never on my own; we're all here to help you! ya right! I love hanging IVs and all that stuff........if I go to LTC I wont have that and am afraid I will lose my skills. I was told that in LTC you dont assess every pt. everyday, only certain ones.....that makes sense...theyre residents, not patients....I dont even kow what options there are for a new nurse with 4 months working experience!!!!!

Midwest4me · Jan 19, 2008

Hi Lorabel! You wrote: "I need to interact with patients and make a difference in their lives......sometimes its the small things that matter most".

The first thing that came to my mind when I read this was hospice---have you looked into that specialty or does it require a year or so of hospital experience first? I've never worked it (because usually it's RNs that are hired into that area and not LPNs) but it seems to me that you'd get more patient interaction in that area than some others. Just an idea.....

Makingadiff · Jan 20, 2008

I'm kinda having the same having problem. I have been a LPN for 6 months and during school I thought I really wanted to work in hospital but now that I'm there I don't really like it. I'm also working in EP office which is a little boring for me. I'm looking at lab results, phone triage, misc tasks. Basically a desk job. I have always been a person that stays somewhere for a long time, so I feel bad to leave this hospital after 6 months but I'm not happy. How do I find something that I really like and passionate about without looking like a job hopper? I plan on going to get my RN so that will open up new opportunities but what do I do until then? Any advise from experienced nurses would be greatly appeciated.

sissyboo · Jan 20, 2008

I realize alot of what you do in LTC is meds and paperwork. But you CAN make a difference in LTC, alot more than you may think.

I'm not a nurse yet--but I know that residents in LTC have just as much need for a good nurse as patients in the hospital.

Best of luck to you!!

BayouLPN · Jan 20, 2008

Hi. I justed wanted to reply to your post. I see from your profile that you are a RN. Most long term care facilities here in my area employee LPNs for their nurses. They use RNs for DON, ADON, ect. But...if that is what you were referring to when you wrote LTC...I can give some advice. I, too, am a "new" nurse..LPN. I have had my license for just over a year. I started in a "nursing home" because as an LPN...it pays much more than at a hospital. Yes, it is all about passing meds and charting. LOTS of charting. Especially when 70% of the people on your hall has the crud that goes around this time of the year. I have 50 beds on my hall, we are always full, we always have a LONG waiting list. I am in one the rare exceptionally good homes locally owned...by the DON & the administrator. You said that interaction with your pt means so much and it is the little things that count. If this is the case, you will LOVE working as a geriatric nurse in a LTC facility. These people become your mawmaw & pawpaw. They love seeing the same people everyday. For some...you are the only family they see on a regular basis. You walk in the door on any given day..look at one of your residents and can say "what is going on with her/him?" You come to know them so well, you know when something isn't right. The little things...a hug, a few minutes talking about the family they don't see except for holidays, celebrating birthdays with them, making sure they get mayo on their sandwich, assuring them they will be back when they have to go out to the hospital, being there as they leave this world. And so many other numerous "little things" I can't even start to communicate. So rewarding, so fulfilling. From what you wrote, I think geriatrics is a good choice for you. However, don't let anyone fool you. A LTC is hectic, has alot of medsurg, not skills like IV's and such but you do assessments. Just not your traditional "head to toe". You are looking at the res while passing meds. Listening to who is coughing from the dayroom while you are charting...and believe it or not...you will know who the cough belongs to without looking!! :specs: You will always be aware of where your risk for falls are and be poised like a snake ready to strike to rescue before they hit the floor. All that being said, I have spent the past 16 months in my facility, love them all, watched many go on to their reward, and accepted new ones. In 3 weeks, I will be starting a new job at our local Family Birth Center. I feel that I now have the "new" worn off. I don't question my judgement so much anymore. Things just seem easier. Many drug names don't confuse me. I have learned time management skills. I am scared of relearning skills I haven't used since nursing school. I am scared of having to make new friends, learn a new building, talk to new doctors, etc. But, not nearly as scared as I was those first few months our of school. So, hang in there. When you accept your new post, stick it out for the first year, & look around at other areas of interest. Things DO get better. Hope to help you a little....Bayou LPN:cheers:

glb1960 · Jan 20, 2008

Hey lorabel - Go ahead and apply for those jobs that state 2 yrs experience, if they are appealing to you. Many times your drive, desire, intelligence or heart will make up for your lack of experience. And sometimes you might be the only applicant.

Hang tough bel, Gary

Katie82, RN · Jan 20, 2008

Lorabel, Part of the problem may be that you jumped from school to a specialty floor, and have encountered a lot of nurses who feel that specialty-floor nurses should not be spending their time precepting new grads. I really wish hospitals would hire new grads to med-surg floors for at least a year, it would be a lot less stressful for a lot of inexperienced nurses. All of the hospitals (back in the old days) I worked at started new grads in med/surg. When I worked on an oncology floor, you had to have at least 2 years of med/surg, and when I precepted a new nurse, I expected to have to teach her how to flush a port or the ins and outs of chemo, not the basics.... Try again on med/surg for at least 6 mos to a year. I left hospital nursing after 10 years. I worked Public Health (loved it), got a Masters and thought I had to reward myself by being an Administrator (hated it), and finally settled into Case Management. I love it, can't imagine doing anything else. Point is, there will probably come a time when you get tired of fighting for holidays and being nagged float. Nursing is a wide open field, assess your strengths and weaknesses then try a few different things.

lorabel · Jan 20, 2008

Good advice from all! thanks so much! Each post gave me something different...funny thing, I have been told by several professors and nurses that I would make a great hospice nurse! Problem is, they sometimes require 2 yrs or at least one of med/surg. Yes, my unit was a specialty and shuld have been a step down unit...I agree that part of the problem is hring new grads on a specialty unit! I agree completely and told my director that when I quit. Told her I felt it was too much for me as a new grad, when I was learning to get my feet under me and on top of that all these complicated patients. I didnt hang chemo..had to be there a year and then go to class. Also, I did mean long term care in my post.....I do think i will like it. I just have no confidence in myself at this point. I feel like a failure.....I wasnt organized enough.....though I was told that would come with time.......how much? 4 months? Maybe LTC would be a good choice for now. Hospice is what I said I wanted to do when I was in school and completed a 4 day hospice rotation......the professor wouldnt assign hospice, we had to request it and I was lucky enough to be chosen. I need to be needed....bottom line. I am at my strongest when others are at their weakest.........maybe thats why i struggled where I was? Some of the nurses had VERY "strong" personalities.......if an aide or student were to ask me questions, which they sometimes did, I could answer with not problem and even taught them things. I was the nurse that called the students into a patients room to hear rales or wheezes, or to see what was under the chest tube dressing, etc. They loved it...because I told myself I would never forget what it was like to be a student. Yes, I'm still new....but I always try to think about how the other person feels. In the meantime...I'm still looking and waiting to hear from a couple places I applied to......The Veterans Hospital I applied to has a 6 bed hospice unit, alzheimers and subacute unit. I think I would like any/all of them! thats where I really want to go..so yes, I'm drawn to hospice! Very intuitive those that had that thought! Thanks! This is my therapy session!!!!

BayouLPN · Jan 21, 2008

Lorabel, I am so glad you are thinking LTC. It sounds so much like you would be perfect in that setting. And as the wife of a Desert Storm veteran...I hope you get that post. At my facility, we don't use hospice. We do our own. And I can say that it is an honour to be trusted by the resident and their family to care for them during their last days. Just get in a facility that is good. You will never regret it even if you move on to a real hospice agency later. As for your self-confidence...Don't let that one experience get you down. I was hired before I even graduated at a facility based on my instructors recommendations. I was considered one of the best students in the clinical setting and my instructors always made a big deal about it. I was hired for a psych facility and my best scores were in psych. I have a gift from God that lets me reach people. As you said, "I am my strongest when others are at their weakest" This is a true gift. This facility, however, was not for me. From management to the Charge nurse who was supposed to train me (but spent her time screaming obsenities & telling me she didn't have time to train someone). I was not cut out for this type of environment. I left after 3 weeks. Was at the store paying my power bill, struck up a conversation with the lady in front of me in line. She saw my name badge and encouraged my to call her job. The next day I became so frustrated I walked out of the facility, call them, had an interview for that afternoon, went to work there the following Monday and have been there ever since. In an LTC you get Alzheimer's, Dementia, Schizophrenia, ect along with physical illness. I am glad I didn't let my feeling of "failure" get to me. My boss actually cried when I turned in my notice last week. I will still do PRN there. Just shake that feeling, onc may not be your cup of coffee but somewhere there is a whole pot brewing.

meryheart · Nov 7, 2008

:heartbeatLorabel, where are you now? What are u doing now? Yoour question was great, and the answers are helping me. :yeah:Mary

Good advice from all! thanks so much! Each post gave me something different...funny thing, I have been told by several professors and nurses that I would make a great hospice nurse! Problem is, they sometimes require 2 yrs or at least one of med/surg. Yes, my unit was a specialty and shuld have been a step down unit...I agree that part of the problem is hring new grads on a specialty unit! I agree completely and told my director that when I quit. Told her I felt it was too much for me as a new grad, when I was learning to get my feet under me and on top of that all these complicated patients. I didnt hang chemo..had to be there a year and then go to class. Also, I did mean long term care in my post.....I do think i will like it. I just have no confidence in myself at this point. I feel like a failure.....I wasnt organized enough.....though I was told that would come with time.......how much? 4 months? Maybe LTC would be a good choice for now. Hospice is what I said I wanted to do when I was in school and completed a 4 day hospice rotation......the professor wouldnt assign hospice, we had to request it and I was lucky enough to be chosen. I need to be needed....bottom line. I am at my strongest when others are at their weakest.........maybe thats why i struggled where I was? Some of the nurses had VERY "strong" personalities.......if an aide or student were to ask me questions, which they sometimes did, I could answer with not problem and even taught them things. I was the nurse that called the students into a patients room to hear rales or wheezes, or to see what was under the chest tube dressing, etc. They loved it...because I told myself I would never forget what it was like to be a student. Yes, I'm still new....but I always try to think about how the other person feels. In the meantime...I'm still looking and waiting to hear from a couple places I applied to......The Veterans Hospital I applied to has a 6 bed hospice unit, alzheimers and subacute unit. I think I would like any/all of them! thats where I really want to go..so yes, I'm drawn to hospice! Very intuitive those that had that thought! Thanks! This is my therapy session!!!!