I got the new grad blues :( / Graduate Nurses / Nursing General / Forums / NurseCentral -

Author	I got the new grad blues :(
lesles85 (offline) Joined: Mar 2009 Location: Sydney Posts: 1	Tue Mar 03, 2009 8:03 pm Hi everyone, I'm new here but I stumbled across these forums after googling "quit new grad". I dont know if I'm being completely melo-dramatic or not, but at this point in time I am fairly close to throwing in the towel. I had so many choices for my placement, but after hearing about a small hospital in the centre of Sydney that runs a 7-rotation program through ED, ICU, Med/Surg Wards, Drug/Alcohol, OT, Recovery, etc, I thought that would be perfect for me seeing I had little to no idea about where I want to end up as an RN. At my first day of orientation I was informed that this year, we would only be doing TWO rotations!! It was too late for me to back out and apply for a new program at this stage and I was bitterly disappointed. So I started in a specialised ED in Sydney city, and I spend 40 hours a week undertaking the SAME tasks, over and over again. I have given ONE (yes ONE) injection since I started a month ago, and a few irrigations. Otherwise, I spend my day taking histories and similar pen-to-paper tasks such as this. The staff have all been in this area for a very long time (some for 30+ years!) and therefore the dynamics in the place are really hard for me to fit in with. On my 2nd day I was shouted at for something so mundane, and since then have been continuously subjected to a torrade of abuse, sarcasm (one nurse even telling me to, "....go on a diet you're fat!"). And although I made the appropriate noises, and this nurse was spoken to by my educators, I just feel like I cannot see the light at the end of this tunnel. I want the most out of this year, I want to be confident and have new skills when I finish, and I just don't think my allocated wards are going to provide any of this exposure that I so badly crave. The combination of this and the staff's treatment of me are just getting on top of me :( Does anyone have any advice about the consequences of quitting a new grad program? How common in NSW is it for hospitals to employ RN's who haven't done a new grad? And does anyone know if I can quit this new grad program and apply again next year, will it affect my chances if they know I have quit a previous grad program? Thanks. :)

Jessesgirl (offline) Joined: Feb 2007 Location: Posts: 2	Mar 04, 2009, 01:56 pm Hi There I totally understand how you are feeling. I am also a new grad, but in my case I have resigned after 6 weeks. I was thrown in at the deep end on a busy surgical ward in a public hospital. I was given 7 days straight, first up, then had 2 days off, then another 7 days straight with only 2 days off. I felt jet lagged then I was told to expect 9 day and 10 days straight! Also looming ahead of me was 3 weeks night duty. Now I have a life, a 6 year old who basically hardly saw me at all. I was prepared for shift work, but was not prepared to put my family life on the line. In my case I have contacted nursing agencies ( Vic) who are more than happy to accept me as a new grad . If you are not getting the support you need and also not getting the depth of experience you need, I would seriously look at other options. There are definately other options out there. You could contact other hospitals directly. I know of several people who have successfully launched their nursing career without a grad year. If you want to pursue a grad year, then you can apply to other grad programs. I know of grads who have swapped their grad year. Good luck and remember there is a shortage of nurses out there, you should be able to find an alternative. All the best

keeshy (offline) Joined: Apr 2007 Location: Melbourne Posts: 189	Mar 16, 2009, 09:40 am I really dont think you have the new grad blues are per your title...I think you are perfectly justified in feeling unhappy. From everything you say, you are being treated rather badly and unfairly and I think you need to make a change pretty quickly before it turns you off nursing altogether. I would seek advice about trying to swap into another grad program or at worst trying to find some agency or other work so you can get out of that hospital. It sounds like a toxic environment to be in for a new grad. Im sorry to hear you are having such a crappy time :(

Molly (offline) Joined: Apr 2007 Location: Posts: 135	Mar 19, 2009, 06:30 pm Hi Jessesgirl ! There is something very wrong with this. You should not do 7 or 9 or 10 days straight. I would contact your state Nursing Council and if you are in the Union contact them too! I think you are being used. For such this is a toxic environment which is very wrong.

priscillasmum (offline) Joined: Sep 2005 Location: Melbourne Posts: 36	Mar 29, 2009, 02:29 pm Hi, Starting any new job is stressful and it can take around 3 months for you to feel that you are starting to belong. All workplaces have interpersonal conflicts and politics which you are unaware of as a new employee, which can be difficult to deal with. I think you need to take some time to talk to your grad coordinator. You may need to explain to your grad coordinator what you are experiencing, what your concerns are, what you are feeling. It may help to write down what you hoped to achieve clinically and discuss that as well. Your grad coordinator may be able to spend some time with you in the clinical area. Jessesgirl, the work conditions that you describe I would say are typical of working in a rostered ward situation, of more concern is that you say you were "thrown in at the deep end". Did you have a hospital orientation? Did you have some time supernumery? (this is often no more than the first shift on the ward). Working shift work can leave you feeling "jet lagged", getting plenty of rest is important, but when you have a dependant child it can be difficult to find time to rest. I would suggest that you look at working as a Practice Nurse. Just because you are a new grad or have minimal experience shouldn't put you off applying. New funding is being put up by the federal government for GP"s to employ practice nurses. The hours are regular, but can involve Saturday work, the pay is generally less than in the public hospital system. Friends of mine who are Practice Nurses just love their job say it is one of the best kept secrets of nursing.

jpnurseforce (offline) Joined: Jul 2009 Location: Melbourne Posts: 7	Jul 09, 2009, 03:43 pm Hi, Unfortunately I would have to agree with many of those comments below. I am the Recruitment Coordinator here at JP Nurseforce and I have heard some similar scenarios from new grads. My advice is to do some agency nursing. This is a great way of working shifts at various hospitals and then this will give you some exposure to the types of work environments/work cultures out there. JP Nurseforce are based in Melbourne and so if you decide to relocate to Melbourne you can contact us on 03 9617 9000. We also have a sister company in QLD called In2Nursing and their number is 07 3039 4577. As for quitting your grad program - I don't advise either way whether you should or not, however it's not the end of the world if you choose to. Remember that as a nurse, you are highly employable. There are many professions, especially in this global financial crisis, that are doing it much much tougher. Cheers Jennifer Nini Recruitment Coordinator JP Nurseforce

Schizo (offline) Joined: Jan 2009 Location: Posts: 239	Sep 11, 2009, 05:18 am This thread is scary....I was working in a hospital that took phone order meds by only one RN (never checked by another RN) and worse, never subsequently signed off by the doctor within 24 hours. Sometimes, these phone order meds are continued indiscriminately...again without doctors signature. On the other hand, there's a smaller hospital which did evrything by the book. The excuse given by a CN on the "offending" hospital was that they know their doctors very well, hence there's no need for a second nurse to counter sign and also for the doctor to follow up later.....HMmmm if something goes wrong and belly up big time, who will own up then? I certainly won;t want my registration to be up for striking off. Any comments?

Ronnie (offline) Joined: Oct 2006 Location: XXXXville Posts: 34	Sep 11, 2009, 01:01 pm Last edited Sep 11, 2009, 01:01 pm update #2 Schizo, this is very bad practice and the offenders are sailing very close to the wind. As a duty of care to the pts I would think this needs to be taken higher than the CN as it is obvious they are not rectifying the problem. If something does go wrong it is the names on the paper/document who have to answer for their actions, not the Dr who "supposedly" gave the phone order. It is a legal requirement that phone orders must be heard by two nurses. If their butts end up in court they have NO recourse. On the topic of this thread, grad years will differ markedly from place to place and the level of support will vary also. I was given very little support and felt I was in the deep end but I also had no problem with speeking up for myself when I thought it was getting a bit too much. Sure, for the first few months it is going to be a massive learning curve but after a while things will gel and gradually get easier. Previous replys have said to move on and that is a pretty good option if you can. If not just hang in there and try and get the most out of it......it may very well be happening for a reason. If down the track you are exposed to similar behaviour when you are in a leadership role you will be able to identify with the problem and have the neccessary skills/experience to be able to fix it. All the best to the new grads, its not an easy transition but great things will happen if you stick to your guns. modified: Friday 11 September 2009 1:04:55 pm - Ronnie

Schizo (offline) Joined: Jan 2009 Location: Posts: 239	Sep 11, 2009, 03:22 pm Last edited Sep 11, 2009, 03:22 pm update #2 Thanks Ronnie, the problem here lies with management who are unwilling to enforce the rule with doctors whom they "depend" on...its a private hospital. Even the NUM ignores it, that's why I keep quiet and stay out of this. Half these orders are S8 class, 1/4 S4 and the rest are a mixture of OTCs and misc classes. Nurse initiated meds are even pretty shocking....not your everyday paracetamol or maxalon stuff. I thnk its a problem which only gets worse as private hospitals compete for doctors and patient load. The fear is for a grad nurse to sign up like lesles85 only to find that the environment is crap and risky. I recently identified a long QT interval and significant inverted T waves in all posterior and lateral leads in a patient who went tachy (3 continous days over 120 bpms) after weeks at baseline of 80 bpm. Was asked to bring ECG to ICU for interpretation and they said its normal (basically they did not even identify the inverted T and did not calculate the QT interval - said there's a P, QRS and a T in lead II - all is good!). Pt continues to be tachy over (135 bpms) at bedrest. Pt discharged and sent home. Inverted T waves signifies possible ischemia of the heart, MI and/or reaction to drug toxicity. No referral pain or discomfort but pt's non verbal cues were not compilant - slight palour, tired and looking worried. My bet is Ischemia of the heart (SAO2 will not tell as this is measured peripherally and not supplied to heart) but I was told by CN to shut up and concentrate on basic cares. So here I am...wishing hard that nothing happens to the patient. BTW, I auscultated pt, there's a slight "bruit" in the left atrio-ventricular area...maybe no significance as there were no notches in P wave to suggest Mitral valvular compromise and then again maybe yes but I am a junior and what can I do...My notes were taken out from chart!! If anyone who are experts here on ECG, please advise as I am still learning. But like Lesles85, I am frustrated too. modified: Saturday 12 September 2009 5:44:03 am - Schizo

Ronnie (offline) Joined: Oct 2006 Location: XXXXville Posts: 34	Sep 12, 2009, 09:16 am Hi Schizo, all I can suggest is that you record everything you have done in a diary just in case. Record what you found, pt condition, what you documented and who you told. This is at least something to jog your memory if an adverse event happens to the pt. Are you in a nursing union?, if so it would be handy to run it by the rep so they are aware of what is happening. If not, it may be a good time to think about joining one. I know what some private facilities get up to with regards to bending over backwards to keep their medicos and yes it can feel like you are banging your head against a wall. Its a very tough environment sometimes and can leave staff feeling frustrated and helpless. Just make sure your practice is sound and legal and your butt is covered by documentation and good diary entries. I write alot in my diary sometimes it can be fairly minor things but if a case goes to court it can be many months after an incident has occured. All the very best

Schizo (offline) Joined: Jan 2009 Location: Posts: 239	Sep 13, 2009, 05:04 am Thanks Ronnie for the advice, I will certainly start up a diary and log all my experiences. I am still a student and I was advised by a clinical facilitator to sign up with a Union. I thought that was only when I graduate...I think maybe this advice is a lot more sound that I gave it credit. I'm on to it right away!!! Many thanks for your feedback Ronnie. And hopefully, things will turn up alright for you lesles85.

ticklish (offline) Joined: Sep 2009 Location: North Brisbane Posts: 38	Sep 13, 2009, 11:31 am Im no expert at ECG's, but i do know a little bit and will try help you out here. Firstly, i find it very intersting that you are able to identify a prolonged QT interval in a patient who is tachycardiac! When it comes to reading an ECG there are so many other factors you have to consider. Had you seen the patients previous ECG's from 3 days ago or from a previous admission? The abnormalities you saw on the current ECG may be old changes. What about the patients history- do they have a history of old MI or other cardiac condition? Conditions such as chronic cardiac failure can affect the ECG. The patients blood test results- were there any abnormalities in his electrolytes or presence of cardiac altering drugs? What was his presenting problem- maybe the doctor has prescribed something that has affected his ECG? Who did the ECG- maybe they didnt put the leads on properly? I find it very hard to beleive they would discharge someone with a rate over 135! But a rate that high will make your patient look tired & palour and worried! What was the patients blood pressure? The coronary arteries which supply the heart recieve their blood during diastole, so knowing the BP is very important. How about the patients other vital signs- resp rate and temperature- were they elevated? Has the patient been under alot of stress lately in his life? Have they had a recent infection? It is very difficult to read what is happening on the posterior and lateral sides of the heart. Lateral, posterior, septal & apical regions of the LV are silent on the ECG and a 15 lead ECG is used to identify an infart/injury/ischemia. Its very hard to interpret what you are describing without seeing the actual ECG im sorry. Ok, as for the 'bruit' you heard over the mitral valve. How experienced are you at listening to heart sounds? It takes awhile and lots of experience to fully understand what you are listening to. And listening to heart sounds on a patient who is tachy is very very difficult! Firstly, a patient with a murmur may not show any changes on the ECG. Remember an ECG shows the electrical activity of the heart, not the mechanical! This is why you never trust an ECG reading, just because someone has a lovely sinus rhythm doesnt mean the heart is beating- always feel for pulses. Next, did you only listen to the mitral valve? What about the other areas? A murmur is described by the location of where it is heard the loudest- sometimes a murmur can radiate to other parts of the body. Next, what was the pitch of the sound? What part of the stethoscope did you use to listen? Did the murmur sound different when the patient moved or on inspiration/expiration? Where there any changes in the sound during systole & diastole? There are soooooooooo many things to consider when listening to heart sounds and it takes a very experienced person to understand them. If you are really interested in heart sounds i suggest carrying your stethescope around and listening to anyone who will let you. Start by identifying what is normal. You cant identify abnormal til you know what normal is. Read about how to properly listen to heart sounds, have a system or routine to follow when listening- the same as you do when listening to lung sounds. There are heaps of websites which have audio clips of different heart sounds, go and listen to these. On your pracs if you read in a chart someone has a murmur ask if you can listen to it, the majority of patients love having the attention!

Schizo (offline) Joined: Jan 2009 Location: Posts: 239	Sep 14, 2009, 05:30 am Ticklish, I agree with what you have written. I did mention that the patient was tired, worried and "lost" a bit of colour compared to before he went tachy, he never strayed from his bed except when he needed to go to the toilet - he was always lying down and would not sit up, I did ask him if he felt numbness or not too well but he would say that he is ok which did not gel with his general appearance. The QT interval wasn't too difficult to measure (QT/RRsquare root) because there wasn't any ST elevation or depression. Whilst Tachy, the rhythm was regular and not so close that I could not isolate the various segments. When I got a long QT of 0.5 secs from lead II, I rechecked with VI and V2, where QRS are clearest. Patient had no prior history of MI, hence it was difficult to suspect inversion from previous MI (If that what you meant about comparing baseline ECGs on admission or from previous data). Patient was on Zofran which has been cautioned to cause long QT and generally I believe where such caution is possible, solatol is prescribed (not in this case). BP was 150/58 on average. pt over 70 and on Beta blockers for hypertension - aren't these suppose to cause vasodilation and hence drecrease heart rate?. Pulse was regular and strong. No previous baseline ECGs, when his tachy continued into its 4th day, I informed CN and monitored his pulse every 1-1.5 hours but it never came down much..the lowest it dropped to was 122 bpm. Next thing, he was discharge in the afternoon. Ausculated around the chest and I have done a fair bit of practice on patients before because of my interest in cardiac and emergency medicine. I agree with you that patients love the extra attention and as such I always try to listen to as many as possible, because only through practice would I be able to increase my knowledge. I have done at least 13 patients with Pnuemonia alone and its interesting to hear where those pop crackles are located, sometimes in just one lung, sometimes both but most are in the lower lobes (wonder if that's because fluids tend to gravitate to the lower section) You can hear the varying volume of the bruit from different locations and loudest near the left atrio-ventricular region...Yes I do agree with you that I am NOT an expert and I did put this in notes for CN to follow up with the attending doctor. The 12 lead ECG was done by me, I have passed my ECG practical placement when I did my ECG elective...I hope I did not do the wrong thing...aVR was inverted as expected, all other leads showed normal progression. Axis was normal...if I had got the lead placement wrong, I think this would have been either a Left Axis or Right axis deviation. Well anyways I think its was properly placed and recorded. Anyways, an abnormal ECG is nothing when the patient shows no signs of discomfort or pain. I agree that ECG is a tool but not an exact science. I had even read a friend's ECG when he started having referal pain at the ripe old age of 40 and active as a horse (cycles 40 kms every weekend and around 20 on weekdays whenever he can), the ECG read normal but we sort of suspected more...eventually he had to have 4 bypasses done. Sigh...whatever it is..its done, I can only hope that i am wrong and the patient is on the road to full recovery.

Meggles (offline) Joined: Aug 2009 Location: Perth Posts: 11	Sep 20, 2009, 07:20 pm Wow. As a student who has only JUST started studying to be an EN (and externally at that), I find the threads by experienced/qualified nurses to be really interesting to read. It gives me a bit of insight into what I can expect - I only hope I have a more pleasant experience than you lesles :( As for the last few posts, about Schizo's patient, all I'm seeing is a bunch of letters haha! "I got the AB from the CD and then the EFG 123" ... I can't believe I'm going to know all of this stuff eventually haha!

Schizo (offline) Joined: Jan 2009 Location: Posts: 239	Sep 22, 2009, 08:22 am LOL Meggles...your optimism is infectious. Good luck for your studies :)

Meggles (offline) Joined: Aug 2009 Location: Perth Posts: 11	Sep 23, 2009, 11:18 pm Hehehe thanks. It's all a bit overwhelming really, especially when I read things like your post and realise that I'm going to learn all that and know what you're talking about one day soonish :)

Giraffe (offline) Joined: Oct 2010 Location: Posts: 1	Oct 07, 2010, 10:51 pm Hi Les Les, I think that you definitely have cause to be unhappy...I have had similar experiences and although I have gone through all but most of the available resources to fix the issues - it has continued. I am also a parent and have come to the conclusion that I am the one that controls my future so instead of following the pack and allowing this behaviour to continue I have resigned and will be making the issues known to the highest level management that in fact nurses do eat their young and if noone makes a stand it will continue. It is sad that new grads try to do the right thing and come into the job with the intent on doing it well to only be knocked flat by others. I certainly will be reassessing my career as a nurse after this and have discouraged my daughter in regards to following in her mummys footsteps. I hope that all gets better for you and that you find your niche in your career :)

Nurses Only (offline) Joined: Apr 2010 Location: Sydney Posts: 13	Oct 15, 2010, 11:59 am Hi LesLes85, I am sorry to hear you are having a hard time, I remember about 10 years ago when i entered a new grad program i was terrified as there was much documented about how "nurses eat their young" I never finished my new grad year as i applied for position on one of the wards i had done a rotation on and got it. I had done 6 months of the program and never having finished this program has never held me back I have always been employed into whatever position i have applied for in 3 of the biggest hospitals in Sydney. I do think in a lot of places "cliques" form amongst staff that have been in the one place for a long time and especially in smaller institutions. I think you have good reason to be dissatisfied about the amount of skills you are gaining for the work you are putting in. Your learning curve in your first year should be a sharp rise and yours sounds like it has flat-lined. with good reason such as yours to leave a new graduate programme i would be definatley taking steps to explore my options it can't hurt to ask, ring around to some of the human resources offices of some of the bigger teaching hospitals in Sydney and find out they may be able to do a transfer of your new grad program if someone has dropped out of theirs. Don't give up and don't lose heart there are places out there that are geared for teaching and bigger teaching hospitals tend to have a younger core staff base who still remember what it is like to be a new grad.... take care and keep your chin up Cheers Nurses Only www.nursesonly.com.au

rado38 (offline) Joined: Feb 2011 Location: Posts: 8	Feb 24, 2011, 03:38 am hey i too have recently graduated and still talk with some of my former classmates and we all have been chucked in the deep end and get spoken to rudely just stand your ground about the way they treat you and when and the way they go around speak or should i say bark orders and remember they too were once new graduates hang in there!!!!

minigmgoit (offline) Joined: Apr 2010 Location: Darwin Posts: 50	Apr 24, 2011, 07:10 pm This all petrifies me. I'm having second thoughts about the whole prfofession due to the sheer amount of nasty people working in it. THis isn't helping lol.

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Nursing issues

I got the new grad blues :(