Massachusetts Nurses

[Disney Doll]

I definitely see what you're saying, but luckily I live in one of the strongest teaching areas in the medical field. There are ALWAYS slots for new graduates in just about every specialty, but they are competitive and always fill up quickly. I don't think it benefits nurses to work in med-surg before a specialty like the NICU because there is so much learning to be undone. At this point, I can't even get a med-surg job to pick up the bad habits that need to be unlearned! Thank you so much, I'm looking forward to being overwhelmed.

I've been a med-surg nurse for 25 years and I find your comments about "bad habits" to be quite insulting.

Med-surg is the basis for ALL other hospital care, even those "specialty" areas.

You're a new grad and you're making comments like this?
You already have bad habits to unlearn...like attitude.

I was going to tell you to come to CT, but forget it...we already have enough new grads here who think they know everything...we don't need another one. How do I know this? Well, I'm a hospital nurse and am teaching a couple of new grads all my "bad habits" right now. What I am trying to do is unteach all the bad habits they already picked up in nursing school.

Perhaps your attitude is more of a reason for your lack of ability to get a job. Think about it. There is nothing more dangerous in medicinie that someone who has no idea how much they DON'T know who thinks they know everything.

 

[Cup Cake]

I have to agree with Disney Doll. Your comments are a bit insulting.

I went to an excellent school, but my academic education was just the beginning of my education. It takes years to be a great nurse. Heck, it takes years to be a good nurse. That's why new grads don't normally start in high acuity areas like the NICU.

I wish you well in your job search.

 

[PediNurse]

I've been a med-surg nurse for 25 years and I find your comments about "bad habits" to be quite insulting.

Med-surg is the basis for ALL other hospital care, even those "specialty" areas.

You're a new grad and you're making comments like this?
You already have bad habits to unlearn...like attitude.

I was going to tell you to come to CT, but forget it...we already have enough new grads here who think they know everything...we don't need another one. How do I know this? Well, I'm a hospital nurse and am teaching a couple of new grads all my "bad habits" right now. What I am trying to do is unteach all the bad habits they already picked up in nursing school.

Perhaps your attitude is more of a reason for your lack of ability to get a job. Think about it. There is nothing more dangerous in medicinie that someone who has no idea how much they DON'T know who thinks they know everything.

Easy there. I've worked at three hospitals as a tech and "bad habits" is a term that is used among every nurse I've ever worked with - young, old, male female - very loosely and not meant as an insult. It is common knowledge that you can't do everything by the theory that school teaches you. You'd be there two days before you finished a shift. Med-surg units around here tend to be VERY busy and chronically understaffed (without a budget to enhance the unit support). I don't know about your area hospitals but in ours it's not uncommon to have nine patients on an evening shift. Going "by the book" is not possible, you have to cut corners somewhere to prioritize. Do you find this to be untrue? Because that's the way it is around here.

We are taught all throughout nursing school that med-surg is the basis for all forms of medicine, which I believe is why we had two rotations of it and one of everything else. That and fundamentals is where you learn your vital signs, your assessments, your medication administration techniques. It's very necessary. However, I think it's difficult to disagree that a NICU is fundamentally very different. Your dealing with parents who room in, babies who use developmental positioning, finding the right balance between hands on contact and not making them crump from too much contact. You're teaching parents how to find a sense of normalcy in the chaos that has become their life while helping them through stages of grief. You can find similarities to it in med-surg and all other aspects of nursing, but they are all very different in their own right.

Please don't take offense to what I said. I meant none. Your knee-jerk reaction tells me you've had to defend your position as a med-surg nurse a lot through the years, but I was just stating facts. I don't pretend to know it all, but I'm excited to learn something. My attitude is positive, I'm intelligent and open to experiencing. I'm also not afraid to show my vulnerability and I believe my biggest weakness is confidence coming into the real world as a new graduate. But that comes with time and experience. I have compassion, a loving heart and a lot of passion.

 

[PediNurse]

It takes years to be a great nurse. Heck, it takes years to be a good nurse. That's why new grads don't normally start in high acuity areas like the NICU.

I wish you well in your job search.

Cupcake, where do you live? It seems like a mixed bag of nurses who work in hospitals that openly accept new grads in specialty areas and others that are firm in new grads needing a year of med-surg.

 

[ERMama]

when i graduated in 95 i had a hard time finding a regular job too. i interned at a hospital but in an area where they could not keep me on as a new grad (day surgery). i ended up getting a pool/on call type position with no benefits at the hospital i interned at on an inpt oncology floor.
i worked there a year then took an ER job. 3 yrs later i moved on to the trauma center in the area.

like someone else said, you may have to look at moving a bit farther out and taking a job on postpartum or whatever first.

good luck!

 

[minkydog]

I've been a med-surg nurse for 25 years and I find your comments about "bad habits" to be quite insulting.

Med-surg is the basis for ALL other hospital care, even those "specialty" areas.

You're a new grad and you're making comments like this?
You already have bad habits to unlearn...like attitude.

I was going to tell you to come to CT, but forget it...we already have enough new grads here who think they know everything...we don't need another one. How do I know this? Well, I'm a hospital nurse and am teaching a couple of new grads all my "bad habits" right now. What I am trying to do is unteach all the bad habits they already picked up in nursing school.

Perhaps your attitude is more of a reason for your lack of ability to get a job. Think about it. There is nothing more dangerous in medicinie that someone who has no idea how much they DON'T know who thinks they know everything.

 

[PediNurse]

when i graduated in 95 i had a hard time finding a regular job too. i interned at a hospital but in an area where they could not keep me on as a new grad (day surgery). i ended up getting a pool/on call type position with no benefits at the hospital i interned at on an inpt oncology floor.
i worked there a year then took an ER job. 3 yrs later i moved on to the trauma center in the area.

like someone else said, you may have to look at moving a bit farther out and taking a job on postpartum or whatever first.

good luck!

Did you know you wanted to do ER all along? My ten year goal is to become a pediatric transport nurse, and every time I saw the Children's Hospital transport team pull up to our ER ambulance bay a chill would run up and down my spine. There must be such an adrenaline rush to be a nurse in the ER, especially a trauma center, but where I worked the nurses ate their young for breakfast, lunch, and dinner and it killed any learning possibilities for a new grad.

 

[ERMama]

Did you know you wanted to do ER all along? My ten year goal is to become a pediatric transport nurse, and every time I saw the Children's Hospital transport team pull up to our ER ambulance bay a chill would run up and down my spine. There must be such an adrenaline rush to be a nurse in the ER, especially a trauma center, but where I worked the nurses ate their young for breakfast, lunch, and dinner and it killed any learning possibilities for a new grad.

For me, not really. In fact I was all signed up for another major in college and quick switched because my bf (now dh) told me he thought I would be a good nurse.
I worked as a housekeeper in a hospital in OR, OB and ER in high school. I thought I wanted to go to school to be a geneticist or something like that.
I got an intern job in day surgery and liked the constant changing pace. My brain/attention span just works like that. I got a job on inpt oncology and although it was very challenging, I knew it wasnt my lifetime career. I didnt really want to work day surgery again. I had no interest in ICU (sorry folks but no patient, no matter how sick they are, is interesting enough to sit and watch for 8-12 hrs straight).
When ambulances went by I always wondered what was going on inside them, so I happened across and ER job and took it. The ER job I worked at was fantastic. A bit inner city so it was a total wakeup call to a small town gal, busy all the time, great/fun staff, I learned alot. After 3 yrs I decided I was ready to try the trauma center in town and got the job there. 9 yrs later Im still as happy as can be there. I used to volunteer as an EMT (when I was an ER nurse) and I do miss prehospital. Flight nursing would be great but not right now, the shifts dont work for me and my family. Im just glad I dont hate going to work every night. (btw, our ER/trauma does NOT see peds, we are connected to a childrens ER who luckily for me, takes care of those cases).

 

[ERMama]

(just a fyi.. our ER, the top level ER and only trauma center in our area will and has hired new grads. BUT they were always ER techs that had worked in our ER a few years prior to nursing school graduation. they then make you work a minimum of 1 yr in the ER and often 18months before even starting training in the trauma room).

 

[MagicalMom]

I'm not in Mass, I'm in Delaware, but here it is very rare for a new grad to start off in a specialty area. It is very important to work med-surg for awhile. It's a great way to really work on your critical thinking. I've known so many new nurses that really believe they know it all when they graduate but have seen actually do. It would also give you time to think about it. You may want to get through your first code with a 90 yo who has lived a wonderful life before experiening one with a newborn. Just something to tink about.

 

[Pea-n-Me]

Just curious if you are an AD or BSN grad?

 

[ERMama]

(back in 95 when i had a hard time getting a regular RN job, i was a BSN grad with honors, magna cum laude, had interned with high praise, still just didnt know the "right" people to get in).

 

[Pea-n-Me]

In 95 new grad jobs were scarce in Boston hospitals and many had to go to rehabs and even nursing homes to get a year's experience under their belts before returning. It was a drastic change to when I was hired years before and could take my pick of positions just about anywhere I wanted, literally. Over the years it has waxed and waned as someone else said. Currently they are hiring, but usually from within - employees who've worked as aides and gotten to know managers and build their professional reputation.

 

[roliepolieoliefan]

Easy there. I've worked at three hospitals as a tech and "bad habits" is a term that is used among every nurse I've ever worked with - young, old, male female - very loosely and not meant as an insult. It is common knowledge that you can't do everything by the theory that school teaches you. You'd be there two days before you finished a shift. Med-surg units around here tend to be VERY busy and chronically understaffed (without a budget to enhance the unit support). I don't know about your area hospitals but in ours it's not uncommon to have nine patients on an evening shift. Going "by the book" is not possible, you have to cut corners somewhere to prioritize. Do you find this to be untrue? Because that's the way it is around here.

We are taught all throughout nursing school that med-surg is the basis for all forms of medicine, which I believe is why we had two rotations of it and one of everything else. That and fundamentals is where you learn your vital signs, your assessments, your medication administration techniques. It's very necessary. However, I think it's difficult to disagree that a NICU is fundamentally very different. Your dealing with parents who room in, babies who use developmental positioning, finding the right balance between hands on contact and not making them crump from too much contact. You're teaching parents how to find a sense of normalcy in the chaos that has become their life while helping them through stages of grief. You can find similarities to it in med-surg and all other aspects of nursing, but they are all very different in their own right.

Please don't take offense to what I said. I meant none. Your knee-jerk reaction tells me you've had to defend your position as a med-surg nurse a lot through the years, but I was just stating facts. I don't pretend to know it all, but I'm excited to learn something. My attitude is positive, I'm intelligent and open to experiencing. I'm also not afraid to show my vulnerability and I believe my biggest weakness is confidence coming into the real world as a new graduate. But that comes with time and experience. I have compassion, a loving heart and a lot of passion.

A tech is not an RN. And nursing school is not reality.

Even though the hospitals here do hire new grads into specilaties , I am a firm believer a new grad should work med-surg for at least a year for some experience.

Med-Surg will teach you the real world. Nine patients on evenings? Wow thats low, around here. I used to get 12, at least with no unit clerk. it will teach you organization, and basic experience. My feelings are if you can do med-surg you can do it all. It is the worse and hardest nursing I ever did. So to all those med-surg nurses.

 

[Disney Doll]

Easy there. I've worked at three hospitals as a tech and "bad habits" is a term that is used among every nurse I've ever worked with - young, old, male female - very loosely and not meant as an insult. It is common knowledge that you can't do everything by the theory that school teaches you. You'd be there two days before you finished a shift. Med-surg units around here tend to be VERY busy and chronically understaffed (without a budget to enhance the unit support). I don't know about your area hospitals but in ours it's not uncommon to have nine patients on an evening shift. Going "by the book" is not possible, you have to cut corners somewhere to prioritize. Do you find this to be untrue? Because that's the way it is around here.

We are taught all throughout nursing school that med-surg is the basis for all forms of medicine, which I believe is why we had two rotations of it and one of everything else. That and fundamentals is where you learn your vital signs, your assessments, your medication administration techniques. It's very necessary. However, I think it's difficult to disagree that a NICU is fundamentally very different. Your dealing with parents who room in, babies who use developmental positioning, finding the right balance between hands on contact and not making them crump from too much contact. You're teaching parents how to find a sense of normalcy in the chaos that has become their life while helping them through stages of grief. You can find similarities to it in med-surg and all other aspects of nursing, but they are all very different in their own right.

Please don't take offense to what I said. I meant none. Your knee-jerk reaction tells me you've had to defend your position as a med-surg nurse a lot through the years, but I was just stating facts. I don't pretend to know it all, but I'm excited to learn something. My attitude is positive, I'm intelligent and open to experiencing. I'm also not afraid to show my vulnerability and I believe my biggest weakness is confidence coming into the real world as a new graduate. But that comes with time and experience. I have compassion, a loving heart and a lot of passion.

My reaction wasn't knee jerk. Most of the nurses I know who have had any experience have a great deal of respect for medical nurses & med-surg nursing as the backbone of the profession and most institutions. You were stating facts as you see them, having never been a med-surg nurse. That doesn't make them facts. That makes them your perceptions.

You did not learn everything you need to know about the basics of nursing in 2 rotations on a med surg floor during nursing school.

I'm not sure what Massachusetts med-surg floors are like, but as a med-surg nurse, I don't cut corners...I prioritize care, I assess what is important and what is not, I look at ALL aspects of every patient, regardless of their size, age or developmental issues and react accordingly to their needs. And amazingly enough, we do deal with families, parents ( I do take care of 18 years olds with parents and developmentally delayed people who although they may be chronologically 25 are developmentally 2 months old), positioning, giref counselling and all the other things that you mention are so "unique" to NICU.

Good luck with your job search & your career.

 

[Disney Doll]

A tech is not an RN. And nursing school is not reality.

Even though the hospitals here do hire new grads into specilaties , I am a firm believer a new grad should work med-surg for at least a year for some experience.

Med-Surg will teach you the real world. Nine patients on evenings? Wow thats low, around here. I used to get 12, at least with no unit clerk. it will teach you organization, and basic experience. My feelings are if you can do med-surg you can do it all. It is the worse and hardest nursing I ever did. So to all those med-surg nurses.

Thanks rpofan.
There is a certain amusement factor in all this, isn't there?

 

[minkydog]

gotta love a new grad

 

[TeresaNJ]

I haven't read through all the threads, but I'm not surprised you can't find a NICU job. They need very experienced nurses to work in a NICU, not a new grad. Ultimately, you should first work med-surg, then ICU, then NICU. Babies are extremely fragile, and can turn on a dime. You have to have excellent assessment skills, of which a new grad barely has any. Have you aggressively tried looking for a med-surg position? I know our hospital is always looking for new grads. Sorry you're having such a tough time of it. Congrats on graduating, and good luck in your job search.

 

[TeresaNJ]

I definitely see what you're saying, but luckily I live in one of the strongest teaching areas in the medical field. There are ALWAYS slots for new graduates in just about every specialty, but they are competitive and always fill up quickly. I don't think it benefits nurses to work in med-surg before a specialty like the NICU because there is so much learning to be undone. At this point, I can't even get a med-surg job to pick up the bad habits that need to be unlearned! Thank you so much, I'm looking forward to being overwhelmed.

Okay, I can't believe you just said that. If you are coming across with this attitude at your interviews, I can see why you're not getting positions. Bad habits? You really have no idea what nursing is all about. Anyone that can work med-surg successfully will do very well in other departments. Med-surg is a specialty all in itself. I'm sorry you have such a low opinion of med-surg nurses. I worked as an ED tech for 18 months while going to school for my RN. I HAD to work med-surg first per the powers that be. Thank God I was made to do that. I learned so many wonderful skills, learned to prioritize, and got a good, solid foundation to build upon. I then worked ED for many years, and when I transferred to ICU, I was shocked to see how much I still didn't know.

If one develops bad habits it is their own fault, not the fault of the unit one works on.

 

[Pea-n-Me]

I'm not sure what Massachusetts med-surg floors are like

I can tell you, about Boston anyway.

They're just like yours - insane but wonderful. There is a very high expectation of what type of nursing care will be delivered. Slackers need not apply. "Not getting to something" is really not an option. You must get to it, regardless of what it is, and that includes anything from helping someone get comfortable, to speaking with family members, to troubleshooting equipment, to starting a nitro or other drip, to attending an inservice in the middle of the shift, to helping new docs understand procedures, to training a new nurse, to planning staffing for the next shift, to fielding phone calls when there's no secretary, to doing all of your own vitals, bed changes, foley emptying and countless other things when there's no aide, to figuring out how to perform a complicated procedure you've never done before, to thinking critically and taking action when you are asked to do something that you don't feel is correct, to, well, you name it... Staffing levels (in my hospital, anyway) are such that you should be able to, unless the unforseen happens, at which time your co-workers will back you up (and if this doesn't happen, that's a problem, but generally it does). Oh yes, and no matter how busy your shift has been, your documentation must be stellar.

Yes, how about that evening shift? Family are visiting and want to speak with you; patients are coming back from procedures having not eaten all day and are hungry and quite possibly irritated, need fingersticks, meals, want to phone home, etc, and you have to make that patient feel comfortable and cared about, while at the same time taking off post procedure orders correctly and completely, assessing the patient to make sure they're stable (because the report you got isn't quite making sense), possibly dealing with hypotension, a groin or dressing bleed, vagal episode, vomiting, rigoring, etc, but really all the patient wants is to eat - how do you deal with that?; the ER is on the phone wanting to give you report on your new admission now, and someone mentions this is the third time they've called (which is news to you); another patient you have, ie the "stable/quite one", is reporting chest pain, has fallen on the floor, is becoming confused, has a BP or 210/108, has a fingerstick of 32, has a critical lab value back, a K of 6.3, just had a run of VT, you name it, something always goes wrong yet you have to deal with it in the midst of everything else, and just when you do, your ER admission rolls onto the unit and isn't happy about the 9 hour wait on a stretcher all day and would like to eat, use the bathroom (but needs help), and hasn't taken any of his pills all day but wants them now and you have to explain that the doc must write orders and pharmacy has to approve them before you can give anything, etc. My job, in additon to all this, throws in the task of supervising the care given, troubleshooting any problems that come along, teaching, handholding whoever needs it, staffing for the next shift (which in and of itself can be an overwhelming task), and a myriad of other things. Welcome to Evenings!

Seem overwhelming? You got it! Nurses who do it make it look easy, but I can assure you, it ain't.

If anyone wonders why Med-Surg nurses get defensive, especially when criticized by new nurses who've never done it in the real world, now you know. Nurses who do are highly skilled at managing many things at once. The best complement any nurse can get is when a patient is happy with the care they received. Most patients have no idea how many things that nurse juggled that shift, so if they had all their needs met, then that nurse did a nice job. Some nurses will even volunteer to take the most difficult patients, which makes it even more remarkable when they are able to do everything required of them and more.

I can assure you there is nothing less pleasant than working with a whiny or lazy nurse who does not want to pull his or her weight on any given shift. Other nurses do not take kindly to this. Nor do they take kindly to new grads coming in to a unit spouting off that they really wanted an ICU job but took this as the "consolation" position so they can learn and move on - do you really think, knowing this and feeling that kind of "dig" to the work they've chosen for whatever reason, that the majority of nurses are going to "take you under their wing", develop a relationship with you, spend countless hours helping you, knowing it's kind of "below" you to begin with? I've seen this type of nurse many times and they're often the ones who think it's below them to give basic care - don't fool yourself, patients, and even the aides pick up on this and will develop a dislike of you if you're always asking them to do your dirty work. I say this because I'm trying to explain why you're getting some of the reactions you did and hopefully you take it in the helpful spirit it is given. None of us know you personally, obviously, and you sound very bright and enthusiastic (like many of today's new nurses), but we're all picking up that your condascending tone may be the thing that's hindering you're getting a position. A little humility will probably go a long way here. There will come a time later when you can be the greatest NICU nurse the unit has ever seen. But for the next few years, you should concentrate on learning the basics, and I do mean basics, wherever you ultimately work. Remember, everything we do is driven by what's best for the patient.

Sorry so long... as you can tell, it's a passionate subject for many of us.