I woke up this morning to this headline about how new nurses basically just up and quit in droves out of frustration and improper preparation for a crazy-difficult and terrifying job. The timing is interesting because just yesterday I was remarking to a room full of people that I now completely understand the healthcare staffing shortage. I understood it partially before (long hours, poo flinging, overwork and underpay...), but I didn't see how nurses could contribute to the staffing problems by quitting or how they could throw away years of education and tens of thousands of dollars invested in that education. I see it now. Clearly. (Particularly after two shifts with a preceptor who tried her hardest to discourage me about being a nurse---in addition to browbeating me about my decision to remain childless and other bizarre topics. See below about electing against more orientation.) I have had 6 weeks of orientation, which sounds like a lot, but it covers about 1% of possible situations that are really likely to arise in the critical care area where I work. I paid attention in school, I'm a quick study, and I'm one of the sharper knives in the drawer, but none of that stacks up at all to experience, which I do not have. I fly solo on my next shift. I had the option of several more precepted shifts, but I voted against it for compelling personal reasons. Two or three more shifts probably wouldn't make much difference anyway. My hospital considers 6 weeks generous, and they can't afford much more, and I think that's standard or even long for orientation.
I have good time management and critical thinking skills, and they don't substitute for experience either. I walk into patient rooms exuding confidence and competence because my patients need that, but inside I'm terrified and thinking, "It's a good thing you don't know I really have no idea what I'm doing." I know the basics, and I can check off my tasks and administer medications and conduct/chart thorough and correct assessments. I know when I'm in over my head and when to go get someone NOW. But the small signs that someone is ABOUT to decompensate? Will slide past me until I've seen it happen, and that keeps me up at night.
Experienced nurses crow with delight at this attitude and say, "The scary nurses are the ones who think they know it all; you'll be fine." Small comfort. My hand cannot be held anymore, so now I have to rely on my training, common sense (oh God), and best practice as I know it. I hope it's enough. I have many assets to bring to this profession and to my patients, and I hope I survive my first year without burning out so that I can keep those assets in this profession. A year of orientation would be great, but in These Troubled Times (DRINK) it's not financially feasible. We new grads are going to have to suck it up and tough this out for now. Bah.
PS: I still love my job. It's just freaking me out right now.