Advice I wish I had as a new graduate RN- When it rains it pours
Last month, I attended a career fair for the sole purpose of networking, this being my year 6th year as a RN and 2nd year as a nurse practitioner. I ran into several students there I have taught in past years who will be graduating next month. They all said they were looking for an ICU position and were discouraged and disappointed many ICUs were not hiring new grads.
I clearly remember applying for new graduate nursing jobs all those years ago and feeling defeated and rejected. At the time of my graduation, the financial climate was very difficult and there were hardly any new graduate RN positions in my area and the country. Many hospitals in the area and in other states were on indefinite hiring freezes (including the hospital I had aspired to work at for years).
I quickly abandoned the idea I would land my dream job as a new graduate RN (pediatric intensive care). After I passed my N-CLEX, I started frantically looking for a job while moving back into my parent’s house (good-bye, college!). The few jobs out there usually said experience required, no new graduates. I applied for over 100 nursing jobs in a month and used every connection in the health care world I could think of to no avail. I rewrote my cover letter, triple checked my resume for errors and to make sure my phone number and email address were correct.
After countless job applications I received 3 requests for interviews at 3 different hospitals in 2 days! Interviews pouring out of the air, I was so excited. One position was at an inner city hospital in the cardiac ICU, the 2nd another inner city hospital in a stroke/rehab unit and the 3rd was on a cardiovascular step down unit in a suburban hospital. I quickly made lists of pros/cons of each employer and patient population and ranked my choices accordingly. I pressed my new suit, bought new pantyhose, and printed out copies of my resume and nervously drove to my first “big-girl job” interviews I had worked so hard for.
Leaving the interviews, I decided the cardiac ICU position was the one I wanted the most out of the 3 and prayed I would be offered the job. The unit was small but busy and they offered a very comprehensive orientation program. A large portion of their staff were planning to go to CRNA school (I was too at the time) and the manager was happy to support that.
The cardiovascular step down position, my interview lasted 6 hours! I was shocked. I interviewed with human resources, the unit manager and charge nurse. The manager was great and he was very encouraging and assured me new graduates do very well on the unit. I still hoped for the ICU job though!
I ended up canceling the stroke/rehab unit as I found it they were not considered an acute care unit and thought I would take my chances with the other two jobs.
About a week later, my phone rang with an inner-city area code, I nervously answered the phone hoping for good news. Sadly, I was not offered the ICU position as “I was just too green” but to try again when I have some experience. I was devastated.
The next day, I was offered the step-down job which I accepted. Don’t get me wrong, I was grateful to have a job but I couldn’t shake the feeling that meant I wasn’t good enough to find an ICU job as a new grad like many of my classmates who left my home state did. I anxiously counted down the days to my start day and continued to look for an ICU job anywhere in the state. Fortunately, I failed at finding that magical ICU job. Looking back at my career, working in a step down unit for my first RN position was the best decision I have every made.
My advice to my former students and to any new graduate nurse:
-Working in a step down unit where I would care for 4-7 patients at a time has given me fantastic time management skills
-My history taking skills were much improved. I always felt awkward in nursing school asking patients personal questions, that flew out the window very quickly!
-I grasped a much better understanding of practical pharmacology, I did not have to learn drips at first and was able to become very familiar with the medications we gave frequently with out the high pressure learning environment in the ICU with inotropes (IV medications that affect your blood pressure)
- Many of my classmates who had boasted about their ICU positions prior to graduation were miserable and overwhelmed- several leaving or being asked to leave within the first three months of employment
- I became very comfortable calling physicians and APPs at all hours of day and night for my patients. I quickly learned to never apologize for waking a provider at night- this is their job and their responsibility to answer questions and to listen to your concerns
- When I did switch to PICU a year later, I was able to focus on drips and ventilators while feeling comfortable with basic nursing care and time management. I was overwhelmed but no where near as bad as if I started in ICU as a new grad
- I don’t know if I would have enjoyed PICU as much as I do now if I had started as a new grad and been extremely overwhelmed
- Even though I’m a pediatric provider, I still to this day call on knowledge gained in the adult world
- It was an honor to care for the older adult generation. I received some great unsolicited life and love advice. I also heard amazing stories of struggle and survival first hand including Holocaust survivors, WWII veterans, people who should not have survived their condition but were thriving and so many more
- I met some wonderful people and I do miss working with them
You will be ok if you don’t find your dream job immediately after you graduate, I promise! Find a nursing job to start gaining experience and do whatever you can to build your resume.
-Reach out to the manager of a unit you were not hired for or where you would like to work and ask how you can become a more competitive applicant or if you can shadow.
-Take certification classes that you will need in your dream job! I took pediatric advanced life support when I was an adult nurse and paid for it myself. At my PICU interview, they complimented me on my drive to succeed
-Join an organization in the area your are interested in, for example AACN for critical care. Memberships usually include continuing education credits, journal articles and opportunities to network on discussion forums
-Network! Keep in mind many hospitals will consider internal candidates after a 12-24 month period over external candidates!
-Never burn a bridge- EVER! Nursing and health care is a surprisingly small world, it is amazing how many physicians, nurses, APPS, and managers know each other!
Peace, love, and job hunting
Zen APRN 