It's getting better....

Nurses General Nursing

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I have been an LPN for all of four months, and though I am an LPN, I am given the same patient load as the RNs. I have to advocate for myself frequently in order to avoid practicing outside my scope. I've had some rough nights, and have come "this close" to throwing in the towel.

Recently, I had an epiphany. What I realized is that in NS, we are taught the ideal way, and when we get out into the real world, we are sorely unprepared for the reality. Reality was not matching my expectations, and vice versa.

Another thing I realized was that we, meaning myself, the lone lowly LPN, the RNs on the floor, the charge nurse, the nurse manager, the CNAs, the unit secretaries, the docs, we are all in this boat together.

Once I was able to see beyond my own stress and feelings of inadequacy and fears of failure, and see the support I have available to me and the support I have to offer others, even when all hell is breaking loose and we're swamped with more admits than seems humane, patients circling the drain, computer glitches and random snafus and and and......, things just seem to be better.

I guess the way I see it is, if you have to cross that river of s#*@, you might as well pull on those hip waders and put a big grin on your face and wade right out into it, cause that's the only way you're going to make it across. :lol2:

So I guess I'll hang in there for a while longer. Just wanted to share, in case anyone else out there is having a rough time.

Yes, they cannot really tell you, because the instructors are basically training you to answer the questions for NCLEX-PN; and if they deviated from there, there would be trouble to come. And, let me tell you, you will probably still be reading texts, but under different circumstances, and maybe a bit less stress. I read now for a fuller understanding of the illness and nursing implications moreso than learning for the first time just enough to memorize for the exam.

For example, I work in a clinic, do healthfairs and occasionally do homecare, where a great deal of teaching is done. I have information handy in my PDA such as a drug guide, diseases and nursing implications, and the Taber's Medical Encyclopedia installed. In the clinic, I am not sure what will walk in, and if something is unfamiliar, I pull it out and read a bit just before I call the patient inside, and make a note of it to read further when I get home. When I am about to go to a healthfair, I need to know the theme of what services we will be providing and I read a bit before I go there, and the same for the home; the diagnosis of the patient, medications and nursing management while I am there. Nothing is textbook, unfortunately, however, I have a guideline to follow and chart. Good luck!

"Nursing reality shock", can be avoided/minimized, by providing 6- 12 month mandatory internships, like PT, PT, Pharmacy, and of course, MD. No other health care profession expects its new grads to function like experienced nurses the day after they graduate. It is an unrealistic expectation.

As I stated in a previous thread a couple of days ago, nursing is the only health care profession that expects this of their new pracitioners. It accomplishes nothing but burn out, frustration, and new nurses leaving the bedside in droves. JMHO.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Specializes in Assisted Living, Med-Surg/CVA specialty.
I don't understand why some nursing programs are not talking to their students about this. What you are describing is a well-known phenomena in nursing: It's called Nursing Reality Shock.

There was a best-seller written on this waaaaay back in 1974- here's a link:

http://www.amazon.com/Reality-Shock-Nurses-Nursing-Paperback/dp/B000MEAQGC/ref=sr_1_1?ie=UTF8&s=books&qid=1195373618&sr=8-1

I really think programs should include open discussion re: Nursing Reality Shock in their curricula.

Anyway, Nancy, glad things are going better for you. Keep goin' at it, and keep those waders pulled up tight!

I'm still in nursing school and I often hear instructors say "Well this is how it should be..." and then will go on to tell you the way it's usually done.

I am a student and appreciate your honesty. I'm expecting hell for the first year, but hoping to get used to it or get out. But what us students really need to know is:

Is it even worth it? Are you telling us to forget it? OR Are you saying it is hell for a while until you get used to the ropes..............

Specializes in Cardiac Telemetry, ED.

Well, I got my butt kicked tonight, and of course, while bicycling home in the rain, I remembered all of the things I forgot to chart.:uhoh3:

But a couple of things made the difference between getting my butt kicked and wanting out, and getting my butt kicked and thinking this is great experience that will make me a better nurse. One of those things was having the support of the nurses around me, including my charge, who pitched in and helped out when they saw I was going under (one of them said she owed me one, since I had helped her out a couple of nights before when I actually had a little free time). The other thing was that since I had my Big Epiphany, it really wasn't a shock to feel that sinking feeling yet again; instead of feeling like crying or just walking out the door, I just pulled up those hip waders and kept on trudging along. And last, but not least, the oncoming nurse that I gave report to was so stinkin nice. My God. I just can't thank her enough for being so understanding instead of judgmental. I've had those nights where you get your butt kicked and to top it off, the oncoming nurse makes you feel two inches tall for not getting enough done. It's so wonderful to have that not happen.

So, I guess what I would say is it's hell for a while. I don't know if you ever get used to it, and whether it's worth it or not is completely up to you! I am not going to let this job beat me down; I'm going to keep trudging along and become the best nurse I possibly can.

Specializes in Community Health, Med-Surg, Home Health.
"Nursing reality shock", can be avoided/minimized, by providing 6- 12 month mandatory internships, like PT, PT, Pharmacy, and of course, MD. No other health care profession expects its new grads to function like experienced nurses the day after they graduate. It is an unrealistic expectation.

As I stated in a previous thread a couple of days ago, nursing is the only health care profession that expects this of their new pracitioners. It accomplishes nothing but burn out, frustration, and new nurses leaving the bedside in droves. JMHO.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Your humble opinion is very correct, unfortunately. I have been an LPN since 2006, and the orientation I had basically sucked, but I have to remain here for at least three years because this facility sponsored my education by allowing me to be on paid leave without showing my face at work until the nursing program was over. And, they also gave me time off to study for the boards.

My clinicals were poorly managed, compared to nurses that obtained their licenses at least 10 years ago. Had only one day a week, and not the whole day. Other programs from the past had one week clinical, then one week of theory. Those nurses worked wings around us, and were more acclimated to the set up of the hospital. Our staff ed at this hospital is so sorry that I have sought continuing education credits from outside sources. And, as you said, I am burned out, frustrated and downright angry. Each time I get ready to go to work, I feel a heaviness in my body and soul. We are not doing right by these patients at all. It is a rush job, a meat market, basically. I do enjoy nursing, but not under these circumstances. My hospital had the nerve to apply for magnet status, and from my observation, when the surveyors came, I do not think they were impressed. I have to say, I hope they do not receive that accreditation, we do not deserve it. If they really observed, they would see that many of us received CEUs and certifications from elsewhere, that served us better.

Specializes in Community Health, Med-Surg, Home Health.
I am a student and appreciate your honesty. I'm expecting hell for the first year, but hoping to get used to it or get out. But what us students really need to know is:

Is it even worth it? Are you telling us to forget it? OR Are you saying it is hell for a while until you get used to the ropes..............

It is hard to say. You have to have a passion for nursing, on any level. And, in many cases, you will not see the real deal until you are actually in the foxholes with us. I can't say it is not worth it, but I will say that you will have to give yourself accolades, because it is highly likely that administation and management may not show you their appreciation except for when Joint Commission is arriving or some other regulatory agency. Then, they want to shove you up like a platter.

There are good things as well, but I think that many more seasoned nurses think we got the same education and clinical experiences as they did, and it is not so. I think there is a culture gap between what is taught in nursing school versus actual practice.

Thanks for the reply! You are saying pretty much what I have expected. Is there anything I can do now to make the gap from student to nurse better? It's hard to think I am just getting my feet wet because I am stressed out in school and to think its really going to hit bottom before it gets better isn't very encouraging. BUT, I am in this and I am not quitting! I've been in the "real" world for some time and really feel nursing is a calling. So, if you can think of anything I can do to really dive in now (especially when I have an instructor on the floor) let me know. I plan to get an internship over the summer to gain more experience too----then when I graduate I hope to do a Nurse Resident program........ blah blah....OK, got to do a care plan :-)

Thanks again!!!!!!!!!!!!!!!!!!!!!

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