hearts895, RN BSN 12,552 Views
Joined: Mar 29, '08;
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Registered Nurse; from
The clock has struck 9 pm; you realize you haven't taken a single bathroom break in the past 4 hours. The last thing you remember eating is the leftover crumbled muffin from two days ago while on your way to work; that was ten hours ago. As you soon as you think you have a break in sight, two patient call lights go on followed by a doctor calling with roughly five new orders on a patient. The bathroom break will have to wait.
This is an all too familiar scenario in the nursing profession. There is a saying in the nursing field; Nursing, the hardest job you will ever love. Skills, knowledge and excellent time management are critical components in being a strong nurse. However, one of the most difficult tasks new nurses are required to have is being mentally prepared for such a challenge.
The psychological toll can weigh heavy. So how do you prepare yourself? How can you psychologically prepare for such a seemingly difficult task? The first step is digging deep within you and finding that confidence. It is in there, it is what got you through endless hours in nursing school. It is what you had you when you sat down to take your nursing boards. It is within you. You will have to dig deep and conjure it up, but it is there; I promise you. One important thing to know is that not a single nurse, no matter long she/he has been in this field knows everything. It is just impossible. Be confident in what you DO KNOW! If you feel it isn't much at all, that is okay. Hold strong to what you are confident in and build from that. Patients rely on us; they sometimes think we have all the answers. Be okay with knowing we don't. But do your best to find the answers out!
Another beneficial psychological component would be humility. A confident nurse is assertive in her knowledge, but has enough humility to know when to ask for help. I honestly cannot stress enough that no one will know everything. Whether you aced every test in school or not it is the application in the field that is an entirely different process. People are different, their bodies, their minds, everything is different. No one can know it all. Having humility can only help you as a nurse grow and learn. Step back and look at a situation and tell yourself, maybe I need some help with this. This will only save you the mental anxiety later as you question yourself over and over on the drive home, did I assess that patient correctly? If you were able to ask other nurses their input, or even the aides their observations, it can only benefit you and the patient.
A sense of humor will also save you long hours of beating yourself up over a silly mistake that was maybe just a mere oversight. "There is support in the literature for the role of humor and laughter in other areas, including patient-physician communication, psychological aspects of patient care, medical education, and as a means of reducing stress in medical professionals." (Medscape, Humor in Medicine, 2003) If you can't laugh or enjoy the moment you are in, the passion and fire you have for being a nurse will eventually die out. You will drive yourself down to the point of burn out. Everything will seem like a daunting task. Laugh, smile and remember that a smile can go far. Our patients are already stressed and nervous from whatever ailment they have, a smile will go a long way. Sometimes our patients have nothing medically left we can do for them, but a smile, or holding a hand is the best medicine we have.
Remember that old saying, Patience is a Virtue. Notice the difference of patience and patients. As a nurse, you have to have patience in yourself, and your patient. Be prepared for your patient to not always understand their directions or care plans. If it takes five times to explain it, then explain it once more just to make sure they are fully aware of their directions. High patient outcomes are the goals of nurses, so it is critical we are patient with them. It will also only benefit you psychologically if you are mentally prepared to accept not everyone will learn or understand at the same rate. If you are going over and over your mind about what is due or what is next you may let this moment slip by. You need to be able to give your patient your best undivided attention. Be patient with yourself in learning. Be patient with your supervisors, your doctors and your aides. Everyone is going to work at different paces, or have a different way of doing something. Don't stress yourself out trying to change them or modify their approaches. When you grasp patience, you will have a peace within in yourself.
To be psychologically prepared for the nursing profession I cannot emphasize one critical component: compassion. Compassion is what drives us in our endeavors. It is the vow you took at graduation. Remember the nursing pledge, ".....With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care." (Lystra Gretter, 1893) Your compassion will take you to a level of care that only a nurse can provide. Compassion will guide you in achieving humility, patience, and even a sense of humor. Holding that compassion will guide you in your bedside care with patients, it will give you the drive to do the best possible care for those you are responsible for. If will keep you focused on the patient and their needs and not your personal desires and beliefs which can often blind many nurses.
As a nurse your skills and knowledge will you get you far. But if you are not psychologically prepared, no matter how well you have intellectually prepared yourself there is a little chance of success without a healthy mind, a compassionate heart and desire to make a difference. Keep your mind straight, your confidence strong, your smile bright and your heart open. Go forward and remember; People will forget what you said, People will forget what you did, But people will never forget how you made them feel. (Maya Angelou, 1989)
First and foremost, I'm sorry for what you and your family are going through.
Second, this post brought tears to my eyes as I remembered the hundreds of people I "sat" for as a sitter before I became a nurse. Thank you from the bottom of my heart for saying thank you to sitters. Boy do I have stories of my own from my sitter days. The one that comes to mind first was the lady I cared for on a neuro unit. I came in the morning at start of shift. Everyone thought the patient was still sleeping. I knew this was unusual for her. She didn't wake when I took her BP. I called out her name, over and over. She didn't wake, I began to call out for a nurse when one walked in. Rapid response followed by a CT of the brain. It turns out she had a hemorrhage. And everyone thought she was just sleeping. Many others saved her life, but I've always silently known that it was I, a lowly sitter, who caught it to begin with.
I had another patient as a sitter who began seizing while eating, sitting up at the edge of his bed. I cleared the food and lay him in in a safe position as to not aspirate.
I know I've prevented countless injuries and falls from confused patients trying to get out of bed. I know I've eased anxiety in countless patients.
Thank you for reminding me of all I've done. And thank you for being appreciative. Being a sitter is one TOUGH job.
I used to be a sitter. I'll never forget the night that I was sitting for a suicidal young woman, and her family came in with their pastor. They asked if I would like to pray with them, and so I held hands with them and all of a sudden I was listening to the pastor say "And Lord, thank you for bringing sandyfeet here to keep (patient's name) safe, please bless her and give her the strength to stay awake all night...". I wish all sitters could hear things like that. They deserve it! It was such a difference from the treatment staff members gave me--waiting until 0330 to give me a lunch break, or making me beg for a bathroom break!
Thank you for the article.
I am a night shift nurse aide, and as part of my job I have to be a sitter quite frequently. The job can be exhausting and very frustrating at times. To be honest, I don't usually look forward to these shifts. The worst is when you have staff that don't support you, such as when your RN seems irritated to come in and assist, if needed, in a situation. Luckily, the nursing staff is great most of the time. I have been hit, spit on, you name it.
What gets me through these shifts is knowing that I can make a difference. I very much hate restraints, so I would prefer a confused patient have a sitter. On occasion, you get the patient who is so confused, agitated, restless, and combatitive that you don't feel like you've made a difference, since they required a restraint, despite the sitter, to keep you and themselves safe. I especially hate these nights because I feel like I have failed in some way.
Thank you again for the appreciation.
Two mornings ago I received a distraught phone call from my mother telling me that my dad, who is suffering with end stage COPD, spine compression fractures, and a distinct lack of proper narcotic metabolism, became flighty, picky and squirrelly to such a point that he was assigned a sitter.
Look, I've been around. I know what can be said about sitters. I know that for every one that understands the amount of sheer effort and work that goes into trying to keep someone in bed, calm and intact, there are several more misguided individuals that think sitting is easy, requires little effort and even less work.
Obviously those individuals need to meet my dad when he is blitzed out of his brain on Fentanyl and Vicodin. Let's just say that when my family decides to lose it, we don't just misplace our minds, we straight up blast them into orbit never to be seen or heard from again.
Maybe it's the southern mentality: go big or go home.
We pride ourselves on hearing the blankets whisper, seeing shadows slip through the walls, and having full out conversations with no one physical. We sing with gossamer birds, swat at oily, ethereal spiders, undress, and boot scoot boogie down the hall, crumpled spine and inability to breathe be damned. We talk back at the television (even though it's off), recite bits of poetry, and try to lick our meatloaf. We load pills in the end of water straws and attempt to "tranq" the "elephants" in our room. And yes, the nurse would just so happen to be the elephant in question. Perhaps wearing grey scrubs in the presence of one no longer operating on this plane of reality was a mistake. Just sayin'.
But regardless of all the insanity, of the wandering, flitting hands that pluck at skin tears, scrape at desperately needed picc lines, and fidget with the oxygen in his nose, and never, ever rest, he is safe, cared for, and, although gently, patiently re-oriented again and again, he is even kept company in his joyful delusions.
I went to see him the other night only to walk up to the room to hear him murmuring, "The birds...do you hear them?"
"Yes, sir. I think they are canaries. Let's lay still and see if they come back to sing to you."
And there he was, staring at the upper corner of the ceiling as if watching a menagerie in the zoo, rapt, still, his hands resting lightly on his bedding. The sitter, Margaret, greeted me and explained everything he had been up to in a hushed whisper.
After all, we were waiting for the canaries to return.
And then last night, a half mad, partially naked Humpty Dumpty decided to have a great fall.
It would seem that someone decided to tap into their inner ninja and attempt to vault the bed rails and make a beeline for the room exit. The gown was apparently trying to rat him out, so it was discarded for the sake of security (thankfully, he didn't manage to totally disrobe).
Mission impossible music may or not have been involved.
The sitter only looked away for a second. And you know what? I totally believe her. I've seen my dad move when properly motivated.
But it is not because of any "blame" issues regarding his escape attempt that she caught my attention. No.
It is because she was fast behind him, and when his foot caught and his burst of strength gave, she swiftly, skillfully guided him safely to the floor, cushioning his head on the soft toe of her shoe.
Because of her knowledge, her quick thinking, fast reflexes and sure hands, I am not writing a grieved announcement of my dad's need for a crani or an intermedullary rodding of a femur.
Because of her, I get to watch him listen to the sweet chatter of the blankets and blow bubbles in his soda.
And although that may sound like the strangest thing you have ever heard, I could not, ever, be more grateful.
It may not be much, but thank you.
Thank you for giving him the same dedication you would give your own loved one. Thank you for never yelling, never losing your cool. Thank you for laughing with me because crying is not something built into my coping mechanism. Thank you for not laughing at him. Thank you for speaking calmly with my hysterical mother when I could not be reached.
Above all, thank you for "doing nothing".
Hi everyone, I just got my license today and I would like to share this prayer I found somewhere here in allnurses.com. I believe that this prayer is really powerful.
This powerful prayer is very effective in examinations. It has to be said before appearing in the examination. There are two variants to this prayer. Both the prayers are equally effective. You can choose any one of these:
O Great St. Joseph of Cupertino who while on earth did obtain from God the grace to be asked at your examination only the questions you knew, obtain for me a like favour in the examinations for which I am now preparing. In return I promise to make you known and cause you to be invoked.
Through Christ our Lord.
St. Joseph of Cupertino, Pray for us.
O St. Joseph of Cupertino who by your prayer obtained from God to be asked at your examination, the only preposition you knew. Grant that I may like you succeed in the (here mention the name of Examination eg. History paper I ) examination. In return I promise to make you known and cause you to be invoked.
O St. Joseph of Cupertino pray for me
O Holy Ghost enlighten me
Our Lady of Good Studies pray for me
Sacred Head of Jesus, Seat of divine wisdom, enlighten me.
Good luck and God bless to everyone taking NCLEX PN or RN soon!
Jenni811 hit the nail on the head, it's about $$$. Shockingly, inexperienced nurses (those with 1-3 years of experience) are cheaper to hire than an experienced nurse. Additionally, those coming out of nursing school are typically young and attractive as 22 to 25 year old females are apt to be. What I'll also say is that as a male I never had to deal with the garbage that the more... experienced... nurses dealt out to these new grads. That isn't to say I didn't hear about it, probably since I wasn't viewed as any type of threat to the pecking order. I even had one nurse tell me that the nurse manager was purposefully hiring attractive people to work the floor. That made me chuckle a little bit. What I'd suggest is to get over it. NOTHING good will come from being so superficial. Is it their fault that they're attractive? No. Is it their fault that they are young? No. Are you liable to let your jealousy over SUPERFICIAL things ruin some potential relationships? Yes. If you see that they are not acclimating the the job/culture (ie cell phone use while patients need something) let them know. I'll say though that you may need an attitude adjustment just as much as these new nurses because your feelings will translate in to actions in how you treat/interact with them... and then we'll get to read new posts about how we continue to eat our young.
I started as a new grad in a Level I Trauma ICU last November. My 20 weeks on orientation flew by and I can't believe it's almost a year since I started.
Things that I studied:
1. Vent Settings (including oscillator, bivent, etc)
2. Common "ICU" drugs and their side effects (prop, vec, succ, versed, fentanyl)
3. Brushed up on Sepsis, lactic acid, etc.
4. Got to know ABGs very, very well
5. Pressors for sure
There's more, I'll probably think of some more as soon as I finish this post.
As far as general advice (I didn't read all of the previous responses):
1. Preceptors want you to ask questions. Take advantage of this and ask even if it seems stupid.
2. You will make mistakes. Learn to forgive yourself, learn from them and move along.
3. Learn your team. At the beginning of each shift try to identify one nurse who you can go to if something arises during your shift that
you need help with who won't bite your head off.
4. Someone else said it, but a good respiratory therapist is priceless. Know yours. Ask them questions. Usually, they appreciate
someone's respect and they are really great teachers (IMHO).
5. Know your support staff. We don't draw labs unless pt's have an ALine or a central line (and sometimes not even then) so I like to get
to know our phlebotomists and one just commented the other day that she's so appreciative I took the time to learn her name and
don't just call her "lab girl." You never know how far a little mutual respect might go. One of these staff members may be able to
really help you out one day.
6. Get yourself organized. Do whatever it takes to keep yourself that way.
That's about it for now. Maybe later I'll post more about staying awake on night shift. I do love nights though .
I'm a recent New Grad RN hoping to get my start off in the ICU. I've read many posts both for and against this issue and I was hoping to get some advice either from New Grads who had gotten their start in the ICU or experienced ICU nurses! I have my first interview for an ICU unit this coming week and I'm both excited yet terrified. I know I am ready for the challenge and I did have my senior preceptorship as charge in a 12 bed ICU as well as many clinical experiences in the ICU.
What kind of advice do you have for me?
What should I expect? study?
Any help would be greatly appreciated!
I wanted to be a nurse because I was inspired. When I was 15 and very naive, I got pregnant. I was scared but my boyfriend at the time was very nice, as were his parents. Everything was going ok. I had plans to finish high school and go to college with their help. Then, I had my first ultrasound.
The tech put the wand on my then 22 week tummy and said, "Lets see what we have, shall we?" After about 20 seconds, she turned the screen away from me and said, "I'm just going to call the doctor, ok?" She seemed very shaken. I waited nervously for the doctor to come back.
They explained to me that my baby girl had Osteognesis Imperfecta Type 2. They told me that my baby had 22 fractures at that time, her femurs were growing severely bowed, and that she would die within moments of birth due to lack of collagen in her body. They told me I need to have an abortion or my child would die screaming in pain.
I left the office numb. Sure, at 15 a child would complicate my life but I loved her. I had wanted her. I was supposed to think about my options and come back 4 days later. I talked to my boyfriend's family and him that night. As first generation Irish Catholic immigrants, they couldn't condone an abortion and I couldn't either. We decided to name the baby Aisling (Gaelic for "Beautiful Dream") and go through with the birth. We grieved.
The doctor was wrong. My Aisling lived for 5 hours and 22 minutes. She was born with several fractures and received another just putting a diaper on. She cried. I couldn't pick her up and comfort her. I saw the nurses in that NICU cry for me and my little broken girl. As she breathed her last breath, one of those nurses placed her in my arms. She told me I could say good bye now. She held me as I cried.
I want to be that nurse. I want to comfort and be the angel that other people need during the best and worst moments of their lives. Isn't that why we all want to be nurses? The difference between these wonderful people and a nursing instructor is that teachers make expoentially more of those life touches. For every one student, they touch hundreds of lives. Call me selfish but I want this for me. I want to touch thousands. Can you imagine? Isn't it our duty?
This is how I fight the nursing shortage. I'm going to make more nurses. We need more teachers. I hope my story inspires you to help me!
Attached is the report sheet that I created. It is for a Medical ICU, so it doesn't include drains, etc. Feel free to use it and make it your own!
I just looked mine up on DOH in fl and the exam results are up and it says pass!!!!! Yaaayyyy!!!! It's official I passed!!! =)
I'm not trying to be a Debbie Downer, but it may be time to consider going through a nursing program again. Nine attempts in four years leads me to believe your original schooling did not do it's job. JMO.
when I came home after the test,I had really bad headache even during the test I feel so horrible. five hrs later I did pvt good pop up with 76q's and 19 sata,6 put in order and 1 Ekg strip no math qs one picture . Thanks ! everyone for your support.
my main study tools was:1, NCLEX 4000 & 3500 AND NCLEX 10000 2,saunder's 5th ed. q&s book I did use kaplan cd 180qs my and some test from qbank. good luck who's going to take the test feel free to ask any questions. KEY TO PASS THE TEST STUDY HARD TO DO TONS OF QUESTIONS EVERY DAY AND READ THE RATIONALS WHY YOU GOT THE ANSWER WRONG OR RIGHT.
I would like to share my experience of NCLEX with you all since others have been kind enough to share their experiences and maybe I can be one to impact someone and make them feel a little more at ease...I Have separated this into sections so if you dont want to read the WHOLE thing you can just scroll to the area of interest:
NIGHT BEFORE THE EXAM
TRAVEL THROUGH NURSING SCHOOL
HOW I STUDIED
HAVING THE CONFIDENCE
NIGHT BEFORE THE EXAM:
Today (Jan. 15, 2013) I took my NCLEX @ 8AM!...it started out rough...I kept waking up in the middle of the night.. I went to bed at around 0930/1000 last night and woke up at 1100 fell back asleep but then woke up again at 3AM then I NEVER FELL BACK ASLEEP! =( so as I start to get ready for the exam I start freaking out..thinking what if I fall asleep during the test?!?...ahhh!!!
Anyways I get to the testing center and PRAY in the parking lot, leave me phone and other belongings in my car...I am the first one to get checked in and the first one to get seated at a computer....I take my time reading EVERY single word even through the tutorial!!!! This is where i PRAYED AGAIN!....(Im telling you it helped me soooo much during the test) then this is where the TEST began! OMGosh I nearly had a heart attack my heart pounded out of my chest like I could feel it pounding in my feet!!!...by question three I got my first SATA question ....may okay...it wasnt as hard as I thought it would be....ok...(im thinking in my head maybe I'll do better than I expected!) later in the test i decided to cover up the time and question number (was getting to nervous...i prepared myself to get the whole 265 questions) after more questions I started to think oh man...I am about to fail these questions are crazy?!?...after an hour or two (cant remember) into the test I the screen changes...i got scared....but it was just asking me if i wanted to take a break or not LOL i took at least 2-3 minutes deciding if I wanted a break and winded up not taking the break! lol as soon as I chose not to take the break I had the sudden urge to PEE sooooo baaaaddddd!!!!!! but i wanted to stick it out and take a few more questions....more SATA questions popped up....1 med calculation.....1 EKG..more SATA (14 in total)...I used one whole erase board and had to request a clean one to finish with other questions on it...i peeked at the timer and the question number #73....oh my gosh!!!!!! anxious!! I said Id answer a couple more questions then take a break and go to the bathroom....so after answering the next two questions ALL i can remember is the screen going blank and the survey popping up WOOOOWWWW!!!!!..... Im finished reallly?!? this was the test that I prepared weeks and weeks for to sit for 2.5 hrs and only 75 questions?!? Was this going to be enough?! (man i hope so) I hurried out the testing center went to my car checked my phone was about to do the PVT but decided to wait till I got home....as soon as i walked into the house I was on the phone with my boyfriend and checking the computer simultaneously!!!! There it was the..."good pop up"....OH DO I HOPE THE PVT IS REAL!!!!!
TRAVEL THROUGH NURSING SCHOOL:
While in nursing school I was the average kid literally I DIDNT make straight A's I didnt always ace my test...but I worked hard and did my best and that was all I could do....at my school we had four semesters FALL & SPRING semesters so while over the summer I would forget a lot of the things we learned in the SPRING semester which sucked alot!!! so it felt like while I was studying for NCLEX i felt like i was teaching myself these things ALL OVER AGAIN! We took the HESI exam on the last day of class and on that I failed horribly on it...I forgot the exact score that I got but it stated that I may need remediation and needed to test again...(I still passed my class though) That HESI exam discouraged me sooo much but of course I didnt let it depict my future!...so after Leadership is when I began my studying for the NCLEX. I graduated on December 10, 2012 and that when I full force studying started. I was given the opportunity to gather my classmates together and offer them a free strategy seminar from KAPLAN which helped with tips for NCLEX and then I received the KAPLAN course for FREE....the details are on the website so if you are short for cash check on the details to take apart of this opportunity!
HOW I STUDIED:
the way I studied was a bit different than most....I have a very short attention span and undiagnosed ADD so I cant read a whole NCLEX review book because I will be thinking of other things lol so what I did was first listened to all of HURST review....HURST is great for content review Marlene makes things soooo much easier to understand....I made sure that I understood the reason WHY a disorder has the s/s it does so it would be easier to recall them later...then i did about 50-200 questions throughout the day and reviewed rationales...when it was time for me to do KAPLAN i did all the questions on there to make sure I get a goo amount of review ...I didnt really watch the content videos because they were VERY dry to me and again SHORT ATTENTION SPAN lol...my scores for KAPLAN in case you're curious:
Diagnosis test: 68%
Readiness test: 60%
Qbank 100% done: 62%
So for those of you who feel that your scores suck or are too low...dont be worried because look at mine?!? lol KAPLAN is great for their questions since the screen is set up like NCLEX as well as the questions really prepare you for the actual thing...I would totally recommend this to anyone out there. I tried to read sauders although it was a bit rough because it was just sooo much to read but then again it is an easy read and easy to understand....there were time when I would break down and cry and just tell my boyfriend maybe I wont be a nurse maybe this isnt for me...its too hard....becaus after some of the Qbanks I would 43% or 50% would make me feel like a failure....what Im trying to say it you cant let these scores get you down they are just practice!
HAVING THE CONFIDENCE:
Sorry for the lenghty post....but I thought this would help someone who might be on edge about things....To anyone getting ready to take their NCLEX or even waiting for their ATT to schedule an exam and havent begun studying....dont fret...you are prepared or you wouldnt have made it this far!!! you might be saying to yourself..."HA! yeah easy for you to say"...i used to say that all the time but REALLY dont worry....I was once in your shoes before...take deep breaths and be CONFIDENT in yourself....dont put too much stress on yourself as well because that will make things that much harder..
Another thing that really helped me was drawing on my dry erase board "YOU worked HARD for this YOU CAN DO IT! Chanel (My last name), RN" this reminded me that I will reach my goal in the end I took a picture of this and put it as my screen saver and background on my phone, My boyfriend also wrote on the white board at his job (because he works at the hopsital) Date: 1/15/13 day: Tuesday Nurse: Chanel, RN TECH: Vlad patient Goal for today: BE CONFIDENT AND PASS...that made me feel much better about it as well...I also had great people surrounding me supporting me and giving the boost to keep going and telling me I WILL PASS!! not to mention I had a job on the line that was depending on me passing on ther first try! lol I hope this helps?! (sorry for any typos as well...Its late, im tired and trying to type this fast lol) Thanks for reading!
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