Latest Likes For PacoUSA

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PacoUSA, BSN, RN 30,919 Views

Joined Mar 25, '09. Posts: 3,493 (33% Liked) Likes: 3,317

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  • Apr 26

    It's too bad many nursing students and new grad nurses scoff at the idea of working on med/surg as their first job, desiring instead more luxurious (for lack of a better word) specialties such as NICU or some other critical care. I fell onto a medicine floor just for the sake of having a job right out of school in this economy. Granted, I know I won't be on this unit forever, but for the time being I am learning so much, my foundation will be strong for whatever I choose to do thereafter.

  • Apr 26

    Quote from iowa27
    Need help here.....I've just become an RN after a long career in another field. I've just been hired to start on a med-surg floor and have now completed my 6th shift with my preceptor.
    I'm very frustrated with myself and can't help but think that my preceptor is going crazy, even though I continually get positive feedback.
    I'm finding that there is so much to "take in" throughout the day, while I normally keep up, I know it's only because I have someone "holding my hand.
    I feel as though I'm always asking some of the same questions before it finally "sinks in", while I know I'm slow because I'm scared to death that I'm about to kill my patient by giving the wrong med, wrong time, etc.

    During hand-off there seems to be so much info given that much of the info starts to get lost on me, and I feel as though I'm shutting down before I even start the day.

    I really want to succeed at this, but am wondering if the stress of this is worth it at my age.

    Any advice out there?

    Thanks in advance
    The problem with med-surg is that there are too many patients per nurse, and too many details to keep track of. Ask me if so-and-so has COPD and I will literally pause for 5 seconds to think if that is true. Patients are also sicker now than they were 30 years ago and medications are also more diverse and complex. To get more than 4 patients these days I feel is already substandard care. When the job becomes more about "getting crap done" and less about "lets think about what we need to do to get this patient better care," it's not nursing anymore. And I do think many nurses are simply not programmed to work with more than a couple of patients at a a time. I've been a nurse for 3 years and I still detest having anything above 3 patients. I was once floated to a cardiac stepdown with 3 patients to care for and I felt like I could do it forever. I don't mind being busy at all, but give me a manageable and realistic workload, damnit! This is one reason I want to transition more towards critical care.

    Anyway, to answer your question: it takes time to get it. Be more patient with yourself. Your experience sounds a lot like mine when I started and I am also a 2nd career nurse. It's not easy starting over, but the rewards are awaiting you. I now sit here very glad I got to where I am through perseverance and positive thinking, and you can too. Eventually you will get to the point where you will finally get it!

    Sent from my iPad using allnurses

  • Apr 24

    I'm glad I never listened to someone like the OP. Going into nursing as a 2nd career is the best decision I've ever made.

    Sent from my iPad using allnurses

  • Apr 17

    My PERSONAL experience is that med-surg nursing is perceived as a dumping ground, and (except for California) a higher than normal patient load is the norm and nurses are expected to deal with it. There is very little time to spend with patients and an exorbitant number of tasks to complete. Too much babysitting and not enough time to critically think. It is viewed as the place where you start out your nursing career and then move on to critical care or more lucrative specialties after you have the requisite experience under your belt. I've even heard others comment that some excellent nurses are "too smart" a nurse to stay on a med-surg unit, and that critical care nurses are more astute clinicians. Med-surg nurses have to move their patients to higher level of care when they decompensate enough and they have restrictions on what they can or cannot push or what interventions they can or cannot allow (i.e., no continuous pulse ox monitoring or continuous nonrebreather use on a med surg floor). In this sense, the critical care nurse is viewed as a better or more qualified nurse. In this day and age, few newer nurses seem to tolerate the idea that they have limitations on the care they can provide to their patients.

    I'm not saying this is the truth for EVERY med-surg unit, just saying that this is the perception from where I stand and live, and why someone here too would crinkle their nose at the idea of going into med-surg. It's no wonder many new grads are killing puppies at the chance to start out in ICU or other critical care. Charting on 2 patients is viewed as a hell of a lot less onerous than charting on 6.

    And btw, the concept of starting out in med surg for a year and transferring out to another specialty seems to be slowly dying. Many specialty RN job listings are beginning to specify experience in the specialty as the preferred qualification for the opening (i.e., 2 years critical care or ER experience for ER or ICU) and med-surg is no longer enough. Maybe this is a result of oversaturation of qualified candidates in the job market and employers can be more choosy. So the idea of starting out in med-surg and being stuck there seems to be a growing concern. It's harder now to change to a specialty after med surg. Also, this could be a regional thing, but again, that's how things are perceived around here.

    Sent from my iPad using allnurses

  • Apr 4

    Quote from jeanbeth
    ... I just took a 2-hour training course in serving food because our LTC facility is changing to a "household" model where everyone pitches in to give the residents a more home-like environment. Next up is a training session on "throwing in load of laundry when you have time." ... Two of six nurses on my unit have already given notice.
    I would have walked out the door straight off. No notice. No way.

  • Mar 31

    I worked at a hospital once where a medical resident (a RESIDENT!) visiting a patient at bedside put my patient on a bedpan at her request. She came to the nurse's station (where I was busy charting) to tell me that she did that. This was the first time a doctor had ever done anything like this in my experience, so I was a bit shocked. She shrugged it off as it not being a big deal, but just wanted to let me know so that I was aware when the patient was done. That doctor earned my highest respect from that day on. She was quite awesome in all respects. Oh how I hated the day she left for another rotation

    But I have also had frustrations with these moments you describe, where personnel take MORE time to find a nurse to perform a menial task that could have been done quicker doing it themselves. And case managers who now think they are above floor RN status and dont need to touch patients anymore, I really resent this. What is wrong with doing a blood pressure yourself? Arent you still a licensed RN?

    BTW, there are some days when patients take me to the point where I start thinking about becoming a flight attendant, because it is exactly how I sometimes feel. But just when I am convinced that I should go that route, another patient experience reminds me that nursing is truly where I am meant to be.

  • Mar 30

    I'm lucky to work where I work, where EVERY single CNA on my unit (day, eve, and night) is plain AWESOME! Not one of them is lazy, and they work well with us nurses. And there are a good mix of men and women CNA's on my floor. We treat them with respect and they don't huff and puff when we ask them to help out. Everyone knows their scope, and no one thinks they are above the other. When I did clinical there as as student, they even treated me awesomely. Now as an employed nurse, I embrace their value. Without them, my job would be much more intense.

    So, not so unfortunately, I have never met a bad CNA.

  • Mar 30

    Quote from gonzo1
    med surg x 1 year, ER x 8 years and now 4 years in ICU. At my last job we had 2 nurses that were 70 and working in ICU. They rocked it. I'm wondering if you think ICU is too much for "old" people or what?
    I want to be you when I grow up .... in my 40s BTW

  • Mar 28

    Never having to get involved with nonsense conversations about bridesmaid dresses for an upcoming wedding ...

    Sent from my iPad using allnurses

  • Mar 27

    I used to work @ a hospital in NY on a travel assignment where the ER would fax SBAR to the unit and that was it. The patient would come up in about an hour. No phone calls, no phone tag, nothing. The SBARs were pretty concise enough that you rarely had to call ER with questions. And the MD's notes already in the computer so you already had a full picture of the patient when they came up. I LOVED it! Maybe it is because I am not much of a phone person anyway ....

  • Mar 26

    Quote from cs1031rn
    Everyone wants to start in their speciality. Work a med-surg floor for a couple of years though and you'll be able to go anywhere!
    This is starting to become antiquated advice I fear. Lots of job announcements I have seen for specialized nursing units want specific experience in the specialty and med-surg experience does not seem to necessarily equate. ER wants ER experience, L&D wants L&D experience, ICU wants ICU or critical care experience, etc. Almost feels like if you start out in med-surg you risk getting stuck there. Just saying this because I have tried several times to transition to these kind of jobs with med-surg tele experience, have a great interview only to have someone with specialty experience grab the job. Where then can I get the experience if not given the chance? I will keep trying though, cant give up.

    Sent from my iPad using allnurses

  • Mar 25

    Quote from anon695
    Won't they see that my friends are linked to the school and class year (everybody does that, I had done it too until I deleted the account last week) and figure out it may be me in disguise? Even if the profile is "friends only" I just feel like I still don't trust it... what if a friend of mine uses foul language and I get turned down for a job not because of what I posted, but because of what a friend posted?
    You must have not had the tightest privacy settings in place for your profile. My profile is like the Pentagon, lol. To someone who is not my friend, all they can see is my profile picture, my name, and the buttons to add a friend and send a message. No one can see my friends list except anyone who is my friend. Additionally, there is something in Facebook that allows you to be hidden from searches. So it makes it harder for people to find you.

    I am not trying to sell you back on Facebook, just letting you know that there are things you could do to make yourself less of an open book out there.

  • Mar 25

    Quote from anon695
    I considered this but it would still maybe be attached to my nursing school class and year, have a picture of me on it, and would therefore raise a red flag to employers anyway (that I'm using a fake name on Facebook to potentially hide something)
    Still does not make sense. I don't see how employers would think of finding you on Facebook if your name is Mary Smith and you list your name as Jane Morgan. You don't have to use your real picture as your profile picture. And there is no rule that says you have to list both your school name and class year. How different is that from them not finding your profile?

  • Mar 25

    Quote from rscodadn10
    so my question to you is: if you get accepted to nursing school will you delete your account? or if in school now will you delete after you graduate?
    excuse me: it's when i get accepted to nursing school, not if ... :d ... now that we clarified that ...

    as far as deleting my facebook account, absolutely not. facebook has become a lifeline in my daily living. it's the major artery to my friends and family across the miles about what is happening in my life and what i am reading and discussing online (supplemented of course with phone calls and skype). it has also reconnected me with friends and family from the past that i had once believed were lost forever. taking that away from me would be quite devastating. that's basically what i use facebook for, and not for time-consuming nonsense such as farmville. as others have said, a common sense approach to what one posts on facebook together with diligent monitoring of one's privacy settings and what certain friends can and cannot see is all that is required to stay out of trouble.

    that girl who posted the placenta picture online was a fool. she should have known better. at least i am sure she does now!

    edit: came back to add one thing to say that one has to be careful as well what friends to have on your friends list. i don't accept just anyone. and i do have everyone on lists so not everyone on my list can see everything i post.

  • Mar 23

    LTC is not for me. It is not where my nursing skills are best utilized. Although I must say, there are people out there for whom LTC comes easier and for that I respect them. I would rather be in a non-nursing job than LTC. It is where I would be happier.