Good Morning, Gil 9,875 Views
Joined Jul 27, '11.
Posts: 626 (41% Liked)
Some people say that working in a hospital is more difficult than LTC as the patients are more acute, order changes, more prioritizing, etc. (This couldn't be more wrong). I think each have their challenges, and LTC in a poorly run facility or one with very high ratios definitely has to be more challenging than acute care, that is, acute care that has good or decent ratios.
My worst night in the ICU with 2 patients (even if both were to decompensate at the same time), still is less challenging than LTC with 40 residents. I always can visualize my patients, so I know what they're doing, monitored, if they're trying to crawl out of bed, etc. Not being able to see your patient or wondering if you're demented patient is crawling out of bed again would be more stressful. In my previous job, which was not LTC, but pretty close, I worked with 10-12 patients, med pass, etc, lower acuity, and I would take 2 critical patients any day of the week. LTC is definitely not an easy job. Even on a good night, 20-30 residents is a lot, and I can imagine med pass must take a while.
Your foleys don't have that blue lab sample port? Ask your manager to switch to Bard then. I didn't even realize they made foleys without one. So, of course getting a sample will be more of a pain then lol. If it doesn't cost that much more, they might consider it, especially if you tell them the CAUTI rate is falsely elevated from nurses contaminating the samples...that'll get 'em moving to a new product lol.
Any experience is valuable experience, though some experiences are obviously better than others. My new grad experience wasn't the new grad friendly type with lots of orientation. I had a short orientation, was thrown to the wolves, became charge nurse very quickly afterward, but I am no worse for it. Experience is what you make of it. I learned time management, ended up working with great people who I looked forward to working with, and learned much needed leadership skills. I became a leader because I was placed in that role, and I am more confident now.
I then transitioned into the ICU after a year, and had a great orientation, newer nurse friendly, etc. I love it there, and have no plans on leaving. (And, for the record: I did not leave my other job d/t job stress, I was very comfortable there; I wanted more learning opportunities, to advance my career, utilize/expand on my clinical knowledge more).
Don't know how many options you have as a new grad; that depends on your location. You may be able to be more choosy in what you apply for or you may just have to apply for something and be glad they hired you. You sound young, like a person coming right out of school, nothing wrong with that. I'm by no means aged lol, but nursing will help you develop a thick skin if you don't already have one. Nursing is very rewarding. Best of luck to you!
If you're getting that much orientation, you should be fine. Are you getting 9 months? That's insane, but pretty awesome. My guess is you'll be more than ready to be off orientation when it's all said and done.
Best of luck to you! I started in ICU as a newer nurse, have been there almost a year now (including orientation, which was close to 3 months), and it's going well. It will be intimidating at first, naturally, but you'll learn quickly, and gain confidence as you gain experience. Namely, just read that ICUfaqs.org site; that's what I did when I was brand new, and studied my rhythm strips, too (you need to know these really well, and your hospital will probably enroll you in a class, and critical care classes). The knowledge will serve you well when you start. Also, get your ACLS as soon as possible since you can't push drugs during a code until you have it nor can you travel independently off the unit with your patient (which even if you work nights, you will be doing; I can't count the number of times I've gone down for a stat CT at night). And, once I had handled a code or two, I felt comfortable travelling off the unit, and handling codes. After a code or two, and other acute situations, you'll feel comfortable. It's really just knowing your ACLS protocols, which aren't rocket science, and knowing what to do when your patient's going south. Emergent situations become routine once you know what you're doing. You just need to be able to work quickly, but accurately, of course. And, always ask for help if you need it or if you second guess anything. Also, don't get complacent with meds, etc; I still triple check, but efficiently, even with the computer system, and its served me well. Best of luck to you! Enjoy the process!
Not every wealthy person is going to be a pain in the rear. Wealthy people are people, too, just as any other, and I've taken care of very down to earth, pleasant wealthy people, and very rude people that don't have money. A person's personality is not dictated by how much money he/she has, though I do see what you mean. There are those wealthy people on occasion that are elitist snobs, etc, but it's not an every day thing.
I live in a mixed area wealth wise, urban area, rich, poor, educated, not as educated, everything in between, so I take care of all population types. You probably will, too, as I'm sure that hospital takes patients from neighboring counties, as well. Don't worry about it. I've taken care of wealthy patients that you wouldn't even know they had money until they told you what they did for a living. Point being: just don't generalize, and you'll be better off.
Really depends on staffing ratios, unit culture/teamwork, and hospital differences in each unit. I think from those options, the ER would be the most stressful (and I don't work in an ER; I work in an ICU). You have no control over families in the ER really, and you never know what's going to walk in the door, and you have something coming in constantly.
In the ICU, we never know what our new admission will look like either, but we don't travel near as much as ER nurses, which adds to the time away from your other patients. Yes, we go to CT, MRI, etc with our critical patients, but with far less frequency than ER nurses who might have 4 other patients that need to be transferred or stat labs, etc.
Least stressful: mother/baby. They're generally happy to have their baby, generally healthy, so you don't have the emotional burn-out that the other specialties have in seeing frequent fliers, suffering, end of life on a routine basis.
I have a fungal infection that hasn't been identified yet. That should do it lol (from Christmas Vacation, best movie ever made).
I don't understand how cameras over the bed help. You have functional bed alarms, no? So, if your hearing is not impaired, you would hear said bed alarm. The money spent on cameras would have been better invested in hiring 3 more nurses (money to train, while not cheap, is still not more expensive than a bunch of cameras). They could have hired more CNAs, too, but unfortunately, one unit can't just do whatever they want ratio wise, probably would not have gotten that approved even though it would be more effective in fall prevention.
You could have had the extra CNA designated just to do very very frequent rounds on high fall risk patients, spend their time walking the unit, if falls are such a big problem where you are.
I agree with the first poster. I was not assertive, and wasn't the most confident person before I began this career. Fast forward just a short time later, and I feel like a whole new person. Nursing really does make you that way....I feel so much better having more confidence in myself, and being more assertive. You will see.....although the extreme anxiety you have is concerning, particularly because you have to be able to make decisions quickly and not get choked up. Do you only get choked up during social situations? I think they prescribe beta blockers sometimes for the whole "stage fright" thing, but really...if things are that bad for you, and you can't afford to go your primary care doctor, could you at least take advantage of the EAP program at your school?
It really all comes down to confidence in yourself, and I will tell you, that if you stick it out in nursing, you will not recognize that old self-conscious nervous to speak to others self. Be confident in what you have to contribute.....you got into school just like the others. You can do it! When I first started nursing school, I doubted my decision to pursue nursing, too....I think many people do as the profession is difficult, but once I got in there, I knew why it was that I chose this career and enjoyed the patient care.
If you do better in 1:1 situations...maybe home health is more for you where you could spend time (well not forever lol) with one patient at a time....but you usually need at least 1 year of hospital experience first. Best of luck to you! Those other students that laugh at you are crappy, ignore them.
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