cheri1859 2,580 Views
Joined: Feb 9, '12;
Posts: 24 (54% Liked)
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People who feel bad-- act bad---whether it is physical or emotional. That phrase alone helps me tolerate less than polite, nice people and makes me change my approach.
This is a very good article! I think that you packaged and wrapped the feelings of a new grad RN very well. It was a reminder to me of how I felt when I was brand new. I think everyone who has been a nurse has felt this way starting out. (If they say they never did they are probably either lying, incompetent or both *gasp*
Even after being a RN for awhile there are still moments of worry, stress and self doubt. Focus on the good, hang on and pray through the bad and you will get there.
I once asked a nurse I respected "Do you think that I'm smart?" when I was having a self doubt mini crisis after a really long and crazy shift. She replied as a matter of fact "Of course you are smart. Anyone who makes it through nursing school is smart. You just need a little more experience." And that was just the encouragement that I needed. We did make it through nursing school, even though that seems so long ago..
You ARE a RN, You ARE a good nurse and you ARE making it! I wish you all the best!
Emergent those rose-colored glasses look really nice on you.
I think the problem right now is you see a lot of nurses being pushed into crappy jobs in order to get "experience." These jobs don't respect or care for their workers. They give their nurses ridiculous work loads and then write up nurses for working overtime. Why should a nurse feel any loyalty towards them?
If you offer me a years contract that states I can't be fired you got a deal.
Bring a protein shake - it is easier to drink some basic nutrition than it is to try to eat something fast with your hands.
Keep spare scrubs/socks/shoes/underthings in your car or locker. One complete set.
Pee when you can, because if you put it off, it'll be 6 more hours until you get a chance.
You can make a "smellulizer" with a nebulizer, hand sanitizer, and a little water. That mist can de-funk a recently vacated room.
Sodium bicarb will neutralize stinky feet.
Don't underestimate the power of a warm blanket.
Be kind, even in the face of unkindness. It's rarely personal.
Hi, everyone. It's Day 38 since I was attacked by a patient. I've had 3 panic episodes since. The first one I told you about (not very smart to come back to work 4 days after being choked from behind). I went full on crazy: chest pain, difficulty breathing, sweating, puking, dizziness, crying hysterically. After that, HR gave me time off, paid, without touching my PTO hours.
It was a wake up call: I had been in denial. I wanted to be strong, unaffected, unchanged by this stupid isolated incident. I wanted to continue taking care of people in need. But it had marked me and totally changed my attitude towards male patients, confused patients and towards work in general.
There are times when I just want to turn in my two weeks notice. I sometimes think- "Screw this, it's not worth it! I'm sick of blood, vomit, pee, and poop. I've had it with being grabbed, scratched, spit at, bitten and thrown pitchers at! I'm done with this alphabet soup, giant Petri dish of a workplace with MRSA, CDiff, VRE, ESBL! Goodbye hospital! Goodbye nursing!"...It took my mind into a really dark place.
The next two panic attacks were triggered by being alone in a hallway at work. But I'd seen a counselor by then (I still see her), so I was ready. I ran to the break room which was my "safe place". Did breathing exercises. Prayed. Then went back out there to finish my darned shift and fight the terror.
I've completed six 12 hour night shifts now. Some nights were good, some were inner torture.
I developed a mantra: to help myself, help others. It helped me get through the palpitations, the cold sweats, the queasy dizziness I felt when I was about to have contact with a confused patient.
When I felt like resigning, I thought of my son. My husband is a non compliant sleep apneic, hypertensive, smoker in a high stress job who doesn't listen to the health tips of his wife who just happens to be a registered nurse in a step down unit. I NEED to keep doing this for my son.
In a month, I will be switched to day shift. Management hooked me up with trauma specialists, trauma support groups, etc. The CEO wrote me a letter. My Director has been incredibly supportive, calling me at home to check on me. The staff members made a Welcome Back poster when my leave was over.
I wrote a long email to my boss about all the things we at AN talked about here, the issues that have come to light at work because of this and what the heck are we going to do about it.
They said Risk Management, HR, and other departments are linking up to come up with measures to protect and educate staff regarding workplace violence. We'll see...
I thank you all for your support, prayers and advice. We'll keep doing this, doing the good work, fighting the good fight. Nurses ROCK!!!
You always have the right to defend yourself. Root Cause Analysis needs to be conducted just like any "event." Staffing, layout of the unit, how often patients are checked, cameras, Security rounding. Some systems have a panic button on the ID badge. I think it was inappropriate for you to continue working. If you were told to continue, that may be actionable. As soon as you were attacked, you suffered an OJI. It is your decision to inform the police - the hospital doesn't want to be on the evening news, which is why they want to minimize the event and handle it in-house. Take care.
your background is the EXACT SAME as mine. I graduated last June, interned in the ED July/August, got licensed in September and started my first nursing job in the same ED in December. I had the same feelings as you too - it's all 100% normal.
I can honestly say now, looking back, all you need to be successful in the ED is decent "do no harm" nursing skills and a pure and undeniable interest in emergency nursing. you are new, everyone knows you're new. it is ENCOURAGED for you to ask questions, lots and LOTS of questions. I still ask "what are we giving this for?" or my nursing colleagues "what is 'paresthesia' again?" develop a good rapport with people, don't act like a know-it-all and they will always be there to support you.
and now that I'm 6mos into it, I am pretty confident on most days - not cocky but confident and totally certain I'm an ED nurse doing what I love to do.
my point is, it will pass - the feelings you're having are GOOD - give it 6mos and you'll look back thinking "why was I so stressed out?"
Interesting post Knitwhich, reminded me that one of the things I picked up that helped me greatly early on in my ER career was going to TNCC. Not because we get alot of traumas, we almost never get life threatening traumas, they are flown from the scene here. However, when I'm in a situation where I don't know what needs to be done I fall back on my ABCDE.... It works just about every time, and you can never reassess airway, breathing... too often! It also helps to keep me calm when a room is getting a bit out of control, I have made the crew do it on a couple of occasions to bring order back, "Ok, so you've got the airway and breathing, good; I see your working on the second IV and you have fluids hanging...." It's always worked for me.
Stick it out.
I graduated in Dec. '11, passed my boards in Feb '12, started my first ED job in Sept. '12, and transferred to a different ED (for commuting reasons) in Oct. '13. I have spent A LOT of time being the New Kid. In a lot of ways I am still the New Kid.
I'm just now starting to not feel a sick twist of panic when told I'm getting a code into one of my rooms. I'm still a little wobbly on stroke alerts and I've never had to give TPA. Acute MIs throw me into a panic because in my huge hospital I'm still not sure of the fastest path to our cath lab. I'd almost rather an 'unresponsive' with no further info because at least then everyone in the room with me starts off on the same "*** is this?" footing that I do.
But that's the thing -- anytime someone super sick or complex rolls through the door, there are always more people in my room to help me than I have tasks to delegate. All I have to do is call out for something, and it's there. If the doc asks for something that I'm not up on, someone else is on it in a flash. The teamwork in my department is on point, and I couldn't do my job without my coworkers. On the flip side, I try to be there as much as I can for my coworkers, even if it's just as spare hands for tasks, fetch n' carry or interfacing with family members.
I am working with nurses who are "newer" than I am, but who were techs in my hospital for years before becoming RNs. I'm working with RNs who have worked ICU, home care, and every other unit. I'm working with RNs who have worked 20 years of ED and know nothing else. And every now and then we get a patient who presents legitimately ill and no one (RN or doc) knows what else to try. And that makes me feel a little bit better too.
Of course I've made mistakes (nothing makes my stomach drop more than one of those huge inter-office mail envelopes in my work mailbox, signifying that Something Has Happened), and I've tried my best to cop to it when I make a mistake, and to defend myself and my coworkers just as vehemently when the floor or the residents are trying to throw us under a bus.
tl;dr: Stick with it. Stick together. Never be afraid to admit you don't know. Never be afraid to ask for help. Help out when you can. Not knowing is NEVER a crime, but not asking could be. Sometimes NO ONE will know *** is going on. Assess, run your ABCs, confer with your coworkers. You'll find your rhythm. Eventually you'll find yourself answering questions and acting on instinct. Don't rest once you get there -- always try to be better -- but take heart that you're doing it and you HAVE gotten better.
I would have to agree, If your hearing that you will be crying coming and going, then I would suggest that there is something wrong with the way that ED is run. That would be a warning sign to me.
Although the ED is a very fast paced place where the nurse has to be able to assess and prioritize on the fly, it is also a really cool place. At first it looks like everything happens on the fly, but there really are protocols that are followed, and people do work well together, and this allows us to form a team for a very short period of time to treat someone and then once that emergency is averted, we can disband that team, and form another team for the next emergent situation.
It takes a while for people to get a full understanding of those protocols, the team work, how to deal with all of the individuals and their different roles on an equal and collegial manner, etc. But once I got it, I would never want to go back to something where that didn't exist!
Any other encouraging words are welcomed because for the most part I've heard nothing but "most nights you'll be driving home in tears and most mornings you'll be driving to work in tears"...hmmm.
Throughout my orientation, I found not just a preceptor, but a mentor, a colleague and a friend. I am forever grateful that, for me, she provided a safe environment free of hostility and judgment - but one conducive to teaching, learning and growing. I ended my orientation with many of her pearls of wisdom, nuggets of knowledge and the confidence to know I am on my way to one day being the nurse God created me to be. I only hope she knows how truly special she is!
To my preceptor:
With your many years in nursing, I know I am just another face; just another mindless new grad - clueless, jittery and slow. Although my face will soon fade from your memory, yours will forever be present in mine. Your razor sharp intelligence, your thick gritty exterior, your invaluable experience, and warm, compassionate heart have helped mold me into the nurse God has called me to be.
The worst kept secret in nursing is the difficulty transitioning from 'student nurse' to 'real nurse'; and boy is that transition rough. No amount of schooling, studying, or clinical time will ever truly prepare you for 'real world nursing'. It much reminds me of the military. Basic training is absolutely essential in laying the foundation for a good soldier, but it will never prepare him for the gruesome reality of war. The process of such a transition is quite difficult and at times extremely painful. For this I am forever grateful for your willingness to help me weather the blustery storms that blow through the trenches of nursing. Thank you for being my battle-buddy.
Thank you for sharing your wealth of knowledge with me. Thank you for showing me how to prioritize in the real world and explaining that not everything is a crisis. Thank you for nurturing my fragile, almost non-existent confidence. Thank you for not making me feel absolutely incompetent for asking silly, mindless, and seemingly basic questions. Thank you for teaching me to pop in a piece of gum when I feel the urge to cry in front of my patients. This will hold the tears at bay until I can make it to the supply closet; with this I can hold it together and remain a strong pillar of strength for my patients in the midst of highly emotional situations. Thank you for showing me what it really means to be a patient advocate.
Thank you for forfeiting those sacred moments of 'down time' you rarely seem to find to instead graciously help me better understand those wonky tele strips. Thank you for always reassuring me and reminding me that everyone makes mistakes - even you. Thank you for reminding me that every mistake, every error, ever near miss must be taken as an opportunity to learn and to grow. Thank you for pushing me, for giving me just enough rope to feel uncomfortably independent, but not enough to hang myself. Thank you for reminding me that this unnerving phase in my nursing career is much like a jigsaw puzzle - the pieces are there, but figuring out how they fit together takes a little time. Thank you for your incredible patience with a bright eyed, bushy tailed, green-as-green-can-get new nurse.
With this I must say, you were so very right. The tears, the long hours, the doubts, the frustrations and fear are all worth it when your patient tells you that yes, you were the calming presence in a painful, scary situation. Yes, to you I am just another face, but to me, you are the physical embodiment of the confidence, focus, peace, compassion, and patience I prayed for in a preceptor every night. Although I am only a few steps out of the gate and have many, many more to go- thank you for helping this turtle come out of her shell. I only hope that someday I can provide a scared, inexperienced, doe-eyed novice the same guidance you have provided me!
It was a normal shift. I started out with the typical two patients. One stable and one not so much.
My not-so-stable patient was a 50-something guy with a wife and 4 kids. He had a massive ischemic stroke from an unknown origin last night. He was intubated and his neuro exam was so poor that he didn't even need to be sedated. He only had minimal reflexes. His wife sat at his bedside, utterly broken. She looked to me for any glimmer of hope and I had none to give her.
My second neuro check was worse than my first. I tried to have my nursey poker face on, but she saw right through it. I immediately called the doctor. An emergency craniotomy for decompression and bone flap removal was in our very near future.
When the doctor quickly came by to tell her what needed to happen or he would become brain dead soon, she lost what little grip she had on her sanity. She became inconsolable and walked away because she just couldn't take it anymore.
I asked my charge to watch my patient while I looked for her. I found her huddled on the floor in the bathroom, sobbing uncontrollably.
I wanted to sit next to her and console her for a while, but time was a factor. We were getting ready to hit the OR in a matter of minutes. I had to get her to pull it together and FAST.
First, I hugged her while she sobbed snot onto my scrubs for about two minutes. I told her I was so, so sorry while she cried. I then looked her in her eyes and said, "Hey, you can do this. He needs you right now. He needs you to be strong for him right now. You can do this. And I will be there with you the entire time."
With tears in her eyes, she said, "okay".
"This is what we are going to do, okay?" I said.
"I'm going to walk with you back to the unit. We're going to talk to the anesthesiologist and answer some important questions. We're going to call your son and let him know he's going to surgery now and that everyone needs to get here and meet you in the waiting room. I'm going to pack him up and we're going to take him down stairs. All three of us will ride down the elevator to the OR together. You'll give him some good smooches and I'll take him back. I'll be there with you every step of the way."
She pulled it together. She blew her nose one more time, dried her eyes, and held her head high. "Okay, let's go," she said, as we walked out of the bathroom.
She answered the anesthesiologist's questions and we started packing him up. I could tell it was taking every ounce of strength she had not to hop in that bed with him.
As we were making our turn to the OR, I told her to get some smooches in. I tried with all I had in me not to cry as I watched her sob into his shoulder and smear tears all over his cheek.
He came back to my unit after surgery and didn't look so great.
By the end of the shift, I was taking him to hospice.
After I extubated him and gave report to the hospice nurse taking over, she sobbed as she said goodbye to me. I wanted to get out of there before he died because after the last 12 hours, I don't think I could have taken that and still gone back to the unit to take care of my other patient.
I'll never forget her. I'll never forget the strength she had summoned from deep inside of her to get herself out of that bathroom. That kind of strength she had to find underneath those tears she was crying; the kind of tears that make your throat burn. I pray that if I'm in that situation, I'll be able to find it. I think that I could because she showed me it was possible.
And as I said my goodbye to her and told her I was praying for her, my phone in my pocket buzzed.
After I walked out of the room, I checked it and saw that I got a text from my coworker.
"You're up for the next admission and report is on the phone."
Cheri1859- don't listen to people who tell you negative things! Honestly it's what YOU make it. Ask a million questions.. You will at first feel overwhelmed but what new nurse isn't? Just ask questions and be a good team player! When you aren't busy go help others as much as possible. Build relationships because you will want the help of coworkers. You got this!
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