Content That Race Mom Likes

Content That Race Mom Likes

Race Mom, ADN (8,388 Views)

Joined Jul 2, '05 - from 'Exactly where I want to be!'. He has '8' year(s) of experience and specializes in 'NICU/L&D, Hospice, and back to Mom/baby!'. Posts: 800 (9% Liked) Likes: 162

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  • 11:40 am

    Phew! Wears me out just imagining it........I've seen plenty of terminal agitation, but nothing I couldn't handle with an aggressive medication schedule using the normal dosages and calling hospice when the patient needed a higher dose. Hope for your patient's sake that she passes quickly---it surely can't be any fun to be her right now.

    Just wondering if her spiritual/emotional needs have been addressed adequately, since she's still experiencing so much anxiety and anger about dying. That can hold up the process for quite a while and contribute to horrible anguish. I once had a patient who was actively dying for over a week, yet kept fighting it tooth and nail.....she was comatose, yet remained agitated despite doses of morphine and lorazepam that would have put me beyond any further worries after the first go-round. Her family kept telling her it was okay to go, but for some reason she just could not relax and let it happen.

    Then one day the hospice brought in a volunteer who sat down in the room and began to play her harp. The patient's daughter and I were in the room at the time. Within five minutes a look of inexpressable peace came over the patient's face, she smiled one last time, and then she was gone. I like to think she was lifted up to Heaven on the music of the angels.

  • Jan 2

    Western Governors University (WGU) is an immensely popular online virtual university because it offers an array of aspects that attract adult learners, such as reasonably priced tuition, nonprofit status, a respectable assortment of majors and concentrations, regional and national accreditations, and an innovational competency-based format that promotes expedient degree completion.

    I am an ASN degree holder and my first six-month term at WGU officially started on May 1, 2014. Even though my first term technically does not conclude until October 31, I have decided to take a two-week break until my last term begins on November 1. In a nutshell, WGU's transcript evaluator allowed me to transfer 86 previously-earned credits, which left me needing to earn 34 credits in order to receive the BSN degree.

    Since May, I have earned 27 of those 34 much-needed credits. Therefore, I need to earn 7 more credits before I will be able to sign my name TheCommuter, BSN, RN. I quite possibly could have earned all 34 credit hours in the span of one six-month term but I work full-time 12-hour night shifts, and to be completely candid, my motivation waxes and wanes like the four seasons. Without further delay, here is a breakdown of my first term in WGU's online RN-to-BSN completion program.

    Care of the Older Adult

    This course was fairly straightforward. I worked in long term care for six years, so I already had some real world experience with the course material. This class covered topics such as the different types of aging, theories on aging, Medicare, Medicaid, gerontological nursing assessments, determining level of function, and the Healthy People campaigns. A third party genetics course was required.

    Biochemistry

    Biochemistry consisted of five different PowerPoint presentations that were graded by TaskStream, which is a third party grading company. Two of my presentations passed on the first attempt, two passed on the second attempt, and one finally passed on the third attempt. Essentially, I crafted models of hemoglobin using yarn and created two models of fatty acids using toothpicks connected to peach ring candy. Topics covered included lipids, hemoglobin, myoglobin, metabolism, enzymes, fatty acid synthesis, cell death, and other interesting themes.

    Organizational Systems

    The organizational systems course consisted of two papers and a third party course offered through the Institute for Healthcare Improvement. One of the required paper assignments required the student to formulate a root cause analysis and other required that I furnish a detailed resolution to a multifaceted ethical situation involving an elderly patient.

    Health Assessment

    The health assessment course was comprised of an objective final exam and an applied assignment that required me to record myself as I performed a full head-to-toe assessment on someone. I assessed my best friend from head to toe as my laptop's webcam recorded the 36-minute affair. I became spooked and dragged out my studies for the final exam, but the testing was straightforward.

    Nutrition for Contemporary Society

    Since my knowledge base in nutritional issues is relatively strong, I easily passed the final exam for this course. Topics included lipids, carbohydrates, proteins, vitamins, minerals, water balance, nutritional diseases, deficiency symptoms, obesity issues, and exercise physiology.

    Professional Roles and Values

    Essentially, this course covered topics such as the role of boards of nursing, professional organizations, nursing theories and theorists, the history of nursing, historical nursing figures, interdisciplinary and multidisciplinary teams, leadership, management, and differing levels of educational attainment in the nursing profession.

    Information Management and the Application of Technology

    In essence, this course was a survey of introductory nursing informatics. It discussed the history of nursing informatics, information systems, networks, interfaces, operating systems, hardware, software, electronic health records (EHRs), clinical decision supports, and the various levels of informatics nursing professionals.

    Community Health and Population-Focused Nursing

    Students must pass an ATI final exam with a satisfactory score in order to pass this course. Topics included the differences between community-based nursing and community health nursing. Moreover, the different types of community-based nursing were extensively discussed, including public health nursing, parish nursing, hospice nursing, home health nursing, school nursing, disaster response nursing, and ambulatory care/clinic nursing. Principles of epidemiology were also introduced.

    Introduction to Probability and Statistics

    This very straightforward course consisted of seven modules that were formulated by a third party company called Acrobatiq, which is a subsidiary of Carnegie Mellon University. StatCrunch, a software program for data analysis and calculations, was an optional component of the course. Topics included exploratory data analysis, descriptive statistics, analytical statistics, theoretical probability and empirical probability.

    In summary, my time spent in the Western Governors University RN-to-BSN completion program has been enjoyable. My self-efficacy has blossomed with each competency test that I have passed. In addition, I am pleased that this degree will cost me less than $7,000. Feel free to ask any questions.

  • Nov 16 '15

    You're welcome Tanaciou and missamelissy8! I forgot to mention perfusion. In newborns sometimes you see acrocyanosis, where the hands and feet are somewhat cyanotic in appearance. This is a normal occurrence. But they should be pink and well perfused otherwise or this is an abnormal finding that needs to be further investigated (eg. pale, cyanotic throughout, or differing colour i.e.. well perfused in trunk but pale legs).


    2. b) Mother assessment- Assess general mood and coping, provide support and encouragement as it is a difficult time with little sleep and it's always important to let them know how they are doing such a great job
    - you can auscultate air entry, heart sounds and bowel sounds although a lot of maternity nurses don't do so, it's good practice for a new grad.
    -VS of course
    -Breasts- if breastfeeding assess nipples for any broken areas, bleeding, bruising etc. Emphasizing with mom the importance of ensuring a good latch and how to break the suction before removing baby if the latch is poor. Also assess the softness/firmness of the breasts and ask the mom if she's noticing a change/feels her breasts are heavier etc. If she is not breastfeeding, encourage her to wear a firmly supportive bra and avoid any stimulation of the breasts including letting hot water run onto them a lot in the shower, etc. This can help prevent milk from fulling coming in when they don't want it.
    -Fundus- Fundal height should always be checked. Lay the patient flat on their back in the bed and palpate starting near the umbilicus. After delivery it is usually at or below the umbilicus and should continue to go down. If it is higher than previous assessments you need to figure out why and what is going on. If you can feel it at the level of the umbilicus (it feels kind of like a ball under the skin, for some women it is harder to feel than others - women with more adipose tissue usually) it is called u/0. If it is 1 finger below the umbilicus it is u/1 and so on. If it is a finger above the umbilicus its 1/u. Also assess for fundal tone. It should be firm. If its note, it's called boggy. Sometimes it may become firm with massage. If it is boggy you should always try to firm it up with massage. The funds should be central in the abdomen. If it is off to one side you need to ensure the patient is flat on her back and that she doesn't have a full bladder. Get her up to try and void if you are unsure. If a uterus is boggy, there may be clots inside, etc. and bleeding is definitely a risk here.
    -Lochia/flow/bleeding- Assess bleeding. Hemorrhage is a risk so you always want to ensure you are educating the patient what to report (soaking more than a pad in an hour, saving clots larger than a toonie to be checked for tissue, etc). Rubra is the initial red bleeding, serosa is when it turns to more of a pinkish and alba is the final step, whiteish/yellowish, which you don't see in the hospital usually. The flow should be stopped by the 6 week checkup appointment, usually lasting 3-6 weeks. Make sure mom knows not to use tampons, pads only at this time.
    -Perineum- inspect perineum for bruising, swelling, intactness of sutures if applicable, appearance of episiotomy if present, and also check if hemorrhoids are present (and if so get ointment for her). It is very normal for some swelling to be present. We have ice pack peri pads that help a lot with this. Just always be cautious with unilateral swelling, we have had a few hematomas form under the skin where it initially just looked like swelling but it quickly became quite large and very firm, not to mention the patient was in an immense amount of pain so we got the doc in, and he ended up having to take her to the OR to drain it (no colour change to skin). So just something to keep in mind! Also make sure she changes pads regularly, and does her sitz baths (or applicable hygiene method your hospital uses).
    -Legs/feet- assess legs and feet for swelling/edema, and also check homan's sign (for DVT) by having patient flex foot out against your hand (sorry little hard to explain, google it if unfamiliar).
    -VS- obviously same ranges for any other adult
    -Hydration/Nourishment- If breastfeeding especially, these are veryy important. Encourage the mom to still take multi vits as the baby will draw from Mom and her bones even for it's nutrients if not supplied. Eating a good balance of healthy foods.. also drinking an adequate amount of fluids will help with milk production

    Education- is a biggg thing on mother baby. Some topics to brush up on : the importance of DTAP vaccines for herself and close family members to help provide a "cocoon" effect of safety from pertussis (whooping cough). I really emphasize this as I mostly work as a meds nurse and it is a horrifying disease to see, and can be fatal, and there are current outbreaks, so very important to educate re: this!!
    - importance of keeping sick people away from baby, and the importance of good hand hygiene for everyone who touches or is near baby
    - "Back to sleep" and the prevention of SIDS (sleeping on stomach/side biggest risk factor, other biggest ones are sleeping in bed with parents, or 2nd/3rd hand smoke.Educate to all of these topics)
    - Second hand/3rd hand smoke- preferably no smokers around baby at all but if not possible- definitely no smoking in the house or car!! Person should remove their coat/sweater they smoked in, wash hands, arms etc. and put a blanket over clothing if going to be holding baby. This smoke does increase risk of SIDS so make sure they are aware of this.
    -Proper bathing technique for a newborn
    -Formula preparation if applicable, and emphasizing not using powder until 6 months for safety (even though they say 0+ months..)
    -Car seat safety- never add anything to the car seat- ie. strap paddings, head rests, cover that also goes under the back and around the straps. All of these just decrease the fit of the suit (As does large puffy clothes ,don't do it! Dress them when you get out, or put it on backwards after all buckled in. Discuss importance of keeping baby rear facing as long as possible for the seat and that it is very important for preventing neck/spinal cord/head injuries and this greatly outweighs any risk of leg injury which has been shown to be very smlll ( a lot of parents feel they have to turn because of their leg length). Also of having food or other objects in trunk secured so it's not possible for the baby to be hit with this in an abrupt stop or car accident.
    -General safety- no hot liquids while holding baby, no bumper pads, extra blankets, pillow etc in crib. Not leaving baby unattended on changing table. Once a bit older, start having chemicals locked away, including cleaners, and baby proofing sharp edges, door and outlets, etc.
    -Crying- watch the period of purple crying and educate yourself re: same. Our hospital implemented this and hopefully yours does too, but if not its still a great learning and teaching tool. Teach everyone re: shaken baby syndrome and the importance to know you can just set the baby down in a safe spot if you are getting frustrated and try to have a break, as it's normally people reaching their absolute peak of frustration that shake.

    Hope this helps! It's meant as a guide so if I forgot to mention something, forgive me I'm very tired :P Tons more education areas you will cover with families. We have checklists we have to have completed on topics before they leave. These were just some off the top of my head lol.

  • Nov 16 '15

    I agree, very generous orientation Some words of wisdom.. :

    1) breastfeeding- take a breastfeeding course or two on positioning and latch if you can before you start or during your preceptorship. Learn as much as you can from your preceptor about manual expression (very important when you can't get baby to latch), and ways of supplementing when baby can't latch (we do cup feeds- which I personally never usually do cuz I hate them, scared i'll spill, syringe feeds, finger feeds and SNS- supplemental nursing system which is a feeding tube attached to manually expressed or pumped colostrum tucked in while the baby is latched at the breast. In some cases if deemed necessary we can also use formula while doing this, with mothers consent of course). Breast milk pumped is like a med, label label label, and put date and time. ALWAYS clarify with the Mom before you give it, or if in a separate area with mom's permission be sure and double-triple check with bands.

    2) Assessments- a) baby- I don't know how familiar you are, so if this is too basic you can just skim it. Newborn Head to Toe: Always initially observe colour, work of breathing (you can see nasal flaring, hear grunting, moaning, etc, even before you undress. Retractions can sometimes be noted while dressed even once you are used to them)- obviously if you notice distress you should address it and not continue the head to toe yet.., and
    - tone. Floppy baby is not good! Increased tone also is not good. Research into tone and what causes changes, also into what to expect with different gestational ages. Jitteriness is something to always watch for. Can be caused by multiple things but most commonly it's usually hypoglycemia. Test a blood glucose if you suspect low sugar. Here in Canada <2.6mmol/l is low and requires a lab sample to confirm as well. Most important intervention is to feed the baby but you should make sure the lab is called up stat for their sample if your facility carries this same policy. In some cases even after feeding and rechecking the hypoglycemia persists and the baby may end up on an IV of D10W. We have a whole algorithm we use for hypoglycemia and I imagine most facilities too. Become very familiar with this. Hypoglycemia in a newborn is very serious and cause neurodevelopment issues if allowed to persist! (other causes of jitteriness may include neonatal withdrawal syndrome- from methadone, cocaine, etc etc. may have some jitteriness from tobacco and caffeine, occasionally from SSRI's or SNRI's. Hypocalcemia, and hypomagnesia are other causes but not very common.)
    -fontanelles- anterior fontanelle is diamond shaped towards the centre top of the head. Familiarize yourself with the feel, and the size. Some are enlarged, some are small, some you can feel overlapping suture lines.. etc. The posterior fontanelle is a lot smaller and more triangle shaped. These should both be basically flush to the head. Bulging is a very bad sign- increased intracranial pressure. Sunken can indicate dehydration. Depending on delivery cephalohematoma, or caput. Learn the difference.
    -ears- any skin tags or extra growth on the ears can be an indicator of kidney disease as the ears and kidneys develop at the same time in utero. Just something to be aware of. Low set ears may be seen in babies with down syndrome, FAS or other syndromes, this can be a sign further testing should be done. (the tops of the ears shouldn't be lower than the eyes)
    -Mouth- you should assess the mouth with a gloved finger to ensure there is no cleft palate (not always visible in the lip! may be far back and no one else noticed it yet), and that a sucking reflex is present. If a sucking reflex is not present and the babies is not premature this can be a sign of a problem. Also assess for tongue tie (baby can barely lift tongue when crying, seems short in length when they try to lift it..) as this can cause issues with breastfeeding and very sore nipples for Mom if not noted! They usually snip them quickly here if the mom wants to breastfeed. It's very low pain, low vascular area, very quick, no sutures or anything required.
    -Then you can start to unbutton the sleepers (I usually will count my respirations by having a hand on the belly now, but when I started I always made sure to do it with the sleeper open for easier visualization since it's faster than you will be used to). Respirations should be between 30-60. If they are below 30 and the baby is awake you would want to consider why (did mom have meds in surgery and baby is very fresh, does it need some narcan is it that depressed? etc) >60 can be normal if crying, but otherwise can be a sign of respiratory distress. Other signs of respiratory distress: nasal flaring, retractions (subcostal, substernal, intercostal, suprasternal, supraclavicular (last isn't easily seen in babies compared with children)), moaning, grunting, etc. Research into Transient Tachypnea of the Newborn (TTN) this is a common sign of respiratory distress in newborns that usually resolves in <4 hours. If it persists longer than that it's likely something more serious.
    -- Auscultate the chest, if the baby is not in any respiratory distress I will often get a heart rate first in case they start crying. If they are in distress I will listen to breath sounds first. When listening for heart rate it should be between 120-160. Sometimes may be around 110 if sleeping or sometimes even lower, but you should usually mention it to a senior nurse or a doctor if unsure as it may be abnormal. >160 may be normal with crying but otherwise is not. Murmurs can be heard at times, some people are better at others than catching them (it's not my forte sad to say :P) its like a wooshing, almost like a sound of a breath sometimes when they aren't breathing. Breath sounds should be auscultated under the clavicular line bilaterally, under the armpits, and down under the nipple line if that makes sense. You may also listen in a pattern posteriorly, or depending on unit policy but this anterior approach is standard for us and our docs. The breath sounds should be clear and equal bilaterally. If one side is more decreased than the other, or crackles/wheezes present this is abnormal. (although if you are there immediately after birth you can often still hear some wetness as the amniotic fluid is not completely resorbed yet). Also look for equal chest expansion as they breathe.
    -- Auscultate abdomen- listen in all 4 quadrants for bowel sounds, which should be present. Assess abdomen if it looks distended or scaphoid (scaphoid could be an indicator of congenital diaphragmatic hernia), also if you see any bulges/loops of bowel. Can gently palpate as well.
    -Umbilical cord- should be clamped, with no discharge around the base, or foul odour. If it is very dry in appearance the clamp may be removed. Parents should be taught to clean around the cord once to twice a day with soap and water, and dry.
    -Genitalia- Males- should not have hypospadius or other abnormalities. Females- more premature the inner labia are more prominent, but at term should be more covered by the majora. Both sexes ensure a patent anus.
    -Overall perfusion- This isn't necessarily done after genitalia but during the undressing process in general. They should be equally warm throughout the body, without for example, cold lower limbs and feet for no reason (i.e. if they were dressed). Brachial pulses should be easily palpable. Femoral are a little trickier to get used to but good to practice. These are the two main we focus on but your unit may be different.
    -Reflexes- there are also some standard reflexes you should assess- sucking, grasping, plantar, babinski, etc.
    -Temperature- I usually save the temp till the end cuz we do axillary and the babies hate it so I like to keep them calmer for the assessment lol. 36.5-37.3 is normal and we maintain a much tighter control in babies than adults!! I have had students before say the vitals were normal then 6 hours later tell me the temp was 36.1 when I asked "So what was the temp earlier?" (I learned after that to always get the correct numbers instead of believing someone they were normal!) Babies have brown fat that they will burn off when their thermal regulation is not maintained and this can cause hypoglycemia, and obviously lead to weight loss as well. High temps could be signs of infection or may just be over bundled with clothes and blankets at times. (high or low temp could be sign of sepsis). Important note* If mom is GBS+, has unknown prenatal history, has been sick (i mean sick other than "morning sickness", i.e. influenza, etc) in pregnancy, any distress in labour, ETC (too many things to list but you get the idea...) be on higher alert for infection in the baby!

    That got really long and is probably overwhelming, but when you actually do it, it is nice and quick I just like to try to explain to newer people how I do it and why.. If anyone finds that helpful I could do it for the mom's assessment if you like

    Other things to look up: hyperbilirubinemia, direct and total bilirubin, coombs, cord gases, congenital heart defect screening, newborn screening..

    Good luck!

  • Oct 29 '15

    I totally agree with all the other posters who have said there are SO many options for RNs! Find something that fits you. Such as school nurse, industrial nurse, outpatient clinic, nursing home, assisted living, rehab, psych, public health, WIC, home health, IV team, management, quality, utilization review, case management, educator, it just goes on and on. I have worked many different areas over the course of my career. Some I loved, some not-so-much! But I don't regret any of it! I've learned so much about myself and met so many wonderful people over the course of my career. Good Luck to you!!

  • Oct 29 '15

    @herbie06:

    I make more as a nurse than I did in my previous career. I decided to change my career due to the many opportunities nursing provides. You may not start out landing your dream job or you may realize your dream job isn't so dreamy. In this economy, yes you'll most likely start in an undesirable unit/specialty before you get to where your niche is. Nursing isn't for the faint of heart, you will work hard. Our patients will name us the most trusted profession and at the same time give us the least respect.

    I knew going in that finding a job as a new grad may be difficult and it was. That was in part my fault because I was very picky on what positions I wanted to apply for. I finally was able to get into critical care almost a year after I graduated. The learning curve was steep, but I luckily worked on a unit that was new grad friendly and my preceptor was supportive.

    The real world of nursing is different than nursing as a student. I realized that from day one but I wasn't interested in a 3rd career. I enjoy what I do and work with great people. Knowing what I know now, yes I still would have chosen nursing the first time around.

    It's up to you if you want to continue to pursue nursing; we can't make that decision for you. Good luck!

  • Sep 18 '15

    I'm over The View. (not that I was ever under it)


    I don't care if they are cancelled or not. I don't watch them, nor do I know anyone who does.
    I am sick of women being paid to bash other women for "entertainment", though, especially when the bashed are nurses.
    That's what I'm sooooooooo over.

  • Sep 13 '15

    I graduated in December 2008, couldn't get a job for the life of me, for first job at snf in 2010, also worked HH and clinic later. For my first acute care job on med surg/tele in march this year, and FINALLY after many years got a job offer just this Friday for post partum! Yay I'm soo excited I start late sept or early oct!!

  • Sep 13 '15

    I was hired into an L&D/mother-baby program immediately after school, but I originally graduated right in the middle of a nursing shortage in my area....back in the time of sign-on bonuses, lots of openings, etc. some of the things that helped my application and interview, though, was that when I did reports and papers in school I tried to center them around OB nursing and health issues. Not always possible, of course, but it was enough to both give me something to talk about during my interview and to show my passion in that particular field. I lasted 2 yrs before my personal life became too overwhelming. I am going back to mother/baby at the end of this month after an 11 year hiatus and I couldn't be more excited. I couldn't believe how giddy I was when the unit educator emailed me my unit orientation schedule yesterday. LOL!

    RaceMom, what a transition from hospice! I admire anyone who can do that job. I hope your return to mother/baby is a good one for you.

  • Jul 23 '15

    You already said it- there's very little turnover. I work with some nurses who have worked in the birth center for going on 36 years now. It's their niche too.

    Though I wonder- and please don't take this wrong, how one can say that any field is their niche until they've worked it? You like to teach, and yes, there is definitely teaching to be done in OB. But when I worked in cardiac, there was teaching too- different kind of teaching, but still there was a TON of stuff to teach. Many of the nurses who have worked in OB have said they get these new grads, or nurses with about one year of experience who say that OB is their dream job, that this is what they're meant to do- and a month or so later they quit because it's not the fairy tale they thought it was. I know you said that you're not about "babies are so cute" and all, and that's good because while OB is generally happy and good, there's a lot of ugly on that unit too- babies getting taken from mom from CPS, babies born to 16 year olds who dress them up 6 or 8 times an hour like a dolly and then whine that the baby is crying and they're trying to sleep/watch cartoons/talk on their phone and while I'm at it- change the baby's diaper. Or the uber rich people with 46 page birth plans that give you the death stare if you pick their baby up.

    It's a popular field, I hope you get your foot in the door. Persist and give the managers good reasons why you're interested in it.

  • Jul 20 '15

    Remember that you have the power to change lives in an amazing way! Not just your patient's life, but that one and every life connected to it.

    My father got sober because a nurse in a VA rehab asked him, "What's a nice person like you doing here?" He said the total love and acceptance in her voice gave him hope that he could be a better person.

    You are signing up for some very hard and discouraging work. Addiction, oncology... the odds are not good. Don't get discouraged by any one apparent failure. You don't know what the seeds you are planting will do. Keep planting the acorns and trust that an oak will grow.

    Keep planting seeds of love and hope.

  • Jul 20 '15

    I work in a free standing, medical detox unit. we have patients from three to five days and see them through acute withdrawal and use mostly Valium and Suboxone (for our) opiate addicted patients. I love what I do because it is never the same. Besides the routine of passing medications, doing assessments and triaging patients requesting admission, there are always unusual situations that makes each patients care challenging. Perhaps they are using a combination of substances and knowing what protocol to use and talking with the providers to get orders, can be very challenging. Often the patients give very complex and convoluted, conflicting histories. Sorting through the information and formulating a plan of care can be difficult at times. I do a lot of physical assessments before the providers see the patient. This is most important in getting the orders and implementing them. We are not attached to a hospital and we are an acute care facility so determining which patients can be taken care of safely in our facility and those that need to be seen by an ER physician is a large part of what I do. The other thing; the attitudes of many of the clients can be difficult to deal with for some nurses. Often angry, entitled, victims, resistant to help is something that you have to work with. Also, some have complex medical problems made worse by drug and alcohol issues. Heart disease, HTN, Diabetes and other problems that are often neglected by the addicted client make the job even more complicated but not impossible. I do a tremendous amount of patient education on an informal basis, i.e, when giving medications or helping with diabetics diet choices. This is my favorite job in years. I was CARN certified two years ago and I am grateful for that certification because it gives me recognition as having the specialized body of knowledge required to provide the best care possible. Good luck!

  • Jul 17 '15

    "I am a 40yo who switched careers to nursing after a long previous career in nothing related to nursing. "

    ME TOO!

    "I absolutely dread going to work each shift. "

    I HEAR YA!


    "I feel so inadequate and... sure, I realize that I'm new, however, this constant cheering on by other staff to stick it out a year isn't encouraging and I was a pretty strong, no BS person in my former career."

    Oh, don't even get me started about it. My "tone" my directness, my abruptness - all of these things have been relentlessly criticized. Oh, so in nursing, the only appropriate mode of communication is some obscure passive-aggressive style of communication? I'm working on sweetening up my demeanor so my direct form of communication doesn't offend others. Whatever. Personally, I prefer directness.

    " I am drained. I work in a high-risk facility and deal with so many problem patients, deaths, STAT everything, etc. I am hyper-aware of how litigious this area is, and I'm always waiting for a patient to pounce or my manager to scrutinize my documentation. "

    No kidding.

    "I received an orientation with inconsistent preceptors, feel there's always something I didn't learn daily and overall, in my past career, I would have been well on my way to good at this point. "

    Inconsistent preceptors seems to be a standard of nursing training. Who doesn't enjoy inconsistency, contradiction, and general non-consensus about the way things are to be done? Truthfully, I never imagined health care to be as sloppy as it is. It's a bit frightening.


    "I spent so much money re-educating myself for a BSN, and I feel like I made a huge mistake."


    Yeah, I've never been treated with so much disrespect and like an incompetent boob as I have as an RN. It's like I put the nametag on and it says "Verbally abuse me at will." I've never been subject to treatment like that in a work environment before - and I've worked in many different fields. Customers and the general public can be abusive - but my coworkers, colleagues and supervisors all treated me like a competent, valuable, intelligent member of the workforce. Being blindly treated like an incompetent peon is relatively new to me.


    " I'm trying to see if I can find a middle ground of a more administrative position or perhaps something in an office. I don't even care what specialty anymore (L+D was what I was in love with in nursing school), but I want a normal outside life again and could care less what specialty. The hours are crushing my health and my family notices how drained I am, impatient, angry and fed up, which makes me feel so defeated and embarrassed. I don't know what avenues are even out there for a newbie that are slower and less stressful, or is this it for me?"

    Hey - here's the great thing about nursing. There are nearly limitless opportunities for you to work as a nurse - in many different fields and environments. Clinics, offices, schools. Heck, just another area of the hospital. Here's the good news: YOU HAVE OPTIONS. Get the H out of L&D - it sounds like a toxic environment.

    "This is nursing, suck it up and deal? I'm at the end of my rope here. I need some advice from anyone. Ready to just cry each shift, but I need to bring home a paycheck and hide my discontent."

    Sometimes I cry before my shift - that really seems to help. Just get it all out prior to going in to work. Then I don't have to do it while I'm there. This might sound like I'm joking, but I'm not. I tell myself every day "If x or y or z happens again, I will quit." I do promise myself that, because there is only so much verbal abuse and jeapardization of my professional license that I will endure.

    I had to read and re-read your post because except for a couple of details - I could have written the exact same thing myself.

    My biggest piece of advice or information for you is : YOU HAVE OPTIONS. Apply to other jobs. Apply to clinic RN jobs. Apply to any other area of the hospital. Apply to a different hospital. Apply to home health positions. You have a lot of options as an RN. You don't have to stay in a sucky situation. You don't.

    I wish you luck! Don't beat yourself up for changing your career goals - and for not LOVING L&D. Peshaw. Take stock, look around and move on. There's something better out there for you.

  • Jul 17 '15

    I don't work in your specialty but I've had rough patches in my career. Hating my job was one... You need to adjust your attitude. I don't mean you have a bad attitude, but you need to look at your job in a different way. Since what you are doing isn't working for you, do something different. I started to focus on my own internal compass of what I felt was a good day, not what I was receiving from my dysfunctional workplace. My problem was management, not the patients, but it took me a long time to readjust so I could at least, not hate going to work. Every job has its ups and downs so this skill will serve you well over your career. Look for makes you feel good at work and focus on that. If there is truly nothing, ask yourself what would be different in a different environment. Sometimes leaving is the best choice, but not the only one. I hope that helps...

  • Jun 23 '15

    After 20 years as a RN I'm getting out of nursing. I start law school in the fall with the goal of working in an area of law that is in no way related to nursing or health care.


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