Bah. Was gung ho, now just don't know

[suecna]

I have been in "pre-nursing" all this past year. Scheduled to begin the actual nursing classes in January. The closer I get to it the more I see how the school I am signed up with, (the ONLY school within 100 miles), does nothing but try to discourage people and get them to drop out of the program before even beginning.

I just received my packet of information of all that has to be done prior to January classes and all the supplies that need to be bought. First semester expenses come to over $3000.

From what I understand - in talking with people currently in the program and such - even into the first semester they are getting nothing but discouragement almost to the point of what I would call hazing.

I do not fear the academic side of any of this. I already have multiple bachelor's degrees and always carried over 3.0 average (usually more like 3.75). So thats not the side of it that concerns me.

I have done CNA work on and off over the last *ahem* shall we just say many years (over 15) and frankly, when it comes to in facility work, I'm not very good at it. Usually I've tried wherever possible to stick with home care as I'm usually pretty good with that if I do say so myself. But thats all more self directed, one gets to make more of their own decisions for a client, one gets to go by what they themself see as reasonable and such - in facilities, what I've generally found is an attitude of "hang your brain by the door and follow procedure" - and usually just being a temp when in facilities, there is always something that I don't know about and therefore don't do or don't do it right and then have people screaming in my face over it and telling me how I'm giving poor patient care.

(Before you all think I'm a rampant danger waiting to happen - let me give you at least one good example of the sort of thing I'm talking about - I normally have done psychiatric care giving and case management - one big thing is to allow clients the maximum of choice - choice over their own schedules, choice over what clothing to wear (so long as its not wet or filthy that is!), choices of what and/or how much to eat (so long as not starving self or something - but even then, a day or so as long as client not diabetic or anything is still under the realm of client choice) - so one night I worked at a facility where a woman (elderly) was in her bed, in her clothing, when I got there. It was a dress made of like a t-shirt material, appeared relatively comfortable and she was sound asleep. So I didn't wake her. I didn't wake her when it was time to eat either. I was not told that she was someone who should be awakened for such things. I did go in there and gently let her know that it was mealtime and she just was not into it at all so I didn't push the issue and force her wide awake.

So later on, I got literally screamed at for A) not making her get up and get her into a proper nightgown and B) not waking her up all the way and making her eat whether or not she wanted to.

Okay, so maybe I was wrong. I don't know. I'm not convinced there is a clear right and wrong to this situation. I was going by what I knew and what I'd always been taught were patient's rights. Apparently in this facility it was considered near abuse. Maybe it is near abuse - I don't honestly know anymore - it certainly caused a sensation in this facility and caused all to talk of my extreme incompetence.)

Okay, so that outlined, this is the sort of thing that bothers me. I mean maybe I should have somehow known to be more forceful with that lady. Maybe I should have seen the high level of importance of people being properly dressed for being in bed. Problem is, I still don't see it. I don't see the importance of a lot of little things like that. I try to concentrate more on things like comfort and individuality for the client. I miss things that others consider important. Sometimes I've even missed things that WERE actually important - this next one I will outline disgusts me with myself - One night I was in a facility - I was assigned 18 clients that night. I was running rampant. I had like 6 people that were to be spoonfed. By the time I got done with all that and taking out the trash for all the rooms and trying to pick up all the dinner dishes, it turned out at the end of the night that one woman who was indeed assigned to me, not once on my shift got her wet diaper changed. And I had to account for why some of my dishes didn't get picked up by the kitchen (they were too late coming back out of rooms).

So that example really disgusted me with my own incompetency. No client should have laid in a wet diaper all night long. I just couldn't manage to be fast enough to get everywhere I needed to be (not to mention one of my clients was busy throwing orange juice and crackers around her room and soaking her bed twice with it.) But still, someone else COULD have done it apparently.

So anyways, with my rotten history of facility work and the entire attitude of the nursing school, my feeling is that instantly I will be labeled as the incompetent one when it comes to the clinical end of things and end up wasting the coveted spot in the school and my money and their and my time and effort.

Anyways, I guess I am writing this as sort of a last ditch effort to see if anyone thinks it might be worth it for me to try to get back some of my motivation towards taking these classes or if its clear to others that indeed I should just give up now. All thoughts welcome, even ones that tell me I would be a disgrace to the profession.

I have no plans of doing regular clinical in-hospital or nursing home work once done with the program but of course you do have to get through it. I am a mental health person and intend to continue being so. And that *is* something I am good at. Very good at if I do say so myself. But I'm tired of being incredibly unemployable much of the time. Frankly I'm too old to be working for $7-8.00 an hour. Anyways, any thoughts much appreciated. Thanks.

[oldiebutgoodie, RN]

Hi, Suecna,

Well, first of all, I think you would make a great psych nurse! Facilities seem to have a hard time finding psych nurses, and you have the experience and wisdom.

However, realize that nursing school is a lot like basic training in the military. You do kind of have to follow procedure, whether you like it or not. Yes, the first year is a lot like hazing. No, your instructors probably don't want your opinion.

That being said, if you can suck it up for 2 years and learn what you can and ignore the "hazing", you will be able to make a lot more than $7 and hour.

So, it is a hard choice. I sympathize. But, psychiatric nursing needs folks like you.

Good luck,

oldiebutgoodie

[jannecdote]

My thoughts are, if you have multiple bachelor degrees, what the heck are you doing working as a nursing assistant in the first place? Makes no sense to me.

[Town & Country]

that is way too much money.

[color=#ff8c00]

[color=#ff8c00]go to a community college. don't pay that much for a nursing program. you don't have to...........

[babynursewannab]

that is way too much money.

[color=#ff8c00]

[color=#ff8c00]go to a community college. don't pay that much for a nursing program. you don't have to...........

unfortunately, it looks like she's stuck there. only school w/in 100 miles...

i would try not to be so hard on yourself. you do have a legitimate fear based on experience. however, you have not experienced the healthcare world from the nursing angle. in your examples, it sounded as if you were overwork and/or undertrained. your patient responsibility load on the "diaper" case was well above and beyond considering the total care aspect...you could not have been the only one working. where were the nurses or anyone else for that matter? did they all have that kind of load? if so...facility's fault. ratio should not be based solely on numbers but also on acuity. not that my words will change anything...

in the t-shirt, sleep case: whatever. apparently, someone was not on the ball enough to inform you of these "items of importance". you did what most patient-focused care givers would do. don't let it eat at you.

as for the being screamed at.... *sigh* i hate to say it, but if you were a cna, chances are, the nurses or your supervisors looked down on you and took out their frustrations on you. i'm not saying at all that all nurses or supervisors do that. (no flames plz). i'm just saying that in most of the cases of cnas and new grads getting blasted...its because of that. it is sooo not appropriate/acceptable. but, unfortunately, its out there.i've seen it many times myself. i was treated as less that competant as a tech in the hospital. nevermind i'm a 4.0 honors student. it was solely because i was a tech and not a nurse. in fact, i got rave reviews from the nurse manager, so go figure.

if you can swing the program financially, do it. you will increase your standard of living dramatically. plus, when you get hired somewhere, you won't be "a guest" so you will get to know protocol with experience.

good luck to you and keep us posted.

[okie2]

Do not give up on yourself!

18 patients!! How can anyone keep up with that?! I know how you feel in your CNA work. I worked in LTC for a short time but left after continually being assigned an entire wing! I was also not certified and still in CNA training (onsite). As well as bath, feedings, etc I had to answer all lights! There was no way- the facility was putting those peoople at risk and my liability was huge. Don't blame yourself for not being able to do the job of 3 people! And you seem very intune to real priorities with your psych patients.

Yes! some schools rely on a weeding out system. They allow the maximum numbers in then slowly dwindle to a select few.--I guess they feel it really gets rid of the riffraff!! but I think they're missing out on a lot of talented people. Don't let them scare you--go for it & show them what ya got!

I also have a bachelors and have 1year toward a masters, but I never worked in the field after graduating. I worked as a pharmacy tech in retail and inpatient, CNA, and medical research...I understand having degrees and wanting to work elswhere.

If you have no other school--make the very best you can, use all resources available and learn real quick how to play the game--you've got to know the rules they're playing by to win!!!

Good Luck!!

[suecna]

My thoughts are, if you have multiple bachelor degrees, what the heck are you doing working as a nursing assistant in the first place? Makes no sense to me.

Thanks. It kind of makes no sense to me either but I guess I went for ones that are pretty worthless around here. (social work, psychology, sociology). The best I've ever been offered around here based on my degrees, other than private duty case management (ie being self employed - which is very shaky at best), has been $7.15 per hour in a physically dangerous, barely supervised, group home/halfway house. Regardless of what I do or do not do with the nursing school, I do plan to start working on graduate credits soon also. But even with a masters degree, most of the above max out around here at about $30,000 per year anyways.

[suecna]

Hi, Suecna,

Well, first of all, I think you would make a great psych nurse! Facilities seem to have a hard time finding psych nurses, and you have the experience and wisdom.

However, realize that nursing school is a lot like basic training in the military. You do kind of have to follow procedure, whether you like it or not. Yes, the first year is a lot like hazing. No, your instructors probably don't want your opinion.

That being said, if you can suck it up for 2 years and learn what you can and ignore the "hazing", you will be able to make a lot more than $7 and hour.

So, it is a hard choice. I sympathize. But, psychiatric nursing needs folks like you.

Good luck,

oldiebutgoodie

Wow, thanks for this. That was a lot of how I used to feel when I felt a bit more confidence in the combination of myself + nursing. That was good to hear.

As to the 2 years - this is just over one year that I am looking at - it grants LPN ability then one can take LPN to RN if they desire online. And my plans have been to do just that and beyond.

As to the follow procedure whether you like it or not - I'm very very very willing to do that. I think I just question my *capabilities* of doing it when it directly conflicts with things that I consider "having basic respect for a client" and such. Now maybe in the school there aren't those kind of conflicts, but I've certainly seen a lot of them in long term care facilities.

And as to the hazing type part - I'm not worried about getting my feelings hurt. What does concern me though is to get onto the "lets toss this person out of here" track.

[suecna]

that is way too much money.

[color=#ff8c00]go to a community college. don't pay that much for a nursing program. you don't have to...........

actually..... this *is* a community college. course it probably doesn't help that i don't qualify for such things as the pell grants and all that so all the expenses are out of pocket expenses. its not even just the tuition thats the main issue, its things like all the supplies, the required uniforms with the engraved logos on them that must be special ordered from a particular company, the required immunizations and titres, etc.

[suecna]

Unfortunately, it looks like she's stuck there. Only school w/in 100 miles...

In your examples, it sounded as if you were overwork and/or undertrained. Your patient responsibility load on the "diaper" case was well above and beyond considering the total care aspect...you could NOT have been the only one working. Where were the nurses or anyone else for that matter?

In the t-shirt, sleep case: WHATEVER. Apparently, someone was not on the ball enough to inform you of these "items of importance". You did what most patient-focused care givers would do. Don't let it eat at you.

As for the being screamed at....

Good luck to you and keep us posted.

Interesting - I've wondered a bit about that. It always *feels* like a ridiculous patient load but on the other hand, it seems normal and just what places do. That particular day (of the diaper case) there were myself, another temp CNA and one LPN for 3 hallways of clients.

In the dressing properly for bed one - I'd felt very much that if that was policy that I should have been informed but when I stated this, I was told that it was standard procedure and something any CNA *should* have known. I then was foolish enough to suggest that if there are standard policies like this that maybe the facility could make out a policy sheet to be handed to each temp as they come in. I was told that was ridiculous as no one would have the time to do such a thing. I held back from volunteering to do it for them.

[suecna]

Do not give up on yourself!

As well as bath, feedings, etc I had to answer all lights!

Yes, that was the same as how these facilities were. I believe the one had 37 clients and the load was split between 2 CNA's and then there was an LPN for meds and such. Course on one of those occasions, we were both temps and had not been to that particular facility before.