Cutting myself short?..but trying to make the best

Mebzone05, BSN · Nov 18, 2020

5 hours ago, WonderousIvy said:

I’ll try to give the short version here. I’m a new RN. I’ve been a CNA 5yrs then LVN for 5yrs. Most recent experience was a little over a year in ER. I passed NCLEX in May, when I was 35 weeks pregnant. I continued in the ER for like 2 more weeks then stopped working. I have an Active duty Army spouse with a insane schedule so I always work PRN. We have a 3 yo and now a 14 wk old. I left my hospital bc they required a residency-which I can’t swing those hours right now (COVID+childcare+newborn+no support=not gonna happen) so I switched hospitals to the only one in my area that takes new grads in the ER without residency. It’s a small critical access hospital. ER nurses float to ICU(4bed) when needed, otherwise they stay put in the 6 bed ER...occasionally floating to med surg. I’m bored,I don’t feel like I’m learning much of anything,I'm biracial yet still,I’m the ONLY nurse of any color in the entire hospital which feels awkward and I took a PRN position bc my baby won’t take a bottle so my husband is driving her up to me twice a shift(yes,we’ve tried going a long time thinking she’ll cave and take it but she hasn’t yet-de appt soon for a tie eval). It’s all working out but I feel like I’m cutting myself so so short-I’m a new RN but I’m a good nurse. I need someone to build me into a ER machine that I know I can be but it’s just not happening right now. I’m gonna pay for my TNCC out of pocket bc I feel like I could benefit from the education. I already have ACLS and PALS. What else can I do by myself to educate myself more? To make myself feel more confident in my skills?

TIA

I wouldn't bother with the TNCC. You need to sit down and really think hard about your career. It sounds to me like you are needed at home. PRN as a new nurse is a bad idea. Experience is what makes you a better nurse. You can get a bunch of certs but they are worthless if you don't have any real experience to apply the knowledge to.

WonderousIvy, BSN · Nov 18, 2020

8 hours ago, Mebzone05 said:

I wouldn't bother with the TNCC. You need to sit down and really think hard about your career. It sounds to me like you are needed at home. PRN as a new nurse is a bad idea. Experience is what makes you a better nurse. You can get a bunch of certs but they are worthless if you don't have any real experience to apply the knowledge to.

I feel like no experience would be worse than PRN. I don’t plan on working full time for a few years due to our lifestyle. Usually I work 1-2 shifts a week PRN.

Dacatster, ADN · Dec 4, 2020

Consider ENPC and NRP (just in case you get a pesky preemie or newborn that just cant wait to go to OB). It's not that you are cutting yourself short. Sometimes you just got to do what works best for your family. Never feel guilty about that.

JKL33 · Dec 5, 2020

On 11/17/2020 at 7:58 PM, WonderousIvy said:

I’m bored,I don’t feel like I’m learning much of anything

Honestly...sorry...I cannot fathom this statement coming from a new RN under almost any circumstances that involve any kind of ED anywhere, including CAH.

Is it possible that your other life circumstances are just (rightfully) more important right now such that they are somewhat a distraction? (And of course when I use the word "distraction" I would mean it in the literal sense--as in, there are just other things on your mind--not in the negative sense of you being generally a distracted person).

A little mental exercise regarding what you do/don't know or are/aren't learning: So if you were staffing that CAH as the lone nurse at night, do you view yourself as being able to handle whatever might roll in? What do you fear? What would make you a little uncomfortable? What kinds of problems would you rather not deal with? Are you the triage, trauma, cardiac, stroke, sepsis and psych King/Queen, and the Supreme Jack-of-all-Trades at everything else? I don't mean this in a snarky or mean way, I promise (??). I'm just trying to get you thinking of some things you might be able to focus on if you need to learn more.

Do you have a copy of something like this and are you familiar and comfortable with everything in it?

It's good that you are motivated to keep learning. ??

**canoehead, BSN, RN** · Dec 6, 2020

If you are bored in any ER as a new grad, you aren’t paying attention.

WonderousIvy, BSN · Dec 6, 2020

On 12/4/2020 at 8:35 PM, JKL33 said:

Honestly...sorry...I cannot fathom this statement coming from a new RN under almost any circumstances that involve any kind of ED anywhere, including CAH.

Is it possible that your other life circumstances are just (rightfully) more important right now such that they are somewhat a distraction? (And of course when I use the word "distraction" I would mean it in the literal sense--as in, there are just other things on your mind--not in the negative sense of you being generally a distracted person).

A little mental exercise regarding what you do/don't know or are/aren't learning: So if you were staffing that CAH as the lone nurse at night, do you view yourself as being able to handle whatever might roll in? What do you fear? What would make you a little uncomfortable? What kinds of problems would you rather not deal with? Are you the triage, trauma, cardiac, stroke, sepsis and psych King/Queen, and the Supreme Jack-of-all-Trades at everything else? I don't mean this in a snarky or mean way, I promise (??). I'm just trying to get you thinking of some things you might be able to focus on if you need to learn more.

Do you have a copy of something like this and are you familiar and comfortable with everything in it?

It's good that you are motivated to keep learning. ??

I appreciate the comment! You’re right about being a bit distracted bc if the situation with my child.I have Sheehys Manual but I could definitely pull it back out and review. I’m bored because this ER can go hours..like half a shift..with 0 pts yet there are 3 nurses there at all times. Which in all reality is nothing to complain about- great for pts.I’m just not great at sitting idle. My friend and I came here from a higher acuity ER together, we had lots of psych,MVAs,GSWs,lots of emergency traffic calls,codes...a variety of patients..it was fun and I was always learned something new. This hospital transfers out to our old job. That was my first ER job and I think I got accustomed to pace. The doctors were much better and I respected them-while here they really aren’t much help.
On downtime I could work on cardiac, read some material (such as sheehys LOL),practice USIVs if someone lets me practice on them bc I suck at those. I’ll continue to make best and learn what I can. Thx again for your comment-it was actually pretty helpful:)

igtgrnokbye · Dec 12, 2020

ER Machine Build Guide Part 1

BLS/ACLS/PALS

Recognize all cardiac rhythms within 2-3 seconds

Memorize your areas EMTP protocols as you must know what they have performed

Master your equipment. Especially the code cart. Can you emergency pace? IO operator?

Memorize major department protocols and procedures. Can you set up an emergency chest tray? Deliver a baby?

Memorize all ACLS drugs doses and indications

Memorize RSI

Build a relationship with your doctors and learn from them

Know where everything is and make sure it’s all in date

Small hospital ED is boring till it’s not and can get quickly out of control from lack of resources.