Just a simple interview, help greatly appreciated!!

Ellie-Mae · Sep 4, 2013

If answers from a new grad just starting her first nursing job I will be happy to help you out, Im lacking in experience so I don't know if my answers would help you but if they can I'd be happy to help :)

JustKeepDriving · Sep 4, 2013

Here's my detailed response:

Here goes...

Question 1. Career background

What do you do?

I'm a psychiatric mental health registered nurse at a state hospital. I work in the float pool as a 17 month hire as part of the forensic stabilization department.

How did you get to where you are?

The market isn't great for new graduate nurses where I live right now. I graduated in December 2012 with my BSN and sent out application after application to acute care hospitals to get that golden acute care job so I could get my 1 year of med-surg experience and cement in my nursing skills. Sadly, the hospitals in my area only hire new grads through new grad programs - so all of the replies that I got back were "not enough experience". I did apply to some new grad programs, and had a couple of interviews but the amount of new graduate nurses that applied were overwhelming. I'm talking like >1,000 new grad applicants for 3 acute care positions. That bad. I was invited to a group interview - I self scheduled for my 15 minute time slot. A group of 30 new grads showed up. Those 15 minute time slot interviews ran from 0800 to 1800... that's 30 new graduate nurses every 15 minutes (with the exception of interviewer breaks) for like 10 hours. After that I just started applying everywhere, even long term care, the prison system and rehabilitation places wanted experience. The job market was SOOO saturated that everywhere, even places that many nurses I've met didn't want to work in, were being picky... because they could be. So I capitalized off of my first degree (psychology and social behavior - where I have a lot of volunteer and research experience) and started applying for psych nursing. I was hired by the State in May and started in July.

What made you choose nursing?

My first degree is in psychology and social behavior and I originally planned to get my MSW (Master's of Social Work). While I was enrolled in UC Irvine, I got all of the things checked off for getting into a MSW program. I did my 600 hours of experience, I did the honors societies, I was a research assistant, I did independent undergraduate research with psych patients involved in corrections and on and on trying to go for that perfect graduate school application. Well, one of the volunteer groups that I was involved with was the clinical care extender program which trained its participants to give hands on basic care. I did rotations at Hoag hospital through med-surg, ortho, rehabilitation and wound care and outpatient surgery and got to do basic patient care (feeding, bathing changing ect). The medical social worker didn't have as much interaction with patients as I thought she would, and I felt like being a nurse was a really good option. I started prerequisites for nursing school while I was getting my BA in psychology (originally as a back up plan if I didn't get accepted to grad school). I actually did get accepted into graduate school for MSW but the cost was extremely high and California at that time was cutting social workers. We were getting social workers from USC (the school I got accepted to) applying for the $12 an hour house manager position at a homeless shelter that I was currently volunteering at. That's an 80K degree. I said "thanks but NOPE!" to USC and decided to pursue nursing.

Are you happy with your career?

Ha ha, depends on the day, the patients, the unit i'm working and what my role is for the day. Unfortunately the place where I work is incredibly understaffed and more often than not I'm floated in a capacity other than

RN

capacity. I'll either do LPN/Certified medication Aide work and do nothing but pass meds to 20 patients all shifts or I'll be floated as a Mental health Tech and sit on constants for 13 hours. When the staffing is good and I get to work as an

RN

, I love my job... especially if it's on a "not-competent-to stand trial" unit because I actually get to see some incredible progress from those patients and watch them go from labile, confused, delusional, assaultive patients to really awesome individuals.

Question 2.

What type of writing does your job entail?

When staffing is good and I'm floated as an

RN

then I do a lot of writing. I do progress notes on my patients (which involves a lot of adjectives because they're loosely based off of a mental status assessment - What was the patient's mood? Appearance? Thought process? Sensorium and cognition? Thought form - circumstantiality, neologisms, tangential? Perception - Hallucinations? Delusions? ect). I also have to communicate with other people at my work, write telephone orders, email coworkers, transcribe orders, write a shift report and chart patient summaries (basically patient progress throughout the week).

Question 3.

How much writing does your job require?

If I'm acting in the

RN

capacity than I do a lot of writing - in fact I pretty much write throughout the entirety of my shift. I have to document patient behaviors, physical and psycho-social assessments, my interventions and the patient's response to the interventions, safety measures put in place ect. Basically whatever my staff or I do and any deviations from a patient's baseline have to be charted.

Is this writing done by hand or is it made easier by the use of computers?

Both. The system is kind of redundant and the same information will be recorded electronically on a spread sheet, in the patients electronic chart, written in the hand off report and the really important stuff is written on a white board. If a restrictive event happens or the patient is on precautions - the staff (

RN

& MHT) have to chart on the patient every 15 min for the entirety of a shift on paper flow sheets.

Question 4.

Whats the economy for your job? Meaning how in demand are nurses today..

The economy for my job as a new grad is rough. Some of the students in my BSN cohort still haven't found work. In my area of nursing, if I was to go by staffing census... we need more nurses! However, not a lot of people really want to work in this environment (it can be seriously depressing some days and people can easily get injured), and the state doesn't want to spend the money to hire more nurses so they just cut the minimum safe staffing needs down so less staff can run the unit (scary!).

Question 5.

How does your career effect your personal life?

I work 13 hour 20 minute shifts three days a week, two of those days are weekends. The drive to work is 1 hour and 15 minutes. That means my entire day is about 15 hours. I get about 4 hours of sleep on work nights. Plus I never get to see my husband because he works weekdays. I like my job for the most part, but it's a rough schedule. I thought having 4 days off would be awesome, but they're serious all spent recovering from my 3 day shift.

Plus because of the nature of my work it's made me kind of jumpy and a bit paranoid. The patient's can be really unpredictable and we are often understaffed. We're also not part of corrections, we're a hospital... so if I'm putting a thermacare patch on a patient's back and the patient decides to start pummeling me in the face.... the best I can do is try to get away. If he/she takes me to the ground and is hitting me... the best I can do is lay there and take it and hope that staff is able to pull him/her off me before I get permanent damage (which happens). If I hit back or try to do anything more than evade or safe contain (holding limbs ect) than I can be charged with patient abuse, get fired and lose my license. Some of these patients are very mentally ill and don't know what is going on so they can't be held accountable for their actions (and I really empathize with that), however they're all criminals (some of them with horrendous crimes) and can (and have) seriously damaged staff. I stress all the time that I will be placed in a situation where I will have to decide between my life and my career.

Question 6.

What are some challenges you faces in your field?

I think one of the hardest part of my field, the most stressful part is maintaining patient rights while providing for unit safety. I'm always worried weather I'm making the right call - that I will make a decision that will get one of my staff members (or myself!) hurt, or if it will impede on the patient's rights. Also I worry a lot about the line of "safe containment" and "excessive force".

When I'm working in LPN/CMA capacity, I always worry about med pass - we use a paper chart system and being responsible for 20 patients who have a zillion meds (many are crushed, some can't be crushed, some can't be crushed but we have orders to crush them anyway... and every patient want's their meds a certain way and if they're not done correctly some patients will throw the meds at your head) and keeping track of it all because we work with a paper chart and an old med cart is a huge worry. I triple check everything and still worry every time I give a med if I'm doing it correctly, and when I leave work I pray that I didn't make any errors.

When I'm doing Tech works and sitting constants, I have to be super careful because as a float staff I don't know these patients and I don't know what might set one off and cause him/her to try and hurt me. I'm super nice and cheery to all my patients (huge believer in unconditional positive regard and giving my patients respect) but sometimes they'll spend the whole shift verbally harassing me (my new name is a 4 letter word starting with a "C) and sometimes try and hurt because they're super paranoid and what not.

What are some I can expect as a nurse just out of college?

Depending on where you live finding work might be difficult. My advice is to be really flexible and keep your hopes up. Just plug away at application after application. Also take some certification classes (ACLS, PALS ect.) it helps. Furthermore, every hospital and every unit does things differently. It has been really hard for me to go from electronic charting, EMAR, scanners, computers, ect to paper chart and MAR. I'm slowly getting the hang of it though. Don't be too hard on yourself if you don't get it all right off the bat.

Question 7.

Have you ever doubted your career path?

Ha ha, I doubt it at least once a shift! I still love nursing and most of the time I love my job, I just don't think I'll be moving to a permanent position at my current job. I have pretty good rapport with most of the patients, but there is too much chance for injury on some of the units. There are some hospital policies that I have a really hard time swallowing.

I love nursing though, and I do like psych nursing and most days I love criminal psych. I probably will continue in this capacity, just maybe in acute psych or corrections.

Question 8. (Last question!!)

What is the most rewarding part of your job?

I really, really love the team work that goes into psych nursing. On a professional level the respect that I have for the people I work with (Nurses, Psychiatrists, LPN's, MHT's...) is immense. You have to have one another's back in psych nursing because you'll probably end up being saved, or saving someone else (I've totally been saved by staff members, and hope that I've made decisions that have saved staff from harm).

The work is also immensely interesting. And when I'm on the right unit (I really, really like clients that were found not competent and have been admitted so they can get stabilized and then go back to jail) I get to see great progress and build some amazing, professional, therapeutic relationships.

Hope this helps and doesn't sound too depressing! Good luck with your assignment and your classes!

Ashley4560 · Sep 4, 2013

Any and all answers would be very helpful...whether you are just starting out or have been a nurse for years!! Thank you very much :)

Esme12, ASN, BSN, RN · Sep 4, 2013

moved to nursing student assistance for best response