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nanceinmypance 1,180 Views

Joined: Jan 9, '08; Posts: 9 (56% Liked) ; Likes: 6

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  • Jun 19 '09

    I am in the seat, feeling comfortable, calm (even though I have went through enough security to enter Fort Knox). I read through the instructions as to not miss anything. "You have 6 hours...." Sounds good, all is well.....

    First question, okay, 50/50.....A or C..... hmmm...A.... "next".....2nd question.....what? What are they asking? These are all right, and there are no indicators in the question showing priority. Can I ask them "is this patient stable?" "how old are they?" "should I assume they are anxious?"....Can I phone a friend?
    Okay, quit assuming, take the question at face value......uh......well, if I were getting this done, this is what I would want to know.......B........

    Right about question 8 I hear the girl next to me groan. Then about 10 questions later she does a big sigh, then a few later she says, "Oh gosh." Seriously? Shut-up.....I am freaking out, too. The least you can do is give me some silence, right? Maybe I should've said yes to those earplugs.

    Where's the delegation? Where is the alternate question with apical pulse location? Where are the labs? Where is the question on crutches?

    Why do I get the feeling they are asking me about the same thing over and over? Maybe they are thinking (I have now humanized the NCLEX monster as "they") if I give her the question 5 or 6 more times, maybe she'll get it right.....then.......

    Black screen.....wait! They are thinking....we gave her every shot possible, but she blew it. 75 questions, and I knew the answer to a whopping.....TWO (with certainty).

    I do the outgoing survey, looking for the question that says, do you think this test was made as an evil joke? "Strongly agree"

    I again get fingerprinted (I am thinking, if you think I actually paid this pathetic looking, short-haired blonde girl in sweatpants to take the test for me, then she did a poor job.....I am demanding a refund). I courteously smile and get my stuff. Then I realize, it's time to hit the potty. My stomach is gurgling, and I can actually see my heartbeat in my abdomen. It is pounding. I get into my car, deciding who won't think I am crazy if I call in this state of mind. Okay, my hubby, of course, he always makes me feel better. "Oh, that stinks." Is his response to my description. "When can you take it again?" I'm thinking "I DON'T KNOW, I DIDN'T PLAN ON FAILING!" You're not helping, click......then, my mom. Mom's always make you feel better, right? "Oh sweetie, it's not the end of the world, you can just take it over." Again, not what I wanted to hear.

    At this point I am hoping that Ashton pops out from behind the car next to me with his trendy hair and crooked smile and says, "You've been Punk'd!" so that I can slap him in the face or kick him where the sun don't shine or something equally degrading.

    Where are all of my girlfriends who are RNs? Voicemail, Voicemail, Voicemail.

    I am sitting in a random parking lot thinking, "Maybe I'll just tell everyone that I had to reschedule, then take the exam again before anybody finds out that I've failed." How vain is that?!

    Ugh!!! My stomach is hurting again. I get a few calls/texts and I can't bear to tell the whole ugly story again.

    I get home (I can't even remember driving really....it feels like I got home in 5 minutes). I sit on my couch for about 45 minutes.....no TV, no kids, no talking, maybe even no blinking. I didn't take the NCLEX serious enough. I should've done a different review. I should've done more questions. I should've taken it later or maybe earlier or maybe I should've just NOT studied.

    Of course, nothing on BRN the next day, the day after that, I wake up at 0500 and check...nope...I am even looking on allnurses.com to see what the odds are of failing at 75 questions. Meanwhile, I am talking to people now. I am trying to convince myself that I am okay with whatever happens (of course, I am MORE okay with passing!). I contemplate setting my alarm for 0200 Saturday morning (I've heard the BRN updates their website at 0200 for the previous day). I decide that if it isn't there, it will ruin the rest of my night's sleep, so I pass on the alarm idea.

    Saturday morning, I sleep in, 0900.......I click on my bookmark (yes, I have bookmarked it).....type my last name.......can you believe it? There is another woman in my county with the same name....well, that is annoying, even SHE passed the NCLEX....wait....oh, okay, I think I can actually hear the word relief as I exhale. Now, I can drop the weight on my chest and the pit from my stomach. Phew.

    Moral of the story, sometimes the signs and symptoms (abdominal pain, bounding pulse, anxiety, feelings of impending doom) don't match the diagnosis (Effective testing output r/t using my noggin aeb name showing up on BRN site)

    What's next?

    You mean, now I have to find a job? My stomach hurts again.

  • May 5 '09

    At my nursing school, we had over 100 nursing graduates...it was a very large group because our school has a part-time program and it includes those graduates as well.

    Our pinning ceremony was beautiful...we didn't have the lamps and things...those have gone away due to fire hazards.. but they did have the auditorium decorated very nice...there were tons of people there and you could "feel the love".

    When we lined up to do our procession in....I didn't know what to expect...I, of course, had never been to a nursing pinning before...so we were out in the hallway.

    I want to say first that many of us (and to my pleasant surprise MOST of us), elected to wear a traditional nursing dress (yes...dress), with white hose, shoes, and the nursing cap.

    It was up to us what to wear...we could have wore white scrubs if we wanted to.

    As soon as I took a view, for the first time, in my full length mirror...I got so emotional I almost cried...I really looked like a nurse...I am just a couple of weeks from being done with school (we have ours before graduation)...I had my dress and my cap on...and I had never been so proud to wear white in my life.

    It had a very, very different feeling than wearing our whites for clinicals.

    I was wondering if some students would wear dresses and caps..and I looked around, and though it was optional, I was also very proud to be in the majority. To me, it was traditional...it made me feel like a part of all of those nurses when pinning ceremonies started...wearing caps similar to mine...to me it was just as part of pinning as a veil was to a wedding dress....it just seemed to "go".

    When we walked into this massive auditorium...that had tons more people that were standing...a spotlight was on the first student in the processional...when she started to walk in...the entire audience stood up and applauded as we entered the room....the applause roared through the auditorium and in an instant...I was choked up with tears.

    Yes, this was a huge accomplishment...it was more than just finishing a degree...sometimes I felt that it was just more work than other degrees...but when you graduate from other disciplines...you sure as heck don't get a welcoming to the community like this.

    I just look forward to the day, that I will get to put RN after my name.

    I plan to go further with my education...but nothing, absolutely NOTHING could top what I felt that day.

    So...to those of you that don't want to wear the "silly cap" or the "whites again"...I am here to tell you...please do...seriously...please do...and wear it proudly...don't miss your pinning for the world.

    There is nothing like it.

  • Apr 30 '09

    Thank you, Press-Ganey scores! :flmngmd:
    Administrators are so afraid of getting even one bad survey, they give this type of patient anything they want, usually to the detriment of the facility, staff and other patients. Positive reinforcement for negative behavior is why society is in the nasty shape it's in now.

  • Apr 30 '09

    I was in the first grade when I had to get my tonsils out. I was probably six or seven. My mom was an evening shift worker and when I went to sleep she was there but once I awoke, she was gone. I was crying and this nurse (I use the term loosely, she could have been a tech for all I know) was walking by.

    She heard me crying, came in and asked me what was wrong. I replied that my mom was not there. She consoled me by telling me to eat the popsicle that she had gotten for me. She hugged me and promised me that once I fell asleep, my mom would be there when I woke up, and she was there!

    How did this lady know that?

    I am young and impressionable. Oh my Lord, I thought this lady was something.

    From that point on I knew I wanted to be like her. I wanted to grow up and be a nurse. I wanted to able to help people and console them when their mommies were not there. When I tell this story, I well up with tears because this woman has no idea the impact she had on me. That little bit of compassion has gone on a long way; this is what my career for the last 16 years has been built on.

    Fast forward to today; I am an adult ICU nurse who had the pleasure of getting to repay that nurse and be just like her. A woman in her forty's having a "simple" hysterectomy, was supposed to go home in a few days, and is bleeding into her abdomen slowly.

    Her nurse prior to me tries to find the cause of her vague "my stomach hurts" and the moderately low systolic blood pressure in the 90's. Nobody finds it until she crashes and is coded when she comes into my assignment. She has a husband and three children ranging in age from 16 to 7. Seven the same age I was when I had my first hospital experience! I see myself in this little girl, although the circumstances are different!

    We both want our mommies; unfortunately her mommy won't be there next time she wakes up because her mommy ends up being a compassionate wean and dies two days later in the ICU as my patient. In the two twelve hour shifts I took care of her mom, I got to give her many popsicles and promise her that mommy would be looking down on her from heaven, and got to give her many hugs as she would sit on my lap as daddy and her bigger brothers would be in mommy's room crying. I do not think she realized the situation as she often skipped up and down the hall from the ICU to the elevator.

    I hope I impressed upon her a positive view of nursing, and she one day writes a letter about the ICU nurse that took care of her mommy when she becomes a nurse.

    So, I challenge all that are reading this to be nice, promise popsicles, and that mommy will be there next time your little patient wakes up.

  • Apr 24 '09

    Quote from imenid37
    Customer service and common sense have become mutually exclusive terms in the hospital. It isn't the Ritz Carlton or Burger King. Sometimes, you even have to wait in those places too! My daughter had some old *** complain that he didn't get his ginger ale for over an hour. She told him her one of her other eight pts. had coded and she was sorry it was late. He said "I don't care, you *****. I wanted a drink and I am puting your name on my survey because I am dissatisfied!" Okay for pt. to call her a profane name. Her NM didn't care about that. She was talked to because the NM needed to know why this loser didn't get his drinky-winky when he asked for it. At the same hospital, patient get a gift card if they are unhappy re. waiting in the ED too long. Boo Hoo! This is craziness.
    I might have charted something like "Summoned to room, requests ginger ale. States he has been waiting for "over an hour". This nurse explained inability to immediately fulfill request due to emergent situation, but offered to do so now. States "I don't care, you *****. I wanted a drink and I am putting your name on my survey because I am dissatisfied!" Ginger ale provided, no further requests at this time. Will continue to monitor."

  • Apr 24 '09

    As a nurse, I have been on the "other side" when I spent one week in the hospital with my mom following heart surgery. I can say that I did way more than any family member should have been expected to do, and I did it because no one else was there to do it. She was having frequent, loose stools as a result of some of the meds (that I had to ask to get d/c-ed). Because she was post-CABG, it took her aome time to get to the edge of her chair, stand up, and walk to the BSC that I put as close as possible to her. She wasn't even able to wipe herself, as she was not to stretch her arm behind her, so I got to do that as well. If I had used the call light to ask for help with any of this, I know she would have soiled herself as we waited for the nurse or NA to arrive. No, I didn't mind, and we even joked about it just to get through it.

    On the other hand, I didn't like that I was *expected* to pretty much do her ADLs with her 24/7, because I was in the room with her for 24/7. Since I was the one doing the transfers from bed/BSC, chair/BSC and bed/chair, I was beat. Also, the heart monitor alarm kept me awake more than I wanted (hers, as well as the many at the station that was right outside of her room), so I was somewheat sleep deprived, and frankly wanted to rest a bit sometimes. While I wouldn't have minded giving her a bed bath or changing her linens, I did not feel like I had to be super nurse/daughter and do everything. When they handed me the bed bath items, I just asked when they were planning to do the bedbath. I had to be direct. (I honestly don't think that they really knew how much I really was doing when I didn't call anyone to help.)

    I came to be with her from 400 miles away, and did not know my way from her house to the hospital, so I wasn't able to leave for about a week. Also, it was snowing and freezing outside, so just leaving for a walk wasn't an option. I was told that they only had one rollaway bed, and that someone else was using it. I was there for a week, and really wonder if this highly respected and huge hospital in Pittsburgh really could only find one rollaway bed. So, I got to sleep in a recliner that didn't recline much at all, because cardiac patients can't recline in the recovery phase. So, I was sleep deprived, not sleeping well with nosie, and sleeping in a very uncomfortable position as a result of the chair that I was given to sleep in.

    To top this off, she began retaining water and I/O monitoring became very important. So, I started keeping track of it myself, as I knew everything that she put into her mouth. Dayshift asked for this information, but there were 2-3 nights where no vital signs were taken at 4am and no I/O were measured at the end of the shift. When the MD was perplexed about the I/O on the chart, I pulled out my list and told him that no on had asked for it on PM shift lately. My numbers were not anywhere near what was charted, and mom could have been treated earlier with Lasix and the resulting chest tube, had I/O been charted correctly.

    Another thing that I did was call the nurse in the middle of the night for the wheezing that mom was doing. When no one responded, I had to get up and go to the desk to ask them to get respiratory there STAT as whe was audibly wheezing and having trouble breathing. Again, regular shift rounds could have caught this, as you could have cracked the door and heard her wheezes.

    So, when I see a family member not directly aprticipating in the care of their loved one, I remember my mom's situation. It is my job to do for the patient, not the fmaily's. It is their choice if they want to help or not, unless the MD specifically writes an order for family to be doing certain interventions. Also, I have to remember that the family is often doing more than I'll ever know, and often they are exhausted and stressed, so I need to consider that.

    I think that we need to involve the family as much as they want to be involved, at a level that is consistent with the request of the patient, as some patients do not want a family member giving them a bath or doing personal care.

    Sorry for the long post, but I did learn alot about what family members go through by being there in those shoes myself. Big lesson learned for me that will always impact my future nursing care.

  • Apr 24 '09

    I hear you, and all the posters who said you have to set limits and demand the respect you deserve are exactly right.
    We had a lady on the vent for 60+ days with pulmonary fibrosis, and every day you could tell what her family had looked up on WebMD the night before. Asking detailed, questions about vent setting trivia, acting angry the split second it seemed like she wasn't the center of attention at all times. Her husband yelled at one of my co-workers one afternoon about how "no one has been taking care of her". I went in the room and told him to google pressure ulcer when he got home and then ask himself how she had been laid up here for 2 months without having one....then see if he still thinks no one's been taking care of her.
    He must have done it because the next day he apologized and that was the end of them acting like that. Miraculously, without us ever taking care of her, she managed to survive her admission and went back home.

  • Apr 24 '09

    I agree whole heartedly!!!! It's like this; NURSE= ONE WHO CAN BE VERBALLY ABUSED AT ANY TIME AND FOR ANY REASON. THERE WILL BE NO REPRECUSSIONS. (Did i spell that right?)

    Anyhow, I too wish there was a way to scream to the world about this very same thing. Just because we are nurses does not mean that we are not human beings. Alot of the time, people don't understand that we too have feelings. I do understand that there is a certain amount of customer service crap that we must put up with but I also believe there is a very fine line. I am lucky that in my job, we do have the support of our managers. I have decided after 18 years of doing this that I will NOT allow people to cross that line with me, patients, family members or otherwise. We DO have the right to be respected just like the next person. Demand it and you will get it.

  • Apr 24 '09

    They are just killing me. Why is it that so many of them feel so entitled to sit in their aging parents rooms and just boss us nurses to HELL and back, while they sit there, fully able to do much of what we're doing for their parent, but simply do NOT have the time to do when we have other patients and issues to deal with. i MEAN -- can't they get mom up at least perhaps ONCE during the day? Does it have to be a nurse doing it every single time, ten times a day??

    I just came off a shift tonight where I literally waitressed all day long, making and fetching coffee and water and 100 millions cups of juice for these patients (because we're always short a tech) -- and a patient's daughter was literally screaming at nurses at change of shift to come in and do something or other for her mother. It was absolutely NOT an emergency. (She was actually screaming -- "Good thing it WASN'T an emergency!!" These people have been on our unit for over 2-3 weeks, running every nurse on the unit ragged. Their mother is far over 80 years old and is only going to head to weeks of rehab after being on our unit. They want a private nurse -- that is what they want and need. But they can't get that on a floor. I think their call light was on for perhaps five minutes, max.

    I am just SO tired of family members not understanding what we do -- and our managers from the floor to the corporate headquarters not backing us up to explain it to them. We are simply to treat everyone as our "family members" and go above and beyond 1000 percent of the time. Who goes above and beyond FOR NURSES??? DOES ANYONE???

    We have no private space to do our charting, we are like fish in a bowl for these family members. If they see you at the nursing station -- that's it. They are ON YOU like flies. If they don't have a reason to bug you, they will find one. So, you don't get your charting done on time and are left to stay after a shift for an hour.

    I am just so tired of it. So burnt out. Is it any wonder why they can't keep nurses for long? I mean -- come on, management -- take a LOOK at what you are doing to nurses nowadays. Put some LIMITS, please, on these family members. It is OUT OF CONTROL.

  • Apr 24 '09

    Personally, I don't think nursing school is the time or place for students to learn delegation. Not all students work as nurse's aids, or techs, and need hands on experience, which for some of them is only going to come in nursing school clinical. You would be surprised with how many nurses I used to work with that didn't know how to do blood sugars, but they could just delegate this to the tech. This is unacceptable, IMO. Before being able to delegate a task, a nurse must themselves know how to properly perform a task. Proper skill, is what needs to be learned in nursing school.

  • Apr 14 '09

    I work in one of the largest/busiest ED Trauma centers on the East Coast and I honestly feel that IV's are one of the easiest parts of my job. We never use the IV team unless we have multiple unsuccessful attempts by a couple nurses only because its hospital policy to call them. We do as many IV starts if not more than IV nurses and I believe we're better at it.

    There really isn't a shift that I don't do atleast 5 IV's and I've done in the upwards of 20+ IV starts in some shifts where I'm extremely busy. I get more annoyed having to do my own EKG's than IV's.

    Most ED's don't hire you with a contigency you know how to start an IV. Alot of people in my orientation group had never done an IV before and are good now. I can't speak for all ED's but the one I work at, I'm not always in the assignment with the trauma's. We have 2 designated trauma bays and 3 critical care rooms next to they bays and that whole assignment has 3 RN's working it per shift, one of them being a trauma clinical leader. So what I'm saying is I can go a couple of weeks and not be assigned to the trauma assignment because we have almost 200 nurses in our ED alone. Of course I've gotten trauma's in less acute area's when we're full but most of the time it doesn't work that way.

    If you need practice, start off with 20G IV's..they're not so big where its hard to advance but they're still stiff enough where they're not going to bend too much. I hate 22G for that reason, they're too damn flimsy. And I've never even used a 24G, not even for a newborn.

    I'd say that probably 95% of my IV starts are 18G. Some people think 18G should only be used for trauma's or critical situations but in critical situations, I'm using a 16G or 14G. And you never know how serious a pts situation is. There are people that you think just have a cold or indigestion and they end up coding. I've seen it multiple times, so I rather have atleast 18G for those circumstances. I will say that I've been putting in a few 16G IV's per week and alot of nurses look to me when they can't get large bore IV access. Just this past weekend I put in 3 16G and a 14G on top of numerous 18G.

    Don't worry, you just need to practice. During our orientation they made us practice on each other. One piece of advice I'll give you is, in the beginning during you first few weeks, don't tell pts you're new to starting IV's. It makes the pts nervous and less likely to let you stick them and in turn makes you nervous and anxious starting IV's.

  • Mar 27 '09

    I would tackle the attitude as well as the English usage if I were the OP. Even LTC facilities have standards for nurses. It is a fact of life that many new grads work at LTC facilities if they want to work, hospitals can't accommodate everyone. Seems to me this has been discussed before in another thread by the same person.

  • Mar 11 '09

    When I first came to the USA 4 years ago I really didn't think I would do Nursing. First of all I didn't know any English, second I thought I needed to go to a Nursing School again.

    For about 2 years I just worked as a volunteer in different places. Then one day I saw Johnson&Johnson's advertisement on the TV saying : "Nurses, We need you more than ever" That really touched me. The other day I saw another ad of an hospital saying "Nurses, come work with us, we have great benefits for you"

    I started thinking why not? When I was doing nursing in Turkey I really enjoyed working with patients, Now sometimes I still receive calls from people who used to be my patients and now they are my friends. When I thought how much I enjoyed Nursing in Turkey I started to search how I can be a Nurse in the USA. Then I found out It wasn't that hard. I had to take an exam. I studied hard and when I passed my exam on my first try with minimum questions I felt like you could do whatever you want as long as you are determined. When I got my license I was the happiest person in the world and I will never forget how I jumped in the house and said "I did it, I did it"

    Now it was time to find a great hospital that I can enjoy working in. I was reading allnurses.com and one of the nurses was saying :"this hospital would be a great hospital to work in DC area." When I called HR of the hospital she was suggesting, they told me to come next day as they were having an open house. I took the bus and when I got off I didn't know where to go and I asked somebody and he was so pleasant showed me where I should go. For a couple months later, when I was preparing my medications in med room somebody from pharmacy came in, smiled and asked me "Oh, now you can find your way easily ha?" And I realized it was that person who showed me my way that day.


    When I first started I was so excited, happy but at the same time so stressful. Everything was new for me. First off all the system, language, people.. everything. When hospital gave me a great orientation I felt really lucky again, I had my confidence and I knew I could be a great nurse again.

    When I started to work with patients I started to get positive feedbacks and they also made me believe again I was born to be a nurse.

    One day as soon as I entered one of my patients room, pt recognized me and stated "Ah, Now you are wearing blue instead of red jacket, how nice" I had seen that pt when I was volunteering on the CCC 4 months ago when I was waiting for my papers and we had some conversation. He came back to the hospital again after 4 moths for afib and he was going to have Cardioversion. He was so nervous. We talked in the morning and also he recalled one of his happiest vacations in Turkey with his family and he smiled. I went out for my other patients and he pressed the call button as soon as I exited the room. When I got back to his room he stated "Serpil, Can you check the monitor for me. I think I converted" " I feel great" I went to check and he had converted to NSR. I called his Dr. and he stated pt could go home. When I told this to pt, he gave me a big hug and stated "You did it" "You are going to save a lot of people's lives with your smile" I always believe remembering fun days you had in the past can make your day go beautifully. I believe that's what made my pt's heart to beat normally again.

    Another day when I got in for day shift in the morning I received a report on my pt. They stated he doesn't talk at all, he is in big depression as he got fired his 30-year job. When I got in the room he stated I don't want anything. The curtains were closed and he looked so miserable. I told him that I would go back. After I finished everything with my other pts I went back to his room and took my time, sat down and talked to him. He then explained to me why he was so sad and everything else that was bothering him. He had one son needed to go to collage and he needed money. He stated wherever he starts he will never earn that much money that he used to earn. I told him that I understand his frustrations but you never know what's good for you. Maybe God has different plans for you. I also told him that his son would prefer a happy father. Worrying doesn't make problem go away, I told him to take a walk, do something that he enjoys for a while. I was able to see some smile on his face then. I opened the curtains and I told him I would come back again and he told me how much he appreciated my time. Later on his wife came into the room and pt called me just to introduce me to his wife and his wife also thanked me. The same day I d/c him home and he also gave me hug stating "I will never forget you". I really heard this from my other pts also later. I do love Nursing and I believe it's not only assessment-giving medications or anything else. It's feeling what's going on with your pt. I think It doesn't matter what language you speak as long as you show them you care.. That's most important and I would like all foreign nurses to realize that..

    The other day I had 24 year old patient who I was told always asked for Ativan. Around 9 pm she called me crying "I feel so anxious.. I don't know what to do.. I need Ativan" She was not due for another ativan at least for 2 hours. I just sat by her on the bed and put my hand over her shoulders. I stayed there for a while, used silence and her crying stopped. She then lay back and I just said I will come back let me know when you need anything. Pt didn't ask for another Ativan all night and the way she asked the things changed, she started to say "I am sorry to give you trouble.." Her doctor saw her calm in the morning and we discussed about pt and doctor thanked me for taking care of her.

    I also have a great experience about how important it is to have foreign nurses in terms of having patients from all over the world. One day when I came to my unit, I recognized one of my pt's name. It was Turkish. They told me she only spoke Turkish. When I went to her room she looked so happy when I talked to her in Turkish,
    Her son was in the room, looked so tired as he's been staying with her mom to translate. I told him he can go home and get some rest as I am already there all night. He was so happy.I heard next day they had to take her down to ICU and that day I went down to visit her and let the nurses know that I am always ready if they need some help translating.

    On my other experience I really believe I made a difference on my patient's life. Pt was born in Turkey. They told me he was at the terminal stage and they were planning to take him to the hospice care. When I got him in the morning I asked him if he could speak Turkish and he started to talk in Turkish. He talked about where in Istanbul he was born-lived.

    He smiled and kept talking about his house in Istanbul and everything that he remembers. He smiled. My sleepy, not talking pt now wide awake talking about his life in Turkey. When his son came in that afternoon I will never forget his face. He was so surprised, happy to see his father awake, talking.

    He couldn't find a word to say to me but his smiling happy face was enough to made me happy and when I got out the room he came and stated "Thank You"

    My philosophy is to approach pt like they are one of your family members. They are my mom, sisters, brothers.. How I want them to be treated when they need some help? And this makes you a safe nurse because you never want your family to be given a wrong medication. You also become a natural pt advocate as you feel like your pts are one of your family member. How many times I received a call from a doctor asking me to have the pt sign the consent for a curtain procedure, when I found out pt was not aware of the risks and what's going on, how many times I had to call back the doctor stating can you please first explain this to pt or family member (if pt is not able to sign for a reason) before I get the consent..

    I believe doing what you like is the most important part of our lives. That's what I do at the moment, Nursing.. Giving hand to people who need your help when they really need you.. With your knowledge, experience, being a safe, proactive nurse,

    When I first started I also had communication problems. Since I started my orientation at nights I wasn't able to meet the doctors. Talking to somebody that you have not met plus with your second language makes you nervous in the first place but by the time when I get to know them and get used to the system, I can say now I am able to communicate without any questions. I was having hard time giving suggestions as I didn't know the people, doctors and I didn't/t know what to expect. Now I am more knowledgeable as I read everyday to make sure I am up to date, I remember warning acouple MDs multiple times when they prescribed D5 on severe diabetic patient, when they wrote order for an IV fluid on CHF pt.. They all thanked me for these warnings and also it gave me encourage for future I can always be a pt advocate and it's supported by all team members.

    When I think about my first days I also remember having dreams about computer charting. This was very new for me. I remember all night long when I was sleeping I was doing computer charting without any interruptions. I believe it was the stress of a new environment and new system and every new thing around me. But now I am comfortable and I only do computer charting in the hospital, not in my dreams.


    As a summary I had hard time in the first place because everything was new for me. Language, system, people.. But with my hospital's great orientation, the support of great people I work with, my growing knowledge, with my patients' positive feedbacks I am now more confident. My goal is always be a successful nurse and be knowledgeable as much as possible.

    It's been almost 3 years I have been RN in my hospital. I think I improved myself alot. When I first started I didn't know how to explain a telemetry box to a patient appropriately, now I am a competent-independent RN and do work as a charge nurse sometimes. I believe there is nothing in the world as beautiful as doing something you like or you want.. All challenges pass by and you learn so many new things and become stronger everyday.. Patience, passion, loving your job.. That's all it takes.. Now when I think about the first days I started and compare it where I am now, It's just indescribable.I would like to reach all nurses who are just starting as a new nurse in the USA or about to start and tell them about my experience..

    I would like to thank to my hospital, my wonderful mentors, great people I met/work with and of course to my patients who always made me happy and kept going with their wonderful compliments.. Also of course thanks to the person who was suggesting my current hospital as a great working environment on allnurses.com..I feel so lucky to have encountered your post and lucky to know allnurses.com.

    I WROTE THIS LETTER TO MY MANAGER IN JUNE 2007 ( 1 YEAR AFTER MY HIRE DATE) NOW I EDITED A COUPLE OF THINGS AND SUBMITTING TO ALLNURSES.COM AS ALSO YOU CAN SEE ALLNURSES.COM HELPS ALOT OF PEOPLE.. I HAVE BEEN WORKING IN MY HOSPITAL NOW ALMOST FOR 3 YEARS THANKS TO ALLNURSES.COM.. 6/5/2007

  • Mar 10 '09

    I read all your posts on this subject with great interest. There have been similar posts since I found this website. I am the DON at a 70 bed facility. Sometimes I get so tired of the stress that I just want to quit, but I am so attached to my staff and residents that I don't. The majority of my stress comes from other areas. I have an excellent staff. I try so hard to make their jobs as good as I can. I am afraid if I leave that the next DON will not pay attention to their needs so well. I have had some lousy DONs over the years. I'm so saint, but at least I do care. Anyway, I read your posts with this in mind. I want to know why you feel burned out, why you are unhappy in your jobs, etc., so I can try to make sure it is not the case in my facility. I have argued with corporate to get my aides and nurses a pay increase. I finally got enough staff to suit me...we are now staffed very good. You guys are generally not treated well it seems. My LPNs have 30ish pts to care for, but they have a treatment nurse and an RN on the floor to help them with IVs, PD, behavior problems, families, charting, and the umpteen problems that arise. I am on the floor often, they can always call me, give them time off if they are over tired, etc. I hope they know how important they are to me and to the residents.

  • Mar 6 '09

    Accounting, computer software, engineering, teaching, professional sports writter, business owner. I could go anywhere, do anything. I was always attracted to nursing on some level though. I really had no definealbe reason to be. Most people I talked to were going into the field to work as a nurse for a second income. More than a few people told me nursing full time was just not any way to live. Still, for some reason, it always stayed there, on my long list of options.

    I worked hard to earn good grades during the school year and worked just as hard during the summer as a landscape laborer. I was good at what I did, in both aspects, and took pride in everything I worked on whether it be a paper focused on "The Old Man and The Sea" or trimming back someone's hedges. A couple years went by, and I found myself becomeing frustrated by the fact that my list of possible career choices had not become any more defined than before. This in fact became a major source of stress in my life. I was almost completely done with all the basic courses (algebra, english comp., chem.) and the time was coming to decide exactly "What I want to be when I grow up." I often filled out my semester's schedule with unecessary classes simply because I felt I was not ready for this decision. I was doing what I could to extend my deadline for having to decide.

    Then, a proposition. The owner of the landscapeing company I worked for during the summers was expanding. There was an acute need for workers who were familiar with his way of doing things and could be trusted to work alone. I fit the bill like a glove. I was offered a crew boss position, but there was a stipulation that I would work full time, all year. This left little to no time for school. I balked at this at first, it would mean all the time I spent in school up till now was a waste. Besides, I never considered landscapeing a career, it was just the first job that accepted me that first summer I was looking for work.

    The hourly wage being offered me was the best I offer I ever saw. It was certainly a step up in lifestyle for me. Perhaps I could even afford a car that ran during the winter too now. Still, I declined, school's magnetism was too much to resist. The school year started and I returned to the classroom as always, now more than ever determined to decide where all this was taking me. About half way into the semester, I found myself, for the first time, struggleing to make the grades I was accustomed to. Now, I was only 20 at the time, and I had no understanding of how my outside life was affecting my grades. I was experienceing hard times in my personal life at the time, mostly due to lonliness with my friends moving onto four year colleges. There was also a financial aspect to my troubles though. I was falling behind on bills, my car was in the garage because it was stalling at stop lights (first time ever it had problems in warm weather) and for the first time, I was begining to use credit cards for day to day things like groceries. As though he knew exactly how to time things, the boss from the landscape company called. He told me the owner still needed crew bosses, more now than ever. He also inserted that if I decided to take the position that was offered before, I could also work into the deal the right to use a company truck at home until I got a new vehicle for myself. I made the call, got two dollars added to the original offer made to me, and decided it was the best route. "My career has chosen me" rang in my mind like a mantra. I never even withdrew from my classes. I just quit showing up.

    For the first three years, my choice seemed like the right one. I stayed out of the debt pitt many of my friends dug themselves into and lived a life that was full of hard work, but rewarding in a simple way. I was content if not happy, and a lot of people could not achieve that even. Then things started to change, or maybe I changed. I found myself avoiding overtime. That was where it started. Then I started staying out later and later on weekdays, usually at the local bar with a few of my friends who had moved onto four year schools but were in the middle of changeing majors........for the third time. Work became something I did because I had to. It was, as I saw it, a setback on my schedule. The owner of the company had not been showing up at the office for close to two years now, the company ran itself. Word was, he sat at home with his best friend Grey Goose watching old movies. Fine with me, just meant I didnt have to put in overtime. I felt like I was in the movie "Groundhog Day", each day was for the most part a carbon copy of the previous. I kept repeating the same day, over and over, until I was almost 28.

    I got the call one winter day while I was recovering from a long night out with the boys. It was the boss at work. The company owner was getting divorced and moving away. He no longer was interested in the landscape business and was selling all the equipment to help pay for the divorce. We got together, decided we could all pitch in, buy the business from the owner cheap, and get things going again. Problem was, not one of us was the long term financial planner type. We had spent our lives working and living paycheck to paycheck. The three of us couldnt put together enough money to buy a bus ticket much less purchase a business. In the end, the company folded and we were left to fend for ourselves. The other two went onto other business avenues. One took up driving a tow truck, the other went on to plumbing school. Me, I applied to landscape companies with the idea that I would just remain a crew boss. The landscapeing business is very tribal though. Being a boss in camp A does not mean anything to camp B across the river. I was stuck working entry level laborer positions. More often than not, relatives with no interest in the business were picked for crew boss positions before me. I went from company to company, seeking to replace what I lost with my first company. I never found it. I was trapped in the business and had no way to improve my standing.

    I fell into a bit of a depression. I was drinking daily, now at home alone instead of at the bar with friends. I was convinced my life would be spent just existing, not living. Fine with me, there were worse things out there. I got into a landscape company and stayed with them despite zero opportunity to move up the ladder. It provided a stable paycheck and that was all I needed. One night, my mother gave me a cash gift and told me she hoped I spent it on getting out of the house a little, maybe take a vacation. I intended to buy a nice bottle of Southern Comfort with it. She begged me not to do this, suggested going camping. I didnt go camping anymore, especially since I didnt own a vehicle at this point. But, one night, while walking to the local gas station to get my staple dinner of two hot dogs and a soda, I passed by a sign for a new karate class opening up in the church right across the street from me. I dont know why, but I joined. It looked like it would be fun, and I was tired of being in the house all the time.

    I made new friends in the class. Hung out with the instructor on off class days a few times. Most couldnt understand how I was working an entry level position. I was getting job offers from other members who saw how reliable I was. Everyone needs that extra helping hand from someone you dont have to stand over to get them to work a little. One offer was for a road worker, one of the people we drive by without hardly noticeing. It was hard work, long hours, but it was a career. People raised families on that wage. I could maybe get my life together again. I applied, was accepted and was going to start classes that would last a month and start working. I had caught my break in life and was not going to mess it up.

    If this were a Disney Film, the story would end here. I'd get married, have kids, work hard, love my community and be loved by it. But I am no wodden boy with a cricket to warn me of good/bad decisions or to help me out of a jam. In the same class where I met the people who gave me the break I needed, I dislocated my knee. I was hurt badly, would not be able to work for three months. I went to physical therapy, it took me two months to get off crutches. The job I was supposed to have started got filled by a younger guy who wasnt far removed from high school. He was taking classes at the local college and, reminded me of me at that age. The people at the karate classes comforted me, kept telling me there would be other opportunities. But their comforting words came with a tone of caution that, hard as they try, they could not hide. I dont know if they were not as interested in me because of my bad wheel or because the positions were just getting filled, but I knew that road was now closed to me.

    During the two months on crutches, my life was a cycle of going to physical therapy, ashamed because I was on public assistance to pay for it, and returning home to wait for the next session. I said I was depressed before, when I was job hopping between landscape positions. Things got worse, depression of a clinical variety set in. I'm not ashamed to admit, more than a few nights, after physical therapy, I sat in my apartment considering what sort of cocktail I could make with the pain killers given to me at the ER, booze from the cupboard and a few OTC medications. I could take a permanent nap, and the worries about my situation would disolve away like the pills dropped in Southern Comfort.

    To get my mind off things, I decided to start frequenting the local library. Books offered a break from the boreish television shows I was being forced to watch day after day. I started bringing books home and went many days without even turning on the television. One of the books that caught my eye at the library was "The Stand" by Stephen King. I was already a King fan, but the book I had gotten my introduction to his works with was "IT". Many people told me to give The Stand a chance, but the idea of a book about the world coming to an end because of a virus just sounded like a dead end plot to me. For some reason though, I was ready to give it a chance. Not like I had anything important going on that, if I decided I hated the book, I would think I had wasted my time. I had nothing but time on my hands.

    If you've seen the movie (based on a King short story, ironically) Shawshank Redemption, you might remember a scene that comes to mind for me right now. The warden hands Andy the bible through the jail bars and comments "Salvation lies within". The inside joke is that a hammar Andy will use to break out of the jail is hidden in that book at the time. For me, salvation lied within the pages of a horror/drama written with the intent to entertain.

    In the book, The Stand, a virus wipes out much of the earth's population. The people who are left find themselves drawn to the western U.S. People, for reasons not clear to them at the time, migrate towards CA or Colorado, whichever their drawing is. As they beging to arrive to their destinations, they form new communities in the new world. The book went on, talking about how the new societies were organized and how the chains of command were developed. There was a theme forming, not intentionally I think, that struck me. Peoples priorities changed with survival being priority number one. The book highlighted how, many people considered kings in the old world were lost in the new society. People with skills and knowledge to pass on were suddenly the heroes. Carpenters, plumbers, farmers and NURSES were on the top of the social ladder. No more idolizing people because they can hit a ball with a stick or worshiping rock stars. No longer did knowing how to play the stock market make one worthy of the worlds finest riches. These things had no place/value in the new world. This struck a cord with me. I suddenly found myself thinking back to when I was in school, takeing prereqs and being confused about what I wanted to do for a living. I remembered, above all else, I wanted to find my way into a career that made me feel proud, feel like I was of value to my community. Over the next few days, the idea of returning to nursing dominated my thoughts.

    I eventually was done with physical therapy. I went back to being a landscape laborer with a new direction in life. No more working just enough to make sure I could afford my Southern Comfort and Budweiser. I was now on a mission to get my school loans out of default and go back to school for nursing. I worked overtime like a man possessed. The only day of the week I took off for myself was sunday, and sometimes not even then. More often than not, I did 10 hour days. When my boss griped about the overtime, I told him, if I had to, I would work two jobs to make the money I wanted. He didnt like the idea of me perhaps finding a job I liked more and gave me whatever OT I pleased. Over the time of a year and a half, I cut down my overhead to nearly nothing. I took the bus and used a pass for it that was a monthly budgeted bill for me. I got the cable taken out of the house, I had no time for it. I only bought groceries that were on sale and never once ate out, not even at McDonalds. I made payment after payment and eventually, my loans were taken out of default. With my loans out of default, I could return to school and persue my nursing degree.

    The next three years were difficult to say the least. I worked full time as a CNA in a hospital and went to school. I had no social life, was sleep deprived and chronicly broke. I did make new friends who will last a lifetime though. I keep in touch with more than a few of them still today. I also met my wife to be during this time. The nursing program was one of the hardest things I've ever done in my life. I finished though. I have been practiceing nursing for three years now. I plan on settleing down in Pennsylvania with my wife soon to seek a permanent position and start a family.

    We have all been burnt by nursing and the way we are treated by the general public at some point in our careers. I often think back to the book that started my career in nursing. We certainly are not loved by people today the way nurses were cherished in that book. Still, no matter how bad things get, I doubt it can ever get as bad as before my life took some direction and I turned to nursing to give my life some meaning. I, above all else, am given the feeling that I am living, not simply existing. No poor nurse/pt ratios, demeaning physician or detached administrator can take that from me.


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