Nursing is the only job I've had where I wish time would stop so that I could catch up! I feel as though my shift starts and I am on top of a hill with a freight train chained to my ankle…I start walking….then start doing the run/walk then running full on and I'm thinking "this is going pretty good, I'm ahead of it" then I look back and "HOLY C--P…it's gaining on me!" I start tumbling down the hill and before I know it, the train has plowed me down and now it's dragging me full speed down the hill, flopping around behind it like a fish out of water. Then After I'm done with shift change report…I get up from the floor, brush the dirt off and push the hair out of my eyes and drag my sorry butt towards elevator thinking "I survived"
So I'm a new nurse and still on orientation. I had a patient yesterday on a heparin drip as well as an amiodarone drip. I was so nervous about both of these meds since it was the first time I've been responsible for either. I went into the patient's room and my preceptor and I reviewed the latest pTT and following the heparin protocol figured out the bolus dosage and the increased rate. We cosigned and all was well with that. My preceptor then left me to finish up administering the patient's PO meds. I re-checked orders on the screen as well as the 5 rights. Apparently at no time did I check in with my common sense. He was due for a 9:00 am dosage of Xarelto. I gave it to him along with a slew of other meds. Finished up with him. A little while later I went to daily rounding (in a break room with house intensivist, case managers, nurse managers and charge RN). We discussed all of my patients. The case manager brought my pt with the hep drip and the xarelto and that I should clarify with doctor which anticoagulant he would like D/C'd. I did not make the connection that I had already given it (chalk it up to a blond moment or newbie moment. I just never made the connection and have no excuse). I place multiple calls to the MD of which none were returned - I spoke with my preceptor and she agreed that we will give the oncoming night RN the report and advise her to with hold the pm dosage (which in my mind was when it was due….coumadin is given in the pm so I figured that the Xarelto was the med of choice for bridging from heparin). It wasn't until well after shift change (still very slow at charting) that the night nurse came to me and let me know that I had already given the med at 9 am. I must have had the stupidest look on my face when I said "What? I did? I just don't remember - it seems like days ago when I was giving morning meds. Anyway….nothing more was said by her and I was left standing there waiting for instructions. She walked away and went on about her med pass. I was done charting so I gathered my things, clocked out and left. On my drive home I slowly started to panic (I guess shock had worn off), I probably should have stayed and written a report or talked with the charge nurse. I came home and sent emails to my nurse manager and assistant nurse manager and am waiting for a reply. I'm so new there that no one would call me to tell me if my patient's pTT went through the roof or not. The scary part is that this was a huge wake up call. You can check the 5+ rights of med administration but you as the nurse giving the meds are still responsible for what was originally ordered. This is what went through my mind during the PO med administration….Xarelto for VTE prophylaxis. When I ran the heparin through my mind - Heparin for anticoagulation d/t new onset uncontrolled a fib. I didn't connect the 2. I feel so incompetent….I knew this day would come but didn't expect this awful feeling deep down in my soul. We just want to help our patients. To do the opposite is just the worst thing ever!
Thanks for reading….it helps to know there are people out there to vent to :-)
Cheri
I'm looking for opinions here too…Is this considered "extraordinary circumstances"? I was assaulted in my first ER position this past July (and only just started this past May so technically I am still on orientation) and am cleared to begin back to work this October (Fractured radius with 7 screws and a plate and a fractured ulna). I wouldn't say I am suffering from PTSD (I believe that I have a good handle on why it happened….sick people loose control sometimes and sometimes people get hurt). I am to having nightmares about my first shift back...being assigned only the psych patients…and these patients getting out of control and no one hearing my requests for help. I know consciously that this won't happen and try to laugh it off but I am seriously feeling as though my facility isn't safe (no security in the main ER). Prior to getting my license, I worked for 8 years as a paramedic in both urban and suburban areas and have never felt "unsafe". I've always felt that ER nursing was the direction for me. Landing my first job in the ER was a dream come true and I'm trying not to let this patient/event change my perspective on my new career. The logical person that I am feels that I should at least get my first shift over with and then see how I feel. If I decide afterwards that I am simply not able to continue there, do you think an interviewing manager would see me as a bad risk for hiring? I go over in my head "I am leaving my current position because I just don't feel safe in my facility after being assaulted by a patient" and I sound unstable even to myself!! We all know the risks of nursing (as unacceptable as being attacked is - it happens). Just looking for insight from you all.
I just want to say a big "Thank You" to all of you! I am a new graduate and started my first job in May. Unfortunately I was assaulted by a patient and am on medical leave with a broken arm until Oct. 4th. I've been getting increasingly more anxious about going back to work. This thread has helped to ease my anxiety quite a bit. The funny thing is that I'm not sure why?! Maybe it's a good distractionI'm just not giving the "assault" a thought and am simply thinking of getting back on the horse. The night that I was assaulted I was devastated that I would be out of work and my orientation would drag on. As the days progressed I've become more nervous about having to face this patient again. (frequent flyer)I know that he won't be assigned to me but I just don't want to have to "see" him or his family again. I won't leave my job because of this guy....I love my job and won't give him that power. (I've worked way too hard to get here). Anyway....I just wanted to say thanks to all the ideas of prioritizing tasks (I especially love the sticky note idea since I can just pull off the little sheet when I am done with those tasks or need to re-prioritize).
One of my favorite preceptors gave me the best bit of advise for when it gets crazy.....When you are being given patient after patient - don't bother to complain about it. Just put your head down and keep going. Complaining is a waste of time, since everyone is getting hit with a lot of patients. Complaining only increases your anxiety which leads to mental confusion. Keep going like a freight train....and get your work done!
Thank you KeepItReal and ChristineN.....Good points. I am definitely treading lightly on this one. I'd like to go into this with my eyes side open and my mouth zipped. Since the ticket is non-refundable it's mine and not going anywhere....so I am going to hope and pray that quite possibly I'll have a long weekend but I'm fully prepared to be home and miss the wedding. I will be honest here....I am more comfy with missing the family wedding than the possibility of a cancelled return flight (for whatever reason).
This is a long one...but it has been very cathartic for me to write it down (thank you in advance for enduring it you decide to read on)
This is an old thread but figured I'd get it going again. Not mentioning a planned vacation until after I was offered a job blew up in my face. In this climate (at least in NJ), where ADN's are up against magnet status, I knew that getting a full time position in ANY speciality was quite a reach. Low and behold I was offered a full-time position in an ED. I went to an open interview and filled out an application and signed paperwork for a background check before I was interviewed by the 3 nurse managers and nurse educator. This was back on February 22nd, 2014. I didn't even have my license yet figuring that at the very least it was experience in the interview process. Took the boards and passed. I only just was formally offered the position one week ago via the phone by HR. I went in to meet with him and asked him at that point how vacation scheduling occurs. His answer was that the nurse manager authorizes all vacations. I went home and emailed the nurse manager (I've had only one conversation with her since the interview and it wasn't a formal job offer so I didn't dare bring up a vacation at that point....big mistake!). The nurse manager doesn't return phone calls or emails and I felt that if I could put the request in an email it would at least get to her. Well I received my answer (within an hour! and cc'd to HR and the other ED managers)....."I am unable authorize time off until after your 12 week orientation has been completed". My reply was short and sweet "thank you for getting back to me so quickly and I will do what I need to do to be at orientation on May 12th". The vacation is my brother-in-law's wedding in Mexico. The WHOLE family will be there. It is breaking my heart to not be there but I can't give up this job opportunity. I need to mention that the ED was holding a position for me until I passed the boards and got my license in my hot little hand. I feel they already accommodated me by saving a full-time DAY position for me. What more could I ask for. I keep telling myself that although I won't be in the family photos, that when my family returns, the vacation will be a beautiful memory and I will be an ED nurse kicking off my career in emergency medicine just as I had dreamed! (I'm hoping that my kids will see this as a good lesson about hard work and sacrifice and not me choosing work over them...)
This has been the most difficult decision I have had to make. My dear husband and my 2 amazing children are going off to Mexico for a week in paradise and I will be here in NJ. (at least my kids are 12 and 14 and are not toddlers - much easier to manage on his own). UGH!!!
Hey - JuneJames…I too have been hired to the ED from school straight away. I start on May 12th and have a 12 week orientation. I am scared out of my mind!!! I worked as a paramedic for 8 years but I feel so underprepared! (I do feel hopeful that I can at least tell a sick person from a not so sick person….any bit helps!!) I am so glad to hear that you love it!!! Any other encouraging words are welcomed because for the most part I've heard nothing but "most nights you'll be driving home in tears and most mornings you'll be driving to work in tears"…hmmm.
The great thing about nursing is the flexibility and diversity it offers. I started out in nursing school, but was distracted from finishing, at first, in order to become a paramedic. I worked as a paramedic in both rural and urban settings and loved it for 8 years. I knew I wanted to go onto become an RN and many years later (almost 14 years after my last shift as a medic) I've landed my first job in the ED as a full time RN (I start on May 12th). When I went back to nursing school I really thought that I'd want to work in a department other than the ED. Turns out I am hard wired to think as an ED nurse. I guess it's my comfort zone. That's my story (for what it's worth).
The reason for my post is more about my husband's career path as I think it will be more of interest to you (zmansc). He started out as a paramedic with a dream of becoming a firefighter with FDNY. He has been with FDNY for 14 years and is still a medic. He is also a flight medic and going to nursing school with the hopes of becoming a flight nurse. I don't see him ever working in the hospital environment, but ya never know. He has mentioned that he really enjoyed his clinical rotations in both the neuro ICU and the CCU. He has never been cured of the "lights and sirens syndrome" (probably why his hearing is less than stellar…or could just be a co-morbidity of 17 years of being married to me).
Working as an EMT while going to nursing school is an option. I don't think a patient care technician/nursing assistant in a hospital setting earns much more than an EMT (which is how many of my fellow nursing students earned $ during school….) As an EMT you'll be able to hoan your assessment skills during your working hours. Same is true if you decide on the medic route.
Whatever you decide…enjoy the ride and get the most out of each experience along the way.
I took the exam feb 25th and an hour later signed on and got the good pop up….didn't believe it until this morning when I signed on (49 hours later) and it said "Pass"! it worked!!!
PVT Works!!!! I took the test at 8:00 am on Feb. 25th and did the Quick Results and It was posted at 9:03 am today, the 27th when I signed on! For those of you that are waiting the 48 hours - I feel your pain because you just won't rest until you know definitively for yourselves - I had my doubts since my computer shut at 75 questions. I cried most of the way home. Signed on and got the good pop up 1 hour later and felt some relief but STILL spent most of the last 48 hours in the bathroom. Now I can officially breathe!
Good luck to you all!!!
(BTW…I graduated on January 9th of this year. Did the 2 week Kaplan course. Finished the entire q bank and took all of the trainers. Scores were all in the 60 - low 70's range. With the exception of the Sample exam #4 - all alternative style questions which I bombed with a 43%!!!).
DON'T STRESS THE NCLEX SATA!!!!!!! If you seem to be getting them one after another - you are still in the game (my theory). At a certain point early in the exam I started praying for them…HONEST! I knew if I kept getting them then it was a good thing. 17 of them in total!!!!!
You've got this!!!!!
Hopefully someone out there can answer my question. I took the NCLEX RN this morning and got the good pop up when I got home after it said "Delivery Successful". According to Pearson Vue I can get Quick Results - there is supposed to be a link in the Status box and there isn't a link. It's making me a bit nervous. Do I wait the 48 hours and then the link appears (and pay the $8 at that point?) or is the link supposed to be there from the beginning, pay ahead of time and wait for the results to appear.
I will also add that luckily I have no issue with working in a LTC facility or Hospice facility - age on baby boomers!!! I'm ready to take care of you...
Nursing is the only job I've had where I wish time would stop so that I could catch up! I feel as though my shift starts and I am on top of a hill with a freight train chained to my ankle…I start walking….then start doing the run/walk then running full on and I'm thinking "this is going pretty good, I'm ahead of it" then I look back and "HOLY C--P…it's gaining on me!" I start tumbling down the hill and before I know it, the train has plowed me down and now it's dragging me full speed down the hill, flopping around behind it like a fish out of water. Then After I'm done with shift change report…I get up from the floor, brush the dirt off and push the hair out of my eyes and drag my sorry butt towards elevator thinking "I survived"
So I'm a new nurse and still on orientation. I had a patient yesterday on a heparin drip as well as an amiodarone drip. I was so nervous about both of these meds since it was the first time I've been responsible for either. I went into the patient's room and my preceptor and I reviewed the latest pTT and following the heparin protocol figured out the bolus dosage and the increased rate. We cosigned and all was well with that. My preceptor then left me to finish up administering the patient's PO meds. I re-checked orders on the screen as well as the 5 rights. Apparently at no time did I check in with my common sense. He was due for a 9:00 am dosage of Xarelto. I gave it to him along with a slew of other meds. Finished up with him. A little while later I went to daily rounding (in a break room with house intensivist, case managers, nurse managers and charge RN). We discussed all of my patients. The case manager brought my pt with the hep drip and the xarelto and that I should clarify with doctor which anticoagulant he would like D/C'd. I did not make the connection that I had already given it (chalk it up to a blond moment or newbie moment. I just never made the connection and have no excuse). I place multiple calls to the MD of which none were returned - I spoke with my preceptor and she agreed that we will give the oncoming night RN the report and advise her to with hold the pm dosage (which in my mind was when it was due….coumadin is given in the pm so I figured that the Xarelto was the med of choice for bridging from heparin). It wasn't until well after shift change (still very slow at charting) that the night nurse came to me and let me know that I had already given the med at 9 am. I must have had the stupidest look on my face when I said "What? I did? I just don't remember - it seems like days ago when I was giving morning meds. Anyway….nothing more was said by her and I was left standing there waiting for instructions. She walked away and went on about her med pass. I was done charting so I gathered my things, clocked out and left. On my drive home I slowly started to panic (I guess shock had worn off), I probably should have stayed and written a report or talked with the charge nurse. I came home and sent emails to my nurse manager and assistant nurse manager and am waiting for a reply. I'm so new there that no one would call me to tell me if my patient's pTT went through the roof or not. The scary part is that this was a huge wake up call. You can check the 5+ rights of med administration but you as the nurse giving the meds are still responsible for what was originally ordered. This is what went through my mind during the PO med administration….Xarelto for VTE prophylaxis. When I ran the heparin through my mind - Heparin for anticoagulation d/t new onset uncontrolled a fib. I didn't connect the 2. I feel so incompetent….I knew this day would come but didn't expect this awful feeling deep down in my soul. We just want to help our patients. To do the opposite is just the worst thing ever!
Thanks for reading….it helps to know there are people out there to vent to :-)
Cheri
I'm looking for opinions here too…Is this considered "extraordinary circumstances"? I was assaulted in my first ER position this past July (and only just started this past May so technically I am still on orientation) and am cleared to begin back to work this October (Fractured radius with 7 screws and a plate and a fractured ulna). I wouldn't say I am suffering from PTSD (I believe that I have a good handle on why it happened….sick people loose control sometimes and sometimes people get hurt). I am to having nightmares about my first shift back...being assigned only the psych patients…and these patients getting out of control and no one hearing my requests for help. I know consciously that this won't happen and try to laugh it off but I am seriously feeling as though my facility isn't safe (no security in the main ER). Prior to getting my license, I worked for 8 years as a paramedic in both urban and suburban areas and have never felt "unsafe". I've always felt that ER nursing was the direction for me. Landing my first job in the ER was a dream come true and I'm trying not to let this patient/event change my perspective on my new career. The logical person that I am feels that I should at least get my first shift over with and then see how I feel. If I decide afterwards that I am simply not able to continue there, do you think an interviewing manager would see me as a bad risk for hiring? I go over in my head "I am leaving my current position because I just don't feel safe in my facility after being assaulted by a patient" and I sound unstable even to myself!! We all know the risks of nursing (as unacceptable as being attacked is - it happens). Just looking for insight from you all.
Thanks!!
I just want to say a big "Thank You" to all of you! I am a new graduate and started my first job in May. Unfortunately I was assaulted by a patient and am on medical leave with a broken arm until Oct. 4th. I've been getting increasingly more anxious about going back to work. This thread has helped to ease my anxiety quite a bit. The funny thing is that I'm not sure why?! Maybe it's a good distractionI'm just not giving the "assault" a thought and am simply thinking of getting back on the horse. The night that I was assaulted I was devastated that I would be out of work and my orientation would drag on. As the days progressed I've become more nervous about having to face this patient again. (frequent flyer)I know that he won't be assigned to me but I just don't want to have to "see" him or his family again. I won't leave my job because of this guy....I love my job and won't give him that power. (I've worked way too hard to get here). Anyway....I just wanted to say thanks to all the ideas of prioritizing tasks (I especially love the sticky note idea since I can just pull off the little sheet when I am done with those tasks or need to re-prioritize).
One of my favorite preceptors gave me the best bit of advise for when it gets crazy.....When you are being given patient after patient - don't bother to complain about it. Just put your head down and keep going. Complaining is a waste of time, since everyone is getting hit with a lot of patients. Complaining only increases your anxiety which leads to mental confusion. Keep going like a freight train....and get your work done!
Thank you KeepItReal and ChristineN.....Good points. I am definitely treading lightly on this one. I'd like to go into this with my eyes side open and my mouth zipped. Since the ticket is non-refundable it's mine and not going anywhere....so I am going to hope and pray that quite possibly I'll have a long weekend but I'm fully prepared to be home and miss the wedding. I will be honest here....I am more comfy with missing the family wedding than the possibility of a cancelled return flight (for whatever reason).
This is a long one...but it has been very cathartic for me to write it down (thank you in advance for enduring it you decide to read on)
This is an old thread but figured I'd get it going again. Not mentioning a planned vacation until after I was offered a job blew up in my face. In this climate (at least in NJ), where ADN's are up against magnet status, I knew that getting a full time position in ANY speciality was quite a reach. Low and behold I was offered a full-time position in an ED. I went to an open interview and filled out an application and signed paperwork for a background check before I was interviewed by the 3 nurse managers and nurse educator. This was back on February 22nd, 2014. I didn't even have my license yet figuring that at the very least it was experience in the interview process. Took the boards and passed. I only just was formally offered the position one week ago via the phone by HR. I went in to meet with him and asked him at that point how vacation scheduling occurs. His answer was that the nurse manager authorizes all vacations. I went home and emailed the nurse manager (I've had only one conversation with her since the interview and it wasn't a formal job offer so I didn't dare bring up a vacation at that point....big mistake!). The nurse manager doesn't return phone calls or emails and I felt that if I could put the request in an email it would at least get to her. Well I received my answer (within an hour! and cc'd to HR and the other ED managers)....."I am unable authorize time off until after your 12 week orientation has been completed". My reply was short and sweet "thank you for getting back to me so quickly and I will do what I need to do to be at orientation on May 12th". The vacation is my brother-in-law's wedding in Mexico. The WHOLE family will be there. It is breaking my heart to not be there but I can't give up this job opportunity. I need to mention that the ED was holding a position for me until I passed the boards and got my license in my hot little hand. I feel they already accommodated me by saving a full-time DAY position for me. What more could I ask for. I keep telling myself that although I won't be in the family photos, that when my family returns, the vacation will be a beautiful memory and I will be an ED nurse kicking off my career in emergency medicine just as I had dreamed! (I'm hoping that my kids will see this as a good lesson about hard work and sacrifice and not me choosing work over them...)
This has been the most difficult decision I have had to make. My dear husband and my 2 amazing children are going off to Mexico for a week in paradise and I will be here in NJ. (at least my kids are 12 and 14 and are not toddlers - much easier to manage on his own). UGH!!!
Hey - JuneJames…I too have been hired to the ED from school straight away. I start on May 12th and have a 12 week orientation. I am scared out of my mind!!! I worked as a paramedic for 8 years but I feel so underprepared! (I do feel hopeful that I can at least tell a sick person from a not so sick person….any bit helps!!) I am so glad to hear that you love it!!! Any other encouraging words are welcomed because for the most part I've heard nothing but "most nights you'll be driving home in tears and most mornings you'll be driving to work in tears"…hmmm.
meant to type (BradS) and typed (zmansc)…by mistake (thinking zmansc was the OP). Sorry
The great thing about nursing is the flexibility and diversity it offers. I started out in nursing school, but was distracted from finishing, at first, in order to become a paramedic. I worked as a paramedic in both rural and urban settings and loved it for 8 years. I knew I wanted to go onto become an RN and many years later (almost 14 years after my last shift as a medic) I've landed my first job in the ED as a full time RN (I start on May 12th). When I went back to nursing school I really thought that I'd want to work in a department other than the ED. Turns out I am hard wired to think as an ED nurse. I guess it's my comfort zone. That's my story (for what it's worth).
).
The reason for my post is more about my husband's career path as I think it will be more of interest to you (zmansc). He started out as a paramedic with a dream of becoming a firefighter with FDNY. He has been with FDNY for 14 years and is still a medic. He is also a flight medic and going to nursing school with the hopes of becoming a flight nurse. I don't see him ever working in the hospital environment, but ya never know. He has mentioned that he really enjoyed his clinical rotations in both the neuro ICU and the CCU. He has never been cured of the "lights and sirens syndrome" (probably why his hearing is less than stellar…or could just be a co-morbidity of 17 years of being married to me
Working as an EMT while going to nursing school is an option. I don't think a patient care technician/nursing assistant in a hospital setting earns much more than an EMT (which is how many of my fellow nursing students earned $ during school….) As an EMT you'll be able to hoan your assessment skills during your working hours. Same is true if you decide on the medic route.
Whatever you decide…enjoy the ride and get the most out of each experience along the way.
Hooray! congrats am312!!!!
I took the exam feb 25th and an hour later signed on and got the good pop up….didn't believe it until this morning when I signed on (49 hours later) and it said "Pass"! it worked!!!
PVT Works!!!! I took the test at 8:00 am on Feb. 25th and did the Quick Results and It was posted at 9:03 am today, the 27th when I signed on! For those of you that are waiting the 48 hours - I feel your pain because you just won't rest until you know definitively for yourselves - I had my doubts since my computer shut at 75 questions. I cried most of the way home. Signed on and got the good pop up 1 hour later and felt some relief but STILL spent most of the last 48 hours in the bathroom. Now I can officially breathe!
Good luck to you all!!!
(BTW…I graduated on January 9th of this year. Did the 2 week Kaplan course. Finished the entire q bank and took all of the trainers. Scores were all in the 60 - low 70's range. With the exception of the Sample exam #4 - all alternative style questions which I bombed with a 43%!!!).
DON'T STRESS THE NCLEX SATA!!!!!!! If you seem to be getting them one after another - you are still in the game (my theory). At a certain point early in the exam I started praying for them…HONEST! I knew if I kept getting them then it was a good thing. 17 of them in total!!!!!
You've got this!!!!!
Thank you RNNik….you've made my day! (but yes….stomach is still rocking' and rollin' waiting for actual results).
Hopefully someone out there can answer my question. I took the NCLEX RN this morning and got the good pop up when I got home after it said "Delivery Successful". According to Pearson Vue I can get Quick Results - there is supposed to be a link in the Status box and there isn't a link. It's making me a bit nervous. Do I wait the 48 hours and then the link appears (and pay the $8 at that point?) or is the link supposed to be there from the beginning, pay ahead of time and wait for the results to appear.
Thanks for your help!!
I will also add that luckily I have no issue with working in a LTC facility or Hospice facility - age on baby boomers!!! I'm ready to take care of you...