Latest Comments by albsRN

albsRN 896 Views

Joined: Apr 19, '12; Posts: 11 (45% Liked) ; Likes: 5

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  • 1
    Drstrangelove88 likes this.

    It sounds like the right decision for you to get the ADN cheaply now. But I would definitely plan on getting the BSN soon after. I already know of hospitals that are requiring RN's to get their BSN's within certain time frames. Your hospital might eventually do that. Or like others have said, you may want to change jobs for a number of reasons and you'll be more likely to get interviewed with a BSN. The great thing is you save a lot of money if your employer helps you with the RN-BSN tuition. I have my ADN and am getting the BSN now and it's awesome to not have any school loans because I paid everything as I went!

  • 0

    Quote from throughaglassdarkly
    Hi all

    I am a new grad RN just beginning my RN residency as an SICU RN. I was a good student and I hope to become an exceptional ICU nurse. I greatly enjoy my unit, my managers - who have been so very positive and supportive - and my RN residency program (though it has a great deal of learning involved, understandably).

    However, I am feeling stressed out, overwhelmed, down on myself, and honestly, I am intimidated by my preceptor. She is an exceptional nurse and constantly corrects me in all things big and small - from the right way to spray cleanser on a wash cloth when cleaning a urethra with a foley to managing an Art line. I entirely respect her experience and she always has un-arguable insight and correction, however I have become so intimidated and frustrated with my self for her mulititude of corrections. By this point I feel as if I can't breath without it being incorrect, but I know I need to overcome my timidity and insecurity to prove myself to her and to be a good nurse. Adding to it, my desire to do better sometimes leads me become nervous and lose my train of thought - for example I will remember that we must zero the Art line with our morning comprehensive assessment but then forget to mention that a moment later because I am trying to keep track of everything and not let her down. I have tried to speak with her and have honest heart to heart conversations, but both times I ended up just voicing my concerns about the amount of little errors I make - which she says is understandable for a new grad in the ICU.

    Overall, I feel I connect the dots at a new grad level regarding vitals and changes in them/ how these correlate to the meds & drips/and other physiologic changes and effects. I do my very best to practice safe care - always monitoring I&O, vitals, patient changes, and med administration. Of course I am nowhere near perfect - I make many little mistakes and I need to learn how to discuss the bigger picture with Doctors and make moment by moment calls on how to adjust my drips in conjunction with the pt's changes in status (i.e. learn not to jump the gun too soon in my decision to address changes in vital signs).

    I guess what I am trying to figure out is: is it normal to be intimidated by your preceptor, to feel flawed and inadequate much of the time, and do you have any advice for managing these issues and growing into an good new graduate RN. I was good in nursing school but none of that matters now - all that matters is that I am worthy of this position & my patients and succeed. But how do I get over the anxiety and my stress I feel when I am with my preceptor and my own self-doubt?

    I want very much to succeed in this wonderful opportunity, to make my preceptor happy, to not fail out of this program, and most importantly, become a competent ICU nurse that provides exceptional care to my patients. Any advice and thoughts are greatly appreciated!!
    Yes that is exactly how it feels. I just finished a new grad icu residency and it sounds like you're perfectly describing my first month. The way I got through was by doing all the little things and big things that my preceptor instructed me to do. Eventually I was less and less anxious and my preceptors trusted me more and more and breathed down my neck less and less. You'll also meet other nurses who do some things slightly differently than your first preceptor. You'll learn which things are ok to change a bit and which are set in stone. Hang in and you'll get through it. Then comes being on your own and you'll want someone to ask all those little questions to! Like another said, try to soak it up. Also try not to take corrections as insults- your preceptor is trying to give you the best odds at being successful and she probably had someone do the same for her when she started!

  • 1
    NightBloomCereus likes this.

    It really stinks that the program would be unpaid. Of course you should make sure it would be doable to work both jobs at once, but it may be worth it if there aren't many opportunities in your area for new grads. The three months will be very hard but they will probably go by fast with how busy you'll be. As long as you don't have to work days and nights at the same time, I think you should do it- unless you have a good job lead somewhere else, don't like your hospital, or you want to work in a non-hospital job. Three months is not a very long time to wait these days. I have friends who graduated with me over a year ago who have yet to find work...

  • 1
    NotReady4PrimeTime likes this.

    It's best to get an infants apical pulse with your stethoscope. It helps if you can catch the baby while sleeping or see if parents or you can calm it before you try, then you won't have to try to listen with the crying. It's hard to count at first but you'll get the hang of it. Try tapping your finger with the rhythm of the heart beat to keep on track.

  • 0

    I think you can definitely still be a nurse. Yes, as a nurse you will do a lot of teaching/explaining to your patients and I can see how a stutter may at first come off strange (the patient might think you are nervous). But I think that if you feel like you are stuttering a lot with a patient it would be ok to say "I apologize- I tend to have a stutter" or something like that. As for my nursing school, we didn't have very many presentations except for demonstrating patient teaching mainly. Don't let it hold you back!

  • 1
    mitral likes this.


    I'm a new grad as well into my second month of orientation on a critical care floor. I know very much what you're feeling! I remember during weeks 1-3 my preceptor was the same way: at the beginning of the shift, she'd say she wants me to be in charge of stuff, take initiative and have responsibility over everything. Then it would end up with her doing most of the patient care and telling me to chart constantly! I felt so discouraged and thought I wasn't learning- I was disappointed in myself for not being able to do everything and also felt she expected too much of me at the same time.

    Now that I'm a couple of months in I realize she needed me to become very fast and good at charting. In reality you have to be able to do everything and also chart what you did well and I think it was actually good to get the charting skills out of the way so now when I do care I know in my head how I need to chart it. She was just stepping in to help, and things balanced out as time went on.

    Also, I found out that a lot of the times that I felt I was doing barely anything- turns out she just thought our pt's were too critical or complex for a new grad and she herself was stressed out caring for them. I think sometimes preceptors seem mean for taking over but the reality is that the assignment is very busy and they just know it needs to get done. Hopefully you two can have a more appropriate assignment that allows for time to teach and learn. I wouldn't complain about it to your educator yet- you've only had one bad day so far. Trust me I know sometimes our confidence is just totally shot after a shift like that but in a few days you'll be able to go in there again optimistic. Write down the drugs you didn't know and look them up with you get home if you need to. Sometimes there just isn't much time for questions. Now, if it was a relaxed assignment and your preceptor acted like that then I'd say you may have a problem there. Good luck and I hope things start to turn around for you sooner rather than later!

  • 0

    I had 25 SATA questions and passed in 75 questions. A bunch of my friends said they had about the same amount. For a few weeks leading up to NCLEX I did a minimum of 50 multiple choice q's plus a quiz of 20 SATA's per day. I used Kaplan and NCLEX 4000. Kaplan is a bit harder than NLCEX I think so I recommend it to make the real test seem easier

    My advice for the SATA's is to take each answer one at a time, consider it, and if you think it's a valid answer, check it off. Don't get caught up thinking about all the answers at once. Once you decide on an answer, do NOT change it unless you think of a concrete reason why it can't be correct. Also, whenever you get a SATA wrong, look at the rationale behind each answer and study up on that topic a bit. Who knows, you might get a similar question on the real test!

  • 1
    StephMom&RN likes this.

    I'd say the major flaw is that you're banking on getting a job as a nurse right away with no experience working in a hospital (since you are not planning on being a CNA). Without your BSN it will be challenging to find that first RN job unless you already have CNA experience. Also, as the other commenter pointed out, a 2 year nursing program is actually longer once you factor in the pre-requisites. Your best plan would be to get your nurse assistant certification over the summer after graduation. If you still want to be a nurse, do the ADN and work as a CNA through school- then you will be very likely to get a job offer after graduation and finish out the BSN with the help of tuition reimbursement/assistance.

  • 0

    I'm assuming you know the general things to do for an interview in terms of dressing right, being on time, etc. When I was interviewed for a CNA job at a children's hospital they asked the normal interview questions and then added in things having to do with how you feel about working with families and small children. It would be a good idea to think of a few stories from your experience that can show how you successfully deal with upset families, conflicts, and scared or challenging kids. Also, be sure to have something ready when they ask why you want to work at that hospital (mention some things you've read about while researching the institution).

    It sounds like you're passionate about it and already have a bunch of experience so you have a lot going for you! Good luck!

  • 0

    I agree, it's really annoying. But at the same time, it's somewhat of a compliment that so many healthcare workers wish they were a nurse lol. It's kind of like a PA telling people they are a doctor. They may be embarassed to introduce themselves to new people as a nursing assistant. When I first became a CNA I remember getting a lot of flack, even from some friends. Ex: "haha, why would you want to clean up people's S*** for a living???" However, when still in school, if my boyfriend told people I was a nurse, I would quickly correct him and say "nursing student".

    Where I really draw the line is letting a patient believe you are a nurse when you're not. Also, referring to yourself as a nurse in front of health care workers who KNOW the difference!

  • 0

    Quote from A&OxNone
    I've been wondering about a situation that happened the other day, so I just wanted some feedback. Be gentle, I'm new to almost anything pediatrics! Just started in a pediatric floor this week! (I've been in a mostly adult ER for most of my career, so we don't see many peds bc we don't have a peds unit.)

    Long story short, 2 week old with pyloric stenosis, scheduled for surgery later in the day. Had been NPO all day, however he hadnt been really eating for a few days due to the condition. He had a wet diaper at 0800, but when I checked him at 1230, he was bone dry. Got vitals, and the first time the BP looked low, so I rechecked it, and the second reading was high. This is with the automated cuff.

    So, I know in the ER and with adults, at that point I would just get a good old fashioned manual reading so I could trust it. But how/where would u do that on an infant? Same way, just a smaller cuff? Can u actually hear anything with those tiny arteries?

    Preceptor ended up calling the doc and baby got a bolus anyways, so the BP wasn't really an issue, but for the future, what do I do to know its accurate?
    Hi! I work in pediatric cardiology and it is possible to get an infants blood pressure manually. The first step is to make sure you have the right size cuff. Also, the stethoscope I use is shaped in a way that I've found fits underneath the cuff a bit. I always palpate for the brachial pulse first so I can put my stethoscope right over it. If you find you can't hear it at all, you can do a palpated blood pressure: Feel for the brachial pulse, pump up the cuff until it goes away, release, and feel for when the pulse returns. You will only get the systolic pressure but it's very accurate! If you can't even feel the pulse, this is when a doppler is needed. I always go for the doppler last because it requires two people (one to hold the doppler in place and one to pump the cuff).

    And of course, all this can be challenging with a fussy baby! With a little practice you'll be able to get them on almost any baby.