RNperdiem

Please start looking for another job ASAP. This job sounds like it has no redeeming features. The longer you stay, the more damage it will do. One or two issues you can handle short-term, but inexperience + understaffing+ toxic work culture + ineffective management + lack of support will destroy your mental health. Something terrible is likely to happen on one of your patients due to the poor work conditions, and you will have to live with that. Workplaces where people support each other exist, and you deserve better.

Were they arrested at work? If so, did they get a chance to hand off their patient assignment?

From what I have read, a big factor in early retirement is being a high earner in the early part of your career, investing a lot of that money so it has time to grow, and living below your means. For nurses who were able to take lucrative travel assignments while still early career had the chance to make a lot of money. Taking advantage of sign-on bonuses, overtime, critical staffing pay and maximizing shift differentials helps too. So does marrying a high-earner. How doable this is depends on how early you want to retire. Life is unpredictable. An expensive divorce, health issues that keep you from working, or a change in the cost of living all matter. Even if you aren't able to retire early, a healthy savings account provides security. There is a reason some people call savings their "freedom fund".

Trouble is the mixed messages nurses get. On one hand we are told that if something isn't charted, it wasn't done. We are told stories of nurses who escaped unscathed from legal troubles due to their excellent and comprehensive charting. If your hospital has had trouble with Joint Commission, then the charting hysteria really begins. Nurses charting will really get audited then to make sure you documented the exact times you held and restarted that Propofol for your Q2 hour neuro checks, and have the flowsheet documentation to follow up. Other times, nurses will get blamed for overcharting as a reason for poor time management. Before Joint Commission made a visit, there was actually a nursing committee formed to look into ways that charting could be streamlined and reduced. No changes were ever made.

This barely counts as personal disclosure to acknowledge that you know someone in common. You are fine, especially when you realized the conversation was heading into territory you wanted to avoid, so you turned things back to patient needs. When your thread listed "personal info" I imagined a tell-all about your health problems, your family drama, etc. It is an individual thing where you draw the line on personal information. In healthcare, less is more. But there are some people with certain personalities who can get away with what I would consider oversharing.

Reputation is its own currency. You might not lose your job, but becoming known as the nurse who had an affair with a pediatric patient's mother can give you trouble in the future.

EHR was not built for the end user. Data extraction, compilation and business metrics is the real goal. A nurse's time is just not considered that valuable. Doctors and other providers too deal with the demands of EHR as well.

Maybe you don't need to get married now, but you do need to protect your child's interests. Get life insurance for yourself and your boyfriend. Keep your job, and build savings. I know the job is not your first choice of jobs, but it brings in income, and in this world money means choice. Always have the means to support yourself and your child. Your boyfriend has the kind of job that is disappearing (my Dad was once a Company Man), if the company should go under, what options does he have? If his job has generous benefits, can you get your child enrolled as a beneficiary? If he has children from a previous relationship, what are his responsibilities to them? You and your boyfriends seem to be at different life stages. You want to spread your wings, explore your options and have the freedom to move to get what you want. Your boyfriend reads older- like he had done those things already and is settled in for the duration. Until your child is born and you recover, there is not a lot you can do now. Look into insurance, keep your license active and your resume updated. Finish school and prepare for motherhood.

This article really resonates. Thanks for understanding. Over my nursing career, I have noticed a decline in the staffing of ancillary staff. Orderlies and candy stripers were before my time, but I remember having way more CNA support, stock clerks, more available patient transport and free charge. When we went to computer charting, the higher management decided that we didn't need unit secretaries anymore, the CNAs could do both jobs. The nurses would do the rest. When the phone rang all the time, our new manager hired some unit secretaries again. Another factor that contributes to turbulence: open visitation.

Is the progressive care the same as intermediate care? If so, this unit has its positives. Unlike the floor, you have 3 patients (depending on where you work). When I worked the floor, I had to split care among 6 patients. Intermediate care patients are monitored, so if they are not doing well, you have advance warning of uncontrolled a-fib, low oxygen saturation, etc. The skills you learn here are transferrable to ICU and other units. The patient turnover can be fast as patients move out to the floor and former ICU patients take their place. IV skills are big, since in intermediate care, central lines are removed, foley catheters come out. The patients are often well enough to use the call bell to make needs known.

Tell a story, real or hypothetical about why accurate intake and output is important. People respond to stories. I was once a CNA, and my job was based around getting tasks done. Little thought about why we did some things, or whether some tasks were more important than others. Less critical thinking was involved. Teach them the ways intake and outputs are actually used to guide medical care, and the consequences of missing or incorrect data.

As long as you avoid university medical centers, magnet hospitals, and some big-city places, you will probably have no trouble finding a nursing job with an ADN.

I will be honest. I was looking at the cheapest and least demanding BSN. I was not looking for any great intellectual fulfillment or demands. I had enough going on in my life (husband with pancreatic cancer, two kids at home during the pandemic, job, elderly mother etc.). But, I knew in my area that a BSN mattered, and for professional survival, I needed to get one, especially as an older nurse working in a magnet hospital.

The USA is not a monolithic entity. Some places have the highly educated populations where maybe 80% BSN is a feasible idea. I live in an urban area with many colleges and universities and the area attracts people from outside who want to live here. But, the USA also has places that run rural, elderly and downscale where there are too few nurses to go around regardless of degree. I would be in favor of grandfathering in ADNs, but a part of me wonders if this can be used as an excuse to bypass older nurses without being accused of ageism.

It is amazing how time is such an important yet scarce resource in nursing. Building a patient rapport requires time. But yes, I agree with everything you wrote. In my first nursing job, I was the nurse who did little more than give medication, do essential procedures and chart. Presence, active listening were fleeting things with my crushing patient load. The lack of time to be more than a med passer destroyed any joy of nursing and burned me out in a year. I stayed late, skipped lunch, prayed for assistance of our aides of variable quality, but there was never enough time. I knew a lot of our long-term elderly patients were lonely too, and I could never give them enough time and non-medical attention.