New Job found, but would you stay???

Moogie · Jul 28, 2009

Thank you!
My last nursing instructor was the best because she was very forward. (she did use the scare tactic once. I gave colace instead of aspirin and she knew it before I gave it. scared the pants off of me. ) But when it came to explaining things she was very blunt. She would make us think without making us feel stupid. I also loved how she would ask for our powerpoints and then do a mini review after clinical. But she would do it differently, for example she would say ok book situation this, real world situation is this. She was blunt about everything, when she taught me about CBI, she would say this is important and this important. This is a short cut. When I started on the floor, those short cuts and important stuff were the things I remembered the most. Especially with me, just be forward don't beat around the bush. You don't have to scare someone to show that it is important. Just say its important! LOL but that is just me.

Thank you! She sounds like a great instructor!

whipping girl in 07, RN · Jul 28, 2009

ITA with other posters.

As far as the blood pressure med goes, you may have some parameters for holding it, such as "hold for SBP

If the nurses are nice and helpful, STAY THERE!! Read some nurses who eat their young threads for some horror stories.

kerric511 · Jul 28, 2009

Not to be redundant here, but I totally agree with all of the above. Especially if the nurses are nice and willing to help you out.

Wish I had that! My first instructor was a _______ (use your imagination)

I think my DS in bootcamp was more pleasant.

Even if you don't want to seem like one of "those" students that asks a million questions, so long as its not a critical issue (e.g. something that may endanger a patient) Post your question here. We all do our best to chip in and answer whatever we can.

PostOpPrincess, BSN, RN · Jul 28, 2009

except for not checking for 2 forms of id, i'm sorry, but i am just not seeing anything so earth-shattering that would warrant leaving a job.
furthermore, and you said it yourself, you have gotten a job on a unit where the nurses are "nice" and seem willing to help/answer questions.
it sounds like a goldmine, to me...
esp when you hear about the horror stories out there.
yes, i would stay.
and keep mental notes, for when you are on your own, and will be able to do it according to your nsg judgment.
wishing you the very best.
leslie

I think it is her (truly) first taste of the "reality" versus the ideal of school. I think she is definitely in transition and is probably getting over the initial shock of "wait a minute, that's not what I learned."

I know it's been awhile since I felt that, but I can still remember the reality transition and how much I was so overwhelmed with what I was taught in school versus what I really did on the floor.

leslie :-D · Jul 28, 2009

I think it is her (truly) first taste of the "reality" versus the ideal of school. I think she is definitely in transition and is probably getting over the initial shock of "wait a minute, that's not what I learned."
I know it's been awhile since I felt that, but I can still remember the reality transition and how much I was so overwhelmed with what I was taught in school versus what I really did on the floor.

absolutely, jo...

totally agree w/you.

but she needs to know THAT SHE FOUND A GOLDMINE. :lol2:

it's also interesting to now think of the "know-it-all-newbie" because they too, are experiencing the same type of "reality".

come to think of it, this post vs the know-it-all-newbie, is a perfect demonstration of fight vs flight, don't you think?

leslie

NurseKatie08, MSN · Jul 28, 2009

I'm curious ... really ... I don't mean to be obnoxious or anything ... but ...
What are they teaching about blood pressure these days? It seems as though almost every week we are getting questions by students and new grads who want to hold BP meds on patients because their BP is normal. The latest standards are that anything over 120/80 is too high. The "target" is to be below 120/80. Yet all these students and new grads seem to think that any less than that is a reason to hold the meds that are maintaining that normal BP.
So ... what are schools teaching to give them that impression? Are the schools teaching that you should give the meds only if the person has a higher than normal BP?

Not where I went to school...I was taught as a general rule to hold BP meds for SBP

miss81, BSN, RN · Jul 28, 2009

Moogie,

Funny, I was just thinking about the important things that I DIDN'T learn in nursing school. My husband and I often have this conversation, either about ourselves or new grads that we encounter at the hospital. He's an RN as well. Some of the things we discussed are critical vital sign values and what to do in urgent situations. Especially in specific situations like post op and MI. I remember having a post op pt with a BP of 99/60 (no tachycardia) and being terrified that he was bleeding out. That was until I had the post op patient with a BP of 70/40 and pulse 120 that really was bleeding out. Also teach your students WHAT to do in the situation so that when they finally are faced with this patient, they don't freeze. I had an awesome preceptor on the surgical floor when I was a student. He said short and sweet, "You have too watch their BP and Pulse, assess their belly for signs of bleeding, assess their LOC. Know all about they type of surgery they had and what's the norm with this surgery and what is not!" He also said, " GENERAL rule of thumb, you have a low BP or think they are bleeding here's the steps to follow... trendellenburg + IV wide open + apply pressure if appropriate + call MD + cross match and Hgb levels." I know every patent is different, but this simple explanation helped me to think critically and systematically when I otherwise may have just froze! Another thing that I remember stressing out over were lab values. What was critical and what could wait? I remember having a K+ of 3.0 and being terrified and thinking "Is my patient was going to go into some kind of arrhythmia?" We learn 3.5 - 5 is the norm. but don't know exactly what is critical...

Just some thought on what I wish I had learned in nursing school instead of Orem's Self Care theory...

Be_Moore · Jul 28, 2009

Not where I went to school...I was taught as a general rule to hold BP meds for SBP
And then you have s/p MI patients who are waiting for a cabg that you might just go ahead and give a b-blocker even if their HR is 54 and their pressure is in the 90's...because cards wants them blocked.
It's really key to know what your physicians want. Knowing your patient is even better. For example...if I know that 6.25mg of PO metoprolol can drop this one person's pressure from 160's systolic to 120's and HR from 80's to 50's, I'd probably hold it a lot sooner than the person who takes 50mg PO BID and it barely changes their pressure or HR.

beachbutterfly · Jul 28, 2009

Seriously you are exaggerating,from what you described here there are far more worse things that are going on at other facilities now as we speak...you will never work in a perfect hospital with the perfect staff...anyway BP of 114 definitely is not a reason to hold BP med...

learning08 · Jul 28, 2009

Bunnie04...I agree with the others, you may have found a good job, don't leave it because of things that really don't matter. The other nurses helpful? Orientation adequate? The commute easy? The shift OK with you? Take it. You will be basing your practice on your judgment, not on that of a nurse you briefly observed. BP meds are rarely held for SBP=114, non-narcs are not counted, and believe me, you won't be asking every single pt. every single time what their full name and DOB are before every single pill while also checking their bracelet.