One year later as a nurse, what have I learned?

[Catch22Personified]

So I've been a nurse for a year and I still cannot shed the new nurse title just yet but I came up with a few things that I have observed over the first year when it especially came to changes. The stuff is probably going to be either ok with you guys or I'm gonna get my head bitten off.

• I still hate calling doctors if the patient isn't looking like they are going to be sent to the ER (I work 3rd shift)
  
• My Clinical Instructor was so right that I was not ready to go out on my own upon graduation and that my best bet was to find a preceptor that would take me under their wing. One of my preceptors ended up being a family friend that treats me like her own son.
  
• Being liked by your coworkers makes things a lot easier.
  
• This may start a shift war but, I really feel like 2nd shift has it the worst. They get the admissions and phone calls. They have no charge nurse and their nurse staffing ratios are closer to 3rd shift's.
  
• I know customer service is very important and all but I have patients that are just flat out liars. I used to pay heed to every word a patient said, and I would waste time trying to please them. I actually spent 20 minutes looking for a specific order when I was new because a 350 pound patient that eats said he was allowed Jevity 1.5 shakes only to find in the physician progress notes that "All supplemental feedings should be kept away from patient, due to manipulative behavior and recent weight gains."
  
• I can see why my pay is so horribly low sometimes (key word sometimes), the amount of indigent cases our facility has been getting has been extremely high. How is the facility supposed to pay us if most of the patients that come to stay end up not paying a dime?
  
• Long Term Care is indeed soul crushing. I've had moments where I have indeed snapped at a patient due to the nature of the stress. (See 350 pound patient's manipulative behavior)
  
• My mom is right that I can't stay at the floor forever. I just can't imagine all this bedside drudgery for the rest of my life. (Sorry to all those bedside nurses that love doing it)
  
• I honestly like taking the leadership role if given to me, it feels weird when you've only been there for less than a year and people are already asking for your help.
  
• RN vs LPN doesn't really matter especially if they are more experienced than you. My 2nd shift regular nurse is an LPN and she is fantastic to work with. We just have different approaches and ideas to care.
  
• Why must I be a patient's punching bag? I got in trouble when I responded to a overhead page about a patient being violent and punching people in another floor. Everyone was afraid to get near the patient to give the IM Ativan. So I decide to put the patient in a wrist lock while another nurse gives the med. Administration thought that was excessive and I got warned about it.
  
• Whoever invented the call bell should be dragged out into the street and shot.
  
• Everytime I see an order for a bed alarm for a patient that is capable of walking own their own, I die on the inside.
  
• Vancomycin is a first line drug for everything! (Hey Doc, maybe you shouldn't repeat your 12 week order of 500 vancomycin 250mg 4 x a day again if the patient's C.Diff and UTI isn't going away) I'm serious it seriously is the most common antibiotic I see.
  
• I still hate "poop". I every once and a while have Bob Saget's reaction to the stuff from Dumb and Dumberer.
  
• I think nurse's notes are incredibly repetitive and have so much fluff. Is it a wonder why no one reads them except when we get sued or investigating us. I can seriously write a PAGE of a 3 minute encounter of a patient who was sleeping peacefully.
  
• Just because I'm a guy doesn't mean I'm your personal hoyer lift. I ended up responding to a nurse's "code" and all it ended up to be was one of her patients on the bathroom floor, still conscious. All she wanted was for the other nurses to put him back to bed for her. When I left she said: "Thank you ladies so much!" Hello? I was there too lifting your cow of a patient and you didn't even help!
  
• The nursing shortage is bull. The only shortage is, fools like me that are willing to deal with the risks.
  

And that's all I have at the moment

[bookworm78910]

"...Sometimes what gets me is when my aides try to get on my ass about call lights. REALLy? I will answer as many as I can, I don't mind, BUT not while you sit on your butt! I also have a job to do! I know I don't have to explain my job here, but it seems as I they think my only job is to sit and scratch my behind all day! But it's not, they fail to realize that when they leave after report, I'm still there dong what couldn't get done!"

I never mind answering call lights either, but you're right: our nursing duties are higher priority than making sure a res. has water or their favorite pillow, etc. While I was working LTC, I never quite got good enough at it to actually sit down, much less pick my butt. 2nd Shift is very hard in LTC, and I have a lot of respect for the nurses and aides who are so good at doing it. With 1 meal and 2 med passes, I was often staying over charting for an hour or two after my shift ended..without answering many lights. Plus, it seems like if people are going to die or fall, they tend to do it in the evening when there is shorter staffing. LTC is very hard work, but in our area, it actually pays as well or a little better than clinics, and about the same as the hospital.

[OR-RN in Colorado]

Try operating room nursing. It feels safer because you can focus on one patient at a time. You rarely encounter a "code brown" and if your patient is a particularly difficult one, they'll be asleep soon anyway! You still get to work with patient's and families, providing education about their procedure and recovery. You still get the nursing piece with assessments and medication administration while also learning new equipment and technology constantly. The personality of an OR nurse or a surgeon is usually very direct so you can't be too much of a softy for this area but I have found it to be a challenging and rewarding specialty.

Good luck!

[MombearNurse]

Wow! You hit the nail on the head with ALL of your points! I also work in LTC although we are about 50% rehab as well. I just have 6 months experience due to the 6 months it took to find a job in this glutted field. I am fortunate enough to work the evening shift (2-10). I love it, even with the admissions and more phone calls to the physicians. Some days I feel like I'm missing out because I didn't find a job in acute care, or I wish I had a 3-day work week... but in my case, I really love my job and I truly hate the idea of having to be put through another interview. I actually think that if I were to have to leave this facility, I may even leave nursing altogether. I do hope I get over this way of thinking. Maybe I will feel better about interviews once I have more experience and try to network along the way. :)

[PRNketamine7, BSN, RN]

Love the comment about the call bells. I hear them in my sleep.

[cindyloowho]

I think you have a lot to say after only one year of nursing experience. I hope you find a job that suits you better. I think you sound like someone who has been a nurse for one year and already knows everything there is to know about everything...nursing and otherwise.

Lighten up, he's just venting. I'm sure he's a wonderful nurse and I can't imagine that you haven't felt this same way on many occasions about many of his gripes. And if you haven't, then I'm sure you are in the minority. Bedside nursing is hard work. It never hurts anyone to vent and have a sense of humor about things.

Comedians make most people laugh and often times it is by being crude, or crass, or making jokes about things that most of us dare not say on the street for fear of getting shot. But they can sit on a stage and suddenly we all laugh. That's because humans can appreciate the need to not always be perfect, or PC, or good and holy.

And besides, you can form opinions about your work even if you've been at it for only a year. Yes, he will know more in a few years but that doesn't mean that what he knows and feels now is wrong or that he should keep his brain shut off about his thoughts on life as he knows it now.

To the OP: your post is funny and I laughed out loud about the Bob Saget and call light comment :-)

[VivaLasViejas, ASN, RN]

I wouldn't want to dismiss what the OP has to say because he "only" has a year of experience. I'm a grizzled veteran of 15 years and agree with much of what he's said here. Besides, it doesn't really take very long for a reasonably bright person to catch on to the BS in nursing, and you either make peace with it and carry on with your career, or you leave. :)

[on eagles wings, ASN, RN]

my faves

• Whoever invented the call bell should be dragged out into the street and shot.
  
• Everytime I see an order for a bed alarm for a patient that is capable of walking own their own, I die on the inside.
  
• I think nurse's notes are incredibly repetitive and have so much fluff. Is it a wonder why no one reads them except when we get sued or investigating us. I can seriously write a PAGE of a 3 minute encounter of a patient who was sleeping peacefully.

[Epic_RN]

Love the Android AN app, just wish I could figure out how to "like" posts on it.

OP, I can relate to every item you listed and I've only been a working RN for 2 months!

I was actually contemplating posting a thread of my own on the reality shock of actual bedside nursing vs nursing school and how disillusioned I've become in only 2 short months, but after some of the responses I read on here, I'm hesitant to.....

[bratmobile]

haha,, you would hang yourself at our facility... our call bells play very loud songs at the station,, each room has it's own song,,songs such as..La Cucharacha, Happy Birthday, Twinkle TwInkle Little Star..I mean sooo loud .. LOL

[dudette10, MSN, RN]

Love the Android AN app, just wish I could figure out how to "like" posts on it. OP, I can relate to every item you listed and I've only been a working RN for 2 months! I was actually contemplating posting a thread of my own on the reality shock of actual bedside nursing vs nursing school and how disillusioned I've become in only 2 short months, but after some of the responses I read on here, I'm hesitant to.....

Don't let some of the responses stop you. Most people realize the truth of the statements without criticizing the length of experience. I do think, however, that these things don't bother long- term nurses as much as they bother the newbies because the experienced nurses have become inured to these realities.

[AtomicWoman]

Yep, so much of what you say is spot-on. And lordy, I did always feel for the 3-11 shift when I worked at a facility that had 3 shifts. They were always getting stuck with admissions. One of the reasons I am glad I am not in bedside nursing and am back in school is that I began to feel like a "pill pusher". Get in at 7, take report, start med pass. Literally RUN up and down the floor getting through that first med pass. Finish. Do a little charting. Do noon med pass after doing Accuchecks. Do my treatments. Do a little charting. Get the 5 PM med pass done after doing Accuchecks. Give report to incoming nurse. Stay to finish charting. I guess it depends on how many patients you have, but in subacute and LTC (especially LTC) the med passes are endless.

[Horseshoe, BSN, RN]

Try operating room nursing. It feels safer because you can focus on one patient at a time. You rarely encounter a "code brown" and if your patient is a particularly difficult one, they'll be asleep soon anyway! You still get to work with patient's and families, providing education about their procedure and recovery. You still get the nursing piece with assessments and medication administration while also learning new equipment and technology constantly. The personality of an OR nurse or a surgeon is usually very direct so you can't be too much of a softy for this area but I have found it to be a challenging and rewarding specialty.

Good luck!

That's a very diplomatic way of saying it.