bsngrad2be

sewon16, I hope my experiences help you and just so you know, posting here and having the support system available has really been helpful and put my mind at ease so take advantage of it. I talked to my boss yesterday and she said I have 7 more days of orientation and then I'm on my own. :uhoh21: Yikes. The only thing that made me breathe a little easier is that she said they start us 'new-bee's' with three patients by ourselves or four with a care assistant. I had a great CA on Saturday and a crappy one on Sunday. I'm not sure where to go with this because a CA with an attitude (especially because she knows you are new and completely discounts your opinion as nonsense in front of others) can break you. SO....I have to ponder this one. I can't pick and chose because, of course, that would be favoritism and I don't want that reputation. Anyway, I'm very nervous but have decided to dig in and just do it. My boss told me I'm way to hard on myself and that they don't expect me to know it all by the end of orientation. I struggle with this because I am used to being the one in charge and I am used to being the one people go to when something goes wrong. In my former career, I was ran the show. In this one, not so much. It's real hard for me to adjust to this but I'm working on it. Plus, I like this career way better so I will get better because I'm not going back to an office and four walls. As far as my 'brain', I don't have one on the computer-yet. I am using the one at work and tweak it as needed. They have very, very small columns with the standard information you give during report but on the back, I make columns for vitals, PCA information, nsg communication notes, significant events, and anything else I can think of. I do keep it to one sheet because I think carrying around to many pieces of paper is confusing but that's just me. Report for me is a struggle so I had my preceptor help me out with this. I really am very lucky. I've read some posts about other preceptors and man....I got lucky. Anyway, she has me write this on the back of my sheet too so that when I give report, I am hitting all the systems and not LIKELY to forget anything. I make a column for each pt. and it really does help me stay on track. Here's what it is: R: Respiratory C: Cardiac N: Neuro GI: gut GU: urinary issues I: skin MS: musculoskeletal DEV: developmental issues PSY: psychosocial/psychological issues (this is where the family dynamics come and in and boy do we get some interesting ones!) So, while giving report, I go down the front of my brain, turn it over, and go over this list and make sure I haven't forgotten anything. I've only been able to employ this once but it made a world of difference in report. Although I did tell the night nurse that my kid was trach'ed when he'd actually only been intubated. Just one more thing to add to my list of stupid things I said or did.

A_Simp, thanks for your post. I have a brain I'm working on too but if you want to post yours here, that would be great. I think the more information we have the better off we are. I worked this weekend and it was much, much better. I had 4 patients and my preceptor pretty much stood back and let me do my thing which scared me at first but ended up being a blessing. I used the "now, soon, at end of shift" philosophy that rbezemek posted about and it really worked well too. Another thing I did, and I suppose it's not 'best practice' but it worked, was I didn't rush around trying to document as soon as my initial assessments were over. There was nothing significant so I felt it was okay to do this. When I did my noon assessments, I documented them both at the same time. This helped too. I think I will stick to that unless something happens. If something significant does happen, I have a spot on my brain to jot down notes so I remember to document it. Things went realtively smoothly but I did have to stop myself every so often and take a breath so I didn't get freaked out because a med was 10 min late (it was actually missing from the med drawer so this was out of my control) or because I wasn't able to finish all my documentation before noon. Like I said, things went great. BUT, on Sunday just before shift change, I got a new order for a BMP that couldn't wait for the next shift!! AAHH!! Since I've only done this once, it takes me a WHOLE LOT LONGER to do it than just a few minutes!! My preceptor was great though, she stepped in just enough to ensure that we were got it done in time to document and give report. :bowingpurPhew! I love it that I can come here for support and I hope that my experience helps someone else out there. Stay tuned, there's bound to be more!

rbezemek, I really like your 3 categories of organizing. I am going to try that on Saturday. I'm already dreading the weekend. I'm trying to stay positive, but jeesh! it's hard when all you do is mess up! I think this category thing may just work for me. I just need something I can hold onto and when I start feeling that knot in my stomach I can stop and ask, is it a "NOW", is it a "SOON", or is it a "SHOULD DO BY END OF SHIFT". I really like that. Thanks so much!

Thanks for your posts. I have been thinking about what Julielpn said, and you are right, I'm not drowning, I'm new. I need to give myself a break and a little credit for the things I do right. I can't think of any at the moment (oh wait, I remembered clear before cloudy the other day so that's good--basic, but good). I do have a 'brain' that my unit provides me but I find there isn't enough room for me to write down all the pertinent stuff and on my unit that's pretty much everything. I need to tweek it a little. I just feel like the minute I make one mistake, it flusters me and then the whole day just snowballs into one big, well, snow storm. I actually emailed my NM yesterday and expressed some concerns about my performance over the weekend. She is great and called me almost as soon as I hit send. She told me not to worry that I was doing great and that they don't expect me to know everything. She also said that they would not rush me off orientation if I wasn't comfortable (it's only been 6 weeks so I have 4 more to go) and that we would revisit that when the time came. So, in the mean time, until I work again, I'm just casually reviewing the basics so I don't have to waste time looking them up. I'm also reviewing some of the posts from people about organizing their 'brains'. It's a start right.

I am a new second career nurse, just graduated in August and passed NCLEX last week. I have been working on a pediatric CICU step-down for about 5 weeks. I did my capstone (internship) on a CICU unit with adults and did great. My job started out great and I really like my preceptor. Here's my problem. I went from a comfortable 3 patient load to an extrememly stressful 4 patient load last week. It did not go well. I made stupid mistakes, got frazzled, all--yes all-- of my patients recieved their meds late. Not just an hour late, like 3 hours late and one I even had to mark missed because the next dose was already due. UGH!!! I started reading doses wrong even when they weren't. And don't even get me started on giving report-that was a horrible experience. I'm sure my preceptor thinks I'm an idiot. I am a very organized person and chaos and mayhem throws me for a loop. I have my 'brain' and I try to adhere to it and I know life happens and and you have to be ready for the unexpected, but I don't know how to do that yet and am feeling so overwhlemed. I am not sleeping, I'm crying (not at work-yet-God help me when that happens), and now the headaches are starting. What can any of you tell me to help me stay on task with my day. I guess I'm looking for a pattern of activities that allows for the unexpected without throwing you three hours off. HELP, please help. I love my job and the other nurses are great and I'm so scared I will lose any credibility I have with them.

Thank you so much. I've really been thinking about this today and I want to do the right thing for my patients as well as for my family. I had a thought that I can't get out of my head while cooking dinner of all things. If I do a year of Critical Care-which I loved and have been saying that's what I want to do pretty much since I walked through the doors of nursing school-it can only help me, if I don't, it might really hurt me. I agree that the experience will only benefit my patient and help "hone" my skills; all positive things. I'm also questioning if my interest is more the scheduling than the work and I don't want to do this for the wrong reason. I really felt like I'd made a difference in the short time I'd spent with the three patients we saw (one even told me God was looking down and blessing me for being there--I about cried). I have only my capstone left which is in critical care so I have some time. Thanks again, your input is very valuable and helpful to me.

I am going to graduate soon and thought I wanted to go to the ICU-until today. Today I followed a hospice nurse as part of my clincial rotation and loved it. Loved it. I liked being able to take the time to visit with the patients instead of rushing out of the room to get to the next one whose meds were already late. I especially liked the autonomy of it. As a Mom of three kids and a wife of a traveling husband, I'm thinking this job would be an ideal fit for my family. Here's my question though. The nurse I was with today said they do hire new grads but she would recommend that I do a year in ICU first to which I agreed. Then as the conversation progressed, I gently reminded her that I was not a 19 year old new grad (This is my second career) and that, unlike most 19 year olds, I was dealing with circumstances like kids, mortgages, husbands and that maybe I could bypass the year thing. She did agree with that. She just said that you don't get the clincial skills like IV's, cath's, hanging blood that you would get in the ICU. BUT, If I do ICU for a year then move to Hospice for the rest of my career, I would lose those skills anyway right? I'm so confused right now. This is the problem with nursing, to many optons! :chuckle Thanks to anyone who can give me some input.

Hi! We lived in Shreveport/Bossier several years ago and loved it. The food is outstanding and the people, for the most part, are very, very friendly. I had my son at WKBossier and couldn't have been happier with the care I received. Then, when he was 4 he got bit by a spider in a most inconvienient place and had to be hospitalized for 4 days at WKPierrmont. Again, superior nurse care especially the pediatric nurses. They were just awesome and truly seemed to be very happy working there. I think it was then that I really, really started considereing changing career fields to nursing. I wasn't a nurse then, nor am I now, but I am a nursing student and if I returned to the area I would feel comfortable working at any of the hospitals there as they all have excellent reputations. One of my best friends graduated from Northwestern many, many moons ago at worked at what was Bossier Med. Center (I think they are an outpatient clinic or even a psychiatric hospital now...i don't know) and liked it. She then went on to work at the VA and loved that. I think your pickings will be abundant. Enjoy Shreveport/Bossier, its a great place to live.

I LOVE KALISPELL! Unfortunately, I don't live there but my Dad, 2 brothers and sister do. My husbands job won't transfer to that area so we are in the midwest which I also love but miss my family. Have you moved yet? My dad was in KRMC last september and I was so impressed with the nursing staff as well as the PT, OT, ST, and anyone else who came in contact with him. They were all very professional and very caring. I was in A&P (am currently in Nursing school now) then and they really helped cement my decision to go to Nursing school. I hope you decided to give it a try. McKenzie River Pizza is probably the best Pizza I've ever had! Big Mountain is the best skiing I've ever done! Whitefish is a blast especially in the summer and believe it or not, their beach is pretty awesome! My family lives on Flathead Lake and I'd move there in a second if I could. Lucky you.

Hi there! I will be in your class as well! I'm very excited. Nervous about Patho tho. Did you go to the first meeting in Nov/Dec I think it was? Tim was there and he was telling us that Patho is just a little more indepth Physiology but that it's one of the most important classes so to really focus on it. I'm taking Med. Ethics as well as Christianity I the first half of the summer so focusing on it may be a challenge to me. Oh well. I figure it's going to prepare me for the chaos that is about to become my life.

I talked to a friend of mine this morning who took him last semester for Morality in Healthcare and she said he wasn't her favorite but he wasn't the worst either. She said it's a pretty easy class you just have to be there; that's his big thing. She said if you miss one class it's a zero for the day. The AO students do three "meet and greet" types meetings before we begin the program and the first one happened to fall on a night she had his class and he would not excuse her for it. Luckily, it's not required to be there as much as it is recommended but it ended up being a pretty basic meeting with most of the questions having already been answered by Leslie. Hopefully, when we do the second one in March, it won't fall on the night I have classes because I sense it will be more informative. I tried to change the Christianity I in the summer as well but it just doesn't work with my schedule. Oh well. I'll just grin and bear it I guess!

I haven't. I would really like to get on with OPRMC or Menorah if possible. I live close to both. I have a friend who is a PA and does rotations at Research and loves the hospital. Is that where you think you'd like to work? They've been around forever so they must be doing something right! Do traditional students get to take advantage of the tuition reimbursement program through Research?

I'm taking him this semester as well, Morality in Healthcare or something like that. I haven't heard great things about him either. I have heard that if you miss even one class it could drop you an entire letter grade. That worries me a little. Not that I make a habit of missing classes but life happens and sometimes it just can't be helped. BUT, I'm with you. I'm more focused on doing well in the science and nursing classes and can't be bothered with someone who has an ego the size of Texas. I am taking Christianity I this summer, with McInerny so you will have to let me know how it goes.

Good luck to you! I'm jealous. I'm so ready to be done with all this pre-req crap and get on with it! Hey, did you take any classes with McInerny (sp?) at RU? I've heard he's, shall we say, moody? Any thoughts?

I am entering the accelerated program in Aug '07! I am taking patho this summer along with Medical Ethics, Christianity I, and Human Development. I think I've lost my mind but I guess it's a good warm up for the accelerated program huh? I'm really excited about it! Are you doing the traditional or the accelerated?