GrumpyOldBastard

You are not alone. It took me about 16 years to find the right nursing job. I then put 22 years in there! If I had paid attention, and let go of my ideas of what I “should” do versus what I was good at and enjoyed…. I would have been a lot happier earlier. Of course, battling depression every day (since my teens) didn’t help me make good job choices. I learned that it was absolutely OK to admit that some of the jobs that I thought I “should” be good at… I absolutely hated. I learned that for me… having my time was more important than making lots of $$$. So I accepted a lower annual income… to enjoy huge amounts of time off (with benefits). I found that I could make a positive impact on nurses and patients doing what I love… not doing what I “should” do. I learned that the setting/context can make the same patient population either a good experience or a living hell. I learned that the modern American hospital is fundamentally a toxic place for nurses. There are exceptions… but overall, hospital work is becoming more impossible every day.

Unfortunately, this is sometimes reinforced by mis-guided faculty: “With a BSN you will be the manager.”

I agree with most of what you say! In my years as an instructor in an Associate Degree nursing program, I saw many smart students who chose a path very similar to what you propose. These were students who could have attended a generic BSN program, but chose to attend our ADN program to get lots of clinical time and emphasis, and follow that with an online RN to BSN program. In many cases they were able to get their employer to pay for the ADN, and in most cases they got the boss to pay for the BSN. These students felt that this allowed them to get “the best of both worlds”… given the options that they had. It is true that decades ago the diploma program students often were doing essentially all of the RN job and RN workload before graduation (under supervision). I would argue that the increased acuity and complexity of care for the majority of inpatients today makes this a less reasonable goal. Certainly some modern students are able to take on a large portion of a nurse’s role and load… but the vast majority of students are not.

As a general rule, I find students who are skilled at the dimensional analysis (aka: unit cancellation or Chemistry approach) approach to drug calc are the most comfortable when faced with complicated dosage problems.

Shampoo the carpet in your home. Do it now..... you won't have a chance to do it after school begins. The above suggestion is half in jest, and half quite serious. The meaning of that suggestion is to do NOW any nagging, "important, but not urgent" tasks that will drive you bonkers if you can't do them once school begins. Spend time with the ones you care about. You are likely to be surprised at how difficult it is to carve out time for "non-essential" activities, like sitting with friends and family. Take a reading skill assessment and remediate if you score lower than "Rock Star"! It is hard to express persuasively how important high-speed high-comprehension reading skills are for study, clinical, and EXAMS. Put your ego aside for a moment... find an assessment and take it. If you crush it... no big deal. If you discover that your reading skill isn't as good as you believe it is... fixing it now will be a HUGE step forward. Having a previous degree does not guarrantee that your reading skills are excellent. Watch this video: This video describes HOW to apply metacognition to your classwork to help you achieve mastery (and great grades!) https://www.kaltura.com/index.php/extwidget/preview/partner_id/245942/uiconf_id/19789012/entry_id/0_i04vfe2l/embed/auto?&flashvars[akamaiHD]={"loadingPolicy"%3A"preInitialize"%2C"asyncInit"%3A"true"}&flashvars[twoPhaseManifest]=true&flashvars[streamerType]=hdnetworkmanifest

What an interesting and important question! I suspect that the answer is multi-factorial: 1. It is quite clear to me that the pandemic has impaired the learning experience for many students. However... I don't think that is a complete explanation. 2. Some schools are seeing a rapid loss of senior faculty members. While there are both good and bad faculty members leaving... The loss of the good ones and the loss of their ability to mentor the newer faculty is significant. In good schools, the more senior faculty play a HUGE role in developing new faculty (especially new faculty whose graduate education was exclusively clinical and lacked "how to teach" content). One of the faculty activities where senior faculty often help junior faculty the most is with developing fair and effective examinations. Building fair and effective exams is NOT easy! 3. Nursing schools have been pushed to increase enrollment to adapt to the coming demographic nursing manpower crisis. This demographic crisis existed LONG before this pandemic. The boomers are retiring and becoming patients... and the number of new nurses has been insufficient for a long time. The result of this increased enrollment is that students who previously could not compete effectively for admission are now in nursing school. In the last few years, my peers and I have been shocked to discover how many students lack fundamental learning skills necessary for success in school. The most glaring example is the MANY students whose reading skills are weak. If you are interested in reading more about this reading issue... see this article about the SATIN project. Donnell, W. M., Walker, G. C., & Miller, G. (2018). Statewide At-Risk Tracking and Intervention for Nurses: Identifying and Intervening With Nursing Students at Risk of Attrition in Texas. Nursing Education Perspectives, 39(3), 145–150. There are likely other contributing causes too. While any ONE of the three that I have listed could create a difficult situation... the combination of all three can result in REALLY, REALLY poor student performance.

Interesting. 1. If during the first semester of PRE-nursing, you had any contact with the Dean of the nursing program... that seems worrisome to me. The fact that you expect support from the Nursing Dean when you aren't even a nursing student is odd in several ways. First the Nursing Dean is responsible for NURSING. If you aren't yet a nursing student, you probably aren't the Dean's responsibility. Even if you ARE in the Dean's scope of responsibilities, it is quite unlikely that you should have any contact with the dean.... unless you have exhausted getting help at all the subordinate levels (faculty, department head, etc) 2. At most schools the advisor's job is to help students select the proper courses to meet their stated goals. If you met with your advisor twice in one semester, you probably got WAY more contact than most students. Again, you seem to be expecting support from the wrong people. 3. A professor who did not supply study guides? What is the problem here? That is perfectly reasonable behavior from a prof. You may not like it... but it is well within the authority of the prof to decide to provide study guides or not. Again, you are expecting support that is not owed to you. 4. "I get singled out for not knowing the how to do something right away." Well, the cure for that is to come to lab PREPARED. If you have read the assigned material and used the internet to fill in any gaps (perhaps even watch a task video or two).... you will be FAR more likely to thrive in ANY class! 5. "I don't feel like anyone actually cares about my education but myself." No one should care MORE about your education than YOU. This may be a shock... YOU are in charge of your education. TAKE CHARGE of it! Stop focusing on how others are supposed to support you... and focus on taking control of your education.... PREPARE, STUDY, WORK REALLY HARD. This tool might help you take control of your education: McGuire, S., & McGuire, S. (2018). Teach yourself how to learn: Strategies you can use to ace any course at any level. Sterling, VA: Stylus The video linked below is by the author of the above book. After watching this video I have had many students say: "Why hasn't anyone told me this before?" https://www.kaltura.com/index.php/extwidget/preview/partner_id/245942/uiconf_id/19789012/entry_id/0_i04vfe2l/embed/auto?&flashvars[akamaiHD]={"loadingPolicy"%3A"preInitialize"%2C"asyncInit"%3A"true"}&flashvars[twoPhaseManifest]=true&flashvars[streamerType]=hdnetworkmanifest

OR and ICU? That is an unusual pair of choices! Usually the folks who are temperamentally inclined to OR are NOT interested in ICU and vice versa. I fear that you may not be clear about the realities of those settings, or not being honest with yourself about your strengths and weaknesses. Good Luck!

1. Rose_Queen is correct. 2. "I am looking to move to other states, but I do not know where to start and so far I have no leads. I'm looking to the southern states such as TN, TX, FL, NC, or SC. Also neighboring midwest states such as WI, IA, MO." You have SO MANY options. You might start by making a few decisions to help narrow your search... pick a specialty you are interested in OR pick a place you want to live. The decision does NOT need to be "forever" but simply a way to manage your hunt. Your geographic list is remarkably diverse... WI, IA, TX, and FL... apparently climate isn't a big factor for you! 3. The Nurse License Compact can take a lot of pressure off the decision about "which state should I license in first". https://www.NCSBN.org/nurse-licensure-compact.htm

I forgot to mention a humorous trick that I use to manage my time and effort in retirement: I strive to do ONE "adulting" task each day. At first this seems silly.... "Why stop at one when you could do more?" Well... because I am retired. I can balance getting chores done with enjoying life far better when I set my goals LOW. Certainly there are days when I do more than one "adulting" task, and others when I do none. But when I start to feel like I haven't done enough, I ask "Did I do ONE adult task today?" If the answer is yes... I exhale and enjoy the rest of my day!

Not dealing with this until after the end of the semester is a HUGE mistake! If you had addressed it at mid-semester, administration could have tried to steer the professor toward a more effective path. Waiting until the end, you are now putting the college in a bad position, where their options are WAY more limited.

Scared? What is there to be scared of? Gather round, the GrumpyOldBastard has a story to tell: LONG AGO and far way, in a time before cell phones or standard precautions, I applied to my "ideal" BSN nursing school. The program was closing their BSN program to focus on graduate nursing education. I applied for admission to the LAST class to be admitted to this program. I didn't have all of my pre-req courses completed, and as a result I was not admitted. There was NO second chance, as the school was closing. How did that work out for me? Was that a disaster? Did I end up following a dreary path of professional marginalization due to this failed application? NO! NO! NO! For the next semester I applied to FIVE schools across the state. I got admitted by several... including my preferred school. My career worked out OK.... I got good clinical jobs, a graduate degree from a famous school you would know by its initials, I served as president of a national specialty nursing certification board, taught nursing for decades, got a second masters in a related health field, served in the Navy Reserve Nurse Corps (at home and overseas, in peace and in conflict), and retired in Spring 2021. There is noting to be scared about! Good Luck!

Yes, I bet that you can get "a job" as an RN after completing that program. HOWEVER.... it may not be with a desirable employer! As mentioned by the reply above.... the REAL trouble is that you may find yourself stuck in a dead-end situation regarding education. More and more employers seek a BSN for all RNs. It is VERY likely that RN to BSN programs will NOT accept you as a graduate of that program without additional preparation. Yes, the current "shortage" of RNs may open some previously closed doors... but when things settle down after the pandemic, it is likely that many employers will return to desiring BSN degrees. It is also important to ask "Why is the program not accredited?" I suspect that the program is weak. You are likely to be unhappy about your experience there. A few years ago a local proprietary nursing school closed suddenly. My school admitted many of those students as transfers. They were AMAZED at how different our well-established community college nursing program was compared to their previous program!

Completely off topic: This thread made me smile... I graduated from CSU Chico's nursing program 40 years ago! "worth it to apply".... Of course it is! The ONLY guarantee is that you will NOT be admitted to schools that you do not APPLY to! Chico is a great school and a great community... it is well worth your time and application fee to TRY! Good Luck!

If you work in TEXAS, using the "Safe Harbor" process would DEFINITELY be an appropriate response to this situation. Safe Harbor protects YOU directly, by protecting you from some employer and board of nursing sanctions. Safe Harbor protects patients indirectly, as it lights a fire under management to fix the situation. "Safe harbor is a process that protects a nurse from discipline by the Board and retaliation, suspension, termination, discipline, or discrimination from the employer for invoking safe harbor in good faith. [Board Rule 217.20(a)(6) & (a)(15); NPR Law §303.005(c)]" https://www.BON.texas.gov/pdfs/safe_harbor_forms_pdfs/GeneralInformationAboutSafeHarbor.pdf

Welcome to retirement! I retired in May 2021. I too, had a sense of "Who will I be?" as I anticipated retirement. Like you, my social network outside work was really small. I have found that it is just fine! I found a volunteer organization that has a good "fit" for me (US Coast Guard Auxiliary https://join.cgaux.org/). I work to maintain contact with key previous co-workers. It felt weird at first... but it is fine. "Come on in... the water is fine!" ?

Interesting. How was your school dishonest about nursing? What do you wish they had said to you? In my experience as a nurse educator, I have found that MANY students don’t believe me when I attempt to explain the ugly realities of being a new nurse.

I have mulled this over much since my first comment above. There are at least four ways to "Hate" nursing: Hate "Nursing" as a whole. Hate a nursing specialty (med/surg, ICU, ED, peds, onc, etc). Hate a setting (acute hospital, outpatient, home health, etc). Hate a specific workplace. It is critical that we understand that each of these is different. Just because a specific workplace is hell.... does not mean that all workplaces are hell too. Just because a specific setting is hell, does not mean that all settings are hell. Just because one specialty is hell, does not mean that all are. I have seem many folks hate a specific workplace and then say (incorrectly) "I hate nursing!" Until you have tried various flavors of nursing... you can't really determine that you hate all of nursing. I am retiring this month after 39 years as a nurse. My last job was wonderful and lasted 23 years.. the job immediately preceding it was a soul crushing nightmare. The trick for me was to be honest with myself... I needed to stop doing a job that I thought I "should" be competent at... and instead do what I was happy doing. A key lesson for me was that different nurses excel in, and are happy in, different situations. Other nurses LOVED the job that I found to be a soul crushing nightmare. Similarly, the job I really enjoyed... many others say they could not do! It took FAR too long for me to let go of the idea that I "should" be good at nursing jobs that I hated. Nursing is a BIG world.... hunt for your niche. I wish you the very best!

Not all nursing is inpatient acute care. Lots of us don't want to do that! Find a setting that works for you. Good Luck.

An employer may not care if the allegations were true or not. It may simply be that you were too much hassle to have around.

BRAVO for asking for help! That is SO IMPORTANT! Get a psych evaluation promptly! There is much that can be done to help you. You are far, far from alone in your situation. There are thousands and thousands of doctors, nurses, pharmacists, physical therapists, and others who suffer from similar mental health challenges. If they can be successful in school and effective in the workplace... you can too! As nursing instructor I have heard stories like yours many, many times. The successful students are those who seek help and who follow the prescribed plan. On a personal level, I admire your reaching out for help early in life. I “toughed it out” with my depression from my mid-teens until I was 52 years old. The quality of my life is SO MUCH better since I got treatment! Good Luck!

Based on what you have reported, I think you have mastered the content. However, it appears that your emotions are the biggest threat to your success. Pick the emotional control tool that you find works best for you: meditation, visualization, cognitive behavioral therapy, prayer, etc... and use it twice a day, every day between now and the exam. When you get your emotions under control, you will do just fine on NCLEX. ?

I have been teaching nursing for a long time. I teach in the last course of an associate degree program. It might surprise many students what I am REALLY looking/hoping for in clinical. You may think that you can find it listed in the course objectives or the clinical evaluation tool. Nope. You may think that it is something that I want you to say or do. Nope. You may think that it is a perfect care plan or paper. Nope. What I most want is for the “light to go on”. That is a phrase that many faculty use to describe the moment when a student understands what nursing is and what the role of the nurse really is. Once a student understands this… everything else will fall into place for them. Until this occurs, students often see everything in nursing school as mere obstacles or busy-work… not as having purpose. This awareness occurs at different times and different ways for various students. Students can have different responses to this awareness too. The good students often seem to be more confident and at ease after the light goes on. They know that there is much more to learn… but they understand why and are eager for it. Some weak students find the awareness to be frightening. I remember one student who had “floated” through nursing school. He had done the minimum required, and had promptly forgotten what he had learned. When the light went on for him… he was terrified at the enormity of the responsibility of a nurse, and lamented that he had wasted so many opportunities in nursing school. I don’t have an easy way to accelerate this process of becoming aware. Certainly more clinical contact with patients is helpful. Thinking deeply about the patient’s situation and the care needed will move students along. Watching really good nurses in action can be really helpful. Sometimes asking experienced nurses “What do nurses do?” is helpful. Often it takes a combination of the above and a dose of luck for the right situation to trigger the awareness. Do you remember the moment that the light went on for you? Tell me about it. If you are faculty, do you have any interesting stories of the light going on for your students? Smile, Breathe, Relax.

1. Many Nursing schools in Texas are quite competitive too! However, the state has set up grants to pump money to nursing schools that increase enrollment. If you can find one of those schools, it might be easier to get in! 2. You may want to meet the requirement to be classified as a TEXAS RESIDENT, if you intend to attend a state funded school. “Out of state” tuition is much more expensive. Good Luck!

Welcome to where the “rubber meets the road”.... the bedside! I absolutely agree with all the “DO IT!” suggestions already offered. That behavior is good for all of the obvious reasons... and for a less obvious reason. While there is no doubt that your instructor has a huge impact on your clinical experiences.... so do the staff nurses. If the staff nurses like you, and see you as well prepared and eager.... THEY will connect you with opportunities that your instructor may not know about. (Caveat: “DO IT” is within the limits set down by your instructor and the institution. I am advocating courage... not recklessness.) When I was a student, I found it useful to write out a 3x5 card with the assessments that I needed to do for a specific patient... I could take that to the bedside and use it to keep me from missing things. When doing assessments remember: “If god didn’t put it there... you are responsible for it.” In other words, your assessment is NOT limited to the patient... but includes ALL the equipment attached to the patient too! Pull back the covers and LOOK. It is very common for nursing students to be uncomfortable pulling back the covers and REALLY looking at the patient. Unfortunately, there are a great number of bad things you will miss if you don’t look there. Remember: “As a nurse, you have the authority and responsibility to look where Momma taught you not to look!” (Of course, you do this in the context of providing privacy and asking the patient for permission.) Remember that a huge part of a nurse’s job is to prevent, detect, and intervene to prevent REALLY bad outcomes. As you think about your patients, ask yourself... What are the really bad things that could happen? What can I do to prevent them? How would I know if they are happening? What do I need to do if they happen? Knowing what your school’s reputation is among the staff can help you understand their response to you. For example, there is a school in my community that has a reputation for most of their students being quite clueless and useless at the bedside. As a result, the strong students from that school have to fight past that reputation with the staff. Knowing that can better prepare you to understand the situation and overcome it. Put down the clipboard! There is one behavior that often telegraphs a whole set of the wrong messages to the staff...... holding your clipboard to your chest with your arms folded across it. Having a clipboard may be OK.... using it like a shield makes you look scared and useless. Perhaps a story will help put the above in context: My wife was a nurse in an inpatient hemodialysis unit. As you can imagine, it was really busy. As a result, she didn’t have time to mess with unprepared, scared, or useless students who were there for an observation experience. She used to give students about 60 seconds to show “signs of life”.... if the student was engaged and eager, she would bring them into her activities. If the student was unprepared, scared, or disengaged... she would move the student aside and carry on without them. You might wonder: “How can I show “signs of life?” Simple, put down the clipboard, and ask: “How can I help you?” Understand the value of asking GOOD questions. You can’t know everything. Nobody expects you to. However, we do expect you to TRY to learn. Sometimes we know that things are confusing and if you ask about them... we know that you tried. For example: If you were with my wife in the hemodialysis unit and she said “What do you know about hemodialysis access sites?” If you say “I don’t know”.... that is not a great answer. On the other hand, if you say “I am confused about the difference between an AV fistula and an AV graft.” That is a GREAT answer! How can it be a great answer if you are saying that you don’t understand? The reason is that you obviously TRIED.... or else you could not have asked such a great question! (The AV fistula and AV graft are similar and easily confused by the novice.) In other words, often your questions tell us that you tried or you did not! Another hemodialysis example regarding access: You say: “I have read about assessing the bruit and thrill... but I don’t really understand.” It is VERY likely that at that moment (time permitting) you will be dragged to the bedside and shown what those are! You would be amazed by how much staff are willing to invest in in you..... IF you show interest and are trying to learn. Of course, the best questions go beyond “What” into “Why”..... “If an AV fistula is so desirable, why would a patient have a hemodialysis catheter?” BINGO! That sort of question is GOLD! Understand the first hour. Many students find that staff can be abrupt and unfriendly during the first hour of the day. Why is that? There can be many reasons but some key reasons are: Feeling a need to get organized before getting behind with tasks. Feeling an urgency to see all the patients and determine that they are not trying to die. Feeling an urgency to check a zillion things in the patients’ rooms. An example is identifying any IV bags that are almost empty. Acute caffeine insufficiency. Often staff are more approachable and friendly after they get through those immediate tasks at the start of the shift. GET A GOOD NIGHT OF SLEEP BEFORE CLINICAL! EAT A GOOD MEAL BEFORE CLINICAL! SMILE, BREATHE, RELAX.