PAnurse94

Hello, I am a new nurse (6 months experience) working part time in a hospital on a tele/ICU overflow unit. It is very busy and I've learned a lot. This hospital network is HUGE, I have amazing benefits (at part time) and the hospital is literally 2 minute drive from my house. There is always an opportunity to pick up extra hours. However, I have had some major issues especially recently. I posted about this on here a few weeks ago - basically, to keep it short, there are tons of safety issues that I am seeing and even being thrown in the middle of. I am seeing patient's safety being compromised due to cutting costs by cutting staffing, and tons of burnt out nurses/management not handling situations appropriately. I am being stretched extremely thin, given 6+ patients (when most of them are critical, on drips and such), dealing with patients I've never had before (example: i gave my first blood transfusion on my first week off orientation, told my manager and 2 other nurses i never did it before and needed help, had SEVEN patients that day - the blood transfusion patient was critical as well as 4 others and then the other two were non critical tele patients. Long story short I basically ignored my tele patients, half ignored my other critical patients, rushed the transfusion but whatever time I had was spent looking up information about it so I didn't harm the patient. It was EXTREMELY unsafe and I drove home sobbing). I also got punched in the chest about a month ago by a combative and confused patient who had his 1:1 d/c'd because of management cracking down on physicians to cut "unnecessary costs" and I had this patient 2 days in a row, and this was on the 2nd day. I told the physician multiple times as well as my manager that this pt needed a 1:1. There was also no nursing assistant (there hardly ever is) and none of the other nurses had a second to help me, so every time I went in there I was alone and he was throwing things at me, spitting at me, refusing things. I did my best to be patient and kind but at one point he was going to fall, I was holding him steady so he didn't, I called for help several times (pulled the call bell out of the wall and the secretary verbally told me she was calling every nurse and my manager to come to the room ASAP) and it took about 5 minutes before anyone showed up. By then I had been scratched, hit across the face, spit on, and punched in the sternum. I ended up letting go of him when he punched me, unintentionally, so he fell anyway. On top of that, the way management treated the situation was horrible. I had to go see their doctor to be cleared for work. I wasn't cleared initially because I had fluid in my lungs from not taking deep enough breaths because I had some pain still, and then they kept me out for a week and then cleared me and I went back. I was written up for an unexcused absence (which I am fighting) and employee health/HR/management is all claiming that I was cleared for work at my initial visit. I have a paper from every visit, dated, signed by the doctor, stating whether or not I was cleared. I've sent them this multiple times and they just ignore me. I have called, emailed, gone in person, they will not fix it. I also didn't get paid for that entire week. Apparently if it's injury, they pay for it (which they said they're not because it was "unexcused") otherwise it should come out of my PTO, which I have. But they just didn't pay me at all. It's so frustrating. I am in a constant battle with them daily over this. Anyway, I know I need to get out of there. I am interested in moving toward pediatrics anyway, and hopefully out of the hospital setting, or maybe just keeping a per diem hospital job on the side of another job that is more my speed. This is where I need advice. First - part time vs full time, the job I have now, and benefits. I am in school online for BSN, also planning my wedding which is in 10 months. My fiance works full time and he suggested I work part time with the opportunity for extra hours so that my schedule is more flexible and on busy weeks with school and wedding-related events or appointments, I can just work my part time hours. This works great with the job I'm at, but since I am trying to get out of there, I'm unsure what to do if I find a new job. Ideally I would like to find somewhere else part time, and then maybe try to move to per diem status at my current hospital just because it's close and always has shifts open to pick up. But then I wouldn't have any benefits. I also don't know how to work it with the timing of getting a new job and leaving or changing status at this one. Do I try to find another full time job and then quit this one completely? Should I wait it out a little bit and try to transfer somewhere else within my current network, staying part time? This location, while the closest, is relatively small, but I could work somewhere else within the company, even their home care system, probably in or around my area. My company doesn't really have pediatrics, though, and I wanted to try getting experience in that area. So, should I go for a full time job for the benefits and quit this one? I don't want full time PLUS per diem plus BSN and wedding planning... that would be too too too much. Full time and Bsn and wedding planning is already stressful to think about, but if that's what I have to do, I'll do it... My fiance suggested starting off per diem at another job to see if I like it, and keeping this part time hospital job for now (it's two 12's a week so I have 5 days off if I don't pick up any hours) and do all of my other hours at the new per diem job. Then, maybe after a month or so, see if I can switch to full time and get benefits at the new job, if it's working out well for me, and at that point I can completely quit this hospital job. Second, types of jobs - for the places that will take me with just 6 months of exp and an incomplete BSN - I'm looking into home care (pediatrics), same day procedure/pre op and pacu (i'm not sure if I can get this but someone recommended since I have that little bit of critical care exp), and some outpatient pediatric places.. I'm also considering some facilities I did pediatric clinicals at that are anywhere from 20-60 minutes from my house...I did enjoy those places, and might enjoy them more? Down the line (just keeping this in mind), I'm thinking I would like to get my school nurse certification and become a school nurse, with a per diem hospital or home care job on the side to even out the income (since school nurses tend to make a lower amount) or take summer jobs like camp nursing or even home care, and when I have kids, I can have the option to drop the per diem or summer job if I want to take the summer off. This is why I'd like to get into pediatrics now for some experience. I always loved it the most in clinicals. Advice would be appreciated! I have an interview today with a peds home care company in my area offering per diem, part time and full time. I am hoping to get some feedback from you guys should they make me an offer in the next few weeks, and also for any other interviews I might get. I am also still actively applying to new places, so input on types of places to look would be awesome too. Thanks for reading! xoxo - Stressed out graduate nurse (:

Hi everyone, I got my first job as a new grad in the beginning of December (so im coming up on 6 months). bsn is in progress with about 12-18 more months. I work in a hospital on a telemetry/med surg floor. We are horribly understaffed, we are also ICU overflow and have critical pts sometimes and the ratio goes 6:1 more often than not. I have felt very unsafe with my assignment many times. Almost a month ago i was injured by a combative patient (due to lack of staff he was supposed to have 1-on-1 supervision which was discontinued before it should have been). I was sent to the ER, treated, followed up with employee health and they sent me to one of their office docs to get cleared. Three visits later i finally got cleared (they were concerned i wasnt healing properly) finally cleared me, back to work, light duty (chest injury). Understaffed, 6 pts - 2 critical, 3 confused. All alarmed, one gets up, i call for help and of course none shows up. The pt is halfway to bathroom and falls risk. I try to steady him and get him sitting down and of course he goes down. He leaned my way and i had the opportunity to catch him - felt like my whole chest wall ripped (just the already damaged muscle pulling more i guess) super sharp pain and i DROP the pt. Handle the situation, notify appropriate people, an hour later im in severe pain still and nursing supervisor gets pissed when i tell her i need to go to the ER again (couldnt catch my breath, tons of chest pressure and pulse ox of 77%). Had to give report to other nurses and walk myself down, nesrly passing out at this point, and was treated again in ER. also, as im in pain charting the fall, supervisor is coaching me to "leave out" parts where i dropped him/couldnt hold.him up. I was in pain and getting lightheaded so i did as told and now im very worried. then employee health sets up another dr appt with a new guy (other doc was away). He walks in, says my CXR was clear so hes clearing me to go back in 1 day no restrictions. I told him my concerns and he dismissed them, interrupting me. He also marked me off as non-work-related injury (theyre treating the re-injury/exacerbation as a new injury) and that my symptoms and the new injury didnt happen at work. He also didnt assess me - at all. Just sat and talked AT me for a total of 2 mins. No eye contact. I left in tears. Called employee health, emailed HR and my manager. Told my manager everything and said im not coming in tomorrow or ill hurt myself again or another pt possibly. Unless i can be promised light duty (which due to staffing i cant). She said i will be penalized for calling out. Employee health said its coming out of my PTO since it was ruled non work related, and Hr wrote back that they cant do a thing because its a medical situation. I am so upset and done with this place. Dozens of nurses have quit in the past year with management changes and now i see why I need advice - do i stick it out til december (1 year) or leave after 6 months? Im not sure how much luck ill have without the BSN being complete... Im not positive of my end goal but im thinking outpatient, maybe ambulatory surgery or pre/post op, endoscopy something like that. Also considering school nurse cert after BSN is done. I think i can get into somewhere outpt without the complete BSN but would that be stupid? Do i really need that full year - will having 6 months tele unit then afterwards ambulatory surgery or something like that look bad and screw me over later? Thanks for reading. So stressed about it :/

I am in my first year of nursing on a med/surg/tele/PCU overflow unit with my RN/ADN. I am currently in BSN school online and will finish August 2019. I am considering NP but don't handle stress well and will be starting a family within the next few years so I don't know if that path is worth it. From what I've researched, school nurses find their careers rewarding, though sometimes the pay is lacking. I have a few questions that I haven't been able to find clear answers for: 1) In PA, what do school nurses make? 2) In PA, what are the educational & experience requirements/preferences for school nurses? 3) Is it difficult to find a job as a school nurse? I am thinking this might be the way to go after I have 1 year of experience, or 2 years of experience and my completed BSN. I love the atmosphere of schools and always wanted to be a teacher as a 2nd career choice. It is worth it for me to make less money for a lower stress job. I would rather have a schedule that works well with my kids' when I have them - working at their school or a school with almost the same hours/days would be ideal! I don't know how realistic this is, as I am still new to nursing and I don't know much about the nursing world yet, but any input would be appreciated! Thank you, Keri

Hi everyone, I am a 1st year RN. I graduated with my associate's in August 2017. In December, I got a job on a med/surg/telemetry/PCU overflow/stroke unit (obviously, they are in the process of reorganizing the units! Haha). I am learning a TON there, and I'm really happy to be getting this kind of experience on my resume. The people are nice for the most part. A lot of nurses recently quit (we went from 50 to 16 in the month that I was hired, and I was one of 12 hired...since then about 15 more have been hired). The hospital restructured a lot due to a merge with a big company and that's why many nurses quit. Unfortunately, there are hardly ever nursing assistants, and the nurse:patient ratio is 5 or 6. It has even been as high as 8 (with some patients being critical if they are PCU). Needless to say, it's stressful. A little about me: I just turned 24, getting married in about a year and a half, planning to have kids, super family oriented, have always, always, always struggled highly with anxiety. I am on medication daily to control my anxiety and getting through nursing school and this job has been quite the challenge. I am so proud of myself for my accomplishments so far, but I need your advice/input on the plan I am creating for my future career and more importantly my work/life balance. Money has always been important to me, I am materialistic and I like to be seen as "important" so I always wanted a job like this where I would be able to say "I save lives." When I started nursing it became more than that - I love the skills, I love the people. However, I do not love it to the point where it makes me forget about the anxiety and overwhelming feeling constantly. That part makes me hate it, to the point where I don't even care about the people (and that isn't me). I understand the first year of nursing is tough, and I understand from experienced long-term staff on my unit that these changes have made it unbearable but it isn't usually like that. I feel like if I stick it out, things will be okay. I'm okay where I am for now, as hard as it is. But I am trying to figure out where I want to go from here. Obviously, I want out as soon as possible from this unit. I was hoping to leave after 1 full year (December 2018) or possibly 2, depending on what I realistically need on my resume to get another job after this. I think a lot about where I want my nursing career to go in terms of how I want to spend my days at work. I'm not lazy, I don't mind pouring effort and passion into things. I pour time, effort and passion into hobbies, favors for family members, etc etc etc constantly and I love it. That is a strength and gift of mine - and I want to take FULL advantage of it to thrive in my career. But I need a job that I don't hate and that I'm not so, so afraid of. It's awful (not to sound dramatic). I get anxiety about it to the point where physical symptoms manifest such as diarrhea, panic attacks, heart palpitations, night sweats, nightmares, and lashing out at my loved ones. I'm not enjoying the things outside of work - I can't get work off of my mind. I don't enjoy time with my family anymore, or my dog, or my boyfriend. I am house hunting, a process I was so excited for, and I have no desire to get dressed or leave my apartment on my days off. I basically hide and hope that the clock will freeze so I don't have to go back. I only work part time (24 hours a week) which is nice. At first I picked up extra hours, and then they started automatically scheduling me full time and tried to argue with me when I asked them not to give me extra hours. I stood up for myself and now I don't take any extra hours, for now. That is helping. I am also doing my BSN online, and I'm taking my time with it. I'll be done August 2019. It only takes about 5-10 hours a week and isn't too stressful. I have been trying to exercise, meditate, practice my hobbies more often, go out (movies, shopping, visitng friends, dog park), exercise like going for walks, going to the gym, doing a yoga video in the livingroom. I've been trying to learn new healthy recipes and organize different parts of my life at home. All of this has helped me feel more relaxed and in control of things. I feel good about the progress I am slowly making. When I think about the "dream job" that I want to ultimately end up with, I want the obvious - I know this probably sounds cliche, and bratty - I want off on the weekends, the holidays, the snow days. When I have kids, I want to be home when they're home. I want to work part time when I have kids, and I want to take a year off with each baby. I possibly want to take summers off. Family time is so important to me (as it is to everyone, of course) but my point is - it's not worth it to me to work super hard and make lots of money. my boyfriend is extremely supportive and he doesn't make a ton but we worked it out and we will manage if he works full time and i work part time, or switch between part and full time. I have researched jobs where nurses work in office settings Monday-Friday with paid holidays off, weekends off, and work from home on snow days or days when their kids are sick. Perfect for me in the future, I think. The only downside is I would miss hands-on with patients. I was also thinking something like same-day procedure or pre-op nurse. I kind of like repetitive stuff. Putting in IV's or whatever all day I feel like would be lower stress because it's less management and more just performing skills. Something I've really been considering, hear me out, is getting my NP. I would love to get my NP in cardiology and work full time, in an office or something, seeing patients. I could have the ideal schedule that I want, and my day-to-day would be a lot of work I'm sure, but it would be a different kind of stress and I feel like I'd like it better. It would be a little more repetitive/routine and maybe that would work nicely for me. Even if I switch to part time later as a NP, I would still make more money than RN so it's not like its a waste to go to NP school then go to part time. I might make the same part time NP as I would full time RN. This would allow me to have more of a balance between home and work, and also make the money that I would like to make. I think becoming an NP is a good compromise - but I need your advice and opinions. I obviously don't fully know how the nursing world works yet. I need experienced nurses who have been there, done that to guide me. I try researching online - nothing helps. I also get very stressed from school, but I was thinking if I continue part time then I can handle getting my MSN simultaneously? I'm willing to put in the work, I jsut don't want to push myself super hard if its not even worth it. My current plan is: 1) Stay on my unit (part time) while doing my BSN until I reach 1 or 2 complete years 2) Transfer to a slower paced job, like pre-op, telenurse, or maybe home health 3) Complete my MSN while working in my lower stress job 4) Work as a NP and be done school! Work full time, or part time to balance with family if I have kids by then. Do you guys think I'm totally delusional/stupid or do you think my plan is smart for me? I'm welcoming all advice with open arms! Also - does anyone have tips for getting through work. Any at all. Thank you! PA Nurse xo

Thanks for all of the replies! I appreciate it so much. You all make a great point that everyone has problems and it's all about perspective. As I said in the original post I would never expect any special treatment, etc and I don't plan to go into my new job and go around talking about my personal issues. I probably typed wayyy too much info but I just wanted to give the 100% full story so you guys knew exactly where I'm at in my head trying to make a decision! It sounds to me like I should get about 2 years of hospital experience first, make the best of the days/times I'm not working even if the schedule sucks, and then try to move into something with a more ideal setup for me and wherever my life is at that time. To the person who suggested maybe my anxiety isn't as in control as I might think - you are probably right, and I am seeing that more now with the family situation. My concern with taking a hospital job first is the stress/anxiety issues building up and interfering with or jeopardizing the job. Thank you all so much! You've given me more to think about. :)

Thank you, that definitely makes sense! The thing is, I don't necessarily want hands-on in the future, I'm fine with staying in a non-clinical setting, but I'm just afraid to shut that door completely since I am just starting out. Maybe I will try to just stick it out and do the hospital job for at least a full year. Thanks again!

Hello, I need some advice from you guys with more experience in the nursing field. I am brand new, right out of school and looking for my first job. For several reasons (I explained with every detail in another post lol) a job in a Monday-Friday 9-5 setting would be best for me, and I have an offer. It pays well, has benefits, it's perfect - except, it is not clinical. Now, I don't have a problem with this. I would still be helping people, just not hands-on. I think I would honestly be very happy with it. My only concern is - what if for some reason it doesn't work out? I don't want to be stuck if I choose to leave this job, or choose to move into a clinical setting if this job isn't fulfilling, or if I get laid off in the future or something like that. With no other nursing experience on my resume, will I be stuck?? So the way I see it, I can look for a hospital job for a year or two to get that on my resume. I understand this would probably be the best thing/smartest thing to do. However with my current situation, it would be extremely difficult to do that - if I have to, I will. But I had some advice from a nurse who works in a non-clinical setting to do what she does, and I wanted to see what you guys have to say about this: She works in the non-clinical office setting as a telenurse full time. So she gets her benefits and all that good stuff through that job. She works per diem in a hospital and gets floated to different med surg and ICU floors. She said for her, she just likes having the contact with patients and that's why she keeps the per diem job. She said for me, perhaps I can take the full time office job and work a clinical per diem job on top of that for awhile so that I can have my "2 years of clinical experience" My big question for you is - does that COUNT? Or am I still going to be stuck later if this job doesn't work out long term? Thanks a bunch!! ~K

Hey!! So, if you were to have completely off between now and November 27th, would that be enough down time for you? Or do you mean that November 27th is too soon? If you want down time between Target and the nursing job but can't afford to completely stop working during that time, perhaps you can decrease your Target hours? Like if you work 40h/week maybe decrease to 20 or 15 (if that is possible) so that you're still making the money you need but you'll have plenty of free/downtime. Otherwise...I am out of ideas!! Good luck to you and I hope you get some great advice here! ~K

Hello (sorry in advance for the long post, I just want to tell the full background to ensure I get advice from informed readers!!), I graduated with my ADN in August 2017 and passed NCLEX-RN in October 2017. I live in Pennsylvania and I currently work in a large hospital right near my house as a nursing assistant, for about 18 months (during nursing school and I still currently work there). Before I move on, I just want to say a few background things: 1) I understand that as a brand new nurse, I have no business being picky. That is NOT my intention. 2) I have pretty bad anxiety and PTSD from an incident 4 years ago. It doesn't affect how I am with patients or anything, however I am afraid to be out at night. 3) My dad is currently pretty sick (COPD, CHF, septic shock) and it's very hard...if he passes, which he probably will within a year, this will be my first "big loss" and combined with my anxiety issues, I'm already falling apart 24/7. 4) My family is trying to be together because of my dad's condition and weekends are usually the time when they get together with him. Holidays are also extremely important to my dad and most of my family travels in only for holidays. If you see where I'm getting at, I know I will likely work some/many weekends and holidays as a nurse, especially a new nurse. This fact adds greatly to my anxiety, the fact that I am missing out on these moments that are important to me, my dad and my other family members. 5) Just in my job as a nursing assistant over the past few months, I've had a few call-outs on some of my evening or weekend shifts due to anxiety about being away while my whole family is with my dad, or just my general anxiety acting up more than usual about the whole situation. Now, with all of that being said, I have been dealing with this problem of mine for about 4 years and I take medication, go to therapy, have well-practiced coping skills, and like I said once I get to work, I do my job right and I put safety for myself and everyone else before anything. I feel that I honestly do a good job of dealing with this problem. So why I'm asking for advice is this: in choosing my first job, I want to have a smart set-up. I am willing to take what I can realistically get, but I want to at least make some kind of an effort to give myself weekends/holidays (even just some) off so that I can be with my family and reduce anxiety in that area. Also, obviously I will try to work daytime hours to minimize the anxiety, but again if I have to work evenings/nights, so be it. I can handle whatever is thrown my way, but I don't want to be constantly taking a mental/emotional beating and having panic attacks and meltdowns about going to work if there's something out there that can better meet my needs/preferences. I truly do like being in a hospital setting - I think it's cool and exciting and I love action. I just hate the schedule and the stress over the schedule almost isn't worth it. But the job itself, although challenging and exhausting at times (and this is just as a CNA), is worth it and makes me feel like I'm learning and doing something important. I do love to help people. I feel like I would rather work somewhere that is only open weekdays - closes at night, on weekends and holidays. A doctor's office, perhaps an outpatient setting like same day procedures or something. I would benefit greatly from those hours mentally and emotionally, I don't mind a pay cut (I know hospitals pay more than these places), and I would still be doing hands-on patient stuff, getting to help people, and feeling "cool/important" although the action of the hospital like codes and stuff wouldn't be there. I feel that these places would also have a less stressful day-to-day environment which would also benefit me. I've also gotten a few interviews (and an offer) for a position in a business setting. It pays decent, it is NOT contract (permanent, full time), daytime hours with an occasional weekend which is fine, no holidays, right near my house, and an opportunity to work from home sometimes (inclement weather, etc). The benefits are great, the place is beautiful (I stopped over and toured it) and the nurses who work there seem truly happy. I would be helping patients, but over the phone. It is non-clinical and there isn't any hands-on experience. I am very tempted to take this, but I worry about later - what if the job doesn't work out (what if I get laid off, what if I end up hating it, what if I decide later I want hands-on) would I be stuck? I spoke to a trusted family friend, nurse of 20 years, and employee at the hospital that I currently work at. She knows my situation and she said her personal opinion/advice is to find a job within the hospital that I currently work - any job I can get, even though it'd be many weekends and holidays and maybe even nights, and stay for 1-2 years to get that on my resume. And when that time is up, go work at the office setting or an outpatient type of place. Then if they don't work out, I'll have that med-surg hospital experience to open up my options so that I won't be out of a job. This sounds like a good plan to me, but I am so scared of taking a hospital job for 1-2 years. The thought of the anxiety I would have, the thought of this year possibly being my dad's last year alive, and me spending half of those weekends and half of those holidays away from him and family absolutely kill me. On the other hand, if I take the office job (which I truly think is perfect for my situation at the moment), I don't want to risk killing my career and being stuck in a tough situation later down the line. I plan to get my BSN right away (I'll have it within a year - getting it online), and I am not sure yet if I am getting my master's. I am considering it, but it'll depend where I am in my life. I know that if I become a nurse practitioner, my options will open up a ton as well. I don't want to depend on that though, incase I end up choosing not to pursue that degree. I just moved in with my boyfriend of 3 years, and we have discussed marriage and he told me in September to expect a ring within the year (his way of making sure I would say yes, I guess!) So I will be getting engaged sometime in the next 10 months, and then a wedding a year or so after that, and then probably kids a year or two after getting married. I am currently 23 years old... I have friends and stuff but a social life isn't a priority for me (especially after it basically died in nursing school..haha). I don't care about parties or drinking or going out on weekends. I would rather spend most of my spare time with my family, and my friends and I make an effort to meet up now and then but it usually ends up being on like, a Tuesday at 6pm because we all have very different schedules. So I am literally braindead and overwhelmed trying to make the right choices here. I want that office setting - the pay, the hours, the benefits - it's like everything I want and will minimize the anxiety about being out at night/not seeing my family enough, but I'm just afraid of not having that clinical experience on the resume incase that job isn't a good fit down the line. Sorry again for this post being so long. I have gotten so much mixed advice from people and I wanted the full, thorough story to be told so that all factors can be carefully considered by all of you wonderful people! I am always looking up posts on this website and I love the amazing feedback that others get. I also would like to reiterate incase it was not super duper clear, I have absolutely no feeling of entitlement of having the perfect schedule, I do not have high expectations/demands as a new graduate, I do not expect special treatment anywhere due to my family situation or personal anxiety problems. I just wanted you guys to understand all of my deepest issues and thoughts and preferences to try to help guide me toward the best fit for me. I hope that nobody thinks I am being a brat here, and I seriously would not appreciate any negative judgement, or anything like that. I am just looking up to you guys and hoping for some information to help put things into perspective, based on your experiences/knowledge/opinions. Thank you all so very much!! ~K ETA: Forgot to mention! My boyfriend works at a healthcare place with the telephone nurses (not the one I have the offer for, but same type of place) and the nurses he works with told him to tell me that they love it, and that if I want clinical experience under my belt I can just work per diem at the hospital on a med-surg unit and do that once or twice a month, even if it's a weekend or night shift. They said that I'll be able to say no as much as I want to and I'll probably have a small requirement of working once a month or something to keep the job. I wouldn't be able to do that too much anyway if I'm working the office full time. That way I'll get that experience, to put on my resume and help me have better options if the office setting doesn't work out, but I'll still get to take the office job and have the ideal hours to minimize anxiety and give me the family time I need. Could this be the solution? Or is a per-diem job not good enough to count as the "few years of med surg" experience that I should get? Thanks again xo