Biology2Nursing

Here is my dilemma. I graduated from my ADN program in May of 2018, licensed in June 2018 and have been working since July 2018. Naturally, I found it difficult to work full time as a new nurse and do my BSN work, while running a household. It took me some time trialing a few online BSN programs until I found one that has been working great for me, SUNY Empire State University. I now have three courses left and I work in a hospital system that will reimburse 80% of my tuition, so paying for school isn't the problem. Prior to this, I was doing agency work and paying out of pocket. I managed straight A's so far and its been a great experience. I will take my Leadership & Management course come January. The last two classes, I can not even register for without an approved clinical site which must be approved for months in advanced. For a Fall course, I need paperwork signed by April for my school to approve the site. For a Spring course, by September. For the Community Health Course, I must find a spot to volunteer twelve hours a week. I have been calling and emailing any free clinics or community health centers to find something local but have not had luck. I live and work in Staten Island, New York. For my capstone course, I will ask to either shadow an educator or a manager in my hospital system while I am off the clock as my choices are education or leadership. I have been a nurse for almost seven years and I truly want to get this finished so I can move on to graduate school. I will also get a pay differential in my current workplace. I am grateful that its not poor grades or finances in my way but It is just so frustrating that finding a clinical site is slowing me down. If anyone has attended this RN to BSN program, how did you find clinical hours for community health?

Thank you so much for the encouragement. I had a very rough start and I am just starting to feel more comfortable now, but they gave me two more weeks until I go on my own. I only experienced two very complicated cases that were labile hemodynamically and had other issues such as IV drug use history and on methadone. His blood pressure would not stay down for the life of me until during rounds I realized that nobody called his methadone program! He was without his dose for 48 hours! I found his clinic and the PA called. Getting his dose stopped his BP issues. They only extended me so I could try to experience more very sick open heart cases with CRRT and cardiac assists, etc. Most of the cases I took care of independently were pretty straightforward CABGs. I got to also have a post op day 1 after a triple valve procedure, something uncommon in my setting. This same patient I also took care of his pre op. He went from having the loudest murmur I have ever heard of my life to normal heart sounds. It was pretty amazing. I was lucky to experience ECMO twice on orientation already as their ECMOs aren't common. They are in the process of expanding their ECMO program. Their only complaint is about me finishing my documentation on time because I came from the ED where we didn't chart as much as I have to in a critical care area. I am also trying to get a little more social with them prior to coming here. I was an agency and a travel nurse in emergency departments. This was my first staff job in over four years. I missed having the concept of having a work family. I truly miss the stability that comes with being a staff nurse. So basically I transitioned from ER to CVICU transitioned from night shift to dayshift after working six years on nights and transitioned from being agency to staff so the adjustment process has been so rough. This specialty is truly amazing.

This is by far the hardest thing I've ever had to do in my life and I am feeling like I am drowning, but management says I'm holding it down,

We play on both sides of the fence ! I will be in touch!

You just made me so much more excited ! Thank you so much for the book recommendations. I'm going to look into getting them. I have a CCRN book. That is the Ascencia study guide, which I use for the CEN. I have a good feeling as you said because the acuity level was very high in my last emergency department so it makes tackling those practice questions a bit easier! The last emergency department I worked, and I worked in for two years and out of all the ERs I have worked, and it was the only one where I would be setting up for the A-line. I can't wait to see the care continue. I am excited to learn all of the new skills!

I have been an ER nurse for five years and was looking for a change and knew I wanted to stay in a high acuity area as I mainly worked in critical care/trauma sections of the ED of a level one trauma center and loved caring for ICU and chest trauma patients the most. I also love complex cardiac cases. I've been selected for a staff position that starts January 8th in a Cardiothoractic ICU that has a reputation for only choosing those with a year of ICU experience but the nurse manager believes I am a good fit having ACLS, etc. I came from a critical care ED with ICU level patients but of course not spending as much time with them as I would have liked. I look forward to having the opportunity to care for these patients outside of the ED, continuing their care in a more controlled and organized environment. I am excited but also a bit worried. Transitioning from ED to ICU will make me feel like a bull inside of a china shop. I have always admired the ICU nurses. I hope to develop the finesse and organization skills that Critical care and ICU nurses have in their practice. I know I have many things to learn about critical care, but also a lot of things to unlearn from the ED. My orientation is going to be a bit longer than others which is reassuring. I will be enrolled in a critical care core course prior to transitioning to the CTU. Part of my orientation will be rotating through the MICU, neuro ICU, burn unit and SICU to learn the basics prior to orienting the Cardiothoractic ICU. The nurse manager seems very kind and understanding and said that if I am uncomfortable for any reason, my orientation can be extended. If anyone has transitioned from ER to ICU, what was your experience and what advice can you give me to help me succeed?

Hello! I graduated from Trinitas in Spring of 2018. While it’s a rigorous program, It was a very good experience for me. I truly learned how to be disciplined from that program both as a student and a nurse. I don’t think there was a day that went by where I did not study. I worked 32 hours a week at a doctors office during the early courses of the program which for 130 and 131. By the time 132 came around I was only able to work two days a week just to have some pocket money for gas to get to and from school and clinical. I would suggest lots of reading and lots of practice questions, especially from Lippincott. I would love to hear about your progress in the program and if you have any questions, feel free to ask me anything.

I don’t care if that other patient is in cardiac arrest I was here first!!! I need the doctor now!

I don’t think this is a code sepsis; but we are going to do the sepsis work-up anyway and just play it by ear! Blood cultures x2! LACTIC!!! 30ml/kg of normal saline ! Zosyn! Vancomycin!

Story of my life ? “hey doc they’re on dialysis!”

Everybody was right! Dialysis nursing did set a pretty good foundation for me but I only stayed for six months until I got into an ER. Emergency nursing Was something I had always wanted. I have to say that a lot a dialysis patients do end up in emergency care frequently. I feel confident caring for a dialysis patient and having an idea of what is going on with them. I’ve had two situations with arterial sides of the fistula that could not stop bleeding. These patients were in the trauma bay. Any of the dialysis complications in the ER most of the other staff come to me. Another interesting coincidence is that in my hospital anything that is outpatient such as the cancer center or the dialysis floor; Rapid response is up to the emergency department nurses (me) Anything inpatient is up to the ICU nurses. I feel very confident doing a rapid response on the dialysis floor because of my exposure to it. I guess as a new grad I was just really worried about ending up in a setting that was not ideal but I realize now that I was smart for taking the job at the time, As many of the new grads were a bit picky which left them a full year still not employed.

thank you! Best of luck to you too! I was also too of my class and graduated with high honors.

I did have long stable friendships already outside of school. My isolation probably was my fault to an extent. Nursing school was a lot of runaround between school, my job at the time ( I was working 36-40 hours a week during my first two courses) and clinicals. I was probably always rushed and had no time anyway. If I had a night lecture, I couldn't stay and hang because I had work at 7 AM next day at the busy Doctor's office I worked at. Many of the other students did not work. My last semester is when I became more involved with the student nurse association and my last semester is also when the Doctor's Office let me go from my Medical Assisting job. Maybe I was too preoccupied to establish closer friendships at that time.

I am in the same boat but lucky for you, many of your courses in the Biology degree are transferrable depending how old they are and which school you try going for your BSN. The statistics course that I took in 2013 transferred to my online BSN school. In some cases if your BSN requires a chemistry course, some also might qualify. As a fellow past Bio major like yourself, I sure know that we took a lot of chemistry! I did my research with BSN programs to see what would be the best option cost wise and also how many credits will they transfer. I only wound up needing the Nursing courses for my BSN due to already having a Bachelors of Science. My online program also happens to have a bridge program to finish with with the BSN and MSN. If you do your research, I am sure you will find what works for you. Good luck!!!

So the dilemma I have is that I see that Nursing is actually NOT Nursing School AT ALL. I knew that being a licensed RN would be different but this is insane. There is both good and bad to Nursing not being like Nursing School. I am happy with the independence, autonomy and responsibility and being present but my main problem is trying to time manage my new work load. In school clinicals, we are only to manage one or two patients at a time and now in my first job, outpatient hemodialysis I am responsible for 9 patients each shift. So for me that is 9 pre assessments and 9 post assessments, medications for 9, 30 min vital checks for 9, problems to troubleshoot and all of the catheter patients are mine to initiate and terminate treatment as only the RN can put them on and off the machine. PCT's handle most fistula/graft patients. Managing my PCT's and their workloads gets out of hand as well. I feel like I literally do not have time to breathe some days. Some dialysis patients blood pressure base lines are extremely high yet they remain asymptomatic. When I won't discharge a patient with a diastolic over 90, the patient is annoyed at me saying things such as "you new nurses are killing me, my BP is always high, just let me go!" In this situations, I try to reassure them that it is for their safety. I document that they are asymptomatic/ deny headache and even get them to fill out AMA. These patients who have been on dialysis a long time think that they run the show and want to try to tell me how to do my job. I know that patient satisfaction is important but It is still my priority to keep them safe. If they go home and have a stroke from a high BP, I got in trouble. NOT THEM, NOT THE TECH. I know that nobody is on their best behavior if they are not well but I feel that dialysis patients are extremely difficult. I am doing the best I can. The first year as an RN is the last year of Nursing School.