Hoshio

Ask lots & lots of questions. The only stupid thing you can ask if not ask your stupid question. When you need more support - seek it out, don't expect people to flock to you. And get on good terms with your preceptor. Your preceptor is likely going to be someone who knows the ins and outs of the floor, and has a good knowledge & understanding of how the show runs. Expect to be overwhelmed, need help, and feel ineffective in the begging. Going to an ICU or any floor straight out of school with little experience is stressful. But in time, you'll get your hang on things.

Even when I started working we were never shown or taught how to insert an IV. My employer told me at hire that IV skills were gone over in orientation fully - it was a lie/joke how they even showed us. Needless to say I learned IV insertion from just doing it on patients. Some of the nurses I work with use to practice on each other in order to not look stupid in front of a patient who needed IV access.

Nursing schools these days all just throw a bunch of information at students without really emphasizing to them on applying it to the clinical setting - let alone helping them learn valuable clinical skills. It really is on the individual to put the puzzle together themselves. And unfortunately, critical thinking, data collection, and bringing ideas & skills together is so foundational to nursing. As someone mentioned earlier, a new nurse who has the ability to comprehend why actions are being taken, the risks associated with that action, and being able to anticipate and or identify when things are working are not working are more valuable than a nurse who has been on an assembly line and only know how to do tasks without any understanding. From experience on my own floor, new graduates that come in wanting to learn, are asking for help, and attempting to identify concerns are all easily mold-able into great floor nurses for our floor. On the flip side, we've had a few who come in, and either have no ability to connect the dots - even when you've drawn a map for them. Some new nurses also don't seem to get that someone else's life is in your hands. You could very well kill someone - and some of em wouldn't even have that thought cross their mind, which is scary.

Curious what thread you’re referencing :0. True statements though, lawsuits & taking legal action is a sport this day in age.

In my setting, which is not an ICU, we do not allow Iv insulin per our policy by nursing. I’ve had some MDs that try to pressure nurses to do it here, but I simply tell them per policy I cannot administer that med, so either we do subq or I tel them they can come up and administer it themselves and stay with the patient to monitor them. I had one moonlighter tell me after explaining our policy to them “it’s just insulin I don’t get the big deal”. The big deal that this isn’t an ICU, an IV insulin might kill my patient if done incorrectly ?. Only different step meds I’ve done are either blood or tpn. Any high risk medication infusion will have a policy. Just lookup, and READ it. For example, on the unit next to mine I remember a new nurses started a heparin drip on a patient and “looked up” the policy, but doubt she read it because the provider never ordered initial labs prior to initiating the drip which per our policy MUST be done before heparin is hung. If you’re unsure about a policy, go up your chain of command to make sure you’re doing everything per your facility. Also, depending on your facility providers may not need to specify rates for medications IV in their order. If you’re running things that don’t exist on a smart pump , always always always - verify the rate is acceptable for that medication with the pharmacist , and have them check your math and do a double check with another nurse. Basic mode is a scary mode on pumps, because the pump will do whatever you plug into it.

Always always always always have it. When it comes between saving their own ***, & throwing a single nurse under the bus, the hospital will always choose to save their own ***. And when it is you vs them, they sure as hell won’t be providing you with any protection or resources it’ll be coming straight out of your own pocket, and hiring a lawyer to defend your license is not only going to be expensive, sometimes it takes months to years for a case to be resolved. That is a lot of $$$$$& for an attorney or other consultation needed. So yes please please please get your own insurance. If you’re a new recently passed boards nurse, it is generally cheaper, but for even those who’ve had a license a long time, it really isn’t too much of an extra cost. And what’s 100$ a year compared to 50,000 for a year or more of legal fees.

Honestly in my experience, there isn't a standard set of IV medications. The IV medications you'll be giving depend a lot on the patient population you're working with and their medical issues. Most IV push medications I've used are lasix, narcotics, protonix, sometimes even I've had antibiotics IVP. IVs on a pump have been anything from certain antibiotics, heparin, blood, fluid. I would really encourage just having a basic understanding of pharmacology going into your job, and while working lookup and become familiar with the medications you'll be working with on the floor. I think it's much easier to grasp medications by working with them. Biggest tips to remember for IVP medications is knowing how long to push them over. For hung medications it's important to know if the fluid & the medication you're mixing with are compatible with one another, and or if you should run a medication as a primary only or with a secondary.

This!! Anytime I called the state about my application I was on the phone for 45+ mins at least. They're horrid at answering the phone.

I think it depends a lot on the unit & who your coworkers are. I primarily work nights on my unit, but also have picked days up to help out. I like the fast pace of day shift, where as I find night shift usually drags by depending on the night. On the flip side, I enjoy my night shift a lot more than my day crew. While there are lovely nurses on day shift, some of them I could prefer not to interact with. I find they treat other members of our team poorly, and are the typical grandfathered in older nurses who think they know everything and exclude everything you have to say even when they are clearly wrong. I also feel my night shift is more supportive to one another. Still the day life while stressful is less chaotic on your body, than working a night shift.

I believe when you fill out your application for licensure on the New York State website, there is a section that asks you to upload all relevant documents with it. when you finish the courses, save a copy of your certification of completion and attach them to the application.

Luckily I never delete my emails. Try this link. This is where I did both my infection control & child abuse course online. http://www.elearnonline.net/statemandate.aspx?x=44

I applied for a New York license after passing my boards in MA two years ago for plans of going to nyc in the future. In the process of seeking a job myself. Anyways, you can find links to the required courses on the states web site, they’re fairly easy, and are like 20$ I think each if my memory serves. They take maybe an hour to do, they’re fairly simple. The longest part for me was New York State reviewing all my school work & receiving my current licensure information from MA. It took about 2 months to get an actual New York license issues to me.

Sorry to hear that you're having a hard time. My unit was switched to a COVID unit right when the pandemic started in MA, and honestly it took a few weeks to get use to all the PPE & feeling confident in using it. As suggested antifog spray is helpful, or you can try ensuring you have a tight seal on your N95 and don't breath intensely heavy. D/t the difference in the temperature in the air and between the face shields, your breaths will make stuff worse. In time I promise you'll get use to using everything. Also try to work your required hours if you must. On my unit I use to pick up a lot and work consecutive days straight. With COVID, doing those things exhausted me, and I've since tried spacing workdays out not stacking more than two days straight if I can. You need recovery time, especially now.

I've had almost all of my nursing experience in an LTAC and most of the patient's I've worked with are acute in different ways. Overall I've loved the experience of being able to see how far my patient's have been able to come. A little background for you, I started working at this LTAC in 2016 as a nursing assistant on a cardio pulmonary floor. It was my first actual hospital job, up until that point I honestly associated "sick" with cough/ cold, not being who actually can't breath or have machine's keeping them alive kind of mind set. My floor had "stable" patients weaning from ventilators, recovering from acute episodes of heart failure, and some had LVADs - I even had patient's with Bivads (RVAD & LVAD). Obviously I was a CNA so I didn't comprehend much of the machinery, but it got me very comfortable with providing patient care, and the nurses who I worked with were always willing to teach, explain and demonstrate stuff to me. It was very beneficial while I was in nursing school, it defiantly made school a lot easier. When I got my RN I switched to a different floor for a different environment & got hired onto the neuro & Traumatic brain injury unit. While there were no vents here, most of my patients were completely dependent for care and were going septic left & right. It really taught me how to prioritize & how to put clinical data & status together. Also it doesn't hurt that most of my patients were not alert enough to see how horridly my IV & skills were. After being on this floor for about two years I feel I've really developed my basic skills & am feel confident as a nurses that I'm starting to look into going to an ICU next - many of the RNs here go to an ICU after because we take so many patient's from the city nearby and they know just how much we do. Hell we had to take COVID+ patient's on ventilators at one point d/t the pandemic. Long story short, LTAC is a great place in my opinion to start. It's a great place to master basic skills, see a lot of different patients, and plus it's a job. Now don't get me wrong I feel like at any LTAC, staffing sucks, the floor can be heavy, and the pay not be great, but I think the experience makes it all better at the end of the day. Good luck!

So I have been freaking out all day. I received a call from my boss this morning stating that a USA on the floor had told her that I have been harassing her, pulling their hair, tripping them, assulting her, and making do things outside of their scope of practice. I had to submit a written documentation of my accounts of the accusations for hr purposes. I'm literally 2 weeks from finishing nursing school and have been completely in disbelief. a little backstory, this USA and I were very friendly for a time, but recently our relationship turned sour. She has spoken to me very rudely lately and the events she spoke to our manager about have been completely misconstrued in their context. For example with tripping, this happened last summer and she had been fooling around trying to trip me so I reciprocated the behavior. Since we haven't been getting along she's gone and made it sound like I'm sexually harassing her all of a sudden, and we have not even worked or spoken with each other in weeks. Im completely scared this event could impact me getting my license, especially when the allegations have been misconstrued or are complete lies. Especially with today's culture of girl says guy touched them and they all jump on sexual harassment. Ive worked at my facility a long time, and both the staff and patients really like me. I've never had any issues before. My manager says an investigation will happen which I have no idea entails or will take how long. My biggest thing is we don't have cameras and a lot of stuff is he said she said. At this point I don't even know what I can do. Not sure if anyone has some advice or has or has ever had an encounter like this.