CommunityRNBSN

I am a new nurse and I could use some advice. I work in an outpatient clinic where we also have Medical Assistants. Part of their job is to submit pre-authorizations for prescriptions. This is not part of the nursing job description; we do not even have access to the online PA system. I went to an MA today and said “Hi, can you please do these PAs for me?” She said— and this is a quote— “I’m sorry, I’m just super busy. It is finals week and I am studying for my Psychology final so I can’t.” She had her textbook open on the desk and everything. Okay so obviously, they’re not paying her to study for class, she shouldn’t be doing that. She needs to do her job. The question is, how do I handle it? I was so taken aback that I just said Okay. I’m new and don’t want to get a reputation as a troublemaker. I know that probably I should have a private conversation with her about it— except that I am not her supervisor. It’s not like I’m working in a SNF and she is a CNA, where I would have the right to correct her. She is known as a reasonably helpful employee, I don’t think she has a reputation for laziness etc.

Haha well if so, it worked! No, seriously though, now that I’m OFF the clock: you’re right— I was channeling my inner Millennial and posting every experience in real time. I’ll disguise details better next time...

I think this is probably pretty accurate. My workplace is disorganized but it does not seem dysfunctional or toxic. I think the MA figured I am new and that she could get away with things that she wouldn’t normally try. Update is that about 5 minutes after I left her (as soon as I wrote my post!) , she popped up at my desk and said “Actually you know what, I can do those for you.” I have no idea what made her think twice about it. I am going to let it lie for now— I don’t want to report it since she did come around on her own— but I’ll be prepared, if it happens again I will feel more confident in how to handle it.

I’m not saying it would be a wise idea— I’m just saying I’m bored and curious!

Yes I just scrolled all the way down here because I want to know what the joke was!

I am 35 and graduated last year. There were several students older than me— one in her 50s— in my class. All of us had jobs at graduation (excellent jobs; one is in L+D which was her dream). I don’t think your difficulty is related to age. Are you in an area where it’s just generally hard to find a nursing job? Do you get nervous and not interview well? Or maybe it’s just plain bad luck. I encourage you to think about factors other than age that may be at play here.

I would also say— speak up early! The alternative is to sit there and take it for weeks, until one time when you’re having a bad day... then she comes up and pats you, and you flip out. “Why are you always touching me? I hate that! It creeps me out!” When that happens, YOU will look like the crazy person. So don’t wait for it to get to that level! Address it while it is still a tiny little annoying problem and everybody wins.

I gave birth in Japan which has a hybrid system. The hospitals are private but everyone has public insurance. In a lot of ways it was amazing— very little waste because there was no marketing (I’m thinking of the Alexa-equipped rooms in the US and other insanely unnecessary equipment AND drugs). A visit to the doctor cost about 8 bucks. I had a prenatal US at every visit because the OB just grabbed her US machine and spent two minutes doing it herself. However there were trade offs. Nothing psychiatric or psychological is covered. Nor is childbirth, as it’s not an illness. The US population obviously expects insurance coverage for these and a host of other conditions that are not covered in japan. (Full disclosure is that my understanding of the system was shaky at best so Japanese people feel free to correct me)

People also need to learn that not EVERY thought that passes through your head needs to be posted publicly online. He could have told all his friends at the next dinner party that nurses are awful. He’d have gotten the support and sympathy he wanted, and kept his job.

I’m not a school nurse, but I’m a parent and I wanted to thank you for saying this. I know the nurses have to deal with all the injuries and it gets old! But I’ve seen people on here calling to ban everything from glue guns to monkey bars. As the parent of a 7-yo, I WANT him to use these things and it’s FINE if he gets injured. (His BFF fell of the monkey bars and broke her arm— that’s part of life!). My child is uncoordinated and clumsy, and the only way for him to improve is to practice. He needs to learn to be careful with a glue gun, and getting his fingers singed is probably the way to learn it.

This is a great point. In my FQHC we have a chiropractor. Now, I’m not really a believer in chiropractic care, and I was all annoyed that we can bill Medicaid for this. Until, upon reflection, I realized that our “real” doctors, when they have a patient with back pain, often prescribe narcotics and/or refer them out for questionable surgeries and injections that are shown not to work. If visiting a chiropractor makes the patients feel better, it is certainly the less harmful of the two alternatives.

The word “evidence” doesn’t even appear in this. I’m glad you found something that helps you, but isn’t evidence-based practice (evidence outside of and beyond your own personal experience) the foundation of modern nursing?

My husband and I laugh about how well-suited we are for our respective jobs. He’s a lawyer. Crying in that field would be... frowned-upon, to put it lightly. I’m a nurse, and honestly, my coworkers and I have been known to tear up at texted photos of our colleague’s new baby. I don’t cry in front of my patients (I’m in Community health so I don’t deal with death), nor do I start crying when somebody is mad at me. But just in general? Count me in for a good cry.

My school just wanted us to have started.

People have always cried a lot. About their jobs, kids, and everything else! The only thing that’s new is advertising that fact. It’s fun for a lot of people to take photos and share them, because then their friends jump in with sympathy or “hey me too!” and it makes them feel less alone.

I work in an outpatient clinic (a FQHC) and it is so different from bedside. She may want to try it. For one thing, my schedule is 8:30-5:00. I certainly am helping others, which you said is important to her, but it lacks the chaos of a hospital floor. She may still decide she wants to do pharmacy, but she definitely needs to try at least one more nursing job before she jumps out of the profession entirely.

Your situation is a bummer. It sounds like you worked hard and had a tough time of it. On the question of oversleeping and missing your project: I have the personality of a Hermione— never late with assignments, always sitting in the front row with my hand up, super annoying. It drives me BATSH*T BANANAS when students miss projects, or show up late to clinical, etc etc and then are just passed on through anyway. I say that knowing that I’m a human, and I could easily make a similar mistake someday. And if I do, honestly, I think it’s fair for me to fail the class. Even if I got a flat tire, or the flu, or my babysitter didn’t show up. Because it is so disrespectful to the kids who were there on time (some of whom probably had similarly difficult situations) if you can just miss a major end-of-year project and get waved on through to the finish line. None of that actually answers your questions. But I just had to get it off my chest. I’m not saying you won’t be a good nurse; I’m not saying you’re a bad person; I’m not saying you should give up on your dream. You’ll be a great nurse, I’m sure. But that will be after you finish a program by fulfilling the requirements, NOT once a lenient professor just says “Oh ok fine, just let him graduate” after you’ve messed up.

I’m a new nurse, and one more piece of advice from my experience is: Form your own opinion about each doctor (and each nurse for that matter!). Sometimes, all the experienced RNs will tell you “Dr Smith is awful, so watch out” and “Dr Jones is great” but you may find that you get along better with Dr Smith. If you listen to a bunch of gossip before you even meet the doctor, you may walk into a conversation defensive and expecting a battle before the other person has even opened their mouth.

I agree with this 100%. Your parents are in parent mode— so they are entirely on your side ready to cheer you on. They are not being objective. So be thankful for their support but do NOT take them at their word about the nurse “covering” herself. That doesn’t sound at all like what is happening in reality.

It does sound inappropriate that you didn’t have a chance to correct your mistakes. (I realize we only have one side of the story here.). I am consistently saddened to hear of people failing clinicals. At the start of our last semester, the instructor said “Nobody fails my clinical. My job is to help you become safe nurses, and we are going to work together to make that happen.” Now obviously, if somebody was ... I don’t know...showing up drunk, stealing pills, constantly giving meds to the wrong patients... obviously there are ways to fail clinical. But something like being inept at inserting a Foley— My instructor would have made sure you had 50 chances to practice (starting on a mannequin) so that you could do it. You may have to re-do. But in 5 years this will be just a painful story that you hardly ever think about, and you’ll be a nurse.

It’s good that I read this today. If I had been in their shoes, I might have thought “Well let me just search his name, out of curiosity.” I wouldn’t have gone into what I think of as the “real” chart (that is, I wouldn’t have looked at notes or labs or anything) but certainly might have done a 2-second “see if he was here.” Good frightening reminder to stay in my lane and not go peeking at things!

I just wanted to mention that there are such a variety of jobs that you can get (after you finish out your hospital contract) that are totally different, and that you can do without being in advanced practice. I am a new BSN grad and I work in Community Health. It’s not for everyone (obviously if you love acute patients on vents, it’s not going to be satisfying for you) but because of your comments about FNP work and a 9-5 schedule, it sounds like it could be a good fit. As a CH nurse I see patients for nice long visits, on my own, when they need monitoring or education. It is really fulfilling work (again, for ME), and the patients tend to be appreciative. We certainly do have drug seekers etc but it’s just very different from a med/surge environment.

I just started a new job, at a health center, and I had to show proof of everything— vaccines, titers, and TB screening. It’s a federally funded facility, so maybe that’s why I had so much paperwork, but the requirements were the same as for clinicals.

I have just finished clinicals (at a well respected university) and we didn’t put gait belts on people who were stand-by assists! The purpose of “standing by” was to do exactly what you did— jump in and prevent major injury, not to physically keep a person standing up. This was in two different hospitals, too. I know that’s irrelevant to your situation, since you are required to use gait belts, but I am amazed.

No. My mother refuses to get the flu shot (she prefers to use evidence-based prevention strategies like swabbing the inside of her nose with Listerine) and when she wanted to volunteer to play the piano in the lobby—no patient contact—they made her wear a mask. That’s flu (droplets) but there isn’t anything similar you could do to prevent airborne or bloodborne transmission.