themurse

@londonflo I don’t know why you continue to quote smart remarks? And take bits and pieces of past conversations and repost them, without any context. Better yet, quote someone’s first post from two years ago from their first two months into an accelerated nursing program, and then try to use it against them. Glady chime in with any critical care experience you have on a COVID unit, working with COVID patients who are intubated and trying to keep them sedated. But let’s continue to ridicule the new grads trying to learn during a global pandemic. I already said I left that floor, so why do you continue? I bet you’re super supportive to all the new grads on your floor, a real peach.

@londonflo You can say I’m being critical of others rather than taking responsibility for my actions. That’s fine. I feel horrible for what I did. Not a day goes by that I don’t think about it. The example you bring up about my first ever post and having a hard time during my first semester of nursing school, I feel is very common for a lot of new nursing students. I see their posts all the time. But I picked it up and ended up being very successful in it. So obviously, I didn’t blame everyone around me, I blamed myself and literally got my own *** together and stuck it out. In terms of the situation on my floor, I feel betrayed by my preceptor more than anything. I think I have a right to be angry about the situation. I believe there were people on this post who said they go up by 15 on prop all the time. So what I did is NOT unheard of. But what I did should of been made into a learning opportunity, rather than punishment. Did I make a mistake? Yep sure did. Should I have went up by 5 instead? Yep, I’ll own it. But what I can’t understand, is that if what I did was so wrong, why my preceptor said she would have done the same thing in that situation. If what I did was so wrong, why didn’t she stop the situation immediately? She was standing right next to me, she could of immediately turned it down before it even hit the patient. But nope, she stands there and lets it go. So why is it all on me? If she was so afraid of me practicing unsafe nursing care than why leave me alone for the last eight hours of that shift, after that happened? In fact, I don’t believe I saw her the rest of the night. Why punish the orient in this situation? What’s the angle? What are they going to take away from that? That they can’t trust their preceptors in the future? That their preceptors are only their to report mistakes, not teach you how to become an effective nurse? To not report med errors and cover them up? That “just culture” is a lie? But it’s fine. I’ll take the blame and move on from it. And I will be a lot more careful in the future that’s for sure.

@londonflo The original post you are referring to was the first two months (first semester) of a 15 month ABSN program. I ended finishing that program with 3.6 GPA with no issues. And that professor actually got fired the following semester for dating students. But you are correct, being that COVID hit the second semester we lost out on a lot of hands on clinical experience. And I’m definitely looking at lower acuity jobs to reflect that lack of hands on experience. I went up by 15 on prop for a pt that was desatting into the 70s. The preceptor I was with that was my second and last night with her when it happened. She was standing right next to me while it was happening. She watched me do it, and even said she would of done the exact same thing. But she told me, next time go up by 5 only. Hell she’s the one who charted we went up by 5 at a time. She never made it out to be a big deal at the time. Which is why I was so surprised she went to the NM about it. Not only that, but I was only doing what I had seen done in the past. Before her, I was with a preceptor for 8 weeks, who would go up by 15 of prop all the time. Who would bolus prop. Who would take a 10cc syringe and bolus it into someone who was ordered to be off it. So I was only doing what I had learned up until that point in time. And in actuality, I had absolutely no idea we were only aloud to go up by 5 at a time cause I’d never seen it done like that before. I was only aware after it happened. So it’s not like I broke protocol on purpose. I was only doing what I had been trained to do in that situation. I had also had that pt before, my preceptor didn’t, and that pt was very very difficult to sedate properly. Also, the night before, that same preceptor who reported me, told me I needed to take more initiative because I wasn’t titrating down on my Levo, for a pt who’s MAP was 85, BP 100/60. The order said titrate to a MAP >65. So I never touched the Levo because it was already above the parameters of the order. So in my eyes, I’m wrong if I follow an order and wrong if I do. I get the whole “just because I’ve seen others do it doesn’t make it right.” But they can’t expect something different, if I’m only doing what I was taught during my first 8 weeks. Monkey see monkey do. Hell, I saw the preceptor who reported me miss a straight cath on a pt, pull it out of her lady parts and try again with the same cath, before grabbing a new kit. So it just baffles me how I’m getting reported for something, when all I’m seeing is unsafe care and broken protocols happening anyway. In my option that floor was just a *** show. Everyday I would come in and in huddle it would be another med error by a new grad. Fet running greater than 250mcg. Heparin running as insulin and insulin running as heparin. Or heparin running dangerously high. So this situation just woke me up to the fact that the training isn’t adequate on this floor at all. There are more new grads on that floor than experienced nurses. They hired so many new grads they can’t keep up. People were writing SERS reports on each other for everything. So I’m glad I got out.

Thank you for the replies. So I tried to give it one more shot on Sunday night and my shift went horribly. However, I was going to stick it out, but at the end of the shift management called me in and basically told me they are worried I don’t practice safe nursing care. And that if I don’t improve I would be terminated. I guess the preceptor I worked with on my last few shifts reported me for going from 15 to 30 on a patient’s prop who was bucking the vent, biting the ET tube and desatting in the low 80s. I had this pt a few nights before, and she was hard to sedate properly. I decided to take initiative of the emergent situation. Because they told me I needed to take more initiative, in my last meeting with my educator. My preceptor was standing in the room and let me do this. Then preceded to ask me what I should of done, and what I did wrong, and at the time I had no idea. She said I should of titrated by 5 and waited 5 minutes then went up another 5. However, she then preceded to tell me she would of done exactly the same thing I did in that situation because titrating to protocol wouldn’t have worked in time. If it was a serious thing I did, I had no idea. Absolutely, no clue at the time. But she could of also went over to the pump and immediately corrected my mistake and turned it down to 20 and taught me what to do in that situation. And I feel like this is why I made this mistake because nobody is teaching me what I should be doing in these emergent situations. Like she had plenty of time to stop my actions and didn’t. And I feel like if it was that dangerous she would of stopped it. If she wanted to teach, she should of said “OK our patient is bucking the vent we need to go up on our sedation, we are going to go up by 5, wait 5mins, and go up by 5 again. Bam, instant learning opportunity for me. But instead, I’m getting reported for this. I’m being threatened with termination. I’m being told I may not be able to transfer to another unit because they have to tell the manager of that unit I don’t practice safe care and they wouldn’t want me. So basically I feel like I just lost my entire career in nursing in one moment. One moment that could of been prevented had I been properly trained. I’ve witnessed a different preceptor I’ve had on this floor for 6 weeks, take a 10cc syringe, stick it in a prop bottle hanging on the IV pole still, and bolus it into a pts IV who was bucking the vent (we had turned the prop off early per verbal order). I knew immediately this was wrong. And I would never do that. But just to put into perspective what I am seeing here. I’ve also seen him go up and down on prop by 15 before. I’ve also seen preceptors bolus prop via the IV pump during these situations. Which they aren’t supposed to do either. Yet, I’m getting reported for titrating up by 15 on prop during an emergency. There are new grads on this floor (out of orientation) running heparin and insulin over ordered rates. Running fet over the 250mcg limit. This is obviously a floor issue. But yet, they are still there. And those are serious med errors. I think this preceptor that reported me wants me out. Her and a few of her friends on nights did this together. Like I said, they are super tight knit. They don’t like me and want me out. I don’t know what to do. Can I get another new grad job at a different hospital in med surg at this point? Do I not include this position on my resume? I can’t use my manager as a reference. I pride myself in practicing safe care. I would never hurt my patients on purpose. What do I do? I think I’m done with ICU all together. It’s too much and way to serious for me. And just gives me constant anxiety.

I just started my first nursing job as a new grad in the MICU two months ago and I want to quit so bad. I need advice. We are at max capacity Covid right now and have been since the beginning of November. While I knew it would be challenging starting in the MICU as a new grad, I feel like I did not sign on to work on a Covid only floor. Our hospital system has a lot of MICUs throughout the general area, but we are the one that gets all the Covid. Nobody told me this before I started at all. I had done a rotation in a different MICU in late January 2021, during the second wave and that MICU had maybe 1 or 2 Covid. So I thought it would be similar to that. Not full capacity that’s for sure. Long story short, I feel being on this floor is severely hindering my learning, growth and development. And it’s absolutely exhausting, not being able to walk in and out of pts rooms freely. Not to mention, I have yet to see a Covid patient who is intubated, actually walk out of our unit alive. And 99 percentage are vented, paralyzed, RASS of -5 and proned — waiting to get on CRT and die. All of these pts follow the same course of treatment, all are on the same drugs. It’s just the same thing everyday. I feel like I’m losing skills. And the death is affecting my mental health. And I know it’s only going to get worse when I’m out of orientation because then I’m going to be responsible for withdrawing care on these patients or coding them knowing there’s nothing I can do for them. I know working in an ICU, I would see death at some point, but when none of the care you provide has any impact on patient outcomes you feel like everything you do is hopeless. I want to feel empowered as a nurse. Like the care I’m providing is actually doing something. I want to see a patient get better. I want to see a patient actually walk out alive. I just don’t think that’s ever going to happen in this MICU. The nurses on my floor are super tight knit, lots of power cliques. The ones that are left from 2020 are really close. There’s a lot of new grads on the floor and they are very cold to us. Preceptors don’t want to teach. They are exhausted. I don’t feel supported at all. It’s a lot of blaming new grads for things as well. There’s been a lot of serious errors by new grads, and that makes me worried that obviously the training isn’t what it needs to be. They are just rushing us through orientation/residency because they need all the help they can get. When I interviewed in April, they had maybe 1 Covid patient. And when I shadowed in early May there were none. I asked how many Covid pts they had during the fall 2020 and Winter of 2021 and the manger said maybe half. Obviously that was a lie. She practically handed me the job I didn’t even have to sell myself at all either. Now I’m thinking that was a huge red flag. Should I leave this job? It’s at one the best hospital systems in the US. It seemed like a great opportunity with plenty of training and a two year residency. I just don’t know what to do. But I feel sick every time I go into work. I have dreams about work when I sleep. And I’m petrified of getting Covid and giving it to a loved one who is severely immunocompromised.

So I am in my first semester of an ABSN program, I won’t say where, as I am fearful they will kick me out if I leak any information about it (more on that later). So I was a straight A student until this program, I didn’t go in thinking I would get straight A’s, but I also didn’t think I would be fighting just to meet the “minimum” requirements either. So lets start with our exams in fundamentals of nursing, they are extremely difficult, but NOT because the material is difficult, but because of their disorganization. It doesn’t matter how long or hard you study because they put things on there they don’t cover in class on purpose to “prepare us is for the NCLEX.” Not only that, they never tell us what is important to study for the exam, so we are left to guess and just go off of the PowerPoints that they literally just read straight from in lecture. They don’t follow a book at all. So books are out of the question. So there is just no way to study for these exams. Even NCLEX books don’t help because they make up there own questions that are extremely weird and difficult and usually over something we didn’t cover. Not to mention, aren’t aloud to see our tests after we take them. We aren’t aloud to go over any questions to see what we got wrong or where to focus our time more on certain topics. We have three different instructors for this class. One will tell you a lab value, the other will tell you a different one, and the other will tell you another completely different number. All three will be on the exam as answers (only one is correct). And we don’t get points back either. We have to average a 75 percent (82% is a B) on five exams just to pass, or get any points added to our grade from all are other assignments. I feel like they do this to get their NCLEX first time pass rate numbers up. Anyway, I just wanted to know if this is normal. I feel so out of control of grades. There is no tutoring for this course I already checked. Everybody seems to be doing bad as well. About 1/3 of our cohort already quit. This program preaches about how good they are all the time in class. How they are “preparing us for the NCLEX” How “they wasn’t us to be a nurse.” But when you need help, or anything they are no where to be found. We never have any clue when anything is due at all. They move due dates around from the syllabus and then one teacher will be like “why didn’t you guys complete this assignment”? Maybe because the other 1 out of our 3 teachers told us it isn’t due until next week. Yet the syllabus says it’s not due to the end of the semester. I mean even when we got to clinical the first day we couldn’t log onto the computers to chart because they didn’t send out the email to register through the hospital. The hospital was shocked. We told them “yea it’s pretty normal we never have any idea what’s going on.” I mean it’s just an absolute unorganized, utter chaotic program. And I feel like it’s hard, but hard for all the wrong reasons. All they do is brag about first time NCLEX pass rates. Like we can’t even pass your exams because you won’t help us, or let us see what we got wrong. Even if you schedule an exam review they don’t go over it with you. They read like three questions and say “here this is the right answer” without telling you the other answers. Like these are 130 question exams I don’t even remember the other answer choices were anyway. Like I mean they even show us what we got wrong? I can take practice NCLEX style fundamentals tests through Kaplan and pass them, but somehow I can’t pass your exams? Like is this normal? We also aren’t aloud to talk about the program at all. We aren’t aloud to talk to each other about the tests. Not aloud to see our exams. They say it’s unprofessional and slander if we do. Our lab instructor also says to do things his way and not listen to CDC or hospital recommendations. Or the textbooks (which they don’t use at all anyway and paid thousands of dollars for). One time he even slipped up and “this my program” like bro you’re just the coordinator. Like this program is just horrible I feel like. And they are insane. But I have nothing to compare it to. Is this what it is supposed to be like? I expected a challenge, but NOT this type of challenge. Should I transfer. Are all ABSN programs like this?