Quidam

I graduated Dec. 2009, first day of work was Jan. 2nd 2010, I was not licensed until sometime in late January I think. I worked as a graduate nurse during the interim. I was hired before I graduated. I was not employed at the facility. I work at a large county hospital in Fort Worth Texas.

It would be invaluable experience!

It took me about 3 - 4 months to really adjust to 12's. But I did and I tried different shoes. UGH. I bought a pair of Saucony running shoes that hurt my feet badly! Wore them about 3 times. I bought Danskos and really liked them...then I bought a pair of Alegria on a whim. I thought they were really ugly but a lot of the nurses wear them at work and they just raved about the comfort. So I tried them. Now...I have 2 pair and that's all I wear. Super comfortable and my feet never hurt with them. I can't rave enough about them...still don't think they are cute...but comfort beats the heck outta cute!

I am 8 months in and so far have only had one doctor act up with me. He was telling me I was wrong when he asked me about some clerical procedure that I had already told him I was unsure about but this is what I thought....He proceeded to speak loudly to me about how wrong I was. Took me a whole 3 seconds to say to him "since you seem so well versed on the subject, do it yourself" and I walked out of the patient's room and promptly returned to my charting. He came out behind me and told me he would not discharge the patient until "so and so" was done. I told him it did not matter to me one way or the other. All said in a very calm, matter of fact tone. He said this to me as I was sitting at my computer. I never even looked up at him. He stood there for a moment, then walked away and handled it himself as I had suggested. LOL!

I have never had more than 4 patients. LOVE IT!!!

Ya know...this compelled me to post what has been on my mind for a while. I am a new grad and have been working at my first position for 6 months now. I feel truly blessed to have landed where I did. My co-workers are wonderfully supportive. My preceptor was patient and encouraging. I never feel awkward asking for help or asking questions. I am repeatedly asked if I need help..."what can I do for you"? "Do you need anything"? And I hear them saying this to even experienced co-workers. I am sure to offer assistance when I can as well, as I want to be a part of this team they have built. Now I have had a few minor incidents but nothing major. And nothing that got me down. There are a few not so wonderful people there, and my goal is to not let a rotten few spoil a good thing for me. But the vast majority are good nurses, with a genuine interest in new nurses and the patients. I hear the horror stories others tell...and have even heard it about other units in my facility and each day I am grateful for this awesome unit I was lucky enough to be hired into.

Betcha learned a lot today. :hug: And I think that it may have been somewhat of a compliment that he said since you were a new grad then you did ok. Really there is a world of difference between an experienced nurse learning a new area and a new grad learning an area...especially something like the ED. Sounds like you did a fine job in very difficult situation. Be proud.

Hard working techs are awesome! But I have come in contact with some who are just as bad as the lazy nurses. As for being a student nurse...keep your head about you and always remember there is much to learn from good and not so good nurses. I learned what kind of nurse I did not want to be from some not so good nurses I encountered in my school and externship. Now that I am working as a nurse, I do realize many of my responsibilities limits my time with the patients. When I do find the need to call for a tech, it is because I am so behind with what I have to get done that if I take the time out to do whatever it is, that I will fall farther and farther behind. As a student, I was not aware of all these "nursing responsibilites" that get in the way of direct patient care. So...just learn what you can, make every interaction a learning experience, and continue to praise those great techs. They really do deserve more recognition.

I was not trying to be sarcastic. I see how it may have sounded that way. I just curious as to your thought process when you were doing it. I have no ideas for you as far as getting your job back...but I do wish you well.

It was my experience that more employers were looking at GPA's when I graduated (Dec. 09). I think it has something to do with the job market. But, either way...it's done now. Just move forward. No sense dwelling on something that is done and over. If your program offers it, take advantage of any extra credit opportunities, even if the points seem negligable. You just never know when you are going to have a tricky test. Good luck to you!

As a new employee I have a lot of trouble knowing who is who...and what the names are and as I chart and cannot put the names with a face, I generalize and HATE it. I am doing my best to get and remember names, and know which Dr. is which as I don't always speak to the ones rounding on my patients but I usually at least see them . For the exact reason mentioned above...I need to have specifics in my notes of I am ever called into question.

Dallas/Ft. Worth here...and I have associates. I have not noticed a problem with ADNs being hired. I went to work immediately as did many of my classmates.

I would tell the patient that it is really hard to have an opinion about options when you are not actually in the position of having to make that choice for yourself. Then offer information on each option. As much as I think I would choose this over that...I really don't know what I would choose until I am in that situation. I have found this to be true in many areas of my life...not just when it comes to health care.

Hi everyone, I am a student in an accelerated 2nd degree BSN program at Georgetown University and I am working on a small project on the experiences of new grads. I'm looking for some opinions, from new grads as well as more experienced nurses and would appreciate anyone that is able to answer some questions. Feel free to PM me. Anonymous. 1. What type of education program did you complete? BSN, ASN, Second degree, etc. ADN 2. When did you graduate and how long have you been working? I graduated in December 09. I have been working since January 4, 2010. 3. Current position and goals for the future. grad school, specialty? I work in the short-stay unit that is an extension of the ED. We have tele and med/surg patients, we do potent drips, and we run an infusion clinic out of our area. 4. Tell me a little about your orientation. How long was it? Was it structured? Did you feel like you were just thrown in? My official orientation spanned 8 weeks. I had class almost every Thursday. EKG interpretation, ACLS, 12 Lead EKG class, Potent Drips class, ABG interpretation class, and an infusion class. The actual preceptorship was one on one with my nurse and I progressed at my own pace and was not forced to do anything I was unsure of or uncomfortable with. A very new nurse friendly environment with almost every other nurse on the floor willing to answer questions or jump in and help. The environment made my preceptorship a wonderful experience. I got really lucky from what I hear from other nurses. I would say it was structured, I knew my schedule, I knew my preceptor and it was the same one with the exception of maybe 3 days here and there. And that proved valuable so I could see how other nurses worked and helped me to realize I could deviate from one set way of doing things. I never felt like I was thrown out there. I had and still have great support from other nurses. Someone is always coming and asking me how I am doing and if I need anything. Even the charge nurses. 5. What were the biggest challenges you faced in orientation? when you got on the unit alone? My biggest challenge while in orientation was understanding all the paperwork involved in admissions and discharges. How these were generated and where all the paperwork went after a patient left. One of the few drawbacks to having extremely helpful coworkers...my paperwork would always just magically appear in my hands at the appropriate times. After being on the unit alone my biggest challenge has been time management. 6. Biggest suprises? How jaded some nurses are. I mean I understand the shine has worn off, but I have seen some outright callousness too. We can't change the patients or their circumstances, or why some do the things they do to themselves...but we can at least moderate our reactions to them. 7. Did your educational training adequately prepare for the "real world"? No...I don't think so. But I served an externship, again at a really student friendly hospital. I was able to work in a variety of settings: PACU, ED, ICU, Tele, etc. This experience did more to teach me real world than did school. 8. Something you wish you had been told while you were in school? How incompetent we can still feel during and post orientation...but that this is normal and reassure us that it gets better. Better to know to expect those feelings, than be blindsided. 9. Were more experienced nurses helpful and receptive to your questions? what about the doctors? The nurses were, absolutely. The doctors...not so much helpful, but I have not had anyone be rude to me when I was asking a question or when I did not understand something...not yet anyway. 10. Any advice for new grads? Do not go into a situation with an air of superiority. Yes, you are fresh out of school...probably still remember a bunch of facts that more experienced nurses have forgotten...but do not underestimate what they know and what experience has taught them. One of the major complaints I have heard from the nurses I work with is the new grads coming in thinking they know everything. Also, don't forget your basics, the fundamentals from your early classes. Everything comes down to the basics. The later classes consume our minds, the facts and values, the processes and procedures. Remember to "see" your patient, put your hands on your patient. Assess your patient, not the monitors. Any questions you can answer would be great! Would also love to hear from ANY nurse relating their new grad experience to compare experience across time. Thanks! Jessica

I would work with her to find a short amount of time to talk. Sugar coat it. Tell her you appreciate her time and the things she has taught you but that you are having a difficult time grasping some of the finer points of time management and despite your best efforts things are not improving. Say that you think it might be beneficial to see how other nurses handle this and that perhaps you might work with someone else for a while before you are off orientation. Keep it nonconfrontational, do not accuse, do not blame. Maybe she is using you, maybe this is truly her idea of teaching you. I dunno. Whatever you say, come across as grateful for what you did learn from her and appreciative of her efforts. I think I would change preceptors though, especially since it has already been mentioned to the nursing supervisor. It might get back to her anyway and if she finds out on her own that you were even talking about changing preceptors and she has no real idea why that could end up causing more trouble than if you just talked with her about it. Who knows...maybe she will change some things to accomodate your learning style...maybe not. But I think it is best to express your feelings and concerns...just be careful in the delivery.

As you previously stated, there are not many jobs available where you are. Realistically, what are your options? While not an ideal situation, this sounds like a prime opportunity to gain experience and become a more well rounded nurse. I think I understood that the aquity of the tele patients bothered you...but new nurses start out in tele all the time. Get a good EKG interpretation book, ask if the hospital offers a class. If you want to stay in that geographical area, and there are no other positions available to you, make the best of things. It is so much better than being layed off. Try to FIND some positives and focus on them. There are plenty of negatives I realize. If nothing else this can help you learn to roll with the punches. Sometimes that is just what you have to do. Good luck though, with whatever you do.

I don't know about you, but preparing care plans helped me tremendously in understanding patho. I DID look up the disease my patients had. I correlated the signs & symptoms the patient was having with the expected signs and symptoms of whatever the disease or disorder was. In listing my labs, I looked those tests up to see what was being tested for so I could understand what the abnormals meant. Care plans were a pain, but I learned so much doing them. I still study, there are many things I look up and research just because I want to know and it will enhance my practice as a nurse. I think I will forever study in this field. An example is last night I looked up why metformin is prescribed for PCOS. Had I seen that in practice I would have been confused. I saw it mentioned here on allnurses and made the effort to research it so now I will know. There have been other instances when a Physician has ordered a test and I did not understand why. So I look it up. But without my solid educational foundation, I would not even be able to begin to put the pieces together. I would be struggling daily. I work in acute care area, and see a variety of disease processes. I have been on my own for 3 weeks now, and although I struggle with time management, the rest of my practice seems to be going well. I am told I am doing well, and I strive to constantly do better. I embrace every learning opportunity that comes my way. But that is what I did in school as well. So...to the OP don't wait to learn to be a nurse once you have a job. Your employers will expect you to have a solid foundation of knowledge. They will not teach you patho, they will not teach you labs, they will not teach you critical thinking. That is what school and clinicals are for. Be a self directed learner. Bring a solid knowledge base to the table and you will be more successful in your first position. It is hard, and I constantly feel inadequate in comparison to experienced nurses. But I am proud of what I do know, unafraid to say when I don't know, and I am proactive in advancing my knowledge base. Just my .30 or .40 cents worth. :)

Sometimes they are disorganized...sometimes hodge podge describes the experience perfectly. In the end, you get out what you put in. Focus on learning something from each clinical experience. Research whatever disease process your current patients have. Look at what labs are being done on those particular patients and try to connect the dots as to how these labs monitor this disease process. I think clinicals are invaluable. You get a feel for the ebb and flow of different units, get comfortable with being hands on with your patients, get comfortable with the different personalites you encounter, and the different disciplines involved in day to day care. Being familiar with equipment will help you tremendously once you graduate. Get your hands on as much as you can. Do as many procedures as possible. I am a new nurse, since January and yes, I am still learning how to be a nurse. But without my clinical experiences I would be so far behind in the learning curve. Don't stress over how clinicals are done, just be grateful for the opportunities and make the best of whatever is set before you. You will be glad you did.

Each semester I gave my instructor a Satin Hands set from Mary Kay.

"I think he or she was saying that the right spelling is acceptable. Exceptable, if it's really even a word, would mean that something is able to be an exception. Or that an exception can be made to it or against it. Totally different meaning. I guess it's considered rude to correct spelling or grammar or other errors, but I don't really see why. Don't professionals want to use proper English? I would like someone to let me know if I'm doing something wrong" I believe we all know what was meant by that....and yes...it was rude. The rest of the post was fluent and well written a simple mistake can be tolerated. Had the entire reply been riddled with misspellings and grammatical errors, then it would have been more understandable for a correction to be made. In my opinion, just as important as teaching of the 3 R's, social ettiquette, and rules of propriety are also of the utmost importance. They also go a long way professionally. :)

I had about 6-8 SATA.

I got 75 questions and I guess it took me about an hour and a half or so. Maybe not quite that long. Good luck to all those preparing to test.

SBAR. You can google it for more info...but it is a system that helps "gather" your thoughts for report. S-Situation-why here, most recent treatments, meds, special considerations, most recent pain meds, special precautions such as seizure or fall precautions. B-Background-history, allergies, etc. A-Assessment-Current condition, most recent vitals, labs if pertinent to situation, any new findings, etc. R-Recommendation-What you think needs to be done, I include pending diagnostics here, etc. If you look it up I am sure it will be much more detailed. Works for me.

Thank you!