kcsun3

Lady Jezebel, Thank you :icon_hug: - I'm at a loss for words...that was a really nice thing to say and it really made my day :icon_hug: Steph

Hi Cardiacnurse33, Merriam is an older suburb of the KC metro area. Topeka is about an hour away - not too far, really. I think I will look here first, but I appreciate the tip. It never hurts to keep one's options open :) Thanks for the scoop and the moral support! Steph

Heart Queen, Very good points, and as I think about it, probably very true. I never considered myself an "expert" as a nursing student by any means...I struggled as much as anyone else. But I felt comfortable in the school setting and felt my strengths were valued there; I felt encouraged to use my strengths to define my own success, to expand and grow, to share as much as I could with others. In the nursing world, my strengths are not so much valued, at least at the novice level. More emphasis is placed on skills - and rightfully so... You are right...it IS hard. You have to work hard to turn your weaknesses into strengths to have enough collateral to get your bigger strengths a platform to be noticed. I have no idea if that even made sense to anyone but me LOL But, I understand what you were saying - you are right and I appreciate the guidance and support. Thank you, Heart Queen... Steph

Simao, I have heard that from experienced nurses several times since graduating...I really think that is part of it. I need to emote confidence - not that I know everything I need to know (which would be wayyyyy off mark), but that I am confident in my basic skills and assessment abilities (even if I am not), and know when to seek assistance. It's just harder to do than to say...but it is something I will continue to work on. Thanks for the great advice! Steph

Lady Jezebel, I agree with you absolutely, which is one of the reasons why I deferred the start of my program until the summer of 2006 (which would have had me at 2 years of experience at the start of the program). The summer of 2006 also coincides with the start of their online courses for the BSN-to-PhD program. That will allow me to continue to work while "in" school. As I understand it, the program takes 5 years to complete, which would put me at 7 years' nursing experience by the time I graduate, and my hope is that, as you said, the work experience before and during the program will help develop and guide my research so that it is useful and applicable to nurses. Thank you for the valuable and insightful post, LJ - I learn so much here and appreciate your advice greatly. Steph

My409, You did not come across to me as an inconsiderate hag at all - the underlying message was a good one, and your follow-up touched me (plus it was filled with good advice). I posted here knowing I would get a variety of opinions and thoughts - not just all flowers and hearts. For me, that was the point - so I could soak in the insights of all the experienced nurses here to help me see where I went wrong and what I can do to turn things around. The deeply touching messages of support and encouragement were a bonus that I cherish. Thank you for your honest response - I really value and appreciate it. Steph

Thank you, llg - I have so appreciated your insights and advice, and cannot adequately express my gratitude. Yesterday, I was feeling lower than low, and today, I feel like I can do this - I can learn from the past, move forward and start fresh. I am actually excited - so, thank you! :icon_hug: Steph

I will do that - and again, thank you for the wonderful support and encouragement - I really cannot express how touched and filled with hope I have been reading your post and those of others :icon_hug: Steph

Hi DaMonk, Great suggestion, and one I had considered, as I liked my psych rotation a lot. I believe I will give hospital nursing one more go first...one - to give me a chance to prove to myself that I can do this, and two - to get a solid foundation in the nursing world. Down the line, however, psych nursing may be a good fit for me :) Steph

Oops - a few more... Medsurgnurse: Great thought you posted, which gave me much comfort: "Everyone has had bad experiences. That does not make you a bad nurse." Thank you for that. Also, excellent advice on low-acuity med-surg, which is what I plan to look at tomorrow. Thank you! Mattsmom81: Thank you for the warm post and encouragement - it really means alot, and I am so appreciative *hugs*

More personal notes of thanks: Gerinurse10: I think there is an in-patient AIDS hospice here, which could be something to pursue down the road...but for now, I think I will bite the bullet and try med-surg, if I can find the right spot. Thank you for sharing your experience and thoughts - I appreciate it! BETSRN: Thank you for the warm response. While I do agree that there were issues with poor management and policies, I also take responsibility for my own role in this. I have taken your advice to heart and will shop around to find the right place :) Tweety: Thank you for the warm wishes and encouragement. Gerilou: Outstanding advice - thank you so much! Stidget99: Good way to look at things - that helped me immensely today. Thank you! Angie O'Plasty: Thank you *hugs* for your moving, compassionate post. Great advice, great insights. Thank you! Trauma-R-Us: I agree and will search to find a really good orientation program. Thank you so much! KPrice: I so agree about not being out in the field this new - years of experience should be required. Thanks for sharing your thoughts and insights with me. cpomb: What a horrible series of experiences you had, but how heart-warming and inspiring to learn that you overcame it all and have found happiness and success - your post was very helpful, and greatly appreciated! SunStreak: Thank you for the warm post and support - and I agree completely about CNAs - they have been my best allies and friends in nursing. VeryPlainJane: Would you mind if I PM you to get some local advice? Thank you so much for your post :) Joyful Nurse: Excellent advice, and greatly appreciated - thank you! Jnette: *hugs* Thank you for the support and encouragement - I cannot express how moving the responses here have been for me - how encouraging and how much hope it has given me. Again, I thank all of you from the bottom of my heart - for the support, the guidance, the warmth, the insights, and how you all have shared your experiences and helped me to feel not so alone. You have given me hope and helped me find the courage to try again - I cannot thank you enough. Steph

Thank you all for the support, encouragement and excellent advice. It is deeply, deeply appreciated. I have had a good night's sleep, and spent most of today looking at my situation as honestly and rationally as I could and thinking about the best way to come back from it. SO...here is what I am going to do - an action plan based on all of your guidance, one that I think may work: Tomorrow, I will (despite my hospital phobia) go over to the hospital where the hospice said they would help facilitate a transfer. I will visit each of the units with openings and talk with the managers (or set up a time to talk with them). I will be open about my experiences, what I feel I would need in terms of orientation and support to be a successful, contributing member of the team, what my assets are, and what areas I will need help with. I will be looking for a lower-acuity adult med-surg unit. My hope is to find a unit that would provide the right environment and support to help me rebuild my confidence and gain some solid experience. Now some personal notes to all of you who have graciously taken the time to advise me and share your thoughts/experiences: llg: I appreciate you sharing your insights and experiences - you posted so many valuable things to honestly think about. I will say that at my first job in nursing, with the floating situation...I did express my concerns to my preceptor, my peers, my charge nurse, my direct supervisor/manager, the manager of the NICU, and the director of all the units in our "float family" - in that order. It did finally result in a change in policy where new grads were not to be floated at all, and experienced nurses would have the option to not float. I am happy that that change happened, but it was not implemented until right before I left, and other issues on my unit had worn me down in ways I cannot express. With regards to calling in sick to avoid floating...I should have clarified that somewhat. I did so at the direction of my preceptor and the director - it was not "sneaking around it" so much as it was an accepted (at that institution) practice. So, one did not have the option to not float at that time unless they called in sick and had paid leave time to use. I did, however, leave without finishing out my notice - not professional at all, but what I had to do for me. Why did I allow 6 hours to pass before the NICU manager came to help me? Lack of cajones, not wanting to make waves - but bottom line, not standing up to my professional responsibility to my patients. I agree with you there. Regarding my second job - again, you are absolutely right. I jumped in without thinking it through, ignoring the advice of my preceptor at that organization and ignoring the red flags I saw. In hindsight, even if I had had an excellent, extended orientation and support system there, being out in the field on my own requires a significant practical foundation with a wide range of experience, which I am years away from having. Anyway, I thank you from the bottom of my heart for sharing your insights and experiences, and for the solid advice. *hugs* (more personal notes to other posters on the next post...)

Hi Dixielee, Good advice and insights, as before - thank you. There are many hospitals in my area, but...gosh, I need to really think this through. 12-hour shifts have a significant negative effect on me physically I found - more so than I ever expected. 8-hour shifts would be more conducive to my health, but I'm not sure if any of the hospitals around here allow 8-hour shifts any more. At any rate, my career interests hover in three areas: * Hospice * Teaching * Research I was accepted into the BSN-to-PhD program at the state university this Spring and deferred my start to the Summer of 2006 (felt I needed to get experience in the profession before pursuing graduate studies of any kind...) - but that is my road map to teaching and research. Need to figure out what I should do now, in the interim...thinking, thinking, thinking... Thanks again for your advice - I really do appreciate it. Steph

Hi Walter, Thank you for the pep talk and encouragement - I appreciate it greatly. I hope that I can find a place with a good orientation and supportive staff - and I am glad to hear that there are such places out there. Sounds like you work with a great bunch of nurses, and that is encouraging :) Steph

Hi Dixielee, Thank you for sharing your advice and insights - it is greatly appreciated. My hospice supervisor said I could use her as a personal reference, and I know that I can call on several faculty members and the dean at my nursing school. The hospice folks gave me a listing of all the job openings at the hospital they are affiliated with, and said that they would help facilitate a transfer over if I let them know what I am interested in by next Friday... I don't know though...while it is not the hospital I worked for previously, it is the hospital where I did most of my clinical rotations. The staff did not seem to be very welcoming of new grads and it has not gotten a good review from my cohorts working there now. Your solid advice is the gold standard, I know...but I really did not like working in a hospital setting, and there's the rub. Can I do anything without 1 year of hospital experience? Thanks again...I value the input. Steph

CRJnursewarrior, Thank you for your warm response and helpful advice - it is greatly appreciated. I am also encouraged to hear that you were able to move beyond your initial negative experience and on to something better. Thank you for sharing that with me *hugs* Steph

Hi all, I apologize in advance for the long post, but I am devastated right now and need some guidance. While I have never been a big poster here, I have been an avid reader of this forum for over 5 years. Those who know me will appreciate the irony of my story. I am a new grad (May, 2004). Nursing was a dream of mine for as long as I can remember. When my children were old enough, I started to consider nursing school. I read everything I could, made a web site to share the information I found and sought to encourage others. I even wrote a book and was hired to write a weekly advice column for nursing students and potential nursing students (very ironic...). Once in nursing school, I set up a mentoring program, pairing alumni with interested students. I organized a peer tutoring program. I held game show challenges to help junior students through the bewildering first semester. I coordinated the junior-senior "buddy" program. I was passionate about nursing and wanted to support others on the same journey however I could. I did very well in school, but knew that the real learning was to be had after I graduated. Great grades do not automatically equal "great nurse." Great nurses become so only with experience. Knew all about the stages of reality shock, nurses eating their young, yadda, yadda, yadda. But the idealist in me held out hope that a positive attitude, a willingness to ask questions, a willingness to jump in and try, and a desire to learn would be...well...helpful at least. First job out of school: I went to a large metropolitan teaching hospital and worked on the pediatrics unit weekend nights. Horrid. While I was blessed to have a great mentor/preceptor, I dreaded going in every shift. I spent most of the week recovering physically and emotionally before heading back in again. It was so stressful, I had six MS attacks in 6 months. Never called in sick until the end...just carried on as best as I could. My second day off orientation, I was floated to the NICU - the NICU! "Oh, they'll only give you feeders and growers - you'll be fine." Yeah...no orientation to the unit AT ALL - we did computer charting, they did paper charting. Their equipment was different. Their protocols were different. Their patient acuity was higher (obviously). I asked the charge nurse for a brief tour of the unit at least before diving in...but she was busy. I was stuck in a side section separated by a WALL from the rest of the unit by myself - no other staff there - with 3 NICU babies getting complicated (to me) drips. Again I asked for help - charge nurse said she would be over in a minute. She came over 6 HOURS later, and of course I had done everything wrong, not having the first clue about NICU. I just thank God the babies didn't suffer any harm. Scared the crap out of me. Anyway, the rest of my stay at that hospital was horrible. More floating to NICU, with a devastating near-miss. I did not have the option to NOT float, so I started calling in sick on nights when I was going to be floated. On my own unit, I was given patients whose care needs were way above what I felt comfortable or even remotely competent with (i.e., chemo patients without having had any chemo classes, etc.). My self-confidence dropped and dropped and dropped. Each week was worse than the last and every day my license was on the line. Then, out of the blue in December, I received an e-mail from the manager of a hospice where I had done a clinical rotation. Hospice has always been my nursing dream - I love everything about it. She wanted to hire me on, said they loved me during my rotation and that I had a great future there. I was so excited - here was a way out of the hospital and into a job where I could be the nurse I had always hoped to be. I called my preceptor from that rotation to tell her the great news. She told me that she no longer worked there, and said, "Don't do it...That hospice will use you, burn you out and drop you." Did I listen to my mentor? No... So, I quit my hospital job - didn't even work out my notice, which I have never done before - but I was terrified that I would lose my license - so unsafe there! On I went to hospice, heart filled with joy and elation. I should have listened. I received all of 2 days of orientation, riding around with another nurse, and then was handed my caseload and sent out on my own. On my own, out in the field, with just 6 months of nursing experience under my belt. Can you see the disaster waiting to happen? I asked for support, help, guidance - anything - but my supervisor, manager and peers were all perpetually swamped and not available. I tried my very best, worked as hard as I could, researched every diagnosis, all the appropriate interventions and tried to expand my knowledge fast enough to be able to meet the needs of my families. It just wasn't enough. Friday, my supervisor called me in for an afternoon meeting. I asked what was up - she said, "I would rather talk to you in person." Not good...not good at all. As I feared, I was being asked to voluntarily resign. She said she knew I had tried really hard, but I didn't yet have the confidence or strong personality needed for being out alone on home visits with no support. She felt bad that I hadn't received a decent orientation, but they just didn't have the time to do that. They needed experienced nurses who could hit the ground running. Of course this makes sense - obviously! But then why did they seek me out and hire me in the first place? I should have seen the red flags, but I was so excited about hospice... I am devastated. What do I do now? Where do I go? I shudder at the thought of going back to a hospital setting - I am still traumatized from my first job. In fact, my confidence in my nursing abilities is so low right now, I am terrified to start again. I cannot get a reference from my first nursing job, and I am not so sure on the second, either. Any guidance or suggestions would be greatly appreciated. I just don't know what to do, and I am broken-hearted. Steph

llg, you are a gem. I always have enjoyed reading your posts and did not once feel that you wanted to start an argument. To the contrary, you had sage insights (as always) and I appreciate the point-counterpoint :) Thank you for providing good clarification and food for thought - that is what I love about this site!

Hi llg, I agree with what you are saying - the number of licensed nurses does not equate the number of nurses actually working; that said, the report I was citing gave the number of licensed nurses currently employed in nursing. The report does not, however, specify if these nurses work full-time, part-time or PRN, which is a big factor, as you mentioned. Other parts of my research paper addressed this issue, but I did not want to post the whole huge thing :) Anyway, you raise valid points - nothing is ever black and white, I agree.

Here is a short pull-out from a research paper I wrote on the nursing workforce last summer - it maybe has some of the figures you are looking for? Current Data on the Nursing Workforce Studies by the United American Nurses, AFL-CIO (Lake Snell Perry, 2002), the SEIU Nurse Alliance (2001), and others claim that the current nursing shortage is the biggest problem faced by the profession today. The mainstream media has been quick to concur (Pekkanen, 2003). Nurses surveyed by Peter D. Hart Research Associates (2001) on behalf of the Federation of Nurses and Health Professionals almost unanimously responded that they believed there was a current nursing shortage. 84% indicated that the shortage was moderate to severe, and 14% believed that there is at least a minor shortage; only 2% felt that there was no shortage to speak of. The facts do not provide evidence of a shortage, however. In 1998, there were 2,221,000 active registered nurses, but only 2,078,810 nursing positions. At that time, despite cries of a shortage, there was actually an oversupply (Levine, 2001). More recently, the National Center for Health Workforce Analysis (2002), drawing on data from the 2000 National Sample Survey of Registered Nurses (Spratley et al, 2000), claimed that there was evidence of a shortage dating back to the year 2000. They cite an estimated national supply of 1.89 million employed registered nurses, with an estimated demand of 2 million. Interestingly, a review of the actual figures in the Sample Survey reveals a different picture. The survey, conducted by the Bureau of Health Professions, Division of Nursing, indicates an actual supply of 2,201,813 of active, licensed RNs employed in nursing. Rather than a shortage, this is indicative of an oversupply (Spratley et al, 2000). Reports that the nation is currently experiencing an overall nursing shortage, then, are largely unsubstantiated. Most of these reports actually refer to shortages in specific specialty areas of nursing, certain geographic areas, or in the proportion of experienced nurses to new graduates. These are not indicative of an overall shortage, but rather point to a maldistribution of available labor (Levine, 2001). The GAO (2001) found evidence of an emerging shortage of nurses willing to fill vacant positions in hospitals, nursing homes and home care. This was linked to poor working conditions, high staffing ratios, mandatory overtime and inadequate pay in those sectors (GAO, 2001). The sector hardest hit by the human resource distribution inequality is the hospital industry, which reports up to 126,000 unfilled registered nurse positions annually (American Hospital Association, 2001). The SEIU (2001), concurring with the GAO, points out that this may be related to the hospitals' staffing practices; in an effort to contain costs, hospitals have long held down nurse staffing levels, despite increasing acuity. The resulting deterioration in working conditions, and increasing level of stress for staff nurses, has led to a mass exodus of nurses from the hospitals (SEIU, 2001). Even today, hospital nurses report a decline in the quality of nursing care. This they directly relate to inadequate staffing (Cornerstone, 2001). Projected Shortfall By the year 2008, the expected supply of registered nurses will be 2,514,000, while the demand is projected to be 2,529,674. This points to a shortfall of just 15,674 registered nurses. The margin of shortfall is so small (0.6%), "some might regard it as indicating a balance of supply and demand" (Levine, 2001, p. 12). A more significant shortfall is predicted by the year 2020, when it is estimated that the demand could exceed the supply by 20% (GAO, 2001; Levine, 2001). The projected shortage at that time will be anywhere from 400,000 to 1.5 million nurses (Bleich et al, 2003).

MaryRose, No need to apologize - yours was a sincere post, and did not create any negative feelings at all. I hope my post did not make you feel that way, but if it did, please accept my apologies. I was responding more to the frustrating oppressed group mentality that seems to pervade the nursing profession. I would continue, but I fear it would develop into a long, drawn out rant... Thanks for posting, MaryRose *hugs*

I guess I'll be the lone voice of dissension...but what purpose would that serve? I guess I'm looking at motive (not of the original poster - just regarding the idea in general) - would this be to "show those mean doctors how hard it is to be a nurse?" Doesn't that sound, well, petulant and childish? I do not mean any disrespect, but it just feels co-dependent and needy to me. The medical model and the nursing model are entirely different approaches to healthcare - often complimentary, but still distinct disciplines. A required pre-med degree in nursing doesn't make sense, although some choose that route and it works for them. But I don't think anyone would suggest that doctors must first be occupational therapists or pharmacists so they can understand how hard those jobs are. And you don't see physical therapists clamoring for understanding so that everyone will play nice in the sandbox. If we focused as much efforts on developing our own profession as we do on trying to get approval from others, we'd be further ahead. Just my two cents...

Marie, Here's a good article on Nurse.net about PDA's - what they are, how to select one, what you can do with them in nursing, software you can use, etc.: http://www.nurse.net/clinical/pda/index.shtml Steph :)

Here's two sites to check out: Freeware Palm http://freewarepalm.net/ PDA Cortex (RNPalm) http://www.rnpalm.com/software_palm.htm Steph :)

Bassbird, NCLEX implemented an onscreen, drop-down computer calculator you can use during the exam in April, 2001. Here's the link: http://www.ncsbn.org/public/testing/info_update.htm Hope this helps! Steph The Student Nurse Forum http://kcsun3.tripod.com