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I wonder if perhaps the patient asked the question in front of his family members because he wanted those family members to hear a nurse answer it. Sometimes it's not the patient who's in denial. Is it possible he was enlisting the OP to gently chip away at their denial?

Bear with me. There are several types of tires. Most cars come with all-season tires. Most people replace their tires with more all-season tires when the mechanic warns them their old tires are dangerous (or, let's face it, when the mechanic warns them they won't get an inspection sticker unless they replace the tires). There are also 3-season tires, that give more grip in wet or dry conditions, at the expense of not doing so well in the snow. There are also winter tires, which may not be so good in rainy and dry conditions (and they wear out very fast in these conditions), but get much better traction in snow. Why am I telling you this? Because winter tires and front-wheel drive perform better on snow and ice than all-season tires and four-wheel drive. So if you want to get to work safely year-round, you could start with a set of winter tires for your Honda, then get a set of three-season tires (or all-season tires) in the spring. (Yes, it's a drag that you have to store your winter tires, and you'll probably need to buy another set of wheel rims). You could spend a lot of money on a new car and still not fix your skidding in the snow problem. If you apply what I'm telling you above, you could fix the problem for $400-$1,000, which is a chunk of change, but much less than the cost of a reliable replacement car. Good luck!

Hi everyone, This month (October 2014) the UK Nursing and Midwifery Council (NMC) revised its process for registering for nurses trained outside the European Union (EU). The short version is: this is streamlining the process. Instead of making applicants document some 4,600 hours of clinical practice in training and making everyone take a course, they're administering computer-based and practical nursing tests and you're eligible to take the test if you can pass the IELTS English test and demonstrate you're an RN in your country. More detail at NMC's Trained Outside Europe page. Is anyone in the new process yet? I started an application in the old process, and I don't think NMC will accept my US BSN because it doesn't have enough clinical hours. Side note: I guess that the reason for the change in process is that 4,600 clinical hours is a lot more than many programs demand. In the US, the only way to accumulate anything like that many hours in training is to do an ADN, which ironically, NMC won't accept! So: anyone have any insights yet?

canesdukegirl, this is such a good perspective. I wish I could have gotten this advice when was orienting in the OR! There are definitely those who will intimidate, bully, or try to establish pecking order by finding fault with what you do. And just because somebody (surgeon, preceptor, manager, tech, whoever) tells you to do something one day today, doesn't mean somebody else won't scold you and tell you to do the polar opposite thing tomorrow. None of the individual tasks in the OR are super-hard to learn. The hard thing seems to be learning the rythm and culture of the OR you're in. If you can show you're receptive in that way (think about how quickly you call time out, reply loud and clear to others who can't turn to look at you while they speak to you, hurry up and slow down at the right morments), you can learn to fit in. And you can remind yourself that the hazing (Otis elevator? Really?) and the condescension aren't good, aren't fair, and aren't something you can really do much about. Just resolve that you won't be that person when you're the veteran working with the newbie.

I graduated from UT El Paso, then moved to Virginia. It took me months to find work; all my classmates seemed to find jobs in town immediately. More than half of the population of El Paso speaks Spanish at home, so if you are bilingual that will help, but it doesn't seem to have been a requirement - non-Spanish-speaking folks seemed to do fine too. El Paso is kind of big and sprawling, and the desert environment isn't for everyone, but the people are friendly and it's one of the safest big cities in the US.

Well, I'm off for Memorial Day but with all this good advice and perspective, I'm already looking forward to going back to work! Thanks so much to all who posted - I am very grateful.

I'm struggling to relate to a colleague in my unit. I'm six months off orientation in the OR - because it's OR, we have to partner closely with another nurse or OR tech in the room each day. I have a nurse colleague who seems to be universally liked, caring, and very, very good at the work. And every time I work with her, I get immensely stressed. On the surface, our relationship is fine. Every time we work together, however, I encounter a constant stream of corrections. Yes, I still make mistakes - of course I do. Many more than she does. But every mistake seems magnified, every task I choose to do next is the wrong prioritization. While I was on orientation (and remember, OR orientation tends to be longer than on other units), I despaired because every partner I worked with seemed to do this to me all the time. Eventually another man on the unit took me aside and told me, You're doing fine - remember some people will have an interest in making you continue to seem incompetent to build themselves up. This was enormously helpful. Now, the combination of practice, my slightly increasing competence, an increase in confidence, and lots more practice, have got me to the point where I can function OK. I enjoy most days. When I work with this one person, can be like the worst days of orientation all over again. So: is this overwhelmingly respected and beloved co-worker picking on me? Is she just trying to help in a way that adds to my stress enormously? It only happens with one person. I really want to believe that she just wants to help - she has no need to "build herself up" in the unit. Everybody but everybody thinks she's terrific. But this only happens with this one coworker. It really only just crossed my mind that perhaps this is a male/female thing. I'm still optimistic that perhaps it'll get better as I get better at doing the work - I'm still very, very new at this. Guys: do you have any experiences or perspectives that can help?

I'm 6 months out from my OR orientation. The truly terrible days are coming much less frequently now. It really does get better. My orientation was supposed to be nine months, but it stretched out to almost eleven, even though my unit is perenially short-staffed. If you're not ready, you're not ready. Everything else I could say has already been said by other posters, but I will add this: I have found Evernote to be quite useful as a way to keep my notes organized. I write hints sheets on individual surgeons, on specific types of cases, and on some of the less frequently used instruments. It's especially good for instruments because you can take photos with your phone. The pace is so fast that I seldom look back at one of my notes before I'm doing a case; I think just the act of writing the notes helps me absorb the content more effectively. But it is nice to have that reference. Remember everything with Evernote, Skitch and our other great apps. | Evernote Good luck!

Gloves on top of gown, slide towel and gown out. The rule that was stressed when I was learning was that you can't put your gloves or gown on the sterile field with other supplies. They must be on their own surface, and the gown wrapper then becomes your mini-field for picking up the towel (if needed), gown, and gloves.

I'm just coming up on one year in the OR. It's my first nursing job. Definitely harder than school for me. I recommend "Pocket Guide to the Operating Room" by Maxine Goldman. I bought the Kindle edition so I can read up on cases on my smartphone (though as other posters noted, don't be tempted to get your phone out during a case). The App I used most is Evernote - great for making out preference cards for surgeons or cases, and also useful for snapping photos of instruments with my cellphone (again, not during a case) to teach myself the instrument names.

Hi dontcallmeamurse, How's it going since you posted in July? I'm about to start working independently in my OR after 10 months of orientation, and I'm still not sure if it's the right place for me. But I have several compelling reasons to stay put for now: Hours: if I wasn't working 7-3 weekdays, who would pick up my son from school? The "grass-is-always-greener/out-of-the-frying-pan" question: this is my first job in nursing. Would I be happier in a different nursing job? I have no way to know. My indenture: I agreed to stay two years after they trained me. And what other nursing job is going to offer a new grad a 10-month orientation? I don't think I'll ever be one of the cool kids in my OR. I feel as if there will always be people looking at me wondering why on earth the manager ever hired somebody as slow and stupid as me. I hate the feeling I sometimes get that my employer wants me to look after doctors more assiduously than patients. I wonder if the OR is ever the right place for an introvert like me. But I'm making it work. Just about. Where's your head at?

I use a small carabiner that I bought at Walgreen's. It's versatile: usually I clip it, with my wedding ring, to my car keys and leave everything in my locker. If you didn't want to leave it in a locker, you could use the carabiner to secure it to a necklace or ID badge lanyard. I'm a guy, so I can't comment on how it would feel clipped to a bra strap. But I think it's a least as secure as a safety pin, wherever you attach it, and 100% less likely to stick me.

I am in the same position. Even with the benefit of a formal training program, it's tough being a new nurse in the OR, and I rather sense that I am already seen as "the slow one" in comparison to the other new nurse hired with me. To some extent, showing a willingness to mop floors and take out the trash, especially as the circulator, who is on the hook for a quick turnover, is going to help. On the other hand, keep in mind that you are expected to delegate appropriately - if you need to get on with something else, you need to figure out the right way to tell one of the orderlies that the room needs to be turned over. Other than that, I've found it helps to talk to as many people as you can - strike up those conversations in the break room, even if it doesn't come naturally. If people ask about how it's going, tell them about something that went well for you recently, then think of something that didn't go as well and ask that person how they would have dealt with that situation. That's the best way I can think of to show that you're getting it (even if, like me, it may be coming slowly) and that you're eager to learn.

It sounds like you may be over-thinking this. I agree with everything you say - it may be difficult if you're offered a job you don't want; it may be too late for the job you do want; you may never get a job at this place. All of these things could be true. The only thing that's certain is that you'll never get a job if you never apply. The worst thing that can happen is that you are offered this job you don't want. And then you can come back to allnurses for more advice! Good luck with the search!

babyb78, You mentioned waiting for the immigration process, and I want to make sure you realize that you should be working on that before you leave for the States. Certainly, don't show up without a visa and say to the immigration people at the airport, "Oh, I'm here and I'm going to get married." That will not go over well at all. There is such a thing as a fiance visa, if you aren't yet married. I got one of these when I married an American and moved to the US. If you're already married but are living in the UK, you can get a spouse visa. Finally, if your fiance is living in Texas now, he (she?) might want to consult an immigration lawyer for more detailed advice. The proximity of Texas to Mexico means such lawyers are plentiful and cheap, at least in the parts of Texas I have lived in. Having good advice on this before you arrive can be well worth the $100-$200 a person might spend on an hour of a lawyer's time. (This was certainly my experience. I had no advice, but had to wait nearly four months for work authorization!)

I'm in just such a program after getting my license in November. I'll say it's a challenge alright. My hospital sends me to another, much bigger, hospital nearby for training - we're taking Periop 101, which is a blended online course offered by AORN (Association of Perioperative Nurses). Several months of one day in the classroom and four days of clinicals at our hospital, and lots of homework on the computer and written assignments and quizzes. I am struggling and I have a lot of days when I don't want to go to work. I wake up night worrying that I have harmed somebody. Luckily for me, I'm a second-career nurse and I have experienced this feeling before. I'm glad, in a way, to be experiencing it, finally, as a nurse. And, lucky for me, the nurses I work with are terrific and recognize what I'm going through, and they do provide reassurance. But still, it's tough. Compared to other specialties, I think the difference is probably that they don't let you start working alone until later. They keep telling me it'll be a year before I'm working on my own. That may sound nice, compared with a 6-week orientation and then off you go on the floor with four or five patients for a whole shift - that's certainly what I thought. But that certainly doesn't mean that it isn't enormously challenging. I have almost complete confidence that if I had gone to a med-surg unit, I would have known, even when I was a struggling newbie, that eventually I could do this. With OR nursing, I find myself thinking, maybe I'll conclude that the OR isn't for me. I'd be OK with that - one of the great things about nursing is that there are so many different things you can do. But I do find that I am in a weird other world that's nothing like any of the nursing I saw in school. And I loved everything I did in school. Final thought: one OR nurse I met told me, "I think everyone should get some experience elsewhere first, because then you know how much better it is in the OR." So: for the right person, it is SO the right place to be. I work with a ton of nurses who, I am sure, wouldn't want any other kind of nursing job. Hope that's helpful.

Another poster mentioned that new grads at WHC must work rotating shifts. Is that true at other Washington-area hospitals? I'd love to hear your experiences, in particular as it applies for new grads. Am I going to have to work rotating shifts? Permanent nights? Is permanent days a pipe dream for a new grad right now?

I'm just getting over the first-week block. I find what it takes is one good day when I really focus on getting momentum. Another more suggestion: if you're done for the day and watching some TV, turn it off and go to be earlier rather than watching a sitcom for another half hour. You'll be SO happy you did the next day.

I will be 39 when I finish. Not as old as many who've already replied. It's certainly not too late, and your age gives you two advantages for school: first, you know what you don't want to do with the rest of your life. Second, you have a sense of urgency. When you're in school and you look around at some of your younger fellow-students, I expect you'll see that these are two valuable attributes.

I'm in a medium-size city with several hospitals. I would think that the difficulty for the school arises from juggling several sites and instructors and 90 students divided among nine sections.

I'm a junior already in my school's nursing program registered for my first clinical class in Spring 2009. I'm already registered, note. This semester, the class I'm taking is offering clinicals sections on two different weekdays, 0630-1530 or 1400-2300. Here's my problem: for next semester (remember, I'm already registered) there's no indication what day or time (or place) the different clinical sections are - only the lecture is scheduled. When I asked the course manager, he said, See the department secretary. When I asked the department secretary, she said, Ask the course manager. When I explained I already had, she very kindly tried to help and had me write her an e-mail seeking the information, which she promised to forward. The result: I get an e-mail back from the second course instructor saying "In nursing school the clinical hours are very irregular," and I'll have to wait for the semester to start before we can sort this out. Really? I understand that arranging nine sections among several clinical instructors and several hospitals may be a challenge and subject to changes, but can they really not give us any scheduling information? I don't want to be a squeaky wheel, but frankly, I don't want to let this go either. I have special-needs childcare and therapy to coordinate; I happen to know my classmates have divorces to complete, chemotherapy to coordinate for family members, and jobs to work. So I'd love to hear: Has your school ever said "We'll get back to you about the clinicals hours when the semester starts"? Does this sound reasonable to you? Has anyone ever pushed back in a similar situation?Thanks

I too would advise talking to the instructor first. Regardless of reputation, instructors generally don't bite. I'm not sure why the fact that the instructor is the department head means you can't approach this person. Perhaps you could start the conversation: "Look, I know I'm new here, but I want to promise you right now I won't turn out to be a squeaky-wheel student - I know you must get your share of those. But I do have a concern, and it is ..." Best of luck

Does your wife already know you're not going into the ministry? It's hard to tell from your post exactly how much she knows about your plans, and my only observation there is, the more she feels as if this is a decision-making process that you're sharing with her, the more likely she is to be happy with and supportive of your decision. My wife has taken it pretty well. She knows I didn't like life in the corporate world, and I liked work in a boutique consulting firm even less. Plus she's a foreign-service officer: if she stays in the service, her job is going to take us all over the world, so it's in her interest for me to have a fulfilling profession that I can take with me. If she doesn't, she will surely appreciate the fact that nurses can get hired very quickly in most locations stateside.

I did not necessarily have the "calling" to be a nurse like others may have. But I must say that I give the patient my all for the 12 hours that I am on, and I take my job as a nurse seriously. After my shift I leave everything behind. I must also say that I enjoy being a nurse.It seems some people believe nurses should not be compensated for services rendered, or should only work for the gratification of others. Why is that? Nurses have mortgages, children to care for, and bills to pay like everyone else. Would I do it for free? No, and I doubt others would also. Nursing affords me a good salary and the means to support my family. If it didn't I would choose another profession, that I enjoyed, which would preserve and maintain the lifestyle that I am accustomed to living. This does not make me a bad nurse in my opinion. Rereading my original post, I think I have given offence without intending it. I didn't intend to convey that I think nursing is a calling or that good pay and flexibility aren't important. My point was, pay and flexibility are great, but I suspect they aren't enough to keep a person in a job as demanding as nursing - satisfaction has to have a role. (For example, good pay, coworkers I liked a lot, and fantastic health benefits plus subsidized child care on site didn't make me want to keep my office job.) From time to time, I see posts along the lines of, "Is it true nurses can make $80k a year working three days a week? How many butts would I have to wipe?" It seems to me that such a question is putting the cart before the horse. Of courses nurses deserve their good pay (when they get it). But nursing's a tough job. I suspect you'd also have to find it was worthwhile and fun to stick with it, even with good compensation and flexibility. Or put another way: nursing can be well paid, but not so well paid that you can stick with it if you don't also like the work. That's the perspective I wanted to share and to hear people's thoughts about. I want to get to the point where I'm well paid for doing work I like - that's why I've chosen nursing.

Here's a twist on the flexibility angle: my wife's job will take our family all over the world for the next 18 years, maybe more. Part of why I chose nursing (I'm completing prereqs for an accelerated BSN right now) is that I don't just want to have part-time jobs teaching English as a second language for the for the bulk of that time. Of course, another part of my choice is that I don't want to ever go back to the cubicle farm after 10 years in the corporate world; still another is that my parents just retired after careers dedicated to helping others (my mum as a teacher, my father as a clergyman) and I realized that part of my frustration with my corporate job was that I didn't care two beans about my organization's mission - not to beat up on corporate jobs, I'm sure there are corporations out there I would feel much happier in, but that's another thread. Going back to flexibility: I have the impression that if I had chosen nursing only for the flexibility and pay, I'd have trouble sticking it out for very long. Does anyone have thoughts on this?