SuperStockRN

I love the excuse that ER "holds" patients for shift change time. That may be true for the floors, working 12 hours or 8 hour shifts, 7a-7p or the 7a-3p routine.... RARELY do ERs have the same shifts! ! ! ! ! Many of the ERs I have worked at have 3a-3p, 5a-5p, 7a-7p, 11a-11p, etc. It is hardly ever shift change in the ER and we do not, and cannot run on the floor's schedule. I TOTALLY agree with the policy of not holding patients in the ER. We do not close our doors and constantly have to expand our capabilities to accomidate the people coming in. We cannot tell the lady in triage with chest pain to wait 15 minutes more before the floor nurse can take this pneumonia patient who has had everything done except the antibiotics started. I don't have time to start your floor orders when I have an MI to get ready for the cath lab. At my current job we fax report to the units and call to acknowledge the fax and transport 30 minutes later. Period. The only variation is the RN-to-RN report to the ICU RN in the meantime with the same 30 minute transport time. Bed not ready? That's your problem, not mine. Call for a stat clean, clean it yourself, whatever you need to do because I'm rollin' out in 30 minutes, GUARANTEED. I think the communication can always be improved and it is important to avoid hasty interactions if at all possible. If I am not busy, you better believe I will start the abx, anchor the foley, start a new IV, maybe even feed the patient for the patient's sake and the floor nurse's. And I will start whatever you want if you get this patient out of the ER so I can get the next one started! BUT, in true triage fashion, I will treat the most acute first because that's where my ultimate loyalty lies. What a sensitive subject! Just the beginning!

I think it is great that everyone has their own technique - DO WHAT WORKS FOR YOU!!! However, if you ARE having problems, my 2 cents would be to make sure you are "palpating" the vein and not relying on sticking what you can see. I have seen this with a lot of new nurses, and I was guilty of doing the same thing. I was lucky enough to be taught to: - palpate the vein, evaluating its location and length and size. - palpate an approximate insertion site (if direct insertion). -palpate around your approx. site to evaluate if it is straight, curving, diagonal, etc. This will facilitate threading it in once you get the flash. It will also tell you if its particularly "rolly". -if it is curvy, etc consider an indirect approach to eventually land/thread the end of the catheter into the most straight portion. -Do not poke what you are not confident you can atleast "hit". This doesn't mean to not try if you don't see anything. Perhaps ask another staff to help you find it before conceeding to asking them to completely do it for you. -Like others have said, GET EXPOSURE. The more the better. Sample everyones styles and develop your own. AS FAR AS 18GA.: I agree that short of a resucitation or a trauma, the time you would waste not getting the 18ga, you could have been infusing with a 20ga just fine. 18 ga. are more rigid and are more prone to fail threading, so I stick to the methods above to know what direction I am trying to thread. CONFIDENCE AND PRACTICE. You can do it! ! ! ! !

There are many online RN-BSN programs, and many on campus RN-BSN programs. Rush University (Chicago) has an ADN-MSN program. There really are so many out there for both options. I don't think graduating from IVY TECH will hinder any of your continued studies, other than having to take a statistics class, etc. that many of us ADNs didn't do in our ADN programs anyway. I don't know where you are located, but I am in northern Indiana and there are probably greater than 15 programs I can think of in this near area (South Bend, Fort Wayne, Chicago, Calumet, etc.) Google It!

I would omit that position from my resume. Isn't that an extreme punishment? Wouldn't they be willing to hear your side of things and evaluate whether you truly meant to give the med, etc.? It is unexceptable to just "give" the meds to the patient, so I guess it would make sense on the other hand to terminate you in the probationary period rather than put you on probation in a probationary period. A tough postion.

this is good news!!!! that pit in your stomach that made you go out and ask the veteran to help you is (hopefully) the beginning of what will become your best friend- intuition. not every nurse has it, but good ones definitely do! you might dismiss it as a pit in your stomach because you feel inadequate, but take it and nuture it! like everyone else has said- don't be afraid to ask for help. anyone who critcizes you for that is truly a dangerous person to work with! good luck. :up:keep it up!:cheers:

That was great to read your post! I am an ER RN- 2.5 yrs into it, and I just realized how much I love my job within this last 6 months, so I am so happy to see that you had a similar course... maybe it wasn't "just me"!

It would likely depend on the nature of your firing? Since it was within the 90 days you might me able to "omit" it, or if it is something like going into OR when you really wanted to be in ER, perhaps it would be a good interview point that they would ask you about... Were you out of the profession for any length of time? I know you probably want to keep the details private, but it is kind of hard to help if no one knows a little more... Would love to help!

They say I do... once a PA said... your face... it looks, "nice". I thought maybe my makeup was especially good that say or something. He preceeded to explain that I have a friendly look -cherub like. Yah - I am pretty sure that it's the porcelain skin and the round cheeks (little chubby) and the red hair. That was a compliment I hang on to. My husband, on the other hand, says that I am a great nurse, but also says that I have a look that I give people (i.e. slow people who can't drive carts well in the supermarket) that make them question their own existance. I guess that is why I am an ER nurse, and not an OB nurse, for example? I think what "they" are seeing is the professionalism so many of us pride ourselves in. I think you start expecting it out of everyone else and it flows into your home/social lives?

How does the process compare for American Nurses? So far I've researched the process and I have seen that the visa is easy to obtain as a nurse and that it is expidited if you have a job waiting... Also, can you make sense of the currency exchange? $1 USD =____? Thank you!

When I was about 3 months out of school I thought I wanted to do OR. So, I started at a brand new surgery department as a circulator. HATED IT within about 3 weeks. I had lost interest. But I held in there for about another month thinking that maybe I was a pompus new nurse who though I knew everything and "clearly there must be something good about it since these other nurses had been doing it for YEARS". Well... I never felt any better, so I went to the director of the two surgery departments (two campuses) instead of my direct supervisor because she was much like the overworked picky one that was first described. The director listened to what I was saying, and offered me an awesome position to learn how to scrub for open heart procedures. This was a much longer orientation since I knew NOTHING, but it was more exciting. Just because I didn't like circulating, doesn't mean that circulating is a BAD JOB, it just means that it doesn't FIT ME. So... what to do.... I would say two things: 1) Stick it out because other employers have likely heard about this floor and would respect anyone who could survive this place. Once worked at a Detroit ER where I was threatened by patients/families to bbe shot outside, etc. Wanted to quit, now it's on my resume and I get a lot of respect for having SURVIVED it! 2) Resign (full 2-week notice) and search for either another position within that hospital or elsewhere. LIke said before... life is short, why WASTE time there? ANd, it is a waste if you don't see any benefit whatsoever. Don't worry about your resume at this point. As you may have found, a lot of us went to a position initially that we thought was good, and switched early on. Just don't make it a habit!

As a new nurse, it is very important that you take the time to look up information about all new medicines, doses, etc. For a few more days anyway, you are in orientation, and hopefully your preceptor will understand and encourage you to look info up if you are at all insecure about it. Eventhough you are going to be off orientation Sunday, you won't know it all, and make sure you as questions. Actually I think you can never know it all! They are making new drugs everyday it seems or using medicines in different ways all the time. Don't beat yourself up too bad, but take with you the reminder to look things up and double-triple check things. Not too bad of a first error though! Keep learning! We all are...!

I agree with the earlier posts that it is not a good idea to go into Home Health Agency work until you get some experience. I would decide what kind of Home Health you are interested in - adult, child, infant, geriatric, critical care (ventilators), etc. Then I would go into that area for atleast a year. If I wanted to go into Pediatric Ventilated care, I would start on a general Peds floor, then work my way into a Peds ICU, then consider home care. The earlier post was correct about having to pick up on suttlties (sp?) of the patients you are seeing. Although my primary specialty is ER and I am comfortable triaging and looking for those symptoms, I believe it would be even more difficult to pick up on those in someone's home where they might say they feel well when they aren't. At the ER, they atleast present believeing that perhaps something might be "off". Don't get discouraged! It's difficult to be a new grad, new nurse and have others say that you shouldn't go right into exactly what you want to do... we just want you to be prepared and safe for yourself and your patients! Hope this helps!

Have you considered Agency Work? There are local nursing agencies, versus the national kind. I do that, and I am able to tell them when I am available and when I am not. They pay a little better than PRN. PRN rates at hospitals are usually about 1.5 times the regular rate whereas the agencies are about double. My local agency also offers insurance that can be deducted from paychecks or you can pay them if there is a week you decide not to work. I don't know exactly where you are in Indiana, but I do know that Nursefinders is in Indianapolis, Merillville, and South Bend for sure. There are many others out there though. Hope this helps!

I did this in 2005 from Michigan. Although they are proficient, I was missing one part of the process so it was delayed about a month. My advise would be to absolutely check and make sure everything is there. If you have certified mail receipts, etc. I would imagine that the hospital here would work with you. They would probably start your orientation or something. Also, are you aware that you can check it online? Go to in.gov and find the online look-up for professional licensing. Then type in your name and once you are granted the license your name will appear. Hope this helps!

Goshen General is a Magnet Hospital and is revered (and recognized) as having great dedication and respect for it's nurses. They pay well, as far as I know, and I knew (a few years back) quite a few nurses in the ER. I also have some friends on the Oncology and Med Surg Floors. The ER docs are the same that I worked with at another local hospitals, and they, along with the ER nurses, are some of the most intelligent, proficient, and professional people I've worked with. I have no experience with the other hospitals that were mentioned, but I would definitely recommend Goshen! Hope this helps!