GratefulHeart

O do try to be more kind to yourself, or you won't last long in this profession. You are learning, working very hard, and did the honorable thing once you understood the mistake you had made. Therefore, you have nothing to be ashamed about nor to run away from. EVERYONE makes mistakes, no matter how careful, brilliant, and experienced they may seem at the moment (or even project themselves to be). Please keep that in mind when you are mercilessly corrected as well. The person confronting you is just as guilty of errors. It comes with the turf. Fortunately, as blistering as these experiences are, they can be excellent teachers, and thinking through how you might handle the situation differently the next time something similar occurs *will* make you stronger and better. Talking through the scenario with a trusted nurse friend may also lend additional useful insights.

Honestly? --If you enjoy and are quite capable in the sciences (especially in chemistry), go for pharmacy. You will have plenty of interaction with others (if not patients). Pharmacists are in short supply pretty much everywhere, so you should be able to find a job no problem. They also do exceptionally well financially.

Ditto. It seems to be one of those well-kept secrets that isn't let out of the bag til after you're actually on the job. True too that I feel very little loyalty to this employer for the lure of so much time off per year - but with almost NO opportunity to ever use it (that's the second half of the equation that they don't tell you during recruitment). To the poster who spoke about lack of employee loyalty: The onus is on the employer to create a work environment that promotes a sense of loyalty. When managers & policies are in place which wreak havoc with employees' personal lives, the employer has got to expect that they're going to be continually losing their workforce to better opportunities when those present. [Just wait til the market turns...]

Take a read at the First-Year After Licensure board here & also the Student boards. Plenty of real-life stuff there to get your feet wet.

I'm about 5 months into my first nursing job on a monitored bed floor in an acute care hospital and am growing discouraged by the lack of quality of life and stress & strain on my family by not being able to plan anything with them. Though I'm thankful to be employed as a new grad with good pay & good benefits, I have no predictable schedule other than that I work 12-hr nights. Most of the time my schedule isn't released until less than 2 weeks before I am required to work. My manager is a pleasant person, but he has delegated work scheduling to one of the night nurses and doesn't like to confront people or get involved after he has delegated a task (by his own admission). The scheduling nurse is not receptive to my requests to be placed on one of the two night teams, so I can know more predictably when I will be working. Instead I am being used to fill in wherever needed, which means if someone on one team wants a night off, then I am switched to that night, back & forth. I am scheduled to work overtime without being asked, and my schedule is changed without anyone telling me. I literally have to check every time I go in to work to make sure that I haven't been "written in" to the book for the next night without any notice. When I have spoken to my manager about this, he says that it's hard to cover all of the scheduling needs and that "next month it will probably get better" because so-and-so will be back from being out sick/having surgery/on vacation/on family leave/etc (endless problem list & excuses - I don't see any end to this). Does anyone else reading here have experience with this problem and/or can offer me some constructive suggestions?

You'll learn a lot about the balancing act that occurs between the heart, the lungs, and the kidneys...how to care for people experiencing CHF, CP, CAD, COPD, diabetes, and renal failure (among other conditions). You'll learn about fluid and blood sugar management, supporting circulation and respiration, putting together what is going on with your patients by correlating their clinical presentation with their vital signs, as well as the results of their labs, imaging studies and other tests (a dynamic process that is continually changing). You'll learn to recognize early signs/symptoms that require further assessment and intervention. You'll learn to continually zoom in on pertinent details while at the same time zooming back to capture the larger picture - prioritizing and reprioritizing your patients' needs and what to do about them.

Do you have a trusted advisor at school, perhaps a nursing instructor you especially respect that you could speak with about how to write your resume? If so, I would get their input on how to do this. I think they may be better acquainted with the nursing market in your area to give you specific tips on how to present your strengths.

Yesterday during my clinical rotation in the ER, a nurse shared with me that she was working her 12th day (12-hr shifts) in a row. This apparently was voluntary on her part, but it still raised questions for me about the safety of the practice. What are the legal requirements in California regarding time off (recovery time) for RNs?

Wow, you have been through so much, and I really needed to hear your story today. Your passion for nursing and perserverance are beautiful. Thank you for strengthening my faith that no matter what the results of my exam are, the LORD will get me through this.

When you got home, did some research, and then counted up the number of questions you got wrong - how many did you miss but then still pass the exam? Was anyone out there convinced they failed based on the number of questions they know they failed but then end up still passing the exam? I've got quite a long wait until I get my results, but when I count up the questions I got wrong of those I can remember, I'm pretty sure the number is somewhere between 15 and 20. I'm wondering if it's even possible to pass if I missed 20 questions.

I agree with this post. I took the NCLEX yesterday. I practiced using test questions from many sources, but those from NCSBN were the most like the NCLEX in difficulty level. Nothing, though, in reality was *as* tough. It got very intense for me by question #40, and I will be surprised if I passed.

Yes, do hang in there. I spoke with a representative at the BRN in California last week, and she happened to mention that this is one of the *peak* seasons for taking the NCLEX, which may account for the delay. BTW I just took my NCLEX today for the first time. I received 75 questions but left feeling like I absolutely failed it (does anyone ever leave feeling like they've passed?). I need to wait 4-5 weeks to see *if* a FAILURE notice arrives in the mail. If I don't receive one, then that will mean I passed. Sort of convoluted, huh? If I have passed, BRN will not give me formal notice of same until after they receive my final transcript when I have graduated from my nursing program this May. So I feel for you having to wait, I really do. On the bright side, I now know where my greatest nursing weakness is and will be working on it. Most of my questions had to do with priority of care...which patient would you see first, which problem needs to be addressed first, etc. It was like splitting hairs to figure some of those out. Of course, I could always get it down to two, but from there at times I truly was clueless.

I agree with the others that the only way to overcome this kind of fear is to take it one step, one lab, one test at a time. Find a way to keep yourself from sweating over what's up far ahead of you. Just concentrate on the next thing you need to do right now, on learning and passing that. Your confidence and competence will grow as you gain more experience and pass the milestones one at a time. I could have written your post when I was first starting out. Now that I am close to graduation I can assure you that one day giving injections, performing catheterizations, and doing dosage calculations will not be a big deal at all. They will seem like second nature to you. You will actually look forward to managing more complicated patients and having the opportunity to learn and practice more advanced nursing skills. Re the math: I found that the more I dealt with meds in a real world setting, the more the calculations made sense and the easier it has become. They are basically the same type of questions over and over. Learn a method for now that works for you (like dimensional analysis or one of the others) and also always check your answers to see if they seem reasonable. Try to remember the generalities - for instance that kgs are heavier than lbs so the pt better weigh less in kgs than he does in lbs (that type of thing). You can do this: If you made it through A&P, microbiology, and chemistry, no dumb math problem is going to stand in the way of your goals!

Just yesterday, written by a new intern for a patient who was unresponsive, unable to swallow, and being considered for intubation: "Hard candies to suck on." [sheesh, and what did the poor guy ever do to you, doc?]

Retype your lecture notes as soon after class as you can and supplement from the book or reputable online sources in areas that you are having difficulty understanding. Study as you go instead of trying to cram it all in just before the exam. Early in the course, try to figure out your instructor's particular style - by asking others who have had taken the class before you and by listening closely to what the instructor(s) emphasize. Some instructors go almost 100% off of their lecture notes, while others require reading the book and using class objectives as a study guide to fill in material that they don't lecture upon. Tweak your study plan to the instructor's style. I found that if I wasn't sure about the instructor's style that I couldn't go wrong using the class/lecture objectives as a study guide. I also found a study buddy whose preparation style is similar to my own. We sometimes break up the objectives and share our answers (via email), or else we both do them and then exchange our notes. We have occasionally caught mistakes in each other's notes or discovered things that we didn't quite understand (then sought and received clarification that helped us on exams). It always helps to see the material from another student's perspective. Guard your study time jealously and invest it wisely, then review, review, review as you go.

Funny (thanks for the laugh today)!!!

How about pulling out a job description for the nurse's aide job and discussing item by item why what they're doing is so necessary for patient care and reminding them that they're each being held personally accountable for what's in their job description (including their attitude/lack thereof re team spirit). It's a little unclear to me why you feel like you have to walk on eggshells around them. Who's responsible for overseeing their work? Shouldn't that person be documenting the incidences of laziness, etc, and dealing with them on an individual basis re their job performance? In any case, be ever so careful! Anything critical you're ultimately responsible for, make sure you personally do (even if the aide is supposed to do it), especially VS. I've always thought it's a little crazy that RNs hand off that piece of assessment...

Funny, I was just thinking the same thing. Wish I had that problem. LOL.

In my experience, the best *teaching* nurses are the ones who are eager to show or talk me through a skill they can see that I'm clumsy with. Instead of expressing shock about what the student doesn't know (how does that attitude help the situation?), try looking for ways to come along side to help them improve. IMHO your attitude of shock that the student isn't up to your expectation is a real barrier to you being an effective teacher. If they sense you're disgusted with them (and I'm sure they do), the last person they'll want to turn to for help and instruction is you. It really doesn't matter when their nursing program teaches a particular skill or what you learned by their stage in school. There's an old saying that goes, "No one cares how much you know until they know how much you care." My gut response to your original question, "Are they supposed to know this by now?" is does that really matter? They're at where they're at. The next time you see a student struggling like that, you might want to try, "I can see you're having difficulty remembering how to do this. Can I help walk you through it?"

One of my friends wears cargo scrub pants, and I wear uniform pants that look (and feel) like normal pants.

Nope, not even close.

I wouldn't stress over pharm at CSUS; it's really not that difficult. Though I didn't take it at CSUS, many of my cohorts did, and if it's still being taught the same way as it was last year, it's an open book type class with not a lot of memorization involved. The reason is that you are going to encounter most of the key meds again when you are in your clinicals, and you will really learn them then. In pharm class, you will mainly be concentrating on the major *classes* of meds, how they work (with common side effects, lab concerns, and complications), as well as a few of the leading meds in each class. Straight forward stuff, definitely nothing to worry about.

Is this your homework assignment?

The best brand is the one that feels best on your feet (really). I had read raving reviews about Danskos on these boards and so decided to try on several styles in a local shoe store. For casual use I may one day (when I have money again) purchase a pair of their clogs. However, I decided not to buy Danskos for clinicals. Every style of them that I tried on felt heavy and clunky, making me too aware of their presence (if that makes any sense?). I then went to a uniform shop and tried on every nursing shoe in my size but was similarly unimpressed by the way any of them felt (especially when compared to how much they cost). After that, I read that some nurses/students had purchased medical shoes at their local WalMart and were quite pleased, so I checked there and found two different medical styles that met our program's requirements. They were the least expensive of all the shoes I tried on (at under $20 a pair) and were by far the most comfortable to me, so that is what I ended up purchasing. They're so lightweight and comfortable that I'm blissfully unaware of my feet. I haven't tried on Crocs, but at my last clinical site I noticed many nurses wearing them, and some of our instructors prefer them as well. I didn't try them on because I don't care for the way they look, but if my present styles get dc'd, I'll probably try some of them on, either that or hunt around for a very supportive athletic shoe.

When I'm in good control of my diet, I notice an improvement in my memory capacity - fiber 35 g per day, whole grains only but controlling the amount of wheat (it puts me to sleep), using meat/poultry/fish more like a condiment than the main part of the meal, low glycemic foods, a lot of fresh vegetablesand fruit, nuts as snacks, as little processed food and dairy as possible. Taking a swift walk back and forth across campus between classes or a bike ride every other day or so encourages blood flow to the brain and makes me feel more alert and able to focus. I also take supplemental calcium, flaxseed oil, and have ordered an antioxidant nutritional supplement but haven't tried it yet and so don't know if it will make a noticeable difference. I read a book from the public library that helped me determine my learning style and offered specific recommendations on how I should study: How to Learn Anything Quickly, by Ricki Linsman, M.Ed. It's probably saved me from wasting time on unproductive study practices. BTW, I'm 47 and have straight As in nursing. Like you, I continually worry about my weak memory, but so far my fears haven't materialized. I think I probably compensate by *overstudying* material from a concern that I won't be able to recall as well as younger students do. Some good news to cheer you up: There are definite advantages to being an older student that help to level out the playing field academically. In general we enter the program extremely motivated, aware that due to our age it's probably going to take extraordinary effort to succeed. Because of that, we tend to be more emotionally prepared to say no to distractions. While social needs often drive younger students nuts (getting together with friends instead of studying, etc.), older students don't seem to struggle with this as much. Also an older student who's experienced his or her body slowing down is keenly aware of the ongoing need to be conservational with respect to time and energy, which greatly helps with time management and focusing effort to be maximally productive. Most older students *get it* that if they cheat on sleep (for instance) they're going to pay for it dearly, so they pick and choose more carefully when and how to do that than younger students do. [You can do it!]