SeekingBalance

Hi there, Your story resonated with me because it sounds just like mine. I started as a new grad at a highly specialized and very acute unit at a prestigious Boston hospital because I wanted to be on the cutting edge. I did my final practicum on the same floor, so I thought it would be a breeze transitioning into the RN role. However it turned out to be a disaster, sounding a lot like the position you are in now. I beat myself up, thinking I couldn't cut it as a nurse, which killed me. I had been successful in my previous career, so why couldn't I get this? My preceptor made me feel stupid when I asked questions more than once. I was repeatedly told that my performance was "concerning" to the management. I kept asking for additional help off the floor, where there was less pressure, but I was ignored. I finally opted to get out. I was so stressed it was starting to affect my personal life. I moved to a smaller community hospital that was in the process of re-vamping their new grad program, and started all over again. I was up front at my interview about what happened at my previous job, but was careful to emphasize my successes as well, both in and out of nursing. My interviewer shared with me her own similar experiences. She completely understood and made clear that her goal was to provide a different experience for me and the other new grads in my group. Clearly they place a lot more value on the new grad role at my new hospital, and although I get paid less, I am actually ENJOYING a job that 5 months ago gave me panic attacks to even think about. My life is completely different now. I love my job, and I am thriving at my new hospital. Don't get me wrong, there are still those crazy days that make me question all of that student debt, but for the most part, I know I've found a good fit for me. You can't look at it as "quitting", you have to look at it as "finding the right fit." Do some research, ask around, open your eyes to settings you may have not considered before. Look for a program that requires preceptors to go through training, and has a 360 degree evaluation program (your colleagues actually have input in your regular evalutions, meaning that if you're a jerk it affects your paycheck and potential for advancement!) Ask if there is a system for evaluating feedback from the nursing staff on how to improve the unit. Ask for examples of how this feedback has been implemented to make positive changes. Most importantly, think of yourself as a valuable addition to your potential new employer, and interview THEM about how they will support YOU! You're in a good position because you have some experience now, and you have a better idea of what you need, so you'll know what questions to ask. I've actually found that my new role on a less acute floor is much more interesting than I thought it would be, because the pressure is off and I have more time to investigate details I never would have had time for in my old position. And my colleagues are not as stressed out so they have more time to be FRIENDLY and HELPFUL, and SUPPORTIVE of the new grads! It's easy to say "oh just stay there, grin and bear it because these jobs all suck like that". But it's not true. It takes more strength to stay true to yourself, and put yourself int he scary situation of leaving that job for a new one, the unknown. Just think of the potential rewards... good luck! SB

Love this tool (SBAR) - thanks so much for posting! I have printed it out and plan to have copies with me when I start on the floor next week!

I'm not sure it is all that uncommon these days for us students to graduate without having much experience with "the basics". I personally have given about 4 bed baths during my 16 month accelerated RN program. I have no other nursing or tech experience aside from that, and so it really is the most basic of tasks that make me the most nervous about starting on the floor as a RN next week. Just planning to ask a lot of questions of my assistants and fellow nurses, and planning to be straightforward with my colleagues about the fact that I was fast tracked through & missed out on some things. So far I have found that being straightforward about my inexperience balanced with expressing a genuine desire and effort to learn it fast and well is an effective approach when I need help or advice.

1) As my A&P professor stated a million times in class, "repetition is the mother of retention." A fancier way of saying "practice makes perfect", I guess. But its true, if there is stuff you can't remember & you think it is important, MAKE FLASH CARDS! You absolutely need to know your lab values like the back of your hand, so start making cards of those ASAP. I brought my cards on the train with me, to the grocery store and the bank to do in line, while waiting for appointments - every 10 minute block of flash card time helps. And remember that successful test takers use little word tricks to remember things- there have been studies to prove it. What can you find in a word to remind you of its meaning? I memorized a lot of lab values this way -for instance, the "M" in "Mg" has 1,2 peaks = normal Mg range is in the range of 1-2...1.5 to 2.5....it may sound absurd but if you practice this it becomes second nature & you find yourself retaining a lot more info. 2.) Do THOUSANDS of practice questions. Statistics show that doing thousands of practice questions is predictive of NCLEX success. I did about 4,000 including the ones assigned for my required review class at school. About 2,500 of these questions I did day and night in the 2 weeks before the test. Most were from the Saunders review book, which I found to be very comprehensive. However, during the last week before my exam a friend offered to let me do some review questions under her Kaplan account. This was a true gift! She told me that she found the Kaplan questions to be most like the NCLEX, and boy she wasn't kidding. If you can afford it, get yourself access to these questions. They are big on prioritizing, which is a lot of what NCLEX is about. They include a strategy in each rationale, to help you practice skills like deciding if you need to choose and implementation or an assessment answer. This is really a key skill, because sometimes you can be "tricked" into choosing an appropriate implementation, when really they wanted you to assess first. Kaplan is expensive, but if a group of you from school approach them to put on a class for you, you can get a discount. If you aren't interested in taking the in-person class, you could probably also get a group discount on access to the online qBank without the actual course instruction. I'm sure this is not encouraged, but it may also be possible to "share" a subscription with a friend.... 3.) COMMIT yourself to a prep schedule, and STICK to it. I graduated in the winter, so I planned a vacation my first week off, visiting for the winter holidays my second week off (I brought my review book and flash cards for when I had a little down time, of course), and then intensive study the next two weeks, until the day of my test. I warned my friends, family, and boyfriend that I would be "off the grid" those two weeks, and to please bear with me, and be supportive. I did 100 - 300 questions per day, intermixed with flashcard review and reinforcement, and hardly anything else. This helped me to feel very prepared, and keep my anxiety to a minimum. Of course I wasn't working, and I don't have kids, so it was easier for me than those of you with other responsibilities. Hopefully you have a good support system - ask for help! Maybe the kids can go to gramma's for a week, autie's for another. Maybe you have some vacation/sick time at work. You don't want to have to go through this twice, do you? Hope this helps! I really feel it is a perfect recipe for success.

I'm in my last week of nursing school. As I review now for my NCLEX-RN exam, I keep realizing how helpful my Saunders review book would have been for med surg class. It outlines topics in a much clearer way than a med-surg textbook. You get concise bullets of what you need to know, and the pathophys. is exlplained in simple terms. (And you will need the review book once NCLEX time comes anyway.) Another tip- do not buy your text books until you know you will actually need them! Wait until a week or two into class, and ask how the teacher prepares exams. Many teachers test only from their class notes, making the textbook completely irrelevant. You can also ask the teacher if they will make the text book available at the reserve desk of your school library. Useful for classes where you only need the text book as a reference for a paper or a few homework assignments. Save your money for the things you really need!

Posting for everyone looking for something besides Crocs and Danskos! I have been a loyal Dansko wearer for years before becoming a nurse, but have found they don't work for me by the middle of my 12 hour shift. Done a LOT of research and finally have become a true fan of the Quark's Pro Air II. They are non-skid, closed back, light as air, CUSHIONED, fully enclosed but vented, and oh so comfy on my large feet. They form a sort of seal around your foot so you don't step out of them. Also, you can't beat the price for the quality. My search is finally over! Still need an insert if you have higher arches, but this is true with any shoe. I admit they don't look as cute as Danskos, but well...time to take care of my feet I guess so I can still wear cute shoes OUTSIDE of work!

Good stethoscope & shoes. Don't spend a fortune but pay a little more for quality. A popular stethoscope brand comes in a "light" model perfect for students - look at the online allheart nursing store for the best price around. Great moderately priced quality shoe: a popular brand's Pro Air II model. Things to look for in a shoe: non-skid sole, air circulation, a cushioned insole that is supportive at the same time. Also, sole height. (An expensive, popular brand of nursing/comfort shoe is known for turning nurses ankles so beware of those.) Most schools require white, which look the most professional anyway. And remember - look for comfort over fashion! I had a VERY hard time with this at first but have finally come to accept that my feet are my living. Instead of getting hung up on the fact that I wouldn't be caught dead in such an ugly pair of shoes in my "normal" life, I try to focus now on the pride I have in being a nurse, and what my "ugly white shoes" represent - a profession that people respect and trust above most others! Take care of yourself! If you're into gadgets then a PDA can be helpful, but if you aren't comfortable with it then you appear distracted when you use it on the floor, and people might not take you seriously. Professional image is important if you want the respect of your teachers and other staff on the floor, including docs and veteran nurses. A good dictionary of nursing and health professions has come in very handy, much to my surprise. It can be hard to look things up quickly in, say, a med-surg textbook. These dictionaries are made for just that though, so if you forget a term or find a new one & just need a quick explanation, it comes in very handy.

Hi Cfrimer, If you're still trying to decide on a DE program in Boston, you should really consider Northeastern! The program is fairly new (5 years old?) so it can still feel a bit disorganized at times, but as a nurse you need to learn flexibility anyway! NEU has great relationships with area hospitals because of their undergrad co-op program. NEU students are respected in the hospital (though you're bound to run into some flak once in a while for being DE - some of the traditional path nurses are jealous I think!) Anyway - I have one semester left at NEU before the NCLEX & I am confident they have prepared me to pass! All of the area DE programs have their shortcomings & all are EXPENSIVE, but I researched each of them & have never once regretted my choice (also applied & was accepted to MGH.) It's been a tremendous amount of work & have broken down in tears at times from the stress of it all - but I know I'm a stronger person and a better nurse for the experience. Hope this helps!