AddyRN07

I graduated a year and a half ago and began my career at a prominent hospital in the DFW area on the Trauma Med/Surg floor. I want to start traveling at the end of my contract with this hospital (which is another year and a half away). Is 3 years experience with Trauma Med/Surg enough? Should I consider doing something else for awhile, like ICU, ER, or L&D? I particularly like the Trauma floor though. When I first interviewed, my manager made the statement "After working a year on this floor, you will be able to go anywhere." Now, I suppose most floors tell you that. Right? This floor is however, a very fast paced floor. We get our patients either straight from the ER or from ICU. Of course, they have had some kind of 'trauma' such as a gunshot wound, stabbings, a closed head injury. We deal with trachs, chest tubes, all kinds of drains, rectal tubes, ng tubes ect. We do get an occassional lap appy or lap chole too. Traveling, I'd like to stay in the Med/Surg arena. But then that lil voice in my head says....um, but you don't know anything about a respiratory patient, or a colon-rectal patient. I don't know a thing about telemetry. If one of our patients has to be on tele, they are on the tele floor, not the trauma floor! So there in lies my concerns. Will 3 years of Trauma Med/Surg be enough experience to take me out on other Med/Surg assignments? I'd like to know what kinds of experiences you all had before starting your traveling career and how did you handle situations you weren't too sure about when you traveled? Is 3 years of Trauma Med/Surg alone enough experience??????

The interview went well and she offered me a position. I need to think about it though, the company is new and only has a caseload of about 40 pts right now. I am wondering if that will be enough to keep me busy? She offered a pay per visit position. If I don't get enough visits then I don't eat...lol. So I dunno. I'm kinda bummed. BTW, she has 2 LVNs and an RN that will be coming back in June full time, after being off for medical reason. Then she has an RN that is PRN and works a couple of days per week. So do you think that is enough patients for everyone?

The interview is tomorrow. I will update y'all as soon as I'm done. Again, thanks to all of you for your help. :)

Thanks Sue! Those will help. And as far as pay, I know I will be working more hrs in HH than I am at the hospital. Being I am a weekend person, I only have 48 hrs per pay period every 2weeks. So the extra hrs will help to off-set the pay cut. And I will have more time for my family, which you really can't put a price tag on anyway. I'm just a worry wart when it comes to bills, so I'm doing what I do best and contemplating the "what if's" in my head. And probably worrying over absolutely nothing. LOL Thanks for your input! :nuke: ~Addy~

I am still a new nurse with just a year under my belt. I have worked in a trauma/med-surg unit for a year and PRN at a local rural hospital on the med/surg floor for almost 6 months. On the trauma floor I only work Saturday and Sunday nights and have patients that have,.....well, trauma. Motorcycle accidents, gun shot wounds, chest tubes, ect, and occasionally we'll get some SBO or Lap Chole patients. At the rural hospital, we have a variety of patients, CHF, DM complications, Pneumonia, Cellulitis....you name it. I have a family too. A husband, and two children that live at home and one who is on his own now. And frankly, I'm tired of my weekends being tied up at work. My husband works Mon-Fri days, and we sat down and figured it up....including Christmas and Thanksgiving - we have only had 5 full days off together in the last year! So I have called a HH agency here in my town and have an interview set up next week. Problem is, I have no idea what kind of questions to ask to ensure I'm seeking employment with a reputable company. Is there anywhere I can look up this company's track record? Also, I'm leary of what the pay rate will be. Working weekends and PRN I get a decent paycheck from both hospitals. From your experience do you think HH pay is comparable to hospital pay? Oy! I have so many questions. I know most will be answered at the interview......if I can only figure out what to ask and how to ask it...LOL. Thanks for your help!

Nope, they are not looking for another nurse. We are "overstaffed" they say. We have 2 extra nurses scheduled for that shift and guess what, they either get called off or floated. So I don't have to ask if they are looking for someone to help out....I know the answer. I will say this however, I have almost perfected my time management skills in the last 5 months - I had too! It was sink or swim. Well, I'm out the door in a couple hrs to do it all again! I'll update you all and let you know how this weekend went.

Thanks everyone for your input. Being a new nurse I sometimes think that I am over-reacting. But this is a usual patient load for me, and all the other nurses on my unit. Needless to say, our floor has a high turn over rate. Those that have been there a year are considered long timers. You would think the clinical manager would see there is a problem by this. But I guess all she sees is what the day shift endures, but they only have 5 patients max....and because of procedures during the day there is usually one patient per nurse off the floor leaving them with 4 each. It scares me though, I'm afraid I'm gonna make a mistake because I feel so rushed, so demanded by the patients, and the fact that we are evaluated by our level of customer service. We are expected to answer the call light and be in the patient's room immediately. I agree this should be a standard! But when you have so much going on it isn't possible to be in a patients room immediately. Then the patient complains and the nurse gets into trouble. I have taken some time to think about it and I have began looking for something different. I worked way to hard to earn my license to let this kind of pressure cause me to make a mistake and have it taken away. I will finish my committment and follow through until my contract is up, but then I'm out of there.

Unfortunately these patients were on PCA pumps. But they still allow them to call for pain meds for break through pain. One patient refused to use his PCA pump regularly because he could only get 0.2 mg dilaudid every 6 minutes and he wanted the full 2 mg every hour instead. Ahhhhh! I tried to explain to him that he was not getting "more" by having me push his meds. But he got upset and said "I'm not an elephant that you can train to push a button every 6 minutes!" He wasn't happy....at all. Let me explain my patient load without sounding too judgemental. On our floor we get a lot of trauma patients - mainly gunshot wounds. These people are usually shot because of some type of criminal/gang related activity. They seem to have built up a tolerance to the medications and require or just want more. One night a patient was scheduled 12 mg morphine every 2 hrs. NOT PRN - SCHEDULED! She was out of it and did not need that much that often. Luckily, it was not my patient. But the nurse that did care for her refused to give her anymore morphine when she found her on the toilet passed out. And the patient complained on the nurse the following day for not giving her the morphine. Here I go again! LOL. I know one day I will sit back and say man, I remember when nursing kicked my butt! But right now, I'm just disgusted.

I work a weekend shift - Sat night and Sun night. I am an new grad and have been working for 5 months now. My patient load is 7 (usually I start with 6 and get an admit in the middle of the night). I work a trauma floor and there is a lot going on. This past weekend my 7 patients broke down like this - 1. PCA pump and orders for q1h dilaudid (which he called for every hour), NGT to wall suction, O2 per NC, abdominal incision with 2 penrose drains, central line with nurse drawing AM labs, and contact isolation. 2. Trach patient, contact isolation, quadrapeligic needing turned q2h, called q2h for pain meds, central line with nurse drawing AM labs. 3. Contact isolation, sterile dressing change, called q2h for pain meds. 4. NGT with TF, uncontrolled pain and called q1h for pain meds, central line with nurse drawing AM labs. 5. S/P open appy, Chest pain with Hx of MI, NPO but was trying to drink water anyway, central line with nurse drawing AM labs. 6. PCA pump, not much going on with patient other than recording pca med usage every 2 hrs. 7. S/P abdominal surgery, patient called for pain meds q2h. Not much going on other than that. This is all in addition to giving scheduled meds and hanging IV fluids. I was totally overwhelmed on Sat night, mainly because of the 5 AM lab draws, 3 contact isolations, and 3 PCA pumps (which have to be recorded every 2 hrs), and running all the PRN meds (i ran 24 PRN meds Saturday night). I talked with my supervisor and told her that was too much and I was overwhelmed. I requested that I not have all these patients again on Sunday night and that I would feel comfortable taking half of them. When I came in on Sunday I had every one of them again. She said "it'll be easier tonight because you already know them". Well it was not any easier at all. I ran 20 PRN meds sunday night - I guess she interprets that as easier??? Anyway, another graduate nurse that had a good patient load that was managable on Saturday night had half of his taken away and he got new patients. (note, his previous patient had not been discharged, she just changed his patients) Why couldn't she have changed MY patient load? We do have 2 techs - but they stay busy with their 19 patients each and can't really help much!!! I use my brain to manage my time. And on Sunday I decided to write out when I began a task and ended the task (medroom to exit pt room). I figured it up after my shift was over that I spent and average of 53 minutes an hour performing tasks and a total of 7 minutes charting. IS THIS NORMAL????? Okay, I'm venting and my purpose is to find out if this in a "normal" patient load. This is the usual on the floor I work and I am thinking when my year contract is up I will be looking for something different.

I just finished school and graduate this Saturday. I still feel that way myself. I do have a job lined up and have spoken with my supervisor on numerous occasions. She even says it's okay. There is a lot to nursing and a lot to learn. You get more confident with experience. And there are plenty of nurses out there to help you as you go. Being cautious is a good thing. As long as you are worried you don't know enough, you will always be cautious. Good luck - hang in there. And as each semester passes you WILL feel more comfortable.

I never stayed up the night before a test. Actually, I never studied the night before a test. I worked hard to learn the material beforehand and attended every lecture. I have scored successfully on all my tests. I graduate in 9 days from the RN program. And even though I have never had any medical experience I was able to complete nursing school with minimal stress. I am a mother of 3 (which 2 are teenagers) so I had obstacles. I chose not to let those affect my schooling and found ways to work around them. I hope you can too. But remember, you do need your sleep the night before a test. You will recall things much easier - even if it isn't something you read and only heard in lecture. Best of luck to ya.

I was told I could start my intership at anytime after I graduated....but the absolute LAST DAY to start was June 4th. I would ask about it. They need nurses now. And if you have already graduated then you are ready.

If you are offered a sign on bonus, you usually have to sign a contract (for a year or two). I am getting a bonus with my job - but I will not spend that bonus until the contract is up because if I decide that is not the place or position for me and want to move jobs I would have to pay that bonus back. So keep that in mind.

It is possible to keep a 4.0 in nursing school, but it is hard. The tests are very different than the types you are use to taking in your prerequisites. There are a couple of girls in my class that are maintaining a 4.0 but they have to constantly read and have NO time for family or friends. Not to metion, I think, their clinical practice suffers because they are too worried about book tests and then don't understand how to carry that knowledge over to the clinical setting. But again, that's just my opinion and it doesn't account for ALL people holding a 4.0. My recommendation is to do your best, keep everything balanced as much as possible - lectures, clinicals, family, and you should do fine. And having a B average is not the end of the world. There is only one girl in our class that I know of that has not recieved a job offer - and she is a 4.0.

If you're in clinical take your time to look at the label. Your instructors know you are just learning and they will be more appreciative of your cautiousness than they will your quickness. It will come, repetition is key to remembering. Good luck.

I have started a web forum to help Me and others quit smoking. I am a nursing student in my second year of the ADN program. I need to quit smoking so I can be a better example and educator to my patients. I am asking you to join to support me and others who wish to quit. Also, if you have any web links that would be helpful (information, tips, ect) please let me know as I am trying to expand the site with plenty of information. Please register in the forum. My quit date is July 7th - I will so desperately need the support and encouragement. www.peteyamikes.com Thank you!

I have started a web forum to help Me and others quit smoking. I am a nursing student in my second year of the ADN program. I need to quit smoking so I can be a better example and educator to my patients. I am asking you to join to support me and others who wish to quit. Also, if you have any web links that would be helpful (information, tips, ect) please let me know as I am trying to expand the site with plenty of information. www.peteyamikes.com Thank you!