DallasRN

Actually, when I went back and started looking on Google, I found several studies. Obviously, being out of the loop as I am, I had never heard of these "concept maps" and, similar to you, my Nursing Process Model has served me well for years. Perhaps some current students and/or newer nurses might join this discussion with their idea and impressions.

You always deliver much-appreciated well-thought-out thoughts and ideas. Perhaps I misunderstood the entire article but after reading through it a second time, I still wonder if these "concepts" won't be shifted to the ongoing clinical environment vs. teaching environment. How did you determine this is not for bedside nurses? Per AI: (and yes, I love AI?) "Nursing concept maps are not merely for educational purposes; they are actively used in the clinical environment, with strong anticipation that they will continue to serve as a vital tool for organizing complex patient data, improving clinical judgment, and bridging the gap between theory and practice." Nevada State University +1 I've been out of the hospital/clinical environment for a very long time, but reading comments on Allnurses and other sites, I can't imagine this being well-accepted with nurses already struggling to keep up. I fully support nursing moving into a more professional arena, developing professional reputations and recognition, and eliminating many of the time-consuming "tasks" required, but this model certainly appears cumbersome to me. However, before that transition can be made, I believe we need to improve staffing models and decrease the current attrition rate of 30%-50% of new nurses within first couple of years. I think I've said it before, NSKaren, but I wish you lived near me. I think we could have some GREAT (and lively!) discussions. Thank you. The "dinosaur" has spoken.?

https://allnurses.com/education/what-is-nursing-concept-map-r36/ For those who have read the above-linked article, I'd be interested in your thoughts. I'd especially like to hear from current or recent students who used this model in school. One of the first things that jumped out at me was how cumbersome this "map" seems to be. It may be fine for the student with 1-2 pre-assigned clinical patients, but completing this "map" on a med-surg floor where a nurse may be assigned 6-7 patients...not to even mention 2-3 may be discharged while 2-3 are being admitted from ER. From what I've seen and read here, many nurses are just barely holding their heads above water. Maybe I've missed the entire point. Admittedly, I'm from the very "dark ages" of nursing, so perhaps I'm just a giant dinosaur. But seems like the old nursing process has done us well for many years. All thoughts and comments are welcome and appreciated.

It is atrocious what they do to nurses. Yep, can't go to the bathroom, a true meal break is a joke (just eat the peanuts in your pocket), not to even mention the associated legalities nurses deal with every minute of every shift. With the amount of money you are making as an LVN (not much in my area), you would do just as well working for Walmart or some place like that. At least you could go to the bathroom! And perhaps have energy to work a little OT to stash away for additional schooling. Seriously, just a few years ago, I was fed up, quit nursing, went to work in a 1000% non-nursing environment, worked my 6 hours a day, 3-4 days a week, 10A - 4:30P, had a guaranteed meal break and bathroom break, great manager, no physical exhaustion and actually felt like a human when I came hom every afteroon. As an RN, I made a bunch less (just a little less than LVN pay) but it allowed me to regroup and after a couple of years, was able to go back to a very, very easy nursing position in a very part time role. Best decision I ever made. Give change some thought.

Perfect response! And thank you, NRSKaren, for thinking about suggesting EAP. A valuable tool we don't always use.

"Does anyone else have similar experiences or know of any similar experiences? This was literally the worst day of my life." Yes, and this will not always be the "worst day of your life". Great responses from everyone. I'm so old now I have only vague memories of my first code but I bet I didn;t do a great job. In the meantime, my comments are: Fight or flight or freeze. Your brain momentarily went into overload. I'd dare say it has happened to most of us in one form or another. Unfortunately for you, it was witnessed by people who are likely always on the lookout for opportunities to demean and criticize others. Perhaps it makes them feel better about their own inadequacies? Who knows? Your first code experience is over, and I'd bet things will improve. The initial steps in managing a code is a skill...recognizing, calling for help, positioning patient, etc. Muscle memory will help you move forward. You will become increasingly confident with a bit of time. I have 2 suggestions: 1) I'd talk to my unit manager about the situation without casting stones. Perhaps suggest a "private" debriefing (as opposed to a hallway conference in which other patients and families can overhear comments - think HIPAA) would be a positive thing to implement on the unit. 2) With every assignment and upon entering every patient room, give a brief thought to the nursing process. Assess/Plan/Implement and after shift, Evaluate. If you consciously follow that process, it will soon become a subconscious process. As for the hallway hooligans, flick them off your shoulder like an annoying mosquito.

I looked back at your prior posts and it seems you are very new to nursing. As I read, it appears you were trying to gain entry into nursing school during the Covid days, so I'm thinking you've only been an RN for about a year or so? You've gotten some good responses, and I especially like traumaRU's comments on the pro/con list. Always helpful. Nursing is not for the faint of heart. I find it frustrating to see all these articles recommending the profession as if it's a one-size-fits-all thing. It isn't. (I have a hard time adding 2+2, so accounting wouldn't fit me. See what I mean?) But now that you're here...time/years of education, dollars spent on education, stress of nursing school, not to mention new jobs/responsibilities - all those things - I'd strongly suggest you do some serious reorganization of your thoughts before tossing in the towel. To start, forget about the "prestigious" hospitals that might look great on your resume. Look for something more low-key that will allow you to build confidence. When you interview, remember YOU are interviewing the facility and management as much as THEY are interviewing you. Look for a place that will offer a great preceptor program. Look for a place with decent staffing ratios. What is your niche? Adult, peds, ortho, surgery, cardiac? I suspect ICU/E isn't your goal right now but if it is, you can work towards that. It seems you're in the LA area so I would think you have lots of choices in places to work. I would be 100% honest when interviewing. "I've had a couple of less-than-stellar experiences and now realize maybe I placed myself in positions of failure. Ultimately, those experiences have dealt a blow to my self-esteem and self-confidence"....something along those lines. That's when I would inquire about preceptors, orientation periods, etc. As for confidence, I don't know a single RN who came out of school into the clinical environment with significant confidence - including myself. Honestly, it took me a very long time to develop confidence and feel like a "real" nurse rather than an imposter. Finally, if after making your pro/con list and doing some serious soul-searching, you decide the profession isn't for you, that's OK. It isn't for everyone, and there's no sense in trying to fit the square peg in the round hole.

Food for thought. First, you moved 2500 miles across country. That alone is stressful enough and frankly, I probably wouldn't even like the "new" air I was breathing in the first month. Couple that with new living arrangements, new co-workers, perhaps a new type of culture in the new location, a new job with different requirements...what's not to hate?? I have found it takes a minimum of about 6 months to settle into a new position. Even one within the same hospital (e.g., had you moved from ED to ICU in your prior hospital). I don't recall ever really loving a job during those first few months. I've worked in many different ICU's and ED's over the years. They all have different personalities but I will say ICU's seem to be more clicquish than ED's. Finally, remember your primary goal. Every day wake up thinking you are one step closer to that goal. After a few months if you're still unhappy? Move on. Best of luck.

I realize this is an old post and comment, but you mentioned a point I've wondered about. In terms of deductions (and I realize you're not a tax authority), but what about those of us who use the "short" form? A few questions: 1. I don't own a home, no significant medical expenses, etc. And I only work part-time. Any ideas on how we can recoup the extra $$. 2. The agency I work for (part-time) has a very small coverage area. They only pay mileage after the first 44 miles per day. Even the full-time nurses rarely get enough miles to go above 44. 3. The agency doesn't really have an office. They have a "space" in a fancy office building (5 miles from my apartment) that isn't any bigger than my apartment kitchen (really!). They "lease" a conference room in the building for interviews/orientation, and all "staff meetings" are online. Therefore, my home is very literally my office. If we need supplies, we text and they leave them with the building receptionist. I like the job, have a great supervisor, and frankly, it's OK for me as a formerly retired RN now needing just a little income supplement. But it doesn't seem exactly right. Always enjoy your comments and just wonder what you may say about this situation. Thanks!

Actually, the joke wasn't on me. I'm not now, nor have I ever been a pedi nurse or had any interest in that area of nursing. So, no. I definitely didn't take that suggestion. For me, working with peds and their parents would be incredibly stressful! I'll gladly leave the kids to others.

Hmmm...I don't know about that. In my somewhat limited experience in working with non-skilled personal care providers can be tough duty. Retirement plans? ? Some things are much easier in today's environment while others are much harder. IMO, I think the simple act of dealing with patients and family members can be more difficult today as everyone is now "Dr. Google" - including myself. I (we) no longer accept the word of any HCP as the gospel. I research everything...meds, treatments, need for diagnostics, etc.

As an old-timer of 43 years (and still working tho' not at the bedside), I'll just say "ditto" to all you said. We were using glass thermometers when I started and we certainly didn't have automatic b/p cuffs. We didn't have RT's or PT's lurking behind every door. We did it all ourselves. My, oh my...how things have changed!

Interesting post and comments. But first, my caveat: I've been a RN longer than many of you have been alive (LOL) but have ZERO experience with children other than ER visits in distant past. I don't even have children of my own! I'm talking double ZERO experience. Therefore, my comments/questions may be totally inappropriate. My first thought is that a bp entering into the 200/100 range is dangerous for anyone. Perhaps less so for a teen, but I wouldn't want to be the person standing there when/if a stroke occurred. Or if he/she lost consciousness d/t low cardiac output, fell, hit head... any number of scenarios. How often do these episodes occur? You said CPS was involved. What have they done/ what have they reported back to you, if anything? How long ago was CPS referral made? If nothing has happened, I'd keep reporting with every episode. I'd be the dog with a bone. On prior trips to ER, what was the outcome? I understand your hesitation in not wanting to call EMS or go to ER but you said "I cannot call the squad 3-4 days a week and run to the hospital with them every single time...". Is it happening that frequently? To my mind, that's even more concerning. Aren't you legally obligated to call EMS for those findings? And if yes, that might get the attention of the powers that be that can help you address the issue. Do you have a district nursing supervisor (or even a medical director). If yes, I would involve them immediately. In writing. Paper trail. I'd also send my concerns to the school district administrator. I may be 100% off the wall wrong, but IMO you are in a position of having some serious legal liability if anything negative happens on your watch. One other comment. Another poster mentioned energy drinks. That may be a very valid concern given the frequency of these SVT episodes. I sincerely wish you the best of luck as you navigate this issue. It's definitely thorny. OK...one more comment. Several years back I was looking for a "relatively" easy nursing job for my "retirement" job. A non-nurse friend suggested school nursing. "That will be easy-peasy" she said. Yeah. Right. What non-nurses sometimes think!

I haven't had that experience. However, there is always a manager over the manager and in the situation described, I would push on up the ladder. That's part of the issue, as I see it. People stay silent. If immediate manager doesn't rectify the issue, move on up.

To me, the most egregious aspect of the scenario presented is the absolute lack of professionalism demonstrated by "Janet". Unless the situation is life-threatening, it is inappropriate to confront another nurse in the manner described. This could wait for a hallway discussion and clarification of the situation. We can all learn from each other no matter how long we've been nurses (almost 44 years for me and still learning) so I'm all for sharing thoughts/ideas. But you don't get to embarrass me in front of a patient/patient family/other staff/physicians. My first step would be a discussion with my manager. Frankly, IMO, these types of situations are exactly the things that keep nurses from being recognized as a truly professional group.