MelBel

So I'm just a few days shy of my one-year anniversary. I can't possibly write everything here that I have learned in the past year, or explain just how much my life has changed because of nursing. In my first year, I wanted to quit my job, and looked for a new one at least every other week. But then the next time I went in, I would have a good night, or a good learning experience and decide to stay. Now, even though I have bad nights, I am staying because I really truly love taking care of my patients, and I love my coworkers. I can't count how many patients I've had pass away on my shift, and even more who would pass away just a few hours after I left. (I work geriatrics and we get a lot of hospice and comfort care patients) I've recently realized how much it changes you to work so closely with life and death. In the past year I've started nursing, moved out on my own, gotten married, gone on several vacations and weekend trips, and just bought a new car. These are all things that I truly believe would have NEVER happened if it wasn't for nursing. I don't want to type forever, but I just want to let all the new grads know that it DOES get better. Some days REALLY suck. But even when you hate the nursing, think of what nursing is doing in your personal life too, because sometimes that helps you get through the bad spots, and eventually you'll learn to love the job, too, not just the benefits.

I work 12s (7p-7a) and our weekend is sat/sun night (sat/sun for days). I have learned to make an effort and when I put in my schedule request, I will work Fri/Sat/Sun on "my" weekend, so then I can request off Fridays on my weekend off. Otherwise I end up sleeping away most of my Saturday off!

I would NOT do it if it was against the policy, unless it was a truly life or death matter for the patient. If something had been wrong with the meds, you would have gotten in a lot more trouble for not following policy. And as nurses, we have to be able to stand up to the doctors in some cases. If the doctor wanted that med given, he should have given it himself. And **hugs**. I don't think you should or will get fired over this...at least I hope not!! Everyone makes mistakes, and if whoever you are working with doesn't understand that, then you need a new job anyway! :)

I'm glad you posted this, because I've had several patients with pretty bad stage IVs, and NEVER considered that this might happen to me! I expect some bleeding at times, but not like that! At least now if it DOES happen, I can think back to this and maybe handle the situation a little better than I would have if I was in total shock! Thank you!

Short answer...everyone is different. I completed my entire RN in 2 years, doing nursing and gen eds at the same time. I worked full-time during the second year (part-time the first), and actually managed to have a LITTLE bit of a social life. (I also wasn't doing it with a husband or kids!) I knew of a student who took 4 years to complete the program, and didn't work at all during it. (No family either) We both ended up with about the same grades. It really depends how much you can handle. I was used to a very busy schedule from before I started...I had worked and gone to school and done extracurricular activities since I was in middle school. But some people need to focus only on school...you need to answer that for yourself! (Sorry not much help!) I agree. And I was a straight-A student before nursing. :) Nursing school is an excellent ego-check.

The other interesting part of this is that last night I had 4 patients. We only had 1 PCA, but it didn't make too much of a difference because every nurse had few enough patients to do their own total care. 3 of my 4 patients thanked me profusely for being so friendly, and taking the time to listen to them. I try to be friendly and listen every day, but when I'm running out of the room yelling "Need anyth......" I don't think I come accross as that friendly. Those same 3 patients also COMPLAINED about the PCA. Now she is someone I've worked with for almost a year now, and have NEVER had a complaint about her. I do know that she felt overwhelmed being the only PCA (usually we have two). I'll have to revise my entry a little bit here, but I'll work on sending that out to a few places. :)

So for some unknown reason, this past week my unit was more OVERstaffed than understaffed. I averaged 5 pts/night this week, and no more than 6. (8-9 is our norm) Things that happen when we have enough staff: - My meds are passed on time. - I don't feel like I have to run out of the room as soon as I finish my assessment. - I get to have conversations with my patients. - I get to actually think about my documentation. - I get to take actual BREAKS. - If one patient is having problems, only 3 or 4 others need looking in on, not 7 or 8. I don't know why this happened this week, but I just wanted to share some good! I'm actually smiling after work for once, AND I even worked OT this week. I have a 3 day weekend now, and althouh I'm excited, I'm also not in as much desperate need of it as usual! :lol2: Hope you all get this sometimes too :)

I just wanted to share that I am now officially on my first vacation after starting nursing! Started in June, have worked a 36+ hr week since then, and now I have no work for 2 full weeks. Just wanted to give something for others to look forward to...it feels VERY nice! :) (See there IS good in nursing!)

I'm 22, was 21 when I started working....another new nurse is 23, but besides us, everyone on my floor is over 30. I was used to working jobs where everyone was about the same age as me, but it didn't take long for us to just become another nurse, as opposed to the young ones! We do joke around a lot about us being the babies of the floor, but that's ok. :)

On nights we can get up to 8-9 patients per nurse. If the ER tries to send more, I always call the supervisor before accepting to see if they are aware. If we are having a good night, I tell them that we are going above our ratios, but I will accept the patient THIS time. This tends to help me when we are having a bad night, and they are more understanding that some nights we just can't accept another patient. If I feel overwhelmed, I will ABSOLUTELY not accept another patient...ESPECIALLY if the ER is not busy. Sending the patient to an already busy floor will do them no good...I've seen nurses accept patients from the ER and not look at them for the first 2 hours they are on the floor. It's taken me a little while, but I've learned how much I can handle, and it changes based on patient acuity. Luckily most of my supervisors know me well enough that when I say no, I really mean no!

We just hired a nurse on my unit who has been a nurse for about a year, but mostly in long term care. She is entitled to the same length orientation as the new grad we just hired. But that has to do with our union contract....so I'm sure it depends on the facility!

I've been charge since coming off orientation...on our floor SOMEONE has to take charge, and we only have 4 staff nurses on nights...3 of us started at the same time last June. If the more experienced nurse is working, she does it, otherwise it is up to one of us new people. I absolutely HATED it at first. I realize now that it has been a really good learning experience. It allows me to have more of an idea about what is going on with all the patients on the floor...and I've therefore learned more about the policies, and different tests, etc. It has also forced me to improve upon my time management skills...on our floor the charge nurse still takes a full patient load. Each nurse is still completely responsible for their own patients and puts calls out to doctors, but the charge nurse organizes things, checks the charts and morning lab work, etc. It has helped me to become more assertive...I never thought I would be able to firmly stand up to a superior of mine, but sometimes, I have to when they try to send us admissions or take aides when we are already understaffed. I am lucky to work with an INCREDIBLY cooperative group of people, and the agency nurses that we get frequently are also very cooperative. I don't have to worry about my coworkers not doing thier jobs, so that takes some strain off me. My advice...if you REALLY don't feel ready to take charge and their are others available to do it, tell your manager. If it is your own personal fear of stepping out of your comfort zone, I would say go for it. I hope that your coworkers will be understanding if you have some difficulty at first, but in the long run you WILL benefit from the experience! Hope that helps a little!

I've realized that everyone needs a different kind of schedule...so experiment and find what works for you! On my first day on, I go to sleep about 2am the night before, wake up at 8, run some errands, and then nap about 12-4. I make my "half days" my work days...laundry, shopping, etc. I sleep as long as I can when I work two in a row, and on my last shift, I try to only sleep about 4-5 hours so I can get to sleep at a normal time. For me, this is the perfect system, and I have had NO problem whatsoever since I started nights in July (but then again I sleep through EVERYthing, the light/noise/etc doesn't bother me). I never thought I wanted to do my 3 in a row, but lately it has seemed better that way...more days off in a row, and fewer "half days" of sleep. The only problem with that is the 3 days in a row are literally only sleep and work. yuck! Hope you find something that works for you!

My second preceptor had the style of "do it for yourself, come find me when you need to". But she was ALWAYS available, and she also always knew what was going on with my patients. She made me think through things, and never just gave me the answers to the questions. Sometimes it was frustrating, but really, that was what I needed in order to be successful on my own once I was off orientation! She prepared me VERY well for life off orientation. Once you are done, you won't have someone to give your meds for you, and even though it feels nice now when someone does that, it will be more difficult for you when you don't have that option.

I think if you notified the MD and documented, you did all you can. I probably would have asked the MD if they would want some Lasix given...but other than that, exactly what you did.

I thought he was more gray than blue....but that is just me :)

I personally love the hours! I work every 3rd weekend, and 1 out of Thanksgiving, Christmas, and New Years; and then 1 out of Memorial Day, 4th of July, and Labor Day. Other than that, the schedule is very flexible. I can plan my weekends WAY ahead, because I know what I'll work, and also that I'll have Fridays off before my weekend. I am taking 36 hours of vacation next month, and will have 14 days in a row off. I frequently have 5-day weekends without taking vacation time. I do sometimes get jealous of my 9-5 friends, but I don't have to wake up early 5 days a week either:)

I hate my job somedays, but I really do like what I'm doing. I enjoy caring for people. I enjoy the challenge of a difficult patient. I find many medical diagnoses incredibly interesting, and I really enjoy poking people with needles, sticking tubes in them, changing dressings, etc. I don't like the politics of nursing sometimes. That we are understaffed, because of "not enough money in the budget". That I need to protect a license every day that I go to work, and they haven't made that easy for me. And I slept through anatomy a lot. :) I found the material interesting, but when it's at 8am, with someone talking at you, and you are forced to listen to it right then, no matter what, it is much less exciting. :)

1. What degree did you get? Eg: AA, BSN.. Have you had other degrees in different fields? Associates...planning on the BSN and MSN eventually 2. Why did you pursue this career (demand, family request, your own interest, money, passion, etc) woke up one morning and said "I'm going to be a nurse" (for real!) 3. When(or how old) did you realize you wanted to become a nurse? a month before I turned 20 4. Where do you currently work (I dont need a specific address or something like that)? A private doctor clinic? Hospitals? Schools? hospital 5. What is your salary?$22/hr +shift differential, charge nurse pay, overtime, etc 6. By far what is the most challenging thing you have faced so far? high ratios, not being able to provide as good of care as I want to, my first code last weekend:down: 7. What do you find the most rewarding? seeing smiles on my patient's and their familes faces, and knowing I help put them there 8. Do you have a family? If so, how often do you spend time with them? no kids, a fiance...I see him only on the days I don't work (I work 12s) 9. Would you say you get days off more or work more? I work 3-12s a week, have 4 nights off...unless I pick up OT 10. If you could choose a different career, would you do it? Definitely not. Even when I hate my job, I remember the pay, the fact that I make my own schedule for the most part, and it is very flexible. Overtime is available if I need money, but not mandatory. I couldn't imagine being stuck in a 9-5 M-F job (my original plan!)

I don't have mandatory overtime...which is nice because I can pass my report to whoever shows up, and I can leave. The bad part being the same thing also happens to me on occasion. We do end up working short quite a bit. I don't think I would work anywhere with mandatory overtime...my shifts are enough for me, and if I want to stay longer or come in extra, I will let them know. :)

8-9 pts on my med surg floor is pretty typical (nights). This weekend I've had 8 or 9 along with charge. I've been a nurse 8 months. The other 2 nurses I've been working with are travelers. Friday night I had a patient fall, last night I had a patient code. I 100% feel the patient wouldn't have fallen if I had fewer responsibilities. I would have caught the coding patient sooner if I had fewer responsibilities. Problem, yes. I'm going to look for somewhere else to work.

Working geriatrics, we get a lot of "expected" deaths. We also have a hospice room...people come to that room to die. We also get younger patients who die young for one reason or another. I thought I wouldn't handle it well, but death is a natural part of life I've come to realize. And it is part of my job to help people to die comfortably, without pushing them faster than they need to be pushed. I've learned that I don't want to die from CHF, or cancer, or COPD. Those patients look MISERABLE at the end. The patients who have massive cerebral hemorrhages look incredibly comfortable....there usually seems to be a peace about them. Those patients tend to die quickly...and it is very hard on the families, which is the harder part for me. I had my first code this morning Don't know yet if the pt will pull through or not. But that one might hit me a little more, because it wasn't expected. Who knows. I've never (and hopefully never will!) have to deal with a fetal death. Or a child's death. I'm sure that is completely different that what I've experienced.

I worked Fri/Sat this weekend, and have to go back tonight. Friday night was BUSY BUSY...9pts, charge, transfusion going, 1admission...things were ALMOST under control when at 0445 my patient who was supposed to be discharged to home at 0800 (rides and everything arranged) fell. c/o hip pain, xrays to be done. everthing turned out fine, but it was a busy morning. Thought it couldn't get any worse. Last night started better...only 8 patients with my admit! (along with charge, another transfusion, etc). 1 aide went home sick about midnight. 0500 I walk into a patients room to draw bloods, find her extremely lethargic, labored respirations, etc. Call a rapid response, rapid response team comes, we end up calling a code, pt is in and out as far as the pulse goes...finally ready to transfer her to the ICU...wheeling her out the door.....out comes the PICC. No other IV access...horrible stick. I left her in the ICU still alive...how much of it from the drugs and how much from her own will and God's will I don't know....guess maybe I'll find out tonight whether or not she made it. As badly as I would feel if she didn't make it, I feel worse about the mess I ended up leaving for day shift! The pt was 79, didn't look all that good to begin with, and either way I'll be ok with the outcome of the code. But I HATE leaving messes for the next shift. They all said it was fine, and they understood, and told me to go home....but I still feel badly. And I have to go back tonight....hopefully it will be better.......

I know of someone who just moved to be with her boyfriend after about 8 months at her first job. I know that she had NO problem finding a new one, and from my experience, being about 8 months in, it was definitely not a wasted 8 months! 8 months sounds short, but you will learn a LOT in that short time that will definitely benefit you!

I definitely have the opposite problem! One of our secretaries doesn't EVER get out of her chair. She is only there for a couple hours on my shift, but she is the type to page the nurse to the desk, and then proceed to tell the nurse that "so-and-so needs a blanket". She lets the phones ring, very rarely answers call lights, and leaves exactly 7 minutes early every day...the earliest you can clock out...regardless of how busy we are. And my manager loves her. :angryfire