mikejsmithrn

Before I was a nurse, I had a career in I.T. (working with computers in almost every aspect except programming...I could do it, but I hated it). I am now an ASN RN. I began my career right out of school into the emergency room. In terms of bedside nursing, I LOVE the E.R. It's just the kind of nurse I am. I am an atypical E.R. nurse, though. I imagine (and witness on a regular basis) E.R. nurses experiencing compassion fatigue and being crude. I like to imagine myself as not being in that crowd...and believe that I am different than that. Other experienced nurses had a hard time accepting me on the unit. They thought I was something less-than an emergency nurse. In some respects, I was less...I didn't have their knowledge and experience. However, over time, I feel both acceptance and respect. Add in there that I am a man in the profession, and that has its own set of discussions. When I left full-time E.R., one of the nurses who I had the most trouble with gaining acceptance and respect, ended up publicly telling me that I was making a mistake in leaving the E.R. She thought I should stay, because I turned out to be a good emergency nurse. Wow, that was quite a high moment at work. The validation was rewarding. I worked there for two years. Then, my nursing educator, knowing my background, approached me about a job in the I.T. department taking care of the electronic medical record (EMR). She thought it would be a good match, since they need a clinician and in I.T. professional in one body - besides...the E.R. needs specialized attention in the EMR and if one of their own goes there, then perhaps the E.R. would get the attention they need. I applied. It was more money (way more money), much better schedule (M-F 8-4, half the job can be done at home, no weekends, occasional call), less but different stress, and it was a great fit. I accepted the job offer of Clinical Systems Analyst, and additionally work in the E.D. per diem. I sometimes miss 100% clinical work, but when I work in the E.R., I get my fix and the world is right again. My new job has expanded my vision of the meaning of being a nurse. When I work with the EMR, I feel like I can affect outcomes. Instead of working with one patient at a time, I work with ALL our patients at any given time. It's a complex job. In a way, however, I was disappointed. When I interviewed, it was explained to me that I would be working more closely with the nurses and managers to focus on workflows, outcomes and the flow of information. What I do more often is worry about how to accomplish the results of someone else doing that job in the last sentence. I later found out that what initially attracted me to this job fits the job description of a nursing informatics person. I get great satisfaction in making things work...but in making things work in an "outcomes based" idea flow. That being said - I love precepting, educating, community health, evidence based practice, emergency medicine, technology and supervising - maybe even managing (I do have some non healthcare management experience). I have an entrepreneural spirit in me, too. I want to be involved in policy, as well as nursing in government, law, etc. I want to go for an RN to BSN or RN to MSN program. I can't go back to clinical nursing 100% of the time - it just doesn't pay enough, the schedule is terrible for my family life. I am trying to decide what to do next with my career. I can and will be happy at my desk doing what I do now, but I am in a place where I want to map out my future a bit and make long-term goals. I am looking for a mentor or coach to help tease these things out of me and help me make a plan. If there's anyone who thinks they could mentor, please find a way to contact me. Otherwise, maybe a good discussion can help. What do you think? Up for a good discussion to help mold the future of a young, entheusiastic, tech-head, nurse - crazy enough to think out of the box?

I graduated from nursing school in May, 2008 and started in an emergency room in June. They had a 6 month orientation, which is now over. I am now on my own and it isn't a year yet. I still have questions, I'm still slower than the other nurses, I'm not by any means an expert at any of it. I am scared on some days and confident on others. I feel like I am just now in the last month getting into my own groove. Things are starting to click more frequently and it's getting easier. I was just told by my manager that some on the unit question my speed and feel I am overwhelmed at times. That was disappointing because I felt that I have been doing better and that I make a difference on the unit. I have 3 and 4 patient loads and that is hard, but my patients are safe and clinically sound decisions are made because we have an exceptionally good team and we all help each other out. The conversation with my manager was positive and I really felt I had his support. Sometimes the climate on an E.R. unit can be more nerve-racking than the patient care. Though, I also admit that critical patients are scary. Just some rambling thoughts.

Let me tell you a funny story. It was my first clinical experience and I was assigned to a nursing home. The resident found out that I was going to be her student nurse for the day. To which, her prompt and kurt reply was, "Only if he's gay!" Another resident overheard the conversation, laughed, handed me a pair of earrings and gave me pointers of how to act gay even if I wasn't. The fact is that no matter the sexual orientation, gender or ethnicity, patients and co-workers will find reasons to question your ability to care for patients and to mock. It is a minority of the whole experience, though. Nursing is designed to be an open-minded, self-regulating profession. Patients need and deserve excellent nurses who serve with all they have. We are protectors, advocates. We detect the subtle (real and perceived, present and potential) changes in physical, spiritual, emotional, individual, community and global well-being. We fight the angel of death, and respect it when triumphant. We reverence life, living, loving and losing. We treat people. We are nurses. If you think you can partake of such a profession...then I say proceed. To what end will the balking get you and them? It will only stand in the way of a person willing to give of himself to better others around him. I've heard some pretty sad stereotypes about being a man in nursing. One of them is that if you're a man and a nurse, you must be gay. I'm a straight male and so that's false. That being said, I work with two nurses who are both gay men. If we focus on these things, we lose sight of who we're really in nursing for...We lose sight of the patient. We're focusing on ourselves instead of the patient. A nurse's focus is on the patient. Thinking about our own biases and knowing ourself and our limitations is certainly part of practicing in nursing...but it is part and parcel...it is the patient who ultimately benefits from our willingness to serve. Willing? Serve. I'm sorry that you are experiencing

You know...I think people just don't get it. Here in Maine, it's a tough nurse job market. Most people looked at me like I had an extra large skin tag on the end me my eye lid - and they just realized that I tied it off with dental floss to stop the circulation and kill the skin tag. Only problem is that now the skin tag is the size of a grape and dark purple. Anyways - I digress. I don't really have one of those on my eye lid, but I did have one in another area of my body...and I did try that technique. I speak from experience...just get it cut off. So they look at me funny when I tell them, "I'm having a hard time finding a nursing job." They say things like, "I thought there was a nursing shortage," and "maybe you should try finding a job as a computer person (previous occupation) until you find a job in nursing." Which, to the latter statement I promptly puke and then stick my finger in my throat to finish anything that I might have missed just the minute before! WHAT? NO I'M NOT GOING TO GET A JOB AS A COMPUTER PERSON AFTER SPENDING THE LAST FEW YEARS IN NURSING SCHOOL HELL! ARE YOU CRAZY? I WORKED MY TAIL OFF FOR THIS?? NO. NO I WON'T DO IT! SORRY. When I graduated in May and soon found myself in your shoes I became very discouraged. I was hired and started work at the end of June in an Emergency Room. I was shocked! Everyone tells me that you need to start in Med/Surg first. No specialty will hire a new grad right cold. That mentality is both wrong AND wrong. Did you want a specialty eventually? If yes, try looking at that specialty. Apply EVERYWHERE. Apply for ALL NURSING JOBS and go to as many interviews as will take you. Apply for the jobs that say 1 or more years of experience needed. APPLY FOR THEM ALL. I take that back...it's a waste of your time to try and apply for temporary nursing jobs. Do that after a year's experience. I applied for a job at a hospital in Maine. That afternoon I got a call from another hospital clear across the state...and I didn't even apply there. What I found was that many hospitals are affiliated with another and share applicant information. Some electronic applications ask you up front how many years experience you have. Zero isn't an option, yet the hiring managers who I talked with before I applied there all told me to just put in the minimum number of years on the application just to make the application accept you and get your application seen by the hiring manager. Do what it takes to push your application or resume on through to the hiring manager. They get it. They see that you just graduated. DO WHATEVER IT TAKES TO MAKE THE HIRING MANAGER WANT TO INVITE YOU FOR AN INTERVIEW. The job of a resume and application is to get you an interview. The job of the interview is to get you hired. The top third of your resume should say what you REALLY want the hiring manager to know about you...they generally only skim the first third of the resume. Streamline your application. Only you will know what I mean by that...look at your application to anywhere and ask yourself, "what does streamline mean and how can I streamline my application?" I REALLY DO UNDERSTAND YOUR PROBLEM! SERIOUSLY! Maine hospitals generally have a poor new grad program because there are so many new grads and so few hospitals here. The problem for us is that it's such a big commitment for them to hire new grads. New grads aren't really up and running right out of nursing school. We so don't know anything. They have to invest a lot of time and money just to get us to take our own patients. If they hire a lot of new grads, the skill mix goes down and the patient ultimately suffers. Miles Hospital told me that they received 80 applications for one new grad position. Nursing shortage? What nursing shortage? Across the country, there is no consistency just how to call new grad positions. Some new grad positions are called nurse interns, while others are just an RN position waiting for any warm body. Franklin Memorial hires new grads and trains them in more than one department and guarantees them a position after the period of orientation - which lasts about 6 months to a year. They just don't guarantee what position they'll give ya. Some hospitals only hire new grads in certain times of the year. Maine Medical Center does that, but sometimes that hire at other times in the year too. MMC also considers new grads for "Nurse I" positions. I think it's a confusing sea of misinformation as a new grad. They tell us that we'll always have a job, but what they don't tell you is that you need to REALLY bust your tail looking for that first one. Sure, some people had jobs lined up...but a lot of people in my class had problems just like you and me. GENERALLY, here are some tips... 1) Use the Maine Hospital Association website to locate all hospitals in the state of Maine. Go here... www.themha.org. 2) Apply to all nursing jobs that aren't temporary and aren't listed seemingly anywhere 3) Remember specialty 4) The more applications and resumes you send, the more chance you have 5) Year requirements sometimes don't matter as much as we all think they do 6) resume and application purpose = get interview 7) interview purpose = get job 8) ADVANCED interview skill to hone so that you get a job offer the same day...don't let them ask you all the questions. don't wait until they offer for you to ask questions. think ahead of what kinds of questions you want to ask. ask things about the hospital, how things get done in the department. show a genuine interest. look for things in their answers that prompt you to make statements about your experience and how you can meet their need or help with this or that challenge or mission statement. In other words, don't let them lead the interview - you lead the interview. Let them know you mean business. Don't push them. Show them that your interest, sincerity and why you're the right member of the team - part of the right chemistry of a winning team. 9) read the mission statement or vision statement of the organization you are applying to. quote it or address it every step of the way. use it in your cover letter, thank you notes, interviews, etc. 10) hand deliver a thank you note immediately after interviews. use it as another opportunity to tell them how you would make a difference in their organization. maybe you noticed something they said after you asked a question like, "How are conflicts resolved in your department?" Tell them how you used to resolve conflicts as part of your daily job at Funtown's security crime scene investigation swat team. The successful person is one who does what others are unwilling to do. Go get 'em partner! [sorry for the lengthy reply - i hope i didn't gross you out about the grape sized skin tag removal]

:stone What have I done? You see, I am a new nurse in the emergency department . Remember me? Green as green can be? Ya, that's me. Just graduated...hired fresh into the E.D. So today, I just observed my first code in the E.D. Patient probably won't make it. I just observed and it's scary all the things I need to know and do and it has to be right away. WOW! Well, it's not as bad as "What have I done?" but it's quite interesting to see how it all works and what level of nurse I will be over time. All the fear aside, I am so looking forward to working and thinking like these nurses. While I am quite aware of my inadequacies as a nurse, I am also in awe of these others - these mentors and examplars...and what I can learn from them and how I can ultimately help the patient. Well done, E.D. team. Are you an emergency nurse? Did you get hired right out of school into the specialty? If yes, what did you make of observing your first code?

I am a new green as green can be R.N. with no prior health care experience. I'm bright eyed and bushy tailed. So, I just got hired at a hospital around where I live and started the job on Monday. I totally didn't think I could get hired as an emergency nurse, but I DID! I am on a lengthy orientation and feeling excited, nervous, scared, happy (you know, the jump for joy kind), curious, knowledge hungry and on top of it all...I feel like I know nothing. Nursing school gives you the basics, but the stuff you need to know about any nursing, let alone emergency nursing, is incredibly enormous! It's both humbling and invigorating...all at the same time. I am looking forward to being part of the team. So far, I like the people, the environment, the culture and all that. What I am hoping to spark here is a discussion on other's experience as a new nurse starting out in the emergency department. What happened? Anything good? Anything you want to tell me about what I should do, not do, keep in mind, etc? What about you seasoned nurses? Do you think nurses should have med-surg experience prior to being hired as an emergency nurse? Or do you think it's good to be hired green? Why? I think I asked enough questions to get the ball rolling.

Oh - I forgot to say the following because I was too busy talking about my experience...I saw a lot of nursing students (married, single, with children and without) WITH JOBS...they came and they went. Mostly, they said that they had to choose between work and school. The schedules were often conflicting. Now, I know it can be done, because I also saw those with jobs PASS NURSING SCHOOL. It was just risky and I saw a lot of tears with those people. The people with jobs seemed to have the hardest time staying in school. This was just what I saw. In my experience and seeing the other students...work and passing nursing school is the exception. I hope you are either the exception or you don't work. Enjoy these years...What are you willing to do to make it work? What aren't you? If I made it through nursing school with my challenges (and there was no lack of them)...ANYONE can.

I just graduated from Nursing School. I was an LPN after my first year and my second year brought the unbelievable treat of becoming an RN just the other week. It's well worth it. I start my first job as a nurse in the emergency department in my local hospital. I just wanted to pipe in here... I am a father of five children (soon to be six in december) and I am the sole breadwinner in the family. My wife is awesome and we homeschool the kids. I actually started nursing school in 2005, failed my first semester and then changed schools to start over in 2006. I DIDN'T HAVE A JOB through any of these three years. How'd did I do it? Grants, SCHOLARSHIPS (awesome ones, too), student loans, state aid (food stamps and cash benefits for parents as scholars program) - as well as family support and dipping into my retirement fund (paying a small penalty, but it was worth it). It was hard, but now it's over and we're OK and better off from the whole thing. It took planning, teamwork, love, work, committment, tears, sweat, HOURS and HOURS of study, late nights, support for all those around us and letting them support us. There were times that we didn't know where the money was going to come from. We are literally down to our last (and I mean LAST) $5.00. Tomorrow I get $40 for Gas, then another small dispursment of aid on Tuesday. The real challenge came after school was out. I didn't know I would be unemployed for about a two months when school let out. BUT I WAS. Once school ended, then rent, utilities and everything of every kind started getting in trouble. My car broke down, the van's transmission is broken. I just had to go to my bank and ask for a loan and we bought a new minivan yesterday. I start work and I have to drive the family vehicle to work for now until I get back on track and get myself another vehicle. The jury is still out as to whether the last two years are worth the FINANCIAL burden. It's been hard and we're penniless now. But it's nice starting over. Nursing school tests every aspect of your life. Let it happen. Let it change you. Don't resist. Resistance is spelled F-A-I-L in nursing school. Don't resist and you will be different. You will be changed forever. The financial hardship is only part of the battle. There are so many things that will change for you. You think I am kidding? Don't take this lightly...it isn't the only hurdle you'll have to overcome (finances). There are many more in store. For me, nursing school changed the way I look at so many things and handle situations. I am glad my advisor was open and honest with me about work - saying that I shouldn't work. Now - that may not be for everybody. I had so many other things besides work, school and wife...I had kids, church and community responsibilities. They said it takes a village to raise a kid. I think it takes a village to raise a nurse (too). I just shared my experience...visit my blog to see many of my struggles and accomplishments from nursing school. I think you can visit my blog by clicking on a link somewhere around my post. They don't like us putting links to our personal sites in these messages. I don't want to turn anyone off by this, because I know it sometimes does, but I am also not ashamed to say that I spent a lot of time on my knees in prayer. If it wasn't the support of the Almighty, I (and my family) would not have done it. It would have been mostly impossible. Good luck and godspeed.

Very interesting. Hmmm. Am I naive? I live in maine. I am an RN ASN senior student. In my first year at CMCC, I had the option of graduating as a LPN, then re-entering the school to finish the RN program to finish the degree. I did that and tried to find a job. What a joke. It was HARD to find a job. One place that actually offered me a LPN job was just so desperate. They were very desperate to hire any warm body (as long as they were legal). I turned them down for a camp nurse job who as it turned out only needed me for 4 days (they told me all summer, but let me go when the hard times were over). So I beat the street again and applied everywhere, but got nothing. They wanted 1 year experience or there were so many other applicants...so on and so on. Is this what I will experience in the spring when I graduate? For real? I didn't think that I would. I thought that LPN's were just outa luck because the trend in nursing is that LPNs don't have the acuity experience. Will this be the climate when I graduate as a RN? Ugh. Maybe I will move. :-( I just love it here, so I will be sad to leave.

I don't know what your significant other's status it. I will assume that you're married, because my situation with 5 (yes, five) children REQUIRES that I have a super supportive wife. I am currently going from LPN to RN. I begin in the Fall and I only have to go through a program that takes a year. That is one thing. Another thing, I don't work. I won't work until I am an R.N. I didn't save up for it. I am just biting the bullet and doing it. Our whole family is going to school. What I mean by that is while my kids are 10, 8, 6, 4 and 1, we are all working, sacrificing , praying , hoping and learning with the common goal to get papa through nursing school. It's been our approach the whole time (first with LPN schooll, now with RN school). It works. We are a family who prays together, learns together and pays together. In all that we do. I probably, no we probably couldn't do it any other way. Nursing school is just plain old HARD. Difficult. Nothing else but just hard, grueling work, sweat, worry, wor, work, work! Ugh. The whole family will pay the price no matter which way you want to get through it. I know my whole family is paying the price. But we have decided on it together. We have given everybody a job to do. We have laid out the expectations for everybody and that all will just have to wait until nursing school is done. One that note, I prefer to just go to school - no work. No job to worry about. With the number of kids you have, I think you'll be spread thinner and thinner than you might expect. Don't be spread so thin that you're not there. Bills still need to be paid...but there is a way. We are doing it. It's hard, but definitely doable. GO Go GO! Check on my web site - nursemike.wordpress.com

I recently considered the College Network for the same program. Here are the things I learned. Indeed, they are a publishing company. They say that each of their modules take a month to study, then you can take the Excelsior exam. There are 6 exams we as nurses must take. So...6 months, then you can take your clinical exam, right? No...here's what happens...You cannot register for the clinical exam until after you have taken exam #7 (for LPN's, it's exam 6). There's a 6-8 month wait from registering to taking the clinical exam. I've heard of people failing the exam after years of being an lpn and paying $1800. I wanted to go through Excelsior directly at the end. Finally, I decided not to go there because the college says most people get through it in less than 24 months...the College Network says under 9 months. Well...there's one too many unknowns in the house of timing for me.