deenasao

The best part of nursing is the limitless options (at least before the economy dipped) so if you could find a community position I think you'd be much happier. A visiting nurse, a hospice nurse, a school nurse etc. I am exactly like you so I can totally relate.

I gave up. It's done. My job search is done. I'm getting an admin job and working my way up the corporate ladder. I'm going to be successful and make way more money than I ever could as a nurse. But I'm giving up my lifelong dream to be a nurse. And that hurts. I just want to say to someone, whoever will listen (sorry. that's you guys) that they will regret this. The nurse employers of this nation are going to regret snubbing their noses at new grads. Yes, the economy dipped. And every nurse who was at home whose husband lost their job jumped back into the workforce. And yes, the employers had their pick of their litter. But what they didn't realize was that by shutting off the jobs to new grads they just lost by attrition a good percentage of the new grads. Me and some of my most talented classmates have left the profession. Probably for good. Because we have a lot of talent to bring to this world and we're not going to wait five years for the economy to turn around. When the baby boomers retire in droves (like they've been saying for a freakin decade) the employers are going to be so desperate they'll be begging for people like me. But it will be too late. My bff got her bachelors in elementary ed. She had the same problem. Couldn't find a job. She got a job as an administrative assistant for an internet marketing company several years ago. Guess what? She's second in command now making six figures. In a sense, this unfairness was a blessing for her. It took her out of the slave labor profession and put her in a position in which she could really live a good life. And I have high hopes that that is my future too. It would be a nice compensation for giving up a life long dream. And it would be a great F.U. to all the places that sent my resume to the recycling bin. If the government had any foresight to the impending disaster they could make a law enforcing a 10% requirement of new-grad hires. So that our new grads wouldn't leave the profession. But of course they won't do that because "There are plenty of nursing jobs". "It's the one profession that's thriving in this economy." roll eyes.

Is an irregular heart rate anything that strays (consistently) from the usual bum-bump rhythm? Like, sometimes a pause or a double beat but then it goes back to normal? Or is it only when there is a more serious problem?

Thanks everyone for the replies... Nursel56, you're right. It is fraction. I agree that making the connection between the bruit I heard and the ejaction fraction already diagnosed by the doctor was probably taking it a step too far. One of you was asking what the setting is... It's a long term care center. SB2010.. I'm definitely just doing what my supervisor says, for now. The things she's right about I'll do though eternity. The things she's wrong about though, I'm going to toss. TexasspadequeenRN... Glad you chimed in. You expressed my thoughts. I mean... observing those things. It's within our realm of practice. I guess, it's a balancing act between covering my butt and documenting what I see. I think the key is to document this stuff upon admission so that when I assess it it isn't a new finding. Does that sound right to people? If it isn't documented upon admission then I have to show that I did something about it, huh? Even though the three issues I mentioned were clearly chronic problems. Or if I put the word "chronic" before it would that help cover my butt? Or not, since I'd probably have to prove that with medical records if it ever went to court. Ugh, this nursing thing is so confusing!!!!!

I'm on week three of my first nursing job. Since I'm still on orientation my nursing supervisor still has to approve all of my nurses notes before i sign them. I'm getting really frustrated because she keeps asking me to take out stuff that I observe. For instance "Pt. had a bruit caused by her 60% Ejaction Fracture." And "Rales in the lower lungs" and "irregular heart rate". She says that if I say that something is wrong I also have to say what I did about it. Like, did I call the doctor? Did I have her cough and then check her lungs again?" What did you do?? I understand that she's teaching me to cover my butt for future law suits. But, what is the point of documenting if I only put the normal stuff and leave out all the (interesting) stuff?!?!

I think this is what it comes down to. Well said. I love that expression "red face test". I've never heard that one. That's great.

lol :)

i thought i'd copy and past the facebook conversation i had about this post: ok. question for you. we're having a discussion on a nursing message board and i want to know your opinion. one of the posters is a crna, so i'm curious if your take is the same as hers [since you are also a nurse anesthetist]. patient is due to be discharged but has a short run of svt. hr in the 70s. cardiologist orders digoxin 0.25mg iv x 3 doses q4hrs. after the first dose, the hr dropped to and stayed in the low 50s, occasionally dropping to the hi 40s. no more dysrhythmias noted. the cardiologist is called and he still insists that the digoxin be given. what to do? we all agree that the doc should institute hr parameters. ask for an explanation for his order. this is where the debate ensues. the two opinions are: "don't give it. the risks outweigh the benefits. if the hr started to rise the dig could have been given. if it dropped you would have a real problem on your hands." "give it because the cardiologists explanation will be: 'a lot of times patients will have an exaggerated response initially to a med and then level off quickly'." so... what's your opinion? i would not give it! if we give another dose, i think the heart rate will drop even further. most svts are short run any way and the pt probably already has been living with it for quite some time and probably asymptomatic. i really never given dig quite that much so im not sure if it will level off.. but to cover our rn license, i wouldnt give it bcuz the heart rate is already in high 40's and baseline is probably 70-80s, im guessing. oh sorry, i guess hr was mentioned to be the 70s. any ways i don't know what the crna said, but 70s is still w/n range its not like the hr is >100. if the patient has it again, i would probably have the patient do valsava manuevers to break the svt. of course, anesthesia is different from the actual nursing environment since we just give meds and we dont need orders for what we give.

All I know is, don't come to Massachusetts. I graduated in Spring of 2009 and I still can't find a job. It's depressing.

wtbcrna, The risks outweigh the benefits in this case, in my opinion. If the hr started to rise the dig could have been given. If it dropped you would have a real problem on your hands.

I'm not sure what you mean by "she's too young for pregnancy". I went through a pregnancy and nursing school, so it's definitely doable. Does she want to? You said "we wanted her" and there's a big difference there. Anyway, I'm not sure it's even legal to kick someone out for a pregnancy, but Nursing schools kick people out for some pretty crazy reasons, so I could be wrong about that.

I am a new grad nurse who can't find a job (grrrrr. but that's a tangent, sorry)... anyway, your post makes me really think hard of even going the hospital/med-surg route. I've been considering going for my masters in Psychiatry and your posts inspires me that that is the way to go. Thank you for your honesty.