TX_Engr2RN

Your focus as a new grad should be on your job and gaining skills rather than socializing. With that being said... Depending on the unit you end up, you may find yourself a tight-knit family. I ended up with 2 options at a hospital where I had my last clinical. I felt it would better serve me to start on Telemetry before going to ICU, and that was exactly what I did. My Telemetry unit was very good to me. They took me under their wings and were very social so they always had family gatherings on the unit or their homes. After 3 years, I moved to ICU. I love ICU work and my ICU team. I've made some lasting friendships in ICU, but that close-knit family feeling was not there like in Telemetry. Good luck on your next adventure!

Dear "Not Settle," I agree with others who have posted about: - Not stating patient ratio as reason you prefer ICU. - Easier to transfer to other units. - Benefits to starting in a less acute environment of med-surg. I knew that I wanted to be an ICU nurse when I had my clinicals. I had the opportunity to start as a GN in the ICU, but I opted to start in Telemetry instead. I was afraid that having too many new things to learn may put a patient's life at risk. I have no regrets in my choice. I was on a great telemetry unit where they valued teaching and grooming me to be a good nurse. It helped me learn the hospital and unit rules/protocols, computer charting system, basic nursing skills, anxiety in dealing with frustrated doctors and patients, learn the meds and diagnoses /conditions that easily can lead to quick turn into ICU status, and most importantly, prioritization and time management. Nursing assignments can "suck" at times (6 patients), but usual assignment was 4-5 patients with discharges/new admits. I stayed in Telemetry longer than I had planned, 2-3 years, because I loved the people I worked with. Once I transferred to the ICU, I knew I was finally in the right place. Being a transfer within the same hospital definitely helped because I could focus on leaning the skills of an ICU nurse without the burden of what I listed above. Many people think "ICU has it nice, 1-2 patients only." But the condition of your patients can change quickly. You have to be diligent and check on your patients often. I love ICU because it provides learning opportunities all the time. But with the low ratios, it CAN get challenging when both your patients are going bad at the same time, you get 2 very confused/combative patients, dying patients who are still full code because family isn't ready to let go, and the list goes on and on. So congratulations on becoming a nurse. May your journey be fulfilling. It may not start where you think you want to ultimately be, but find alternate paths to get there and cherish the learning opportunities at each stepping stone. Good luck!

I am a fellow TWU Alumni, and I was not trying to single out their accelerated program. TWU is a good school and I am proud to be a graduate. My post was merely my views/opinions of TWU's fast track program, as that is the only program to which I was most familiar. Although I was accepted to UTHSC's fast track, I declined it because I felt 12 months was too fast... therefore I feel inappropriate to post about their program. I agree with you... that it IS doable... and that it IS stressful. :wtosts: :bowingpur My recommendation still stands, and I do hope those seeking accelerated programs think through beyond just time/$$, and include how such an intense program may affect all aspects of their lives before accepting. I wish you and those in these programs (yes, even programs other than TWU's or UTHSC's fast track!) much focus, strength, and luck in becoming RNs.

I was accepted to the UTHSC 12 mos. fast track program, TWU 15 mos. fast track program, and TWU's 2-yr traditional program. I ended up attending TWU in both the fast track (15 mos.) as well as the traditional (2-yrs) programs. In the end, I think I ended up taking 2.5 yrs to finish. I, for one, would NOT RECOMMEND the fast track program. And if I could go back and do everything over again, I would recommend the traditional program from the start. Why?? Here are my reasons: #1. TWU's fast track program is NOT what it sounds like it should be, or maybe it was because of the challenge of being a "start-up" program. I was extremely attracted to the idea of investing 12-15 mos. of my life to get this degree done and start contributing in the field. I was a bit reserved at TWU's program structure when I compared their fast track program to the traditional program. Their fast track program takes 4 full semesters (4-5 courses per Fall or Spring terms) and cram it into: (1) Maymester/Summer (2) Fall term (3) Spring term (4) Maymester/Summer. My point here is: THERE IS NO TIME FOR YOU TO LEARN AND ALLOW THE MATERIAL TO "SINK-IN". All you do is cram, cram, cram, and hope you pass the tests. You don't have time to ask questions, and in the truncated time table, they still require you to do outside school individual and group projects/papers in the same fashion as the traditional program. I didn't mind the work, but they did not work with the students to setup resources (i.e., RNs to interview or verify with local organization/group meetings to allow a group of students to attend) and only allowed 2-3 days to get things done WHILE expected to maintain didactic and clinical plans. #2. You get the 10:1 student:preceptor ratio, but that is true regardless whether you attend a fast-track or traditional program. I was told that that was a state mandate (I did not verify with state laws). The only advantage of the fast track clinicals is during summer terms when you go to clinicals 2-3 days/wk for about 3 weeks, and you're done! You also are more likely to get the same patients back because your clinicals tend to be consecutive days. During the Fall and Spring terms, you go back to completing didactic and clinicals with students in the traditional programs. #3. Until TWU restructures their program to be more suitable for fast track, I honestly do not feel that a student can have adequate preparations. During the initial Maymester/Summer terms, there was so much information thrown at me that I regurgitated well enough on the exams, but had to relearn when I slowed down. I would have much rather invested the time and money to attend classes during summer terms to help reduce stress during Fall/Spring terms. #4. The big job fairs/hiring rounds by hospitals are more geared towards May and December graduations. I recall some of the fast track graduates had a harder time finding jobs because hospitals' HR were not as active with recruiting during the summers. On a personal note, I was absolutely miserable AND A PILL to my family and friends while in nursing school, esp. during fast track. I felt like the biggest failure when I switched into the traditional program, but my quality of life improved by 10-folds! I had time to think through new materials/experiences from school, and a better attitude towards my family and what's left of my friends. Fast track may be a good program for some of you, but do a thorough life assessment before you do it because in this short period of 12-15 months, you'll be testing all parts of your life and those you love. Good luck to you all!

I am a new grad too with almost one year of experience on a telemetry unit. It IS hectic, especially on day shift. My internship lasted about 3 months and I went on my own around then end of it. It's still troubling and I often feel miserable leaving work past 8pm (sometimes as late as 9:30pm) AND having to return the following day for more. As a new nurse, you're expected to be slower, and I call it "on time" if I can get out by 7:45pm.! Sooo... DON'T BEAT YOURSELF UP TOO HARD! To help with time management, I often asked other nurses about their routines. I would take 1-2 weeks trying out their way to see if & what worked for me to help me manage my time better. So far, I've been picking what works from various RNs and incorporating it into my own system. Granted I am not perfect and I still leave late, but I have been improving on getting out NLT 8pm. I still need some work though... I also know of nurses who would chart off the clock, and I remember one nurse telling me that I should do that. My work ethic does not allow me to work without being paid, especially when I am not the type who goofs off during my work hours. If I'm lucky, I get to take a full 30 minutes for lunch and I have yet been able to take a morning break. I too have had moments feeling same as you about wanting to go elsewhere. My contract requires me to be there for 2 years from date of hire so I'm doing my best to maximize my learning experience and avoiding lazy and/or negative people. Perhaps talk to your NM, charge RN, or another trusted RN about your qualms to see how you can improve. But don't let this reflection upon yourself as an opportunity to beat yourself up. Remember... You are NEW, and if necessary, remind them that YOU ARE NEW! Good luck!

I'm finishing up my first year as a nurse in telemetry. It can get quite busy as patients may be more medically heavy in comparison to other medical-surgical units. I'm still working on being better as a nurse. For starters, I would recommend knowing your EKG rhythms and understanding your antihypertensive and diuretic drugs. Doctors don't always write parameters so use your best judgement as to when to hold meds based on patient's condition and/or labs. And ALWAYS: When in doubt, ask your more seasoned nurses. Good luck to you!

Thanks for sharing your experiences so that new nurses like myself may learn from you! I too have a story to share, although this was not my patient. There was a man on my unit in his 50s (not obese, but big guy) admitted d/t uncontrolled HTN (not newly diagnosed). The patient apparently had been "feeling weird" and expressed it to his RN or RT around breakfast (~08:00). About an 1.5 hours later, the RT found him "passed out" and his O2sat was in the 40s%. The patient only responded with moans/cries when stimulated with pain. I found out later that he had received 1mg Dilaudid at 05:30 and 2 vicodin pills around 08:30. The rapid response team was called and was able to rescucitate him using Narcan and without intubation. The doctor believed that he had too much pain medication, although the Dilaudid should not have been a problem since he only had 1 mg and 4 hrs prior. He didn't have renal or hepatic dysfunctions, and he takes vicodin regularly at home for chronic back pain. This was an experienced nurse who didn't catch the "signs." I guess the lessons I learned from it are: 1.) Just because the patient takes medication to control chronic pain, the nurse should not overlook possible signs of over medication. 2.) Be sure to check on your patient 30 (if IVP) or 60 minutes (if PO) after administering narcotics or phenergan. ***If patient is asleep, makes sure that they are arousable. (I learned that the hard way while in school when my preceptor administered 12.5mg phenergan to a patient who resulted with respiratory depression. She ended up being intubated.) 3.) Pay attention to the patient's complaints/symptoms. This patient had told his RN and RT that he wasn't "feeling right" and they should have investigated a bit more.

It's probably best to start your job after the trip. If there is a schedule conflict, be sure to mention it to your (future) boss before accepting/setting a start date. Most employers are willing to work with you, esp. if they want you. In some instances, they may not be flexible, i.e., they may have set intership classes for their new GNs, which you are required to attend. Good luck!

NewNurse16, don't be discouraged... It's good that your hospital is willing to look at each new nurses' progress individually instead of forcing unready nurses to be on their own. Take it as a good thing! I'm a new nurse too, and am currently begging them to let me stay on orientation a bit. My preceptor and manager feel ready to let me be on my own, but I don't. I haven't even done an admit on my own yet! We'll see how my manager, educator, and preceptors think.

Hi Laurenjarrod, I too am a new grad on a medical telemetry unit. I'm not confident enough on my reading all my strips, but "PRACTICE, PRACTICE, PRACTICE!" seems to be the key to getting better. My unit doesn't expect me to know it all, so everyone has no problem when I ask them to verify my interpretations. As for as books... My school uses "Introduction to Basic Cardiac Dysrhythmias," 3rd ed., by Atwood, Stanton, and Storey-Davenport. It's pretty easy reading with lots of practice strips. Good luck to us both!