luce2008

I graduated as ASN '07, and worked in NYC since. half of the nurses on my unit are ASN. only top top hospitals hire BSN only.

The time I was prepearing NCLEX, as I still worked as medical assistant. it was in a outpatient clinic, some odd smell made every staff hold breath when pass through the waiting area, and complainted when thay back to nursing station. an man was called in to a room, coming with that strong stinging smell, everyon in the hallway turned her head or moved back avoid the smell. no one wanted to triage him. they said "Hey this will be your nurse enrtence test" so I was in the room with him. I asked him to take off his sneakers since his feet hurted for a week. Because he couldn't bend down to do it, I have to do it for him. as soon as the feet were off the sneakers, the smell hit me like a sting bomb but 1000 times worse. I closed my mouth tight, since i couldn't shut up my nose. I wanted to shut up eyes and ears too so it would not came into me. the room was like filled with tons of rotten eggs. people in hallway yelling "What are you doing, close the door!" I yelled back "only if you want me pass out, or you come in and countinue." the sneakers weighted more than 10 lbs, drainage was dripping from the socks. the poor man keep the feet in the sneakers for the last 3 days for he worried he wouldn't able to fit in the sneakers if he ever took them out. needless to say the feet were in very bad condition, and was sent to ER for admition. Good dicision he made was he was not going to keep the socks and sneakers and allowed us to through away. I passed my "nurse test", my coworker said.

Your story give me my first good laugh since I have been nurse for 1 year.

when you say breatheing treatments, do you mean nebulizer treatmet? He was having the treatment, that was time the resp. therapist took of the NRB and his O2 sat drop to low 80, and I had to connected the nebulizer to 8L O2 for the treatment, maintain it high 80-low 90%. He was not COPD.

thanks NurseBee04. very informative. no ABG done after NRB applied. I should push doc have it done. I have learned. thanks. I understand that NRB delivers highest concentration O2, but not clear about it will worsen elevated CO2. Could you explain? Thank you.

Thank you very much NurseBee04, very informative. there was not ABG done after the NRB started. I should have push the doc to draw ABG. I understand that NRB delivers high concentation of O2, but not clear about it will worsen elevatd CO2. Please explain and thank you. By the way I love the relaxed kitten. I have 500 piece puzzle which drives me nut but still love it.

was on atrovent and xopenex, but not mucomyst. I will remember. thanks. Also to try weaning down.

thank you for sharing your knowledge. no gasses after NRB, not COPD, groggy maybe, but after 15 hours he was the same, eyes opened to pain. First time heard "pulmonary toileting", thank you very much. I did, but think I could do more often chest pt and suction. Thank you. Still wondering if there was something, besides gasses, doc could do (or I could make the doc do) but didn't do.

I need your help about the nonbreather. This is the Pt's history: an eldrely pt admitted for pneumonia. He was doing fine, A&Ox2, no fever, bed resting, on PEG feeding and 3-4 IV antibiotics. He went for sacral pressure ulce debridement at noon, and around 4 pm he became totally disoriented, eye open for pain, SOB, O2 sat down to 87%. They doc. and day nurse put him on nonrebreather with O2 95-98% and I got him at 7 pm. PEG eeding was D/Ced, dressing was changed which with no bleeding. The only thing was the nonrebreather and slightly labored breathing I thought was problem. I talked to the doc. and called the RN from RRT. They all said O2 sat was fine leave him alone, "call me if he needs to be intubated," the doc said. I did chest pts and suctions, and he was on that nonrebeather with O2 about 95-97%, whenever it was removed O2 will go down to low 80. I knew non rebreather was for short time use, but don't know how short is short. A Different nurse came for my district for day shift. When he heard the pt was on nonrebreather for about 15 hours, and next step would intubation, he was very angry. My questions are: how long usually nonbreather used for pts; what else I, as nurse, can do to void nonrebreather or intubation for pt like this; what I can suggest doc to do. Thank you in advence for your help and sharing you knowledge.

my coworker says nothing is worse than calling a code. I am scared of code. wondering what you do to void a code? and what you do during? though the orientation showed us the process of code, it is different than a life one. I really would like to learn from your nurses' experiences. many thanks!:redbeathe

the first 3-6 months is the hardest time for new nurses every where. it feels terreble when we can't accomplish things as we expected. you are doing right things, never skip 5 rights, for pts and our safety. time and experience will help us spead up. :heartbeat hangning there, we have many shouders here for you. pts in hospital are sick but most patients are still stable, though they have a lot of changes in their health conditions and need monitoring. where I work each nurse have 5 patients assignment on regular floors. during past 6 months I got about 3 or 4 shifts had 6 pts when someone called in sick and there was not enough float nurse for the floor. my fiend does get 8 pt assignment every shift. each hospital is different. I am a 9 months old nurse. I cried, had bad dreams like you, still have many questions and wondring, but are surviving like other new nurses do. if you can find a hospital has good orientation program and good nurse pt ratio, then it won't be so hard. Luce

Thanks to all of you for the stories that stopped me betting myself. I am fine now, though will still thinking about it time to time. Today, I saw my preceptor first, and I heard "Don't worry, nothing will happen", next, nursing manager: "That was not good. You need be careful next time", and last my instructor "I know you forgot. Next time do it right after you get the discharge order." Thanks for everyone's understanding,:redbeathe:bow:. I gusse it will stick in my head forever. And since I am new, I will make a discharge list and hope I will have time for checking off. I still don't know how bad it is. For in school, my profs. stressed so much. Guess it diffs from pt to pt-if happens to drug seekers and over dose them self, I might get in trouble :uhoh21:. Fortunatly I got a lesson from a "Safe" pt.

Nursing superviseor sent my preceptor to pt's home to take them off. my preceptor was very upset:banghead:.

I am a new nurse, sencond week on floor. I was like on a swing today. I was very proud of myself that I maintained this very combatitve and confused elderly pt safe stay on the floor and kept myself sefe from his hitting. Later I gave discharge instruction to the family, and they were very happy. Then after my preceptor told my that nurse manager called for I send pt home with heplocks in his arm, I felt so bad like I could not do things right, dumb, and incompetent. I am getting very nervous, thinking about if what will happen to my preceptor and to me, and questioning if I can be a good nurse at all. Will this episode cause the hopsital ask me to leave? I heard that during orientation they can let a orientee go for any reason they have, is it true?

:redpinkheThanks Janet. Once I asked a nurse why she like ICU. She said that she uauslly had one to two patients, had the control over cases (orgnized in her way) , know what was she doing, had everything she needed, one to two patients, and there was always a doctor on the floor. Very reasonable. I think this really needs good ground to start with. And thanks for the tips of floor vs facility. Luce One thing to also consider is not the floor but the facility. For example, a larger hospital will offer many different opportunities without having to give up your seniority and retirement (these things are very important as we age). So pick a good facility to work at and even if the floor you enter in on isn't your dream job at least you know you can work toward it - ie outpatient or ambulatory care. Yes I agree that ERs are not only very fast paced they can also be very cut throat places (yes the staff) - I think they attract certain personalities (young and aggressive and or adrenline junkies) - ie people who are interested in the action without the long term commitment to the patient. I have grown to prefer ICUs - you get the fast pace, but its a controlled chaos if you know what I mean, you get the high tech, but also get to practice primary nursing. You learn a lot and get respect from the docs, and most of the time you only have two patients. __________________ Janet

Thanks a lot my Brother. Congratulation that you made it and you are here helping me, the New One. What a soothing information you sent me. I am not alone!!! I have heard about the first position stories-not many departments want you but med/surg, and then med/surg say not new grads this time. It is hard. Hope I can actually find my first position, manage it and have chance to pay my due.Thanks again Brother.Luce

Thank you llg, very much. You are right about individual trait makes huge impact on our perfomance, and the avoidable failure.I hope I am on right track of field consideration.I am really moved by you and all the experienced nurses out there helping New Grads. Luce

Thank you so much Janet! New nurse born in 50's really sounds old. The fact of everage age of nursing force makes me relexed a bit. You are really cheering me up. I hope nurse managers are as nice as you.I function best in routin settings. I am always thinking ambulatory care or primary care will be my final landing. In this case, my additional questions are what experience requirment usually hospitals' ask, will med/surg banifits me a whole lot or not really? Luce

I am a new grad of AASN, at a age of 50+, and with backgroud of some years of Nurse Aid experience. Now leaving school, I am going to try a position in med/surg as advised by every nurse and professor I know. I imagine it could hard for me as most new grads are young. I really need help for starting my career. Do nurse managers consider older age as a disadvantage? Do I have to start with med/surg? What is the other options? Thank you in advence for your help.:icon_hug: