epsilonprodigy

Actually I am going on to med school, just finishing a few pre-req's and working to save some cash in the meantime. I will be starting med school in 2010. A transport person is a pre-hospital nurse. They can intubate, do art-sticks and so on. Required is at least 2 years of critical care, be it ICU, NICU/PICU or ER. You start out on ambulances and eventually do flight transport if you want.

hey guys, it's been awhile. I am a "2.5 year old" nurse, who started out in PICU but after 1.5 years, was "made to transfer", although according to the powers that be, not fired. I had a lot of issues with the culture and feeling like others were talking behind my back and judging me because I was a new grad. As a result, I stupidly spent a lot of time fretting over these things. This caused me to mess up on an insulin drip once (caught right away and the kiddo was fine... obviously I felt TERRIBLE!) Then there was THE SCALE INCIDENT: (see my previous posts) I put a 15 kg, pt. on the baby scale in order to confirm an estimated weight before giving a high-alert med, with the assistance of 2 others. this was viewed as a fall risk and, so to speak, was the beginning of the end. I was placed on an improvement plan and then "transferred" to the unit of my choice, with an "ever so sweet" promise from the higher-ups to keep mum about it all to my new unit and a "cordial" invitation to come back to PICU in 1 yr. when I had "gained more experience." Needless to say, I silently have some thoughts about exactly where the PICU can put it and have no intention of going back. I now work in the ED at the same hospital and am very happy. The director of transport recently encouraged me to apply for a transport position, which would mean a big raise and would also be great experience for med school (my ultimate goal.) I'd love to but am worried that the PICU stuff will come back to haunt me if the transport people ask PICU about me. Particularly because you have to do shadow days in PICU as a transport person. Should I approach my PICU manager and tell her I'm applying to transport to see if she has any more nasty tricks up her sleeve, not worry about it, or not even apply at all?

Hi guys, I'm a "two-year old" grad, with 1.5 yrs in PICU and now about 9 months in peds ED. I'm about to become a preceptor(!!!!) to a student nurse doing her leadership rotation (i.e. she's about to graduate.) I feel like I'm still getting my own stable ground in the ED, learning a lot of new stuff... I need some tips on how to be a good preceptor! This girl specifically asked the educator if she could have me be her preceptor, so I really don't want to disappoint! I remember when I was in nursing school and how much damage a sh*tty preceptor can do to your morale at that point.. I don't wanna break her!

Can't believe anyone didn't bring this one up: Mr. Really Cute Resident: Every time I see you, I just wanna cuddle up to you! (How inappropriate, I know.) Idiot know-it-all: Shut your pie hole this minute, if I tell you my kid is trying to die, neither I nor s/he needs a ten-minute diatribe about all the things we need to do, code meds and O2 flow. Jump in and help me instead of running your mouth. Charge Nurse: It doesn't matter how nice you are to me. I was classically conditioned as a new grad, so you kinda scare me.

Obviously, you guys are right. I know I should have wrote them up right then and there, but I am always afraid of being one of those tattle-tales who would sell their mom down the river to get ahead! Clearly this situation is different though. The frustrating part is that there's nothing wrong with this girl, she's actually very cautious and conscientious due to all her anxiety. She could be great if everyone would just let her! These two are just jerks, I've had plenty of trouble with them myself. But I'm always afraid to write people up for fear it will bite me in the rear later =( I know that's silly... I think I'll at least say something tomorrow though. The girl's preceptor just arrived to the scene too late to stop it. I don't know if she wrote anybody up, although she was certainly upset. I don't think the CN took it all that seriously though! Yeah, what if she had zapped me! I was just saying that to a friend the other day... takes on a whole new element!

As far as nurses, and in this case, techs, eating their young, I think I have now seen it all. Yesterday I was unfortunate enough to lac my hand. I went ahead and called the ER I work at and asked if they could hook me up with some sutures. The charge nurse agreed and told me to come on in. While I was there, one of the new grads was working. This girl is so sweet and very shy with a high anxiety level. She gets pushed around all the time, and I've seen her crying more than once (mostly it's the ancillary staff!) Anyway, the techs saw me and decided to play a really mean trick on this girl. One came into my room and said, "hey, can we hook you up to the monitor for a sec.. we want to show the new grads what sinus brady with a U-wave looks like." (I'm a runner.) So I said sure. I was super tired, so I was just sitting there with my head propped against the wall in the chair with my eyes closed. A few minutes later, this scared new nurse runs into my room, looks at the monitor, cries out and yells for her preceptor. She runs over to me and puts her stethoscope on me, practically crying. I'm pretty awake at this point and ask her what on earth is wrong and what she's doing. More crying. Turns out the tech decided it would be funny to tell her that he found me "bradying with an abnormal wave" and "wasn't sure but she should come check it out" knowing full well that a) that's totally WNL for me and b) she wouldn't know the difference between a bradying old guy who's about to croak and me. Finally the techs came clean and were practically on the floor laughing. They're like "oh come on, can't you take a little joke..." I told them that if I saw them picking on her again, I would write them up and show them more than just my u-wave

I find it really aggressive and offensive when (usually NON-URGENT) patients' family members stand in the doorways of their rooms and glare at you, or stand at the nurses' station and do the same while you are clearly busy. I work in an inner city hospital. We deal with a pretty rough and tumble crowd-- someone had SUCH a great quote on here somewhere, that went "Remember that the terrible attitude of the impoverished is really just a mix of rage and humiliation- they were never issued the bootstraps by which they're supposed to pull themselves up..." Or something to that effect. Brilliant. I think of it many times a day when things like this happen and find that you can endear just about anyone into politeness when they see that you think they are worth a few kind words. But that doesn't mean it doesn't &^%@ me off a bit when they're in your face saying "my baby's in PAAAAAIIIN...." as the kid is laughing and singing Barney, etc. LOL

I know lots of new grads who started in the ER and did great. In fact, the vast majority of them loved it and are still there. It takes awhile to come into your own in nursing and find out your strenghts, professional temperament, pet peeves, etc... sounds like you have already done a lot of this stuff as an EMT. What I mean is that I think success, or lack thereof, has more to do with what you're cut out for, rather than the fact you're a new grad. If ER is what calls to you, I say go for it. I for one started in the PICU as a new grad. Although it didn't work out in the long run, it had to do with politics and ethics....but, "new-grad wise," it was fine despite the naysayers that tell you to go to med-surg first. That said, I would have a) barfed and b) hid under a rock and cried if I'd started in the ER. I work in the ER now and love it, but it is a MUCH scarier environment than PICU ever was for me. Mainly because you don't know what you have all the time, you don't always have central access or a stable airway, and you have no control over the influx. So anything can happen and generally does, as I'm sure you already know! But you can do it, just don't let anyone shoot down your confidence. Hold your head high and know that you are smarter than the average bear!

What are some tips and tricks everyone uses to muddle through their issues each shift? For me, I work in an ER where the staff is great, but we are inner-city nonprofit... I would only ever work for a nonprofit organization and love working with the underserved. Unfortunately this also adds up to NO MONEY and therefore NO STUFF! What limited equipment we have is often broken. So I pray- silently and A LOT! "Dear God, I know you're busy, but if you could just help me get this pump to work, I really think it would be helpful for my seizing patient :uhoh3:" "Dear God, it's me again, I really have no idea how we managed that crashing kid when we went through three dead monitors in the code bay, but we did it, so... thanks!" I grew up going to church but got out of the habit in college. Nursing has lead me back to it in the way that I often feel like the only thing left to do is pray about things like this. I even carry the Novena to St. Jude (the patron saint of lost causes! )on the back of my badge!

Sorry guys, I was just reading my post and should clarify: I think I made it sound like I gave the phenytoin based on an incorrect weight. This wasn't the case. They were upset because I'd put a big kid who was a fall risk on the baby scale. Everytime I try to explain this to someone, they're like what?

Hi guys, I have been lurking for a bit and find this site sooooo helpful! I have reached the conclusion that in nursing, we all have our horror stories of maltreatment, hard lessons and shattered confidence from being one of the "eaten young." That said, my story in a nutshell..... I started as a new grad in the PICU in '06. Unlike most of my new grad class, I was lucky enough to have one consistent preceptor (most had about 52!) She was an elderly lady who mostly took care of the chronic kids, which remained true with me as her orientee. My fellow grads were having plenty of drama with their multiple preceptors and very sick kids, but my preceptor and I got along famously so I kept my mouth shut even though I didn't feel that I was learning appropriately. My last two weeks of orientation, I was put with a different preceptor and started getting the REALLY sick kids. I made a scary error with an insulin drip during this time (luckily was small, caught right away and the pt. was fine!) I think this was the beginning of the slide of my confidence. I came off orientation all the same and did fine for a year and a half. Then we moved to a new unit which I found to be really tough, because we suddenly had to rely on our techs much more who were not used to doing work. I remember thinking "I think this will be fine for older nurses, but for me.. it's just enough to knock me off my perch!" During this time, I made what was viewed as a serious error, although I'm sorry, I still just can't understand what the big deal is. I had a severely contracted neurologically devastated pt. who I needed to load with phenytoin (toddler age but about the size of perhaps a 9 month old). I had only an estimated weight and was not comfortable giving the weight-based med on this alone (which didn't sound accurate.) Since we didn't have an appropriate scale for the kiddo, or a bedscale, with the help of a tech I got the kid onto a baby scale to at least get a ballpark. Neither of our hands were ever off the patient, and we were able to keep him hooked to the vent the whole time with no issues. I verified the weight and gave the med. Later that day I was pulled aside and talked to about my "unsafe judgement...." I was devastated and told the "powers that be" that if that was their take, I'd do anything to improve.... even drafted an improvement plan and asked for resources to improve my "critical thinking." It was a downhill slide from there.... later got "dinged" for a silly documentation error where the monitor captured a CVP while a med was running.... all the while I tried to take what was said to me seriously.. said (and meant!) that I'd do anything to improve. After being assured by the educators that I'd done a fine job professionally and would surely come out OK, I was "forced to transfer" by the manager... she even had the nerve to tell me that she hoped I'd come back in a year or so after I'd "built my skills" because I was such a "pleasure to work with and a hard worker." What gets me is that other serious errors made by others, and myself, like the insulin.. were not even brought up during any of this! It was all about the #$%! baby scale and CVP! So anyway, they said they'd give me a reference to anywhere I wanted, and I went for the Trauma Center, which I'd been considering anyway. There I met another new grad who was booted from the floor for something equally stupid. I love the new people I work with but am ALWAYS ALWAYS terrified that I will make a bad call, etc. that will get me in trouble or fired (although I don't worry about making a TRULY BAD call, I know I know my stuff and am safe.) I just feel like we are all dodging bullets all the time, if I don't see someone for awhile I wonder if they got fired for something ridiculous, I'm always scared that people are talking crap about me despite generally very good reviews... How can I rebuild my confidence so that I don't create a self-fulfilling prophecy?!