AddieRN

Thanks for the replys. I really appreciate all the input, and encouragement. I'll take all the advice I can get. I did look a couple of books up and found them on Amazon, and I plan to order them. Symptom Management Algorithms: A Handbook for Palliative Care seemed like an awesome resource just from reviewing the context. Say a prayer for me, as I start my new journey in nursing. I'll keep you up-to-date on how it's going. I'm sure I'll have plenty of questions on the forum.

Thanks AtlantaRN, for replying to my post. I have been on the search for some good books and resources. If you happen to come upon any others, let me know.

Just wanted to let you all know,I took the job! I'm really excited. I think I'll do good. Like any nursing job, I know it'll take a good 6 months to a year to get comfortable. I look forward to comforting my patients, and helping them through their final journeys. It seems like I will be working with a great team of people. I'll keep you posted on how the job is going. Thanks for all the advice.

Thanks for the replies. I know hospice is what I want to do, but what I don't understand is where is all my self-confidence? I get myself down, because I don't have the critical care experience that a lot of nurses have. Is my LTC experience enough to make me a successful hospice nurse? I don't want to take on this job and fail. So the fear of the unknown gets to me. At the same time, I'm scared that if I pass this up, I'll be regretful. It's hard to get on with this company, and this job just happened to fall in my lap, like it was God's Will. Tomorrow is the big day that I have to make the decision, the thought of it makes me sick on my stomach. I need advice, and prayers.

Hi everyone. I was recently offered a job as a hospice case manager. I have just under 2 years of nursing experience, with the magority of my time spent in a LTC facility where I've taken care of several hospice patients. I'm really excited about this position. Hospice is like a calling for me. I really want to succeed, although sometimes I lack self confidence. I will have 6 weeks of orientation, and after that a 12 patient case load. Sound bad? Any advice or encouragement you more experienced hospice nurses can give would be greatly appreciated. Thanks in advance. AddieRN

I'm also an RN wanting to specialize in hospice. I've only been a nurse for a year and a half though. I'm currently working in LTC, gaining some geriatic experience before I transition.

I have to say, confidence is something I wish I had more of. I deal with not having enough confidence on a daily basis. It's faith that keeps me going, and a good support system at work. It sounds like you work in a very supportive environment. Never be scared to ask questions. I ask questions constantly. Psych is a great field to work in. It's always interesting. I do consulting for a couple of group homes. It's interesting evaluating how certain psych meds affect the client's behavior. I remember in my psych class it was all about those open-ended questions, that allowed the patient to talk freely. My passion is to one day do Hospice. I always want to keep my foot in the door of psych nursing as well. It took me until after nursing school to figure out what I wanted to do with my nursing career. Just stick in there! It sounds like you're on the right road .

Sorry you guys who took my message the wrong way. I really didn't mean to come across as rude. I apologize if you felt offended, and I hope you will forgive me. I guess some of the negative responses just made me feel a little on the defensive side, and a little upset. I'm just a nurse, trying to get my foot in the door, just like everyone else.

Well the facility I wish to start out in is inpatient, though we do have an outpatient facility in my county. I kinda wanted to use LTC experience as my foot in the door, seeing that I'll deal with a lot of skilled patients. Do they hire mainly LPNs in inpatient facilities? Just wondering what my chances are of snatching an inpatient job. I started out as a new grad on a cardiac unit :uhoh21: and realized it wasn't for me. Hospice or oncology was something I was always drawn too. My husband's grandmother recently passed away, and she had hospice. Just being there for her, and taking care of her during that time really made me realize what my true passion was. It takes a special heart to do hospice. My mom knows a lady who is kind of over the hospice home here where I live. She pretty much suggested I have a year - 2 years experience first. I'm fine either way. At least with a little skilled nursing experience, I wouldn't be jumping into hospice and getting in way over my head. Thanks for all the responses so far.

Hi everyone! I'm a newer nurse with almost a year's experience here and there. I feel that I've always been drawn to do Hospice. I know it's a tough area to work in, and can be sort of mentally tiring. I feel that it is the area that I am meant to work in. I'm getting ready to start working in a LTC facility in hopes of getting closer to my goal. I was wondering how much experience should I get before trying to make a move into the hospice field. Thanks in advance for all the responses.

That's all I have to say. I do not wish to have anymore responses to my thread, as I will not read them. Thanks.

Even with all the negative response, I have decided to take the position anyway. Am I over-confident? No way! But I do feel better knowing that I have support there when I need it. As far as training others is concerned....I believe infection control, etc. was drilled in our heads during nursing school, right? I am a good hearted person, and God knows what He's doing. I'm not one of those people who are like, look at me I'm the RN. I did not go to school for the title, I went to school to help others. I treat others the way I would like to be treated, and that's with respect. I have the common sense and knowledge to do good in any position. I'm also a critical thinker. There is no doubt in my mind that I can do this. Thanks to all the people who gave me positive responses. I really, really appreciate it. If you ever need advice from me (from those who gave positive responses) I would be more then glad to help you out in any way possible. God bless. Goodnight!

Thanks for all the responses both positive and negative. And kudos to Mskiesha and evilolive for starting out in LTC with little experience. I feel that if you two can do it, so can I. For those of you who are older and have more nursing experience, you don't understand the hurdles we new grads face. The job market is so tough right now. It's hard to get any nurse manager or DON to look our way b/c we don't have any experience. As for the weekend supervisor position....I will not be taking it. I was offered an SDC position instead, which I am seriously considering taking. I told her I was worried about losing my skills, but she told me not to worry because I would be oriented to the floor, should there ever be staffing issues and I could fill in as charge. DON also said that she starts IV's and does blood draws when staff are behind or just need an extra hand. It'll give me a little administration experience either way. Thanks again for all the response.

Hi everyone! I'm new to LTC. I'm a newer RN less than a years experience. I graduated May 08 started on a cardiac unit, worked there for almost 4 months and realized it wasn't for me. I've been doing some nurse consultant work for a couple of group homes for DD/MR that I worked as a hab-tech for during nursing school. I also work as a nurse for home care (PCS). I was just offered a job in a LTC facility as an RN supervisor. It's just a part-time position (every other weekend 7A-7P). I'm glad for that, because I kind of just want to get my feet wet. It has a 120 resident capacity. I'm supposed to be oriented to the floor as a staff nurse to get a feel for the floor, then trained as a supervisor. I'm kind of nervous yet excited about the position. I was wondering if any of you had any advice for a newer nurse starting out in this position. I would really appreciate it. Thanks everyone!

Yes, I relate my bad luck to the economy as well. Umm...I live almost an hour from Winston-Salem. Thanks for the encouragement.

I actually found a home health job this week here in NC. I'm really excited about it, kind of nervous being a newer grad. It's more of personal care, rather than nursing care. know what I'm saying? I think it's something I can handle, even though I won't actually be using my nursing skills. I don't want to lose them, but I'm happy to have a job. God has truly blessed me. Thanks yogiRN2b and barefootlady for your input.

Thanks guys. Things sound more promising up there. My husband's aunt works in surgery at Princeton Community. She said that Princeton Community would practically hire anyone as long as they had "RN" behind their name. My only problem is considering whether to commute up there are move. My husband has a good job, and I would hate for him to have to leave it, ya know? We've considered moving up there, and we're certain that we could find a house, his aunt and uncle have one that they've been trying to sale. Idk, I'm praying about it though. Thanks for the input!

Hi WV nurses. I was just wondering if any of you could tell me how hiring and employment are doing up there. I'm a NC nurse, new nurse actually May 08' grad. I started out on a tele floor and hated it, wasn't for me. I worked there almost 4 months and quit. Now I'm having a hard time find a job in NC. Seems like all the hospitals here are on hiring freezes. Idk what to do. I do have a part-time job as a nurse consultant for a group home. I really want to get more hospital experience though. I have a lot of family in the Princeton area. Thanks all.

It's best not to keep it bottled up, it just makes you feel worse. It's hard for people not in nursing to understand why you're job didn't work out. Nursing is a tough job, no one said it was easy. The reality of it isn't exposed until you get that first job.

Well I was back in one of the homes yesterday, and had to pass someone off to give medications. It just so happens that it was the day for that clients BP to be taken. It's been taken faithfully so far this month, so my little note must have helped. One thing I really want to do is hold an inservice on how to take a manual BP. Everyone uses the automatic ones, and sometimes they mess up. I don't always believe that you can trust them either. Yes I do have someone I report to, she's not a nurse, but she's over both of the homes. I'll be getting busy in the next couple of weeks, auditing and doing some evaluations, etc. I'm still lookin for a job, but it's kind of a hard time to be looking with the economy like it is and the holidays here. Anyways, thanks for all the wonderful advice. I'll keep you updated on how I'm doing.

Well, first of all I want to tell you that you're not alone. I too started out on a busy, busy telemetry unit, and quit after 3 1/2 months. I just couldn't handle the stress of the unit. I was hired for nights, but nights was a full schedule, so daytime I went. It was so hectic, meds, assessments, charting, patients going for procedures, my phone ringing off the hook, pages of orders, pt. families with tons of questions, etc, etc, etc. I couldn't handle the stress. Felt like no matter how hard I tried to work on my time management, it wasn't getting any better. I couldn't find a preceptor that would really take the time to teach me. Anyways, I was bringing the stress home. It was affecting my relationship with my husband, family, and friends. I wasn't sleeping well, wasn't eating well at all. I cried a lot too lol. My preceptor would see that I was drowning, and would be reluctant to help me catch up. I knew I'd be on my own eventually, and that was understandable, but still. I have a really laid back personality, which just didn't add to the busy pace of the floor, nor am I an adrenaline junkie who likes the excitment of codes. I don't regret my decision to leave. My husband is very supportive about it. The commute was horrible anyways (1 hr.). Finding another job has been the hard part, especially with the tough economical times and the holidays upon us. I found a very part time job as a consult nurse at the group home I worked at during nursing school, but it doesn't bring hardly enough hours. I also heard that alot of the hospitals are in a hiring freeze right now, and it should be easier to find something in January. In the mean time keep your head held high. Telemetry isn't for everyone, especially not me. I do still have interest in it, and I don't hate it. Maybe if I get some experience on regular floor and can work on my time management and prioritization skills, I'll go back. It's tough when people ask you how your job is going. I just say that I wanted to find a job closer to home, or that it wasn't a good fight. As far as applications and interviews just keep it to "it wasn't a good fit." I wouldn't go into a lot of details. I've worked with nurses who have ADD and they were great nurses too. Don't let that get you down or hinder you. Good luck finding another job, and keep us posted. Also check out the post new RN quit after 5 months. Sorry this was so long.

Thanks for the advice.

I still haven't made the call to find out what's going on with my applications. I keep thinking of what I'm going to say. I also need a little courage. I'm also going to call the unit and get the NM number if HR won't give it to me. I'm also trying to decide what I'd say to the NM. Any ideas people?

Careplans don't really fall into my job role with my position. My main concern was to just make sure that I'm doing everything the right way. You know what I mean. I like your way of thinking though. Just not really writing down, but doing it in your head and implementing a plan of action. Basically my job role is the same as yours in fact that's what they call it (consultant). As far as knowing a baseline BP , as anal as can be about stuff like that. I work in 2 homes and have 12 clients total. The hab-techs that work in the homes are awesome, and provide great care. The other week, I was looking through the old MAR, this one client is on like 2 different diuretics one being Aldactone, the other I can't remember what it is off the top of my head, and a couple other things that affect BP. It's ordered for her vital signs to be taken Q month and her BP to be taken Q week. Well, I decided to look in the old MAR for November to see if everyone had been doing their BPs and only 1 person had done it that month, and then recorded on the wrong day on the back of the MAR. Ewww....that just tore me up. I left a note in the log that the staff have to read daily for updates, the importance of taking the BP, and to take it before giving her meds so that we would have a clue about her baseline BP. Did I handle that correctly?? I think I did. How often do the vital signs and BPs get taken in the homes you work in. I'm so use to hospital practice and never giving an antihypertensive before checking the BP. As far as a full time job is concerned, I'm looking. After reading on allnurses first year in nursing forum, I know I'm not the ony nurse who's first job didn't work out for them. I was a little worried about taking this part-time position with so little experience. I almost backed out of it, but it's nothing I can't handle. I'm more comfortable then I thought I would be. My boss was like, I wouldn't have asked you to do this if I didn't think you cared, and I didn't think that you would do a good job. So far I'm really turning things around there. They were in need of some good nursing care. I wanna make sure they get the best care possible. As far as some clients being "unable to assess" we have some of those. Some have to be put under sedation for some exams. I just make sure those are being followed up. As far as our med-techs are concerned. I also have to med pass them. I have to watch them give out meds, and pass them off. Anyways thanks for the pointers. It's really cool talking to you.

I was hired for night time, but the night time schedule was full, so I was put on days. It's hard enough just being a brand new nurse. It was task after task, and task on top of task, on top of tasks lol. Trying to pass meds, patients going to tests and trying to get them ready, doing assessments, charting, dealing with families with a million questions, patient teaching, etc., etc. I have a laid back personality so that doesn't help at all. It was mainly a telemetry unit that dealt with heart failure 90% of the time. The heart failure teaching got old quickly lol. I still like cardiac, and maybe one day I'll go back to it. I love interpreting strips and trying to find out what's going on with the patient just brainstorming in general. I do want my one year in an acute care area, but I really don't think that hospital nursing is for me. We have med-techs in the homes that pass out the medications. They're not CNAs, and they are there with the clients 24/7. As far as inservices I'm guessing that the LPN and I will collaberate on those. I have a question for you, how about nursing careplans for the clients? This type of nursing is different from hospital nursing, so it's a little tough to adjust, but I love it. Also, one more question, do you carry liability insurance? I do.