mickey56

Yes, you are right. No matter where you go, it is not going to be hard. That is why you need support from your management and fellow workers. The problem which the facility that I left, they pretend there is no issues. You have to suck up everything. Most nurses are not doing for they are suppose to do, such as outdated care plans, meds and wound care. They are comprising the quality of care to these poor patients.

I had been a critical nurse for 29 years and recently retired because of burnt out . I landed a acute rehab ? job. At the interview, DON painted a beautiful picture, she said most of the patients are mobile and only staying at the facility for 2 weeks (transitional to home). They have fast turn over of patients. This facility is brand new and suppose to be offering rehab in a home-like environment. Then reality sets in. My first day on the floor with preceptor, we have 15 patients. 4 were on iv antibiotics q2-4 hrs, 4 have BS QID and multiple dressing changes. Each patient also has multiple med at 9am. Nurses are doing VS q8 , documenting them and also upgrading the care plans when they are due. We did not finished med pass till around 12. By the end of the shift, we have another admission and documenting the assessment seemed like eternity. I was on my feet for eleven and half hours. My preceptor was grateful I was with him to get things done . I felt like I was working in a med-surg floor with triple workload. By the time I got home, I was ready to quit. But I do not want to be a sore loser so I told myself to give the job another trial to confirm my decision. So I went back the second day, and it was any better. We had 13 patients at 7am with multiple medical issues that we had to deal. And by 5pm we had another 2 admissions coming in 15 minutes apart. We had numerous interruptions during med pass, like answering call lights and taking care of patients who almost fall. This is no way a acute rehab that they claim it to be. Most of the patients are in their 80-90s and wheelchair-bound. Also most of these patients have been in the facility for over three months. There is also multiple things that I feel I am not comfortable with the situation. So after the second day, I called the DON and I quit.

Hey, Like any other jobs, nursing has its ups and downs. You don't feel it till you are in it. It is rewarding to see someone at the brink of death recover and live a normal life. Or sometimes you feel totally degraded , because you are trained to care for the sick but not to serve as waitresses or social directors. I have been a ICU nurse for 25 years, I still enjoy what I am doing. I love the flexible schedule and independent decision making. Good Luck!

If you feel uncomfortable to beon your own, you should ask for an extension. It is better to correct the problem earlier than too wait too long. As for the aide you shawdow with, you can tell the DON to switch to a different preceptor by citing personal differences. Do it in a diplomatic way.:redbeathe It happens to me many years ago, I was a new grad, my preceptor and I had conflicting personalities. I went up to my nurse manager and she was glad that I told her my concerns. I got a new preceptor and I finished my orientation with no further problem. Don't wait until the problem is out of control.

90 min of evalu is a bit long. I have been a nurse for 24 years, so far I haven't gota bad one. But I think we do not support each other and nurses tend to kill each other. Instead of confront each other, we tend to do attack on the back. Those people who did the comments are probably jealous that you can fuction well independenly. Don't mind what other people are saying, just do whatever is good for your patients.

In this case, I would definitely file an incident report. Sometimes, the infection would not show up a few days later and you protect yourself. It happened to me before, the vent tubing pop off and water splashed to my eyes. I did not filed incident report, and a few days later I had red eyes. I had to replace my contacts and paid for my own treatment. So, I filed incident report if I think of any doubts on my mind

Hello, If thsi patient is stable, assess the limb for any abnormalites, such as edema, absence of pulse. Then ask the pt if he has any sx or trauma to the side. Big pulse difference may be due to radial harvest, thrombosis, occlusion or more serious disection/leaking artey. Doctor should be made aware of the differences.

I have been working in ICU for 22 years and I still enjoy the challenge of critical care. You need to be an active learner and critical thinker. Think outside the box, things are not always black or white. There are lots of grey areas. Be a patient advocate, do not afraid to stand for your grounds.

Congrats Go and have a great vacation before you start. Invest in some good critical care books. The first six months, you will learn so much yoy feel like you are in nsg school again