mikeicurn

You might be a new grad, but some of these basic skills like straight cathing someone should not be making you nervous. You are going to have to start jumping in and doing them. Transferring to Med/Surg or anywhere else is probably not going to be any easier. Nursing is nursing, every area has their own procedures that are kinda unique to them, but the majority of your job is going to be basic nursing skills. They obviously hired you because they thought you had what it takes to do the job. Now, show them they were right. You can't hide in the charts, your job is patient care. Charting is basically documenting what you did for the patient. So, get in there and do things for the patient, then worry about the charting. Good luck!

Don't get your honey where you make your money.

Good Luck!

You might be able to leave it off your resume, but when you fill out applications they often want all time accounted for, and explainations for any gaps in employment. So you may have to address it then. You have a good reason for leaving, and the fact that you left and went to Florida just supports your reason for leaving. Good luck,

You did good!

I have my own sheet that I use for my patients, as well as a form detailing these notes you are talking about (I have heard them them called fishbones).

1. Do RNs still create care plans anymore? In my area everyone admitted to the hospital or LTC facility has a care plan. 2. Was school beneficial to learning the creation if a care plan if the answer to Question 1 is 'yes'? I think so, in school you learn the process. The "why" instead of just the "how". 3. When a care plan is implemented by the RN on a hospital floor (non-ED), does the MD ever disagree with decisions made by the RN? I have never seen this. 4. Is a care plan becoming outdated in the hospital setting? Is there a certain population, like LTC, that a care plan is more productive? I don't think so. If John Doe comes into the hospital from a LTC with exacerbation of COPD, he will be treated for his COPD, but he also needs to be treated for all the other health problems he had at the LTC facility. If he was a fall risk there, he is gonna be a fall risk in the hospital. 5. With so many lawsuits being thrown around, should the RN even create a care plan anymore and then be prosecuted for causing what the recoving surgery patient says is undue pain because he was made to ambulate or even a differnt example with perhaps more validity? (I see enough RNs/LPNs scared to do what is perhaps "right" for fear of being viewed as "wrong" and then being sued. Let alone poor reflection of the HCAHPS b/c the pt didn't get to sleep in until 10am). In the facilities I have worked in this isn't optional. It is part of doing an admission. The driving force for change in my hospital is not fear of lawsuits, it's fear of not getting full compensation from Medicare/Medicaid. Case management is constantly digging through charts ensuring everything is done correctly so we get full compensation. It is even more important nowadays for these interventions to be done to ensure the length of stays are reduced, core measure patients are treated correctly, and people are not being readmitted for the same diagnosis over and over again. We have to fill out separate paperwork for most of this, but it is really just an extension of the careplan in many cases in my humble opinion. 6. Is the current state of care-planning just to assist student with critical thinking skills? Well, like I said above. Care plans in my school were much more detailed, as a means to make you use the critical thinking process. In the hospital our careplans consist of checkboxes. In school we had to write out the nursing diagnosis, the medical diagnosis it was related to, the subjective and objective data, goals, and outcome criteria. It was a learning tool. If for instance, I get a patient in with dehydration, I don't have to to write out in my care plan that he may have poor turgor, decreased NA+, increased K+, c/o headache, and dry mucus membranes. I am a nurse, I should know that, however as a student I had to show the instructor that I knew it. I also had to detail what was objective, and what was subjective. So part of the exercise was to fill out the careplan, and part of it was to educate me on signs, symptoms, treatments and interventions. I think the careplans in school are a good exercise to tie everything together in a more "real life" manner. I also think they have some value in the hospital/LTC setting. You certainly wouldn't need one in the ER. I wasn't aware if they used them in corrections or not. You taught me something there.

As it's been stated already, it all depends on where you are at, and that particular facilities' policies. I make more hourly at the hospital, but the shift diff at the nursing home meant I actually made more there on the weekends. At my hospital PRN employees make about 20% more than full-time, but at the nursing home the hourly rates are the same, and PRN people get $1 less for shift diff, so the full-timer's actually make a bit more.

Agreed, you also have to be realistic. You may not land your "Dream job" right out of school. I have heard many new grads state they have to have a day shift job, don't want to work weekends, expect to be able to take off for children's birthdays, boyfriend's birthday, grandma's birthday, that concert I just can't miss, because I didn't sleep well last night and I am too tired to work, etc... You might have to take a night shift job to start out, you may not be able to take off at the drop of a hat, you may not get every weekend off, and you may have to take a job on a less desirable floor until an opening comes available on your "dream floor", but you can find work if you look hard enough and have the right attitude.

As others have said, no harm done. It could have been a lot worse. Don't take it personal, although your coworker may have not been the most gracious about it, she taught you something. Take the lesson and move on. When you have the opportunity to help a new grad along and teach them the same thing, remember this and do it in a different manner.

Careplans are a little different in school than in the workplace. The ones you do in school are more detailed, because you need to learn what you are doing before you start filling out the "short form" versions. They are usually meant as more of a teaching method so you learn how to use labs, medications and medical diagnoses to apply nursing diagnoses. So, of course they take longer to fill out. You will learn in school that there are doctor's diagnoses (such as sepsis, cancer, anemia, etc...), and nursing diagnoses. The careplan is filled out by the nurse who is admitting the patient, and every nurse who assumes care afterwords reviews, and if necessary, revises the care plan. This is meant to insure consistant care is given by all nurses. For example, if I admit an elderly patient who has orthostatic hypotension (their blood pressure drops with they stand up), they would be in danger of falling. A nursing diagnosis might be "risk of injury due to falls related to hypotension". So, then I would apply the necessary interventions to try to prevent the injury. Such as "bed alarm in place", "call button within reach", etc... This would all be called out in the care plan. So when you took over care of the patient you would review the careplan, and initial it. This stays in the patient's chart. There is an organization called NANDA North American Nursing Diagnosis Association. They put out a list of standard nursing diagnoses. This is the standard my school used and I would imagine a lot of other schools use as well. Good luck in school, I hope this helps.

I only wear Crocs (the real Crocs not the cheap knockoffs). They are the most comfortable shoes I have found.

I am not sure what part of the country you are in, but in my area $7.50 would be pretty typical for a nurse aid pay. My advice would be, that you may want to research the field a little more before you proceed into nursing school. Since the pay for aids is pretty close to what it is here, I am guessing the LPN pay will probably also be in the same neighborhood. If so, you still probably won't be making $18.00/hr even when you graduate. Also, around here, most new nurses start out on night shift as the day shifts are filled with people with more time. In my unit there are people who have been here for 7 and 8 years that are still on nights. Good luck.

I only worked Med/surg for a short time, and have spent most of my time in the hospital in ICU. That having been said, I don't mind working med/surg. The things you are hearing about being short staffed, high pt to staff ratio, administration expecting too much from you, no time for breaks, etc ... are not exclusive to med/surg. I heard the same things when I worked LTC and also in the ICU. You have good nights and bad nights. I know people in our hospital that love working med/surg. You just have to find your individual niche. I used to run around like a chicken with my head cut off trying to do everything at once. We had one nurse in my ICU that had been there for 35 years (she just retired a few months ago). She never ran around, looked flustered, or got her blood pressure up. I started watching her, and she just prioritized and did one thing at a time, until the work was done. I started trying to do the same thing, and low and behold my work got done more efficiently, I didn't miss stuff anymore, and I was so much less stressed.