Ihoplover

Thanks alot KS for all the info I will do some research on those towns and drive through next time I'm out that way! It does appear from my research already that living in Missouri is less expensive - property taxes etc - so I may check out the smaller towns in Missouri within 30-40 drive of Olathe - decisions.decision...very difficult. Thanks much!!!!!

Hello Kansas Nurses - My family is considering relocation to the Olathe area this coming summer. I would prefer to live in a rural area within 30-45 minutes of Olathe. I come from a small town with 17 churches in it - nice little shops, Christian teachers at the public schools. I like Olathe but want a home with 5 acres minimum and want to be able to drive to work within reasonable time period. I'm looking for suggestions for towns to visit/research and/or websites with more information. I haven't chosen a hospital yet - am trying to concentrate on our home first and hospital second in a way - I want my job to be a side feature not the main focus. Thanks for ANY info. Happy New Year!

Dear Lou - Bless you for caring for your patients and being tender hearted enough to be concerned about this issue. I'm sorry as are all the nurses posting here that you were demeaned by a NON tender hearted nurse. A better statement to you from the nurse would have been "thank you for helping me take care of this patient tonight - I know it's emotional caring for a dying patient - are you doing alright?". I'm amazed at the hardness of nurses caring for dying patients and the aids too for that matter. You did nothing wrong and try to forgive the nurse that did do something wrong - we're all human and make mistakes. Maybe she'll even apologize to you the next time you see her - not that it makes it right by any means but sometimes people reflect and then realize the error of their actions/words. I've seen this happen on my unit - an apology a day or more later and unfortunately the person receiving the apology had already been stressed in the meantime and hurt for no reason. Try to let it roll off you - God Bless. Merry Christmas :redbeathe

I would be more inclined to believe that a significant percentage of nurses who have steered their career in the direction of teaching instead of working the floor have done so as a result of becoming burnt out with the patient load, politics of the floor and the emotional stress of caring for the ill and their families.............

Hi - one quick note for all of you at LTC that state you're stuck there as there are no other hospital jobs available near you - just a quick warning. Everything you're struggling with at the LTC is the SAME things I struggle with at the hospital (new grad too - May 09). I see things done like combining meds by other nurses AND nurses borrowing from other patients drawers AND the pharmacy doesn't send all meds up on time or at all also. AND I also have to answer to my boss if the meds aren't given to the patients AND I'm still learning the forms etc. So honestly a hospital is no bed of roses either. While it may not sound like a lot I had five critically ill patients yesterday on my unit under my care - 1 of which required me to be in his room almost 15-30 minutes out of EVERY hour of my shift - to hang IV piggybacks, give him morphine, assist with his BIPAP, help him urinate, etc etc etc the patient REALLY needed to go to ICU and I suggested same to the doctor who adamently disagreed with me (charge nurse did agree with me also - problem is he's a DNI so ICU doesn't really want someone who isn't a full code).........Then add to that my other four patients - 2 with chest pain (one on tridil-nitro drip), a complete care patient whose IV had to be removed due to bleeding and I had to start a new one plus attend to the skin on her diabetic ulcer legs and feet and skin on her buttocks also - of course passing all meds for 5 patients and contacting doctors regarding abnormal labs, writing orders, watching other patients so another nurse could do lunch (of course I didn't do lunch!) and the list goes on......... I do feel for all of us - believe me - this is not any easy field to enter no matter WHERE you work - LTC, hospital etc. but I guess the focus of my warning here is don't jump from the frying pan to the fire thinking a hospital job will be better. Prayers to you all (they're the only thing that gets me through my shift!).

LeavingTeaching4RN- Hey here's my advice (I'm just a few months out of school and work on extremely busy cardiac IMCU): 1) Know the meds which need to be held before cardiac procedure - like metformin & lovenox held before heart cath - so just review a few cardiac pre op procedure reminders 2) Then look at a few cardaice post op reminders for nursing in your med surg book - like pt on bedrest after heart cath - leg straight, head of bed no higher than 30 degrees etc 3) Make some copies of pertinent "things" and put in a notebook or on back of clipboard to carry with you to work - i.e. ABG's and their translation, INR norms and what it means for coumadin administration, electrolyte norms, etc - quick reference sheets 4) Read through your cardiac section of any NCLEX books for quick and focused review 5) Fret not too much re: EKG interpretations - they're going to orient you to unit and I assume (they better!) send you to an EKG class! 6) They're only going to expect you to know your BASICS initially so review how to do a thorough (but quick) physical assessment 7) RELAX - it will all come together - remember there are new grads who have walked in your same shoes and survived and ......actually THRIVED! You can do it! 2)

Erin - P.S. My unit manager just called me at home and asked WHY I didn't get the meds to my patients (2) last night - the ones I kept calling pharmacy about!!!!!!!!! GEEEEEZ - I told her entire story AND she suggested I should have told my charge nurse - WHICH I DID - and I told her I DID - sigh..............

Erin - I understand your panicky and frustrated feelings - I too am a new grad on a cardiac IMCU, that is to say the least challenging for a new grad. Not knowing the policy is not at all a surprise to me. How can we know every single policy coming out of the "orientation gate"???? We can't -plain and simple. If the conversation didn't come up in orientation then it didn't come up and this unfortunately is exactly how we learn - by experience on the unit and I definitely mean unfortunately because I can read your story and envision myself in same spot. You're not taking care of only that one patient - if you were it wouldn't have been so crazy right? No we're taking care of 3 or 4 more - all with needs and usually a challenge in every room. Last night my trach pt's IV was so tightly taped ALL around his wrist by ER at his admit that the IV solution wouldn't infuse properly AND he refused to be suctioned (we rectified this) and three of my other patients didn't have their drugs up from pharmacy - so I had to keep calling asking meds to be sent up - back and forth to room, back and forth to med room - complete waste of time for no reason (probably because pharmacy is WAY too short staffed also). My final patient - previous stroke needed his meds crushed in applesauce - guess what was not to be found on unit - you guessed it applesauce - not one container - RIDICULOUS. AND when I FINALLY found an aid and asked her to seek out applesauce in another unit (kitchen closed for nt) she was able to find ONE and only ONE left on another unit. So............I give you my horrid rundown of just a sample of how my night usually goes to let you know I TRULY do understand. :heartbeat When you have a set of circumstances like I just described and then a cardizem drip patient is thrown at you also - and you're trying to get answers - it's just plain nuts (because....all the other nurses are working hard with challenges also and don't have much time to talk sometimes). Basically what's happening out there is that on step down units we're getting patients who TRULY belong in ICU and need more one on one care but there's either not a bed in ICU or etc so in step down we're trying to juggle a real critical patient along with 4 others (last week I had TWO patients who belonged in ICU along with my other pts - 1 had just had a stroke that day and really needed to be on NEURO ICU not on cardiac step down -grrr) I too have felt like quitting - going to a drs office doing a day shift and not "stretching" myself anymore! BUT we've just got started and we don't need to throw in the towel yet - like other posters have said - the patient is fine and no one was hurt and as you posted we learn from every situation something valuable. I couldn't believe when I was told I wouldn't feel comfortable for an ENTIRE year on the unit - some of this is because of circumstances I already described - some of this is simply because we have a lot to learn:wink2: A little bit of advice to you (and to myself): 1) Always show up EARLY for shift - read over the orders for the pts you'll be getting - do a couple of blood sugars on the patients even before you get report if you can - anything to get a head start in other words 2) Get report EARLY before all the craziness starts with everybody else showing up and trying to line up for each nurse to get report - so to speak (plus the nurses will love you for taking report early and you'll have more time to ask questions) 3) IF (praise God if this is possible) you have ANY spare time - during your shift to help your fellow nurse (especially charge nurse) then do it because "what goes around comes around". 4) Make a friend out of your aids by helping them when possible (i.e. I set up my room for my new admit last nt then called her & said I wouldn't need her help setting up or getting admit vitals but I wanted her to know pt was there for 8pm vitals and thanks). Offer them a piece of gum, candy, bag of chips, - just ya know show kindness - they work HARD too and alot of nurses are not so kind to them - they'll go the extra mile for someone who appreciates them (I went to pick up fast food one night & ask the aids if they wanted to order & they were amazed that they were included - how sad is that!) 5) Keep reading at home for an hour or so a week (whatever works for you) re: cardiac (I'm reviewing NCLEX cardiac materials for review). 6) Try to ask a nurse each shift a question such as "what was the one thing you wish you knew when you started working here that would have helped you function better" - (I'm going to start asking this tonite!). Hearing someone else's horror stories also helps you not make same mistake. Also asking how each nurse organizes her night or tips for ANYTHING at all is good for both of us! 7) Remember that every new shift is a new day and leave the old bad memories of what happened yesterday alone. 8) KEEP reading this website for insight - it's great!!!!!! 9) If you have a faith in God - you can do as I do each day as I enter the hospital building and pray that God will open your eyes to knowledge to glean wisdom, to bless your patients, to have a smooth shift (and I also add to help me not look so stupid ) God's blessings to you Erin - any more tips you have for me I'd happily read and take to heart!!!!!! P.S. Anytime you want to send me a private message we can share tips, tricks or failures we've learned from:wink2:

Christy RN2009 My unit similar to yours - CVIMCU - usually each nurse has 5 pts (they're trying to push 6 on us almost regularly now). Duties same as yours and many times 1 (or more) of my patients belongs in ICU but they're full so I'm handling an ICU patient (or 2) along with my other 3 or 4 patients. We get fresh open hearts after they're stable and still have to juggle the other very ill patients. It's very demanding and problem is since our facility will not say the hospital is full we are taking any and all patients on our floor. So what this means is......I have an ICU patient needing more 1:1 care in 1 room, 3 other patients (say a post angio in 1 rm, new onset chest pain in other rm and COPDer in last rm) along with an elderly alzheimer yelling and trying to fall out of bed or in wrist restraints or a trach pt with sacral wounds as big as my fist on a wound vac. In other words I sure wish I worked on an ACTUAL cardiac unit instead of a "come one come all" unit - it's rough........

Isyorke - Thanks for your note and I get your point - problem was that the attending was the family doc for this pt and since the pt's family was irate I thought it would be best he knew that they had called the director of the hospital etc.......the surgeon is a stranger to them and I was going to advice attending of situation and mention I'd be calling surgeon if o.k. with him but he didn't let me get that far - unfortunately the surgeon made the man's leg look as if it had been cut with a fork and a knife - very sad situation. Thanks for taking time to reply.

Dear Plaqueis- Hey I feel your pain - I'm a new RN and there are days I feel I'm drowning too! Big difference is I have an AWESOME group of nurses that answer all my simple and complex questions and are very good to me. It's still hard and I've cried over my patient's suffering and stress out over my lack of knowledge at times but honestly if they're not going to support you - you need to find another job. You CAN find another LPN job even though new grad - let them know you'll have to give your notice if you can't have more time WITH a preceptor. God's peace to you!

Hi - I'm a newer grad (May 09) and would like a little bit of feedback. Today a patient's family member wanted me to contact the patient's doctor re: a proposed surgery. So many physicians on the case I spoke with a more experienced nurse on the unit and asked if I should contact the admitting doc first before surgeon and consulting docs out of courtesy and respect. The family member was very upset with a non-compassionate float nurse from the previous evening and had actually reported her to director of the hospital and I was trying to be a liason between this family (rightfully upset - pt very very ill) and the hospital etc. The experienced nurse honestly thought I should call admitting doc first. When I spoke with doc asking simply "Family would like to talk to a doc" He chewed me out for probably 5 minutes - he hadn't seen patient recently and hadn't done the surgery and did I talk to my charge nurse or unit manager before calling him and...I must be new or a float or I wouldn't have made this call and I obviously didn't take the time to read the chart well and ON and ON". I just said "no sir, yes sir, thank you etc" and politely ended the call. Unfortunately I found out later that this doc has a reputation for said behavior. Anyway the question is - how much do we take and simply hold our heads high as nurses - following protocol and professionalism and just hang up and move on and how could I have replied differently perhaps? Thank you!

Hey you made a mistake - you're human! You'll make plenty and the pt rec'd the correct dose. The dr probably won't be too uptight about it. Can't you just call pharmacy anyway? Just wondering...Anyway ask yourself this question "Has this doc ever seen another new nurse make a mistake?" YEP sure has - it's all part of learning and my experience (also new grad) has been that most drs are pretty good people and take things in stride. So here's a couple of tips: 1) Always repeat the info back to the doc and if he/she has an accent that you can't understand just say "pardon me?" or "I'm sorry I'm a new grad, could you repeat that?" etc 2) If you get off the phone and realize you don't have all your info straight call the doc RIGHT BACK - they don't seem to mind this too much rather than waiting and trying to figure it out on your own and it just makes you dread the phone call more by waiting 3) Relaxation - well I sleep, listen to Christian music (&admittedly sometimes pray and/or cry about a pt or two) and then try to just focus on the other half of my life - home, kids, paperwork etc It'll get better - for both of us - for all of us new grads! I would love to join a gym or walk around the neighborhood - problem is not a lot of time is there? Take care!

Well all working moms have this challenge and many of us are dealing with it the same way - rotating child care, errand running, bill paying and household duties with our spouses AND I'm fortunate enough to have a very responsible and trustworthy older daughter - 17 going on 18 that cared for my younger children this summer as well. This was her part time job and I paid her well and this enabled her not to have to work outside the home. My suggestion for anyone not as blessed as I or others doing the same above is to hook up with either another single parent at work and rotate child care and hours - if you're lucky enough to find a competent and willing person OR find a TRUSTWORTHY person from a local church to be hired to come in your home and care for your children and misc duties. It's just too hard to cart your children to daycare back and forth at all hours etc. There are so so many people out of work that if you can find a younger mom who wants to bring her WELL BEHAVED child to your home and then care for yours also it's a win win for her and you - these are HARD decisions. Final suggestion - perhaps the toughest of all - peace of mind re: your children is NUMBER ONE so if you can find another job that works better for your situation with your children then JUMP ON IT! even if the pay is a bit less (then you're not paying child care). Good luck to you!!!!!!!!!!!!

Hi Chocolateskye- LOVE that name! I believe Methodist Southlake is hiring now - it's a bit rough for a new grad where I'm at but I'm learning ALOT - accessing ports, pulling central lines etc - I'd be happy to send you more info if interested - let me know!

Hi Chris - Yes I'm brand spanking new to nursing - May 09 grad and yes again very intuitive of you to notice that I still do not regret my decision. I absolutely love taking care of people. It's emotion and heartbreaking sometimes but I know God ordered my steps and placed me just exactly where He wanted me. This knowledge gets me through the tough daysand with God in control every day is an adventure! You can private messenger me about anything you'd like to know in particular anytime!

Dear 39 year old - You're a youngster! I'm a female who's popped in to post a reply to your note because I'm older and a new RN grad and just couldn't resist the opportunity to say GO FOR IT - you're never too old! I also have young children that went through the part time schooling 3 yr process with me and a supportive spouse too. NOW that said I also have a law background - paralegal and I can tell you I have NOT been happy with some things I've seen done in the hospital setting where I now work - BE PREPARED it's not all a bed of roses out there and it's NOT in our control just because we're the NURSE and the advocate for the patient. FOR INSTANCE a doc wrote an order for nitro iv JUST to keep the pt in the hospital so they could have an early morning cath lab procedure (otherwise insurance would not pay the hospital for the stay) then the pt's bp starting going south and nitro had to be stopped (pt did NOT need the nitro as they had been pain FREE for 2 days). Scenarios like this get under my skin. PROBABLY I just haven't figured out WHERE I should practice my nursing skills yet where I will actually ENJOY what I do. I LOVE the patients - as you have said too in so many words - this is the heart of the matter that draws us to the profession. Pray hard about your decision and explore ALL avenues before you make a final decision. God bless

Little Mouse writes: I'm taking the exam tomorrow! Your thoughts and prayers would very much be appreciated. Thank you. Congrats, bamadeb, and all of you that have passed already Hi Little Mouse - I just got back from taking the NCLEX! Let me tell you I know God was with me as the test was ALOT and I mean ALOT easier than I had feared. I felt that all the test prep questions I've done from EVERY source imaginable were alot harder than the NCLEX. So I will pray for you tonite but be sure to place your trust in God, RELAX and you'll do great! Good LUCK-

Miss Anna - I'm praying for you RIGHT NOW! Let us know how it goes and remember that ALMOST everyone "feels" like they failed when they walk out and MANY have passed - just do your best and hold your head high! I'm taking my exam tomorrow - remember ABC, pick the "killer answer" i.e. if you could ONLY do one thing which one would it be, remember you're a NEW nurse and pick an answer accordingly! Also - Erickson - Autonomy-Toddler, Initiative-Preschool, Industry-School, Identity-Adolescent. Everyone is saying alot of Infection Control - so know your TB etc. We can handle the hold delegation thing - no problem right? We survived nursing school - we can conquer this too!!!!!!! GOOD LUCK!

gdj-I WILL pray for you and you made a wise choice to reschedule at this time....We are all under a lot of stress and things in the family are the roughest to cope with under these circumstances. Put your health and your family first - this is never a mistake but always the hardest for us to do I'm afraid. I pray your children are feeling better now also. God Bless! :heartbeat P.S. I obviously don't know about the circumstances of the fight with the husband but if there is no abuse, violence etc going on then my loving advice is go on a date and relax with your hubby! I don't know about you but I have had only a handful of dates with my husband in the last couple of years. The NCLEX can wait.

Hi! Yes God is good and He ordered our steps and walked up the nursing school so He WILL get us through the NCLEX! I do know He expects us to do our part (as I know you understand too)! So I'd like to comment on the math and on the meds - the math I believe will for the most part be basic I&O and IV drip formulas etc - not too horrid really and probably not ALOT of these. Meds -NCLEX "should" really focus on the common meds that we do know something about AND on meds that could kill someone in quick order if administered improperly - i.e. Heparin. I think it's important to study Adult Med Surg MORE than anything. Peds and OB - a few things on there that would be life threatening especially but not alot - these are just my opinions for what they're worth AND in spending many hours reading different threads and posts in the last few months on this AWESOME forum. Safety, infection control and NOT killing our patient - that is my focus in studying. I bought a book by Marlene Hurst for NCLEX RN and I really like it. I already have Saunders, Kaplan, Lippincott books and this new book is by FAR my favorite. A gal told me she read it beginning to end and passed in 75 questions -cool right? I am still considering purchasing the Kaplan test bank questions but WOW pricey! WHY in the world don't they allow us say 3 wks of accessing it for a discounted price - GREED that's why! sorry... Good LUCK to all (living under Christ's keeping - my favorite acronym)! :redbeathe

Hi everybody - I'm definitely going to test in June just haven't rec'd ATT yet. I was using NCSBN, Saunders then started reading Hurst RN review book - small book about strategy mostly that was recommended to me by someone who passed 1st time with 75 questions and ONLY used that book. Here's my question - I know Kaplan teaches alot of strategy so I didn't do the review course at school but the question bank gets ALOT of positive comments on this forum and I'm considering paying for the question bank to do those these last 2-3 wks before testing. Any insight from anyone on this is appreciated!!!!!!!!! Good LUCK to all!

Hey everybody - thanks a million for all the replies! I love this forum and the fact that people will take a minute to offer advice, a pat on the back etc. just to place someone's mind at ease or help them through something! I'm at ease about the Mantoux now since as posters mentioned above I did get the wheal on my forearm when the nurse administered the test even though it bled a little! Thanks again!!!!! :lvan:

Hi - anyone who's knowledgeable in administering a Mantoux or someone who's had a lot of Mantoux tests performed on them - this is my question....I had a test done yesterday and I believe the nurse may have gone a bit too deep as I had bleeding (very sm amt) at site of insertion and I have never had this happen before. Also, I saw another gal in the hallway afterward you said to me "Hey has your Mantoux ever bled before mine just bled?" So hers bled also - hmm....... Shortly thereafter it almost appeared as if the puncture site was a bit bruised - darker red at just the site and now this morning I wake up and I have alot of redness out from the site. O.K. no induration at all so this may be quite normal at the 24 hr mark but the bleeding was odd I thought. And finally, this is a two step so I have to return to the facility for the same nurse to repeat another Mantoux which is why I definitely want a bit of feedback from the awesome nurses on this forum! THANK YOU

Christina - CONGRATULATIONS! I am so happy for you! You have a wonderful attitude and yes it's a major blessing to have a job as a new grad. You will learn SO much in acute rehab and if you desire to leave you could easily transition into a critical care area with that experience! Those people are going to tug at your heart but hey that's a big part of nursing isn't it! They'll be equally blessed to have you as their nurse! Good Luck and take care! :heartbeat