bbie17

It doesn't seem like a good environment for a new grad. I would not work there even if I was desperate for a job/money. What you need is a nurturing environment that provides you a good foundation on nursing practices. When you're new and just starting out (in any job, not just nursing), the most important thing is doing the job correctly and safely. Being fast, efficient and knowledgeable will naturally come with time. Is it the norm to have patients run out of meds & to have to borrow/steal from another patient's meds? This is acceptable- if your patient needs ambien 5mg, another pt has ambien 5mg. Same dosage, same med, it's ok to use the other patient's med. However, only do it when you absolutely need the med and it can not wait. Don't turn it into a routine practice because you can easily make mistakes (ie. wrong dosage/wrong med) Is it normal for nurses to sign off on whole med passes & treatments & not actually do any of them? wow, absolutely not. Is it common for nurses to skip vitals on multiple patients & then just "come up with something" to put in the chart? absolutely not. Is it common to meet what seems like an excellent nurse only to have to do a double-take when they sneak a pill out of the patient's cup of meds on the way down the hall & pop it into their mouth - slide of hand? Not common, but one of my coworkers got caught stealing narcs and was fired. You need to report this nurse before it becomes a problem. He/she needs help. This reminds me of that guy in New Hampshire who stole Fentanyl and got people infected with his Hep C. This could've been a result of unreported events. I feel so bad for the residents at this facility...

Unfortunately, wherever you go you will have doctors/preceptors/coworkers/bosses/family members/patients who are rude, mean and treat you like crap. The best thing to do is not take it personal and just do your job. If it's a preceptor that's giving you a hard time, try your best to get through orientation. Once you're on your own, it will be much better and you don't even have to go to them for help. If it's certain coworkers you dislike, bond with the ones you do and schedule yourself so that you're working opposite days as the people you don't like. You can't change jobs every time you don't like your coworkers or change your assignment b/c you don't like a patient. Learn to work with people, especially the difficult ones, and you will go a long way. Goodluck on your job search.

hmm I find it strange that nurse managers would think you "have no nursing experience." Either you didn't talk enough about your experience at interviews or you just happened to be competing with a pool of experienced applicants. Like other members, I suggest you keep trying. You definitely have what it takes to work in the ER. At the ER I work in, we don't hire new grads without experience but we do hire new grads who have worked as techs in our ER or who were army medics. Goodluck on your job search!

You did the right thing. When I was a new nurse, I was jumpy over things like that as well. However, I remember one of my professors said that "always do what makes you sleep at night." Whenever I feel uneasy about something, I always get a second opinion from an experience nurse, then I go check it out myself so I can have a peace of mind.

She does seem very unprofessional about this matter. Although I have never seen anybody pushing somebody and not apologizing during a code, I could see how someone could accidentally do it. However, when confronted afterward about the behavior, the person should apologize. It's common courtesy. It's sad how some people can't take constructive criticism. I applaud you for going to her manager. I'm rather passive so I'd probably brush it off after talking to her about it.

If you can go without a job for several months then wait for a hospital job. But you mentioned that you desperately need $$...so take the offer. Who knows, maybe you will like it there and stick out for a year before considering hospital setting. Or...maybe you'll be able to work at both places. The point is, worry about securing a position first, before worrying about quitting. When opportunity presents itself, embrace it and things will work themselves out. My friend tells me once that we tend to regret the things we did not do than the things we did do. Goodluck with your decision

I agree with the post above...if you're able to relocate, definitely consider it. I live in San Antonio and there's a lot of RN jobs out here. My hospital just hired a batch of new grads for ER.

I agree with everyone's comments. I think what went wrong is not the fact that RRT was not called, but that the pt was not transferred immediately to ICU. Perhaps the RN who contacted the MD did not accurately describe the situation...? I just can't imagine a physician transferring a patient who couldn't breathe and had a BP of 50/0 to an intermediate unit. When a patient dies, a sense of guilt or "wanting to do more" tend to tug at our hearts, whether we are just bystanders or someone who directly handles that patient's care. A death of a patient impact us in so many ways and it especially has a great impact on the people who provided the care. I believe the charge nurse and the RN both want what's best for the patient. Having RRT at bedside may or may not change the outcome of the situation. I think it's best to provide support for your coworkers, as I'm sure everyone involved is walking away with some kind of lesson to help them become a better nurse.

I agree with others. Contact the NM and thank her for the interview. It will leave a good impression about you and lead to future job opportunities. When I first graduated, I interviewed for a position. After the interview, the manager asked for my certifications to make copies, ran background check, etc. and told me I'd hear from him on Monday. I didn't get a call on Monday, so I called him and was told he's hired someone with more experience. I still sent him a thank you card, and two months later, he called me back to offer me a job. I had already accepted another position so I politely declined. Bottom line is, don't burn your bridges and keep networking. Goodluck!!

Thank you so much everyone, for taking the time to give me advice. I'm very inspired after reading all of you guy's comment. All the advices were great! I will take everyone's advice and take it one step at a time. I will take my TNCC and ENPC first, then review gradually for the CEN. I was rushing to get the CEN because I really wanted to get trained in the trauma area. At my ER, only RN's with CEN can work in trauma. It's been 2 months in the ER for me and I love it! I'm so eager to learn about everything and I take every opportunity to sneak in the trauma area and watch. Hopefully, one day soon I'll play a role in that room. Thank you all again!!

Hi all, thank you for viewing my post. I have 1yr of Medsurg experience and just started working in the ER for 2 months. I've been thinking about getting my CEN. My coworkers tell me I should wait at least a year or until I have some experience under my belt before trying for the exam. Several nurses on my unit just took the exam and failed, and they all studied and are very experienced ER nurses. So my questions are: What is my chance of passing the exam considering my background and experience? Should I wait a little longer like my coworkers suggested? Has any new grad/new ER nurses pass the CEN on the first try?

Hello and thank you for reading my post. I have 1 year of Telemetry/Med-surg experience and was recently offered a position in an ER with a level 1 trauma center. They're offering me the same pay rate as I have right now, which to me seems very strange because I started with this pay rate as a new grad a year ago. I'd expect with my one year of experience and being a level 1 trauma, they would compensate me more than a new grad salary. I just want to get a census of the average pay rate for RN who works in ER/Trauma, so if there's anyone who works in ER in San Antonio and wouldn't mind sharing your hourly pay, I'd be greatly appreciate it. I want to make sure they're not trying to low ball me before I try to negotiate. Thanks!

Hi Samstra, You can be licensed in both states and remember to renew it every year. I originally got my license in CA and got it endorsed to TX. While I'm working in TX and holding a TX license, my CA license is still active. Good luck with your job search!

The unit you describe sounds exactly like mine, except mine is not Med/Surg. I think everywhere is the same. You should take the job, it will be easier to find another one when you're already working as an RN than being unemployed.

If all three nurses did not document anything, LPN 2 is probably held responsible. It was her patient and there was no documentation to prove she was busy at the time, so it seems like abandonment. She was supposed to round on her patients hourly so she can't really argue that she wasn't aware of the situation. When someone falls at my hospital, everyone drops what they're doing and run into the room, ESPECIALLY the nurse who's assigned to that patient. If LPN 2 had been calling w/ pharmacy ALL shift...what makes her think the problem will be solved by staying on the phone??

Aww sorry you're going through stress. Like everyone said, take a deep breath and just take one step at a time. All this will eventually pass and you can do it! Nursing school is not easy, but it isn't hard either. You just have to be determined and tell yourself that the finishing line is near. Also, hang out w/ friends and pamper yourself to relax. When your body is re-energized, you'll feel alot better. Goodluck and it'll be ok =)

I think 6 patients is alot, especially if you're working day shift. I work on telemetry as well, but we usually have 4-5 patients. Sometimes we have 6, but they're usually stable patients. I'm a new grad, but I was lucky to have an extremely organized preceptor during my orientation who taught me how to manage time well. The way I start out my day is by showing up at 6, even though shift change doesn't start until 6:30/6:45. I'd look up labs for all my patients, check tele rhythms, write down the times meds/procedures are due for each pt, then I go thru the charts and write down any new orders so that during report, I can verify w/ the off-going nurse. All this takes about 20-30mins, so by 6:30 I'm ready to get report. I try to be done with report by 7. Then from 7-8, I go in and do complete assessment on all the patients as well as charting after each one. By 8-8:15, I start passing my 9 o'clock meds. This routine works pretty well for me, but some days, if I get an admission or a discharge right at the beginning of shift, I tend to fall behind a bit.

I'm confused...how can a patient refuse/be noncompliant with bed sensor?? Don't you just set the button on the bed? I set the bed alarm on all my patients who are at risk for fall and most of the time, they don't even know I've set the alarm.

Working atleast 12hrs a day, I think I'm more fit now than I was when I was in college. I'm constantly on my feet, walking, using my arms, bending, lifting...I think that's a lot of physical activity! One of my coworkers wears this mileage meter thing...it tracts how many miles you walk in a day and surprisingly he walks well over 5 miles in a 12hr shift. The only thing that my body takes a toll on from being a nurse is not getting the right nutrients. Some days, I find it hard to eat a healthy meal or even eat at all.

Like others said, don't beat yourself up on it. The important thing is you've learned from your mistake. And it's okay to feel incompetent and nervous because that will allow you to be more cautious of what you do. Everything is computerized at my hospital and we give meds using a computer scanning system. We scan the patient's ID band before giving med to pull the patient's profile up on the computer. We then scan the medication barcode. If you pulled the wrong med, had the wrong dose or tried to administer the med at the wrong time, a pop-up message will alert you on the computer after you scanned the med. And lastly, we scan the patient's ID band again to confirm the right patient. This system is great and one might think how can a medication error occur with a high tech system such as this one? But it still can...!! A few weeks ago, my preceptor and I were in a pt's room to give insulin. Patient was supposed to get Novolog 70/30. My preceptor gave me a bottle of Novolin 70/30 and I scanned it. A message popped up on the computer saying "Medication not found" for this patient. We double checked the insulin box and didn't see any bottle of Novolog, so we called pharmacy and told them the situation. Our pharmacist told us "Novolin is Novolog, they're the same thing." He told us he'll correct the barcode so the med would scan for us on the computer next time. I had a weird feeling that we weren't going to give the right insulin but my preceptor said to give it, so I did. Later that day, we called our pharmacist again to double check on the Novolin and Novolog...and again, he told us it's the same insulin. Next day, another nurse had that same patient and she got a bottle of Novolog brought up from the pharmacy for this patient. I spoke to her about what happened the day before and she said the pharmacist whom she spoke with told her the two insulin were different and that's why they sent up the right one. I panicked and went looking for my preceptor when conveniently I ran into the pharmacist I spoke with yesterday. Again, he told me Novolog and Novolin are the same!! After a while, as my preceptor, charge nurse and another nurse were trying to figure out this insulin situation, the pharmacist whom I spoke with came up to us and apologized. He admitted he had made a mistake, they were NOT the same. From what I've heard, he's been a pharmacist for a long time...so mistakes can happen even to people with the most experience. From this experience, I learned not to depend on what others tell you. Trust your own instinct, go to your coworkers for help but when in doubt, refer to a literature.

Thank you all for replying! twentytenRN: I agree with you...in the past, I've also gotten offers first before I was asked to provide all my legal documents. So when the guy asked me for the documents to make copies and came back to tell me "I'll know my decision by friday"...I wasn't sure if this procedure is routinely done or if he's already made a decision to hire me but just wants to wait for a clear background before breaking the news to me. (???) The wait is killing me!!! Has anyone ever had an employer make a copy of your legal documents at the end of your interview and DIDN'T get offered the position in the end? (Assuming your background chk good)

I had my interview yesterday. It was very brief and I think I did bad. After my interview, the manager asked for my driver's license, s.s card and RN card to make a copy of...but told me he'd know his decision by Friday. Is it routine to make a copy of these documents from candidates or am I hired? I'm so nervous and can't wait for it to be Friday!!!!

Hi Prinsessa, It breaks my heart to know that you don't think about renewing your license. If you came into nursing for the right reason and have made it through nursing school as well as passing the boards, then you're meant to be a nurse. Please don't give up. A new day, a new year, brings new luck and new opportunities. If you become desperate, maybe consider moving to another state to look for jobs instead up giving up nursing altogether. Some of my classmates got hired in NC and Texas before we even graduated...and they were not the brightest students. Goodluck on your job search and stay positive!

Thank you all for replying, I really appreciate all the advice and comments!!! I know I will learn alot working in this Dr's office, as I will be given many responsibilities and automony. I'm not worried about learning protocols or procedures, but what's really holding me back from taking this job is the fact that I'll be the only nurse there. I'm worried I won't know how to handle emergencies or recognize impending crisis since I'm fresh out of school. There's one day in the week where the MD will be out of the office, and I will have to run the clinic by myself for 5 hours, giving allergy shots and monitoring patients for reactions. This part worries me...

Ayvah, Yes, there will be just me and the MD. And that's a good question you asked about who will monitor the allergy injection patients while I'm with other patients. I'm assuming that will be my responsibility. They said the allergy shots are open to the public for a couple hrs a day, so I'm assuming they won't schedule Dr's appointment during those hours? I'll have to ask them for more details. And one day week, when the Dr is not in the office, I will run the clinic by myself for 5 hours giving allergy shots only.