limonada

Hi nurse friends. I need advice. I am a home health nurse and I am pregnant. A patient that I see regularly recently started methotrexate injections. The patient has multiple disabilities and is sometimes uncooperative for injections and the patient's mother needs to assist and try to hold the arm still so that no one gets hurt. I have always been a little nervous giving any injection to this patient. Sometimes the person is very cooperative, but sometimes they jerk their arm at the last second as you are giving the injection. I have always handled it though, and never had any issues. Now that methotrexate has been ordered, I am extremely nervous. There is a warning right on the label from the pharmacy saying to handle with caution and something along the lines of causing reproductive harm. Methotrexate can cause severe birth defects. I already lost a pregnancy due to severe, rare, birth defects of unknown cause, so maybe I am just overly paranoid now. Does anyone have experience with this? I don't think I can refuse to administer this drug? I could try to get a colleague to switch schedules with me so that I don't see this patient on days that this drug needs to be given, but I feel bad causing any inconvenience to my colleagues. Am I worrying too much?

I work overnight and almost never see my manager-usually only a couple of times a year. Our schedules just don't overlap, so I really only see him at meetings. I haven't told anyone yet that I'm pregnant, but want to let them know, and discuss maternity leave. How should I go about this? Email? Phone call? Or ask if we can set up a meeting? It just seems a little excessive to me to set up a meeting to have a conversation that will probably only last a few minutes. I live 30 minutes away and I'm assuming he'll just want to know how long I plan to take for leave, and will tell me I need to go to Human Resources and fill out FMLA paperwork. I do have a night shift supervisor that I see a couple of times a week, that I am quite friendly with. Should I ask her what to do? I just thought that my actual manager should be the first to know. This is my first pregnancy and I just have no clue how I'm supposed to go about this.

At my first job out of nursing school, I felt exactly the same way you do. And I really beat myself up over it. I had done really well in school (straight A's) and planned to work in med/surg for at least 2 years. I had such high hopes. My first few days of orientation were great, I thought I was going to love the job. My preceptors and managers all said I was doing excellent, but I just kept becoming more and more anxious. I couldn't stand the chaotic environment. I am a calm and sensitive person and prefer some routine. After a few months I decided the hospital environment just isn't for me. I'm sure I could have stuck it out for a year, but I would have been completely miserable. I was coming home from work crying, and feeling nauseous every day on my way to work. I felt like such a failure and really struggled with the decision, but when I let them know I was leaving, it was such a freeing feeling. I was ecstatic. My managers were surprised, but told me I would be welcome back any time. I have now been working at a residential facility for developmentally disabled children. I have been working there for a few years now, and love it! The pay is comparable to the local hospital, and I love what I'm doing. I was nervous at first, but not even close to how I felt at the hospital. There is some routine at this job, but every day is different. It is not where I expected to be, but I'm happy. My point is, the hospital is just not for everyone. Don't beat yourself up if it's not for you. There are so many other options for you as a nurse! I know it's a very hard decision, but you have to do what feels right for you. Good luck and take care!

I don't think it is sneaky at all! I have seen managers that are RNs but have bachelor's or master's degrees in other fields, but in emails from them and on the sign on their office door they have their name and then RN, BA or RN, MA, or whatever degree they have. I have worked with nurses who have bachelor's in other fields and signed their names with RN, BS after it. I have a bachelor's in another field but I just sign my name with RN after it when I write nurse's notes, or anything else I need to sign. If the person reading your resume bothered to read the whole thing, they would see that you have a BS in another field. If you had a bachelor's in nursing, you would have written BSN, wouldn't you? So why would they assume your bachelor's was in nursing? I don't see what the big deal is, but I guess if so many people find it sneaky, we should consider changing our resumes...? Maybe just not put anything after our names and then just list our degrees in the education section... I don't know what to think because in my interviews, I never got the reaction you did-they were always just happy that I had a bachelor's... I should add that my degree is also in a related field-psychology.

Just curious. This happens to me a lot and it's pretty annoying. It has been happening to me several times a week. I usually say no. Just last week I was away for the weekend and I told them that when they called me on Friday afternoon, but they continued to call me all weekend-once on Saturday and twice on Sunday. I always let them leave a voicemail and then I call back later and say I can't do it. Anyway, is this common? And what do you do when they call you? Shouldn't they have some sort of relief pool, or have certain people be on call on certain days? I just think that would make more sense....

Long distance relationships can be very difficult, no matter how stable the relationship is now. I personally would not want to live away from my husband for two years, especially when just starting a new job. Starting a new job can be stressful, especially if you don't have your usual support system there with you. (I think you said your husband has been "your rock"). I know I might sound like I'm being negative, but I'm just trying to be realistic, and I'm trying to think how I would feel if in your situation. If your husband is a good sport, maybe you could take your dream job in the city you don't love, and just see how it goes...I'm guessing he would be willing to move there with you...If you aren't happy, then you guys could move to your dream city...Or would it be unlikely for your husband to get another job offer there like he has now? It sounds like a very difficult decision you have on your hands. If it were me, to be honest, I would probably just go to the location that I loved. I think I would be happier in a dream location than in a city I don't care for with a job that I love. I know everyone is different, but me personally-I would move to my dream city where my husband already has a job lined up. You will get a job eventually. I think that's what I would do anyway...Good luck to you :)

We don't have an e-kit. And I have seen people "borrow" narcs too. I think my original thought when I first came across this situation was to circle it on the MAR, but I have worked here for less than a year, and I have been a nurse for less than 2 years, so I pretty much just always take the advice of the nurses who have worked there for a long time, and the explanation to me has always been that it would be silly to just not give it when you can borrow from someone else. Actually now that I think about it, I have even had Nurse Directors from other areas of the facility call to see if I have any of a certain med they can borrow. Thank you for this info, I didn't realize it was that big of a deal. I feel enlightened now! I think from now on I will order meds as early in advance as I can to prevent this!

I don't want to sound dumb, but I'm confused. I understand what everyone is saying here, but I have also seen this happen in my facility. I always order meds in advance but not everyone does. There have been times where I was out of a med so I "borrowed" from someone else who had the exact same med. Our pharmacy makes deliveries at certain times, and if I called to say I was out of something, they would most likely not be able to bring it until several hours later. I have not worked there for very long, but other nurses told me that if you are out of something to just "borrow" from someone else. Even though that is not what you're "supposed to do." But what else can you do? Just not give the med even though another resident has 30 of the very pill that you need for another resident?

I agree with bookwormom...To the OP-were you looking at information of various patients throughout the hospital, or just on your own unit? I know they say that you are only allowed to see the information of your own patients, but as the above poster said, you may need to cover while another nurse goes on break, and you should definitely know what is going on with the patients you are covering then. I don't see how you could possibly get in trouble for that. I'm sorry that you're going through this and I wish you all the best. Try not to freak out yet. Maybe if you explain your side of the story they will see that you truly did not have any bad intentions and will just reprimand you in some small way and then everything will go back to normal. I know a lot of the posters on here have been talking about worst case scenarios, but try to keep those out of your mind. I guess it's good to be prepared for the worst, but this just makes me so sad because it sounds like you truly had no bad intentions and you do not deserve to be feeling the way you do right now! I guess just keep in mind that those are worst case scenarios. It really might not end up being quite that horrible. Good luck and please keep us posted :redbeathe

Seems unrealistic to me. At my facility, each residence has anywhere from eight to fifteen residents, and 24 hour nursing. There is always a staff nurse (RN or LPN) in the residence to give meds, coordinate appointments, do all the paperwork, etc etc. Then there are nurse directors who are RNs who each oversee about 30 clients each. Most of the residents are pretty medically involved at my facility.

emilylucille, how are you doing? It's nice to know someone feels the same way I do...What do you plan to do now? I am considering trying to get into psych nursing or addictions nursing...good luck :)

Thank you so much to everyone who responded! I really appreciate it....Just wanted to let you know though, I quit today. :-\ I felt really bad doing it, but I figured better to do it now than when I'm off orientation and then they would have to fill my position. They were actually really nice about it when I told them. I am moving out of state with a friend and I plan to look for a non med/surg job there. I know my decision may not have been the most responsible one, but I just could not force myself to continue to do something that was making me so miserable. I was literally a different person and I felt bad for my family and friends having to be around me. I was always grumpy. I feel like a loser for quitting, and I really struggled with the decision, but I think I did the right thing. I know I will not be as marketable without the med/surg experience, but I'm trying to be optimistic and hope that someone will still hire me....anyway, thank you again for all your advice!:heartbeat

Well I am very glad to hear you are doing well! But how long did you stay at that job and what exactly are you doing now?

I have been working on a med/surg floor for about 2 months now. My orientation will be over in a week and I am terrified! I dread going to work everyday. Some days are fine, but others I just want to run away. Lots of times I cry as soon as I get in my car to go home. I haven't made any mistakes really, but I sometimes think of things that I forgot to do once I get home and am afraid I'll get in trouble. It's never anything serious, just stupid little things. Anyway, I pretty much HATE my job. I usually have 5-7 patients and I just feel so overwhelmed! If everything runs smoothly I'm fine, but lots of times when things happen I just feel like I don't know what to do and when I'm off orientation I think the other nurses will get annoyed with my constant questions. And I just feel incompetent, like if a pt has something really wrong witht them I might not notice. I did really well in school and I actually have a B.A. in psychology as well as my RN. I know that this job is not for me. I went into nursing because I wanted to help people. I am more interested in the psychological aspect. I feel like I have NO time to spend with the patients and I hate that. I hate running around like a chicken with it's head cut off, never knowing what to expect, and only having enough time to give the pt their med and then run out of the room. I just know this is not what I want to do. I want to either go back to school for my master's in social work, or OT. I also think I might like home health because then I would actually have some time to TALK to the patient. I love people and I hate that if a pt is upset or trying to talk to me, I don't have time to stop and listen. Would it look completely horrible if I quit now? Would it make me look really bad to future employers? What's the shortest I can stay here without looking bad? I feel nauseated every day on my way to work and I just want to cry. please help! thank you!!!

NO you are not alone!! I feel the same way...I think it is probably just because we are new...I am always second guessing myself. Even though I did really really well in school, when I am actually at work, I still feel very unsure of everything. I feel like an idiot all the time. But I think we need to just hang in there and it will get better. And about the straight cath issue you had-don't worry about it. It's probably like anything else-of course you might have a hard time your first few times, but after a little practice, you will be able to do it easily. I just started my first job 2 weeks ago and I can't even imagine how I am ever going to be able to really be good at this. There is so much that I didn't do in school, (like inserting catheters for example) I have no idea what's going to happen when I have to actually do it. But hopefully it's the same as learning any other new thing. The first few times I took a BP I could not get it, it just took practice and then I was fine. I feel extremely nervous every day, and I feel like an idiot all day at work. BUT we have to remember that we are brand new. Of course we can't know everything and be good at everything. It takes practice. Try to be confident. And I think the nurse educator really is trying to help you. Maybe you should just try another shift...hang in there, I know it's hard now, but most people I talk to say they were extremely overwhelmed at first, it just took time to get the hang of things. Good luck!!