Cewens

Recently I have thought that I have become one of those "difficult" nurses. I just left a job where I was part of a very tight team, felt loved, supported and valued by my fellow nurses. In my new position I am running into personality issues that I never thought I had, and am beginning to think that I am the cause of them. After raising 4 children & having a very stable family life, things took a turn for the worse when we discovered that our son was addicted to Meth & Crack and had suicide issues, I seem to be handling things differently and find that my emotions are on edge constantly. One thing different on my new job is that my Managers & Charges know about my situation but never ask me how I am coping which makes me feel like just a number on their staffing census. I really enjoy my fellow nurses and feel badly about the small misunderstandings we have been experiencing and keep trying to keep an even keel at work and not let things affect me so much. But in reality, it is hard to leave everything at home. I am sure that there are other nurses who are battling difficult personal issues which may effect them at work as well. I would suggest to the managers to try and find a way to show interest in a "difficult" nurse's life, and let them know that you care about them individually. It would make a world of difference to me.

I have been working on a busy Renal unit for the last year ( I am a new grad). I find that I LOVE the mental challenges, demands and variety of situations that my floor requires but am frustrated that our staffing guidelines are requiring us to take another pt. Our ration had been 1:4, which had been managable for our acutely ill pts. Now we are required to take 5 pts, and our NACs are now also stretched thin. Just today, I lost a pt, and I am angry that I was forced into the situation of wondering whether I could have made more of a difference if I had only had more time to spend with him. In the past, even though I have had very busy days, I could always went home and say to myself that at least I kept my pts alive for my shift....today I can't say that. It may have been his time to pass, but I will always wonder.

I thought I would tell you how our unit handles new grads. I am a new grad, been on the job 4 months on a 50-bed Renal Unit. My experience is that I was the only new grad on my shift for these past 4 months.There was another newbie on another shift who was 2 months ahead of me. We just hired another new grad who is starting on my shift in a couple weeks. So we were never overloaded with lots of new nurses at the same time. I Precepted for 6 weeks, then continued my Residency for 3 months, then they started me Team Leading (1 RN, 1 LPN, 1/2 NAC). I have a VERY supportive Core Nursing Team who are always there for my questions, but we have been short of Core staff (due to injuries, illness and new-babies)and it is harder when I have unfamiliar Floats who aren't as receptive to my questions. Two nights in a row there was only 2 RNs, 1 LPN on the floor when our census was low. That was pretty scary for me as a newbie, because we had a CODE, and we were stretched way too thin..even by the experienced nurse's standards! During that experience, the 2 more experienced nurses dealt with the CODE while I had to hold down the fort with the rest of the floor. That was a scary position for me and I am lucky nothing else went wrong! Every one has been very patient while I continue to make really stupid mistakes, fortunately harmless ones, and I seem to manage to get through every night amd say "Pheww, another night, another 10 new experiences."

I think it is great you are researching our experiences and how they could help in Nursing Education. I am a new BSN grad from ICN, Washington State University, have been on the job only 4 months on a busy Renal Unit. Nursing School did not prepare me for the amount of organization skills, and focus required daily, nor the ability to handle stress. I managed to get 3.87 GPA, but still did not know my meds as well as I should, nor many clinical skills. My grades came from my ability to take tests well and express myself in writing. I think more emphasis should be placed on learning how to handle pressures and work as a team with other nurses, making physician contact, organizing and prioritizing your patient care, and learning to cope with angry and rude patients who are sick and tired of being sick and tired. I think Patho-Trees were great, but way too much time was spent on 10-15 page Care plans. Put students on the floor instead! I had worked as a NAC before and was accustomed to some of the rigors required but had never been exposed to so many angry patients. At first I took it very personally, but now I am learning how to let their comments roll off, have tougher skin, and continue to objectively give their nursing care. Psycho-social skills have become hugely important in my Nursing experience, at least on my Unit. Another point is that new grads expect that they are prepared when they hit the floor and usually have a rude awakening. New nurses need to realize that they are essentially starting a "new school" called REALITY...which is much harder than Nursing School. They need to be easy on themselves for a while and realize that it will take at least a year to feel confident as a new nurse. I believe that more clinical time is necessary to expose nursing students to these areas. I don't know how to fit it in, but maybe some of the classes such as Ethics and Gerontology can be combined with real life experince in Acute Care, ED, or even at Nursing Homes. Cultivating supportive nursing staff at the clinical sites makes a huge difference. I experienced one Nursing Instructor from my College who works on my floor who seemed to take a less than supportive attitude towards my "lack of experience," and I thought how odd and sad that she could not carry her mentoring abilities into real life.

Will, thanks for the input! I think your ideas closely fit my dream job, but do you have any idea about how easy it might be for a new grad to find a job with the Mental Health Teams? I am also wondering if I am being short-sighted about going directly into this area...and wondering if I should get more clinical skills first. On the other hand, after nursing school, I have found my heart to be more in the psychosocial areas in the community and not within the hospital setting. I would love to create my own job, become a liason between the hospitals and the homeless ER patients, develop a respite center for those too ill to be without shelter but not ill enough to be admitted, and carry my med bag on hikes to the campers where I can do BP checks, blood glucose levels, HcG tests, urinalysis, and hand out prenatal vitamins. I have been told that to do this I had better pursue my Masters and learn how to write grants, but I am torn b/c I would rather focus on learning psych nursing skills rather than administrative stuff.Thanks again for your input! Carol.:)

I am an older student, graduating this Dec on my 46th birthday, and would love advice on how to get into the field of working with the homeless (most of which have some form of mental illness). I am currently in my psych clinical and working down at a shelter and absolutely love it. I have a couple questions. 1. what are some of the roles that I might find for working with this population and how hard or easy are they to get into? 2. What kind of Psych RN job would be good for becoming more knowledgable about psychiatric conditions? As a new grad I feel like there is so much more to learn! I would rather work on the streets and shelters than an institution but wonder which would offer me more learning experiences. Thanks