CHAVNY

I am sympathetic to your frustration and there's lots of comments from all sorts of angles. I went from adult trauma to my dream of NICU. Not right away and not without frustration. So I want to address your thoughts that: "But let's face it: how can working with sick adults help with premies? It doesn't." How a neonate is treated is often different from adults, but that does not mean your time with adults is worthless. Obviously others have felt differently than I do, but I can tell you a few things I learned from working with sick adults that proved invaluable in the NICU (and peds). Aside from all the logistics of being nurse like time management, critical thinking, dealing with clinicians, etc. you learn about the human body and some of finer less obvious signs of distress that will be so important when taking care of someone who can't tell you how they feel. Just a very few examples: Lung sounds, you'll learn to identify the different sounds and what they reflect is going on in the lungs, and what to do to help someone in that situation. Imagine trying to identify those sounds in a tiny person who fits in one hand while an oscillator in sending hundreds and hundreds of breaths a minute while you're listening. You'll be glad you know exactly what you're hearing. IV skills, granted you choose different veins for a preemie, but you will learn what it feels like when you hit the vein, when you've blown a vein, when you've gone through the other side. You'll come to be more efficient and competent with the equipment and the task. Which is important when you have only a few teeny veins to hit. You will learn the physical signs that pain management is working and your patient feels relief. Because you're going to be their voice in the doctor's ear. You'll learn what a person is like when an infection is brewing. Because that can overwhelm a little fast, you'll be glad to catch it early. Even better you'll know when an antibiotic starts working and they turn a corner. Also: What are the different signs that add up to sepsis? What does dehydration look like? What are signs of hyper/hypoglycemia? How do certain lab values present themselves in symptoms that cue you there's a problem. ...I could go on. Who knows, maybe you'll have your own list one day. There's also psychology-social skills for the families and your own well being. How to deal with family members who find what they are dealing with impossible, so they take it out on you--for months. How can you explain treatments and illness? How do different cultures react? How to cope with your patients deaths. (I'm still not so good at that one) When you're getting exhausted and overwhelmed, what helps. I'm sure you've learned a lot of that already but any time you spend taking care of another person, well you'll only get better for it. It will help you and them.

Actually the nurses have stayed. Even until now. We are still here!

Everything is relative, and sometimes when we aren't where we thought we would be in our master plan's time table, we feel old. (then we look back later and think I was SO young and SO gorgeous!! But I digress...) It's not too late. I started nursing school at 38, became a nurse at 42 --was working full time so had to go slow--and now 4 years later --yes that makes me 35 again---8 years after starting nursing school, I have a job I love. Not to say it isn't hard sometimes, it is. But I am so glad I did it and I am also glad that in the meantime, when my master plan took lots of detours and dives, I grew as a person. That gives me even more to bring to my practice. Sounds like you took the time you needed for some growth. That will make you a better nurse.

Our facility requires employee health to plant and read. Its "policy". I have noticed anytime there has been some sort of issue, new hospital policy has been issued. There are all kinds of legal and risk management issues these policies cover. I choose to do my best to follow through and then be really glad I am not involved in the policy making process.

Don't forget the most important thing at stake is the health of the patient, especially if its a baby who can't speak their concerns. That isn't chastisement, I was bullyed on my first unit so bad that even the hospital asked me to file formal grievances because the person responsible had done it for so long.--but thats another post---So you have my sympathy, but what helped me and still does, whether student or teacher, is to remember who the assignment is really about: the patient. And doing your best by them will always help a bad situation feel like a success.

Not that tube, the speckled top one....

I agree LTC will help you with patient care, time management, and med administration that are similar to a hospital's. LTC can be affiliated with hospitals, or at least have a hospital they send their patients to when an acute need arises, so it may be more of a foot in the door than you think. Administrators know what the market is like, so it is recognized not all new grads are getting hospital positions. LTC shows you aren't afraid to work with patients. best wishes!

No PMFB-RN, I am not quoting you in particular --that is why i did not cite your post in a quote box-- but put quotes only around the idiom. ( Just like I did with the other idiom: "wanted it".) I post this to say: I am not quoting PMFB-RN, so no one else misunderstands. (it would not let me amend the other post). Nor do I accuse you personally of making assumptions, nor do I doubt you speak about your experience. But since I have had different experiences, I am warning any readers and the originator of this post --who did ask what would you do--about making assumptions based on what some parents have said and what some nurses have experienced. Because that does not represent what all parents feel. That is my point, every patient, every parent is different. Treat them as individuals, make sure you know how they feel. That applies with every difference among the humans we care for.

I am a NICU nurse. (I too did research on this topic for a school presentation, but received a totally different impression than mentioned above, impressions however are irrelevant) I work in a culturally diverse area. Many parental beliefs, religious or otherwise, often arise. We are always instructed to respect these because they are fundamental to the patient --and for us by extension the parent. I understand each of us must decide where we draw the line when it comes to a conflict of what we believe to be right and the parents wishes. But don't muddle the line with broad sweeping assumptions. I find the assumptions made here disturbing. You cannot blatantly decide how a parent will feel based on what a chaplan or one minister tells you. That's like saying all nurses believe this, because someone once told you a nurse said this, or because a nurse gave you an impression they felt this, or even one nurse does believe this. One person does not speak for all, especially when it comes to their spiritual beliefs. To realize something is beyond your control does not mean you secretly wish it to be or "want your cake and eat it too". It merely acknowledges your limited responsibility. But limited responsibility doesn't mean you don't feel hurt or suffer because of what happened. Being relieved that no harm was done is not equal to glad it happened. I can't imagine anything more difficult or violating than to take away the choices affecting your child's life. When all a parent longs for is to protect and nurture their child. Then to imply you secretly wished it that way, when all your control has been taken away. That is insult to injury. Its like saying the rape victim secretly "wanted it". Please don't do that. Treat your patient and their parents as individuals. Find out what they really feel: themselves. What they really want. Talk to them. Educate them (and yourself) on all the options. Don't decide you are doing them any favors by taking the decision out of their hands or violating what they hold to be true. Healthcare providers do have to make choices based on what they feel to be right. But if we take that parent's responsibility away, let's own it. Let's not soothe ourselves with: they "wanted it".

Someone once told me: "Just because people are starving in other countries, doesn't mean we don't get hungry." The intensity or gravity of our problems may pale by comparision to our patients, but that doesn't mean what we face is not real or challenging or even heartbreaking. We aren't always comparing, sometimes we are looking our problems straight in the eye and dealing with them--and that can be overwhelming. But we have the benefit of being given a different perspective. I work in Trauma and Critical Care, and most days go home thinking: "I have no problems." I see how life can change, or even end, in a split second. That awareness throws a bit of gratitude in the mix. That perspective gives me a different scale to weigh out what is mine. It helps me remember that what is so daunting to me, can be eased by the gratitude that it is all I carry. In addition, there is gratitude for the people that help me carry these loads. And gratitude that my career includes a chance to help someone carry the things I would never want to face alone. But my burdens still has to be carried and dealt with, and felt. --and sometimes I hurt, and cry, and maybe even complain & whine because thats part of coping.

My heart goes out to you. Do not doubt yourself! Find a support group for family of cancer patients. It will give you a place to share what you are dealing with. There may be some practical tips on how to cope, but definitely there will be sympathetic ears. I am also a firm believer in the power of prayer. Two verses that help me, I hope its ok to share them with you. 1 Peter 5:77 "while YOU throw all YOUR anxiety upon him, because he cares for YOU." Jeremiah 29:11, "'For I myself well know the thoughts that I am thinking toward YOU,' is the utterance of Jehovah, 'thoughts of peace, and not of calamity, to give YOU a future and a hope." All the best.

Hi, Any suggestions on what manual and where to get it. Thanks

CONGRATS on getting into Nursing School!! That took work. Don't be scared by the thought of algebra. Something that helped us is to realize we use it every day. If there is a sale and it says take an additional 40% off and you know what that means--you know alegebra. Or if you know you are not getting paid for 5 more days and you need to stretch the rest of your cash over that time so how much do you spend each day--that is algebra. If you can understand what the math is trying to accomplish it will help the math problems make sense. It is usually used with medication so it is important to understand and be accurate. But its using some of the same concepts and formulas over and over. Another tip, get a book that has workbook problems and do all the practice. There's alot of truth to the old saying, "Practice makes perfect." or atleast more accurate. Lastly, its good if you are cautious and recognize you need help. Its will help you avoid making careless mistakes with your patients. Your hard work will pay off. :typing

Does anyone know the night differential for HHC hospitals, Bellevue in particular? Thanks!!

Hi, I live in NYC. The job fairs were major sponsors with both city and private hospitals from the tri-state area. Everyone was nice, but realistic, which was appreciated. I am definitely NOT saying there are no jobs. And certainly don't want to be discouraging. That isn't my purpose at all. I just found it helpful to know that others were encountering the same struggle. Judging from previous posts and the experiences of friends who graduated before, it was not such a struggle. Good clinical experiences, professor reccommendations and extern/internships easily led to continuing at those sites. But now it is different --atleast in many states. Which took some of us aback because it was so unexpected. And its not that we are getting a bad reception, it is just moving slower and the financial climate affects hospitals--even if they want you. So I just wanted to say: if the usual path seems to have obstacles, its not neccessarily a reflection on the new grad as much as the world around us. Don't lose heart, and it may take more work. The experience of others, even a few months ago, may not be our experience.

thanks for the help. i would also like to add my experience and many classmates. the economy is affecting even this needed field, since hospitals (where new grads are most hired) are still a business. it is not what it used to be anywhere. in my city, even those who applied for jobs early on are finding it difficult. i had a job before graduating --thanks to great instructors--at the hospital where i had been an extern since just after my first semester. the hospital pursued hiring me, even sponsoring my graduate permit to begin working before taking my nclex. sounds wonderful, except due to budget constraints 3 months later i have yet to start working and have no guarantee that i will. (i did pass my nclex, at least!!) their hands are tied by financial planning. the hospital hires experienced nurses that do not require the charges new grads would incur. for example travelers that don't 'cost' health insurance or need new grad orientation. at job fairs, most hospitals are telling new grads outright there are no new grad positions, we can't afford to put the resources into it. not to be doomsday crier. my point is--sadly, it is a much different world economically and its hitting everywhere. it is not the same for new grads now as for those before us. for those of us that are searching, there is great advice here. it can only help. but be prepared for it to take longer, much longer. and don't lose heart. we are needed and once things become clearer and calmer we will find jobs. we are used to working hard for our goal, that is how we survived school. we can't feel like failures. and we can't expect the red carpet.

As you can see from all the posts this is not a unique problem. I too have my horror stories. What I want to share tho, is something that helped me cope. During one particularly crazy semester, our study group decided not to spend our precious energy being upset--I know, way easier said than done--but after venting, doing what we could within administration, we worked hard to help each other learn the material, we did practice tests (these were invaluable in learning application of material) and shared other sources that helped explain the material. In the end that is what nursing is all about, learning, sharing and application. We also looked at ways we could learn from the instructor. We had one that only read her powerpoints and whenever a question arose she would let another student answer, TALK ABOUT CONFUSING! But she had a real gift at communication and taught us to be a team. She could diffuse tension with words. She could focus assessment information with just a simple question. We learned that skill from her, we learned the physiology on our own. The flip was true of another professor, she fought with us all and treated us horribly, but she could make complex physiology into something simple with everyday illustrations. We learned science from her and how NOT to treat others. It might seem simplistic, but in the end it helped us keep focused on what we were really trying to accomplish and learn. In a few weeks that person will not be part of your routine anymore. Cling to the things that will be, the material and how to use it. Your time and energy are too precious to spend vainly. It helped us immensely. Hope it will you.