Nugget

It is true, this answer and other answers on this thread, are unwarranted. Is this the type of bad-itude we want to display as RN's, to those who want to join our awesome crew of intelligent people? No question is a silly question, and this is not at all insulting. That being said: You are not too old! I graduated when I was 29, and most of my best friends from nursing school were 35+ years when they graduated! Don't listen to the elitists. Whatever your reason for wanting to go back to school to become an RN (unless they are malicious ones), you should do it. If you're doing it because you like the challenge of going back to school, and you want the added benefit of making more money, who is to say that is a silly reason? People say they went in to nursing because it is their calling, and hell yes it probably is, but at the end of the day, we ultimately have to put bread on our table. You already know what healthcare is about, and it is great that you want to step up your game as a healthcare worker I welcome you to the RN crew!

Hello! I have not visited this forum in awhile, and I have missed it! I live in Canada, and have a ethical dilemma/question: I work for an assertive community treatment team (outpatient/community psychiatry). We currently have a patient who has not been medicated for 2 years (as they refuse any and all medication), and has gradually worsened since then; However, at this point, is still considered capable to make treatment decisions. My dilemma is this: One of the social worker's on the team approached me and asked how I would feel giving our patient money in exchange for allowing me to give them an antipsychotic injection. I told her that I felt it was unethical to essentially bribe a patient to take an injection, and that I would not feel comfortable participating in this. Well, she consulted with our psychiatrist and our psych resident and our resident went out with the social worker and gave this patient $20 in exchange for receiving the IM (typically it is only nurses who give IM's on the team, we are just lucky to have a resident right now who is very hands-on!). So now I feel I have been forced into this difficult situation where I do not feel comfortable bribing our patients, but this patient's IM has been restarted and the only way they would accept it is by me giving them $ (which, I should mention, this patient will end up spending on crack). My question is: Can anyone link me to some standard of practice, or nursing regulation that will help support my standpoint when I am sure to get blow back from my co-ordinator/other team members? I couldn't find anything in the CNO standards, and would appreciate some guidance! Cheers, Michelle

Hi everyone! It has been a couple of years since I posted on this awesome forum, probably since before I graduated nursing school. Just curious to get some ideas about areas of work. I currently work casually for a nursing resource team (was my first job out of school - worked full time doing med/surg/mental health inpatient nursing for 2 years), and recently started a 18 month contract working for an ACT (assertive community treatment) team. I love love love mental health, especially working with those with schizophrenia; however, my equal love for medicine is just not satisfied working for an ACT team. I hate working on inpatient med/surg floors, the stress is just not for me. I was burnt out after 2 years. Anyway, I need to find an area of nursing to satisfy both my love for mental health and my love for the knowledge of medicine. I miss that critical thinking aspect, and the satisfaction of doing a really great dressing, or getting an IV into a patient who is swollen and impossible to palpate, hahaha . Don't get me wrong, I definitely have to think and act quickly in the community, working with people with persistent mental illness, but it is a different type of critical thinking. I would like to do my masters soon, so was thinking I could do my nurse practitioner and open up a NP-led clinic. I am wondering if anyone else out there has the same interest and has found a job to suit their needs as a health care professional? I am just curious to get some ideas :) Thank you! P.S. I am in Ontario, Canada

Mine happened just last night! Hence the reason I searched "mistakes" on here as soon as I came home, crying. These happened with the same patient: 1. Patient had order for lorazepam 1-2 mg IV for seizures. I read the order as IM and gave as such. Realized that this morning, and also realized that I wouldn't have been able to give it IV anyway, because I am not a critical care RN. Called the MD on-call who was unphased and said "Oh, okay! Whatever" haha. 2. Also this morning, realized my patient's foley cath output was ohhhh about 100mL overnight, and I was so preoccupied with the 1 million other tubes coming out of her, I didn't even realize. I actually want to quit and hide in a hole. 1st year of nursing is sucking.

Everyone here has given you some great advice and as a newbie myself, I do not know what I could offer in the way of wisdom - but you got through the night. You did no harm and that is the most important thing. I would have bawled in your situation as well. Nurses laughing at you? Next time, call them out on it. People are not so tough when you confront them about being complete wankers. Your charge nurse obviously has no idea how to take charge. I am sorry you had such a rough night. Hold your head up high and learn from this! Now you have a greater understanding of when to call RR and also how not to treat future newbies who will one day be working with you :)

I am a new grad and just started working a few weeks ago as a float nurse as well! I just finished my first rotation on a medicine floor and let me tell you - it IS hard. I've posted a couple of times on the boards in the past couple of weeks because I have been a bit of a mess. My advice to you is to stay your ground and be confident in what knowledge you do have. The rest will come with time, as I am slowly beginning to realize! Also, as stated by others above - do NOT be afraid to ask questions, or to take a little extra time doing something to ensure you're doing it right. Research and continue to educate yourself as you work - nursing school barely scratches the surface in the knowledge department! Lastly, as I have been told by others on here...give yourself a break and go easy on yourself. Make sure you make time to do fun things to de-stress! Congratulations on the new gig :)

Don't beat yourself up.

Thank you all so much for your amazing comments, guidance and support! I have to say, I am particularly hard on myself (everyone who knows me has told me at some point in time!), so I am sure much of my grief stems from my own lack of self confidence, but I will get there. I spoke with my manager's admin. assistant today and she assured me that the unit I am currently on is the heaviest in the hospital. I am on the nursing resource team, so I am a floater and next week I will be on a different medicine unit. It can only get better I guess, eh? Thank you all so much - you make me take back those moments when I say "What am I doing here? I should have gone to vet school". haha! Best. Forum. Ever.

Good for you!! I am happy to hear you are confident as a new RN :)

Hi, guys! I have to say, most of my posts to this site have been pretty negative. I dislike posting so many negative things, but what can I say, I'm a new nurse and incredibly unsure. So last week was my 7th shift on a very heavy medicine unit. The day-shift ratio is 1:5 and I was up to 4 patients by my 5th shift. I am so afraid that I am going to harm a patient, because my nursing preceptor rushes me through things. She gives me a patient load, but then instead of letting me try to get into my own groove of prioritizing and organizing, she just commands me. It's odd. I really like her, she is a great nurse, but man, I do not feel like I am getting guidance from her at all. I am being taught to dole out medication, make sure the orders get carried out and am expected to have the knowledge of a nurse who has years of experience. AHHH!! Anyway, last week I had a patient with low bp, which has been the baseline for awhile. Pt. was somewhat drowsy, but was saying "pain, pain, pain". Dilaudid was ordered PRN and I really did not want to give it, but my preceptor and the night nurse both urged me to give it. I explained my assessment findings and their response was "oh, it doesn't really affect BP, just give it. He needs it". So I gave it. The patient assignment was under my preceptor's name, not mine. Anyway, of course the pt's respirations went down to 10 and he was just knocked right out. I checked him every 10 minutes for the entire shift, I was so scared I had just killed the pt. The MD got angry with me (and I don't blame her). I approached my manager about this, because I was so upset that I went against my gut. she told me not to worry about it, and that she was happy that I conferred with the nurses before giving it, and assured me that this knowledge and judgment will come with time. Well I had this patient a couple days later and gave insulin according to the sliding scale. He wasn't eating very well, but I managed to get cookies and a fruit cup into him prior to me giving insulin. I went home and realized "well, maybe that was another stupid move". And it was. He had a hypoglycemic episode that night. I read in the notes that he had another hypoglycemic episode, when I was not on shift. I am an honours student. I am a smart girl. I've never screwed up so much in my life. I feel like my critical thinking skills, once pretty well developed, are completely out the window. I can't concentrate. I have asked my preceptor for feedback and she just laughs and says "it's fine, it will take time". Now, I am so freakin scared to give insulin to people that I practically cram food down their throats before I give it. I feel like I am the worst nurse on the planet and should never have gotten into this field.

Thank you all for your kind words, encouragement, and advice! I will be fine, I just need to get into the swing of things and study on my days off. Sauconyrunner - I agree with you about being a floater as a new RN! I am preceptored for the first 14 weeks as I rotate through the various medicine/surgical areas and I won't go into any acute areas for the first while I believe (I hope)! On the positive side, I will see a lot of different clinical areas and hopefully this will make me a stronger nurse for it! Thank you again guys, I needed some nurse-y coddling and I got it! haha Cheers, Michelle

Hi all, This is a rant-y e-mail, so be forewarned! I guess I am in need of some coddling/reassurance from fellow nurses on the internet I just graduated in April (yay!), passed my RN exam (yay!) and have a job in a teaching hospital, in Toronto, Canada (double yay!). I am working on the nursing resource team (NRT), so I will be floating all over the hospital. I did my consolidation placement at this hospital on a surgical unit (mostly ortho), and was able to manage pretty well. My preceptor pushed for me to get the job on the NRT, so she obviously thought I was doing something right! My first day is on Wednesday, on a medicine unit with emphasis on nephrology. I am petrified to start. I still feel like a weeny little student, and though I know I will be experiencing a steep learning curve for at least the next year, I am terrified I will screw up and lose the job. My unreasonable nerves were transferred into a clinical skills lab I went to today, where we had to demonstrate various tasks performed on PICC lines. I had never even touched a PICC line before today, as we are not permitted to do so as students. My manager was the one certifying me and I was so nervous, I was shaking. She said "remember, you're not a student anymore!" and I just about puked on my poor mannequin. I know I am being irrational and that I cannot be expected to know everything as a new nurse, but I can't seem to talk myself down. I do not want this anxiety to run the show. I am such a stress case! I have spoken to friends who say "ohhh, you're so smart, blah blah blah, you'll be fine", but it doesn't allay any of my fears. I am scared that something will go wrong with my patient, and I won't know what to do. I would like some solid advice from all the awesome nurse-ies out there! Is there any advice for how I can be as best prepared as possible, and not feel like vomiting/crying/panicking? Any anecdotal points would also be welcomed. :) End rant. Thank you to whomever got through reading this, and any advice is greatly appreciated!

Pneumothorax is right on the button. Mention the TV shows they're watching or if they have photos around, ask them about that. I always try to find something in their room that I can relate to personally (say, a photo of a person's dog - I grew up in a veterinarian household, so I can talk about animals til the cows come home). You can easily mention the weather or say, talk local politics. Keep in mind, some patients may not want to talk, so one can only pry so much. It will come, trust me. Working with people for years before I went to nursing school really gave me the gift for gab. Along with everything else in nursing, small talk comes with experience. You'll get there, don't worry!

Thanks, Ashley! Your response is encouraging and much appreciated. Hopefully toorrow will be a better shift! Here is hoping. P.S., your dogs are adorable :) ~Nugget

Hi y'all: I am a pre-grad nursing student (wahoo! Only 2 months to go!), doing my consolidation on a surgical floor (mostly ortho, but a lot of gen surg too). I've been there since January 20th. Last night I worked my first night shift and I think it completely threw me off my game. I made a bunch of stupid stupid mistakes that, in retrospect, I realize that I would never do; however, I just didn't think. I gave a pre-op on-call appendectomy pt. tylenol PO for a headache, then as soon as I left the room, I realized what a stupid move that was. Fessed up to my preceptor and she said it was no big deal. I had my first pt. with NG suction, who was vomiting green bile and was receiving NaPO4 over 4 hours (her electrolytes were all out of whack, as I am sure you can imagine). The pt. was complaining of burping and horrendous stomach pain and had pantaloc ordered for 2200. I stopped the NaPO4 and hung the pantaloc (w/ a new secondary line). My preceptor (who is very nice and supportive, but probably thinks I am the bane of her existence now) had told me to hang the pantaloc when we were in the pt. room together and stupid me, I assumed she had noticed the NaPO4 was still running and wanted me to give the pantaloc asap because the patient was in agony. When I mentioned the NaPO4 hadn't finished, but I had hung the pantaloc, she told me to never stop any infusions until they're finished, no matter what and appeared really upset with me. Lesson learned there. So then...I hung the NaPO4 and forgot to open the secondary line clamp and caught it about 20 minutes later. Told my preceptor, and though she was pretty good about it, I could tell she was aggravated with me at this point. Anything I did after that was annoying to her, so I just tried the fly under the radar for the rest of the night. WHEW, end rant. I feel completely dejected after last night and though I am doing my best to see last night as a MAJOR learning experience, I feel that the stupidity of the mistakes mean that I am never going to be ready to be an RN, and that my preceptor does not trust me. Until last night, I was rocking nursing practice in my last semester. Have any of you had nights (or days) like this? Student and RN alike? How do you get over it? Thanks guys! ~Nugget