dizzyray822

Dear AllNurses, I would love any advice, thoughts, experiences, and constructive criticism. I graduated from nursing school with my associates degree in May of 2011, at 26 yrs old. I passed my boards in June 2011 and started my first job in July 2011 on a tele floor. I had gotten a scholarship and so I had six months of orientation into this role. Although there is always so much to learn in nursing I can say I was very prepared. After orientation, I spent another 2 1/2 years on the same unit. Eight months before changing nursing career paths I changed to night shift in desperation for a different environment as I was miserable on dayshift. I was very naïve at this part of my career and confused about what I wanted. Needless to say night shift lead to my last straw with bedside nursing, so to speak, and with my bad thyroid, being overweight, and being burnt out I took a decision to go into disease management away from bedside nursing. This was in July 2014. This was a shame, as looking back I was an awesome bedside nurse, and they were going to start prepping me to be a clinical manager. Immediately I was very bored with this new role and most certainly believed it was too soon in my nursing career to move away from the bedside. I had thoughts of going back to the bedside per diem just to keep my skills up. I never did that and now I have regrets. The disease management role transitioned into case management for the managed-care sector. Fast forward to 2016 and I went back to school to get my BSN. Over the last two years I've had a lot of opportunity to self reflect. I LOVE the profession of nursing. There are so many opportunities within the field to make a difference in peoples lives in so many various ways. I graduate in two months with my BSN. Ironically, for my capstone rotation for my BSN I was placed back in the acute care setting to follow a nurse manager in one of our local emergency rooms. I had my first clinical day this past week and can honestly say I had a blast. Now I completely understand that I'm following someone in a leadership role and this is entirely different from working in the ER. However, the experience has me very intrigued and confused as I really miss the acute care setting. At least I think I do. This ER is a level one trauma center and I was able to observe a trauma come in and this lit a fire in me. I think I moved away from acute care too quick and I didn't explore what my passion in nursing really is. I plan to enjoy the next eight weeks in this rotation and soak up everything that I can. I'm not one to make any rash decisions but I think I need to make a change. Now I know it's crazy to think of going from four years of case management to working in an ER. Has anyone had a similar experience? Honestly, I have had a lot of life changes since my previous experience at bedside and can definitely say that I was in a bad place in my personal life as well that I think contributed to my decisions. Please, tell me your thoughts, and any experiences any of you might have had going back to acute care after a hiatus.

Thank you all for your advice.

I started applying in December. No luck yet. I'm thinking I want something in the peri-op area but it seems they all want you to have experience in that area. I thought doing over two years of tele would make me marketable so to speak but that hasn't seemed the case so far.

First, please don't judge. I've been an RN 2 1/2 years now. I work in Tele and have had the same position as when I started as a new grad. I swore up and down I wouldn't get burnt out and so on. I'm there. So much so I'm questioning whether I made the right choice. My background...why I went into nursing...I was raised by my grandmother and great grandmother. Growing up my great grandmother had a lot of health problems and I loved being her "nurse" as a kid. So when it was time to decide what I wanted to do it seemed perfect that I go to school for nursing. I started college early at 16. Did my pre-reqs and then when I went to apply to my local RN program, well there was a 2 year wait. I was young and impatient and decided Criminal Justice was the next best thing for me. Finished getting an AS in Criminal Justice. Graduated in Dec 2007. My father got sick with lung cancer Jan 2008 and passed by Feb 2008. That whole experience with him brought back the fire in me to become a nurse. Started my Pre-reqs that May. Ended up in the RN program the next summer. I graduated May 2011. I had received a scholarship previously with a local hospital and I landed a job rather quickly. Was in love at first (ie. Honeymoon phase). Would come home and could not stop talking about my job. I was happy. Along the way I learned I have a very bad herniated disc. Not from my job but happened before and I just never was diagnosed. Actually almost the end of nursing school I had my first MRI which showed the injury. I think the intense labor of this field is making it worse which is really weighing me down. I've had 2 epidurals so far. On top of this, when I go to work I feel like a waitress / servant / drug pusher. I don't feel like I make any difference to my patients at all. Now, while I feel this way I continue to be respectful and do my job as best I can and do what's right for my patients. My boss seems to think highly of me. I precept often. I've been offered a charge position recently which I pretty much turned down. If I'm not happy how will I lead others properly. I help lead a support group for new nurses, with which I sit there and listen to people who have been at this only a few months and feel exactly the same as I do. I'm just tired of it all and feeling so down that I've made a wrong life decision. I've been thinking I need a change to something very different in nursing but because I've been out on and off for my back problem I feel I wouldn't possibly be able to transfer in my current facility. No one would want someone with these issues. I feel stuck. Just looking for someone who's been here in my shoes and what did you do?? Thanks.

@Malina9559. I work on a tele neuro unit. Our ratio is supposed to be 1:5. That's what it was when I started there. In the last year or so its always 1:6. If I start with 4 or 5 you bet ill get 6 soon. It's a heavy floor. All of the nurses are burned out. It's a normal occurance for you to not get a lunch or a break at all lately. Honestly, I adjusted really well my first year as a nurse. Had two nights where I cried my way home but I figured that wasn't bad for a new nurse. In the last 3 months I've had two breakdowns at work where I had to go to the break room to cry and I'm often crying my way home. I feel like I tell my clinical managers and even my nurse manger when she's around when I feel I need help but I often get resistance and it they are too busy as well. I don't know what to do. I love the patient interactions. That's why I went into nursing. But I find myself lately running around just to get the job done which leaves me with very little time to connect with my patients. Yet....admin wants good scores so the pressure is on to be super nurse.

@cardiacrocks I went in today. I only call out if really sick. Today was better. Got a 15 minute break. July will be 2 years for me as a nurse. I'm still on the same unit i started on. I'm thinking I may need a change of scenery soon but as miserable as my days are getting I'm a bit hesitant because they say the grass is not always greener on the other side.

Today was another 14 hour day. No lunch. Peed once in the morning. Felt like crying by 3pm as I knew by then I wasn't getting a break. I didn't even sit down to chart...i charted on the go. I feel like a slave. Now Im home with a terrible headache from not eating all day and I feel horrible. Only to get up in less than 8 hrs to do it all over. How much longer can my body take this abuse?

Hi. Just looking for a little input. I've been a nurse for a year and a half. I started on a tele/neuro floor and after just a year and a half I'm feeling a bit burnt out. I was told in school that I should try something where my contact with patients is not as intimate as I get attached quickly. I struggle at times with the fact that all day I rush and rush just to get my responsibilities done and sometimes I feel my patients get neglected. Our ratio is 1/6 and that's just too much. I don't know where I want to really go in nursing. I thought after a year and a half I would figure that out but it hasn't happened yet and as for where I am I'm already feeling ready for a change.

Its just on my floor I'll have a pt on Metoprolol, Lisinopril, and Norvasc all at once and NO parameters. So when my preceptor says hold Lisinopril on one pt then next time hold the metoprolol it has me confused. I had a pt a few days ago with a BP of 178/87 but HR in 50s/60s. The doc wrote for 0.1mg Clonidine and 20mg of Lisinopril, knowing the HR, and said to give them now. Plus Vasotec PRN with parameters. Anyway, after the doc left I took the pressure again before I went to give the meds and it was 125/75. Okay....so now I held the meds. At lunch, it was 141/103. I spoke to my preceptor and she said give the Clonidine and Lisinopril. Gave it and an hour later he was 95/55 with HR in the 40s and 30s. Now I called the doc and we had to bolus the pt. I felt frustrated. Is this just the case sometimes? Crazy BP's drive me crazy as a newbie!! I just don't want to hurt anyone.

Hi. Im a brand new nurse 3 mos in and am having some issues with when I hold cardiac meds and when to give them if there aren't any parameters. Or even whether to hold one and give another. I ask my preceptor each time I'm not sure but there doesnt seem to be any rhyme or reason. In fact at times she's not sure what to do. Will this come with time? Any posts or articles or advice is appreciated.

So....continuation of my troubles with this PCA.... Yesterday it was 12:00 and I looked for the BGL of one of my patients with Accuchecks every 6 hours and it wasn't charted yet. So I called her to see if it was done but just wasn't charted. When I asked her she says "oh, I didn't know he had Accuchecks. Well, I'm on break so you'll have to do it." I obviously did it because I needed it but I'm dreading everyday I have to work with her because I know what'll be like. When shes there none of my patients are ever cleaned, they never have water, their sheets are a mess, and she has no problem passing the buck. I complained to my preceptor that it's an obvious problem with her. She says she has the same issues and I should go to our manager about it. However, I feel way too new to start complaining already. Any advice?

I completely agree with you all. Honestly it was a complicated day for me. My preceptor gives me the most complicated pts so I get the most out of my orientation which is good for me. There is much more to the story in regards to both pts. The one going to the bathroom was a COPD pt that ignited her O2 on fire at home and suffered smoke inhalation and was constantly SOB. The high blood pressure pt I had taken care of the day before and she was going into renal failure and refusing dialysis. She was on IV labetalol q 3 hrs and still maintaining BPs in the 170/90s. I wasn't too concerned about a drop in BP with her but was concerned about the smoke inhalation pt. In the mean time my preceptor was downstairs dealing with a pt she had discharged and wouldn't leave. Just my first day with a lot going on and my first time asking for help from this person. I definitely have much to learn. I love what I'm doing but am still trying to get more comfortable in prioritizing and being organized and delegating.

So...I am a BRAND NEW nurse. I've been in my hospital for 2 months and with my preceptor for maybe a month of it. I have been taking two patients of course with the help of my preceptor when I need it. Now, my problem is that I am still learning to organize myself and delegate. Well, one day I had given some IV blood pressure meds to a patient and was going to lunch soon so I asked my PCA to "please do a blood pressure on so and so when you can." She was chatting at the nurses station to the monitor tech for awhile so I didn't think it was too much to ask. Her exact reply was "The blood pressure machine is in the room." I was so taken off guard. I just said "okay, thanks, ill just do it later." I went to deal with my other patient who needed the bedside commode and when i was done the PCA had done it anyway and gave me what the pressure was. But it just was so frustrating. I am so new and trying to understand my place and all. Was i out of line to ask for a blood pressure. I don't think its beyond me to do it either. This patient had blood pressures in the 200s so I had been taking them all day too. Not to mention earlier in the day I had asked this same PCA to HELP me take this patient (who was VERY obese) to the bathroom. She said "oh..she doesn't need help." I don't know how to deal with this as there is only one PCA that has responded to me this way. So my question is....how have you dealt with situations like this as a new nurse? Thanks.

I have no advice as my first day is Wednesday but wanted to say GOOD LUCK!

Hi! So I had two days of hospital orientation last week and I am shadowing someone for the first time Wednesday. I will be on a Tele floor. Any advice? What should I bring my first day?? Getting a bit nervous, but excited too. Thanks in advance!