CodyRN

Thank you again! I am starting work on the application process! :)

Wow--Thank you for all of the information! I've been to Houston and you're right, it is a HUGE place! I will check into some of the places you have mentioned! Thank you again! I :redbeathe Texas!

Congratulations on your MSN and also on getting accepted into the two post-master's programs! That is so great! Thank you for the information! I have been strongly considering this program and I appreciate you sharing your experience! Would it be too personal to ask what kind of questions they ask you at the interview? Do they ask about your career goals or about your nursing skills and experiences, like a job interview or ??? Thank you again! :heartbeat

I am considering this program (Loyola MSN-HCSM). I still need to make some phone call inquiries but wondering if anyone else knows... 1) If you take this online (or distance ed) will your graduation/degree certificate indicate that it was done online? 2) Can you start at any time or do you have to wait until fall to start? 3) Best ways of obtaining financial aid--are the federal unsubsidized student loans enough? 4) Is it a requirement to actually go to N.O. for the interview or can you do it by telephone if you live out of the area? 5) Do you have enough access to resources (library/electronic database/etc.) that you need? Thank you all so much in advance for anything you may be able to share about this program!!:heartbeat

I thought SQ needles were 24g so that falls in between your 22-25g range. You can choose whatever length of needle you think is appropriate for a person's muscle mass, some people have smaller muscle and a longer needle will hit the bone. Also, for some people with small amounts of muscle, I am aware that some nurses will try to bunch up the muscle to give the needle somewhere to go, it may appear similar to pinching but it is quite a different "pinch" than you would expect with SQ where you are really trying to keep it in the fatty tissue away from the muscle. For IM, the idea is to get the vaccine in the muscle and sometimes you have to modify your technique based on patient's needs.

Also, I THINK for HIV...the size of the "viral load" will depend on whether or not a person contracts it. If the viral load is small enough, I don't think the person will actually get anything.

To Houston RNs! I hope you all can help me....I really want to move to Houston but have some practical & financial issues to consider. One, I am the sole wage-earner for my family. Two, my student loan debt is high. Three, I would like someday to buy a house....and Four, I'm not getting any younger! :) It is also my intention to get a MS degree in Nursing. (I would like to wait until I have some of my debt paid down before I start.) I have started contacting some recruiters and filling out some applications. People always ask for minimum salary requirements before they give you an offer, it seems like. Does anyone know what the general pay range might be for me? I have 2.5 years of experience in a very busy, very high acuity PACU in "one of the Top 4 hospitals in the U.S" according to US News. I volunteered to cross-train to our PreOp units as well as the Induction/Block rooms and float to those areas as needed. I have also recently oriented to and occasionally am assigned as Charge. Additionally, I work PRN (PACU) at another fine university hospital nearby. I feel that I must know what the Houston market is like for someone in this range before I can give a fair answer to the salary requirement question. I feel that I can bring a lot of value to the workplace and would like to earn a fair wage but don't want to remove myself from consideration if my "requirement" is not within market range. It is also important to me to work for an organization that has an excellent reputation and has opportunities for career growth. Generally speaking, not just pay scale, but what's the market like out there for someone like me? My next issue is where to live? Where can we find a reasonable home at a reasonable price in a decent neighborhood with decent schools that is not located in a flood zone and that doesn't have one of those utility situations....I've heard that you have to watch out that you don't get caught in an area that has some kind of problem where your utility costs are outrageous and there's nothing you can do about it (I'm not really sure what this is all about.) I thank you in advance for any information you all can provide regarding these topics. I look forward to hearing back! :redbeathe

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I agree that medicine is not what it used to be and it is highly likely you really won't make that much money. I agree with the other posters that you should ask yourself what you want from your job on a day to day basis. And a lot of nurses have been asked the same questions. Nurses DO deal with patients on a holistic level and they ARE the front lines, holding a patient's hand when he dies DNR, talking someone's anxiety down, and really having that "connection" but also that responsibility. Also, I have found that most doctors have a lot of respect for nurses. If you work in a teaching hospital, many of the residents are often at a loss when they start and actually look to you for a little direction sometimes. Communication is key and I am careful not to present a "shopping list" to doctors. I say, "So and so is...can we give (or do you want to give) him something for that?" not "Can you give me an order for ....." Or say they want to give X and I think Y is better based on what I have seen, then I say, "Do you think X is better than Y?" and it gives me the chance to learn something and if gives them a chance to consider a different option. I would not let Dr.-Nurse interaction influence your choice. And nurses can easily change from one specialty to another if they get burned out, there's a lot to choose from in nursing. In that way, I would think it is more flexible. But really, you have to follow your heart.

If this is a pattern of high BPs and refusals, then the meds need to be given at a different time. Do not raise the foot and lower the HOB, you are right, that is for HYPOtension. And I wouldn't be surprised if the doc didn't immediately call you back for that pressure, you are right, it is not a crisis.

I think you need to be off antibiotics for 3 weeks and then have 2 separate cultures done. Then, definitely get paper documentation that you are free of it. Good job on catching it early!

I agree with the other posters that said she may not know what to say, may feel guilty for making it, may not want to open up a bad subject for you...or simply, as a new nurse struggling (we all struggle, just in different ways) she may not have it to give. Or she just might be tired and not realize she is coming off that way. I would probably approach the subject with her in a non-threatening way and just be like, "I feel like we're not as close anymore, have I done something to offend you?" Or "I feel....are you OK?" At least it might open up the lines of communication. And if she IS a friend/family that sincerely cares about you, even though she may not be able to address her behavior directly, she will probably be sorry that she hurt you and will want you to know that. If she brushes you off, I would just give her space and time and continue to pursue your goals. By the way, I know someone that was dismissed and came back the next year and was very successful. It takes guts to come back and I admire you for that. Hang in there!

Well, I would like to add that the stress of being a new nurse, learning, knowing people are watching you and looking for mistakes, can make people make errors they otherwise would not make. This added pressure is only going to make it worse. Somebody I spoke with compared nursing to driving. She said that drivers that are reckless and uncaring cause accidents. And drivers that were TOO careful, drove too slow, afraid to merge, too anxious, etc. also cause accidents. You have to find a way to relieve some of the pressure and stress so that you can do your job confidently. Easier said than done, I admit. But I also agree with the other nurses that posted...both errors were minor, you learned from them. Move on, forget the whole "third strike and you're out." Even if you did get fired, and I understand how traumatic that would be for anybody because we try so hard, but even if you did....there are going to be other jobs and other managers that will be able to see these errors in the context of a new nurse learning her job. There's so much to learn and your mind is constantly being pulled in a million directions, so take a deep breath and remember that tomorrow is a new day.

It sounds like he wanted you to give it fast and that was one way of diluting the concentration so you could just push it in without being concerned that too much would go in too fast. In this situation, I would have done it that way if he had specifically requested. I would think that it wouldn't be sitting in the syringe long enough for any precipitates to form.

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I would suggest that you speak with your manager and request a longer orientation. If he/she can not accommodate you, then I would encourage you to look elsewhere. It is not too much to expect to be fully oriented and trained before accepting the responsibility of so many patients. I went through a similar situation with an extra part-time job and after a few days I could tell that it wasn't me, wasn't my organization, wasn't anything except that I did not have an adequate orientation. Although I can say that I did everything necessary to care for and keep patients safe, my charting, paperwork, and all the extra stuff that I never reviewed in my way-too-short orientation was not completed to the standard that I hold myself to...my last night, my husband waited in the parking lot for 1.5 hours while I was finishing the paperwork (without getting paid for working past my shift, of course). Truthfully, it was very similar to what you describe. It bothered me tremendously and I did not trust the organization and it's leadership to support me, so I left that job. So...you have to consider a couple of things. You already feel that it is not safe for the patients but it is also not safe for YOU and not safe for your license if something should go wrong because the environment did not support you to be the best you could be. Best wishes to you, I hope everything works out for you!

Thank you all for your support, I am so grateful.

Are the classes during business hours, did you have to take time off from work?

I don't know but I am wondering if I chose the right profession. I love the nurturing aspect of being a nurse but I hate the responsibility. And even though I have now been a nurse for a year, when I start getting stressed or feel the pressure, then I make mistakes, even stupid mistakes. And many nights, I stay up all night wondering if I missed anything or did everything right. And then I pray that God watches out for all my patients in case I did miss anything and I pray that God watches out for me and my family. And there's advice I can give new people, like "not to be too hard on yourself," but I can't seem to tell myself that. I work full-time at the hospital and I just got a PRN job working at a nursing home. This was my first weekend at the NH. The nursing supervisor called me at 1030-1100 pm to ask if we had been able to get a urine dipstick on this one patient and I replied, "No," and was asking the aides if they had taken her to the bathroom and if she had voided...and they were saying she hadn't voided that shift yet and the supervisor was freaking out that maybe this person hadn't voided all shift...and in the back of my mind, I'm wondering why he is freaking out b/c this is a dialysis patient and truthfully, I really expected that she was probably anuric baseline although I really didn't know, so I didn't get worked up that we hadn't got the dipstick yet and I also wasn't aware that the dipstick had to be finished by my shift...and he says, "Were you even aware that she needed one?" And I stated, "Yes, I was aware." But in the back of my mind, all this stuff is going through my head and meanwhile he is freaking out and saying call the doctor if she hasn't voided and acting like I'm an idiot. Well, the lady ended up voiding a good amount right after that, but still...things like this really drop my confidence level, every time I think maybe I know something, something happens and then my confidence level goes down. And it's like if anything messes up my routine or train of thought, then I have to backtrack or I miss things or make mistakes. Add to that the fact that now I am the breadwinner for the family and I have a lot of student loans to pay, so I just feel trapped in this profession. And I don't want to be in nursing just because it is a good job like many people seem to be...although I do want the job security....but I just can't handle going home and worrying all the time. I just don't know what to do. I just don't know how much longer I can handle this. Any advice?

Suzanne4, Would you please send me a message with the travel companies you recommend? I am strongly considering travel nursing. I appreciate any input you can give me. Thanks so much!

I'm curious as to what conclusions you and your facility have come to in this situation? What's happened since the time you posted?

Wow! What agency do you work for and would you recommend them? Thanks!!

What is the CC program schedule like? Is it possible to work while you are taking the classes and clinicals?

"I don't sleep, I just worry myself sick. If I sleep, I wake in a fright at 2.30am. I can't get back to sleep and lay there waiting for morning to come. The lighter it gets outside my window, the closer my shift. Then, the alarm goes off and it's time to go. I am on sleeping tablets but even that isn't enough to keep me sleeping well. When I have a day off the next day, I end up sleeping as soon as I get in. Like I can finally relax and sleeeeep without having to go in the next day. Then, the night before a shift, I am tense and sometimes do not sleep at all. Not a wink. I constantly try to remind myself of the pay check at the end of the month, to give myself a reason to keep going with this career. It feels like I have thrown my life away, like I am in a living hell/nightmare. I can't imagine other jobs expecting so much from a person. I just feel I am clutching at straws and I just don't "get it". I also look like a nervous wreck, especially during that simulation." I know what you mean. I've been there and sometimes I still am. I find myself not wanting to go to bed (even though I know I need to) because I'm afraid that the faster I fall asleep, if I do, then the faster morning will come and then I'll be back there again. You are definitely not alone.

Now that it is June the next year, are you feeling any better? Any more confident? I graduated last June and had a rough time transitioning and just when I finally started to feel relatively OK about things, I have a bad night. RT extubated my patient while I was on the phone with the resident asking when they wanted to extubate, wanted blood gases, etc. and I get off the phone, walk over to the bedside and see that it has already been done (without the order). The RT said that she saw me getting stuff ready so she thought "it was time." Well, I always get stuff ready in advance because I've had too many times where people just walk up and pull tubes. So I feel that even though it wasn't my fault, I get blamed for it. I have had problems with this particular resident anyway and then later, I get yelled at by a doc because she said she told me that a person had to wait 2 hours to leave the unit (while I was covering his primary nurse's lunch break) and I did not pass that on to his nurse...I can not for the life of me remember her saying anything to me about it--we were in the middle of putting in a chest tube at the time, so maybe she said it but I just didn't hear her or was too focused on the task or something but anyway, I left feeling like a total idiot and now I'm afraid that not only do I have to deal with my own insecurities but maybe other people think I'm a complete idiot and can't be trusted to do my job. The worst thing is that I try so hard! And incidentally, all the patients were fine, nothing bad happened to anybody, but still...it really makes my own self-doubt even worse. And I get sick at the thought of going in every day. I just keep telling myself that it takes time and it will pass...and that this is a good exercise in faith. It forces me to really depend on God and not myself. The sad thing is that I was a top student and do have life and job experience...I never even feel like myself anymore.