SMUgrad

The above post speaks true for experience as a new nurse. I know for sure that I have a passion for being a nurse, I am good at what I do when I care for my patients. They have commended me, given me cards and praised me for taking care of them because I have a gentle demeanor. I was told once that I needed to have a "bulldog" attitude in order to work on a high acuity floor like Telemetry but that is not my belief. But with so many facets I think that nurses have to find their niche. Don't discount those that have worked in a unit for a short period of time. As another reader posted, some people may have left because of poor work environments that negatively impacted patient care, and of course during an interview I would not bash a previous employer although it was poorly equipped (management, poor attitudes among nurses); that would go against professional ethics. That would be unprofessional. Also, it really takes a good program and teachers to mentor nurses during orientation, seasoned or new nurses. We are at vulnerable states during orientation (as the above post states), nurses make us do extra work or can be condescending because we are trying to "prove" ourselves. I appreciate opportunities, sure. But new nurses can be taken advantage of especially during orientation. I would never want a new nurse to feel that they are beginning to question why they became a nurse in the first place and get fed up with bedside care so early on in their careers. I would like to see more programs empower nurses to be great and encourage new nurses who have the enthusiasm to want to be more, and perhaps in-service seasoned nurses who have become complacent and disenchanted.

Dear erin01 I am sorry that I cannot provide you with some breakthrough advice, all I can do is sympathize and relate. I have been a practicing RN for 3 years and was blessed to have obtained a position on a telemetry floor. This is a new facet of nursing that I have been exposed to as well as cardiac and neuro were not my strongest topics in school. But I wanted to advance in my career and challenge myself to do it. I am still doing my orientation and it will last for 12 weeks total. As a new nurse on telemetry, I can relate to every emotion that you have expressed. I feel sick each time I am on my way to work because I am nervous, I feel afraid of the legal ramifications that can come to bite me if I fail to do my job or even if I didn't do something that I SHOULD have because "well you should have known." I hate that phrase. I also hate "well, it's your license." Thanks, like I didn't know that. Anywho, I don't know for myself how to get over this fear that's why I come to allnurses.com to read stories like yours, then I feel comforted. It is true you can only do one thing at a time, you are only one person. And don't pretend to know everything. I often do feel as you do and I am worried that I will never get out of that feeling and I loathe that feeling of being scared. However, we are nurses for a reason because we were taught to assess the situation and then intervene. That being said, I have found coaching4nurses which I have inquired about to help find a coach to help me through my career and to help me clearly define my goals so that I can learn how to take care of my patients and feel that I have done the best that I could. I am proud of what I have accomplished of becoming a nurse also, and I have made peace with the fact that nursing will never get easier just more manageable if I know where my resources are and how to access them, then I can better problem solve and "troubleshoot" the situation. If there is any consolation, I am thankful that you have decided to become a nurse and all that you do because it is not easy to give or even maintain compassionate care especially to difficult patients. New nurses, like me, will be thankful for your experiences and stories to help them get through their insecurities, doubt and other "head-noise." Thank you for sharing your thoughts. I wish you all the best, please don't give up. ps- You know why my icon is from Finding Nemo? Because it was Dory who taught me to "just keep swimming."

Help allnurses.com members! I am reaching out to all of you hoping that I can get some advice on how to move my career forward. I feel, at this moment, that I am stuck in purgatory because I have nursing experience but not acute care experience. I have been working at a SNF for 2 years now and am looking to expand and move onto an acute care hospital particularly med/surge or the PACU. BUT . . . job descriptions state that I must have experience in an acute care setting. New grad programs require that I not have worked before as a nurse and must be in the last year of my program, I am 2 years out of nursing school. AM I DOOMED?:hdvwl::vlin: It seems like now the only way you can get in is through someone you know. This begs the question, how am I suppose to gain experience if no one will give me a job? ARRRGGHHH! Please, if anyone can help fill me in to some resources that I can try or some advice/tips I can try I am open. I would greatly appreciate any help. Thanks! -SMUgrad

Dear 910hope: I share your experience. I too have started on my own 2 weeks ago and cried my very first day. At night, I am the only RN in charge of 63 patients and have witnessed RN/LVN's falsify BPs and HRs before giving antihypertensives and Digoxin. I bought myself a digital BP monitor and will use that when I need but the DON says that they are inaccurate. I say if you use them correctly, they shouldn't be and if it's some rediculously high BP, use the manual ones. Thank you all for sharing your story :bowingpur , I can go in tonight with a little piece of mind.

No you are not wrong at all. The same goes at our facility, we are not allowed overtime and I refuse to work for free but if I want any work done I have to do it. Yeah, it sucks!

Dear 1uvakindmom (and all new nurses starting off in the SNF), I hope that my story will help you to see that you are comforted by fellow new nurses because I do, thank you for sharing your story. My very first day working independently in a SNF, I worked in the long-term side, in the morning, with 33 patients, 3 of which were combative and verbally abusive and continuously refuse their meds, 3 hospice patients, 1 of whom who was gonna pass at any minute, 1 who kept climbing out of his bed and was in danger of falling and hurting him/herself, 2 who were addicted to pain meds and antianxiety meds, and CNA's who were also really busy, I was told to write up 3 CNA's although I have never written up anyone in my life not to mention all 33 patients have at least 10 meds to take at 9am and 12pm who either take their pills crushed, whole, or with thick liquids. After I was expected to be done with 9am meds, I needed to do treatments (yeah right!) all of this on my very first day One resident had a nose bleed, another didn't get cleaned yet and I was told to get a handle on my CNA's. In the first 3 hours of my shift, the other nurse saw me and asked how I was doing, at the mere thought of the question, I could not hold back my tears. My stress level shot up so high, I think it would have reached a world record. She called for reinforcements and had to get the unit coordinator to come from the other station to help me just pass my meds, and the wound care nurse to do ALL of my treatments. I was so embarrassed. I took a quick 15 min break to run to the medication room and cry my eyes out but I had to quickly pull myself together. I was so lost, I didn't know if what I was doing was the right thing. I don't think I properly documented a few things. I was so overwhelmed that I was really in danger of making a med error (thank God I kept myself focused on that.) I was so angry and overwhelmed, I couldn't think:flmngmd:. I got through it and my MDS coordinator sat me down to talk to me about my day (I used up his entire box of Kleenex.) I stayed 5 extra hours past my 8th hour just to catch up on charting. On my second day at that station, my patient fell!:smackingf. At the end of the day, I had to reflect on it and think to myself how can I do this differently? My MDS coordinator reminded me how incredibly spazzed out I looked but I have to learn to adjust other wise I'm gonna look like that every day and I refuse to stress! So, I got my computer out and made a sheet of who my patients were and what Tx they needed, who needed a BP + HR reading before giving antihypertensives and Digoxin and assign that to my CNA's. This will be my second week working independently but all I can do is reflect on my day and think of ways I can make it better. Please, fellow nurses (especially new nurses in the SNF) keep posting your stories and advice. They provide me comfort and will help me get over my fear. Kudos to all of you who are working the SNF whether you're a new or seasoned nurse.:yelclap: I hardly feel like a real nurse myself but the skilled nursing facility has its own personality oppose to the acute settings. SNF nurses are very special! Not to say other settings are not but SNF nurses deal with so much. -SMUgrad

sorry PS: I did pass my NCLEX after 265 questions and 349 minutes :thnkg:

I understand how you are feeling, and if I were doing an NCLEX review right now they would say this is not good therapeutic communication but here goes anyway. I have taken Kaplan as a review along with 8 other people from my graduating class. Many of us felt the the instructor was so bad we opted not to return to the rest of the courses defaulting the 100% money back guarantee and just decided to use the online portion of the package and the book but here was my reality (mind you this is just MY EXPERIENCE): I took the boards 2x and the second time I still can't say I have found out what REALLY worked. Kaplan's decision tree worked WHEN I NEEDED IT but the best thing to do is to eliminate choices first and once you made the decision to eliminate the choice DO NOT LOOK BACK and second guess yourself (eliminate it and put it out your mind). Yes, I purchased the Kaplan course; yes, I purchased about 5 more review books; yes, I also borrowed my friend's set of Saunders review flash cards but I can honestly say that the book that helped me out the most is the Kaplan book that you can purchase at any book store that is about 1/5 the number of pages than many of the other review books out there. It talked about strategies that really helped me like learning how to REWORD THE QUESTION. In the back there are 180 practice questions. After that, just practice questions, and more questions, and more questions, and more and more and more . . . . are you following me? On the day of the exam, I took a deep breath and told myself to stay calm no matter what, at 75 or even 265. I went the whole way, 265 questions and 11 minutes to spare until time was up. If you find yourself in that situation ("OMG its question 76 and the computer didn't shut off, does that mean I'm not gonna pass?" Tell your negative mind to "shut up" and remind yourself that as long as they are giving your questions you still have a fighting chance. Give it all you got as if its still question #1. Did I mention I had bad gas too?? Ok TMI. I really hope this helps you, if you get this far in my message. All in all . . . the best of luck to you. Oh and by the way, remember that NCLEX questions will never be "real world situations" so asking yourself that will be pointless. It's ivory tower nursing they are asking you about. Cheers! :typing: :cheers: