SpudID

Just to add another perspective. I avoided ambien for my first 4 months of night shift for the reasons listed above. It was terrible. I slept about 3 hrs a night and regardless of utilizing the suggestions like listed, I could not sleep. Part of the sleep issue was the pressures of new nursing but the other is my body does not like it. I was so relieved when I started Ambien. I still don't sleep a full night's sleep about 6 hrs the nights I work but I was desperate. I avoid dependency by only taking it during my stretch. The next night off I take 1/4 of a tablet and some chamomile tea and then do not take it until the day of my first shift back. I don't have problems transitioning back and forth (and ambien is expensive). Just my two cents. If I had continued to avoid sleep aids, I would have quit nursing. It was terrible. Now I am still tired but not desperate during my stretch. The time in between I sleep well and without aids.

Thanks for your response Flytern. I feel good about my IV starts. I seldom do lady partsl exams as I am at University hospital and there are usually med students lined up to do lady partsl checks. I have been reprimanded for doing ot without asking first; so I just don't bother and notify the provider. I have some great charge RNs but one is difficult on me. She expects me to take psych/difficult pts and complains about me if I take too long/spend too much time in the room/do anything wrong. It is really discouraging. She is little support when I am in the OR and I really dislike working when she is on (which is a lot). I figure RNs like this exists everywhere so transferring or going to clinic may just put me in the same position. I think the hardest thing for me is my complete lack of confidence. By day 4 of my stretch, I am exhausted and ready to quit. It is difficult. I don't want to be miserable but I don't want to give up if I am at the cusp of a major break through. Anyhow, thanks for inquiring. Today was day #4. Arrghh! Spud

Dear All, I had a mom who was on magnesium sulfate, insulin, D5W, NS as mainline for the mag, Pitocin, and PCN q 4. She received IV labetolol for her HTN. She had two IVs because the insulin drip was not compatible with the PCN (it was according to one drug guide and not according to another? Pharmacy said to just start another IV and run the insulin from there.) She was in labor and was a VBAC. Her blood sugars had to be checked q 1 hr and q15 min when I adjusted her insulin gtt until w/in 70-120 x 2. Additionally, she had q 6 hr PET lab draws. This mom was IOL for PET, possible HELLP, and CHTN. BPs were 170/100s. I checked her CBGs through fingersticks, but I was talking to another nurse on ICU. He said when possible he would take it from the IV. When can you do this? I thought the CBGs had to be capillary. Having said that, my gal's fingers were bruised and swollen; she had so many checks. I would love to try another option, but is there one? Where do you all check CBGs? Thanks, Spud

THANX so much for your well said advice. I have caller ID now and I don't have to answer the phone. Secondly, I received a letter and a bouquet of roses from two separate families to thank me for their care. It made me feel like I was at least serving the pt. I hope/pray that things will get better. I am trying to be more forgiving of myself, like advised. I have taught childbirth education for >6 years through another hospital system, but can't do it and nursing. I sub occasionally. I think I need to give it until January and then decide how I feel about my learning curve. Thanks again! Spud

Thanks so much for your responses. It is amazing that the 2 of you have such a broad variety of experiences just 1.4-2 yrs post graduation. It is encouraging. I continue to vascillate but things are getting a little better. I continue to read the want ads and will apply if a clinic job that interests me comes open. After my weird orientation experience and a noncollaborative feel on my unit, I am retiscent to try something else. I don't want to go through the "hazing" and unfamiliarity all over again. Anyhow, I really appreciated your input. Thanks!

Dear All, I am 9 mo post graduation w/ a BSN (and prior BS in education). I thought I would love L & D nursing. I am working at a high-risk, high-volume hospital with a short staff. I LOVE my patients and working with them but the stress is overwhelming. I am afraid all the time. My body won't adjust to nights and working the weekends and holidays (Thanksgiving, Christmas and New Year's) is a bummer. I have to apply for vacation 6 mo out and I am always being the called the days I am off. I feel guilty when I say no because I know what it feels like to juggle so many patients. I would like to go to clinic nursing but have heard from so many older nurse friends to stay at least 1-2 years. I would leave my position not feeling entirely competent and colleagues tell me to that things will get better by 1 year. I am afraid to leave and afraid to stay. I would like to go to clinic nursing but I don't know if I am giving up too soon. Did you some of you wait it out for 1 year and you became more confident and comfortable. I don't want to give up a job that many new grads are wanting. I had to work hard to convince the manager to hire a new grad and many of our hospitals won't do it until you have 1 year of MBU experience. I just don't know what to do and was hoping someone could give me advice on staying or going to another floor or clinic nursing. For some background, I have volunteered with families for 6 years assisting with birth as labor support. I went to nursing school knowing that my only pathway was L & D. Yet, here I am 9 mo later wishing that I had not even considered nursing. Can someone give some advice? Thanks so much, SpudId.

Dear All, I am 9 mo post graduation w/ a BSN (and prior BS in education). I thought I would love L & D nursing and am working at a high-risk, high-volume hospital with a short staff. I LOVE my patients and working with them but the stress is overwhelming. I am afraid all the time. My body won't adjust to nights and working the weekends and holidays (Thanksgiving, Christmas and New Year's) is a bummer. I have to apply for vacation 6 mo out and I am always being the called the days I am off. I feel guilty when I say no because I know what it feels like to juggle so many patients. I would like to go to clinic nursing but have heard from so many older nurse friends to stay at least 1-2 years. I would leave my position not feeling entirely competent and colleagues tell me to that things will get better by 1 year. I am afraid to leave and afraid to stay. How did you decide to go to clinic nursing? Was it hard to make the switch? did you wish that you had not? I feel so forlorn. I have volunteered with families for 6 years assisting with birth as labor support. I went to nursing school knowing that my only pathway was L & D. Yet, here I am 9 mo later wishing that I had not even considered nursing. Can someone give some advice? Thanks so much, SpudId.

Thanks so much for your help. I know that in my reading of Benner that novice nurses are obssessed about time organization and management. So much so, that they can lose sight of the bigger picture. Thank you for your encouragement and support of myself. I hope that I will make it through all of this. I keep looking forward to July and Jan (the benchmarks of 6 and 12 mo for me) Warmly, Spud

Dear All, I wrote once before about my precepting difficulties. Just to update, things are going better. My preceptor is a global thinker and I am linear. Communication/teaching is still difficult. As a novice nurse, I need a timeline and direct steps. I hope with experience I will be able to add intuition that allows me to see the bigger picture. Having said that, I was wondering if anyone had any direct steps out there for Labor, Delivery, Recovery, and Cesarean birth? I am missing things with each birth and would love to have have some 3 x 5 cards that could serve as a reminder when I feel lost/frozen. Does anyone have anything like this or could recommend some? I am trying to make my own. Here is an example that I prepared for cesarean birth: Cesarean birth checklist 1) Declare C-Section to Unit Secretary and state: We are going for a C section, can you page peds, anesthes, the surgical tech and send the type and screen. 2) Raise bed to hip level, unplug the bed, unplug the computer cord and put in dummy plug, switch over IV bags, unlock bed, off steer and pull bed from wall. Steer back on for going straight. 3) Cover mom's hair, my hair, shoe covers, mask, no coat. 4) In OR, TIME IN, transfer mom to OR table assuring mom does not fall off the other side 5) place bump, attach arm of OR table, hook up monitor for FHTs, check suction 6) place ground pad (not on bone) on upper left thigh, plug into cautery machine 7) Place foley catheter, shave hair from incision site, state FHTs, remove FSE. 8) prep belly: open white package to flat, open blue packet holding flaps back and drop onto white, pick up glove package and open on top of pt., pick up other glove packet and unfold and drop onto other glove. 9) glove, pour 1/2 betadine on gauze, turn over and pour rest of betadine on gauze. wipe starting under incision and horizontally to Mons/labia 3X, wipe inguinal folds starting with farthest away not going over previous area 1X and then closet inguinal 1X. 10) Pop Duraprep in container on top of swabs making sure to saturate swabs and Duraprep sponge. Use swabs (1 @ a time) to clean belly button. Use Duraprep in LEFT hand and start 2/3 of sponge below incision line and go up the belly to fundus horizontally. Use RIGHT hand to vertically sponge from farthest hip to inguinal and closest hip to inguinal. 11) Ask if the prep is adequate. Count w/ surgical tech. Do PAUSE. 12) Plug in cautery and suction tube. 13) Drag out big Biohazard Can, get small can and put chux on floor for sponges. 14) Note incision time and page peds to delivery. 15) Begin charting. 16) Note birth of baby/placenta, 2nd count at uterus closure, 3rd count at skin closure. Note surgery finish. 17) Get OR bed. 18) Assist with lotion to remove Duraprep, transfer pt using roller board to OR bed. 19) In PACU, 15 min VS checks, dressing check with fundals/lochia flow, 2 baby VS, ice chips after 30 minutes of stable approx. Fill out paperwork, help with BF if approp. Empty foley. Take up to MBU. Sorry if it is too detailed. Thanks for your help. Each day I go to work I stressed. I leave so drained. Although everyone assures me I will make it, I can't tell you how burdened I am with my inadequacies. Any help would be greatly appreciated. Respectfully, SpudID

Thanks so much for your support! I was feeling lost and alone. I was supposed to meet my preceptor last night to "go over the birth", but she called to cancel. I am going to approach her about her expectations, asking questions appropriately, and practicing independently. Also, I felt like the birth in the bed was my fault but you all helped me feel better about that. Yes, my preceptor was in the room the whole time. I have decided to let go of that "error". I am not going to own it as mine, but I will seek better communication. I can't tell you how relieved I am to have some support. Thanks! I was feeling mighty isolated and lonely. SpudId.

Just to fill in some more details. Patient at last check was 6 cm and never had a subsequent check. I have not been taught cervical exams and really they seldom do them at this hospital. She never made an all out pushing noise (I know what that sounds like) but two briefs moments I thought she grunted. This is a hi risk L & D. Mom was also GDM and spanish speaking only. I was a little lost because I wanted to ask her if she felt like pushing but was a little tongue tied. I will have some time to talk to my preceptor tonight I hope and at least establish some communication guidelines. Thanks for everyone's help.

Dear All, I am in week 4 of my preceptor/new grad orientation on L & D. My experience has been rough. I spent two weeks with a preceptor who disliked precepting and refused to answer questions. She would become frustrated with me and then ignore me in the room and take over. (Admittedly, I had no idea what I was doing or what was expected of me.) She stopped long enough to chide me but never to instruct. An example would be she wanted me to change the BP cuff to auto q 15 minutes. I had never used the machine and couldn't figure it out. She later sent me to an empty room to "figure it out." I asked for a manual for the machine and she said there wasn't one. She refused to go with me and also told me to become familiar with the items in the room. Later, she asked for a patient O2 mask. I could locate it but then she wanted me to connect the water to the wall and then the mask to the water. Again, no one had showed me how to do this simple task. I couldn't do it fast enough. She became angry and then I was an observer in the room; She took over. After two weeks of her complaining about my inabilities (What did you learn in school?), I told the manager that this relationship did not seem healthy for either of us and could I have another preceptor. I was transferred to a second preceptor while my permanent preceptor was being trained in PBDS. My second preceptor, one week, was great. She taught. Gave me my first tour of the birth room and demonstrated how to use every piece of equipment. She was patient with my questions and never discouraged them. She allowed me to function independently until she saw me ask and she would assist me in finding the answer or take over when it was no longer safe (my first crash csection). My third preceptor is so nice. I really like her as a person, but I am lost, again. I feel like it must be me. How can I have another preceptor who is a bit frustrated with me unless it is me? Again, I really like her. She is a nice person, but I feel like she is letting me fail with no clear parameters. For example, I had told her I didn't know how to manage 2nd stage and I was unclear about when to page the Dr., Peds, Birth table set up, ect. . . Last night, during 2nd stage, I didn't page the Dr. I was waiting for her to tell me when to do that, because I had already stated that I was unclear about this stage. Instead, she said nothing and baby was born w/o a Dr./CNM on the bed, because I didn't page anyone. Mom was a multip and making minor grunting noises but I was waiting to be told to page or at least asked if I should. Previously, she has told me that she finds me challenging because of my constant questions. So I am stuck. I can't ask questions but I am supposed to know intuitively answers. Lastly, she never stated that I was the primary nurse for 2nd stage. I guess we were both waiting for each other. Can someone help me with practical suggestions for 2nd stage or a book or something? I am a previous doula with over 100 births as a doula. This is a hospital that I precepted at and have volunteered as a doula for 5 years now. I graduated with a BSN with a 4.0 and I am so defeated and lost. I knew being a new grad would be difficult but I felt I was reasonably intelligent and it would all work out. Now I don't know and lack any confidence I had when I started. Can someone, anyone, please help? SpudId.

Dear All, I was just wondering if anyone was taking alternative medications for memory or fatigue. I am doing an accelerate BSN, a mom of three and still working for two hospitals. Admittedly, I am tired and somewhat stressed. Is anyone taking or doing anything on the list that may be helpful for all of us? One thing I am doing: I boil peppermint tea at night, refrigerate it and take it with me in the morning. It is herbal and non-caffeinated. I find drinking it throughout the day has been just a little energizing. Even smelling it makes me feel a bit less tired. Anyhow, any comments? Anyone taking Ginko? Just thought I would ask you all for your collective wisdom. SpudId

Dear Jill, I remember your name from before. I think you applied to Clark, Linfield, PCC and Walla Walla or OHSU? Anyhow, I was accepted to Clark for the Spring and attended the first week of class. Then I declined when I found out I was accepted to Linfield. I was also accepted to OHSU, but decided that Linfield was more family-friendly. After scholarships, it was in the neighborhood of OHSU. I also tried for PCC lottery (Sylvania is so close to my house) but was not drawn. I did not apply for Walla Walla because of their religion requirements and the distance. Ditto with Mt. Hood and CCC. Have you heard from Walla Walla? A friend of mine that was accepted there, Linfield and most likely MHCC is planning on attending Linfield. The acceptance money is due by April 30th; so after that they should start contacting the wait listed people. I hope you get in and thanks for your congratulations! Lani

Dear Laura, I have also been accepted to Linfield and start June 17th, their accelerated BSN program. I can't help you out since I don't know much but I would love to commiserate with you if you would like. Best of Luck, Lani

Dear Beth, I would LOVE to talk to you. Can we post privately? I don't want to clutter this forum up for anyone and my questions are so specific. I'll see if I can figure it out! Thanks for the generous offer. Selling any books :-) Spud.

Any chance any of you are from Portland but going to Clark or are attending Clark in Vancouver. I am scheduled to start their program in March and have questions like parking and registration. If anyone is willing to let me ask, I would be very grateful. Thank you. Spud

Dear Anna and all those Linfield minded, I talked to Linfield today. Their application deadline is February 15th. The lady I spoke to said that the 18 mo program is brandnew for them and what existed last year may not exist this year. She said that this year you will start in June go thru August have maybe two weeks off and then begin again and they expect that for the following year. I was beginning to think the program was doable but I am not sure. How did you feel about the class load and stress? I have a friend doing the 18 mo program at OHSU and she is a 4.0 student. She is doing great but it is VERY stressful and she is juggling a lot without having any children. She encouraged me to think about doing a two year program knowing that I work for OHSU and LHS and having children. Thanks for the info about the scholarships though. I have a high undergrad GPA and they said that basically the scholarship is automatic for anyone with a 3.3 and above regardless of finances. That was new news to me; so thanks so much about that. Can you tell me how you felt about the program, the clinicals and how stressed you were? If you want you can contact me directly at [email protected]. Thanks again for all your time and efforts on my behalf!

Dear Anna, I will look into Linfield since I already work for Legacy, I believe there is some reciprocal program with LHS and Linfield. Unfortunately, I know I won't qualify for any financial aid. Our income is too high, but it can't hurt to look. Secondly, I am assuming your 18 month stint was including summers. Because of our three beautiful kiddos I can't work and go to school another summer. I did accelerated A & P and Chem this last summer and promised my wonderful family that I would take the following summer off. If you have any other encouragement or I am off base on those assumptions, please reply back. And THANKS for giving your two cents. I really appreciate it.

Dear Hoops Chick, I had some specific questions about Clark. How was the grading system? I called the Nursing Secretary and she said that grades are done with A=4.0 and A-=3.7, etc. . . How difficult is it to maintain an A average? I have a 4.0 in all my nursing prerequ's and a 3.8 cum with my BS degree. I am starting to feel intimidated by Clark's program. I am starting in April. Also, what did you think about the teachers and staff? Do you have any advice for me? I heard that your first clinical is in a retirement home/assisted living and the VA hospital. Can you comment on your experiences there? Any optional books that were a great help to you? Moreover did you find the program doable? I have children and work-parttime and have been able to do school so far but am trying to figure out what is reasonable. Thanks for any answers in advance. I really appreciate it.

Dear All, I had some questions about Clark and Clackamas. While trying to search for it, I stumbled across this forum and thought I might ask some of you that are in the know. I have been accepted to Clark for the Spring term in nursing. I was wondering how many terms there are at the VA and Convalescent home? It appears like two? Secondly, are GPA calculated that includes docking for A- (eg is a 3.8 rather than 4.0). Are you happy there? I have read that someone seems to be really liking it there. About Clackamas, I am applying there as well, because I am an Oregon resident. My specific questions are about the interview and NET. I am taking the NET next week and was wondering how much your score plays into the application process. About the computer literacy exam, is it hard? In the application what carries the most weight? NET, GPA, interview? It appears that the one student who was writing about it has not had clinicals at a nursing home. Is this true? Lastly, are you graded on a scale like Clark with A-=3.8 rather than a 4.0? Is anyone happy at PCC? I have read the comment about Clackamas and OHSU and have contacted OHSU. OHSU told me that from ANY ADN program they have 100% admittance so far for anyone with 2.5 GPA or higher. Thought that may comfort some of you not at CCC. Thanks for the answers. I look forward to any replies and thanks in advance.