Losingfaith

I'm in the process of applying to FNP programs and have decided after graduation I would like to work with victims of domestic violence, including children, teens and adult women. I plan of volunteering to get some experience in the area, as my regular RN job is on a cardiac telemetry unit. My questions are 1.) Does the FNP make the most sense for the area I'd like to work in? 2.) Will my RN experience be a hindrance since I'm working with cardiac pt's now? 3.) Does anyone work in a clinic where they see these types of patients? Thanks for any responses!

Thanks for all the support! I know I'm human and make mistakes. In my head I'm logical, but my heart and gut can only ache right now. It's comforting to know despite all the "perfect nurses" out there, there are still a good number of us who can be honest and support each other.

I can't describe how horrible I've been feeling for the past 24 hours. Yesterday, I got a call from the day RN I had given a pt to regarding a missed insulin dose. The glucose in the AM was over 400 and he was scheduled to receive 11u of lispro per the sliding scale. I called on-call since it was only 6 am and primary sx wasn't there yet to double check if additional insulin should be administered and/or if the pt's tube-feedings should be turned off for a hour or two until his glucose improved. The on-call told me not to administer any additional insulin and not to turn off the tube-feeding. I did as he said. About 630 I saw an order from the primary sx increasing the patients sliding scale to 21u. I checked with a more senior RN whether I should give the additional 10u or leave it to the day RN to give after re-checking the glucose after 2 hours. She advised me to hold the additional 10u and it could be given later if needed. I gave report to the day RN and told her about the changes to the order and she could give the additional units if needed later and despite what the MD said, I turned off the tube-feeding before I left (to be turned back on after an hour). The mistake is, I saw the order for the change in lispro but missed seeing a NOW dose of Lantus. All day the pt's glucose remained high and the MD's were ****** I hadn't given the dose. I know this missed med is a med error and I'm very scared of the consequences (possibly losing my job?) A year ago, right off of orientation I made a med error as well. I had 2 pt's in the same room. One in a-fib on a Cardizem gtt and during the night my patient in the second bed went into uncontrolled a-fib. Long story short, I thought I had been told bed 1 was in uncontrolled a-fib, alerted the MD, took vitals and pushed IV cardizem before realizing it was bed 2 who needed to be tx. I care about my patients. I care about not just being a good nurse, but the best nurse I can possibly be. I was a strong student and always received the praises from my instructors. But in 18 months I've made 2 errors. I acknowledge my mistakes, but I can't shake the feeling that I'm a bad RN. I want to scream, cry and quit. I feel like this job has no room for error so maybe if I can't be 100% I shouldn't be there at all....

I work @ a very large hospital. @ least where I work, we have A LOT of missing night meds that required notes be sent, then a phone call and maybe another phone call. It's getting better, but I notice things are worse when we have a lot of admissions/a busy ER.

knowledge deficit related to

potential for injury related to .....

New grad here, and I've already had my share of issues w/ day shift. You were busy all day, are you sure? Bc when I online this morning to wind down after a long night and 5 of you were on facebook and then again at 11 and 2 and 5 when I'm leaving to come back into my shift. Ha! Sure, night shift has some nights that '"everyone" slept quietly w/out events but don't tell me you didn't have time to do x, y, and z when you were on the internet half the day! I saw you. I also saw the 4 of you walking back into the building from your smoking break when I was pulling into the parking lot to come back in. So you didn't verify the orders from 1830 because why? Oh, you addition to your cancer sticks got in the way of doing your job!

I think it's normal to notice something such as that...especially if it looks drastically different than your own?! I noticed the same thing during my intership and clinical and the nurses told me it was common to have your husband "clean you up" before the big day, especially for women who knew they were having a c-section and were going to be shaved on the OR table anyways. I guess you rather find nothing than look like they just shaved a poodle in the OR.

Unfortunately this won't be the only time things like this happen. But as they teach in school and in life, when there is a problem with someone you speak to them first THEN move up the chain of command if things do not change. I would suggest approaching the subject in post conference so if things feel tense you wont see her again till the next clinical day, and hopefully she'll have some time to reflect on what was said. Be civil. Ask her what her expectations are for the group. Finally, express to her what the groups expectations are for her i.e. to be treated with respect, to build you up rather than put you down, for criticisms to be made in private etc. Hopefully you will see a change but if not, don't hesitate to talk to the professor overseeing the clinical bc if you wait till the end of the semester nothing will be done.

the kaplan 2010 book gives great test taking tips and the mosby nclex RN-19th ed. is amazing

I said that was the dream, not the reality. At least where I am and the program I graduated from 99% were applying for major medical centers in the area (Chicago) in hopes of beginning their graduate programs next fall and growing their careers while still young and without a family. I also read a couple posts of new grads yesterday contemplating this same dilemma, unable to get into a hospital due to the freezes but LTR's offering them positions...I just think if those were the dream jobs of new grads they would not have such a hard time making that decision.

I think your target should be experienced nurses not new grads. This is only to be honest,but as new grads yes, we want that shiny job at the big hospital in our specialty of choice....well at least a lot of us anyways. LTC/skilled facilities are rarely the shiny new dream job we have all been working for. I do understand that dreams dont come to you overnight. I'm a new grad and have worked in a LTC facility for only a week now, they describe there facility the same as yours but still I went home the first night in tears. I know being there isn't getting me anywhere near my dream of being a womens health NP...I have a intereview for a major medical center next week that isn't in my specialty of choice but just being there would be a step in the right direction...it's a lot easier to transfer units then to get into the hospital of choice....so I think new grads are looking for that rather than what you facility offers

I'm a new grad too and I can tell you that for the past week, I have done exactly what you are asking whether you should or not. You should NOT do this. A LTC place was my first offer too, but I have 60 pt's to myself. After a week I am finding more and more things wrong with this type of facility...especially for a new grad. Yesterday I was offered an interview for a hospital, I accepted and quit the LTC place today just because I feel so UNSAFE being there alone. I would not respond to this post if I thought it wasn't important, but I truly believe you should not dive into this situation....

OMG...sorry, but this is exactly my life to the T too. I just started at a LTC facility last week. After the first day I went home crying. I graduated in May. Passed the NCLEX my first try AND have 2 years of experience as a PCT. This is the only job I could get after countless applications too. After 2 day there, I feel nothing but defeat and am counting the days to my first paycheck so I can quit. I know it's not right, but I just cant bring myself to give such unsafe and dangerous care. The passing meds to 60 pt's on my own and trying not to make an error haunts me. I just can't do this with a clear conscious...and I'm only getting 20 an hour so you are doing better than me. Hopefully soon we will both get out of this and move onto the beginnings of making our dreams a reality. Good luck to you girl!