barlowjb

WORD OF ADVICE: When I first started my nursing career, I met another new nurse who was only one month into her nursing career. She told me and practically everyone else that she knew she was in the wrong filed because she absolutely hated her patients and like you, found them to be very annoying and whiny. She kept saying she could not stand them. She even went as far as to say she felt no compassion at all for them and felt that nursing was not the career for her because of how she felt. So not long after, she began studying for her LSAT because she decided that she wanted to become a lawyer. 15 months later she passed her LSAT exam and got accepted into a number of Law Schools. She then decided to defer Law school acceptance just for a little while, so she could work a little more and save some money. In the meanwhile she decided to temporarily switch her nursing Job and work with a totally different patient population, with the intention to only work there for one year, then attend Law School. She took a slight pay cut with this new nursing Job Well Guess what? After only one week in her new nursing Job, she was very surprised to find that she absolutely loved it. I was shocked too. Now almost 6 months later, she loves her new nursing Job (no on call, no weekends, no being called off due to low census, no floating all the time, patients who are very appreciative, and a boss who shows appreciation for all his employees). Almost 6 months later, she feels the same way and she is now seriously rethinking Law School, and is considering a permanent career in nursing. My point - The next time you feel frustrated and angry at the population of patients that you work with and feel you have no compassion for them etc. Think again and don't be oot quick to think you are in the wrong field. It may be that your personality is just not the right fit for the patient population you now work with among other things. Meanwhile, I'm still working in Med/Surg, where my co-worker left me, and I truly love my Job and the patients, despite their whining. I don't mind floating to their units, because I view it as a challenge. I don't mind being put on call simply because I just happen to be able to afford it (Thank God). This job just happens, to be a right fit for me and my personality at this stage of my life (I don't know about later on). Do I have bad days? - You bet I do!!!, Do I get a little irritated at patients at times? - Definitely!!! If I get burnt out or start having more issues than I can handle, I will think of trying something different. But for right now, I love my Job and I am happy that my co-worker found a nursing Job that's right for her. So If you haven't done so already, give yourself a chance to try other areas of nursing. I wish you the very best, regardless of what you chose to do.

Once I had a pt who for three consecutive days at dinner time had BS between 60 and 70 and had and order for both scheduled and sliding scale Humulin. The first two days I called the MD she said hold the scheduled dinner time insulin. On the third day I told her that this was becoming a trend and suggested for her to give me some parameters so I wouldn't have to keep calling her about the same thing everyday at dinner time, so she said hold all scheduled regular insulin for BS LiKwonie, I noticed you said "I know she is going to bottom out like she usually does the next morning" one of my peers suggested to me the other day that If I noticed a trend to either call the MD or leave a note detailing the trend and suggest an adjustment be made to the insulin regimen. Making a decision to call an MD about holding a med is also a part of critical thinking. I think a lot of these issues are common sense and because of that some nurses (and I have been guilty of this in the past) make those "final" decisions to hold meds especially because quite frankly a few MDs make us feel bad about calling about "simple medications issues that "could have been dealt with in the morning". I have been told on more than one occasion by my charge nurses not to be afraid of calling MDs (even if its in the middle of the night) about holding meds - if parameters were not previously given. You did what a lot of nurses have done and still continue to do and get away with, but we have to always be mindful of the limits of our scope of practice - You were on the right track in terms of wanting to hold the med, the mistake you made was in not contacting the MD about the matter. I'm sorry that it had to get to the point of you being written up. However, while some supervisors may be more lenient than others (via verbal warnings), based on your description of the situation I cannot in good conscience say your supervisor did anything wrong. Although it hurts, think of this as a lesson learned. "This Too Shall Pass"

I never before thought that this could be an issue. The facility that I work at doesn't have the policy of checking placement of patches, and there have been several times when I have had an order to remove a patch and when I check the pt and bed there was no patch to remove. In those situation I generally record something like "no patch observed on pt" - do you think that is sufficient documentation on my part?

it was great having another new nurse around, we both shared similar fears and concerns and ended up supporting each other

Not sure of your situation, but my first week of four days of orientation was in a class room no where close to my unit and half of my 5th day was spent touring the facility and my assigned unit and during that first week I was considered an employee (as reflected by my pay check). If they consider today an orientation for you, i would think you are officially an employee Hope that helps Congrats also!!!

I agree. so far 98% of the time when I ask more experienced nurses to start IVs on "hard stick" patients, they can't do it either, plus there are times when they ask me for help with their IV starts - so that tells me that I'm not the only one having a difficult time with IV starts at times. Try not to appear too nervous (even if you are) because pt's pick up a lot on that. Like the above post said try to start every IV you can - in this way you will continue to get a feel of it and hopefully reach a fair comfort level. Reading may give you tips, but nothing builds confidence and technique/skills like hands on experience.

Try hanging in there a little longer maybe say an additional month and see how you feel. When I first started (ortho/neuro and general medical) I felt unsure of a lot of things and documentation took forever. I began feeling a tad bit ok after 8 weeks of orientation, fairly ok after 4 months and now that i'm at the 6 month mark i'm feeling pretty good although I still have a lot to learn. The first few weeks as a new nurse is tough for most, plus working 12 hour shift does not make it any easier. I don't know whether or not you will still feel the same way after an additional month or two, but at least give yourself an opportunity to find out. For me the biggest hurdle was getting comfortable with the other nurses. I had to develop a very tough skin very fast and practicing to not take certain things and attitudes toward me personally was the best thing I ever did for myself. There were times I would just go home and pray for God to help me deal with certain individuals regardless of how stupid I felt around them, then I would just buck up and face another day again. The irony of it all is that now i feel pretty comfortable with most of the other nurses - who knew?. I am aware that sometimes there are places that are really just bad and dangerous places to work no matter the situation, and but based on the info you posted, I would encourage you to give yourself a little more time before you make your final decision. I wish you all the best regardless of the direction you eventually decide to take May God Bless your efforts much sooner than you think or expect!!! Best Wishes

Don't be too hard on yourself, just keep on trying. I wish you all the best

well said!!!

When i mentioned "taking on slack" I didn't say "always take on slack", slack was probably not the right word choice for me, what I was trying to say is when it comes to team work - and lets look particularly at nursing school - if you have one team mate who is not pulling his/her weight (even if its your first time working with this person), you should step in and do something, to ensure that you end up with a decent grade. The point I really wanted to drive home is this: complain after whatever you have to do is over OR if its really bad find a way to address the matter with the professor if the matter is causing that much problems, but in the meantime if I was a part of that team, my grade is at stake, and there is no way on God's green earth that I am going to sit by and allow one lousy team member to cause me to get a bad grade or fail a course. In any case it just dawned on me that my perspective may be related to my NS approach to group projects - At the end of our group projects etc, the professors included 20 points for team work. 10 of those points were based on evaluation of each person by the other members of the team. These evals were anonymous, so in the end, if your team mates thought you sucked, you can get say 0 or 1-2 points. The second 10 points based how much work each team member contributed. so in the end all members got the same number of points out of that 80% bulk, but the remaining 20% varied for each person, to make up their final grade. With this approach on the same team there may be a mixture of students with a final grade of passing and others with a final grade of failing. I don't know if all nursing schools do this but if they don't it may be a good suggestion to combat the problem of people not pulling their weight. I'm not trying to say I'm right or wrong about anything, its just an opinion Best Wishes

i smiled when i read the op's above statement because it reminded me of a quote from the literature book in high school written by author george orwell's titled: animal farm which says "all animals are equal, but some animals are more equal than others" my spin on this quote is that all individuals in a team may be workers but some may end up working harder than others. anyways, before i go any further, let me say this to the op: from a personal standpoint i understand your frustration and you have every right to vent. thanks for your post because reading it reminds me that there will always be people like the ones you complained about and that i will always have to practice navigating wisely around them for the benefit of patients and myself. however i do have some general comments or food for thought if you will, targeted at no one in particular. the same opinion i have right now, is absolutely the same opinion i had in nursing school. many of the things that happen in nursing school as unfair as it may be also happen in the real world of nursing. when working as part of a team pretend for a moment that you are in the real world of nursing where it should be all about the patient and not about how you feel about the fellow nurses around you. picture this: you are assigned 8 patients on a busy med surg unit and your fellow nurse is assigned only 5 patients and it's an extremely hectic horrible next to impossible night. in an instance one of your team mate's 5 patients is crashing and she/he is either in shock or just plain and simple incompetent to handle the situation. what would you do? would you play blind because it's not your patient, you have more than your fair share to deal with and you "can't find the time" to help a dying patient (who god forbid could have been a family member) who has an incompetent nurse? or would you simply jump in and take over, help save the patient's life, complete your shift and report your team mate's incompetence to management later? also picture this, if for this class the grade meant the difference between remaining in nursing school or being kicked out, would you "refuse to take on the responsibility of your team mate" because it's not fair", at the risk of receiving a low grade and getting kicked out of school or would you simply pick up your team mate's slack regardless of how upset you may be to ensure that you get the grade you need -- and then report him/her to the professor after you have received a passing grade? the whole point of teamwork is working together for a common good. some team mates may be stronger in some areas than others, some may be plain incompetent, but the important thing is to not lose sight of that common goal no matter what. if during the time one team member is putting a patient's life in danger (in a work situation) or refuses to partake in team projects, or is just not pulling his/her weight one can document examples of the problem and make a report immediately or later depending on the situation. someone pointed out that we pay nursing school to teach us, a statement which i totally agree with, but we have to remember that that teaching also involves how to participate in team work and wisely handling the problems that arise from the very nature of being part of a team. as for the instructor showing favoritism - it happens all the time even on the job with charge nurses and regular staff - but that's for a whole "nother" post. i'm not suggesting that the op should bend over backward and not say or do anything, but we have to remember that there is a time, place and best way to handle any given situation. i strongly believe that it is important to practice putting things in perspective and think things through before making the decision to act or not to act - because at the end of the day you don't want to harm the patient (because of inaction) or harm yourself (getting a bad grade or potentially putting your nursing license in danger when you become a real nurse). best wishes

This is the reason why I love the allnurses website: u see and hear stuff you probably you would not know of elsewhere - it is such a cool video!!!

I already have a bachelors and masters in Biology and most people expected me to either attend medical school or pursue a PHD. I was told by family and friends that doing nursing was like going "backwards" that nurses were just "wound dressers" and that I could do "better than that". It was a very frustrating period for me because I had done my research and knew that the people who were making these comments were plain and simply ignorant and had little to no knowledge of what nursing entailed. I spent a great deal of time trying to explain to people the different things that nurses did and why it was such a great profession to be in. Eventually I literally stopped talking about it, it was no longer a topic of discussion with people who did not know what they were talking about. I also volunteered in the ER (initially out of boredom, because I had a lot of time after work and did not have a boyfriend), an experience which sealed the deal 100% for me, I knew I wanted to do this. Its Your decision to make, its you who has to look in the mirror and ask yourself am I satisfied and comfortable with what I am doing career-wise. If you are not satisfied with what you are doing, you are going to continue being miserable and may even become depressed about it. I don't know what your mother's motive is and I don't want to speculate, in any case the bottom line is that that is her issue that she has to work out. Keep on loving her, Keep on being respectful of her (you may need her help with your child while you are in school), let her know you understand and appreciate her concern, try not take it too personally or be angry at her, avoid discussing it with her for a while, go ahead and apply to nursing school. Seek people out who can encourage you. Your mom may eventually warm up to the idea and may even express how proud she is of you on your graduation day, like my mother and most of my friends and family eventually did. Best Wishes

Ahh, that definitely illegal.

:smackingf OMG, Sorry for the long post above, I am working on being shorter and to the point in the things I want to say, but sometimes when I am writing in the moment I don't realize how long the post is until after I have posted it. My apologies again and I hope I didn't annoy anyone with such a long post.

I cannot understand the impatience of seasoned nurses with new graduates, I just don't get it. Prioritizing comes with experience. Did they at least allow you to complete your orientation period before showing you the door? Gosh!!! Let me tell you something based on your explanation, the problem is not you. I'm not trying to dog your preceptor too much, but I feel that she was just way too impatient and premature and should have given you more time before making her final judgment. Prioritizing takes time and is something you still have to work on way after your orientation period. As far as skills go there is nothing wrong with asking for a demonstration. Don't give up or despair, pick yourself up, brush yourself off and try to move forward.. "This too shall pass". Get out there and start applying for new jobs and as someone pointed out try getting into a hospital with a nurse residency program if you can. Also bear the following in mind: The first impression a preceptor has of a preceptee can set the stage for how much confidence he/she places in the preceptee during orientation (just my humble opinion). My biggest advice to you is to be proactive during your next Job orientation and help run your own show, it will demonstrate that you hold yourself accountable for your own learning experience: 1. On your first day of orientation with your preceptor request a meeting if even for 30 minutes so you can tell him or her about your past experiences. For example, I told my preceptor that I have a lot of experience with G-tubes and Traches, but not a lot in other areas. For example, I have done IV starts before and one IM injection (in a NICU) but I still need more opportunity to practice. I am telling you to explain these things in the beginning, so that it doesn't come across as if you just don't know anything at all or that the school you went to was not a good school etc. 2. Let your preceptor know that you may ask for a demonstration of certain skills as a refresher because you may not have done them enough in the past. 3. At some point during your first week of orientation write a list of skills relevant to the job that you feel ok with such as: taking vital signs, blood sugar checks, subQ injections etc. and write another list of skills you would like more opportunity to practice during orientation. Again this will give your preceptor a mental picture of where you are skills wise, so there are no surprises if you ask for a demonstration of a particular skill you are not comfortable with. 4. At the end of each day of orientation summarize what you learned and the next day when you go to work with your preceptor, spend a few minutes going over what she taught you the day before, because that will make him or her realize that you do listen and make note of what he/she is teaching you. It may help the preceptor feel good about his/her preceptingl. 5. Keep a running list of every pt you have seen (identify by pt condition ex. TIA pt) and the skills you had an opportunity to perform, so that if for example your preceptor says you should know how to do X Y Z by now, you can remind him or her that you haven't had certain opportunities as yet. You know what I mean. I know all of what I'm telling you sounds a lot, but I did it and it really wasn't difficult. Keep the faith, vent and cry off your frustration if you need to, but keep on applying for jobs. Best Wishes

I'm not surprised, They said that more studies are needed to determine why this happens. Its probably just the body drawing from its orificenal of compensatory mechanisms when an imbalance is detected. For example a drop in blood pressure generally occurs as a result of going from a supine position to immediately jumping out of bed to a standing position, however in the normal healthy person baroreceptors kick in immediately to normalize blood pressure and prevent orthostatic hypotension --- its like the person does not even sense that drop in BP, unlike say a person who is severely hypovolemic (from say loss of blood or use of diuretics). So in the case of individuals with anorexia, the body is probably desperately attempting to produce well needed fat "from basics" with the bare minimum, so it chooses to produce fat cells over bone cells. Its a pity our bodies don't compensate involuntarity when it senses we are overweight. It would be nice if my body senses that I am over 200 pounds, starts increasing my metabolism by producing an excess of thyroid hormones, causing me to lose a lot of weight very fast and when I get to 135 pounds my body returns to a normal metabolism.... I'm just saying :) Anyway, its a pretty interesting study

AMEN!!!

When you need to call them on the phone concerning a patient condition, start by writing down what you want to say, then without procrastinating call them and get it over and done with. Then when you see them in person, introduce yourself to them. For example if the Dr. comes by to make his/her round and you are close to where they are go up to the person and say "Hi Dr. So and So, my name is xxxx, I've spoken to you on a number of occasions" or something like that, or if the Dr. is visiting one of your pts you could say "Hi Dr. So and So, I'm xxxx the nurse for the patient Y, how are you, are you planning to write any new orders for pt Y" or something like that. You don't have to go overboard with it, just do it naturally... you know what I mean? like say you see one of the other nurses when you are at work and you say "Hey Marie, how is it going" Kinda like that is what I mean. You are new and you may feel a little intimidated for a while, but over time especially after getting through the stress of orientation you will get better and feel more relaxed with other nurses and physicians that you work with. I hope I made sense By the way Congrats on your ICU Job!!!

Your MS in biology may help u skip over certain courses, It did for me, but I don't know if most schools do that. They also considered my MS GPA, but again this may depend on where you go to school. Having an MS degree however, definitely has no bearing on your starting salary, you will be like any other new nursing grad when you are done with school.

Hi, I don't know what State you are in but companies that hire research nurses as well as Clinical Research Associates (CRAs) (who they often prefer to be nurses) include Quintiles and Covance. If you can afford to it would be good for you to get CRA certification and go from there, because that would show that you are truly interested in clinical research. In addition to companies like the ones I mentioned aboved, many (if not most) Medical Centers or Colleges/Universities also hire Research Nurses in some way shape or form, although they may not have the title "Research Nurse". I worked at NYU Medical Center a few years ago (Research Tech) and my boss who was an MD hired Research Techs as well as Research Nurses. Some of these research nurses worked on clinical research half the time and bedside nursing half the time. I once shadowed a Research Compliance Officer who was also a former bedside RN and she helped to oversee and monitor a lot of the Research carried out on human subjects at the hospital - to ensure that these research subjects (who are often terminally ill and out of treatment options) are properly informed about the benefits and possible adverse effects of the medications/drugs being tested on them. I could say a lot more on this subject but I won't bore you. Here's the thing. I would encourage you to do a PHD in Biology if: 1. You have a passion for it 2. You have a lot of patience 3. There are job prospects where you live (in the area of biology you choose to study) 4. You are willing to move to where you can find your ideal job 5. You are doing it because of your passion and not necessarily for the money. I watched my first Boss Mr. xxxx PHD, lose a 1 Million Dollar Grant because the Facility's Lawyers tried to get the people (who were donating the money for the grant) to increase their donation so they could line their pockets with more money before handing the grant off to my boss. The people pulled out of the final meeting which was held in the first place to seal the deal. Additionally, PHDs appear to go through much more to get NIH grants for their research. Plus, researcher's on the whole get only a certain percentage of their grant money say 60%, and out of that 60% they pay themselves, pay their techs, and buy equipment and reagents. The remaining 40% goes towards the facility to pay for "overhead costs". Many times the grant money runs out and they have to lay their techs off unless they have another grant coming to cover the cost of paying their techs. The first time I had this experience I got another job, then my boss received a new grant and I stayed and gave up the new job. The second year when it happened again I opted to work for someone covered by multiple grants, who not surprisingly was an MD. While working for that MD my salary was always sure, I earned more and I had a much bigger work space....I think you get my point. I don't have a PHD but I have worked around a LOT of people who regretted pursuing sole Biology PHDs. I say sole because the advise that I always received was in order to have less hassle in your career as a "bench" researcher. If you are going to do any type of PHD add a "professional degree" to it for example: MD PHD, PharmD or Nursing. Which brings me back to my point: Having a nursing degree in your hand right now is like having gold, regardless of the economy, you can mold and merge that degree with many different areas to suit your needs. You can: 1. Teach Biology, parasitology, physiology, medical terminology etc. and many other areas that can facilitate your disability - you don't even have to teach clinicals if you don't want to 2. Become a Research Nurse 3. A in-house CRA (where you help monitor clinical trials in your area) 4. A "out-house" CRA (where you travel to other states up to 90% of the time) 5. Go into nursing administration 6. work in the insurance industry 6. choose many more options Personally, I was unwilling to be in a career where I have to depend on Grants for my paycheck, that's one of two reasons why I chose not to do a PHD and pursue nursing instead. My choice however was based on my life and my needs - I am an only child who have to take care of two elderly parents among other things. Furthermore If for whatever reason I can't do nursing today, I have a lot to fall back on. Although I have said all that I have said, I guarantee there are many PHD researchers whether in Herpetology, Botany etc who if they had to do it again would do so. If you truly want to pursue your interest in herpetology or botany I would recommend that you seek work at a University. When I worked at NYU they paid my entire tuition while I pursued my MS degree. The tax on the tuition came out of my biweekly checks but I got every dime back in taxes. As a BS student you can also be a part time tutor. Once you get to the stage of pursuing a MS you can get paid as a teaching assistant and/or get a stipend. While Pursuing your PHD you can also be an adjunct professor and help support your family. I notice that you mentioned that "...nursing is becoming less and less stable these days..." Remember as I mentioned before there are many things you can do with a nursing degree, if you only use your imagination. Case in point I went to a Nurse Residency class 2 weeks ago and sat in on a talk given by a nurse who is also a paraplegic - she was an RN for about 15 years before her accident - after her accident she found a way to use tailor her nursing skills/degree to her needs and now she specializes in neurological nursing particularly of paraplegics and quadriplegics - she help teach those pts how to deal with their disabilities and liaison between the pts and the social workers - pretty cool if you ask me - plus she still works at the same hospital. Forgive me if I went overboard in my post, I am just trying to be as unbiased and balanced as I possibly can because I am a firm believer in: "If you put your mind to it, it can and will work out for you, no matter the circumstances, and as long as you are doing it for the right reasons - no matter what IT is" When all is said and done - it all boils down to you. You can do well in any area you choose whether it be PHD in Biology or resourceful use of your nursing degree to meet your current needs. The bottom line is do your research - search the internet, read material, call and email other PHDs in the field you are thinking about, question and querry, seek opportunities to shadow (pretty easy to do, just ask), think carefully, do lots of soul searching, weigh the pros and the cons, give yourself lots of time to think and most of all CHOOSE WISELY the path you take from this point onwards. Best Wishes

I literally force myself to chart (99% of the time) right after each patient unless there is a definite emergency that I have to attend to right away. As a matter of fact, I go into each pt's room with their medications, my computer and my assessment screen ready to chart as I chat with them. Most of the time, my assessment is charted before I even exit the pt's room. That helped me the other day, because we towards the end of the shift we had downtime and our computers were not working. I had already charted on all 5 of my patients so I did not have to do any backup paper charting. Unfortunately the other nurses who had not been charting right away were scrambling to do paper charting. It can be difficult when you feel pulled in ten different directions, but you have to practice prioritizing. Many times pts will ask to speak to the nurse and when you leave what you are doing to attend to them you may get questions/comments such as: when are my meds due?; can i get a cup of water? its my bed time I need to get back to bed etc. So you have to figure out is it important for me to do all that stuff or finish what you are doing first. After you assess one pt for example if you feel pressured to go see another pt, go see that pt to see what's going on, and if its nothing that requires your immediate attention, go outside the pt's room and finish your charting for the previous pt. etc. It truly comes with practice. Another thing you could do is do the most difficult or stressful or time consuming tasks first. For example, if you go to work and you are given 5 patients right off the bat and one of them needs IV access in order to get well needed fluids, do that first, then any dressing changes etc., so that after that you will only be left with assessing pts and passing meds. I do 8 hr shifts, but sometimes I am floated to another floor after 4 hrs, therefore I treat my work time as two 4 hour shifts, and approach it as if I have to finish one shift before starting another. If you go into work and have only three pts for example, work quickly to complete assessments and med passes, because more likely than not, you may end up with 2-3 new admits. Try not to procrastinate, if you need to call the Dr. about something, just do it and get it over and done with. One last very important thing is practice delegating responsibilities to the CNAs if there are any working on your floor, that will free up your time to complete other tasks. Its not easy, but it can be done. I am only 5 months on the job and I had to learn all these things very fast. If you don't chart as you go, it will become too overwhelming. Best Wishes

Very Funny!!! he is actually an orthopedic doctor

thanks for the info to you and the other post that responded to my question. it makes more sense to me now. i guess regardless of whether one is an np or a pa, one important thing is knowing how to get the most out of the position/career one chooses.

I'm not trying to change the direction of the OP and previous discussions, but I have a burning question - I'm just curious: Why is it that there are nurses out there who want to become PAs on the one hand and PAs wanting to become NPs on the other?. I know this first hand. My cousin has been a PA in New York for many years now and she recently told me she was "thinking" about becoming a nurse then an NP. She is the second PA that I know of personally who has considered becoming an NP. On the other hand I have also heard nurses say they are "thinking of becoming PAs. I thought NPs and PAs basically do they same thing. I honestly just don't get it.