Tarabara

I just googled "federal resume" and looked at templates then chose one that i liked. The biggest difference between federal resumes and regular resumes is that federal resumes are very detailed. You dont have to try to keep it to one page, include all of your experience, but keep your statements succinct. As a new grad, I included my previous work at old navy and H&R block even though its not medical but i only wrote a sentence or 2 on each. Include as many numbers/outcomes as possible, for example under my VALOR nurse extern experience I put, "assisted up to 27 patients with activities of daily living on a med surg/oncology unit." As a new grad I did include my clinical rotations since I didnt have much other medical experience, I had a section titled "clinical experience" with each hospital I went to, their units, and a sentence about it. For example, "Med/Surg Rotation, Carl T. Hayden VA Medical Center, 72 hours I observed and assisted with nursing care of up to 5 patients on a telemetry and PACU unit, including assessment, charting, and medication administration. The other thing to know is to include as much as you possibly can from the job announcement into your resume. As long as it makes sense and applies you can literally copy and paste sentences from the announcement into your resume. This will help it to get through the auto HR process to be seen by managers. Good luck!

Did you send your resume directly to the recruiter or did you submit it through usajobs? Make sure you submit all job applications through usajobs. All applications go through an automatic filtering process where they see if you have the basic qualifications before HR/managers even see your application. Therefore when you write your resume directly reference things they're asking for in the job posting so that it makes it through that auto process (you can even copy it word for word if it makes sense). I would write simple succinct statements that include numbers/outcomes. They're not looking for "fluff" like the fact that you love working with patients, instead just say simple "care for up to 4 patients on a 14 bed telemetry cardiac focused unit". "Provide pre and post cardiac cath care, assess and work up patients with ACS, prepare patients for LVAD and heart transplants". Certified in BLS, ACLS, PCCN, PICC placement, and moderate sedation. Member of the nursing Professional Standards Board. Keep the resume simple and short, you just want your resume to make it through HR because policy is all qualified applicants get an interview. Then you can explain your accomplishments in more detail in your interview. Don't be too discouraged yet, things take a long time with the VA, it is government after all í ½í¸›And often job postings are listed for 2+ weeks and they won't even begin to look at them until the posting is closed. Hope this helps, good luck!

I work on a tele unit and we mostly have patients who come in through the ED for chest pain and require work up- trending trops, stress tests, or angiograms and we prep and recover post angiogram (post op vitals, checking groin/radial sites). Or for heart failure and require diuresing. Or for arrhythmias that require cardioversions, med drips (diltiazem), or devices like ICDs/pacemakers and we prep and recover those post as well. We also take care of patients who are being worked up for possible heart transplants/LVADs.

Unlike the NCLEX, I felt the PCCN test was actually pretty straightforward and had logical questions. I don't remember which book exactly I used for practice tests but I know I rented it from Amazon which was nice because it was much cheaper and they gave me plenty of time to mail it back. I also stumbled upon these reviews online that outlined info from all the topics in the test outline perfectly and made my own note cards from them. The site is: http://www.aacn.org/wd/chapters/ChapterDocs/00312493/Websites/Images/209%20Pope,%20B.%20CCRN-PCCN-CMC%20Review%20Cardiac%20Part%201.pdf That is just the first one, if you google "certification review Barbara pope" you'll find a bunch more. Good luck!

Whenever drawing labs I always grab enough stuff to stick twice because if I grab just one butterfly Im sure to need the second! And never remove the IV until discharged papers are signed, the ride is there, and they are ready to walk out the door!!!

Thanks for your responses, sorry I should have included more info. The patient does not have kidney disease, his low hgb and hct are suspected result of GI bleed. Therefore if he has a GI bleed I would think he'd be volume down?

I cant seem to find the answer on google. Any info would be appreciated! Thanks :)

Not to worry you but organization and time management are definitely skills you need as a nurse. You'll of course get better and faster at tasks with experience which will help, but I would work on being able to group things together and trying to plan ahead to organize your time better. Just as an exampe, if you know your patient has labs that need to be drawn at a certain time and they need their IV changed that day, you can wait to change the IV at the time of labs so that you can do them both at once (and save the patient from an extra poke). Or if you know lunch trays come at noon and therefore you'll be doing finger sticks/giving insulin around that time, dont start a dressing change at 1145. Thats why I write down everything! At first I kept telling myself "oh i'll remember that" but then I kept forgetting things and feeling unorganized so now I write down everything. Keep working on it, you'll get better :)

I have worked at VAs in two different cities and it can definitely depend on the specific one. One I didnt like much and the other I love now! They all have their ups and downs though, there are definite draw backs to working for the government but the benefits are amazing and it truly is a joy working with the vets.

Thanks everyone! Jarhead, I'm sorry you're work situation isnt supportive. I'm lucky to work with a great group of people who I can always turn to when I have questions. What about the nurse who trained you during orientation? Do you feel they can be a source to go to? It may sound obvious but I guess I would advise to always double, triple, quadruple check everything, dont get complacent and chart to CYA. I wish there was something better I could tell you :/

I officially have 1 year of nursing under my belt :) I know I'm not seasoned yet but its exciting to look back at all that I learned this past year and think about all there is still to learn. I've met so many amazing patients this year too who have touched and inspired me. I wont lie, even as a new nurse I still feel burned out every now and then but overall I'm so excited to have many more years of nursing ahead of me. We have the best job!!

Group as many things together as you can. For example, its now a habit for me to check if my patient needs more water or another blanket or anything if I'm leaving the room for something else so that I can grab all things at once. Also, our policy is we have a 1 hour window before and after med times to give the med. So if the pt has an 1100 and a 1230 med I can give them both at 1130 and save time. Also write down EVERYTHING, don't just assume you'll remember. That's something that I had to learn.

Sorry forgot to add, dont wait until you graduate to search the job market as you said. I graduated last December but started applying for jobs in august, most will post new grad residencies months in advance.

I'm from Arizona but now work in salt lake city. I had no ties to az either and applied all over the country. I'm so glad I did! I love it here and there's so many new areas to explore/learn about that its a ton of fun. Go for it! The VA system is great because your license is good anywhere, I still have my AZ nursing license even though I'm working in utah.

Just a few tips: In school I was taught to anchor below the vein and go at an angle, I always failed that way. I find it much better to anchor above the vein and go at a very shallow angle. Make sure once you get a flash do not let go of your anchor! Hold your anchor while you advance the needle and catheter. If the vein moves after you puncture, its ok. If you can feel that you're right next to the vein just pull back slightly (but not completely out of the skin) move over a bit and advance again. I know that I personally hated the idea of "fishing" around with the needle when I was a student. But you're not doing it blindly, I only do it when I can feel that i'm right next to the vein and only need to move slightly. Take your time finding veins. I will sometimes feel arms for 20 min trying to find the best vein that I am most comfortable with. I would rather take extra long feeling than poke several times. And as much as I hated hearing this as a student, its true that you really have to get used to the feel of veins instead of sight. Feel your friends and families veins all the time. The best ones are usually felt not seen.

NP- nurse practitioner PA- physicians assistant APRN- advance practice RN RT- respiratory therapist PT- physical therapist OT- occupational therapist HT- health tech (aka CNA)

I enjoy having students unless they are more concerned about getting info for their care plans than actually just absorbing and learning as much from the day as possible.

That was probably one of the worst parts about nursing school was the constant overwhelming feeling in the back of my mind that I should be doing something. I too could never truly enjoy any free time and always felt guilty. I'm sorry I cant really say anything to make that feeling go away but know that you're definitely not alone. And once you're finally done you'll appreciate your free time so much more!

Well to start there is no "regular" day for a nurse. They are all different. But as a guideline I start the day with getting report from 730-8am. We have an hour window before and after med times to give them so I start my 9am meds at 8. I go into pt rooms and say good morning and introduce myself, take vitals, see if they have any immediate needs, and give meds. If things are going smoothly I will also do my assessments during that time. This will usually easily take me to 10am to do all that will all of my patients. I will then check orders as we are required to check them at least every 2 hours, I check labs/pertinent pt info at that time as well. If there's nothing immediate to do I will then chart. That usually doesnt happen though, there's almost always new orders or appointments I need to get patients to like xray or dialysis. I also like to round with the docs whenever I can so I try to do that while completing the other stuff. So its actually more like 11-1130 before I can begin to chart. I'll chart some and check orders again. Usually lunch comes about noon so I go check blood sugars and give insulin or help set up trays. Most patients have 1300 meds as well so depending on what it is I'll give that with lunch or after. I like to wait till after for IV meds so they're not hooked up while trying to eat. Then again check orders, as I work for a teaching hospital with docs there all day long orders trickle in all day instead of just in the am. After everyone is settled with their lunch, 1300 meds are done, and if I dont have any new orders I will take lunch. So its usually about 1500-1530 after lunch and I will check on patients, check orders again, chart if i still need to, etc. Most of the time there's not another med pass until 1700 but there's always something that comes up that patients need like pain meds, dressing changes, straight caths, etc. Plus I can get a new admit or discharge patients at any time of the day so if that comes up I have to work that in too. Then 1700 dinner comes and its another round of blood sugars/insulin and possible IV meds after dinner which takes me up until 1800-1830. Its usually quieter after that for the last hour before 1930 report to night shift. Unless of course I get an admit at that time or something comes up! I'm very fortunate that I work with an awesome group of techs who really take care of the patients. Our patients who are on q4 vitals (which is most) get them done at 0600, 1000, 1400, 1800 and the techs will do them but its still my job to make sure they were done and to check them. They will also check blood sugars but again its ultimately my responsibility to make sure they're done and wnl. They also are very good about making sure patients get showers/cleaned up but once again its my responsibility. So if we're short staffed with techs all that falls on me and I have to make time for it as well as everything else. Thats why time management is so critical in nursing!

I thought it was the cheesiest thing when I learned it but it really works. Repeat back to them what they've said. Pt says "I feels so frustrated because something something." You say something along the lines of "it sounds like you're frustrated". Most of the time they'll say "yes! i'm so frustrated because blank!" and they'll keep talking on their own. It can be hard though because sometimes there's just really nothing good you can say to make them feel better. In those cases I will usually just ask them if there's anything I can do for them or if they'd like to be left alone for a bit and remind them I'm there if there's anything they need. You can also offer to ask for a chaplain to talk with them if they'd like. For patients that are nervous/anxious about a procedure or something like that I will remind them that they have the right to refuse anything and to ask as many questions as they need to feel comfortable. Its good practice to always explain what you're doing as you're doing it anyway, but its especially important for nervous patients.

I'm a new grad and my only experience is with the VA so it's hard for me to compare. But what I do know is that both VAs in Phoenix and salt lake city didn't have a step down type unit. There's a telemetry floor which kind of functions as a step down but really their acuity guidelines are barely more than the medsurg floor and as the medsurg floor is much bigger we get a lot of those patients anyway. VA hospitals aren't level I trauma centers so usually the very severe traumas are sent out to other hospitals. Therefore I would recommend going for ICU. Not to say we don't get some seriously ill patients but if you want more critical care than medsurg go for ICU. The biggest difference I know of is that's it's government so everything is mon-fri 9-5. If you need something done on the weekend you'll most likely wait till Monday which can be a pain. (unless it's an emergency) For example, if you have a patient that no one can stick and needs a PICC line but it's Friday night, well that patient is most likely waiting till Monday to get it. Therefore patients end up staying much longer than in regular hospitals. The biggest positive for me is knowing my patients will get whatever they need. It was really hard for me as a student to see pts who needed something but didn't get it due to money and to send them out knowing they still have unresolved medical issues. I don't have to worry about charging out things I use to the patient and I know their needs are met. (there are always exceptions of course). Plus it's very rewarding taking care of our vets, there's a sense of comraderie as the focus is really the best care for them. :)

Part of the problem I think is that a lot of the jobs they list for a long time, like 2 months. So if you apply a couple days after they post the job you'll wait 2 months to hear anything. It shows on usajobs how long the job will be listed.

For some positions like ICU and ER they usually ask for experience. But for medsurg it's pretty much just have your license and be a citizen, and of course fill out a ton of paperwork

Is your comprehensive ATI for a grade or something? If not then I'm not sure why you're so stressed over it, for us it was just to give us an idea of how prepared we were for the NCLEX and areas to focus on for study. So it was a good thing, no pressure. We had to do the practice exams from previous ATIs though and I found those were the best study aid. In fact thats how I mostly studied for NCLEX, I did practice ATIs over and over.

My friend and I did our vital signs check off together and she couldnt feel my brachial pulse and started crying...now 2 years later we're both RNs doing well and we still laugh about it! Its such a hilarious memory now and a great reminder of where we came from. We all have to start from the beginning, you'll get it and then one day look back and laugh as well.