Megsd

My starting salary was $22, which seems to be about average for Dayton, unless you're looking for peds (which pays less)

When I did psych clinicals my friend had a pt who had been in ICU for an attempted OD before being sent to psych. One day he told the nurses he was going home to have dinner with his wife because it was their 40th wedding anniversary. They all smiled and nodded. Suddenly, the patient was gone. They searched all over. Then he came back about 4 hours later. When interrogated, they found out he had actually gotten dressed, taken out his IV, rode the bus home, ate dinner with his wife as promised, and then came back. And my last quarter of school I helped take care of a very troubled 18 year old who was admitted for a possible head/spinal injury. He was brought to the hospital after falling off the roof of a house he was breaking into. During the course of his stay, he escaped the hospital twice. One time he was found a mile away in nothing but his hospital gown. The second time, he was found a few blocks away trying to break into another house.

Can you chart in the control room periodically? That's where I computer chart when I travel with pts to MRI.

While I think a year of med/surg can be valuable, post-partum jobs can be hard to new grads to snag, so that's awesome that it was offered to you. If that is your passion, I would take that position. You would still get experience with juggling multiple patients, and many new moms have underlying health issues you'd be dealing with as well. If that's not what you really and truly want to do, though, perhaps a more general floor would be a good place for you. Try to think if there is a certain body system or patient population you found particularly interesting (I love hearts and brains, but HATE GI stuff, so I took a job on a Neuro unit) that would help you find a good fit.

One other tip, take the tourniquet off the arm before you flush the IV, otherwise you might blow the vein. Been there done that.

My first week of working an a RN I was participating in an internship and my preceptor and I had this fellow who was postop. She and I were both in the room when he started to vomit. I don't even know what happened next, but somehow I ended up WAY in the far corner of the room, by the window, a good 10 feet from my patient, and my sweet preceptor just looked at me and said "Uh, this.. is your patient. You might want to get over here." I was super embarrassed! For me it's a sound thing, and a smell thing. I'm a sympathy puker. I just try not to think about it and focus on the task at hand. And I'm pretty good at avoiding breathing in and smelling things when I have to.

Ha. Heaven forbid she has to assess her patient!

LIST IT. I don't know about the issue of pulling your license and seeing your jobs, but the nursing community is smaller than you think, and they will find out. I would just say, when asked, that your current job isn't a good fit, that you've decided you'd rather work with X patient population, etc. A friend I graduated with went to work at a hospital, stayed about 3 months and quit. He then applied at another hospital (in the same hospital system, at that) as a "new grad". He didn't mention the old job at the interview, figuring since he had only been there a few months it didn't really matter. He was publically removed from his orientation at the new job and fired on the spot because he lied on his employment application about not working as a nurse at the other hospital. He had a very hard time getting another hospital job after that, and ended up in LTC.

Priming them isn't too bad. Just remember to "wedgie" the tubing into where the air indicator is, and make sure the tubing isn't stretched out so it will infuse properly. I find the guardrails very easy to use, not as much math involved for me. We started using the PCA module recently as well, and the pt button lights up green when the medication is available, so patients like it better as well.

I think alcoholism is many things. I have many alcoholics in my family, but my mom is the current active alcoholic. While the initial drink was certainly a choice of some sort, alcohol is so embedded into my mom's life that she can't even tell what damage it has caused. My mother has chosen to buy bottles of wine instead of food, for weeks at a time. She needs a drink to be comfortable in social settings. She needs a drink to fly on an airplane. She needs a drink to "tell me how she really feels." My mother cannot function without alcohol because she doesn't know how to. It is her friend, her crutch. Alcohol participated in my parents' divorce (partly because my dad quit drinking and she didn't), and permanently damaged my relationship with her due to her inappropriate outbursts. People have talked about the rock bottom thing -- "Oh, when things get real bad, then they'll see, and then they'll quit." I'm waiting for rock bottom. I thought it would happen when she got evicted from her condo and declared bankruptcy, but then she just stayed with friends and drank their booze. Her friends pity her and feed her, so she still has the money to buy alcohol. She tried to work an 8 hour job but the withdrawal was too painful for her to go that long without drinking. I don't know what's going to happen to her, but my mom is a very smart woman, and I doubt she chooses to live this way.

I'm kind of similar. I have no game face, my coworkers apparently think that I can't hold it together in stressful situations. I try to handle everything myself, perfectly, and before I know it I'm up to my eyeballs in stuff to do. My advice (that I am trying to work on myself, too): BREATHE. You are new, and you are only one person. Use your resources. On my unit we have a "buddy" who covers our lunch report and also acts as our first line of help. Ask them to help you with things, especially if they offer. Don't overwhelm them -- they're busy too, but they can certainly give someone a pain pill if you're stuck in an isolation room. EAT LUNCH. Most things can wait until after lunch. Leave work at work. Don't read P&P on your days off. Go do non work-related things. Read a novel, watch a movie, go for a walk. I still dream about work every night after I work, but that is improving. Relish your small victories. Did you finally remember the process to send a pt to surgery? Did you get a positive response from that usually cranky doctor? Did you get to lunch on time? Pat yourself on the back. :) Take a moment to realize all the things you learned today. These things will make tomorrow a little easier. And when stuff hits the fan and all you want to do is break down, sit down, alone, and breathe for a second and collect yourself. Go in the bathroom, go in the med room, think about what you need to do to be successful, and when you are calm and collected, you can emerge and do them.

Personally, I don't care about working weekends because I like the slower pace and the extra money. On my unit we finally have enough staff that people who have been there for two years or more have been switched to every third weekend. And you know what? I have heard a lot of them complain about it because they are missing that extra bit of money in their paychecks, and they don't have as many weekdays off. As for the point about whether we would have to work such horrendous hours if it were a male-dominated profession, I present to you: the fire service. My fiance is a firefighter, and his department (along with most departments I am familiar with) works a 24-48 schedule. So he got to work this morning at 7am, he will leave tomorrow at 7am, and he'll be back on Saturday morning at 7am. So only one out of every 3 weekends does he have the whole weekend off. With my schedule, if there's something going on while I'm at work, at least I can catch the tail end of it when I get off. He misses the whole day. Not to mention, he is on call all the time, 24/7. He has had to go into work suddenly while we were at a wedding, during our Valentine's Day date, during Christmas dinner, and at 2 in the morning. Sure he gets to sleep and get paid, but sometimes he's up all night, sometimes he gets home several hours late, and if he trades with someone to get time off, he may have to work 48 hours straight. Fortunately, our schedules work for us, because he always gets two days off in a row after he works, so it's always a "weekend." And sometimes our schedules match up and we have days off together. I'm not saying that a nurse's schedule is wonderful and works for everyone, but I'd sure as heck rather work my schedule than his. Perhaps male-dominated professions are not so progressive sometimes either?

One trick is to put your roll of tape on your hemostats, clip your hemostats to the bottom of your scrub top, and put your scissors/shears through the tape the other way. And yes, cargo pants rock.

1) How quickly did you take the NCLEX and get your license? I graduated 11/17, got my ATT 12/6, and took my NCLEX 12/26, and started working 1/21. I think I got my license in the mail the first week in January. 2) How quickly did you find a job? As your first nursing job, what kind of nursing did you do? I was hired by my hospital in October. I work on a step-down neuro unit 3) Did your employer help with school loans? How quickly were you able to pay off you student loans? My program was kind of different and my employer actually offered me a stipend in exchange for full time employment. I would STRONGLY urge you to ONLY accept a contract for loan repayment unless you are 100% positive you will LOVE working for that employer, because being stuck at a crummy facility bites. (I love mine, but I know people who have been very upset about contracts) 4) What kind of classes are you taking for your required credit hours? How many credit hours are you required to take once you get your license? In Ohio I need 24 credits every 2 years, but none in the first licensure period (only once I renew). As part of my hospital orientation I racked up just about 24. Every so often my employer offers credits, which is awesome because I get paid for doing them. :) 5) How often does an RN have to renew the license? Every 2 years 6) Has it been difficult to balance working full-time, taking classes, and managing your home life? The difficult thing for me has been being exhausted after a 12 hour shift and being unwilling or unable to do things like cook, clean, etc. The "classes" are really no biggie. There isn't usually anything to study (except ACLS) and sometimes not even a test. It's just sitting in a room learning about things that may or may not interest you. And to clarify your last question, while you can "get a job" before you take NCLEX, in most states, you can't actually WORK until you have your license. My employment was contingent upon me passing NCLEX by a certain point so I could attend orientation. I had to let them know when I passed so they could verify my license and then officially offer me the job.

The issue with lab draws only exists if the person has fluids running because of the risk of diluting the sample. So our lab people either draw in the other arm, or ask if we can pause the fluids for 5-10 minutes before they draw. I always start distally too, and we only use the AC as an emergency access if for no other reason than when they bend their elbow, the IV pump alarms and drives the patient and staff crazy!

Yeah the only time I will mention test results is if a test is normal or negative and I am 150% sure I understand what it means. If a head CT says "no acute injury" I feel comfortable saying that, but if it says "signal alteration noted with increased mass effect" I say... "I'd rather have the physician discuss those results with you." I know patients and families get frustrated waiting for test results, especially when those are what are holding up a discharge, but I'd rather not misinterpret a test that could make a difference in their outcome.

I've been off orientation for about two months now and I tend to clock out 10-15 minutes late most days. I've had to stay 30 minutes late twice, due to some issues that popped up right at shift change that I didn't want to stick night shift with. I get paid for my time I stay and only go into OT over 40 hours a week. The only time I've gotten OT was from picking up extra, not from staying late.

Yeah, this woman had been getting blood draws every 6 hours for 4 days, and not one lab tech had called me to tell me how rude my pt was until now. I wonder if she does go to the ICU if those nurses will get calls like "Um, can't your patient take that tube out of their mouth for just a minute to tell me their name and birthday?"

I thought this was hilarious.. hopefully others will too. :) I work on a neuro step-down unit, so we deal a lot with people who aren't in their right minds for one reason or another. Most of the ancillary staff realize this is part of dealing with neuro patients, and they are prepared. Anyway, I had a pt who had a massive stroke and is completely aphasic, but she is alert and is able to move all 4 extremities. She was on a heparin drip and needed a stat APTT drawn. I got a phone call while I was in another pt's room, which went something like this: Lab: "Um, hi. I'm trying to draw this APTT from 27B, and she's totally ignoring me. She didn't even acknowledge me when I came in the room and she won't even tell me her name!" Me: "Well, that pt had a stroke and is aphasic. So.. she's not going to say anything." Lab: "Well. The LEAST she could do is tell me her name." Me: ".... she had a stroke. She can't talk. She can't tell you her name." Lab: "Well I can't draw her blood until she tells me her name. So do you want me to draw this blood or not?" Me: "Yes, she needs the blood drawn. But she can't speak." Lab: "Fine, whatever. " I've never had anyone be so insulted by an aphasic pt!

As a new nurse, my least favorites are "new admit" and "learning opportunity" which usually either means I have messed up somehow and get to learn from it, or they're making me do something really difficult/complicated that no one's taught me to do yet.

During my orientation I had a wonderful, sweet preceptor, who always tried to make sure I had a good day and didn't feel overwhelmed. She would call me frequently (esp. when I had the whole team) and ask if she could do anything to help, if I felt comfortable, etc. It was nice, and wonderful, but I knew (luckily) that once off orientation I would have some bad days, I would feel overwhelmed, and I felt I needed to figure out how to muddle through that (in a safe manner, of course). I feel like had I not forced myself to be overwhelmed every once in a while, with my preceptor as my safety net, I would have been a mess once I got off orientation. Anyway, moral of that novel.. I'd also encourage her to step up the patient load, experiment with some time management techniques. Be there for her, offer help and advice, have discussions about what is going well or not going well. This may sound weird, but I think orientation is the best time to get in over your head (a little bit, anyway), because you do have that safety net of your preceptor to work with you to figure out how you could handle that situation better.

I've never seen a surgery. Not even in my OB clinicals -- none of my pts needed a c-section or anything. Vomit is the thing i can't handle. I'm better now, but the first pt I took care of during my orientation who vomited, I somehow blanked out and when I realized what was going on, I was way in the corner of the room! Had to give myself a pep talk to get back over to the pt and help him.

My grandma's boyfriend (man that sounds weird to me) is a podiatrist. He went to med school in his late 40s or early 50s after he retired from the military. He wound up in podiatry because, according to him, it was the only program that would accept someone that old. He's in his 70s now.

Pardon me for tooting my own horn, but I'm really excited. I've been off orientation for about 4 weeks now, and I have had a string of bad days. Not the whole day has been bad, but good 4-6 hour stretches of time have been really hard, or complicated, or upsetting. Tears have been shed, frustrations have been vented. But not today! I started out worried because I was caring for a pt who had been on our floor for a while and was known to be very agitated and uncooperative. She was frustrated and upset for me, but I tried to focus on what I could do TODAY, which seemed to placate her for the time being. I used my therapeutic communication skills, took time to listen to her during my assessments, and she and I got along pretty good. I also had a pt who was going to surgery for a craniotomy. I had never sent a pt to surgery before, nor had I had a pt with feducials.. which I still don't really understand what those are for. But the offgoing nurse did show them to me and pointed out not to remove them (I don't know why anyone would want to). I managed to figure out the preop process and had all necessary paperwork ready to go on time. I also remembered to clarify which meds she could and couldn't have before she went down. Because my pt was in surgery, I was technically down a pt, so I got an admission. I had not gotten a full admission before. So I gathered all my paperwork, got all the paperwork completed on time, finished all history questions with the help of her family and gave all her medications that came up from pharmacy. All of my charting and meds were done on time, my admission was complete well before the next shift got there, and I had time to help a few of my coworkers out. I went to lunch on time, I even made it through almost an entire staff meeting. I was Super Nurse! I don't know what tomorrow will bring, but I feel really good about how I did today. All my coworkers kept asking if I was doing okay, and I was so glad to finally say yes.

Totally agree with this. I feel like every day I am confronted by some new order or procedure or diagnosis or policy I've never seen or heard of. But I ask questions and figure it out. Last week I took care of a pt with a nephrostomy tube (which we hardly ever get on a neuro floor) and I had to figure out how to flush it. It took asking 3 different nurses, but someone taught me how. Today I got a frantic phone call from a nurse with a few years' experience, asking me if I could show her how to flush her pt's nephrostomy tube, since she remembered I did it last week. So in a week, I went from being the clueless one to the person with the answers (at least on one topic)! And it showed me that sometimes my more experienced coworkers still are confronted with new things too, and also need help to learn.