CJMR

I'm in the same boat as you. I am 8 months into my training and I don't like it. I'm going to try to stick it out until the 1 year mark but I don't see that changing things. I miss interacting with my patients. I feel like I'm losing clinical skills. Plus the bullying in my OR is the worst I've ever seen. It comes from every direction - surgical technicians, nurses, managers, physician assistants, surgeons. The only ones that are mildly pleasant are anesthesia and PACU. The flex nurses decide who gets breaks and when they will be provided. Since I'm new and not BFFs with the flex nurses, I don't get them while everyone else seems to get 4-5 per shift. I have to call a manager every day to beg for lunch. I've actually started drinking less water since I know I won't be able to pee from 6:30am until 2pm. I'm seriously considering going back to the floor. My boss won't like it, but I don't want to be miserable. They tried to get me to sign a 2 year contract when they hired me in the OR but I refused because it was one-sided (absolutely no benefit for me). They still hired me. I am expecting them to blacklist me hospital-wide if I do leave the OR. Because of this, I plan on leaving the hospital completely. I wish I would have never taken this position.

I actually caught someone red handed sitting in the break room halfway through eating my food. I confronted her immediately. This B had the audacity to say, "But I forgot to bring food and I'm hungry." I yelled, "I'M HUNGRY TOO AND YOU ATE MY FOOD! WHAT DO I EAT NOW?" Ugh. She looked like she didn't get it. Selfish. I made her give me $10. She argued that my basic lunch probably didn't cost me $10. I said, "We'll, it's costing you $10."

We have 2 patients to a room so at times it can be invasive. I work nights so at some time before the end of my shift I explain bedside report and ask if it's okay to do in the room, if they want me to kick out friends and family first, and if they'd prefer if I let them sleep. Other than that, I like it because I prefer show-and-tell. It's easier to know if you have a neuro change if you talk to the patient at the beginning of shift. And I've had 3 different occasions where I've called a rapid as soon as I walk into the room and had to transfer the patient to the ICU. One was in DIC and the outgoing nurse somehow didn't think that bleeding from every orifice constituted an emergency. We use a 1 page printed SBAR and I always update it every shift. I prompt the oncoming nurse to read that as we are walking down the hall into the patient's room. I can usually give report on 5 med-surg patients in 15-20 minutes.

I did this. I knew I was moving to another state after graduation. I took the NCLEX in my home state, got licenced there, then transferred my license to the new state. In retrospect I wish I would've just applied directly for the state I intended to move to since I had no intention of working in my home state. Initial licensing was quick (within 12 hours of taking the NCLEX) but the transfer took over a month.

At my facility we are given an SBAR with all pertinent information and we do bedside report. I update my SBARs every single shift with a narrative that has a very brief but concise history, treatment, and plan. I also clean up orders every single shift. I will give a brief rundown of my assessment but the oncoming nurse will do their own assessment when I leave so we are not doing it together at the bedside. If they forgot to tell me something re: assessment, I will find it during my own assessment. The oncoming nurse should also go straight to the source to review orders rather than getting them in report. If I do these things it takes me very little time to give report. I am out the door on time almost every shift. That being said, somehow there are nurses on my unit who take forever to give report and despite multiple attempts to help them cut the fat, they still can't do it. I think your facility has a few policies in place that slow report. If you have to wade through outdated, irrelevant orders to find the "real" orders, that is a problem. Both physicians and nurses are mandated to delete outdated orders at my facility to reduce mistakes. Most of the time the nurse does it, but if it is done every single shift, there are typically very few outdated orders getting in the way. And if the SBAR is used effectively and updated every single shift, you know you can rely on it to pass information so the nurses will know to read it before report, thus shortening report significantly.

I always look at the worst case scenario in every situation. I know my docs and I know how the situation will likely play out. If I call a surgeon at 3am not only will I NOT get the order, I will get yelled at, I will get complained about to management, and worst of all some poor patient is going to get surgery performed on them by a sleep-deprived surgeon. If I don't call the patient will be mad, they might complain about me to management, and they will take a vitamin a few hours late. So the worst thing in this situation is a sleep-deprived surgeon performing surgery because I woke them up for a vitamin. That is where I will rest my argument with the patient and with management if it goes that far. Surgical mistakes happen and sleep-deprivation is more likely to make them happen and if the patient doesn't like that...if they are so selfish that they can only think of their damn vitamin and not the other patients then screw it. It's not my first time at the rodeo and they cannot out-argue me on this issue.

I've found the area hospitals to have really open HR departments. If you call with questions they will typically give you exact figures.

Scottsdale Healthcare will hire new grads into med-surg or float pool (only floating to med-surg for the first year). There are a ton of applicants but do they hire throughout the year. There is quite a bit of turnover in med-surg and experienced nurses rarely apply for those positions. New grad supply and demand changes year to year so the picture could change by the time you graduate. Also, the starting pay info posted above seems accurate. Shift differentials as of Fall 2014 are $1.70 for weekends, $4.25 for evenings (working 4+ hours past 3pm), and $6.75 for nights. Comparing hospitals in the Phoenix area to Scottsdale Healthcare you will find Banner hospitals pay less and don't give raises, Phoenix Children's pays less but their nurses are really happy, Dignity pays more, and Mayo pays the most. If you work nights Scottsdale has the highest night shift diff and best night nurse/patient ratio.

All you are feeling is completely normal. I am 2 years into med-surg myself. The first 3-6 months I got anxious on my way into work. I felt like I was just barely keeping my head above water. Then things very gradually got easier. At 1 year I felt like I had grown and learned so much. At 2 years, even moreso and started to precept students. You will be amazed when you look back how much you learn in your first year or two of nursing.

As a med-surg nurse you will learn within the first year to set limits, not get walked on, and not believe everything a patient says. You will also get experience with psych patients. Is suggest staying in med-surg full-time at least 1 year, 2 if you can tolerate it. It really does build up your foundation nursing skills that you will use in any specialty.

At my facility when a patient is NPO it is the nurse's discretion what to give and what to hold unless the physician specified. I typically give all cardiac, seizure, diabetic, and similarly important meds. My hospital has pretty detailed protocol on diabetic meds so there is never a question as to what to do with those. They also have a policy to never hold any beta blockers for any procedure or surgery. Even if the physician says "hold all meds" we are still to continue those. I'll typically call and remind the physician that the patient is on a beta blocker and it will be continued, per hospital policy. I hold blood thinners, vitamins, probiotics, etc. Then I continue them after the procedure if they are up to it. The blood thinners I will ask the physician to specify when to continue.

My hospital recently changed policy. There is no longer on call pay but they only expect a nurse to be available for 4 hours. I think it's a nice trade-off. On my unit we make a list of people willing to go first if there is low workload. Usually that is sufficient but if not, they go by who hasn't had it the longest.

My behavioral health nursing professor told my class the same thing in nursing school. She didn't have any research to back it up but I did wonder. Personally, I had a very bad childhood. I was abused emotionally, physically, and sexually. Addiction runs in my family and quite a few members are alcoholics, drug addicts, or both. My father left when I was a baby. My mother has been married and divorced 3 times. Thankfully, I have been pretty resilient. Though I did move to the other side of the country as soon as I could so most of my family drama doesn't reach me anymore. I have no idea if my childhood had anything to do with my decision to become a nurse.

In my area when a patient dies the staff collectively makes sure at least one staff member goes to represent the staff at the funeral. They put it on the calendar and compare schedules to see who can make it. I don't see it as stepping over the line at all unless you feel your presence would somehow upset the family.

I can't imagine how depressing that must be for you. Someone who went to my school and graduated in 2008 and took the NCLEX every time she was able to and just finally passed at the end of 2011. And she found a job right away while I'm still looking! I don't know what kind of personality you have, but some people get into pharmaceutical sales. Some large corporations have employee wellness programs and hire people with nursing degrees. I wish you the best of luck.

The pop-up was accurate for me and the 10 or so people from my class that also tried it. I know one person who failed and did not get the good pop-up. As far as how long it takes to get your license number, a classmate of mine had her number as soon as she got home from testing. I took mine at the same testing site at the same time and mine took about 24 hours. Another classmate had to wait 1 1/2 week for hers to come up. She also tested at the same location but a week earlier than me. There doesn't seem to be any rhyme or reason to how long it takes. I'm not sure if it makes a difference, but I am in Indiana.

I'm about to graduate and I've never once been asked in person or on paper if I have HIV. In my physical they were concerned with TB, hepatitis, and vaccines (MMR, Tdap, influenza).

I haven't been in your position but I was in your son's position. My father was abusive to my mother in the same way. My mother left my father when I was 5 and my brother was 2. She rented a home in a bad part of town because that is all she could afford. She waitressed midnights and went to nursing school during the day while my little brother and I were at school or daycare. We were in the headstart program which provides daycare to low-income families. We had friends and family babysit us while my mother was at work and we were sleeping. It was rough by my mom is now a nurse and is financially stable and independent.

I think when dthfytr said NM he is referring to the U.S. state New Mexico. In the states we tend to refer to each state by two letter postal abbreviation when writing.

I'm confused. I guess I just didn't realize that it was not common practice to have the diagnosis for each drug prescribed. As the nurse, don't you have to monitor the patient for a therapeutic effect? If you don't know why the patient is taking a drug, how do you even know what you are monitoring? How do you know when to recommend to the doctor that the dosage may need to be adjusted or the medication should be held? It seems reckless to just give a med simply because it is written on the paper with no knowledge of what it is treating.

I too notice a lot of women will walk right through without even acknowledging the person who held the door for her. So weird. I don't care who it is or how many people are walking through at once, I always say thank you. I say it extra loud & friendly if a little boy is holding the door for me. I just think that is the cutest thing.

I am in an accelerated program. Definitely check that your classes transfer. Just having a degree was not enough for my school as they had specific requirements of what classes had to have been in my first degree. As the poster prior to me stated, most schools have a time period after which your credits expire for certain credits. My school doesn't take anything older than 7 years for math and statistics, 5 years for sciences, etc. Other schools may have even shorter time periods. You may also have to take pre-requisites in addition to your first degree. At my school I had to take microbiology, 2 semesters of anatomy & physiology, chemistry, biomedical ethics, and 2 more semesters of psychology. I had to do this before I could even apply to the accelerated program, which is highly competitive. So I could have wasted that year and all that money had I not been accepted.

Looking at nationwide statistics isn't going to give you a clear picture of hiring in your general area. When I started college for my first degree all of the news sources said there was a "nationwide shortage" for financial analysts. In reality, there was a massive shortage in New York City and minimal job demand in the rest of the country. I didn't know this at the time so I picked finance because of the shortage and excellent pay. Fast forward to graduation day and the recession had already started. It was not official yet, but of course it started in the financial sector so the jobs were already affected. There were massive layoffs and I had no experience. I was lucky I found any job at all but the one I found was ripping me off. They knew I had no other options available so they worked me like a dog. No job security, crappy pay, and I didn't like the field nearly as much as I thought. Long story short, don't get into ANY field because you think it will pay well or because you think it will be easy to get a job. Get into a field because you are sure it will make you happy and fulfilled. Ignore the BS and think of how you will feel every day about your job. Will you feel like you made a difference, did a good job, are proud of yourself? Those are the things that should really drive you when you choose a profession. Those things will reflect when you are job hunting and interviewing. You can't fake passion.

It doesn't matter what I do, I'm getting a B. Nursing is my second degree and in my first degree I had a 4.0 GPA. When I started nursing school I read everything, attended every class, took notes, and studied diligently and got all B's. Then I got sick and was zonked out on meds for a whole week, didn't read, didn't go to class, and didn't study and this was a week before finals and I still got all B's. So now I don't bother with breaking my back. If I read, great. If not, I don't sweat it. I usually attend class but some days I'm just not in the mood. I try to understand the broad concepts, how the drugs work, and I always go out of my way to try tie in clinical with what we are learning in class that week...I try to put a face on the disease we are studying. And I'm still getting B's. At my school we don't get the luxury of slow paper tests. Our tests are online and we only get 1 minute per question, even the multiple multiples (select all that apply) questions. So you barely get enough time to think through. You either know it or you don't.

At my school it is customary to have a potluck on the last day of clinical. If I were you, I would talk to the rest of the students in your clinical and each bring something. Then you can all sign a card to give to the instructor. If the instructor was really good you can include a gift or giftcard that the whole group contributed towards. If you are the only one that gives your instructor something and you didn't forewarn the other students, they might feel like you made them look like jerks because they didn't think of gifting.