epinephRN

Instructors should maintain certifications and credentialing in their areas of expertise and teaching. Anything else is a waste of money and time. As mentioned before, how is requiring ACLS for a NICU nurse any more reasonable than requiring all faculty to have STABLE and NRP, including those who teach about the care of adults only? This doesn't make sense to me. As others have mentioned, BLS is a necessity. Other than that, instructors should consider certifications and credentialing appropriate to their specialty.

I agree, FMLA is fantastic for those who use it as intended. Can I also say: AlsgalRN, I think you're amazing.

Just keep speaking over her when she interrupts. She can hold her questions until you are finished. She is being extremely rude.

The part of your post that makes me most uncomfortable is that others have noticed this person's strangeness/inappropriateness to the point that they took you aside and commented on it. There are all types of odd people in health care, but the fact that others even pointed it out means something is obviously off. If I've learned one things as a nurse, it is to trust my gut. Please trust yours now.

Peer evaluation with a rubric, as Moogie mentions above, can be helpful in some cases such as rating contributions to a group project, etc. However, giving any type of access to another student's grade is a FERPA violation and should not be done. To get the benefit of group input, we allow the students to take a group test after they take their individual tests. This allows them to consult with their peers, make group decisions, and benefit from the knowledge of others. The group testing receives great feedback, and does not compromise the integrity of the exam or violate FERPA in the process.

I would rather work minimum wage than someplace like that. I couldn't adequately care for 165 customers at a RESTAURANT, more or less 165 patients whose lives are in my hands. I like my license too well to agree to that. I hope you will find someplace that is more reasonable to work soon.

I have been reading the thread on families adjusting to nursing school and was thinking that families also could use a positive but realistic "orientation" to what their SO/parent will experience in school. As a nursing faculty member, I am curious: What are your thoughts on this? Also, what topics do you WISH had been covered in orientation that were not covered? What can faculty members do to try to relieve some anxiety? Any suggestions for orientation ideas you enjoyed at your own nursing school orientation?

It isn't dealt with, unfortunately. Despite the fact that best practices show that nurses need debriefing after such events, it never occurs. It hasn't in any of the places I've worked at. I think this is one of the worst things about health care. I'm sorry you've been through such a difficult experience.

Research/evidence yes. Some nursing theories have value, but others I find laughable and completely divorced from the reality of nursing practice.

Tait, I couldn't agree more. As a nursing instructor who works insane hours trying to ensure my students receive an education that prepares them for real-world nursing, the only thing I refuse to replicate is the cattiness of coworkers and the general disrespect that nurses receive (from family, patients, administration, etc). By the time they graduate, my students: -always take a full load of patients -have learned that we aren't in "NCLEX world" and can prioritize -have good assessment and technical skills -can plan care in alignment with reality, not a 40-page care plan -are respectful I am tired of seeing everything laid at the feet of education. This is a multifactorial issue. It belongs to all of us. Managers- if you have created yet another form to fill out, not worked the floor in years, or are disconnected from your staff, you are contributing. Administrators- if you can't see that $18/hr is not enough pay when you hold someone's life in your hands, and refuse to pay for enough staff, you are contributing. Educators- if you assign excessive and unreasonable paperwork that is not based in reality, and overwhelm your students with content, you are contributing. Floor nurses- if you have rolled your eyes, sighed at, or made the "I smell poo" face at a coworker or nursing student, you are contributing. If you've ever acted like someone new should already know something or gossiped about a coworker, you are contributing. To all of us- if you aren't standing up for yourself and proper treatment, you are contributing. I personally have made many of these errors as a new nurse and a new educator. I have contributed. Most of us have! The important things is to change for the better. As we know better, we must do better. Stop blaming the problem on one thing or one group of people. It is so many things: low wages, understaffing, lack of time for self, emotional and physical stress, lack of resources, lack of legislative support, coworker mistreatment, etc. If we spent as much time trying to fix this as we did pointing fingers at everyone but ourselves we might have a solution. What is the future of nursing? I don't know, you tell me. This is a collective decision we all must make.

The most important thing to do, as others have mentioned, is to look at the dress code requirements for the school he plans to attend and the clinical sites where he would be placed, both in nursing school and as a CRNA. Here, students are not allowed to attend clinical with more than one small piercing in each ear (ex- a stud, not a hoop or a gauge), no visible tattoos, and no "unusual" hair colors. I am a nursing instructor and personally could not care less what piercings or ink my students have. It is a part of them and I respect that. HOWEVER- the clinical agencies make the rules. I have to follow them and so do the students. I would ensure your son is well aware of that and agree with the other posts that mentioned having him check these policies thoroughly before having his ears gauged. As others mentioned, he may be able to wear the flesh-colored plugs depending on the policy. You might have him consider the cost of plastic surgery to revise them if he changes his mind, and make him aware that he would need to pay that. Definitely not the end of the world, but as long as he is aware of all potential consequences, ultimately his choice.

I would like to ban rude visitors, small children who scream and play in the halls unattended, call lights, and smelly feet. Of course, many years ago my preceptor told me that if you remove the shoes for any unnecessary reason, you get what you deserve, lol. While I'm at it, can I just go ahead and ban spandex as well? Unless you are competing in an athletic event, it does you no favors. Just saw a rather fluffy woman recently in the ER with silver spandex pants and could have performed a visual gyne exam. And let's not forget the slippers as shoes. And yes, I did have a very, very bad night.

Ours is outside and we love it! In terms of infection control, a smarter move would be to limit visitors to two at a time. I was in L&D the other day and there were no fewer than 40 family members, all clamoring to "see the new baby" who couldn't understand why they couldn't all cram in the room at the same time. More handwashing, fewer visitors = less germs. We don't even have the basics down even after several hundred years.

Thank you all for the responses! I appreciate your feedback!

I agree with the above (wtbcrna); I also have several true allergies leading to anaphylaxis, but the problem with treating the patient as if all listed allergies are equally valid can lead to lack of appropriate care. For example, if I accepted the patient's "allergy" to oxygen that I mentioned in the initial post, this would have been quite problematic as the patient required a vent after surgery, not to mention that if the allergy was real, she would already be dead. I am also not referring to people who have not been educated about the nature of an allergy vs. an intolerance vs. "I just don't like it." I am referring to those who continue to say they have an "allergy" despite education. I have discussed why this is not a good idea and re-educated the mom of the frequent flier multiple times, but she continues to state the allergies unchanged. Also, it drives me crazy when people just don't like a food and claim they are allergic. Ex- a close friend hates onions, but tells others she is "allergic" instead of just saying at a restaurant "Don't put any onions in my food!" and sending it back if they do. To me, this really discounts those with true allergies that will DIE or become quite ill from exposure (such as my niece, who has a severe peanut allergy). My concern is that the people who exagerrate are like the "boy who cried wolf"- and I fear that those without a medical background will be less likely to take real claims seriously when this happens.

Does your school use dosage calculation software such as eDose, ProCalc, or ATI dosage calculations software? If so, what do you think of it? Is it easy to use and helpful to you, and do you take a calculations exam using this software? Also, does your school use clickers such as TurningPoint or eInstruction, either with a smart phone or with a separate clicker device? What do you think of these systems? Are they helpful and easy to use? We are investigating these technologies for our students and would love the feedback of any students who have used these systems. As an instructor, I only want to offer technology that actually benefits the students. Thanks!!

This may/may not apply to your situation, but I am a nursing instructor and it is painful when a student fails. It is difficulty to see someone's dreams shattered. Your instructor may seem distant because it is very painful to tell someone "I'm sorry, but you didn't pass." I can't speak for your instructor of course, but we have to set a standard somewhere. If we keep saying "Well, I will just lower the passing standard by a point," then what about those who fail by two points? Our syllabi are contracts, and it is important to stand by them. It would not be fair to make an exception for some students and not others. I wish you the best in your future career, whatever you may choose. Just wanted to present the information that most instructors really aren't sitting there rubbing their hands in glee when a student fails. The majority enter the field because they care about students and giving back to a future generation of nurses. Of course, there are always exceptions to any rule. Perhaps you could job shadow a few other possible positions in addition to nursing. Many hospitals offer this. It might be a great way to see if another area of nursing or another field entirely will spark your interest.

I live in a non-unionized, right-to-work state. It would be more accurate to call it a right-to-get-fired-unjustly state. I watched 30+ excellent nurses who had been with the hospital for 15+ years be "let go". Mysteriously, it was only those nurses who had reached salary caps whose positions were "downsized"- and of course no hiring freeze for new grads. I am not against new grads, but this led to all sorts of foolishness on the floors. The experienced nurses (i.e. valuable resources) were gone, the new grads took over, and those of us with a moderate amount of experience had to try to mentor many, many people. I love teaching, and I love mentoring, but where is the balance between experience and wisdom, and those needing training? It led to a vicious cycle where new grads could not be fully mentored due to not enough preceptors, and quit. A strong union would have stood up for the rights of those with experience. This would not have happened. In an attempt to save $, the hospital lost one of its most precious resources, it's experienced staff. Seeing where the cycle was headed, I went to work elsewhere. There are a few floors that still haven't recovered from administration's last brilliant cost-saving strategy. I would hop on the union bandwagon so quickly if it existed in our state.

I would do as others have suggested and check policy and bring this to the attention of her superiors. Although in most cases we do have a surplus of nurses, it still costs money to train someone new and get them "up to speed." A manager with common sense will realize this; unfortunately, your manager seems to lack both common sense and decency. I would also let them know that you will be filing to be paid for "on call" pay if this continues. I would do all these things in writing as upper management deserves to know that this manager is the reason that a good employee does not like work. In any case, if it doesn't stop immediately and come with an apology from the manager (which from the sounds of things it likely will not), I would look for another job. That level of constant stress (feeling like you are in part at fault for "not catching" the messages, waiting for the next write-up) is not good for your health and doesn't allow you to fully enjoy your family time or personal time.

As an instructor, I can say that it is not usually the school that needs to "get over it," but the clinical site. I could not care care less what tattoos, piercings, etc that my students have with the exception of anything that would possibly hurt them (ex- no big hoop rings that would be likely to be pulled out). However, I don't make the rules, the clinical sites do. If a clinical site won't accept a student, then that student can't come. If them can't come to complete their hours, they can't pass. Perhaps clinical sites will eventually realize how many people have piercings/tattoos and become used to it. Until that time, we have to follow their rules if we want to continue to place students at that facility.

For new nurses: If in doubt of what to do- wash your hands and take a set of vitals, and ask for help. If no pulse/no resp and you freeze up --> call code, start compressions/bagging pt. Someone will come! The thing you spend all night worrying about after your first few shifts is unlikely to happen.

One other thing you might consider is trying to pair up with another mom with similarly aged children who has a different schedule. This has worked for a friend of mine, they exchange days of watching children. Also, if your school has an early childhood program, there might be a student in that program that would agree to watch them for less than daycare, yet still be responsible. As far as taking a semester off, be sure there is not a limit on doing this. For example, does the program have to be completed within a certain time frame? Could you take a semester off more than once if needed? For example, you mention there are issues in your marriage. What if you were to divorce? Would that lead to another semester taken off? Also, I would look into scholarships. Some states offer scholarship money if you agree to continue working in that state (ex-pay for a year of college if you work in that state 1 year after becoming a nurse) and also local hospital scholarships if they exist. You would have the benefit of more experience and at least here, some hospitals offer reduced childcare for their employees and full scholarships for a work commitment. Some places will even let you combine the state money and the hospital money. This might ease the burden of your need to work, at least somewhat. Of course, this could also depend on whether you or your husband carries the benefits. I would sit down and take time to seriously consider what you would do if you split up tomorrow. I hope things work out well for your family, of course, but have a backup plan ready if it were to happen suddenly. I have seen the stress of school upset the balance of a shaky marriage for many of my students. It sounds depressing to plan for the worst, but just knowing you have a plan in place for childcare, finances, living arrangements can help. It sounds as if the in-laws are quite manipulative. Remember, at the heart of it, you are trying to do something very positive for yourself and for your family's financial future. Don't ever give up, even if your route to success takes longer or is not as linear as your classmates without families. Whatever you decide, do not give up on your dream even if you do need to defer it. PS- find at least a few minutes each day for yourself, even if you have to hide in the bathroom for some peace. This is not an easy thing, but it is worth it.

When she says things like "You are a good nurse" and "I know I can count on you to get things done" what she is really saying is "unlike everyone else." It is manipulation. If you don't want her to talk about you behind your back, don't listen to her talk about others. Listening implies approval to these types. I agree with another post that advised to just walk away or ignore her. For example: Her: "I can't believe how incompetent Jane/John is! Blah, blah..." You: "I want to focus on report/professional issues. I don't want to discuss Jane/John. You need to talk to them directly." This is likely an unhappy person that does this to feel better. If she has no audience, she will likely become even more miserable and angry, but won't have anyone else to talk to. We had one like this in the past; we all started ignoring her and refusing to gossip. She quit and took her toxicity elsewhere. Part of the problem is that this is tolerated. The best manager I ever had asked me during interview: "Do you like to gossip? Because we don't tolerate that here and I will fire those who do." The unit had a policy that no one was to say anything nasty about another employee. If you had any concerns, you could only express them with the other person and the manager present in a meeting. Sounds odd, but it was the best place I've ever worked in terms of morale. The manager followed through and fired the one gossiper we had. Part of your yearly raise was based on how supportive and helpful you were of your colleagues.

I am so sorry for your loss. For me, responding to what I believe to be the intentions of the OP, I think we have all been in a place where we believe we failed to the detriment of the patient. At times, we bear responsibility, at others, we have only vague guilt. We all have so many stories, either those we have witnessed or those we have taken part in. I call them nursing ghosts. All you can do is do your best every day, and learn from every opportunity. I believe we also have systems issues. I also consider how much we have to overcome; not enough staff, resources, or time. Assessment is such an important part of our role, yet so many times we don't have a chance to pee, more or less accomplish everything that needs to be done, especially in the first year after graduation, which I remember clearly. This is when I wish we had more time for true mentoring. I believe there are many nurses who quit the profession when they feel they are the only one to ever miss something or not be able to do all they need to do. It is the dissonance between the perfect nurse I think we all want to be and the time we have in which to accomplish many things. Prioritization is necessary, but I feel the casualty is often the time spent with patients. I have noticed that subtle changes are easiest to spot when you really, truly have time to assess and interact with your patient. Last info I read said that around 80% of those who code had some change in vital signs or assessment within the 8 hours prior to code. This is not always easy to detect when you are running around "putting out fires" all day. I think it IS important to reflect on these things to improve our performance, but not to the extent that we continue to "beat ourselves up" over it. The key is to do the best we can with the knowledge we have at the time. I do wish more facilities offered incident debriefings, not for punitive purposes, but so others could talk through and look for opportunities to change and improve and to heal. I do them informally during and after a code (ex- "does anyone have ANY other suggestions?" and "Is there anything we could have done differently?") but the hospital does not offer formal debriefing.

Reading through many of the posts, I see such common threads of feeling insecure, out of place, frightened, etc as a new student. It reminds me of feelings I felt as a new nursing student. I remember the very first day of clinicals; I felt like an alien on a new planet (!), very out of place, and afraid I would either be in the way or would kill a patient just by my mere presence. Now, years later as a nurse educator, I see the same look of fear on the faces of new students and have sympathy for them. This is what I wish someone would have told me as I started out: 1. You can do this. It is not impossible, nor will it be easy. 2. Do your best at all times, and always look for as many resources as possible. 3. After doing your own research, ask for clarification/ask questions if you still don't understand. 4. You can learn something from anyone, even people who are not nice! 5. No one values your success as much as you do. Invest your time and hard work. 6. Never give up. You will have people in your life who don't believe in you. Your own belief in your self can be enough. 7. You are not expected to know it all. It is dangerous to pretend you do. In your career you will meet other students, nurses, and instructors who act as if they do. They don't. My students teach me to look at things in a new way all the time. I have more experience, but a fresh perspective has a lot of value. Also, don't look at your lack of experience and knowledge as embarassing. It takes time to build expertise. 8. Be the nurse you would be proud of, the one you would want to work next to and have care for you or your family member. The pressure is so great at times, it is tempting to cut corners. Never take an unsafe shortcut. 9. Value yourself. Take time, even if it is 15 minutes each day to do something refreshing that is only for yourself. 10. Skills will come in time. So many students feel embarassed that their skills aren't perfect. This comes with practice. Learn time and stress management. New grads struggle with this. 11. In this economy, find a part-time job as soon as possible with a company or hospital you enjoy. It is not a guarantee of a job after graduation, but it does help. 12. Most importantly, this time will fly. It is one step in a great career. Take time to laugh, to cry, to be present. To have an education is such a privilege when so many worldwide will never have access to such great opportunities. Value it! So, what would you say to encourage new nursing students? What do you wish you had known in your first days as a student nurse?