TNCC RN Guy

Ditto for Provigil. I wouldn't mention it unless there was a compelling reason to, i.e. program policy or a potential affect on your performance issue. While the is an issue of "reasonable accommodation" for those with disabilities, you have an obligation to minimize the potential problems with lifestyle modification, meds, etc.

OP, perhaps you are taking such events way too personally. Both my wife and myself have these experiences with patients are RNs, as does almost every other nurse. If it's not my fault, I just don't take it personally. People vent, that's an unfortunate fact. If I inadvertently did something to deserve it, I'll take my medicine. If not, I'll try to determine what needs to happen to remedy the situation. Families and patients can be angry, but I've rarely had them personally attack me when I keep this outlook. You can express frustration to me without it becoming a personal vendetta. In any job involving customer service, separating our natural tendency as humans to take another persons anger personally, anger that is often not directed at us but the situation at hand, is essential to avoid a very miserable and unhappy work life.

What I've had to remind myself of is that emotions are not a light switch that can be turned off/on. Whether it's children burning alive in front of their parents or a family's patriarch that suddenly experiences a massive head bleed and progresses from normal mentation to a GCS of 3 in less than an hour, these experiences take an emotional toll. If one is to have any emotional connection when away from work, they cannot simply numb themselves out emotionally. Grieving is normal and becoming "desensitized" can create problems of it's own. I will allow myself to greive after the shift ends, grieve appropriately and move on.

I've been a medic in IL for going on 7 years and an ED RN for going on 2 years. I looked @ excelsior and decided against it because of the licensing issues. That being said, Excelsior seems like a good program--for the proper student. Someone who has a strong base of knowledge and is highly self-motivated is more likely to do well. Remember you can always work in a neighboring state (though the pay may be lower, as is the case in WI). It's still a raise compared to average EMT-P pay, from my recollection at least. Don't be discouraged, but realize the limitations up front. Supposedly, IDPR will grant an IL license after a period of years but I've heard it can be a troublesome process (search this site for threads on this issue, I recall finding some when I was looking into Excelsior). Whatever path you choose, I applaud you for seeking to advance your level of licensure. My job fulfillment has advanced to a new level and I've got expodentially more opportunities for professional growth and advancement, and no more 24 or 48 hr shifts!

Essentially, if the OP really has an aversion to the nastier side of nursing (I.e. Body fluids and waste, not people), perhaps some long, hard reflection on her career choice is in order for her own long-term happiness and job satisfaction. However, if she's taken aback by some of the things she's already had to or will have to deal with and just doesn't know quite how to handle it yet, I think that's something we all can or could relate to at some point. I've worked with plenty of nurses who refused to help with dirty jobs and I've seen a lot of new grads who mastered book knowledge but shied away from more practical skills such as clean up. The same with experienced nurses who left all such work to techs. Learning to deal with the challenges of a job is one thing. Seeking ways to dodge them is another.

Vicks is good. If you're "lucky" you have allergies like me and can't smell very much a lot of the time.

i actually did have a couple of classmates in my nursing program that were surprised they would have to deal with the 3-ps (poo, puke and pee). they both quit by the end of the first semester, one never showed up again after her first clinical experience involving stool. better to realize your limits and change course earlier rather than later.

Truly desiring to help others is reflected in a willingness to perform any task necessary,including the least desirable tasks such as bathing and cleaning. If you are unwilling on don't have the humility to freely jump in and lead, not just help with, the least desirable tasks than I question. How capable you will be with the more "glorious" tasks, as you see them. No one can run with out first walking, and crawling for that matter.

Like or not, this quote is right on. If you really have issues with this, perhaps a job where you're elbows deep it would help you overcome the aversion to body fluids and "such," or give you a well-rounded view of what nursing is, the good, the bad and the downright "crappy."

When I worked as a paramedic we were in the Elmhurst ED regularly. The staff were always pleasant and seemed happy to work there.

Feel fortunate that you don't have a "preceptor" (and I use the term loosely) like this regularly. On the + side, take stock of what you undoubtedly learned today. I had days like this as a new RN, and while I was mentally and physically exhausted at the end, the lessons I learned through these "trials by fire" were invaluable.

EMT B, I or P would potentially be useful if you had experience in the field prior to applying for jobs, but that most likely won't be the case here. As for EMT, though, the basic assessment skills taught in the class could benefit a new nurse regardless of specialty.

There is some truth to the "survival" comment. I'm not entirely convinced that new grads should be ruled out entirely of specialties, including ED. As a new grad that started in the ED, I've managed to do quite well (my last annual eval confirms this). However, just because a new grad spends time on a med-surg unit, be it 6 months or 6 years, does not mean that they will be any better adjusted to life in a radically different environment such as the ED. I once worked at a hospital where the ED manager refused to hire anyone who had not spent 2 years on a floor. Several of the techs were long-term ED employees, paramedics, etc and none of them were considered for positions when they graduated nursing school. Many of the "experienced" nurses, however, were just as lost if not more so for their first several months. Fortunately, this antiquated thinking is slowly heading out the door. Just as shortsighted, however, is randomly hiring new grads into a specialty they have absolutely no background in and thus no idea of what they're getting themselves into. TiVo'ing Grays Anatomy and ER reruns doesn't count. I graduated with a couple of people who expected to get hired into ED positions as new grads simply because they were men, even though their grasp on the most basic concepts was questionable at best. Hospitals also need to realize that when it comes to new grads they will end up costing money one way or another, be it on the front end or the back end. A facility can either invest on the front end by first picking them right candidates for a given job and investing in an adequate orientation or invest money on the back end with the resulting high turnover that comes from a lack of investment in orientation and training. As for the OP's question of "inept new grads," without seeing them work in person it is probably a combination of the reasons listed, combined with a lack of properly selecting the right candidate for the job and possibly a lack of adequate orientation or deficiency in preception. Be realistic as well. How long did it take us as inexperienced nurses to become "fast?" Did we cut anything out along the way to become faster, such as time interacting with patients and building a rapport, or providing adequate discharge teaching? I've noticed that a number of the recent grads I've worked with, while "slow," are very in tune to the interpersonal aspect of nursing and the importance of AIDET, discharge teaching, and so forth.

+1. Sometimes, it may feel as though you're back in Jr High, depending on the culture of your ED.

It's nice to see that experienced nurses have faith in new grads to be able to rise to the challenge , or not. M-S is less 'chaotic" than ED and critical care? One of my fellow grads had a preceptor with this belief when she was a new grad in the ICU. The "preceptor" would daily make references alluding to the belief that new grads shouldn't be in critical care while she was supposed to be "orientating" my friend . I wholeheartedly disagree with this line of thought. While I worked as a paramedic both in prehospital and Level II adult and peds trauma center ED environments, I started as a new grad in the ED. I've maintained my ACLS and PALS and completed TNCC in the first 6 months. CEN and an RN-MSN program is next on the horizon (I already hold a non-nursing bachelors). Don't let anyone tell you what you "can't" do (while in the same way taking sound feedback from reliable sources into account). If you we're a little apprehensive, I'd be even more worried. Even with a strong background and months of experience as an ED RN, I still felt anxious in my first traumatic arrest, my first peds trauma code, the first time I had to console the surviving family of a patient who had passed away, the first few times I had "difficult" patients, both from a medical and personality perspective. Each time, though, I gained something form the experience and the next time a similar situation occurred, it felt almost natural to know what my role is and what to do. Remember, when in doubt ask questions, and if you're not sure if you need to ask for help--you really do need to ask! No experienced RN who is worth taking help and advice from will shun you. If they do, then it's probably best to ask someone else anyway. Read, read and read some more. Take as many classes as you can whether the hospital pays for them or not. If you work with nurses that have prior experience in other specialties such as peds, psych, etc., ask them for advice when you have one of those patients and aren't sure about something (especially meds for peds or geriatrics!). If you've got a big learning curve, obviously don't ask for the trauma rooms as an assignment right away ("right away"" being at least a year perhaps). Perhaps seek out express care, fast track, or whatever it's called in your ED if you want a solid start with lower acuity (in theory, at least) patients. As for codes, when in doubt, jump on the chest and start doing compressions or ventilate with the BVM until respiratory arrives and watch how the team works, who performs what roles, etc. The "team" concept of code management is strongly emphasized in ACLS as you'll learn in the future. Above all, be wise and cognizant of when to ask for help. One of the biggest dangers for new ED nurses, be it new-to-ED nurses or new grads, is not realizing when they're in too deep and need help until they're so deep in the weeds they need search party to find them and many more resources than would have originally been necessary to help them correct the situation. Be aware and vigilant to protect both your patients and your license while not shying away from an appropriate opportunity to stretch yourself and learn something. Some experienced nurses may give you a hard time as a new grad. If their concerns have merit, take what they say into account. If they're just complaining, and there are always at least a couple of complainers ho are never happy about anything in every unit, ED or otherwise, take what they say with a grain of salt. Remember, you are new, but not stupid. Just because you are new and need to refine your nursing practice and skills and expand your knowledge base does not automatically make you incompetent. I've been fortunate to work with fellow nurses and a manager that also believe this and provided me with outstanding support when I was a new grad (and continue to support me, as I support others who are now new grads). Lastly,don't forget where you came from. Techs, housekeepers, etc are your friends and they remember who is nice to them and who isn't. When I have a messy patient that needs to be cleaned up or what not, I make a point of always helping with the job unless I'm absolutely tied up with another more critical situation. The techs know that I will help them and consequently are far more willing to help me as opposed to other nurses who the perceive as "abusing" them (their words, not mine). Pardon the long-winded response and try to remember these tidbits as you start your new career. You can do it:yeah:!