rockstar11

Yep!!! I'm tired for various reasons -- sleep deprivation and medical reasons being the top picks. I was working three 12s on night shift, couldn't work my days in a row because I need more sleep. All I did on my days off was catch up on sleep, which didn't help my mood. My answer - I switched to 8 hour shifts. I'm happier, more energetic at work. I didn't realize how poorly 12 hr shifts affected my performance at work and home. And how overtired I was at the end of the day and all the time. I need to exercise more, sometimes that helps with my energy level.

I would say the biggest challenge of being a burn nurse on nights is that we are generally less experienced, and have less resources available to us (i.e., the experienced burn nurses, more staff). I took a burn admission with brand new techs and can honestly say I winged the whole thing, mildly unsafe if you'd ask me though. It's one of the reasons that I am thinking about not staying in burn on nights for much longer. Our dressings are usually once daily, day shift does that, but the dressings often come off when they are hard to secure so we obviously dress those PRN. One of the big advantages I would say is *not* having the 1-3 hour dressing change that you have to fit in your shift, making you unavailable to your other patients.

At the hospital I work at, a Pharmacy tech comes to do a med rec. list from the patient (or family or from pills brought in) upon arrival to the floor. The MD/PA goes over it with the patient later. Can't even tell you how much I love this system.

Sorry... you should never be yelling at or "after" a patient, ever.

Some stuff is just NOT appropriate to be said at the bedside. Like, x patient has been hallucinating all night; other patient overdosed and we don't know on what, it's a guess, his pain is uncontrolled and the doctors won't do anything. Patient z is actively dying, family at bedside and wishes pt to remain a full code. I understand the benefit of bedside reporting [for safety reasons - what offcoming nurse is telling me is consistent with what I am seeing], but this 100% everything all the time bedside report is not wise, it's just a blanket rule for their hopes of raising patient satisfaction.

Ugh, you aren't alone. I've been on my own for a little over a month and it is scary. I haven't had patients with every type of disease or med that I come across, thus looking it up and having pharmacy on speed dial. I second guess my assessments. Or I do an assessment and later think "crap, I was supposed to look for that?" Or get to busy and forget to look up labs. The other day, I completely forgot to give someone insulin within the time. The docs/PAs/NPs at night can be very, very difficult to work with. Most of them don't want to touch the Attending MD's plan at all. And then when a new grad is working with a MD intern... facepalm. And I'm sure you know it, all of this perpetuates that lovely anxiety friend, which doesn't help our cause! What I keep telling myself is similar to you -- I don't have the experience of other nurses. I don't know every policy or procedure. I'm really just trying to give myself some time before throwing in the towel, my education, licensure, and hard work would be such a waste if I didn't try. btw -- bTRUE, I am sorry you are having a tough time with landing a job, the economy is not in the best shape right now. It took about 11 months for my RN job, and I still need to vent every other day. being a new RN is HARD.

Hospital wide we are expected to do bedside report. Many floors, it is enforced heavily, even requiring nurses to write their managers notes when bedside report didn't happen. On my floor? yes, it's expected, and usually happens. As an oncoming nurse, I like it, I can see my patient and assess a few things quickly as the offcoming nurse tells me. Had a couple of times where the pt was unresponsive or AOX1 and was AOx3. Also.... I've noticed that now that the hospital has been enforcing bedside report, a lot more codes get called between 0700 and 0730! Anyways, with all things, we use are nursing judgement. somethings just are NOT appropriate to be said at the bedside.

There are states that do not require disclosure of mental illness. I do know that there are several of us that are very good nurses. I would hate to see a diagnoses hault your pursuit of nursing!

Not sure what else to add... but that I'm so sorry that happened to you. It's such a tough decision to make, especially since it is usually so time sensitive. I hope that you can take some time off to clear your head after that happened and find a new job that will be a better fit (and better management!!!!) It happened to me as well, the "forced" resignation vs. termination. I took the resignation because I wanted to leave on my own terms, didn't wan't that employer to have such power over me, and, in all honesty, I wanted to save my license. It was a horrible place to work, management similar to yours. Always throwing the nurse (especially the new ones) under the bus. Alas, I found a really great job 1 month later, and am now looking back at what never was a great start.

A lot has been said on this thread... most of which I agree with. Anne, these posters are giving you great advice, and from one novice nurse to another..... LISTEN. I will add that I, as a nursing assistant and nursing student, had a very negative view of the nurse/doctor relationship and power struggle. I have come to realize that there is no need for a power struggle, because we DO have one common goal as to care for the pt. However, we do have different scopes of practice, and the basics of that, you should know. If not, ask, quickly. One thing that has helped me immensely in communicating with physicians and providers is the SBAR: Situation, background, assessment, and recommendation. S: Hi, I'm nurse Anne, I have pt ___ with s/sx of ___ B: Pt was admitted for (insert dx___) six days ago. He has a history of ___ (keep it brief) A: He has wheezes, both inspiratory and expiratory, which is/is not a change from the previous assessment. Also, the pt does not complain of SOB, but I am concerned about the new wheezes. R: Would you like to order a CXR? Would you like me to initiate oxygen? I would say that, even as a new nurse, the MD will usually follow my recommendation. Sometimes it helps to make a list of the recommendations before you call, so that you don't forget about what you think the patient needs. The physician/provider will ALWAYS say continue to monitor (that is our job...). If I don't feel comfortable with their recommendation, and depending on the emergent nature, I ask for them to come physically assess the pt. Always keep it professional and courteous, no yelling at each other, no hanging up the phone. The SBAR has made my job, as a nurse, soo much easier to communicate with someone with a different power than I do.

I work in a large teaching hospital - so we thankfully we have a rapid response team. We do have many critical care RN rounders, and there job is dedicated to rounding on acute patients, responding to chest pain, responding to acute changes, and are a quick resource in potential emergencies. In addition, we also have a Rapid Response Team-which has a provider or physician, a critical care nurse, respiratory, and a pharmacist to rapidly assess a pt. We also have a code team. I am not aware of what our statistics are... but as a new-ish RN.... these teams are invaluable to me. I've called many critical care nurses and rapid responses that may have prevented my patients from coding later.

Three responses I get are usually this... or a combination of these - 1. So proud of you!! (recent grad) 2. Nurse = Ca$h omg 3. Face of disgust when I tell them my specialty (burn)

I am so sorry you were fired. I was "there" a few months ago and almost quit nursing for good. You questioned that solumedrol order continuously and still didn't administer it perfectly. Honestly? I think that is a mistake that every nurse can/could make. And you were smart enough to question it. I think a lot of nurses are better than you or I at ducking under the radar by not speaking up. Ask yourself, which nurse is more dangerous to the patient? I was fired for much less :) Well, technically I handed my joke of a manager my resignation faster than she could flip through the termination papers. - Taking a b/p while pt was lying on side - charting b/p on wrong patient (uncharted within seconds, made sure no inapporpriate orders were made, etc.) - charting b/p on wrong patient a week later (uncharted within seconds, and told my boss). - refusing to falsify documentation (!!!) (Yes, I chose to have my license over that job)/ Biggest mistake of my first job was being honest with my manager. BUT.... after almost leaving nursing over a hellish first job, I found a new great one that I love, and even got a pay raise for experience! I wish you the best -- hope that leaving this job leads to better opportunities.

Best of luck!!

"How can you be a nurse" ........... A. Attend an accredited school of nursing B. Pass the NCLEX-RN or NCLEX-PN C. Hold current licensure Just throwing that out there.