Gold_SJ

It sounds like you're doing this for positive outcomes. But I have doubts it will truly benefit your ward. Having a superior watching over your shoulder can cause not only paranoia and lower morale but also generally out of sheer nerves people are prone to making errors which aren't normal or acting unlike themselves in the first place so I don't know if you'll get a very clear picture of an individuals true performance by this method. Honestly I can't think of a fellow co-worker that would see shadowing as a 'positive experience'. I myself would despise it no matter how much I loved/respected the person doing it. I think outcome based assessment is better, eg. Giving an asthma patient a survey to ask were you educated on spacer use, inhalation technique, triggers and so forth. Where they can tick off what they had education on and you can see what was missed. Then later discuss with staff common topics missed to work on in the future. For me walking past and hearing general interaction between clients and staff would tell you more about their true professional interaction/behaviour than shadowing, as a person will probably fake good behaviour anyway if being followed around. All the same this is all just my personal opinion. Sorry it was so negetive. I hope it goes great for you, maybe shadowing is a valuable option that just needs to have barriers removed but I struggle to feel this way currently. All the best and tell us how it goes!

^.^ That's alright, with nursing I do love it but I feel unsettled like I'm supposed to be doing something else. I pray that I do what's right and I have a sense I'm supposed to write. Which I do daily (as I personally love to) but whether it eventuates as being the correct path I don't yet know. Just have to keep praying and trusting the Lord.

Hi Suzie, Lovely to hear from you. I'm a Christian Nurse too, gave my heart to him when just a child, I am uncertain if I'm called to be in nursing, but I do try my best to be kind and understanding with co-workers, patients and their families. I talk about God if the conversation is broached but I've never felt I should force my beliefs on others, I figure it may frustrate people and turn them away, I think some are called/gifted to evangelism others are not and show their love of God through their life and actions instead (me XD ). All the same, there has been many moments in my life I've talked about him to coworkers and patients when the topic arose and they enquired. My faith is very strong (he's been there for me in some harsh times), but when it comes to nursing I sense I won't always be one, but I do enjoy my job and like coming home feeling I've helped someone or have been there for them even if just to listen.

Its seen as the gold standard and being implemented across the state here. ^.^;; To be honest though...I can't stand it. I admit it can take people different lengths of time to adapt to change and that's probably me. But in a kids ward I feel it just makes parents edgy and kids stress. Plus I personally would hate a group of people standing there discussing me in a shared four bay ward. It would make more sense (To me) just to implement a round after shift to check on your patients. Of course I understand patients feeling involved in the care process, checking med charts, lines, allowing questions, meeting patients, assessment. So many good things But I find there's more discomfort, forced to do a second report later about private issues. Father not allowed entry / Department of child safety etc. And I feel the lack of privacy is wrong. XD This is just my personal opinion I can certainly see the benefits but you asked how we felt. I think nursing wise either way is good if you're prudent and assess your patient and their charts on commencement of shift. Evidence based practice however says it's safer to have bedside handover... well from what I'm aware of anyway. So I'm guessing we'll be stuck with it.

Physiology is a massive subject with so many things to take in, I am a little luckier as I've always been a great exam person. But there are some things I always did before exams. Seeing as you have the ability to take practice quizzes. I'd write down every question in the online quizz, then sit down and research each answer and write it out. It's funny but the process of writing out an answer a couple of times really helps cement it in your mind. Then repeat the quizz online and see how you go with the answers. Any questions you struggle with repeat the research and writing out. Keep doing this until you have majority of the answers in your mind so can answer those questions if they occur again. Also for certain things I'd do some route/copy techniques. Example for questions on the heart it used to frazzle me as I'd mess up directions/actions/names. So I practiced drawing the heart over and over with the boxes for chambers and direction arrows for blood flow, then names of valves, what was happening etc. with oxygen exchange. I'd draw that easily 10+ times and immediately when I sat down in the exam I'd draw out the heart on the scrap paper/exam paper in pencil, the image embedded into my brain. So when any questions on the heart came up I'd look at the image I'd drawn to help myself gather the right answers (>. Silly songs or verses, shortened versions helped me too. Example for Mitosis I'd remember: IPMAT = I nterphase, P rophase, M etaphase, A naphase, T elophase. Sounds stupid but having such a short mind jogger really can help you out in an exam. It's things like this I'd jot down in the exam if my brain is overcrowded to help me if it came up. Other things I always did in an exam is: *Read as much as you can the night before, for me I'd read the entire study guide (just reading not focusing on remembering at that point). *Eat plenty of carbohydrates before the exam. *Sit and read the entire exam before starting (lets the questions enter your mind) *If stuck on a question for more than a couple of minutes put an asterix next to it and keep going. Then at the end go back and refocus on those questions (It's ridiculous to waste time in an exam on a question you're stuck on if you can complete others with no worries, you don't want to run out of time. Also during all that time working on other questions your subconcious has some time to work on them and you'll often find them easier when you go back. Like how if you have a problem/question you often think of the answer ages later randomly, like when watching tv or when in bed at night.) I don't know if any of the things that helped me can help you, we all think differently but I wish you all the best :)

It's great you have such a loyal attitude and truly care about the job you've taken on. Personally though I think it's best to do what's right for you and your family. I see no harm in going to interview if it's something that would really benefit you, after all if you don't get it then that is that. I'm sure your new boss won't be happy if you leave but there will always be another person to step up and take the job, so don't burden yourself down with guilt. If you stay you'll give your all I'm sure and if you leave, wish them the best and give them warning (AFTER you find you definately got the job elsewhere. Tell them the truth and say you applied there before this job and you received the job offer and it was too good to pass up for your family. That you appreciate everything they have done for you ect.) Working is a business, managers understand staff leave jobs for better ones whether for pay, worklife balance, closer commute ect. So do what's right for you. You only have one life, don't live with regrets. How I see it anyway ^.~

In complete agreeance with this, I was taught that not breaking a dementia individuals 'reality bubble' was the most therapeutic for their mental health and feeling of well being. Which I believe to be true, if a lady is nattering on about how she just put all the chickens in their pen and if I knew if she remembered to put the soup ladle out? I don't see any harm with going along with her reality at that point in time. At most it'll make her smile or chat about something else, reorientating would create confusion and self doubt. Why bring that on a person unneeded? There really is no benefit it could bring her that I can see. I think there is a difference between going along with a persons perception and lying. To me it's like playing a game with a four year old in imaginery play. We're not (with intent) lying when we're agreeing that the cup of water is quicksand, it's more we're going along with a perception that makes them happy. It encourages happiness, imagination and good memories for the dementia sufferers I think, compared to harsh truths that won't bring about anything but pain and distress. Really liked this article, thanks for articulating it so well.

XD Thought I'd give an update. Reading this thread had me reflect an awful lot on my perception. A variety of members commented on how lateness gave them the feeling their time was not valued, that the individual was lazy, selfishness, how it made them felt undervalued etc etc. It actually horrified me, as although I commented in the past I struggled with being on time and it'd been something I've been working on. To even consider it's harming/angering/or making another feel less valued upset me. I never thought people could think such a way and I tremendously value my coworkers. ^.^ So after the reflection I decided although personally I couldn't care if one is late or not. I don't want to create those sort of feelings in fellow workers either who may actually care. So I became really strict and turned back clocks, set up routines and had family members all assist me in getting out the door. I haven't been late (except twice ) in nearly three months. It's amazing what you can do when determined. So although I did embarrass myself in this thread I'm actually pleased I read it. It's changed me to one of those ten minutes early types (My coworkers think it's halarious by the way). Just lets me chat with them more I guess I still let them leave early once handing over (We have a half hour overlap). So thanks everyone for letting me see how something like this can impact another. We all grow up with different lifestyles and I'd never seen the other side of the coin, another's perception and how this can negetively affect their emotions if taken in a bad way. Just because something doesn't worry me, doesn't mean it's the same for everyone else and I'm only sorry I didn't realise this earlier.

I don't know if this qualifies. But for me the biggest struggle would have to be those occasional family members that are dead set their child has some 'mystery' illness and demand every intervention and test under the sun (Often failure to thrives, skin conditions, constipations). Putting the kids through pain, misery and multiple situations that half institutionalise them or make them think there's something terribly wrong with them. They go from Dr to Dr, demand to be readmitted again and again, put in multiple complaints, or claim all these things happened when I witnessed myself it not to be true. Example: Claiming child vomited all their bottle, isn't doing this or that (development). Yet I saw they didn't vomit it, they are doing those things. It makes me so frustrated and sad I'm stuck thinking about it at home and you actually don't look forward to caring for them. Although the child is generally lovely enough, the family member is like this toxic shark chasing down this condition/test/Dr/plan change etc. Don't know if anyone can relate but maybe some paed nurses have ran into the same thing. (I know mystery illnesses/rare conditions happen. These cases though it's very very much in doubt/or Dr truly believes there is no such diagnosis)

Here we certainly avoid the 'Q' word and some poor people have been told off severly by breaking this unwritten rule. (Generally newcomers by the more blunt personalities who've been around for a while). I've always believed the full moon does something. Odd behaviour comes out everywhere, logically I suppose if the moon can affect our tides who knows what it can do to the body and brain. Here if Emergency ring up with an admission and you prepare the area, pull down the covers and then Emergency ring up and cancel it. You leave the room prepared under this superstition that if you don't admits will flood in. The knot is fascinating I've never heard of it before, same with opening the window. I don't know if it's a superstition XD but was taught pillow covers have to open facing away from the doorway. So I'm padentic on beds, like it'll cause bad luck or something. Which I know is ridiculous. Apparently back in the war days it was common in military nursing so that dust/dirt never got into the pillow through the door/tent opening. So it's a completely unecessary action *sighs* yet I still do it, kinda sad. Hope to see more. it's really interesting to read ^.^

I had a substantial back injury in the hospital system at the bedside with a morbidly obese lady, I was used to hold her weight up. Causing damage to my L4, L5 and S1 I can't describe the pain. Lots of chiropractor, Dr care, core exercises and pain relief later after approximately a year. I returned to a functional level. Now I am very very careful with lifting, caring for my patient and paediatrics (for me) has provided a good area that assists in protecting my back. Generally less full weight assists, children generally are lighter (picking up toddlers though XD and playing games it could be debatable). If you get proper medical care I'd hope you'd be able to return to your job like I did. Maybe a place with less bedside care or lighter patients such as neonates/peadiatrics etc. Where there's a lower chance of someone slipping and grabbing onto you redamaging your back? Just look after yourself ok and hope you find the area that will provide a safer environment for you. Most important praying the pain will go away and you'll get better. All the best.

I feel it's truly unfortunate that the economy is so harsh right now and making it so difficult for new grads to start their first job, so wish you all the best in this endeavor. I do feel however whether an experienced RN decides to stay on in their job isn't particularly a concern for you. Whether they are wanting to buy cars, homes or just try to fund for their grandkids or retirement. Everyone has the right to work and keep working there is no obligation to retire if you're still able and willing from what I can see. Have you considered moving to a different area? To get some experience in a rural/in need area? You could return with experience under your belt and apply again to the big hospitals, in interview your experience would be regarded more highly then just a beginning new grad if the hospitals are being so money tight. Sending you well wishes and I do pray you receive that break you need to help you financially and in your career.

--.-- Horrible scrawl. I see 30 and TDS and that is it. I'm betting we all see completely different things XD I have to say though, I think we sometimes deserve awards for the things we start deciphering because we see the Doctors writing so often lol We have 'zero tolerance' here for scrawl/order rules but... the lectures just seem to roll off the Doc's backs. ^.^;; Bit of a pity.

It sounds like you had a horrific shift and as a new grad you had a lot on your plate. I think you did a rather good job particulary advocating and seeking help for the high acuity. You'll find with more experience and time you'll be able to manage your shift even the nightmares with more ease and less emotion. Reflect on your shift and work out things you could change next time, whether seeking assistance earlier, time management maybe, communication, you've already pointed out things you'd like to do differently so I think that's quite proactive. A part of human emotion is to cry, it's how we're made else it wouldn't happen. So to say it's wrong I think is off the mark, if occuring in private I would think that's more natural than keeping it all inside. My opinion anyway, I've seen grads occasionally can have overwhelming moments which have resulted in tears but during the few crisis/horrors they run into, then when more confident and experienced it's a thing of the past. If someone's breaking down constantly on every little thing you could consider this a coping situation but I think the OP did quite well considering. It's a big thing learning and taking everything in during your first two years out. Hope your future shifts are better and keep your chin up, experience and time make a world of difference so don't be too harsh on yourself, reading your post I think you did rather well under such stressful circumstances. Every moment of chaos makes us stronger I think, as we learn new ways to look, evaluate and approach difficult situations. ^.~ As long as it's not a constant thing, no good for us to be ground into dust.

Like Viva said you don't have anything to worry about. Despite the fact bipolar takes years of mood study to diagnose, a psychological opinion doesn't diagnose the disorder and in my country only a Psychiatrist can make such a diagnosis. You don't need to divulge anything on a declaratory order if it's an opinion/concept/consideration unless it's an official diagnosis. So you can relax a little :) If you were ever diagnosed with a condition, check your state laws on whether it has to be divulged to the BON. Often bipolar, schizophrenia and other medicated or potentially unpredictable conditions do have to be disclosed. Personally I think it's things like this that make so many people fearful/stigmatised on mental illness. Especially when it's perceived as a potential career killer (My career is going fantastic). ^.~ But you have to take the good with the bad and when people realise it's more common then they know, I hope mental health disorders eventually will be seen like any other chronic illness. Lol my hope anyway. All the best to you and hope you feel uplifted and peaceful in the future.

Your GPA is your Grade point average (not an exam). It is created from your grades from your tertiary studies. Otherwise you can get an OP/GPA by doing a steps course. I'm assuming your GPA will be created from your prior marks from your RN Bachalor. Wiki sums it up pretty well ^.~ Academic grading in Australia - Wikipedia, the free encyclopedia Generally aside from the Gamstat, I'm aware an interview is also held to see if you're a personality fit/professional fit for this area of study at the university in question.

Agree with everyone else, inappropriate also risky. If a parent is ringing to check on her baby and the nurse isn't even with the neonate, what if she gives false reassurace? The babe could of crashed in the next shift and the nurse mightn't be aware. Blurring these sort of boundaries can also foster distrust between the babe's family and other nursing staff, which is counterproductive. It'd be frustrating for the team if a mother only wants X nurse to care for her child, or only shares info with X nurse etc. Not good for the unit's morale.

It sounds right now you're really frustrated with the meeting that occured (it's never good to feel harrassed over something like your persona). I advise you though to sit back and cool off for a couple of days before you decide to do something like resigning. We do a lot of things in the heat of the moment that we can often regret. In the past when I was in my graduate period I was once told in an eval that 'I didn't seem to have a personality', by one of my preceptors. I was extremely embarrassed/frustrated. It was because it was a very busy ward, with a large amount of nursing staff who were very close. I was still trying to fit in, plus learn and being introverted the bunch of new staff around me were a little intimidating so I wasn't very talkative. Get me in a small group though and I completely open up. Three months later the nurse apologised to me. New people can take a while to settle in and other staff to get to know their quirks. I stuck it out and am really thankful I did as I'm very happy where I work now. I'm not saying it's the same situation (especially with this worry of being fired). However I was given the advice to to talk more/be more open and joke more in the evaluation. It seemed impossible at the time, it felt like an attack on my persona/personality. I made the effort instead to talk to co-workers one on one where I felt more relaxed and eventually became publicly more talkative, as I knew my coworkers better. It pleased my preceptors/educators. If I made the decision to resign then and not 'attempt' to fufill what they wanted I wouldn't be in the great position I am now with the team I'm with (although in a paed ward compared to med/surg). Just think carefully about what you want, if you truly don't want to play their game and act more cheerful and are willing to leave a job for this reason then kudos to you. But if you are willing to give it a go, you never know it might turn out better than you think. It did for me anyway. Either way, all the best in your future! :)

It's always difficult I think in your first year out as the brand new RN. I certainly found it a struggle, there'd be days I'd come home crying, days I'd come home fuming. I'd fall flat on my face and have to pick myself up and keep trying. I think some of the most important things to help you when starting out is: Time management. You won't be great at it, so don't expect yourself to be waltzing out the door twenty minutes early or sitting around chatting. You'll find it hard to imagine 'how' the other nurses manage to find all this time. Learning to delegate is really important when you start out. My error was trying to do everything myself, it does not save time I learnt that the hard way. Try to remember there is a million different personalities in a workforce and if a person is snappy/grouchy/critical do your best to take it with a grain of salt. Their mood is 'their' problem. Don't take it as an attack on yourself (easier said then done). As generally it's just their persona, a crappy day, personal life issues and often has no real focus on you at all. Although it can certainly seem that way. When I started I took everything personally XD now I realise I put myself through agony that was very much uneeded. Remember to ask for help when you're confused. Check policy, do what you can then ask someone. Don't be embarrasssed, you're a grad you certainly don't know everything, so no need to act like you do and nurses are wary of grads that act like they know it all. Working out how to approach problems or an issue with a Dr can be confronting for a new grad, so taking on the approach of PACE. Probing (are you aware..), Alerting (Mrs X has this problem is there something you'd like to do for this...), Confront (Mrs X's issue is a real concern can we do X/can you review to resolve this as soon as possible.) Esculate (I'm sorry but this problem needs to be rectified immediately, if you're not happy to do this I'll have to alert superior/specialist etc.) This was a help for me because I once was intimidated to approach superiors and medical officers when problems had to be corrected so when applying PACE it made it much simpler and I felt more confident in my approach to the superior/Dr as a grad. Otherwise I think just with experience and trial and error you'll get there. :) Just don't give up! Remember it gets easier, a year from now I'm certain you'll be much happier and more confident then you feel right now. The hardest year to get through is your grad just keep fighting your skills/experience/knowledge will grow fast in this time. I wish you all the best! Hope this was some help. I'm sure you'll make a great nurse. :)

For me I always wanted to work in healthcare and when I watched my mother go through her RN in my senior years of highschool I decided I'd like to be a RN too. (She was an EEN (LPN) when I was growing up. Thus the desire to work in healthcare, she told the BEST stories ^.^) Two of my aunts are also nurses (LPN's). Since becoming a nurse another aunt has gone into nursing, so that makes three nursing aunts. A nursing mother and recently a cousin desiring to become a nurse. ....kinda dangerous it's like the nursing bug is catchy. XD

Our ratio's are 3:1 once we get four little ones we're supposed to have a EEN (LPN) come and work with us. How often this happens is debatable, however if we push we always get someone so I'm not going to complain. I'm actually quite lucky in my work environment, it has a great culture compared to other floors.

Well... it has to be White Collar for me. Through university I had to sit through our lecturers going on and on.... 'You are a PROFESSIONAL!' ....'evidence-based practice', 'responsibility', 'ethics', 'management...delegation...etc. I'm sure you get the idea. And after that many years of being drilled over how we are no longer considered trained/trade based learners anymore, but have shifted gradually into taking on more responsibility and being critical thinkers (All of us, original hospital trained and those leaving the schools). That to me places our profession now in the White collar category, we're stuck with so many expectations. We have to know why we do all the things we do and can no longer follow the miltary style or hierachal system that once was the core of the nursing decision process. If I can be sued/deregistered/told off for not researching everything I'm giving, doing, care and am 'expected' to keep up with latest journals and research, I think as a profession we've crossed the line into white collar territory. Although in the past I do believe we were a blue collar occupation and would be proud whether I was a white or blue as long as I'm still a nurse. However we're trying to place our role in one side or the other and I think the job has changed and we've left the realm of blue collar for a defination. Nursing has changed and with all the heaped expectations, I think we've also transformed (in my opinion) to white collar workers.

Personally I think it's worse to have long sleeves as spills/bugs will hitch a ride. You can wash your hands and arms (especially for sterile procedures) with short sleeves easily, but it's much harder to wash if you have sleeves covering your arms all the time. You'd be forever pushing them up and they'd probably carry lots of little extras from patient contact. Of course I could be wrong, but my logic anyway. Will be interesting to see everyone elses opinions. In my facility we 'cannot' wear long sleeves unless a facility jumper at the desk and have to take it off for patient care.

I love my ward because: We have a great team and all do our best to support one another and boost morale. I work independantly, it's a RN/CN to the ward a shift (Plus an EEN (LPN) if the staff/patient ratio is high) We do self rostering, so pretty much get majority, if not all the shifts off for special occasions we request. I work with children (how can I not enjoy that? ^.^ ) There's reasonable amounts of downtime to work on education. The Paediatricians are great to work with. There's always backup if things go to chaos. Whether the MET team, Nurse manager, Clinical Nurse Consultant, Paediatrican, Security, Nurse unit Manager or even co-staff who are happy for you to contact them in regard to a problem. We work together on solutions, if we have differing opinons we'll often find a middle ground. Overall I'm blessed to be in the ward I am. There's always things not perfect, or we could improve on, but what I listed definately make me happy to turn up to work each day.

In my experience having a two page resume is fine. I've been offered (with God's grace) every job I've applied for and can't see how it's feasible to outline your skills, job experiences and awards in one. At the same time I'm from Australia so managers may have different expectations for what is considered an appropriate resume. I do believe in a concise well thought out cover letter however. I think it speaks volumes on your interest and knowledge of the organisation you're applying to. A specific cover letter I think will win out over a generalised one majority of the time. Either way best of luck! There's been some really interesting opinions from both sides.