busymommy

Thanks, PinkNBlue. I'm having a wonderful time on my unit, learning more every day, and there's great rapport among the PP nursing staff. I think working three 12s back-to-back was a good test of my stamina, and I made it! For sure I will need new, better shoes, but it wasn't nearly as difficult as I anticipated. Fingers crossed this will turn into a job come February :-)

I was given a preceptorship in postpartum, which is where I'd like to devote my career. It is unheard of to get this kind of placement at my college (major med-surg focus), and I have to say that my preceptor is just fantastic! For all of you who agree to precept almost-new-grads, thank you, thank you, thank you!! We so appreciate all you have to teach, share, etc. Mine has been so wonderful at teaching little extras that you don't learn in nursing school, and for those of you who work in this specialty, thank you for being such a great example to emulate :-) I am learning so much, even after 2 shifts, and I have definitely found my niche. I never watch the clock and when I happen to notice that my shift is ending soon, say 1700 hrs, I think "What else can I do?" rather than "Oh my gosh, will this day never end???" I brushed up on neonate & postpartum assessments, and that's helping me. What I've noticed is that I tend to be a "helicopter nurse" because I feel like I should be checking on my patients at least once an hour. But, they generally have had zero birth complications, only need pain meds, and my shift assessments haven't revealed anything unusual. I hope to join the ranks of the newly licensed postpartum RNs in February, after I pass NCLEX the first time!! Just had to give a shout-out to those who've been in the trenches. We students are watching you and you're doing a great job! ~busymommy

Thank you, Jenniebrie. The "Chicken Soup" series is always good for stuff like that, and I keep forgetting that I want the all the "Nurse's Soul" editions. :-) We need to take care of ourselves, especially when school is so demanding, frustrating, and just plain hard!

I'm have 2 weeks left of my last clinical (community health) in my final semester of nursing school. I graduate in 67 days (not that I'm counting!) :) My preceptor at this clinical site (part of a huge ins. provider urgent care facility) is of the "All Nurses Need 1 Year of Med-Surg Before Specializing" camp. Yesterday, he asked me if I'd given any thought to where I might like to work after graduation. Um, anyplace I can get a job will be fine, but if I could hand-pick, I'd go to postpartum. However, I didn't say the last part. He said "You know, we have a new grad program. You're a strong nurse and you have a real way with the patients here. You should apply." This is HIGH PRAISE from this man. He's been an RN for a long time, has seen a LOT in his career. I've never had a nurse suggest I apply to work with them, and it made me feel so great!! This came right at a time when I'm really questioning my skills and whether or not I made the right choice. Then, one of the other nurses at this same facility told me I was just the right sort of person you'd expect to be a nurse, and she could tell I'd found my calling. Needless to say, this has really helped me get over the trepidation I feel about my upcoming preceptorship, and reaffirmed my choice to be a nurse.

Okay. So I graduate in December with my BSN (finally!!) and after clinical experiences in many, many areas, postspartum nursing is where my heart is. As you know, this is a popular specialty and many of my fellow students are interested in OB nursing, although I'm the only one who specifically wants postpartum - everyone else wants L&D. Even though I'm in my mid-40s and have experiential knowledge (note user name ), I know I'm not anywhere near ready for the pace of L&D - yet. So, although I'm going to apply to the hospitals in my area that accept new grads into PP, I'm considering other options, because I don't have much hope for getting my 1st choice for that 1st job. Unless there's a drastic change in the job market, my class is being told to "be open to other possibilities" and I'm taking that advice seriously. It might sound like a weird combination with PP, but I like the geriatric patients too and I'm seriously considering long-term care as another possibility. Does anyone think that if I have, say, a year of LTC nursing, I can transition into PP? If not, where would you suggest I try to get experience? Looking forward to hearing your advice! ~Busy Mommy

Thanks, rn/writer! I especially appreciated the bit about focusing on being a good, competent nurse, rather than on changing lives. Really good advice, no matter the specialty!

We will likely be moving to the Eugene area next year, for family. Hubs is already looking at his employment prospects and since Eugene is home for him, he's well-acquainted with the area, cost of living, etc. I'll be a BSN-RN and have a few questions. Hancock330, what is the nurse-to-patient ratio at your facility on, say, a med-surg floor? Do the RNs generally seem happy to be at work? Do you find there's a sense of camaraderie among your coworkers? What's offered to new hires in the way of orientation/mentoring/precepting? Can anyone who's familiar with the Eugene/Springfield area tell me about the SNFs/LTCs in the area? Thanks!

What can you tell me about the work environment in your hospital, Love911Nursing? Do the RNs generally seem happy to be there? What's the nurse-to-patient ratio like on, say, a med-surg floor? Also, would love to know about the cost of living in that area. We may be relocating to So. OR for family issues, so any info (or links to info) that you can pass on would be great. Thanks!

Jennifer70 hit all the main points I wanted to mention. Especially the ink & paper - those are excellent things to stock up on at Costco/Sam's Club, or wherever you can find the best price for your printer. I also recommend highlighting your lecture notes. Find a style/brand of highlighter that you like and get as many colors as you can. (Sharpie has a 10-pack at Target, fyi) Unless you really really need the pictures, I would suggest printing the power point slides in "outline format". This saves paper and leaves a lot of room for your own notes. I'm kinda old school that way, though. Plus, it saves on the color ink! :-) Yes, do the reading, but (personal opinion alert!) instead of reading word-for-word, read the chapter summaries and skim the different sections in those chapters. I found that for med-surg, it was a good idea to print the lecture notes the night before class and read them along with the chapters covered in those notes. I would highlight each topic in the notes with a certain color, and highlight with that same color in the book, but ONLY the parts that related to the lecture notes. It might seem like a lot of work, but it translated into better exam scores for me. You will have a much better idea of how much to read once you've taken your first round of exams. Lastly, I highly recommend the following book to pre-nursing and current nursing students: How to Survivie & Maybe Even Love Nursing School: A Guide FOR Students BY Students, by Kelli S. Dunham. Newest is the 3rd edition, 2008. My copy is dogeared and has a lot of water wrinkles, because it's still part of my summer reading at the neighborhood pool. I still refer to it and it's helped me tremendously, especially at those times when I'm seriously lacking the motivation to study, or even keep going in the program. GOOD LUCK!!

First of all, I love your handle, nuts4mymutts! I just had a conversation about this with my advisor yesterday, and told her the idea of "having" to work in med-surg makes me so sad when all I've ever wanted is to be a postpartum nurse. I was fortunate to have excellent experiences when I had my babies and those RNs continue to be a HUGE inspiration to me. I agree with you - healthy people need our care just as much as sick people, and being a postpartum nurse does not make us less respectable. I've been thinking lately that I should just go right into med surg and not even try to find a job where my passions lie, but I've switched my thinking. I'm going to go for what I really want, and let God take care of the rest. Thanks for encouraging a student who's almost done! I hope I get to work with other nurses who share your attitude :loveya:

I'm so glad to hear that, egglady! :yelclap: I've talked with one of my nursing instructors and she said essentially the same thing. Another told me that LTC/geriatrics is just "another type of med-surg" and I can see the logic in that. I've seen lots of older adults get dc'd/transferred from the med-surg floor to the hospital's rehab unit, or to another LTC facility. Most all have their IVs dc'd too, but I'm glad to hear that there are G-tubes, etc. My only experience on the floor with that kind of stuff was in ICU and I did not have a good experience there. First, I've never been interested in ICU to start with, and second, my nurse felt my BSN program (and me, by extension) was inferior to hers (other country, different methods, etc.). Not the best way to recruit others to the profession. The more I think about it, the more I see geriatrics in my future.....thanks everyone!! :heartbeat

Thanks, taz! Can you tell me exactly where on the westside that Kaiser hospital will be? Any target date for opening day? That's very encouraging, and I know my DH will be happy to hear about that. Central Oregon has been on our 5-year relocation plan for a while now, so I guess it's time for him to start exploring his prospects up there. He's an electrician and I know nothing about that kind of work, other than he loves it. I'm hopeful that with all those jobs opening up back east that the trend will continue to the west coast really SOON, for everyone!

Thanks, taz5869. I'm from the Tacoma area and have heard about the difficulties in Portland. I know what you mean about prohibitive distance. Ironically, Lincoln City and Newport are the areas we've been seriously considering. I've been checking the 'careers' section of LC's hospital web page and also looking in the Eugene area. I will have my BSN in December and I'm hoping that will put me at an advantage compared to ADRNs, but now, I'm not so sure. I guess anything can happen in 8 months, though. I wish you the best of luck :yelclap: and thanks for posting!

Just wondering if things are loosening up yet in Oregon as far as jobs. Feel free to post about your area, but I'm most interested in the central and southern parts of the state (Willamette Valley & west). Hospitals in my area are starting to post more openings each month (desert SW) and I'm hoping that's a sign that other areas have begun to do this as well. Hope everyone had a great Easter!

I am SO GLAD I read this thread. :yelclap: I will graduate in December and the professors at my college are from both schools of thought regarding med-surg before specializing. Some say "Yes, you absolutely must have med-surg first!" and others say "If you know what you want, go for it, because I did!" I'm in a unique position, because I'm a nontraditional student (read: I'm in my 40s!) and I've had a genuine interest/curiosity about women's health since I was about 12 years old. I read A Child is Born at the library for FUN when I was in jr. high (anyone know/remember that Leonard Nilssen book with the cool photography?) My points being, #1 I'm passionate about this field of nursing and #2 I won't be leaving it to work in some other specialty - this is truly what I've been working toward for the past 5 1/2 years. My program is giving us med-surg clinicals all 4 semesters, along with 1 other (last semester was peds/maternity & this one is psych). When I graduate, not only will I have my BSN, but I'll have a LOT more med-surg clinical hours compared to students at other schools in the area. I'm hoping that will work in my favor, since I would love to work in postpartum. What advice would you give to a new grad in postpartum? I for sure won't be precepting in this area (you guessed it - med-surg!) but what makes one new grad better than another when they start working? What things have you noticed from those you've worked with that make them great nurses and great team members?

LoveMyBugs, I hadn't thought of that. I've got a friendly connection with the wound care RN at my med-surg clinical location, so maybe I should ask my instructor if I can shadow that nurse for a day? It sounds like the SN hallways were a lot like rehab, with some hospice thrown in. Are the SN areas more broad in the ages of the patients or are we still talking about older adults? Where I live, we have a separate rehab hospital and lots of LTC facilities, and a LOT of independent/assisted living communities with LTC sections on one big campus. Do you ever have opportunities for teaching, away from the bedside? That's something I'd really like to do, especially in an independent living/assisted living environment. Do RNs handle that, or do the communities bring in pros from the outside? This is really good input! Thanks everyone, and keep it coming! I'll even take stories about favorite patients :loveya:

Good point. I was wondering about skills - haven't had the chance in my med-surg clinicals to practice IVs much, but lots of post-op wound care & passing meds (not just PO, either). I know what you mean about working with residents. I had the opportunity to work with a lot of older adults last semester in med-surg clinical and it was very rewarding. I felt like I'd made a difference in their lives, even if it was just one shift. Thanks for the well-wishes!

Thanks, NamasteNurse! I have 1 friend in my class who feels the same way I do, and we've pretty much decided we're sticking to the old folks. :) Can you tell me more about what a typical day at work looks like for you? One reason I'm particularly interested in LTC/SNF is that I've heard the shifts are 8hrs instead of 12. Is that the case in most places? What is the nurse-patient ratio like? How many CNAs per unit? What would you say are the top 3 chronic diseases you see in your patients? I'm thinking DM 1 & 2 and COPD for starters. After I pass the NCLEX (trying to stay positive here!) what certifications would you suggest I pick up? I'm thinking ACLS, but any others? Thanks again for your response! :yelclap:

Okay, so I'm graduating in December and I'm seriously considering geriatrics/LTC as a career option. :loveya: I've got a knack for working with older folks (which makes me an oddity in my class of 23) and just don't like med-surg that much. How do I find a job in one of these places? I've been looking online and no one seems to advertise for RNs in my neck of the woods (tourist destination in the southwest) but it could be that I'm looking in the wrong places. Should I just walk in and fill out an application? What about assisted living facilities? Do they hire RNs? How would you advise a new grad in this situation? Also, I'd love to hear why you like this kind of nursing, because I haven't met many RNs who LOVE working with older adults. Thanks!

Learned a hard lesson about this during 1st semester, and it was worth it. When you implement good personal boundaries in school, it helps you keep your perspective. Plus, it's good training for the work world.

Hi MissKrissy! I'm so excited to hear about what you've been doing. I loved postpartum this semester and I think it's great you're having such a good experience. Stork nurses are busy, that's for sure, but it makes the day move fast. I think postpartum is the area I'm being led to after graduation and I can see myself there for 20 years or more. Congratulations again and keep up the great work! Your patients love what you do, I'm sure :heartbeat ~busymommy

Definitely like this series. I have the NCLEX prep book and use it now to prepare for theory exams. The maternity and med-surg sections are especially helpful. They have lots of NCLEX style questions at the end of each section, with rationales for each answer. To maximize your time, maybe try using these books for the concepts you're really struggling with. I agree with the library idea - make sure it works for you before you spend the $. Or, if you like it, put it on your Christmas list, like I did. They also make little pocket guides which I've found very helpful for things like F&E balance, labs, and remembering the differences between hyper- and hypo- (fill in your favorite disease process).

I totally understand, and I've only got 4 weeks left of my 2nd semester! One thing that helps keep me going is that the economy's got another year to bounce back before I hit the pavement, looking for a job. Just think....you can enjoy the holidays without having to worry about buying more books, financial aid applications for next year, getting the least-desirable clinical sites/instructors..... and let's not forget all those wonderful students that have been getting on your nerves since NS started!! You can do it! Best of luck on the NCLEX, too :-)

Yay, I'm so happy for you! This is the specialty where I think I'd like to be as well, so post some stories from your first few days/weeks!

Hi Liebchen. I think you're on the right track - but what about something like "Effective breastfeeding AEB proper latch, no reports of pain by mother..." or "Readiness for Enhanced Knowledge r/t health maintenance AEB...."? You could also toss in "Risk for Caregiver role strain r/t multiple demands behaviors" which could apply to the father or even the grandparents, depending on how involved they are.