joj0bo

hey guys so i'm six months in and its still very hard. but i'm surviving. sure i made mistakes here and there and were given a couple of talks, but overall the unit manager thinks i'm doing a good job. i still am a ball of anxiety, and i hope that it'll subside somewhat the next six months. i survived four ambulances at once, a blackout where the unit had to do paper charting which i had no formal training, my own little psych unit when i had four empty rooms and within 20 minutes i had restrained homocidal pt, suicidal pt, paranoid pt and a verbally abusive pt, etc. its crazy, i love and hate my job at the same time. i'm hoping after six more months i can comfortably say i'm an ER nurse and a survivor. lol.

hey u guys thanks for the advice. i start on my own next saturday. i really don't feel ready at all, but i have to do it and get learn how to swim on my own. i know i can ask for help (even though the unit itself is busy during the day and the group help mentality is missing compared to night shifts) and that in time i will get my time management down. that part is still a struggle. i can't seem to get a flow for four patients. there was one time during one of my night shift orientations i had an open spot for a fourth patient. i was taking care of three patients passing meds/doing interventions when i noticed i had a 4th patient who came in 15 min ago. that patient came from an ambulance and was triaged, primary assessed, passed meds, ekg done and labs sent....apparently the charge nurse and a couple of nurses all did it. They didn't say anything to me and i was grateful they helped. very grateful. However, i thought to myself...how am i suppose to keep up if i can't even do that on my own during day shifts starting next week. its kinda bothering me and i just wish my time management was here..but i heard it takes time.. not going to lie, my anxiety is up.

quick update. had a small off the ER meeting with the other 3 new hires as well as the lead charge nurse. it was just to see how everyone was doing and how far along we were in our orientations. I learned that the ones that had previous floor experience while getting a lot of stuff done and knowing how to manage their time, still have difficulty grasping new concepts or interventions. Also, one of the new hires is also a new grad. It was a relief to hear her stories and how she feels about not knowing a lot of things. it makes me feel like i'm not alone and she's on the same boat. its a sink or swim opportunity and the meeting made me realize that I could swim if I just believed in myself. yes i'm slow now with interventions, but if i keep on pushing through eventually i can be fast and time management would not be a problem. its still a stressful experience, but i am just going to take it one day at a time. learn from the past days but don't dwell on the mistakes. i just had an elopement the other day where the pt still had the IV cath in. preceptor got mad because i assumed the pt was at CT or ultrasound and didn't chart for an hour. did what i had to do which was call the PD and write it on the nursing notes. its all a learning experience. i just keep telling myself that. my first time alone will be august 20. yikes! it coming fast!

watch! you need a watch too! so scrubs, ID, stethoscope, scissors, watch, two pens, sharpie, alcohol swabs, flushes, WATER, snacks and a small notepad that you could put in your pocket. if you have a smart phone, go get pepid or some other nursing app.

i will try and make some kind of routine. the ED is a bit different from the floor. everything is stat and the only routine i can think of establishing is getting a quick triage and primary nursing assessment down and maybe chart everyone's reassessment every hour on the hour. thank you for the advice. two day shift starting tomorrow. wish me luck! goal: faster, better assessment on patients. try and get urine as soon as possible and work on those IV starts. =)

i will vegasmomma. thank you again for everyone's support. my preceptor, lead charge nurse, and i talked about switching to night for the last two weeks of orientation with another preceptor because my shift after orientation is 3pm-3am. i asked if i could start next week and have a full month with nights. the lead charge nurse has to check if the new hire who is working at night would want to switch with my current schedule. at the moment i'm trying to do a 4 patient load, but i'm hella slow when it comes to IV starts (half the time i'm successful, but when i miss it eats up a lot of time), triage and nursing assessments. i do get behind and i feel the preceptor only comes in to tell me what orders i missed and that it was ordered an hour ago or so. her shadowing isn't really teaching me anything and i still feel like a chicken running around without a head. i'm trying my best and i hear that it does get better with experience, but right now its really a struggle at work and at home. its a struggle at home because of all the stress work causes and at the moment i dread going back to work. i hope one day soon its just gonna click and i will look forward and be excited about work. on the brightside, i really like the trauma rooms and absorbing as much as i can as a recorder, med nurse, or even doing chest compressions. that adrenaline is fun. i just want to get to that place where i know what i'm doing, what exactly needs to be done, and do it correctly in a timely manner without missing anything including charting or paperwork.

thank you for all your responses. it has helped me greatly. i'm at the end of my 7th week and i'm seriously thinking of going to the lead charge RN and asking for a preceptor change even if it hurts my preceptors feelings. I think she tried her best, but having 3 years of experience in the ED, i think she might not be the optimal nurse to train me as a new grad. I had another nurse for a couple of hours and she was constantly teaching. it was a different experience. too bad she has a preceptee of her own. I should look at my accomplishments and to do that deep breathing technique. It just sucks when you do something right and you don't get acknowledged, but when you forget something or do something wrong, the preceptor is on your butt. but that's for any work and its life. thank you again for all your support.

so here's my story: graduated two years ago and finally landed a job recently in the ED. I was hired with a few other people. first off, i got my orientation manual about 3 weeks after my first clinical day after repeatedly reminding the lead charge nurse. Second, my new grad orientation class does not start until my 9th week of clinicals. My preceptor is nice and tries her best to teach me the routines while checking off competencies. The thing is i get flustered when i'm doing certain interventions and she comes in the patient's room and asks, "what's taking so long?" I know i have to work on my time management. Its been a two weeks since i've been given a three patient load and last shift I had my first full load of 4 patients. I am trying my best to get everything done, but i feel my preceptor still helps me out a lot finishing tasks. i feel like after i get one task done, i look at the tracker and the other patients have 4 more things to do. That is when i start panicking. i get tunnel vision, i feel my heart pounding, my forehead sweats, and i feel a knot in my stomach. i still get stuff done, but i hate that feeling. I am wondering how I can handle 4 patients after my 12 week orientation is done and i'm having anxiety just thinking about it. The thing is, the other new hires are already handling 4 patients well without much help from their preceptor. However, these new hires had prior nursing experience in various floors. I know i should not compare, but my preceptor stated it doesn't matter that i don't have experience. Its 12 weeks for all new hires. So basically, its sink or swim. I am happy i have this opportunity and i want to make it, but am afraid that i might be let go if i don't improve soon with my time management. Any tips with time management? how do you calm yourself down when you notice there is so many tasks left to do, nurses asking why your rooms aren't moving, preceptor reminding you about the time, doctor's shouting, etc?

I tried actually. the no experience required is false. they was 90 days of experience required. you may have talked to a regular navy recruiter for enlisted and not for the officer program. this is the response i got from the Navy Reserves. "Good Morning, You recently made an inquiry online about Navy Reserve Medical Nursing Opportunities. The Navy Reserve requires a Bachelor's degree (BSN) from an accredited USA school or a Master of Science in Nursing from an accredited USA school. Nursing requires you be USA citizen, have no criminal history, and have no disqualifying health concerns. You just also have at least three months work experience in a hospital setting. The Navy Reserve is a part time opportunity, which requires two days per month and 12 days per year active duty training per year service. Being a Navy Nurse is truly a higher calling. If you qualify, you may be eligible for a sign on bonus. We also offer flexible schedules, commissary and exchange benefits, training, state of the art health care and rewarding experiences you will not find anywhere else in Nursing. You will be a commissioned officer in the US Navy and be treated as the professional you are. "Ask not what your country can do for you...Ask what you can do for your country" John F. Kennedy, 35th President of the United States and World War 2 Navy Officer. If you are interested and feel you qualify please contact me below: v/r XXXX, USNR Navy Reserve Medical Officer Programs Naval Medical Center San Diego Station"

Thank You for your time and effort in helping me in someway! much appreciated. I went to SDSU's School of Nursing for my Bachelors in Nursing so I think I will qualify for the PHN certificate. Anyone else have any other tips?

I haven't. How does one acquire a public health certificate? Are there jobs available that don't have the 1+ year experience requirement?

I have tried applying all over California including the boonies. I am also in the process of trying to get a compact license for other states. I have had DONs, RNs, and nursing managers look at my resume and cover letter and they feel that they present me in the best light. I have interview questions from various hospitals through networking that i go over. However, I do not usually pass HR. I have been looking since February 2010 after I received my RN license. Thank you for your input. Much appreciated. and to WildcatFanRN - I'll try my best to keep my head up and will contact the nurse recruiter for that particular location today.

I have received the following after applying to the latest new grad program. "Good Day, Thank you for your interest in XXXXX. We are very excited that we were considered as your Employer of choice. At this time, your application is no longer under consideration. This is due to one or more of the following reasons: Graduation date falls on or after April 1, 2011 Graduation date was prior to April 1, 2010 RN experience is one year or more, please apply to experience RN job postings No response to site/unit preferences or "Any" listed. We wish you the best of luck and hope to see some of your names again in the summer. We do not have dates at this time for the posting or program start date. Estimate: Posting -June/July and Program - August/September 2011. Again thank you for your time and consideration. " I am a RN, BSN with no experience that has the usual BLS, ACLS, PALS. I will be taking IV certification and PICC Line management seminars soon. It seems because i graduated December 2009, I am not eligible for new grad programs anymore. what can one do if he graduated december 2009 without any experience? would taking a refresher course make me considered? i think its unfair. i'm frustrated in that because of the recent downturn in the economy, last year's new grad programs around California were few and far between. This has caused a great bottleneck in terms of new grads trying to get nursing positions. With a supposed nursing shortage, how can hospitals, SNFs, Home Health, etc. fill job vacancies if they all require 1+ year of experience? now i'm not under consideration for the new grad program because of my graduation date. what am I suppose to do?