tellis6645

Disclaimer: I also cant spell apparently

You bring back memories! It comes with time. There were some days in the first two weeks on my own where I was crying in the med room and conteplating quitting. It was very overwhelming. 1am isnt that bad, my first 3-11 shift on the rehab floor I was there until 2am. Organization: You have to find your own rythm on this one. Some nurses call them shortcuts, but really you need to find what works for you and what doesnt. For instance, I find that I save time if I do blood sugar checks during med pass rather than before or after. Confidence: Also comes with time. I was terrified of calling the doctor when I first started. I still dont like calling the doctor because I work nights and I have to wake them up, but the confidence is there. I lacked confidence in so many places, as an authority figure to the CNA's, in my assesments, in my pronounciation skills. I still pronounce meds wrong sometimes but I just laugh about it. My co workers either think Im stupid or hilarious because I pronounce ALOT of things wrong. If its something that really bothers you then just look up the medication or disease before you call the doctor so you know how to pronounce it. I just dont care all that much Review: I dont know that anything specific is going to help you. You should review your labs, know what they are for and what an odd result means. For instance, if the patient has a BUN of 42, but Cr and GFR are normal you know the patient is dehydrated. You should also know your diuretics because that is the main med that goes with an CMP (besides any potassium supplements). The rest will come with time. This job has taught me more than school ever did. I work as an LPN but have my RN Degree so that should tell you something. Faster comes with organization. Dont be to hard on yourself, give some time to adjust and you will be fine. Best of luck.

Obviously every facility is different! At my facility if you take the order, you take care of it. If our manager takes an order from the doctors, she is the one to make sure its carried out. I have on occasion signed out orders that werent carried out during random chart checks, but its not the norm. These are orders that were written by the doctor and missed, not telephone orders! We dont carry out others telephone orders. So in answer to your question. In our facility, no you cannot take an telephone order and not carry it out. Its considered your responsibility.

I agree that BSN is going to be the new normal. This is because there are just more and more nurses out there looking for work. Extra education never hurts. Im an ADN right now, but looking forward to going back for another 15 months and getting my BSN. I dont agree with that. I would be very interested to see where someone can get an ADN in only 18 months. Where I went to school not only did you have to do all your preqs, but a student wasnt even considered unless they had all their non nursing courses done as well (chem, A&P, micro, english, math ect). That took 2 years before even starting the program, which then takes another 2 (scheduled, you cant cram and get it all done in 18 months). ADN programs are very hard to get into, and almost unheard of straight out of high school.

When I first started nursing I went home in tears more often then not. I was very stressed out. I originally started in LTC on days 7-3. After 6 weeks I transfered to subactue nights (what I was originally hired for). It was the best thing that happened to me. Im considered the permanent nurse for these rooms and shifts. After about 2 months things got a lot easier, but I was still stressed out about the fact that I was by myself with no supervisor and had to make my own calls about "issues". After 6 months I was confident. I have been here now for 18 months and I dont stress about anything anymore. I think learning everything (paperwork, normal meds, times, facility procedures) were the most stressful. Once you become confident in those parts it makes the job a lot easier and enjoyable. Stick with it and if in 6 months you still feel overwhelmed then look to moving on.

There are so many other factors here that are missing. Was she on oxygen? Did you increase it? What did you do to get her sats above 90? If you just left her sating in the 80s and did nothing for her, then I agree with the other nurse. 80s is too low, and if she had pneumonia or CHF then she could have declined very quickly. If you were able to stabilize her saturations then you did everything you were supposed to. Low sats doesnt automatically mean they have to go out to the hospital, but something needs to be done, quickly, to stabilize them.

I would work as an LPN for a few months to a year first. This gives the you chance to pay down some of the debt (after all the longer your debt sits on credit cards, the more you owe). The most important thing however is that it will give you real world experience. This helps a ton in class. It gives you an insider prespective. Also like someone said, most employers offer some sort of tuition reimbursement to help. My particular facility only offers 2,000 a year, but it helps! Are there any grants you can apply for? I had grants for the majority of my nursing education until the last year, and then my tuition remibursement covered most of that. That will help with college costs as well. I know many people dont work during the nursing program, but it is possible to do both. I am the primary provider in my family (with 2 kids) so I didnt really have a choice. I was busy, but did both. In the end I provided for my family, had real work experience, have current work experience, and graduated last week. BTW Im an unusal LPN bridge as I entered into the RN program, did the first year and the LPN option then took some time before going back (which also meant I only had two semesters left, not 15 months). However for our college, to enter as an LPN bridge you had to have worked as an LPN for 6 months to even apply. So make sure that isnt a requirement at your school of choice.

I was watching CNN when all this was happening and they had Dr. Phil on there. He was saying.. "If you know anybody who might seem to be mentally unstable, please call your local law enforcement, they can help you". This is your responsibility. I had to give a sarcastic little laugh. Society does very little to help with mental health issues. I have a family member who is very unstable. I could see him doing this in a second. Have we called the police with our evidence of his threats and crazy behavior.. yup. Did he get arrested.. yep. Did he get help? No, he got probation and is back home. I fear for my life, and the lives of my family and the best they can do is probation. It happens all too often. I agree that we need a better system in place. Im just waiting for the day, my "family member" snaps. So many lives ruined over the inability to help one individual.

I really struggled with this in nursing school and I ended up failing out of the program because of it. I got my LPN and working as a nurse for a year before I went back in. The class I failed the first time (critical care.. last semester), I got an A in the second time. It was due to the experience working as a nurse has given me... it gave me that "insight" I suppose. Working as an LPN not only gave me a boost of confidence (stopped second guessing my answers), but it also helped me to say, well what if this happened to me on the floor.. what is the first thing I would do? What is the most important? I agree with the others, priority is how to think like a nurse. You have to put yourself into the situation and think about it as if you were working with a real patient in clinical. My instructor once said to me... what is going to kill them the fastest? ABCs and all that.

I worked days in LTC straight out of school and it almost killed me. I felt the same way you sound. I think the biggest thing that I had trouble with was the fact of safety. There just wasnt enough time to do everything, and since I was rushing, I was making mistakes. It was scary and it made me feel like a failure every day. After a month I got moved to the sub acute unit and on nights (the original position I was hired for). That made all the difference. Less patients (about 20), more actual assesment and medical care rather than just mostly pushing pills. I have been doing that for 1.5 years now and actually like my job (most days). You have to be happy where you are at. If this particular facility isnt working for you, find another. Right before I got transfered to the subacute floor I remember going into work with the same feeling "I dont care if they fire me". I really almost quit, and that was only a month in.