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Silvergem800 has 1 years experience and specializes in Med surg.

Silvergem800's Latest Activity

  1. Silvergem800

    Med surg nurse breaking into specialty

    Thanks amarilla for your input. This will help for certain. I haven't meant to job hop. The hospital I was in before this one was on the verge of getting shut down. I found out all the nurses one my former unit were laid off only 2-3 months after I started this new job. I don't want to look like a job hopper. I do want Er. I feel it just fits my personality and the way I think about things I guess. I just want to know how to get where I want to be. If I have to wait some more I will. I'm starting to get over the new nurse anxiety and I do my best everyday to meet the expectations of the hospital and unit/manager. So I'm starting to get used to it. I just know where my heart lies. So whatever I need to do to get there is what I'm willing to do :-). Thanks for the great input again
  2. Silvergem800

    Med surg nurse breaking into specialty

    Hi there. I'm a med surg nurse and I have been working at my current job for almost 7 months full time. I worked at another hospital for 6 months prior to that and left because the patient load was unsafe and the hospital was under threat of closing. They are officially closing at this point btw. I really want to be an Er/critical care nurse. However alot of the positions want you to have a year of experience in the area. I am currently trying to sign up for an ACLS course and enroll in a bachelors program which would help I know. But how else can I make myself marketable to Er/ critical care positions. I do one day of OT in the Ed holding PTs admitted and waiting for beds. But I'm not sure if it will be enough. I'm not crazy about the hospital I'm in now and am looking to change venues but am wondering if that is wise. I have a total of 13 months experience. I was also considering applying to critical care fellowships for nurses but don't know of too many other than 1 in my area. I'm in NYC. Not sure where to go to move forward. Some advice would really be appreciated. Thanks so much
  3. Silvergem800

    New RN job feels like nightmare help!!

    I have been working in a NYC small community hospital for 3 months. I had 6 weeks of orientation 1 weeks of classroom time and have been on my own since mid november. Every day before I go to work I have the feeling of impending doom. My anxiety level has been through the roof! My average patient load is anywhere from 7-11 patients per shift. That Does not include discharges, admissions or transfers. Most days it's 9 or 10 I am overwhelmed have been making alot of mistakes. I feel like I got thrown into this job. They couldn't wait to get me off orientation. My first day alone I had 11 patients and over new years weekend I had 9- w of which 2 expired 3 nh discharges and a transfer to telemetry with 3 still left to care for Now yesterday I had 9 PTs I feel like I made a med error. I gave fragmin 2500 to a patient whose h/h was 7.7/23.6 and ptt was 335. I called the dr after my shift had officially ended to tell him the CBC results and he order the Pt to get blood but I still feel awful. There is no pixus so my day is filled with searching for med cart keys and narcotic keys. There are no computers. 10 am meds are not in the med room by 10 am so the majorty of stuff is late. I can't find the time to do my notes during the day so I don't stay until 9 pm. When my Pt expired my manager said that it through me for a loop and I had other patients to care for. It was my first one as a nurse ever!!! I'm sorry if this sounds like a rant but I don't know if I should stay. I'm in the union and I have filed 3-4 protests since I have been there and joint commission is coming this month. Other places get 5-7 PTs. I'm getting an average of 9-10 what do I do should I just quit cuz it's so hard to find work in ny right now. But I'm really scared for my patients and my liscence. It's really hard to give the care I want to give them. And when I ask the nurses aids for help they always have something else to do. I don't know what to do. Everyone says if you can make it at this hospital you can make it anywhere but I don't know how handling 9-10 PTs proves I'm going to be a good nurse? Just means I can give limited care to many Ppl in my opinion. We also get alot of DNR PTs so when a patient is going downhill and I tell my manager that this Pt doesn't look good the first thing out of his mouth is "is the Pt a DNR". And if it is well just give o2 and fluids. Doeant seem to matter what the Pt is here for. I hear alot how things cone with experience and it will get better. I just don't know what to do. Please help could really use the advice from all of you on here. I am very nervous and um afraid I'm gonna harm someone and that's the last thing I want to do. Please help what should I do and if I'm gonna stay how do i manage all this better. Thanks in advance for takin the time to read this.
  4. Silvergem800

    New Nurse Needs Orientation Advice

    yeah its not supposed to be 10 though I have been told that a safe number of pts is 8...most institutuions i know of have 8 pts per nurse and even that is alot 10 is due to being short staff and some of the nurses file protests when the load is too much not sure what to expect from the first few months but the general concensus is that the situation isnt typical
  5. Silvergem800

    New Nurse Needs Orientation Advice

    Hi everyone...Thanks for taking the time to read this I am a new nurse working 5 weeks on a busy med surg floor...now let me say I am overwhelmed...I know this is normal for where Im at in the stage of the game. im not used to this level of responsibility, time management is lacking...im not sure how to manage my day or what things take priority and my confidence is lacking. my orientation has been very hard. My first day I was given two patients and found myself pulling my hair out. my preceptor the next day asked if i was comfortable taking 3...when i said i wasnt she said that I need to build up to 10 patients by end of orientation. orientation is only 6 - 8 weeks. now im up to 5-6 patients. I was adament about my comfort level but it seems that I am being pushed to build up to this expected load. I am afraid by this for myself an my patients. I found myself with 6 total care patients who were of heavy acuity and struggling to get my meds out on time. so when I asked for help in distributing the meds after I had checked all the orders, I was told "If i give out the meds to your patients then they wont be your patients" it wasnt until my manager came over and asked if I needed help did I recieve it. I recieved an admited pt who was in respiratory distress with a very low bp and when I called the dr, I was told the pt should go to ICU. When I told my manager the situation, he asked if the pt had a DNR. I said yes he was 55 y/o and had a DNR. He looked at me as though I had done the wrong thing and asked why did I do that. Was that not the right thing to do. My confidence ha been low ever since. My first week a patient fell off the bed because the bed locks failed. I find this on most of the beds as im performing pt care the beds move. The blood pressure cuffs are manual and some of them dont pump up and wait for realease....they release on their own so as you pump them off they fall right back down making you have to catch the beats in the middle. I am not sure when to fit in a physical assessment in my day and I havent seen my preceptor take L/S or B/S. so when I tried taking my assessment and putting it in my notes I was told I shouldnt write too much just write what I see. Most of the patients are on prophalactic heparin and fragmin, even the ambulating ones and when I mentioned the H/H was in the 8-9 range with 26-23hct my preceptor tells me to give it and then call the Dr. I am also told if I have questions, to ask and am left on my own most of the times. Im too needy and dont trust myself enough....and ofcourse....to relax. I have also heard Im not aggressive enough. I hear alot of what Im doing wrong and not alot about what Im doing well with. I dont expect praise every 5 mn but some support would be appreciated I guess. I know many of these things are in my control but I also feel that where I am is not safe either. I need an expert opinion, someone with more experiece than myself...which is all of you. What can I do different, is this kind of beginning normal? or should I be looking for another job...which is very hard to come by right now. is this to be expected in the beginning f my career, or is this too much? not sure!!! just tell me what I can d to improve myself and my situation. My gut tells me to leave but I need the job but I dont want to quit without another job or if this kind of experiece is to be expected and I just need to handle it better. What Should I do. Your candid and blunt feedback is welcomed and appreciated. Sincerely a Nurse who wants to learn and do the right thing
  6. Silvergem800

    Carlos-Gang member-Registered nurse

    Hey I dont know if any of you have heard of Pablo Francisco. He is a comedian and he did a skit about his cousin Carlos who becomes an rn very funny:yeah: http://www.youtube.com/watch?v=LLYelAh60FY If the link does not work just look up Pablo Francisco-Registered Nurse on Youtube. warning...has some profanity
  7. Silvergem800

    Need advice - when should i take my nclex?!?!

    Thank you so much!!!
  8. Hi there, Im new to this site but so far all the wonderful advice and encouragement I have read makes me hopeful that someone can help me solve my dilema:confused:. I am scheduled to take my nclex exam on 7/14. I have taken Kaplan and am now working on my review material and questions they provide. I am consistently getting in the 56-67% range on various tests that I have taken. I do not feel confident about these scores but also feel overwhelmed with the mount of material. I took the ATI and recieved a 68% on that (87% chance to pass). I am debating as to whether i should take more time to study. What makes this decision hard is that I am scheduled to leave for Isreal on a free 10 day trip on 7/18 and would not be back in the country until 7/29. I have to go on this trip because it will be my last chance to go due to my age. with these kinds of scores, should I take the nclex on the 14th or should I wait until I return from my trip? if you were in my shoes, what would you do? again thank you so much for your help!! such an awesome site!!!