MissM.RN

I have two thoughts about your situation: 1. nursing is a "24 hour role". no one nurse can be expected to do every possible ordered thing within 8 hours. i mean, if the patient doesn't have a productive cough, how are you supposed to collect a sputum for culture? :) 2. urine culture and sensitivity on incontinent patients cannot be collected via urinal or bedpan. This order must be accompanied by a "straight cath x 1 for sterile sample" order. there is no way to collect a worthwhile, non-contaminated sample without it.

If you can deal with a cross-country move, look into NH and VT. new grad and ADN friendly. PM me if you need further detail. I relocated too and never for a minute regretted it

If you feel comfortable sharing, what is your location?

OP, can you relocate? if so, send me a private message. i can give you a couple of leads. if not, best of luck to you. the job market for everyone has been horrible since the 2008 crash!

OP, I echo what a previous poster said: I think it might be time to get your anxiety under control. That doesn't mean you couldn't be a great nurse though! It sounds like you are smart and have some insight. Nursing needs smart, humble people. On the other hand, I will offer that you're going to have to "wipe butts" and that is a hugely important part of nursing. Good skin care and pressure ulcer prevention is essential. I have cared for patients who became septic from infected ulcers, and sadly one of them died. Perhaps being a pharmacist would be more up your alley. Less direct care, still beneficial patient care. Good luck to you! I'm sure everything will work out for you in the end.

OP - yes! I graduated at a very difficult time for new grads to get hospital jobs. It was hard to swallow because I have a family, but I'm glad I did. The hiring process at my hospital was ok - long but reasonable. Recommendation letters/CNA experience/essay are musts. My best advice is to be patient and go where the jobs are. I was lucky that my hospital paid for my relocation, gave me a house they owned to live in for 3 months, paid for all of my training including ACLS, and even paid for the gas I used to drive up from my home state! This hospital agreed to hire me before I passed nclex. best of luck to you.

OP, you should be thanked for your advocacy and getting this pt to the unit where they belong. As a charge RN, I would simply not accept this patient to my unit, not assign a bed or nurse, and maybe even file a union "unsafe staffing" report.

OP, you should be commended for your care and honesty. there are some nurses that i know who would have said "eh" or perhaps didn't even notice the BP AT ALL or worse still, let an entire day go by without any vitals being measured. I too wish that there was a way we could just have 3:1 ratio and do all care. maybe one aide just to help answer call bells or help with max assist patients or turns.

Agree with both OP and previous posters. That job makes it seem as though you were working at a nearly-bankrupt psyc unit in a prison. oy vey! however, yes many new grads state that the work is "dangerous" when it really is the new grad who can't keep up in a full patient assignment. that's not dangerous - that's just the expectations of hospital nursing. i have a hard time believing that gloves were not provided (sorry I just do). my best advice is to try a doctor's office not in the same location as your prior two jobs, get some experience, then apply to a hospital after at least a year. good luck to you.

WHY oh why is "journaling" a new thing in nursing? I find keeping your feelings and opinions to yourself is a lost art. I can't believe your employer (let alone nursing schools) is making people do this. Here's what I would write every day: "thank you, Hospital X, for hiring me". Here's what I would want to write every day: "wow, Dr. So-and-So is an idiot" or "these new dansko's are really tight" :) Best of luck to you, and congrats on being a new grad with a job

Can anyone give me their opinion on this: I've put a few applications out to BWH for staff nurse/floor positions and step-down/intermediate. while I heard back and received good feedback from two other rival hospitals, I have received nothing but auto-rejection emails from BWH. Tough to get in there for other people too? Or should I just move on?

OP, sorry you're going through that. 6 week new grad orientation for a 6 patient ratio? Unacceptable. Please do not judge yourself too harshly given that training and ratio. I refuse to work 1:6 and I am an experienced nurse. agree with previous poster that we always need to be prepared and can't be "too tired for a code" (or however she worded it) but still, staffing is key. I cannot imagine orienting and teaching some of my students/new grads under those conditions. How much meaningful teaching and bedside skill can be taught with 6 patients, two of whom are always confused/impulsive, two are circling the drain, and all need their medications and assessments done in a timely fashion? Best of luck to you. Hopefully you can land at a different hospital system in which cultivation of great nursing care is the priority over $.

Boston nurses, how long did it take (roughly) from the time you applied to a particular hospital job to the time you finally heard back from HR or the nurse manager? I am BSN/experienced. thanks in advance for any insight you can offer. it seems slow...hopefully i'm worrying over nothing :)

yes please! i'm guessing ICU would have to be 1:1 or maybe 1:2 at times. how does the nurse : patient ratio work out generally on other units?

Hi Ashley, I hope you don't mind me asking, but do you know what the ratio's are like?

OP, so sorry you were put in that situation. it sounds like you are working for a crappy agency and everyone who is supposed to support the only one (you!) who was directly in the home failed. The confusion around the actual order, ativan or haldol, the fact that ativan was still in the home, the fact that the nurse is asking you to work outside the scope of your license! Not okay. I sympathize in that I too have been in situations as a CNA in which a nurse (usually lazy) is pressuring you to do too much. Just remember that in many states CNA = NO MEDS. do not even apply nystatin powder or help the patient rinse their mouths with CHG rinse. i watched a nurse i work with hand a bottle of nystatin to an aide and say "put this on after you bathe her". so many things wrong: 1. aide cannot administer ordered medications 2. aide doesn't know where to apply it 3. the NURSE should be helping with that bath! i took the aide aside immediately and told her not to, and to report that nurse right away. you should always do the same. OP, i would start looking for a new job in an environment that is supportive and boundaries are clear. best of luck to you as you forgive yourself for this situation and carry on in your career!

Goose lady - yes, brief moments of patient teaching can occur during med pass. I find it difficult to believe that quality teaching sessions are occurring while wiping someone's buttocks. And how much information is a patient getting while you're for example peeling open a dilantin dose? Is that really enough time to thoroughly discuss regimen adherence and oral care to prevent gingival hyperplasia? You're talking about "teaching in passing". So many other complex learning need examples I'm thinking of.....anyway......it basically comes down to nurses need lower ratio's to provide quality teaching and prevent errors.

"Is there enough time for patient teaching?" NO. I think about this every time I go to work...

BSN, 2+ years ICU stepdown/surgical experience, also charge nurse

BostonFNP, it could be either. I work in a union hospital now, but have also worked non-union.

Forgive me. I can clarify: I would rather be in Boston-city because I'm not really a driver. I don't have my own car, so I'm dependent on MBTA or walking. I would love to be able to walk to work.

Hi Esme, yes I was hoping for feedback about Boston proper places. thanks!

Hello Boston area nurses! I'm interested to find out your opinions about where you work. Do you work in a particular hospital because they are great/nurse-friendly/great manager? Do you even like where you work? All of the good and the bad...please let me know! I have looked all over AN and can't seem to find any updated threads that are not related to nursing school cohorts :) I'm less interested in who has the highest pay, but rather the best working conditions (within reason of course) and best overall experience. I love bedside care and would stay there forever if I could. I can't travel much farther than Boston because I don't have a car. Thanks so much!

ruralnurse84, this nurse in question needs to be reported to the board of nursing. sleeping on the job or be falling asleep while preparing medications?? you were right to call for your support systems. i wouldn't switch any more shifts to avoid the nurse. face him/her head on and don't take any of his/her sh*t. blatantly incompetent nurses should be called out and shown the door - to the BON investigator's office.

Sabr - at the risk of getting tons of "flame emoticons" from AN....if you don't like bedside care then why even go into nursing? i suppose one can also work for insurance companies or something, but "bedside skills" and most importantly a good bedside manner are required everywhere (SNF/clinic/etc) - including working with nurse assistants (or whatever the facility in question calls them). Although the issue the CNA reported you about hasn't been stated - i'm guessing the CNA believed you didn't clean or help clean a patient correctly, or something along those lines. cleanliness in my mind is certainly not trivial. a lack of it can lead to sepsis. I will offer that in this current market, a good two years of acute care experience is pretty much required to move forward. Try to stay where you are and make peace with the CNA. Even if the issue wasn't your fault! CNAs can make or break your career. It's fine if bedside care isn't your cup of tea - just don't leave too early and make yourself ineligible for other opportunities. Best of luck to you