RW23RN

I'm in the AGAC/FNP dual program, started Fall 2020. If you don't get any bites here, there are some active FB groups you can search for by the school name. Good luck!

I emailed the help desk yesterday to see if they could give me my jagmail and they said there was no info on my account yet like it hadn’t been set up. ?

Yay-hopefully that means the rest of us will get them soon!

I had one through work, but you can go to any of the Request a Test or direct to consumer labs and order one. That’s what I did with varicella titer.

You might be right about that, and maybe I’m just a random outlier..but kudos to y’all for getting your apps in early and having great GPAs. I was worried about mine not being good enough but that was well over a decade ago for nursing and two decades for my other degree and it’s not changing ? Oh and I think I got my app in 2 weeks before the deadline. I was surprised to see a response so soon...I figured so much got shut down they had some free time to go thru apps! But I’m thrilled to have an answer and start making plans!!

OP- I’m so sorry you are in this boat. You are entering nursing at a very strange time! Today I’m starting a new job at a new hospital (like my 10th new nursing job in my career!) and interestingly, what I see is everyone is anxious, confused, frustrated, tired...but we are all in this boat together. Don’t let anyone tell you your feelings are invalid-it’s OK to feel all those things. But don’t stay there, OK? I promise, it will be OK. Like everyone else said, find a good hospital with solid orientation or even a graduate nurse residency program-you will find that most of the training you need will be over the weeks/months in new grad orientation. When you get there, find a mentor, someone you can ask about clinical things you may have missed or not covered as well as you would have liked. Watch videos about procedures. You’re missing out a little bit, it’s nice to get exposure to different areas during clinicals, but also, you are missing out on getting yourself exposed to C19 during this time. you’re not alone in your frustration-climb on in the boat, we’ll all make it thru together!

I missed the email last Thursday because I wasn’t expecting it this soon! Saw it Friday-I applied for the Dual Role FNP/AGAC for Fall. I know several that are in or have gone thru the dual or adult programs. I keep hearing if you follow the directions, keep up with assignments/readings you’ll be fine. I’ve already kind of started to network from hospital connections (this is where agency/traveling comes in handy!!) and asking classmates that have already done their programs who they have worked with for possible preceptors down the road.

Depends on the hospital you are working in-if it is a large or small ICU. Don't be scared-just absorb what you can and ask lots of questions. The nice thing about ICU is that you have 2-3 patients usually so you know much more about the history and current situation of your patients than you would on a med surg floor. Likely you will encounter sepsis, acute respiratory failure, exacerbations of chronic illnesses (copd, chf, renal..) DKA and a host of others. It's overwhelming at first but just try to take it in and learn what you can.

Interesting-I'm thinking of leaving bedside (ICU) and agency work (ICU, MS, LTC) and getting into Case Management but I have been worried that I wouldn't be qualified. (5 years as RN, with BSN). Maybe I need to move where you are!

I don't know that its a right or not. But I can get used to the concept. I think done correctly it would lower hospital admissions for chronic diseases. However, I'm not sure we've gone about it correctly. We probably should have spent a few years building up PCP practices, community clinics and preventative care before we dove right in. I'm concerned about the number of PCPs that are leaving the practice, the fact that we are still fighting over the role of NPs in primary level care, and the fact that hospitals are tightening their belts, increasing nurse/patient ratios and workloads. All of the money that hospitals "wrote off" with uninsured patients, where does that go? Now they will be compensated at lower rates without the tax write offs? I don't think we can yet see the full scope of implications that ACA will produce. I hope things will settle, I hope we figure out how to do it right. But I'm still skeptical.

Just be aware, before facilities go improving ratios in favor of long term cost savings, they will pass the buck to the nursing staff. Hopefully none of us lose our jobs when patients don't get turned/groomed/walked and have negative consequences. Document, document, document! And perhaps we start encouraging family members to get involved with grooming, meals, etc... when applicable and safe to do so. Anyone have any good ideas how to document that things weren't done because you were busy?????

That happens too. My point is, it doesn't matter if you're a good worker or not, still an employee or not. Bad references happen to good nurses and you just have to have some back ups and roll with it. If you have reason to believe an employer has given you a bad reference, ask about it. Address the issues they brought up. Sometimes you can get a job in spite of a bad reference, especially if you can explain the negative points.

I did the same thing, on a telemetry unit. The only thing I would add is to take advantage of their extern program. I externed in the ER there and an ICU, very helpful in choosing what I wanted to do out of school. Float when they ask you to float, learn new areas if you can and just be observant and you'll do great.

This happened to me today actually! I have been awaiting reference checks for a new job, I got a call today saying they needed another professional reference because I had a negative one from a previous manager. What was so terrible that I'd gotten a negative reference? I got into a car wreck during my final 2 weeks and had to call in. This translated to "scheduling issues" and a "would not rehire." Never mind being a good employee before then. I've been working agency for awhile and finding it hard to track down professional references. Its frustrating.

Oh, also you can thank the computerized EHR for that. On my initial patient screen all your info pops up-regligion, allergies, insurance-and sometimes a nice scanned photo of your insurance card. Its not that everyone on medicaid gets a free ride, its that a lot of people use the ER as their PCP because they know they pay nothing upfront. Kudos to your for paying your copays though! Its nice to hear there are responsible people out there

Agreed. But I am so sick of writing incident reports. The wheel fell off a bed with a patient in it yesterday, scared the both of us to death when it crashed to the floor but fortunately that's all-no injuries. When I called my supervisor immediately after, I didn't get a "Is the patient ok? Do you need help?" I got, "well, fill out an incident form and a maintenance form." Really? I spend so much time filling out forms I can't even take care of patients anymore... Don't get me wrong-I get it. CYA. Not charted, never happened so its to my own benefit...

I don't have the expectation when I'm out shopping or anywhere else that I frequent that I am always right. I recognize that I should have a certain level of expectation but that people have off days, things happen beyond their control and that sometimes there are just hateful or ignorant people you encounter, however, generally, the person working at whatever establishment I'm visiting knows what they're doing and is trying to help me out. I think whoever invented the slogan "the customer is always right" has done a great deal of disservice across a wide swath of american life. It just isn't true. This is the difference between admin and direct patient care. Admin views them as "customers" and nursing staff views as patients. All in all, they're human beings that have the right to be treated with dignity but the RESPONSIBILITY to treat those trying to care for them with dignity too.

My Ex used to work in the ER downtown...oh the stories!!! I could never figure out why this particular hospital's policy was to give homeless guys with headaches 3 times a week a bed overnight, 2 meals, and a "to go basket" with toiletries and SCOPE! Which of course led to some fights outside the ER and homeless patients being mugged for their tiny bottles of scope. Oh, and the kicker? They WASHED their clothes for them!!!! LOL...that was his job-take their dirty clothes and wash, dry and fold them. The irony is that that ER actually was pretty diligent about checking the narcotics sites and not refilling meds that the patient had filled 8 times in the last month at 9 different pharmacies.

So I've been do some agency work at some smaller outlying hospitals in my area. I've been working a couple of them long enough to recognize the frequent flyers which generally consist of nursing home patients that ping pong between the facility and the hospital about once a month, a sizeable number of non compliant diabetics and COPD patients, and of course the "I'm out of my pain meds and I'm dying. Can I please have some lortabs?" crowd. Granted, there's the sweet old ladies that remember my name (or at least my face), and the reasonable patients who for one reason or another just can't seem to stay out of the hosptital for very long. But lately I have had several patients who are just downright rude and demanding. I guess in a smaller hospital where they feel like they know everyone, they may feel like they have more control and can act any way they want. But seriously... One lady didn't like the chicken strips on her tray (come on-that's one of the better meals at the hospital!) so she violently flipped the tray over and it crashed onto the floor. One of the other nurses went in and asked what happened, she just went into the bathroom and shut the door. Her visitor stared sheepishly at the floor. Of course, housekeeping came and cleaned it up-admonished as soon as they walked through the door with "Its about time you got here to clean this up!" Another one of our FF likes to yell from his room, "BRING ME MY PAIN PILL" and berate the techs that go in and out. I'll take alot from a patient but I will not tolerate him treating my coworkers so terribly. Here's my point: I wouldn't let my kids act that way (if I had any), I don't let my DOG jump all over people and act so undisciplined. I get dementia patients, I understand severe mental illness. But I am tired of the health care profession making excuses for patients who act out. My new motto is, if you're going to act like a child, I will treat you like a child. I told the nurse of the chicken strips patient I would have handed that lady a trashcan and told her when she calmed down and was ready to have an adult conversation she can hit her call light. And I told my pain pills patient that when he acts so rudely, no one wants to come in his room and take care of him, that everyone would be a lot happier (himself included) if he would be kind or at least civil. But inside I'm seething....grrr I paid a lot of money for school and I am a highly trained, capable professional. Does anyone else struggle with this? Or is it just me...

I agree. I quit that job for that very reason. I went to my manager and told her I didn't feel safe with those ratios, I didn't think it was good that more than half my shift was new grads or less than 1 year experience that can't help me with my SLED/prone pts for the most part. Its not safe. She didn't have an answer and I quit. I loved my unit and I gave it up because it just wasn't a good situation. A lot of experienced nurses did-and now that unit is even less safe. So I protected myself but it didn't change a thing in the institution. They went right on doing what they had been doing, and sadly, many of those that are left don't have the experience to know they're being put in a bad situation. I don't know exactly what the answer is. I'm not sure its mandatory staffing-I haven't experienced that but I've heard it gets down to the ridiculous like lunch and bathroom breaks require you to be covered by a nurse with no other patients. Maybe some of the California nurses can give us insight into whether this mandatory staffing is working the way they want it to. But you know the big hospitals are going to fight that legislation. And working in a state where you can pretty much be fired for anything, strikes and picketing don't happen here. But things don't tend to stay at the status quo in healthcare, they either get better or worse. I hate the concept of standing up for my own license at the expense of my friends and patients.

I've been talking about traveling for awhile and recently started researching different agencies and such. When I started talking to my husband, who works as an ER Tech/EMT, about traveling, he was excited and said he was all for it. He's tired of health care and wants to get into photography, so we thought traveling to some places we have really wanted to visit would be a good opportunity to take pics of new people and places. The problem is, now that I've filled out an application and talked to a recruiter about starting in January, he's getting nervous. He's unsure of what to do for work when we travel, he's nervous about leaving the house for 3 months (even though my sister will be staying here for us) and just generally skeptical about everything working out for us to do this. He's worried that we won't make enough to pay the mortgage on our house while we're gone because the places we want to go are "high cost of living." Anyone have advice or experience to offer??

Sometimes when we have been on the job awhile, we get a little bit lackadaisical about policies and standards. There are times that I run into an insolation patients room quickly to stop a pump without gown and gloves, and I shouldn't. Although I have gotten more comfortable doing assessments and such without gloves, working in an oncology unit has made me more diligent about good handwashing. However, gloves for things like bodily fluid or mucous membrane contact is a standard of care for a reason. The OP is right to be questioning this nurse's practice and if I were a clinical instructor I would think twice about having that nurse precept any more of my students. It is not ok. People do die from hospital (read "health care worker") acquired infections. And remember, as much as new grads and students learn from those of us that have been practicing awhile, we learn from them too. They are good reminders to us about the way things should be! Alot of hospitals are also encouraging their patients to be on the lookout for staff hand hygiene and to speak up when they don't see it. Its a growing focus and I think its only going to get more stringent in coming days.

Interesting debate. I had the same problems with Cerner-maybe the bolus should be a seperate PRN order so we can chart them appropriately. At my new hospital, all of our patients on narcotic drips have PCA pumps, if they are on a vent and sedated (usually with propofol here), they have a basal and a bolus order with no demand settings. That way all of our boluses are recorded and accounted for on the PCA. Its a very small oncology ICU though and its not feasible to do that on a large scale. But it has made me more conscious of my boluses. Although, I've seen nurses accidently type in 1000 mcgs of Fentanyl instead of 100...just CYA whatever you're doing cause no one else is going to do it for you!

We have NP's that work with the hospitalists. I wish Oklahoma would give NP's more latitude, because it seems like they run back to the hospitalist on anything and everything. But sometimes I can win over the NP who the doc will listen to and get what I want instead of talking to the doc directly. Just depends. I've considered NP too...thinking of dual role-ACNP/FNP. And then moving to the Northwest.

Don't be too discouraged. I started in the ICU as a new grad-its a whole different ball game. Fortunately I had a preceptor that liked to teach. I kept a notebook in my pocket and scribbled questions or unfamiliar terms then looked them up when I had time or at home. We had computer based learning modules and a group of us that were hired together that had to do classes together to learn more theory. If you don't have something like that, think about what was going on with your patients and try to go back and refresh yourself on the pathophys and related tests/labs etc... when you go home. I didn't take my EKG class for 3 months, ACLS after 6 months. I had a 20 week orientation. It is hard, but its worth it if you think you like critical care. It gets easier. I remember sepsis protocol being soooo confusing at first-all these labs, drips right and left, hourly VBG's-that's just doing. Then you have to call results, and you should know vaguely what they mean...now I can do it in my sleep. If you think its what you want to do, stick it out a little longer and see what happens. Maybe you can talk to you manager about a different preceptor. Or maybe just sit your preceptor down during lunch break or something and tell her you're struggling a bit. Ask her how she felt at the beginning, what worked for her, and maybe tell her what would help you. That way she gets it that you're struggling and maybe starts to think about how she can make your experience better. There have been a few new grads that didn't make it, but very few-and they were just unaware that they were doing terrible-I don't think that's you!! Hang in there!