flashyrn2be

I absolutely love all the responses this post has drawn out. When I am not so tired - I will go back and re-read everything. I just had my first solo shift with 7 pts. 2 were new admits for chest pain, 2 with renal failure, one NSR who decided to to go A-fib with a little tach thrown in (two hours into my shift, same pt also on heparin drip), one post heart cath, and one who fell down in the ER. Awwwww.......welcome to tele. I know this may not sound like much to some but for me.......it was hectic. Some how I still smiled - nobody even knew I was a new RN (except for all my great supportive co-workers - God bless them everyone). Thanks again everyone for your responses. I loved the cat fight too.

Pt was on a heparin drip. Scheduled for a thoracentisis (?spelling) the following day. Lungs sounded clear but diminished at bases. However, Pt at one time, during a 12 hour shift, coughed up a considerable amount of sputum - thick, chunky, green/yellow. I looked up info on the net and found that approx. 26% of pts with subclavian DVT's end up with PE. Thanks for your responses. Just trying to educate myself.

Has anyone cared for a patient with this? My pt had no activity restrictions......I was worried about a PE. What are some key things to assess with this patient? What can I do to help prevent a PE? Thanks in advance.

Congratulations!

Congratulations! What an awesome feeling! Go celebrate

At my hospital, DNR's wear a green band on their wrist. "Green means go - let them go." We also put green tape on the door and indicate which bed is DNR. I think this is a great policy.

It would be a good idea to start "shopping" around now. Get information from the places that you are interested in working. See what they have to offer new grads. I graduated in Dec 04. I started putting out applications in October 04. I did my interviews in November. When I graduated I knew where I was going to work. Hope this helps.

Congratulations!!!!!!

I really appreciate you all taking the time. The infomation you all gave is very helpful to me. I have a 12 week orientation and would not mind extending that time.....I feel better when someone is looking over my shoulder :) I do ask questions constantly. I'm sure my preceptor is sometimes looking for the "off" button. We just had an awful day yesterday - awful!!!! Out of 7 pts, 3 were "high acuity" One of them ended up coding and passed. This was my first code, I had never seen one before either. .And I have to say that my training did not automatically kick in. Why didn't I see it coming? What could I have done to prevent it? My preceptor said there was nothing else we could have done. That we had provided good nursing care. But I can't stop the thoughts rolling through my head, was there more I could have done? This is more of just a vent. I don't expect anybody to have any answers for me. I just need to share. I have to admit that I probably learned more yesterday than I have learned in my previous four weeks of orientation. It was just a lot of hard lessons learned. Again, I thank those who responded to my post. Truly overwhelmed and humbled, Flashy

Hello - I have been an RN for about 2.5 weeks. I am currently in an orientation program for a tele/PCU floor. I have some questions. I do not want to appear uneducated at work. But alot of things I just do not feel were covered in school or in text books. I have asked some questions, but get unclear responses. How do you tell if a patient is going bad? I know I have gut feelings.....but when do I call the doctor? I don't want to call the doctor just because.....what are my key warning signs? I want to be able to provide the doctor with logical, objective observations that they may not have picked up on during their rounds. Do my instincts count? When is a blood pressure too high? When is a blood pressure too low? Is there a panic level? What if there is a huge difference in the ortho B/P's? Do I call or just chart? Is there any interventions I can do without a doctors order? I know you call a code if someone is not breathing or no heartbeat. That much I did get out of school and BLS. But how do I know it is coming...... I had an instructor tell me she did not experience codes because of her excellent assessment skills. I was like *WOW*. She is super nurse. So too shall I strive........ Can anybody help me and my future patients? Many thanks in advance.

hmmmm......... This is just my experience as a new grad. I had no power except to choose which facility I would work at. There are alot of little things that seem to get glossed over in the interview process. Things are promised but not delivered. The hospital I decided to work at requires a two year agreement, but you can move anywhere in the facility after one year. As far as hours, nothing was guaranteed except night shift or day shift. No specific days were discussed. Maybe in a perfect world we would get to negotiate such things........

i also took my boards today. i know how hard it is to stay positive, but please try. you do not know you failed until you get the results. that is what i am telling myself at least. if i give into the despair i feel right now, i will not be able to function. from what i read from other posts it is very normal to feel like you failed. i hope this is true and that we both passed. keep us posted!!!!! sending many positive vibes your way!

took the NCLEX today. Had about 3 Mental Health questions.

My last little refresher course in confidentiality seemed to allude that it was ok to discuss a patients condition with the patient - even if they shared a room with another. This was one of the only if few exceptions to the whole privacy thing. Sounds bizarre, but I re read everything to be sure. I have been in pts. rooms doing assessments, teaching, etc and have the pt in the next bed put in their two cents worth. Oh, tell her about last nite or what about when such and such happened. I find it very unnerving having patients overhear other patients situations or problems. I am all for private rooms, in the ER and everywhere.

Don't get depressed. Just give them a call. Chances are the hospitals are getting flooded with applications from new grads. If you call just to make sure they have your app. - all of the sudden your app is on the top of the pile.

I like your name by the way I wish I had read your post before my interview.....I would have had even more great questions to ask. Thank you.

Thank you all so very much for your replies. I had the interview today.......I thought it went very well in the beginning, then people started knocking on the directors door and the phone started ringing and she became distracted - totally understandable. She gave me the whole song and dance about how she felt new nurses should start out in med surg, but that that did not mean a new nurse couldn't be trained in OB. I told her I respected her opinion and understood her reasoning, but that in my heart I knew that L&D was where I was meant to be. To conclude she said decisions would probably not be made until the end of next week and she was unsure how many applicants she would get. By the way - I had to go to standard GN interview before I was invited for an interview for L&D. I guess this was kind of their screening process. Somehow my confidence kicked in and I feel I did a good job of selling myself. I also asked some good questions (I thought so at least). Again thank you all for your replies. I'll let you know how it turns out. :) Oh yeah - one other thing I took as a positive, she gave me her card which has her direct office line and cell phone number to call if I had any other questions. It might have only been out of professional curtsy(?spelling?). But I took it as a plus.

Since before I started school, I wanted to be a L&D nurse. During school it became obvious that alot of us wanted to do L&D. I kind of saw my dream float away and figured I would have to serve my time in med-surg before persuing my dream. By the grace of God - I have an interview tomorrow with the director of womens services at a local hospital here. I am so nervous and shaky. I can barely type. I did not believe this would even be a possiblity for me. I so want a job in L&D. I have been on 4 other interviews and did very well during those interviews, resulting in 3 job offers. But those were all for med surg positions. But this is the job I actually truly with all my heart want. Ok now to the point - How can I really shine? What intelligent questions can I ask? What should I wear? What would a director of womens services really focus on? Any help, suggestions or comments would be appreciated. By the way, I will graduate school in December, so this will be a GN position. Also, I am an "older" student, 34. Thanks.

Yes - talk to your instructors - if there is a real problem, they should already have talked to you. At my school, they send out letters when students are at risk for failing. Never Surrender!!!!!

I am right there with you - well I am in my final semester, but still I know what you are going through. I too have been called timid my instructors - 2 of them. So of course it has been my mission to get over my timidness. I have not had an instructor as critical as yours however. I would feel greatly intimidated as I am sure you do. The biggest thing that helped me develop my comfort zone was to work as a PCT at a hospital. Being a PCT has helped me to develop the skills of being comfortable with a patient and with their basic care. My clinicals for nursing school helped me to develop my nursing skills, assessment, meds, etc. When you are a student with no hospital experience it is very easy to be overwhelmed when you are knee deep in doo. I totally agree with the fake til ya make motto. Keep smiling, try not to sweat. My most humiliating momemt happened at my last clinical. I had to start an IV with my instructor present. Well lets just say she thought I was making the patient anxious due to my lack of confidence.......she took over. I don't even have the words to describe what I felt. But I can tell you the next time I start an IV with my instructor, I will act like I totally know what I am doing. Fake it til you make it. Anyway - I don't want to ramble. I know what you are going through. My best advice is to keep you shoulders straight and stand tall. This is what you want to do and what you know you are meant to do. We all make mistakes. When your instructor offers "constructive critism", take it and thank her very much. Maybe also bring up any other things you are concerned about, that you may not be doing up to snuff. You can do it!!!!

$12.00 hour, PRN no benefits.

I am only a student. In my adult health I class, the instructor insisted that people on the adkins diet would have blown kidneys at some point. That was really the only thing she highlighted on. I would like to have a greater knowledge base on the effects of the adkins diet on people.

You can pass this class. Don't ever doubt your ablilty. First things first. Make up you own little sayings or rythms to go along with the drug. If you have problems try nursing made incredibly easy. You can do it!!! Flashy

deep breath in........let it out. The most important thing to study is the nursing interventions. They are usually found in a little box in your text book. Go thru the chapter, read all of the highlighted information. Then read all of the little boxes of extra information. The extra information is usually what is on the test. at least at my school. Try to skim the chapter before you read it Look over everything then look at it again. I am in my final semester of an adn progam. Now when I read - I can almost pick out what information will be on a test. Weird, but true. When I study - as I read I write down the stuff that I think will be on the test........usually it is that little nursing intervention stuff that should start to make a bing bing bing sound in your head. I have been kidded recently about my good grades and the quickness with which i take test. Honestly, I think I just figured out the formula. Flashy

hmmmm......I remember feeling absolutely terrified on my first day of clinical. Then I thought - hey - these are just fellow human beings with a bit different perspective on life. I did not really put it all together until I was scheduled to work on the psych ward as a PCT for the first time. I was thankful for all I had learned at school. We had a schizo patient who kept looking at me like she wanted to stick a knife into me. When we took them out for their smoke break - she came up to me and asked if she could talk to me. Of course I said sure. She totally opened up to me - I don't know why. She told me about how her family was against her and why, that the doctors were not listening to her and keep her from her family. She hated make up. Thought it was the devils work. I was thankful I had not worn any makeup that night. Anyway, the teaching they give you in school on therapeutic communication really works. Just go with the flow and remember what you have been taught. With my new critical thinking skills, I was able to realize she was just sizing me up. To see if I would be receptive to her, now I don't think she wanted to stick a knife in me at all. She just wanted someone to talk to. No, I did not solve any of her problems, but if I was able to give her some relief for a few minutes, then I feel I was a success. Bottom line - remember psych patients are human - not monsters (most of them). Always make sure you feel comfortable. Follow your instincts. Flashy