indynurse#2

I would definitely encourage you to hang in there! I too had a long orientation, spent the first week just reading hand books and several weeks after that with a preceptor. I enjoyed it much more once I got to be at my own desk, doing things my own way. I also stayed on prn at the hospital for awhile, but honestly I don't miss the bedside nursing at all. Hopefully once you get settled in this job, you can set up a good schedule for some work hours at the hospital and you will have the best of both worlds! Good Luck!

any utilization review/pre-certification nurses out there? i have been doing this for about a year for a major insurance company and just wondered what others thought about this job. i don't think there's too many of us out there :)

This is certainly just my opinion :) But, a CNA job on a med/surg floor is not necessarily going to be enjoyable to most people, and while it will get you used to being on the floor and around patients, you will be doing very little that you will be doing as an RN. It will be a job of bathing patients, cleaning up messes, handing out trays and taking vital signs (which while you will also be doing some of these things as an RN, it doesn't take long to become real good at it :) Again, this is just my opinion, but I definitely wouldn't leave the comfort of a close, flexible job for a CNA job that was 30 minutes away - commuting gets old, that I do know from experience :) I grew up in a preachers home so I know how important flexibility can be! Good luck on whatever you decide!

I agree that this question could be answered a million different ways depending on who you ask! The great thing about nursing is that you have literally hundreds of options. You will get a feel during school of areas you like and areas you know right away you have no desire to ever work in. I spent 2 years right out of school working night shift on a surgical unit - I learned a lot but hated it! I then worked for a Pediatrician which was much better hours, but the pay was much less. I am now working as a medical management nurse for a major insurance company - I love the job, have good hours and get paid well. So my point is that chances are you will move around a bit after graduation but will finally find your perfect fit!

I found my previous job as a RN at a Peds office online at careerbuilder.com - also look in your local newspaper, especially on Sundays for job listings. And as already mentioned, go to your local hospital websites and do a job search.

Hello - I graduated 3 years ago, so those many days spent in clinicals are still somewhat fresh in my mind :) It sounds like you are a little short on resources - but a few ideas - If anything interesting does happen, make sure everyone gets to see it if possible and then discuss it....Have some nursing journals/magazine articles that relate to the common cases they are seeing on the floor - or even peds in general for the students to read...Is there any "makeshift" conference room like a break room or empty pt room that you could use for some case studies or group discussion?...If nothing else, let them leave a little early, I promise you'll be the favorite teacher

Thanks so much for the advice - I hadn't thought about being able to do a post-MSN certificate down the road but that definitely helps solidify my decision. Thanks!

i'm getting ready to apply to start grad school next semester and i have several options - i need advice from someone who has already done it! one is a msn - nursing administration degree that is all online. has anyone done an entire degree online? - another option is a dual msn/mba which i would love to do, but only if it is truly worth the extra time it will take...as for my future plans, i currently work as a um nurse and plan to stay in the "business side" of nursing - i'm really not interested in being a np or cns - my employer pays for grad school and i always planned on going back anyway, so i feel like this is an opportunity i shouldn't pass up, just not sure what avenue to take. thanks in advance for any pros/cons, advice, warnings, random comments...

We did frogs, pigs and cats...but never people bodies.

I graduated 3 years ago and remember very well the end of orientation, moving to nights for a few weeks of ori then being on my own and just as you described, being scared to death!!! As already mentioned, don't be afraid to ask a lot of questions - you are not expected to know everything just because you are off orientation! I always felt like I asked TOO many questions but on my first review my charge nurse had written that she was not afraid to give me complex patients because she KNEW I would ask for help before I would ever risk harming a pt. There will be frustrations and definitely a few rough nights - but ya gotta start somewhere :) Good Luck!!!

I too hate to sound harsh, but 'several medication errors' in one year would often get you fired on the spot - you were lucky to be given the opportunity to follow a preceptor and keep working at that hospital! Is there anyway they would allow you to re-orient at that hospital, either on that floor or on another floor? I also was going to suggest taking a remedial med admin course on your own, that would show some initiative on your part to correct the situation...I also agree that you need to adjust your thinking on the situation - any med error 'big' or 'small' has to be thought of as a big deal!!! My first year as a nurse, I had two pts getting Metoprolol 10mg - one of them IV, one of them PO - I accidentally gave the IV dosage to the PO pt and it freaked me out - I was in tears, called the doctor (who didn't seem to care, probably b/c this was about 2am :) ) filled out a report then read everything I could about the meds to see if I could have possibly caused harm to the pt. I was scared to death but let me tell ya, I never made another med error after that night. It doesn't seem like you let yourself learn from your mistakes which is vital to being a nurse. Every nurse makes mistakes, it's how you learn from them and let it better you that makes you a good, dedicated nurse!!! Good luck!

I think we all agree that something wrong happened here - the 'nurse' was rude and did not follow basic standards of practice in medication administration - she should be reprimanded about her attitude and given remedial teaching about med administration - yes, I believe OP should follow up on this and make sure it is not just "overlooked" (I worked as a RN in a Peds office, often things do get "overlooked") However - to SUE???? Come on people, our society is very "sue happy" and I think it's getting rediculous. No wonder malpractice is skyrocketing and doctors are getting forced out of the profession - do we really want that to extend to nursing as well? Now if there was intentional harm or GROSS negligence involved causing harm to the patient, it may be different but the fact is, a non-harmful mistake was made (and yes I know, there could have been an allergy etc. but that is not so in this case!) and whether the 'nurse' was rude about it or the most apologetic person in the world, she doesn't deserve to be sued over it, nor does the doctor/NP involved. There are other ways to get the point across that this was not an acceptable standard of practice. There, I'm done ranting :)

My advise - there are too many opportunities in nursing to stay in something you hate!!! I too started out on a specialty med/surg floor from the advice of my teachers, even though I hated it even in school. I stayed 1 1/2 years, then realized the advice I now give to everyone - if you hate it that much, find something else b/c the opportunities are endless! Having said that, I don't regret the experience I got on that dreadful floor, now that I'm out of it and know I don't ever have to go back :wink2: You do learn a lot, but you will learn a lot wherever you go as a nurse, and it can be something you even enjoy! I now work as a UM nurse and I love it.

I know a lot of people have already said this, but what you're going through is very common! I graduated 3 years ago and started out working on a high acuity surgical floor fresh out of school - much of what you've written could have been written by me 3 years ago!!! I always dreaded going to work, I was given too much responsibility too quickly and often ended my night of work at the least frustrated and wanting to quit, and at the most crying and looking for a new job - As I've said to a lot of people, there are too many opportunities/jobs in nursing to stay in something you hate!!! I left for a job in a Peds office - better hours, coworkers were a million times better and I actually enjoyed the job!!! Keep at it, there is a nursing job out there that you can love and thrive in - sometimes it just takes some really horrible experiences before you find that place - I know, I was there!

Hello! I too am a fairly new (3 years ago) RN/BSN grad that hated Med/Surg nursing in school, but as you have probably heard a million times - I was encouraged to do at least a year in the hospital. So, after graduating I worked nights on a med/surg floor for 1 1/2 years, and as I expected, I hated it - not only the job, but having to work weekends and holidays. I left there to begin working at a Peds office, and I loved it. Hospital nursing isn't for everyone and I don't plan on ever going back :) Having said that, I'm really glad that I got that experience in the hospital. It definitely honed my clinical skills and gave me the confidence that I could do anything in nursing that I wanted to. Plus, I made about $7 less an hour at the Peds office. Just some random thoughts, your story sounded so much like mine I had to chime in! Good Luck in whatever you decide, and remember that there are too many opportunities out there for a nurse to stay in a job you hate!

I worked on a high acuity surgical unit for 2 years, during which the hospital obtained magnet status...we thought it was funny, the only change was that we had a ton more worthless "computer modules" to complete. The ratio was 4-6 patients, which I guess is not bad but we did total care nursing, no CNA's to help out- meaning that I did everything from bed baths, meds, vitals, I/O, charting,labs, walking pts, answered call lights etc....I know it took a lot of work including thousands of pages of documentation to obtain magnet status, but I really didn't see any advantage - having or not having magnet status would not ever affect my job decision....but that's just me :)

Just wanted to let you know that your orientation process was not normal! From the sound of it, the hospital, nurse manager and preceptor should be ashamed. That would be a bad orientation for a seasoned nurse, let alone for a new nurse grad. When I started my first job out of nursing school (about 3 years ago now) I was on a high acuity surgical unit - We had 6 weeks of indepth classroom training, and about 4-6 weeks of working w/ a preceptor. First I just watched her, then she watched me take 1 pt then 2 pts etc. until I was comfortable taking a full pt load - in which she still checked in w/ me frequently until I was completely comfortable being on my own - That is what you should expect from most major hospitals - If you want to relocate to the good old midwest, there are several great hospital systems in Indy, Chicago, Cleveland etc. that will provide an excellent orientation process. Good luck!!!

THANK YOU all for your comments and encouragement! You have made my day :wink2:

Utilization management - I do precertifications for inpatient hospital stays and elective surgery. I am in constant contact with Case Managers on hospital floors - they give clinical info on the patient's hospital course and I determine medical necessity/length of stay/acuity needed from the info given me. Although, obviously not a "clinical job" - my medical knowledge has definitely been broadened tremendously. It's a great day job and I would recommend it to anyone!

Here's my question/thought/vent...A few months ago, after working in a busy surgical unit, I started working as a UM/precert nurse for a major insurance company. I love the job - it is fast paced and challenging although in a completely different way than hospital nursing was...Here's what is annoying me - it seems like everyone I tell about my new job - even my fellow RN friends - respond with "you have to be a RN for that?" or "I can't believe you would leave clinical nursing" or even "Why did you leave nursing?"...Am I really selling out on Nursing??? To be honest, I hated bedside nursing in the hospital (now some of that was probably due to the horrible floor I worked on but anyway...) I hate feeling ashamed to tell people what I'm doing - I feel like everyone thinks I simply failed at "real nursing". How should I respond? Thanks for letting me vent :)

From the day I started nursing school, I said I was going to be a L/D nurse, did my senior practicum there and I LOVED it but....when I graduated, I was encouraged to work on a med/surg floor for the experience - which I did, and which I hated :)...Now I work as a UM/precert nurse which I absolutely love! I get to learn so much about every disease/surgery/illness/psych issue imaginable. And truly, I don't miss the bedside pt care at all - does that make me a bad nurse???

I worked as a Pediactric office RN in Inianapolis until 8/06 making $17.25/hr - of course, no nights or weekends...now I work as a UM nurse, also no nights or weekends, making over $50,000/year - office nursing is not the only way to go to have good hours, and definitely not the way to go if you need to make good money.

Hello - We do "self scheduling" at the hospital where I work 3 twelve hour shifts - I think it is definitely the way to go - of course, I'm not the one who has to try and balance the schedule A few rules we have - we have to work at least one Friday and one Monday per each 4 week schedule and any large block of days off (usually any more than 4) has to be approved as a "vacation". We can use 2 "request" days meaning we absolutely can not be moved to those days when the schedule is balanced by our shift coordinator. One major drawback is that we have to do it so far in advance - we're already up to May! I hardly know what I'll be doing next week, let alone 3 months from now:chuckle

hello - sorry, don't know much about the student nurse program at clarian, but i have worked there (at methodist actually) as an rn for two years now. this is my first job out of nursing school, so i do not have anything to compare to - but i think clarian treats its nurses fairly well. people in the community respect "clarian nurses" - it's not always an easy place to work becuase we get the worst of the worst sometimes, patient wise. however, i think it is an excellent place to start out and get experience whether as a student or new nurse. hope this helps some and good luck - maybe i'll see you around :)

I started working full time for a Peds office about 2 months ago - after 2 years on a med/surg floor it is such a wonderful change, I love it!!! Only problem is, I keep picking up whatever the choice illness of the week is! Last week I got the whole strep/sinus/ear infection and now I'm home sick with the N/V/D. Is this common for new nurses in an office setting? How long does it last? Any novel ideas how I can prevent it? I know the basics, such as washing my hands so many times they are pealing - just not sure what else I can do and I'm sick of being sick!