Sherri RN
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That reminds me of my favorite way to get pysch patients to take their meds when they're refused previously... "Mr X, time to take your vitamin H! (or vitamin V, or vitamin A) where H is haldol, v is valium and a is ativan, depending on which the doctor ordered. Works fairly most of the time!
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"The Next Hilton" heh heh
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1. Relax. 2. Plan to relax. If you can get a sitter a couple times try studying in a relaxing place that is relaxing for you. For me, it's by water like the apartment complex swimming pool (passed ACLS that way!) or a pretty, woodsy park with a lake (passed NCLEX studying by a setting sun over a large pond and skipping rocks on study breaks). This might be enough to get you started. There was another nursing test I had that I couldn't study for at home (cable, video games, computer kept calling my name) so I ended up only being able to study for it away from home (like the medical library at my hospital where I worked). 3. Look into a NCLEX review course, like Kaplan or some other, that you attend and review everything as a group. Reviewing in a group is great because then you see all the folks in the same boat as you, and you have access to the review course instructor, some real flesh and blood who specializes in these type struggles, hey! Good luck!
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That's what came to my mind. I want you get some legal advisors and talk over the possibility of a lawsuit. You need to get your state record CLEAN so you can start over and shine like you're supposed to. God don't make no junk, so don't let this ***h*** turn you into junk!
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I went into the ER one summer to be treated for moderate to severe neck pain, a few days after a ride on the "Master Blaster," a fantastic water slide with a 70 foot drop. After the triage nurse flipped me flat and immobilized me with a cervical collar, I was ignored for hours and continued to be treated like a seeker. I saw the techs record vitals on me, but I specifically remember the blood pressure cuff NOT inflating (yes I wrote it up). My blood pressure was "recorded" as normal, but I know it goes high when I'm in pain, like it does for everyone. I was in so much pain I got fed up and tried to leave AMA. When I'm in pain I don't want to talk, be talked to, or be around people. I just want to be by myself and 'die alone like animals do.' When I finally saw the doc, I was given an IV, and given Toradol (IV ibuprofen, basically). When that didn't knock me out they sent me home on the good stuff PO and with an outpatient physical therapy consult. The physical therapist found me to have no muscle tone in my back whatsoever. I was in my 20s and had exercised but never in a way that would have toned my back and I had a long history of throwing my back out. Usually a few days motrin would take care of my back in the past when it went out, but this wasn't in my back, it was in my neck, my jaw, my life. It hurt to chew. It hurt to talk. It hurt to move, to take a step, and finally, to think. I was treated badly and will never go back to an ER (conscious, anyway) but I ended up with two weeks under the care of a great physical therapist whose strength training advice has kept me out of the ER! The thing about it is, the ER I went to, I worked in the same hospital just a different unit, and that same year an OR tech messed with my lines while I was under during my surgery because he believes it was me who got his girlfriend fired. I originally was going to post this under the drug of choice thread but decided to start my own thread. I was friggin' traumatized!
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You're welcome. I hope you get accepted into a program. You are resourceful, using a board like this to get answers to your questions. We need you in nursing. The functions of a professional nurse are to monitor the patients condition, collaborate with the physician and other team members and try to ensure the patient has a good outcome, within the guidance and flow of the nursing process (collect subjective and objective data, make nursing diagnoses and goals, plan, intervene, evaluate, and re-evaluate). Just how do you envision yourself fufilling those at program completion? Do you want to work in ER, do you want to work on a med surg unit then go to ICU? Do you want to work with kids :barf01: or fly around in air ambulances? :yeahthat: Do you have a family member who was acutely (short time) or chronically (long time) sick who impacted you? I'm stationed near San Francisco. Thanks for the kind words and Blessing. I need all the blessing I can get!
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In my career whenever I've been chronically late there was a nurse on the unit who I worked with or relieved who I felt threatened by. I started being on time when I realized how I was feeling and when I realized I was being irrational. I'd rather get up early, eat, play with my dogs, go to work, get off work on time, get home on time, take my dogs for a walk, get back to sleep on time, get up early, and have a pleasant overall routine than get to work late, beat myself up over being late all morning, work hard playing catch up all day, be stuck after my shift still catching up, get home late, waste time calming anxious dogs, get to sleep late, worry about someone else's attitude at work, not be able to sleep, oversleep, be late to work, and start the negative late cycle all over again. I take care of the little things that mean so much, too. I get new mattresses every ten years so I sleep great, and I take my allergy medicine regularly so I sleep instead of snore from a stuffed up nose. I also got into my 30s and lost interest in partying, drinking, etc. It's easier to be hung over regularly, feel irrational about someone at work, not want to work, be distracted, and not have a routine when you're abusing alcohol.
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I think an orientation program for new graduates is great. The one the Air Force uses is called the Nurse Transition Program and they have it at a few different bases; more choices for the new recruit on where to live. It is 4 months long and focuses on managing the transition from new grad RN to a functioning member of a peacetime health care unit and a ready member of a deployable unit on call to anywhere in the world with a wartime or humanitarian health care mission. We have two nurses in charge of the program. One is an older nurse experienced at writing and explaining policies, and experienced in the emotional needs of young females being a single mom with teenage daughters at home. The other nurse is younger but the pick of the litter when it comes to basic med surg nursing skills, precepting, and evaluating time management skill of nurses. The nurse managers of the units nominate senior nurses to be preceptors for the new grad program, and these two nurses hold the training. The training is one day, and annual refreshers are mandatory for all preceptors. Only RNs with so much nursing experience can be preceptors to new grads. They also have to be not confrontational but assertive and be good role models. I have seen the program reject potty mouths and meanies from being preceptors of new grads. These 2 nurses which run the program also back us preceptors up then the stress gets to a grad from time to time and the grad tries to send a preceptor down the river like that one American idol contestant tried to do Paula Abdul. They sit down with us and the new grad and listen when there is grievances and make suggestions so the new grad gets a clue and completes the program. We don't want to have to give anyone an article 15 or a dishonorable discharge! If you could research from past incident reports the ten most common types of errors made by nurses in your facility and train to their prevention, you'd have some solid improvements coming to your facility through this new grad program alone, and it'd be specific to your hospital's needs. :Melody:
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The first thing to do is get your personal worries dealt with so you can shine at work. Explore all the caregiver options for your son; you may have to change jobs or move near your mother or aunt or there may be a viable option in your own neighborhood right now. Have back up plans in case a babysitter cancels at the last minute. Talk to co workers who would be willing to fill in temporarily or ask their spouse if it was okay if they be your back up babysitter. I keep toys at my house even though I'm single/no kids because I want to be there for my friends with kids in emergencies. Next take some ACLS caliber classes so you feel more comfortable in emergencies. If you work when it's slow see if you can participate in a mock code. One of the best things I ever did was befriend some ICU nurses. See if you can shadow an ICU nurse for a couple hours; it would be a chance to discuss how you've been feeling with someone experienced in the very stress you are desiring to master. And I'm sorry, but your hospital needs to wake up to the fact that unstable patients that could crash at any time are not appropriate for an acute rehab ward. They need to make room in step down or ICU for them, and your interns need to have a clue. If you feel like you have to go into a patients room every 2 hours instead of every 4 hours just to make sure they have vital signs inside parameters, they are not appropriate for a unit where the nurses carry more than 2 patients at once. On a unit that gets unstable diabetics, I would request a unit in service from the internal medicine department on the critical thinking skills necessary to anticipate problems before they become "an amp of D50, stat." Before then, ensure on your watch that they have a working IV, 20g or better, to accept that D50, before problems start. Find out the nurse to patient ratios in your state laws and expect your unit to live up to that, in writing, and in practice. Tell yourself, you took the time to become a nurse and get a license. Then tell yourself, you're not going to do anything or forget to do anything that takes that license away from you. On my unit we have nurses that have to leave by a certain time to pick up kids from daycare, take kids to classes, karate, etc., and these are the same nurses that come in early, look at the board, look at what patients they're getting and make a stink if they have a hard assignment that they know is going to keep them past their shift, and explain why they have to leave on time. Caught early, we work with them to fix the problem, and give them an appropriate assignment.
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Congratulations on graduation, starting a career in nursing, and getting to work right away. I went back to med surg to network so I could get the higher paying management jobs. I felt disorganized at first, and what helped me was mapping everything out at the beginning of the shift. It could be as simple as folding a piece of paper a few times so when you unfold it, it has enough boxes for each of your patients. In each box, organize each patient (name, room number, times to go into the room, po meds, IV antibiotics, dressing changes, PCA checks, fingersticks, time to order labs by or the labbie doesn't get the message (check with the lab), likewise for radiology paperwork / orders, check vitals / urine output, etc.) and plan your day. If you or a friendly co worker are computer savvy you could design a form and print out a bunch for your clipboard. Don't print out too many; you'll want to re evaluate your form every few days or weeks for needed revisions. Also, leave an extra box on the form to put things like "check off that I read my email or checked the unit comunication book, check off that I checked all my patients had DVT prophylaxis on their legs pumping air (we call them SCDs), that their teds were on, etc). On my unit, and we called them this in nursing school too, we call it "My Brain." Sounds funny when you lose that piece of paper and you're running around looking for "My Brain" but that's what we call it. Make a point of being on time or 5 minutes early or more, from the start of the shift to the priorities you set, to the charting you do, to the time you are due to go home. Don't dislike yourself for being disorganized. It takes time for any new system "to click." What will happen is you will understand how the unit works as a big picture, and it will make you a better preceptor when it's your time to teach the new nurses. The other nurses would do well to pitch in and help each other take off orders when the ward clerk isn't there and the unit is busy.