Kdids520

I've been in those shoes. My best advise is to make yourself a "brain sheet" to help keep you organized throughout your shift, and keep a blank index card in your pocket. Jot down things you need to look up when you get home, or questions you might have for your preceptor or manager.

I've been an LPN since 2007 and have worked in a pediatric LTC/Sub-acute ever since. (Think CP, seizure disorders, trach/vent dependant, TBIs, spinal cord injuries, GTsetc)... I've also worked per diem for an inner city ER (adult). I recently graduated and got my RN license. I've been hunting for a job (with no luck), but just got a phone call today from an excellent hospital in my area. It's for a temporary (13 week) contract on a pediatric floor with potential float to peds same day surgury, PICU and peds ER. I know that it could be a phenominal opportunity, but there's a catch... I spoke to the nurse manager and she told me that they will only give me 3 days of orientation because it's only a temp position. I told her I'd be uncomfortable with that seeing as I've never functioned as an RN in acute care, so she told me she could probably stretch it to a week's worth of orientation. There's a 75% piece of me that knows that I could do the work and do it well. Then there's the 25% of me that is scared that the expectations will be set to high for my "new-grad" skill set. I've never done IVs on kids--just adults in ER never had to do an admission never did a care plan on the floor (just in school) never accessed central lines never hung blood products (only monitored) Do you think I'm biting off more than I can chew? I'd hate to pass up the opportunity, but also don't want to make myself look like a fool. Give it to me straight, gang...

I've been at my hospital for 6 years and asked from feedback from HR before starting Excelsior. I was told by two HR recruiters that the state board exam is the equalizer in their eyes---as long as I had RN after my name, they didn't care about school. Also, was hired as an LPN in a huge local teaching hospital---did my orientation with 3 excelsior grads.

I was hired with 4 other LPNs and a new grad RN who had been an ER tech for a while. There are only 2 of us left (both LPNs)... I think one of the biggest problems is that the LPN scope of practice for my state does not allow us to do a lot of the required skills needed in the ER. (No ABGs, can't hang blood, can't give IV pushes, etc.) Due to that, the RNs feel like they're responsible for our patients. I come from a nursing background where teamwork is critical and everyone pitches in...so that's how I work. If I need you to give my IV push, I'll get your patient on the bedpan---I'm not afraid to push my sleeves up when needed. I just never imagined that this new environment wouldn't have the same give-and-take that I'm accustomed to. Toxic is absolutely the best way to describe it. I'm glad to hear that you all think that it's particularly so in this case...I honestly can't wait to get the heck out, which is sad because I really like ER nursing from a patient/challenge perspective. Maybe I'll give it a shot somewhere else, but for now---just ugh.

Maybe I'm just venting here...or searching for some sort of validation... I love being a nurse. It is a part of who I am to the core of my being. I legitimately can't imagine doing anything with the rest of my life. I've been an LPN for 6 years and have worked in a pediatric sub-acute/LTC. I feel like my clinical skills are strong and I'm always trying to further my education. I complete my RN in a few months and look forward to starting that new chapter in my career. In the meantime, I took a per diem job in an inner city ER in an effort to get more (non-peds) clinical exposure. I really felt like I'd learn a lot and take a lot from the experience, but all it's doing is making me want to quit nursing all together. I have never (in my life!) been treated the way that they treat me there. It's a huge teaching hospital, and I came without any acute care experience. No hands on IV skills. No adult nursing exposure. They knew this when they hired me and told me, "You'll be fine." I received 3 (!) days of orientation and basically taught myself how to do IVs (thanks, youtube!). The RNs and management that I work with are a nightmare though. As I said, my clinical skills are strong, but I feel like every time I have a question, I'm looked at like I'm a moron. They are downright nasty, unhelpful, and instead of helping me to learn things here-and-there (I'm not expecting them to teach me everything under the sun), they've taken opportunities to cut me down. IE: Got to work the other night, and on RN asked another (during our report), "Any new gossip since I was on vacation?" The second nurse replied, "Did you hear they're making the LPNs take ACLS?" and the two of them started cracking up...as I sat there amongst them, the only LPN. For the record, I'm ACLS and PALS certified. I don't want to be that nurse who goes complaining to management for every little thing, but the overall attitude that I get every time I walk in the door is ridiculous. I have never worked in such a ****** environment. I come from a place where I am respected for my work, and go here to get dumped on. Is this just how ERs are? Is it a different breed of nursing that I'm just not cut out for? Or do you think that I'm just being too sensitive? I really want to ride it out for another few months so that I have 1 year of acute care/ER nursing for my new-grad RN resume, but is it worth it in the long run if it makes me hate being a nurse.

I have one that I used in the ED all the time...it's stored on my work computer, so I'll send it to ya when I get back in on Saturday

I've seen a lot of people mention their CPNE grid on the boards here and on various websites. I can't however find anything about it in the cpne study guide. Is it just something that people have learned to do over time? Or is it some sort of requirement that I'm not finding. Personally, I don't love mnemonics but I guess I could work on some if need be...

I've done one a month while working full time (36) hrs, and part time a few hours a week. It's just me and the hubby, so I have little distraction. If you can do 8-10 hrs a week of studying, once a month is totally doable

I'm eager to see replies to this as I had the exact same questions. (Jersey girl, here!)

Be careful about this. I was always told not to "work below my license" as it presents some liability issues.

A little background on myself: I've been an LPN for 5 years and am almost done with my RN. I expect to graduate in December. I took a per diem job working in a Level II ER. There is so much to learn and I'm doing my best to ask good questions, follow along, and pick up everything that I'm expected to. For the most part, I've worked hand-in-hand with an experienced RN who is great about giving me direction while letting me use my own critical thinking...I had a bad experience the other night though, when I was working with a different nurse. Here's the story... I came in at 11p. This nurse (let's call her "Donna") had been there since 7pm. I had never met her before so I introduced myself and she just said, "What can you do? I've never worked with an LPN before." She was clearly swamped and stressed so I gave her a quick run down of what I could do and I asked her for a brief overview of the patients that we had in our section. She told me that she was too busy at the moment and would tell me later... In the mean time, the charge nurse brought a new pt to us who reported n/v x 5 days. Donna quickly said, "Can you line an lab him, and start fluids?" It struck me as odd that she wanted me to start fluids on him when he hadn't been seen by a doc yet. I did his line and labs, came back to the desk to get a bag to send it to the lab and she said, "Wait--my lady in 7? She needs Tylenol. Can you give her a tylenol?" So I said sure. I pulled the lady's chart and she had no order for it. I asked her if I was missing it somewhere and she said, "No, just give it. I'll get an order later." Ultimately, I told her I wasn't comfortable doing that. She got mad and started to give me a major attitude. It carried on for quite some time until I (politely) said, "I'm doing the best I can to get us caught up here---the attitude from you isn't really helping the situation." She told me she didn't have an attitude. Anyway...my question here is this: What would you have done in this situation? I guess it wouldn't have hurt the n/v guy to give him some fluids but I wasn't comfortable doing it without an order. Same for the Tylenol lady. Am I just being too stringent with my personal nursing practices? Any thoughts and feedback would be great...

As a nursing student, we were doing our clinical rotation in a nursing home. We were told to do AM care for our patients and help them get up and dressed for the day. I was assigned to an elderly man who was talkative and pleasant. I gave him a bed bath and the entire time, he kept saying, "Oh, that feels nice. Yes. That feels good. Mmm Hmm. You're doing a great job." I thought nothing of it, finished up with him and then was standing near the nurses station with a classmate talking about our mornings. I said "I just finished giving my patient a bed bath and brought him to the day room..." The nurse working there said, "Who do you have?? I thought you had Kevin in 104B??" I told her that I did have him...her response? "You just got played, honey. That old bastard walks himself to the shower every morning."