grentea

I plan to be a mommy, a good caretaker of my fiance who has a spinal cord injury, and I would love to counsel and help families who are learning to care for a loved one with a spinal cord injury....and much like Barbyann, I don't want to be anywhere near a hospital floor. I think everything else will keep me busy enough! :redpinkhe

Tell your DON that you will have go to another hospital soon (give a specific time period) if she can't put you on the shift you need to be on. Remind of your problem and tell her how much you enjoy working there and that you don't really want to look at other hospitals. It might even be a good idea to bring something in writing stating that you are giving your notice as of the date you spoke with her in case she says no to you up front. This would emphasize exactly how serious you are. Although it would probably be a good idea to start looking at other hospitals first if you want to do this or think she'll say no right away. I know that you really like your hospital but there may be other hospitals near you that are good places and will work with you in regards to when you need to work. Don't be afraid to look around!

I'm ACE grad from 2005. I wouldn't worry too much about being a "C" biology student. Any college Biology class is probably way more complicated than the kind of science we had to grasp for our nursing classes. Besides that, I knew quite a few people who said that they weren't stellar students in their initial undergrad degree but once they were focused on what they really wanted to do (nursing), they were kicking butt academically. As far as reasons why some people dropped out...I think for some it had to do with the pace, but they wanted to go into nursing anyways. So a few people actually "decelerated" and technically dropped out of the program but did co-op stuff. Some people decided that they didn't really want to be a nurse all that much, and I guess those were the people who dropped out fast. Other people had family commitments that prevented them from being able to devote all of their time to school. I do know a few people who were truly dedicated to becoming a nurse and they struggled academically but they persevered and made it. I guess what I'm saying is, if you really want it and work for it, you'll get that BSN. It was a good program, and in my opinion, not nearly as unpleasant as some people make it out to be. I actually *gasp* enjoyed it sometimes and had a little fun here and there. I'm happy I did it, and I like what I'm doing as a nurse now.

Good luck to you, my friend. I'm an RN/BSN and I couldn't get so much as a single call back from anyone in HR after I submitted applications for a few different positions online. I have good references too. I guess the nursing shortage doesn't apply there, but I say good for them! They're a good place. It all worked out for me anyways at another hospital. I'm guessing you have to know someone to get in there. Seriously, see if you have some sort of connection there with someone. It would probably help with getting your foot in the door.

Thank you everyone for your responses! Morte, the docs actually are trying to wean him off the trach so I think I can see where the RT was coming from. Although I suppose I wasn't completely in the wrong here. I just didn't want to see him suffocate on his own secretions. Next time, I'm going to page the RT when he asks to be suctioned, but if he's in some serious distress, I'll do it myself rather than wait for the RT. I was just worried I committed some sort of big nursing trach care sin in my relative inexperience with trachs, and I guess I didn't.

So I changed units and I'm orienting on a new unit where there are a lot of trachs. I've been a nurse for a year and some change and I've had a trach patient here and there not one for a long term period of time. I had a pt last night who recently had his trach capped. I did his trach care after he had showered and he told me that the humidity in the shower caused a bunch of secretions to be broken up. I helped him with quad coughing but apparently that wasn't bringing up the secretions. He asked me to suction him and I did. I did this three times total in the night (with quad coughing him unsuccessfully and then suctioning him). A few times the quad cough got it all though. So at the end of the night, I just happened to be talking to the respiratory therapist and my preceptor about how many times I suctioned him, and the respiratory therapist was like, "You opened him up three times to suction him!?" To which I replied, I'm sure with a stupid look on my face, "Um, yeah, he needed it." She told me just to page her if he started begging to be suctioned because she didn't want him to be uncapped and next time I certainly will do that. I was bit too tired to process this at the end of my night, but I do think I was in the wrong with what I did. So my question is, should you suction someone who has their trach capped ONLY if they are in distress?

Usually, my floor has to go begging for a unit secretary on my shift. If we have a gaggle of admissions, we'll get one for an hour or two from a another floor to help us with admissions. Every once in a while, we get lucky and have one for half of our shift which is really all we need. If a hospital doesn't do physician order entry, I think a unit secretary is necessary. I do not really have time to run out patients' rooms to answer the phone, process orders, and coordinate communication between doctors, in addition to passing my meds, doing my assessments, changing dressings, and everything else I'm supposed to do. Ever since our secretary has been gone, I've spent way too much time being a secretary. Oh and don't even get me started on the whole thing where one doctors wants another doctor to call him or her while I have three bells going off and my meds are late. I just politely say, "Well do you have their number? Here it is. Call them." Plus I've been encountering a lot of chicken scratch on physician's orders in addition to MDs clearly not looking at meds or labs the patients ALREADY got or had ordered. A fairly commonplace one (since I've seen this situation a few times in the past month) is to order Lasix (first dose to start "now") without realizing that patient ALREADY got Lasix in the AM. I call up the doc asking, "Did you really want the pt to get 80 mg of Lasix IV today?" Nine times out of ten the answer is no. ARGH. It takes up so much of my time! Ok well I feel better now. Sorry about the rant that got a little off tangent, but really if my floor had a secretary things would be a little better. And physician order entry is a looooong way away at my hospital. *sigh*

This had happened to me a few times with a patient of mine who was on dialysis. Then my health system came out with a warning about patients on peritoneal dialysis and false high accuchecks. With my patient her blood sugar seemed to drop for no good reason occasionally. She'd come back from dialysis feeling ok but tired, her accucheck would be somewhere in the 200's, she'd eat a good dinner, I'd give her coverage, and then at 9pm for her next accucheck she's be in the 40's or 50's. Now this wasn't every night, but it would happen like once a week. Her doc adjusted her insulin coverage, and I would hold her insulin if she felt nauseous so it didn't really happen anymore. So when my health system came out with this warning, it all kind of made sense to me, except that my patient was on hemodialysis so I'm not extremely knowledgeable about the diasylate fluid used in hemodialysis but I'm thinking my patient may have been on a diasylate fluid with some glucose in it. Can any dialysis RN help me out here? So I presume that a lab draw would be the only accurate way to get a blood sugar on patient after they've had peritoneal dialysis but my hospital didn't really give us any further guidance about this other than the warning they issued. Here's a link to an abstract of an article about this problem. A quantitative appraisal of interference by icodextrin metabolites in point-of-care glucose analyses

This week on my unit, a new RN who had been orienting on day shift started on my evening shift, which will be her pemanent position. Her usual day shift preceptor did a double and I don't usually work with her. I felt so terrible for her when I saw how her preceptor was treating her. Her preceptor called her "retarded" behind her back. Of course my other co-workers and I were shocked. I've been really stressed at my job. Our unit had a stretch of highly acute patients with not-so-great staffing, and I was charge nurse every day through it all. So I got a little fried and plus I've only been around on my floor for about 7 months, otherwise I would have been happy to be her preceptor. I helped her with whatever questions she had during my shift and was extra nice and encouraging to her. I just felt absolutely awful for her. I went through a similar situation with a domineering and insulting preceptor, and I know it's hard in the beginning anyways. There's just no reason to be mean to new nurses, unless you have some sort of mean streak and need to take it out on someone vulnerable. I've been particularly angry with that day shift nurse who is trying to scare new nurses off of MY shift! My advice to the new RNs out there is to find the nice nurses on the unit and hang out with us, and of course always consider how welcoming a unit is to new grads.

Sounds like you did not get $11,000 worth of an orientation. It's also pretty darn inappropriate to ask an orientee three weeks into orientation to take her own patients and risk being in an unsafe situation for which you have not been trained, especially in the ICU. There is no reason to stick it out at a place like that, and I would definitely get some advice from a lawyer. I wouldn't just hand over $11,000 to your hospital in payment for a shoddy orientation, and by the way, I've never heard of a hospital making a former orientee pay back an orientation (at least in my area). It sounds like they owe YOU. Most orientations to the ER/ICU that I've heard of are much longer than 6 weeks, and you certainly should have had some sort of orientation to the ER.

In my fantasy life I dream of being: 1. A video editor. It was my job in college and was so much fun. 2. A college campus minister 3. An airline stewardess 4. A musician And when my standards are a little low, I day dream about when I used to work in a deli. Although lately, I've been having such a rough time at work that I've been thinking of my fantasy jobs more as viable options to me loosing my mind at work. I've just been having a bad week and I'm hoping it'll get better.

When I was in nursing school I met a resident who was rather pleasantly confused. When I would ask her the standard orientation questions, she said that she was on a cruise ship with some friends. She even remarked about how wonderful the food was and how she was treated so nicely by all of the "workers" (her nurses and aides). And this made me think for a minute.....it would be almost cruel for me to assert, "No, you're in a nursing home." So we started talking about this and that and she told me about how she had travelled around the world and taken some cruises in the South Pacific. I will never re-orient a sick elderly person who thinks that their nursing home is a really nice cruise ship. Think about it...that's just awesome! I wouldn't ever take that away from someone. The subject of those who are not quite so pleasantly confused is an entirely different matter which I would certainly handle differently, but in the case of those who are happy in their realities, so long as they're safe, I say let them be. :)

If you realize that things really aren't working out with your preceptor at some point, don't be afraid to ask for a change. I did when I was on my orientation and it really helped. My first preceptor was really hard on me and I was really not learning like I need to be. Talk to the other nurses on your unit too and ask them how they would handle different situations. Sometimes during my orientation I stayed glued to the hip of my preceptor but then I realized that there are a lot of really knowledgeable nurses on my floor who are happy to share what they know. Just the other day an experienced nurse asked if I thought a cardiac med should be given with the vitals signs she just took. I told her what I thought and then today I had a similar question for her. So you're never alone even after orientation. I've been doing this for about 9 months now and I've really been feeling more comfortable lately. Over time, you'll find that the daily ins and outs of doing your job won't throw you for a loop so much. I know it's more easily said than done but don't be so hard on yourself. We are our own worst critics. I bet you're doing much better than you think. BTW, what kind of floor are you on right now?

OP, I'm sorry you've had such bad experiences but we're not all bad. I would say that a vast majority of us are very good at what we do and we're professional. I personally would never dream of treating ANYONE like that where I work. In my short career as a nurse thus far, I've met a few bad apples that really manage to stink up a whole floor. Usually, they're burnt out and tired but that gives no one an excuse to act unprofessionally and just plain cruel. Don't let the bad apples you've met sour your view of nursing as a whole. If you're ever out here in Philly, I'm sure you'll find the nurses are pretty cool.

This won't come out as very convincing.....but yeah, I'd probably do it again. There are things that I like about nursing and things that I don't like, but the good definitely outweighs the bad. As many people have said, I wish I would have done it a bit sooner.