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.

I get a call from my staffing many nights that I have off. A few weeks ago our census was very high and I was getting calls almost every day I had off. I went on vacation and I had a call from the staffing office asking if I would come back early from vacation! Funny thing is I was in the middle of nowhere so I never I never got the calls on my cell until two days later. I do think that my staffing office needs to come up with a better plan than asking me to come home from vacation early especially when I made plans a long time ago and they knew this was going to happen at least one month prior. Sometimes agreeing to come in does not improve the nurse to patient ratio because my staffing office will use my coming in as an opportunity to pull an LPN off of our floor. So now, I ask lots of questions before even considering coming in on my time off and if it sounds like a dire staffing situation, I call up my co-workers on the floor to confirm it. I have no problems with preserving my sanity, enjoying my days off, and saying "no" to coming in to work when I'm off. I must admit that it took me a while to get over the guilt trip of it all but I've realized that my days off are very important. Having a scheduled day off for yourself isn't selfish, it's necessary.

I'm not happy. Work has been getting to me lately. After about six weeks straight of my usually calm and pleasant floor being turned upside down by poor staffing and an influx of heavy care patients, I've realized that I'm burning out fast. I've complained but no one has listened, not even my union. Luckily, things have calmed down, but I've realized that I've been operating in panic mode ever since stuff started getting crazy on my floor. I guess in other areas of my life, I should be happy. I have a wonderful boyfriend, a nice apartment, and a new car....but the dread I feel about my work lately is like this big cloud looming over everything. I need to loose weight and my apartment is a mess and I just don't have any energy anymore. Needless to say I should find something else to do outside of work but I just don't know how to get myself out of this rut. The best part about all of this is that I've only been a nurse since October so that means I've got to stick this out for many, many more years so I can pay off my student loans. When I'm not running around like a chicken with my head cut off desperately trying to get all of my meds out and treatments done while being a secretary, I enjoy the feeling that I've made a difference to my patients and that I'm truly their advocate. Did you ever have that feeling at the end of the day that you know you did something good but for some reason it's all getting to you or wearing you down?

RowerPSU and anyone else planning vacation- Call up the ACE people and ask them when the orientation is. I had planned a vacation six months before orientation in 2005 (I think it was going to be from September 7-15), only to have it cut short when I got a letter that the orientation was on September 11 or 12 for three days...and class didn't start until the last week in September. (These are proably about teh dates of orientation my year...I can't quite remember but it was pretty close.) So I had thought that logically orientation was the first week of school. Best part about it was I got this letter exactly one month before the orientation. I was exceedingly lucky that I could switch my airline tickets around (thank God for Southwest) but I was still pretty annoyed to have to leave early. My boyfriend actually stayed and left after me because we visiting some friends. So if you're planning something, try to get an answer from the nursing office about when orinetation is or plan your vacation for July or August just to be safe.

Thanks Daytonite and Tweety. Things have been rough lately also from a numbers perspective in that we're short one person. Our ratio was 7:1 tonight and it was rough because some of our patients are pretty darn sick. Although I've realized that if I feel like I'm drowning or if I'm charge and I realize that I need some sort of help for the floor, if I ask the nursing supervisor for some help, he/she won't let me drown and neither will my co-workers. :)

I love my floor, honestly I do, but lately I've been really stressed out. It started about three weeks ago when our secretary took a leave of absence. I'm not sure why and I'm actually worried about her because I really like her. Then this week one of my co-workers, a very experienced nurse who I really love working with, also took some sort of leave of absence. Again, not sure why. Then, for the past two nights one of the overnight nurses had called out sick, which somewhat effects me because I work 3-11. I stayed until 3AM the other night so that the other overnight nurse wouldn't be by herself with so many patients for the entire shift and one of the day shift nurses came in early. To top it all off, we've had a drastic increase in the acuity of our patients over the last week or so. My floor is a rehab floor so typically the patients we get are pretty stable. We've been getting some serious stroke patients lately, and other patients who are heavy care-wise, a few of them only one or two days out of the ICU. I had to stay late again due to an emergency with a patient who clearly was in a worsening neurological status. The truth is I enjoy the challenges of my floor and I know I can handle the patients we've been getting, but I'm just feeling like I don't have enough help and I miss my co-workers. It's stressful to be a nurse and a secretary at the same time. I mean sometimes we get a secretary on our shift but not always. There are two other nurses on my floor who work full-time but sometimes they get pulled because they're LPNs and then it'll usually be one of them, another RN pulled from a different floor, and me and now we have 17 or 18 patients on our floor (5 of whom are heavy care patients). The nurse who had been out the past week who I enjoy working with so much was my preceptor and I very much consider her to be a mentor so as a relatively new (and nervous) nurse it's comforting to work with someone who knows the ropes. I guess I'm just kind of stressed and sad and a little scared. I don't know where my co-workers are going and picking up the slack has been hard on me already. I'm not sure what else is going to happen. Certainly, I'm going to be having a talk with my NM, but anyways, thanks for letting me vent. I'm trying my best to be positive. :)

One of the best thank you's I had ever received was from a patient I had who was also a nurse. Before she was discharged she said, "Thank you for your kindness and for caring about me." The fact that she was a very experienced nurse saying this really touched me because I have all of about 7 months of experience so at times I still feel kind of inadequate. I always do my best with all of my patients, and I've thought about what she said to me many times when I've been frustrated with myself for not knowing everything and not being able to work as fast as some nurses who have been around longer. I guess my patients can really tell that I care about them, and I'm still learning and getting better about my routine and that's ok. :)

If you know your job isn't what you wanted this soon, consider yourself lucky for being that insightful. Don't be afraid to give your two weeks if that's what you need to do and find a job you want. I started out at a job right out of nursing school in September that I knew wasn't right for me, and I'm so happy that I looked around and found one that was. I work in rehab which is kind of like a cross between long-term care and med-surg at least on the unit where I work. So if you gravitate towards long-term but you're not happy with the large amount of paperwork, maybe you'd like rehab. It's very hands-on and most of our patients stay with us for 2-3 weeks. I can't promise you won't escape paperwork because there's still lots of it to do but just as much as any med surg nurse. Take a look around your area and think about what you'd really like to be doing.

Black pen, red pen, yellow highlighter, my PDA, a penlight, flushes, alcohol swabs, my notes, and $3 for dinner. Seriously I can get an awesome dinner for $3 at my hospital. I'm not lying to my paitents when I say, "Mmmm..that food looks good!" Stethoscope around my neck. Although it's been rubbing me the wrong way lately. I'm thinking about a clip of some sort for it. Or my pocket. I guess that would work too. :)

Darn I had enough problems this weekend with the hokey little $5 dollar phones we have in our patient's rooms. I couldn't imagine trying to care for my patients in addition to the expensive TVs and Internet connections in their rooms. Seriously, the phones in three of my patient's room weren't working. It turned out to be a phone line problem but for a good few hours we received numerous calls from frantic family members. I love how people think that just because their family member isn't answering the phone they must have crashed and been transferred to the ICU. Best part was that we didn't have a secretary so all of us nurses had to spend a fair amount of time trying to figure out what was going with the phone line and assuring the family members that the patients were in fact very alive. I'm sure I'm being bitter and insensitive about this, but I spent a large amount of time dealing with this last night. Waaaay too much time. I couldn't even fathom being a maintenance tech for high-tech expensive equipment in addition to caring for my patients. I mean I used to work a job like that a number of years ago, but I wasn't a nurse too. :Crash:

I recently had two patients similar to those, although not at the same time. One was discharged a few hours before the other. Patient #1 had chest pain from a broken sternum and she was terribly anxious. She got herself worked up a lot. My other patient sundowned and I swear I had the same exact conversation with her ten times in one hour, plus she kept trying to get up out of bed and she was really unsteady on her feet. Nothing I could say could assure her that a) her family could find her, and b) we all knew who she was. Ironically enough in between our conversations she even called up her family saying that all of us nurses were "strangers" and she had no idea where she was, this after fairly constant re-orienting. I was lucky in both cases because family members were there to distract the patients for at least part of the time. I found that keeping a close eye on the patient who was the sun-downer but NOT parking my cart right in front of room was a good idea. It seemed like just seeing me outside of her room triggered her almost every time and once I moved to where I could still see her very well but she couldn't really see me, she calmed down a lot. As far as my anxious patient with the sternal pain, I knew she got the cardiac work-up practically every day, and of course psych consults. I have to admit I never did figure out how to get her calmer. Having a really anxious patient almost always makes me anxious too. Hopefully I'll learn how to deal with them better in the future. :)