LTCnurse11

I did apply to another job and I was hired into an RN position in a cardiac stress lab--I really like it. The convenience of the day hours is great and I learn tons about cardiology. The problem is it's very routine and the critical thinking aspect is different than floor nursing. IM happy, don't get me wrong. There's just still a painful part of me that feels doesn't have closure about the whole med surg debacle. I've since resigned from the hospital I was employed at previously. And I wanted to clarify that I never got fired from the hospital however reassigned to my old unit. I've been there for a year now and they seem to like me a lot. Just earned an advanced EMT license--Really I'm in a good place. Still can't shake that med surg!!

I wanted to hear which people preferred large hospitals and which preferred smaller hospitals. You gave me your input on your smaller hospital, thanks. I hope to hear about work in a large hospital. I see you have already worked in a large hospital and didn't like it. I changed to a different hospital slightly larger with a few more departments and more services and I like it a lot better.

Hmmm interesting. I wish I would HAVE the opportunity to go other places in the critical access hospital that I work. I've gotten so eaten up by the internal politics that's what I strongly dislike about it. If you fit into the right "clique" at a small hospital you've got the world at your hands. I work at a hospital on which the inpatient manager had only been an RN in that hospital and worked med surg for 2 years, and only 2 years. This nurse graduated from a technical degree program and sucked up so much the she was given an important management job, then the inpatient manager. Such ridiculous politics and absolutely illogical if you ask me. I prefer a larger hospital myself.

How many of you out there have had opportunity to experience work both a rural hospital (ie critical access) or a large urban or (ie cities greater than 500,000 people)?

All of this---awesome. Just awesome. It absolutely baffles me sometimes that humans are the "intelligent" species. Working EMS, I've seen some stupid crap. A pre pubescent boy who decided to go for a walk and did not come home that night which so happened to be his strategy for "earning" an ambulance ride with lights and sirens. Found him at 0230 that morning. Shows up to the ED dehydrated and slightly hypothermic. *sigh* where were the parents? Not looking for him at all!! Actually very, very sad.

No way. If you work nights it will kick your ass and make you sick. If you like taking up to 9-11 sick patients overnight then maybe it's your thing. Days will seriously kill you if you're working a crazy busy medical unit. Too much to do and workers are stressed so they take out their insecurities and exhaustion on you. Just sayin...

Seriously I'm not sure how my complaining about my bad day makes me disrespectful to the service I do for others. Are you yet a nurse? Are you a student? Have you had the chance to work as a nurse or have clinicals in the field? And if you are a nurse, do you work in one field of nursing or do you do more than one type of nursing job? Because all of those things make a difference. And I DO respect my profession. Not only am I a nurse but an EMT as well and could not be more proud.

I'm better today. Just waiting to get a more regular position. Lets pray one opens soon and I get more hours!!

I'm feeling so tired out lately. I am training full time in a new department that will eventually be part time. I totally love my job!!!! My problem is that I have 2 other part time jobs plus ambulance call time. I'm on the verge of quitting one but my husband would freak. What can I do? I'm so stressed out!!!!

Yep, it is everywhere. I think that in the smaller areas its easier to see because you are one of the few. Larger hospitals are widespread and have more departments and therefore more cultures. I think staff morale is the best indicator of overall business and patient satisfaction.

That is so interesting to hear that from another person. I had been working at a very small hospital as a new grad and it was astounding to see how few people it takes to create a "dictatorship". It's amazing how inexperienced nurses get big jobs and big heads. Tunnel vision is what nurses get once they obtain power. Patient focus gets lost and workplace cliques start. The supervisor I was under had been talking crap behind my back before I was even let out of orientation. And I already can say I have more experience than her. The hospital I worked has 25 licensed critical access beds. So small and so ridiculous. I've recently moved on and gladly can say those issues are reduced in a larger hospital setting.

Oh my lord, LTC is very notorious for having that issue. So much wasted energy when all certain people want to do is catch you in a mistake.

What is the worst place anyone has worked having to deal with cliques? It's very interesting to see how workplace dynamics operate and I'm just seeking out feedback from others.

My nursing thought process is different than my parental thought process, but for obvious reasons you can't deliver the same care to patients as to your kids. There is some overlap but a divide in how you think. However, the point is of course seeing the big picture which I think is mandatory in nursing but also in life.

Lol--EXACTLY!!

I agree with your statement that people can have more natural ability than others. And being under stress can cause roadblocks in the Information processing circuit. Consider the factors at play such as things that cause the stress to occur. Some people are more prone to stress than others and this can be made much worse without the appropriate information and education available especially with new grads. If you ask me, throwing a new grad smack in the middle of a med surg unit with zero training is totally barbaric and dangerous. I just hope they learned their lesson.

That is so amazing and very, very inspiring!! I am hoping to go back within the next year to start my BSN. I am so happy to hear you did it, congrats!!!

I was honestly waiting for someone to get the ball rolling on that. Just because its good to hear other nurses verbalize that theyve observed these stages in really after much discussion with nurses older and more experienced, the whole situation the occurred in that department is almost laughable. Clinical educator experience=5 years and BSN, 1 year med surg experience. Inpatient manager experience=5 years and BSN, 1-2 years med surg in the current remote hospital where I work. Net experience 10 years. Total number of hospitals worked in between both nurses=1. Doesn't take brain power to figure out the lack of leadership and guidance.

This sounds almost exactly like my situation, except that I oriented for 3 months and was let go. Fortunately I was able to transfer back to my original unit which was skilled nursing. I was thrown under the bus by a wicked mean night shift preceptor then followed by an even meaner day shift one. Unbelievable how cruel some women can be. If they interpret your actions as ignorant, you're immediately at their mercy in which case youre screwed. I never actually did anything to cause harm to a patient, my issues were more with time management. But the biggest issue of all seemed to be the education portion of my training. The clinical educator of the hospital was a med surg nurse for only a year or two, had a BSN and was basically grandfathered into the job. She sucked so bad that I got almost NO feedback from her until week 7. I was being destroyed by the night preceptor from hell in the meantime and crucified for making stupid mistakes. That set me up for failure even before I started orienting on days. So that was it. Done. Finished. Because they didn't like me. Because I didn't meet their cultural expectations. And because the unit manager was inexperienced with only 1-2 years of med surg herself and worked at no other hospital. Come on.....can I take the blame for all of that?

If you think this is bad, wait until you start in the real world. Nursing profession can be brutal. I do empathize with your nursing school experience. In nursing school, people are anxious and competitive, some do whatever it takes to get ahead. Some will try to cheat, some will just break down and lose it. Your biggest task is to maintain your intellectual focus and ignore the drama that pulls your focus away. Especially with so many women, it becomes so useless. Find the strong students and figure out who you can trust. Find a tutor or a confidant. Chances are you'll find someone who you trust and chances are that will continue through nursing school :-)

Who has taken this test? IMHO it minimally assesses ones methodology of critical thinking. Facilities use this tool to guide orientation. If you ask me, missing one minor step in the critical thinking process shouldn't be unacceptable.

What is a chiver? And why am I getting the feeling it's not a good thing? Also, working on that floor I wasn't getting it. I'm not afraid to own that. But does that mean I'm not a critical thinker or that I'm not cut out to be a nurse? I don't think so.

Samadamsnurse please read within the above quote I replied to your comments above. Thanks for your feedback.

I critically think everyday and I do well with it. I just need to hear if others have been told "they got it or they don't". To me that's over simplified thinking.