firstinfamily

The only government program that I know of that often offers to assist with student loan debt is working for the Indian Health Services. I don't know what is out in Seattle, but you might look into it. Also, being a new graduate your options will be somewhat limited, so I guess you will have to decide if you will take a job without any loan repayment services versus one that may offer this. With hospitals cutting back in general with costs, this will be difficult for you to find. Good Luck!!

We all want only the best for you and your family. All of us have made some sacrifices between our nursing careers and family needs. It does help to have a mature mate who understands that just because the shift is 7a-7p that does not mean you get off at 7p all the time. I was a nurse before I met my husband, so he had to get use to the odd shifts and the potential over-time, being on-call, working weekends and holidays etc. It took us a while to find a good balance. Nursing is not like other careers, it does require a huge commitment and sometimes more than we are able to give. There are days when I am truly physically, psychologically and emotionally totally exhausted. You will find your nich, but it takes time and experience. Be Patient!!!

I am just guessing, but it almost sounds like you have not been married for very long. Working night shift takes a toll on any relationship. My husband and I have been married for 30 years, and I have worked various shifts. The best shift for me was 3-11, but that did not work for him or my family. When the hospitals went to 12 hour shifts it screwed up most of us!! Working three 12 hour shifts does give one more days off but at what price??? I think anyone who works 12 hour days is pretty exhausted after working them and most likely does not do a whole heck of a lot their first day off. With night shift, getting your body clock (circadium rhythm) to turn around is difficult and sometimes detrimental to your body. I only work 12 hour nights weekends, my shifts are on Saturday, Sunday. I usually try to wean myself during the week so that by Friday night I am staying up all night and sleep on Saturday during the day to help prepare me for the night shift I am about to work. Sunday I go to bed after work and sleep most of the day, work that night, and when coming home on Monday eat breakfast and go to bed, sleep most of the day. It is very hard to rotate your body from night to days, so I really do not become fully functional until Wednesday during the day and by then it is about time to turn my clock around again for Friday preparing for Saturday night!!! I think your anxiety is related to some of the reality shock of being a new nurse but some of it may also be from sleep deprivation and not having contact time with your husband. When you talk to your manager, you could ask that your scheduled shifts be scheduled together, verses one on, one off, one on etc; so your body is not going all whacky. Day shift positions are usually very difficult to get, there is usually a waiting list for them. Wanting to become a NP is a great goal, but most of us can reassure you that it is not an easy path to follow. Most NPs take some on-call, they work very long hours, they do not have as much time with patients as you would think they do, and there are still some reimbursement issues. You are going to have to go through the steps of improving your skills and accountability before you can become a NP. Are your goals realistic?? Also, remember there is a reason why critical care nurses take less patients, because they are more sick!!! There are usually more procedures, testing, documentation being done on the more critical patients. It does not necessarily mean the load on nursing is any easier!!! Perhaps you and your hubby can have a nice sit down and discuss ways you can have time together. With having more nights off(working 3-12 hour shifts) gives you 4 nights off----so what do you two do with those nights---go out, have some fun, have a date night etc. Spend those nights doing something special together. You have to grab the time together when you can. If you are having trust issues there are other problems. A counselor would most likely help, see how your husband feels about both of you seeing one----usually employers offer some psych counseling with limited visits free of charge. Nursing is a very demanding field---it takes a little from all of us; it gives also, but it is not always a balanced equation. Good luck!!! I am glad I am on night shift because I do have the extra time to spend with patients, something that I never had on day shift!!!

Personally, I would not have been very objective with my family members and you made the right call. As we all know, those who look "normal" at the scene can develop complications hours or days later, having them checked out through the hospital was the correct method of action. Best of healing for your family.

Is there an admission criteria or nurse/pt ratio listed in your nursing requirements/job descriptions? If so, then the facility can be held liable for this---do a little digging, maybe see what they advertise on line etc.

Instead of calling out individual nurses, it is something that perhaps has been "accepted" as standard practice on this unit. Has a new manager taken over recently? Do you have a Quality Assurance team/person you can address the issues with? It sounds like this is something that has been done on this unit for a while, that does not mean it should be tolerated. You are between a rock and a hard place. Yes, you should say something. I would take the unit manager aside in a private area and express your concerns, maybe she/he does not see what you see. None of these are acceptable practices for any nurse and if they are getting ready for inspections now would be a good time to have these areas pointed out. It would be great if you could take pictures anomously but just taking the pictures would put you at risk. Just because others are practicing like this does not make it acceptable. Also, if you came from a military run facility and this is your introduction to a public facility, you are going to find many discrepancies.

I think every nurse goes through this when changing shifts. The focus on each shift is different, having the MDs available on day shift also makes it an opportune time to learn more. The flow of patients is different on day shift, and I found little time to really get to know my patients, I prefer night shift even though it messes with my sleep. You will get the flow of the day shift after being exposed to it and getting your groove. Good Luck!!

WE still have an IV team in place who change all central line dressings and central line tubing. Nursing staff is not to touch either of these.

At my facility, I get upset when the stroke patients are told by the ER staff they can have something to eat when they get up to the floor. Its not like I have a swallow test ready to give them before they want something to eat, and I don't have anything more than crackers and soda. Yes, why do patients wait so long before they come to the ER?? If they have been vomiting for a week, why not see the PCP?? Is it because the ER will not turn them away?? I have always thought patient's families come more to eat and use the telephone, watch TV than actually spend time with the pt.

You know it has been so long, I really don't remember. I most likely put some towards my student loans, paid rent and put some in the bank to enjoy later!!! It is a decent living, but I don't think any of us have ever made more than we could spend or owe!!

I interviewed for Fresenius in my area and went through about a month of interviews before I accepted a different hospital position. From what I was told working dialysis can be very long hours, so perhaps more than 12 a shift. It is a controlled environment. Home Care I did for 2 years and loved being on my own but realize that you are totally on your own, no back-up staff. I was working 12 hr shifts 5 days a week and it was too much for me. I was required to see 8-9 pts per day and that did not include driving time, plus because everything was by computer we had to have our documentation in the same day we made our visits. Not all places were wi fi compatible, so often I would be doing documentation at home after seeing pts all day. Gas reimbursement was not as much as what I was spending on gas(price of gas had gone up) and they would only reimburse so much for cell phone use. Since this time our state has passed a no cell phone use while driving law. I learned a lot about wound care doing home health, the areas that I visited were not always healthy to be exposed to. I do better with instutionalized nursing where there is some organization. Have you looked into sub acute care or out patient type services??? Perhaps the PACU or another area of the hospital where floor nursing is not the norm?? You may not want to lose all your benefits of spending 7 years in one place---the seniority does make a difference.

The SBAR tool for communication has been mentioned here and it is very helpful as an organizational tool. It is great when you can cluster the phone calls together. When there is an acute change and you need orders, you call. Never feel that it is against your patient's interest to wake up an MD. Yes, they are paid for on-call and they need to be woken up for urgent matters. If it is something that has been going on for over 24 hours and no one called the MD, then that is something you need to decide. If it is urgent enough or is now causing some negative impact on your patient, call. When you have that "gut feeling" go with it and call. And remember, the MD does not know how to treat the patient if he is never called and that can fall on you as the nurse. I really don't care if they are offended or get sarcastic, I am prepared and ready when I call them, very succinct in what I need and what is going on with the pt. I don't waste their time and when I call it is because I need to. Don't ever apologize for calling an MD, that is your job and you are doing it.

We stopped using restraints on our intubated pts about 5 years ago, there are some who extubate themselves when the sedation wears off. We also follow-up with incident reports, sometimes it makes changes happen, sometimes it does not. This is a very gray area with pain being a subjective assessment, do we consider the discomfort of the ETT as a cause of pain and if so how can this be treated if narcotics are being held due to trial of extubation???

This is happening in Maryland, but the nurses are NPs and able to prescribe, do orders under their MDs guidance. They do not partake in the hospital regulations that apply to nursing staff who are employed by the hospital. Your employer will be the MD??

I started my nursing career as an ADN/RN, I had wonderful experiences as an ADN student, to the point that I was hired as an ICU nurse graduate and did well in that environment. I also continued my education for my BSN as soon as I graduated because at that time there were threats that all ADN nurses were going to be considered as "non-professional" nurses and would have to take separate boards. The separation of the boards never happened and that was over 30 years ago. With my BSN I had a broader educational base and some further advanced classes, however, it was the basics of nursing in my ADN program that got me my first job. The clinical time with my ADN program was exceptional compared to the clinical experiences of my BSN program. However, the theoretical classes of my BSN prepared me for the deeper social and psychological aspects of nursing and managerial type decisions.