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NightNerd

NightNerd BSN, RN

Med-surg/tele
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NightNerd has 7 years experience as a BSN, RN and specializes in Med-surg/tele.

BSNRN with experience in hospice, psych, and med-surg/telemetry. Still doing the bedside thing for now, interested in some kind of community/public health work down the line. My true passions are sleeping and eating, but I also like music, books, and hanging out with my boyfriend. I run and do yoga to counteract my cupcake worship.

NightNerd's Latest Activity

  1. NightNerd

    Setting my orientee up for failure?

    @Jedrnurse maybe "fail" is an excessively dramatic word choice, LOL. I've been trying my best and have put a lot of effort and thought into how to help this nurse. However, I'm also really glad I posted here and got all of these responses, because I'm seeing opportunities to do even better in the future. Hopefully it will be helpful for this orientee, and it will certainly be good for any other nurses I precept. I've also finally been able to sign up for a preceptor workshop at my hospital (have been trying for a while but it never jived with my work schedule). I really do enjoy orienting new nurses, but this experience has me questioning my ability to do that. While I know that 10 or 12 weeks doesn't automatically turn new grads into full-fledged seasoned, confident nurses, I've never had an orientee I've worried about this much at this point in orientation. I just want to know I did everything I could to make this a successful learning experience for her. Based on the feedback here, I feel better about what I've tried to do as her preceptor; I just wish there had been more consistent involvement from our manager and educator from the beginning.
  2. NightNerd

    Epic Rover

    We used these at one of my former jobs. I liked them when they worked correctly, especially for iso rooms when I didn't want to take the whole computer in and have to wipe it down afterward. The major struggle I remember having was to keep a refreshed battery inside it at all times; I think I changed it at least once a shift. I could still use it for documenting if I didn't change to a fresh battery, but after a certain point the scanner stopped working, which could be inconvenient.
  3. NightNerd

    Setting my orientee up for failure?

    @NurseBlaq yeah, this is a med-surg/telemetry unit, ratio 1:4. We are up to four patients in week 8 per our educator's grid, and I asked if I could bring her back down to three or even two for a little while, but no dice. I also asked if there was any room to extend her orientation and was told there is not. Thank you everyone for your feedback! I will do my best with the little bit of time I have left before she moves to nights. I took some of your suggestions and shamelessly stole your wording when we debriefed from our shift tonight. We'll see what the rest of the week brings!
  4. NightNerd

    Setting my orientee up for failure?

    @JKL33 thank you for your reply. We probably haven't been meeting with her as regularly as we should as a team, though I try to touch base every week to see how she's feeling about her progress and if she needs anything in particular. I make an effort to give her feedback in real-time, both positive and constructive, since I know when I was new that made it stick better. But as far as her interaction with our manager and the educators, it's not happening very often. Probably that's why she's texting me on our days off asking questions about her work schedule and the like... Honestly I feel like this hospital in general is a little insensitive to the needs of new grads, just based on observations of others' orientations. The words "sink or swim" and "let her drown" have been used to describe management's ideal approach to this particular nurse's orientation at this point, which seems very unhelpful and cruel. I'm trying to be a little more hands-off to see what she can do and figure out on her own, but I also want her to know that it's okay to have questions and not know everything as a brand new nurse! It may be a blessing in disguise if she were to part ways with this hospital, but I'm sure that would be a major let-down, since I know she really does want to do well.
  5. NightNerd

    Setting my orientee up for failure?

    @Closed Account 12345 thank you, that is really important to hear! I do think she will be a great nurse someday, but this is a smaller, weirdly fast-paced unit where she will not have the kind of support she will probably need. And I have made every effort to acknowledge what she's doing well while also pointing out specific opportunities for improvement, precisely because I didn't want her to be blindsided with any further feedback down the line. I am really trying to give her every chance to demonstrate her learning, but it just seems like nothing is sticking right now. I did express my concerns to both my manager and our educators a couple weeks ago and we did all meet with her to create an action plan. It doesn't seem like anything has improved significantly despite that. I did wonder if nights might be better for her with (hopefully) fewer distractions, but I just have a feeling it's not going to go well regardless of which shift she's working on. And I don't think this is something that will improve by extending her orientation by a week or two; she may just need to work up to this kind of acuity.
  6. NightNerd

    Setting my orientee up for failure?

    I'm precepting a new grad who will be on nights (I'm day shift - lack of evidence staff on nights meant that I was chosen to precept for her first several weeks). We are in week eight by now, and I'm starting to feel like I've failed her. 😔 I'm hoping to hear any advice you guys have; I've got one more week with her and then she'll orient on nights for two weeks, then be on her own. Our biggest issues, apart from normal stuff like time management, is retaining knowledge and being self-directed. She comes to me with the same questions over and over again, she wants help doing the same skills we've already practiced several times, and even balks at going into rooms by herself or recording her own assessment until she's talked to me about it. After eight weeks, not only am I exhausted, but I sort of feel like I can't trust her to do anything on her own. I have been working so hard to turn her questions around on her (I.e., "What do you think we should do next?" "What supplies do you need?" "What are your priorities this morning?") and to let her figure things out as much as possible without severely delaying or interfering with care. It's not just that she needs a lot of direction, but most of the time, she will not, say, draw labs or start new meds or whatever, until I remind her to look at her new orders. Another coworker precepted for me last week one shift during a pre-planned vacation, and she is reporting the same issues. She said she spoke to our manager about it, and I also have been talking to my manager and our unit educators. Nothing is helping. My manager seems to think I'm being too nice, but I'm doing everything I can to let her work things out herself; there are times, though, where if I don't step in eventually, things won't get done at all. I've precepted new grads before and typically enjoy it, but I feel like this is just not going well at all. I've also never gotten any formal training in precepting, so I'm wondering if anyone has any other thoughts or ideas? She is a very sweet woman, very earnest, and I know she was going through school at the height of the pandemic - but I don't know that this unit and hospital are going to give her the time and training she needs to succeed, and I worry for what will happen when she's off orientation.
  7. NightNerd

    Nurse Personality Change

    I don't think that my personality has changed so much as my expectations. I was more idealistic and hopeful as a new nurse than I am now. I still bring some optimism with me every day and like to think I can do something positive through my work; otherwise I wouldn't feel any purpose or strength to keep going. However, I take everything less personally now, which allows me to respond to patients, families, docs, coworkers, etc. with compassion and reasonable boundaries, rather than out of any other motivations - e.g., annoyance, fear, etc. I am glad that I've been able to adjust my expectations of myself and those around me, or I would have 100% crumbled by now! Also, years of experience has allowed me to trust myself and my judgment much more readily, which has done wonders for my work-related anxiety. I'm told that I come off as very calm in my current job, which is great, but I don't always feel that way; whereas I know as a new grad my anxiety was written all over me for all to see. I simply have more perspective, knowledge, and self-discipline to work with, even though many of my same characteristics, both good and otherwise, are still part of me.
  8. NightNerd

    I don’t know if I want to be a nurse anymore

    "Helping people" and "the art of caring" cover a lot of ground. What specifically do you enjoy about caring for people? Teaching new knowledge and skills? Helping with ADLs? Using science to help improve a person's health? Listening to them and providing acceptance and perspective? I think that narrowing this down would give you better direction on other potential options. I will say that, while I completely identify with being tired of people complaining about things out of our control, any career that involves helping people will come with some complaints and negativity. My boyfriend is a social worker and I'm a med-surg nurse, and we both sat on the couch yesterday lamenting how very difficult it is to give people everything they need. All this to say, no matter what, it's an asset to develop a thick skin, know what gives you resilience, and identify your dealbreakers in a workplace - no matter what human services work you do.
  9. NightNerd

    Memorable Firsts

    One of my most memorable firsts is very similar to yours! I was six years into nursing before my first code blue, and I'd been dreading the day it would finally happen. I had just been transferred to a new unit due to low census on my home unit, and was still getting used to the new environment and staff. One day while I was charting, I stopped to watch the monitor, as one patient's heart rate went a little lower...and a little lower...until I was like, I'm just gonna go eyeball the patient. I got to the room first and my heart just sank; even as I tried to rouse the patient, I knew she wasn't going to respond. The primary nurse arrived just a few seconds later, even though it felt like forever; she'd been on the other end of the unit with another patient and came as soon as she saw the monitor. The patient wasn't breathing and by that point had no pulse whatsoever that we could feel. I can't even remember which one of us started CPR and which called the code and got the cart - but everything started happening so fast and people started flooding the room to help. The patient ended up surviving! Afterward the primary nurse and I both looked at each other and were like, "...That was my first code!" It was within the first few months of the pandemic, and I just remember us hugging, social distancing be damned; laughing; and feeding oddly giddy that we'd gone through that together and were able to save the patient.
  10. Are we talking more in a situation like precepting, or actually providing an in-service? If it's the former, I always try to teach my orientee *how* to find the answers they need, in addition to what the answers actually are. As far as something more formalized, I will absolutely do my own research prior to any teaching - but again, I will point whoever I'm teaching toward resources that will help when they're on the floor. As @JBMmom said, it's perfectly okay to acknowledge if you don't have a ton of experience with a certain skill or topic - we all have different backgrounds, interests, and skills, and there's pretty much always something new for nurses to learn.
  11. NightNerd

    Breakroom Pet Peeves

    In addition to basically all of the above, I'm sick of eating my food with a poster of pressure ulcer staging, complete with photographs, right at eye level. I'm not a particularly squeamish person, but chances are I've probably done dressings on something like that before going on break; I don't want to see anymore.
  12. NightNerd

    Which patients are you most scared to take care of?

    I'm a total 'fraidy cat. Anything I haven't seen before scares me. Fortunately after seven years I've seen enough that now I know 1) who and what my resources are, and 2) I'm a prudent nurse and I'll figure out the right way to care for my patient. Example: I've taken care of enough trachs now that I'm not so much scared as merely uneasy - which still doesn't feel great. I feel like I rarely have these patients, so it's easy to forget the finer points of managing trach care. But, I met a wonderful respiratory therapist who helped me out a bunch with my most recent trach patient. She checked to make sure I'd put all the right supplies at the bedside, we quickly reviewed the care I needed to do for the shift, and since she had a minute and was there anyway, she made sure I was comfortable changing the inner cannula and helped me put on a new trach collar. That was above and beyond, but it reminds me that I'm capable of learning since I *did* have all the right supplies at the bedside, and that there are people and resources available for any questions I still have. I think it's important to remember that you are never alone in trying to take care of your patients - though I'll concede there are many days when it feels that way. If something makes you nervous, or you encounter something unfamiliar at work, do your research into how to manage the situation. Figure out as much as you can about what the plan should be, then check in with someone who can give you feedback. It's a good way to learn, and also provides a confidence booster when you realize what you already know.
  13. NightNerd

    10 Essential Tips for New Grad Preceptors

    I was just told I'm going to have a new grad orienting with me for a month before she goes to night shift. These tips will be super helpful. Thank you!
  14. NightNerd

    Getting fired by a patient/ family member

    I think I've only been fired once. I was never able to do anything right for the patient's son, and the last straw was when I told him I had to wait for an MD order before giving a new pain medicine he'd just requested. This was inpatient hospice, night shift, and he told me, "If you won't help my mother right now, then you don't ever need to be her nurse again." Okey-dokey, dude. I don't think he had any other issues with staff, so I guess he was just not a fan of mine. *shrug* Haven't been fired since, though I have wished to be at times, LOL. I had a patient actually fire the other nurse on the floor just today, so we did a last minute trade. The patient is rather anxious but overall has been very polite to me, and even apologized for inconveniencing me - they won't let this other nurse do anything for them, even deliver water. I get the impression it's a major personality difference, though he will discuss it privately with my manager; I don't want or need to know specifics. The nurse I'm here with today is kind of louder, social, in your face, full of information and opinions, which can be overwhelming to some people. Good nurse and knows their stuff; I think this patient just comes from a place where silent and stoic is professional and anything else is decidedly not. Sometimes patients just don't like you for whatever reason, even if you did nothing wrong. Sometimes we make one misstep and the patient is done with us entirely. Sometimes there is something to be learned from repeated firings. It's very case by case.
  15. NightNerd

    Next Steps When You're Not Ready to Be Done with School

    My first impulse is to congratulate you!! That's so exciting! I used to love school too, but my MSN has finally ruined it for me. 😂 It's not even all that bad, necessarily, but my priorities have shifted from school to other things - which is okay! If you like school and find another program you want to pursue someday, that's totally understandable; lifelong learning in some capacity is healthy and even enjoyable. You may want to take a break after you graduate, though! Sometimes slowing down to focus on other parts of your life is good too, and given your prior posts about work-life balance, it may be time to concentrate on improving that and determining what you want out of your professional life. Maybe join a professional organization or something that will allow you to take classes, etc., without the commitment of more regular classes and grades and attendance just yet?
  16. Genuinely wondering - *how* do you love public speaking? What do you enjoy about it? I so wish I could develop this attitude!