Jaade

I don't mind the trackers - as someone else said, I'm doing what I'm supposed to be doing so I just think of it as an extension of my badge. I know the managers aren't truly monitoring them regularly because at least half of another floor at our hospital spends half their nights across the street at the park smoking.

Sorry, one last thing - I do work on a speciality med/surg unit (Ortho/Spine) and we typically have a pt load of 5-6 pts per shift.

Oops - didn't mean to hit send yet. We have trackers we wear that management can use to find out where we are on the unit (say a family member says they didn't see us all night - the manager can show when we went in to check on them). Joint Commission's Goal #9 for 2013 is reduce the risk of falls. They advocate for hourly rounding to assist in meeting this goal.

We do hourly rounding. CNAs do odd hours, we do even hours. We have "PALs" (Patient Access List) which list scheduled tasks by hours in our EMR. We have to document what the pt is doing, pain, if repositioned, bed position, if bed is in low position and if bed alarm is on, if pt can reach call light, how many side rails are up, if pt is wearing compression devices and if anyone is at bedside (family, dr, etc.). We also have to document if we did any pt education.

When I first started in psych nursing, I worried a lot about saying the wrong thing to a pt. It can be more laid back than med/surg, but when it is bad, it is really, really bad. Psych is definitely not for everyone. What kind of patients are on your BHU?

We have standing orders that say after the foley is removed, if the pt has not urinated in 4-6 hours straight cath x 1 and then if the pt is still unable to urinate in the next 4-6 hours, call the MD.

It's hard starting out in healthcare. You will be slow. You will make mistakes. You will improve every day. I try to put on a smile and have a good attitude every day I walk into work. (And I am NOT a bubbly, shiny, happy person.) I like this work, I enjoy not sitting at a desk all day. I like interacting with patients. It can be hard to learn if the culture at your facility is negative. Brush it off and remember that it is temporary. Your CNA experience will prepare you for a lot of the "little things" in nursing school. Team up with your co-workers to get things done. I think it always goes faster with help, especially for all those things you always forget to bring into the room. You'll learn to anticipate what those are and start to carry them around regularly. Make lists if that helps. I do as a nurse. Things can be hectic and you'll never just remember everything you need to do. Find your routine. Use that meal downtime, if there is any, to set things up you need for bedtime. Efficiency is key and will get you a long way. There will be days you won't get done on time. That goes for all of us.

This. Also, I was once told by a dr/former medical director that JC looks hard at facilities that report very few med errors because they know mistakes are being made and assume they aren't being caught or reported when there are too few. The hospitals I work at seem to take this as intended and I only know of one nurse being called to the carpet for her errors (which were numerous).

It's a med error, the doses were missed. Med errors do not have to be the nurse's fault. We frequently have to chart "med not available" as a reason for missed/late doses when the pharmacy can't bring things up right away. Those are errors in med administration, but they aren't blamed in the nurses.

I've seen a pt with a staph infected abscess in his AC vein from reusing his own needles. We drained it for him several times, I've never seen so much pus in my life! It was gross but also kinda cool. IV drug users have the worst veins. I hated having to draw blood or try to start IVs on these people. Sometimes it seems literally impossible.

We can't even get COPD patients to quit smoking when they're on O2. How do you propose we convince people to stay home from work when they're ill? Once they have the full-blown symptoms, sure. By then they've already spread it, more likely than not. Lots of people can't afford to stay home a whole week, some even risk being fired if they do. Having had the flu as a teenager, like another poster said, I gladly line up for a 55% decreased chance of getting that again every year. I don't necessarily disagree that not everyone needs the shot, but I think HC workers are amongst the groups that really should strongly consider it.

It is a national exam, as others have said. I live in south Georgia and took the test in Jacksonville, FL because of the date. The licensing fees are more expensive in FL, I've been told their background check is more stringent and they require CEs, which GA will not start for another year. Those are the true differences in getting your license in different states - fees, CEs and background checks.

You will all get through it. My only regret is that I didn't go ten years sooner. Like the poster above said, you and your family will be rewarded for the hard work when you start making a decent living. :)

Try making a week's worth of meals at a time, with help. Teach your 9 and 10 year old to help out around the house and give them set chores. Give up the idea that your house will be clean, that you will be able to attend every school event, holiday family gathering and little league game (as applicable). I took my books everywhere. Dr appts, work (two waitressing jobs), family gatherings, karate tournaments. Study smart. Figure out what type of info your instructors REALLY expect you to remember. (Think safety). You probably can't read everything assigned. Start with the material you think is most important in the textbooks you find the best suited to your learning style. Have study groups at your house. Our study group was two 20-something single people, a single mom with a 6 year old, a 30-something with 3 teenagers and me - a single mom with two teenagers. You have something in common - you're in nursing school! It's a bond that can last forever, regardless of age or personal circumstances. Utilize your family, classmates and friends. Most of them will understand. And breathe. It's temporary. :)

I took the NCLEX June 2011. It was hard, but I felt pretty confident by the time I finished my 75 questions - you know why? By the end, they were asking me questions that I could never have answered as a novice nurse. If the questions are getting harder as you go, you're doing it right!! I took Loretta Manning's course and I could not recommend it more highly. She has so much knowledge, so many good ways to remember information AND she broke it down for us like this. 75 questions, 15 are "test" questions that don't count. That gives you 60 questions. You answer a little more than 30 right and YOU PASS! Doesn't that sound much less daunting? You can do this. Nursing schools go above and beyond to prepare their students for this exam.

We were taught to make portfolios when I was in school. They included awards and certifications, CEs, certificates of participation, along with the resume, and other records you might need to show when hired (immunizations, copy of nursing license, etc).

"Growing up around them" doesn't imply marriage. It implies that relatives, maybe even parents, were alcoholics. You don't always get to CHOOSE.

My hospital is fairly conservative. No more than two earrings in each ear, no other visible piercings allowed. Staff members aren't supposed to wear big earrings, and I think people who do are dumb. No visible tattoos. No crazy hair or makeup, though it is not a rule to have hair up, I wear mine up. Undershirts must be white or match uniform (royal blue or white for nurses, ceil blue for CNAs), same for jackets. Short, real nails. Solid white, brown or black shoes, no holes or mesh. It may seem a little extreme in some cases but I'd rather be perceived as a professional.

I have a Littman but I recently bought an Ultrascope and I love it. I have been struggling with tinnitus lately, too, and the Ultrascope is just louder. Either stethoscope is a very good investment.