NurseGLC

I am not only a Clinical Instructor, but a New Grad preceptor and Charge Nurse in an acute care hospital. Expecting compliments for doing what is expected and meeting the minimum expectations (like taking vitals in a timely manner) is not only unrealistic, but is setting up the future nurse for disappointments and unrealistic expectations that they will be cheered and championed once they are working for doing their job, for doing what is expected and they signed up for, for being a nurse! Yes, students (and coworkers/support staff) need encouragement and compliments, especially when they are earned, but not because you think you deserve them, and certainly not to get you to do what is within your job description. My students have a job description, it's called the class syllabus and my written outline of expectations provided to them during orientation on the first day of class. I regularly pass out "good job's", elbow bumps, verbal compliments, and pre/post con shout outs of praise when they are earned. As to "being in the same situation in nursing school" in regards to "just not getting it", you couldn't be further from the truth. I did get it. I understood that I was paying a lot of $$ for my education, and that competition for a place in nursing programs was fierce, and competition for good New Grad programs was even fiercer! My favorite Clinical Instructor made me cry more times than I care to admit, because she had high expectations of me, and required I fulfilled them in every class. And when I exceeded those expectations, she would pass out praise and compliments, because they were earned. Many students come into my class (at orientation anyway) thinking that Clinical rotations are supposed to be easy, and we should take it easy on them because they have a test/quiz/paper due in their theory class, or worked the night before, or stayed out late. Sorry, not my problem. My job is to teach you to be a nurse, who's #1 priority is patient safety, and you won't learn that by me shaking my pompoms for you.

Most hospitals don't allow the units access to the ER and vise versa, at least not before they've been formally admitted and transferred to the unit. If I don't ask questions, how else can I know that the patient is appropriate for my unit? How do I know what I need to do to prepare for an easy transition? Should the patient be near the station? Is a bed alarm needed? Lunch was served 45 minutes ago, did my patient have lunch? Was the consultant mentioned in the ED MD report called yet? I hate to think how many patients have been sent to my unit where an ED nurse has told me their skin is intact, only to find a stage III wound on their coccyx, or that a patient is continent, only to find they're practically doing the back stroke in the diaper that wasn't mentioned. I've lost count of how many consultants have yelled at me because nobody notified them of the add to their service. How about the patient whose troponin was 79.0, and BNP was 1250 (yeah, you read that right) and they were trying to admit him to the Med/Surg unit!! (Those test results came in between the time the ED nurse was told to admit and my asking what they were). I don't ask the questions because I can't read the chart, I ask these questions to provide the best possible care to my patients and to try to prevent issues before they are created. And lastly, I've found that those who wish to skip the niceties of a good verbal report, are also those who tend to skip on thorough charting and nursing notes (other departments are responsible for recording labs, radiology reports, H&P, etc). And I'm not singling out the ED here, many of the nurses on my own unit are guilty of that!!

My Daddy's last meal was a Wonder Bread grilled cheese (made with Kraft singles and real butter) and tapioca pudding. Mom was appalled at the idea, having spend years agonizing over every morsel of food my diabetic, CHF, kidney failing father ate, but he had so much joy in those few tasty bites! How could we have denied him? Kudo's for you and your rule breaking!!

I get the flu vaccine yearly ~ I'm usually the one volunteering to vaccinate everyone on shift to get it done and out of the way! I work for a smallish community hospital in CA. If a staff member chooses not to receive the vaccine, they are required to wear a mask from October thru April whenever they are on the unit. Very few healthcare professionals in my circle don't vaccinate. Of those in my world who chose not to vaccinate, it's usually because they think the vaccine will make them sick. On the other hand, I also have several left wing wackos in my life (that I love dearly) who thankfully don't get into discussions of the pros/cons of vaccinations within my hearing........

This was one of my worst nightmares when I was job hunting!!!!

If you live in CA (or another state) where the competition for GOOD New Grad programs is fierce (several hundred applicants for each opening), the answer is yes, join. Do EVERYTHING possible in school to boost your resume! Join your Student Nursing Association and serve as an officer, join Peer Assistance programs as a facilitator, become a mentor, do extra volunteer services, keep you GPA up and join whatever honor societies you can (this shows that you are not afraid to be a leader and a team player). Once you graduate, get extra certs like ACLS, PALS, NRP, EGC, etc to make you a more desirable candidate (it shows you have initiative to progress your career). Every pre-interview/phone interview I had for New Grad programs asked about my GPA, leadership activities, and extra certs. I live in CA and graduated in August. less than 40% of my classmates have landed jobs in acute care facilities and those that have did the above or were already working as CNA's or UC's at the facilities that hired them. Concerning STTI specifically, they are a wonderful networking resource for when you are trying to get that first job, and a great foot in the door if you plan on getting into a MSN or DNP program. Look at it as an investment in your future. You can always let the membership lapse once it is no longer providing you with a benefit.

Loved this thread! I'm in my 5th week as a New Grad RN on a busy Med/Surg floor in a smaller community hospital with a lot of Geri patients and have all of these same issues with passing meds on time, reality vs text book medication delivery, politely escaping chatty patients, etc. Got some great tips here that I will definitely put into use! Thank you everyone!!

The bigger they are, the harder they fall....

It is, and boy do we!!!

I have survived my first 5 shifts on the floor - YAY!!! And so far, so good ~ I'm loving every insane/crazy minute of it !! I really appreciate all the great information everyone gave me in preparation for this big event! Your encouragement, feedback, recommendations and support were greatly appreciated! Concerning scrubs, I bought 3 different pairs, each one a different style, to see which ones I liked the best (found out the more pockets the better) so now I know what brand I want more of! Have lost (and found) 1/2 a dozen pens and love having my own sharpie and white board markers. Only took the basics on the floor with me (stethoscope, penlight, scissors & hemos) and left the rest in my locker. Bought good othro inserts for my shoes (and broke them in), and so far, so good (feet are tired but not sore - woohoo!)! Still trying to figure out how to get enough water during my shift (not allowed to have any on the floor) but since I haven't yet figured out how to get time to pee, it's all balancing out pretty well - HAHAHA!!! Learned the first day that eating breakfast BEFORE work is a must as I dodn't get a break longer than needed to pee until 6-8 hours into my 12 hour shift. In orientation they said we were allowed 10 mins every 2-3 hours, but I'm not stupid enough to walk off the floor unless my preceptor does! Will be SO glad when flu season is over, they tell me it's not usually this insane/crazy (yeah, right, this is Med/Surg). Haven't needed to use them yet, but I have a spare set of scrubs/clothes from the skin out (I've heard some pretty harry stories) stashed in my locker, and I'm taking notes, and asking questions like crazy! Doing my best to listen before I speak, and not try to act like I know everything (cause I certainly don't!) LOVE my preceptor (whew) and have had not incidents or indications that they serve up New Grads for dinner on my unit, but it's still early days yet! Will post an update again when my orientation is up in 6 weeks to let you all know how I faired. Thank you again, everyone!!! Take care!!!

Thank you again, everyone, for your advise, suggestions, recommendations, and encouragement! I'm off and running next week! I'll post an update after that..... IF I survive ~ LOL!!!!

:-) Thank you so much for all your advice, encouragement, and congratulations!! Really appreciate the feedback!

Thank you, everyone, for your wonderful feedback! Looks like I got some shopping to do, and a little more prep work!

I am a new grad RN (Aug 2012) and have somehow managed to get a job on the MedSurg/Tele Unit in an acute care hospital in Southern California!!! WooHoo! My start date is in 2 weeks. Now what?!? School has prepared me for the mechanics of nursing, but they didn't really go into depth on personal preparations/supplies. I don't want to go in looking like Super Nurse reporting for duty, but I also don't want to look like an ill prepared new grad without a clue (yeah, right ~ hehehe). How many pairs of shoes should I have? Socks vs stockings? How many sets of scrubs? Tools of the trade: Stethoscope, mini calculator, scissors, flashlight, drug book, and pens....... Am I missing something? So excited, yet terrified at the same time. Any input, suggestions or recommendations are welcome! Thanks!!