chatty-cathy

Hahahaha that is such a funny scene! Thanks for the much needed laugh after an exhausting day :)

My pet peeve for the day is a mid 20 something y/o female sitting up in bed eating cookies with her friend playing on the phone with a CC of nausea and vomiting x 2 days. Ok first of all put the cookies down and second of all you and your friend are having way too much fun to have vomited "over 10 times in the past hour" …and stop griping over a silly blood test, your the one who came to the ER, remember? Then stop complaining if it takes more than 10 minutes to run you lab work. Sheesh.

People who keep talking on their cell phones about nothing important like what's on TV. They come in begging and crying for pain meds and then act like I'm disturbing them if they have to move the phone to other hand so I can medicate them....sheesh! Mother's who treat their grown kids like 3 years old to the point where they even answer for them if they are in pain or not and where the pain is. How about the grown 30 something year old man can tell me himself how he is feeling...? Asking if they are going to be admitted or when they can go home, before they even take their coat or shoes off! Stinky feet....eeewwww! And my favorite the crazy patient who refuses to take part in personal hygiene and calls 911 because their skin develops a "rash" that hurts....when the cure is called soap and water That's all for tonight haha!

Sounds like you just have a case of the nerves and you are doing just fine! Be gentle with yourself hun. The first day on any new job can be overwhelming let alone a busy ER. These are all minor things that can happen to anybody so try not to forget to breathe and have fun. A little humor goes a long way, I have been known to have butter fingers myself :) Don't worry, your taking on a big challenge as a new grad which is doable so just take it one day at a time and things will get easier. I'm 5 months in now as a new grad in the ER and I still say I'm rusty from nursing school :)

I was really frustrated the other day and needed to vent and ask for some help and I really appreciate you guys for taking the time to post some great advice, thank you. I really appreciate it. Sometimes in the middle of the moment it is hard to focus on the obvious, like checking the protocols of the unit lol. :)

First of all I love this site and read topics on here constantly because as a new nurse I am hungry for all the information that I can get my hands on. And right now I need to get things off of my chest and seek advice on how to appropriately handle this situation of being misinformed constantly. Long story short I am a new grad working in a small community ER, but we have our fair share of critical patients so I am learning something new every shift. I have prior ER experience as a tech at a Level 1 hospital so I have a lot of exposure to highly acute patients. But I am humbly aware that I have a lot to learn as an RN, especially when it comes to giving meds. First of all where I work on nights, it is constant practice to take vitals every 1-2 hours if your lucky. I feel differently and do q30 vitals with my patients, because after all it is an ER and conditions can change. It's a good thing I did because my patient had a hypotensive incident where the Doc ended up placing a central line and I started a Levophed drip. My frequent assessments and vitals prevented this patient from having a more serious situation occur, thank goodness! While the drip began to infuse I was monitoring the patient closely with q5m vitals because I was titrating to the pt's needs. My charge nurse told me that it was inappropriate to do that and that I needed to do q15 vitals "because the blood needs to have time to circulate through the patients' arm." ...I completely disagreed and have been reading material all day about safe practice with this drip and everything I read says monitoring should include q2-3m vitals for at least the first 15 minutes of the infusion. So I'm not sure what to say the next time she gives me bad advice where she won't be offended and then stop giving me advice all together, because she can be very helpful at times. Now that is just an example that happened last night. There are plenty others, but I don't know how to continue to do what I feel is right and appropriate for the safe care of my patients without ruffling any feathers. I like my charge nurse and she is a very nice woman who is full of knowledge and I can learn a lot from her. So I'm not sure how to proceed because I am open to critiques and constructive criticism because I want to be a good nurse, but it's hard when I get both good and bad advice from the same person. It's even more frustrating when I can't admit my patient onto the tele monitor because she doesn't like the noises that it makes, and she will discharge the patient off of the monitor if the machine beeps too much or if the patient was disconnected and went to the bathroom. Never mind if there actually is a cardiac episode or if there is a need to see what actually happened. Also, I feel like she keeps giving me more patients at a time than the other nurses on the shift, and it would be nice if she could spread the wealth so to speak. It is very tiresome to be dealing with 1 ICU patient with a 2nd patient who is in pain, and a new admit who is puking on the floor while other nurses are sleeping at the nurses station or on their facebook. Every time I say something the response I keep getting is that 'your fine.' I feel like because I am a hard worker and the new girl they feel it's ok to give me the more acute patients so the others can get assigned to 'toe pain.' I want to be a team player but as the new nurse on the block I don't know what to do to even out the playing field. Sorry for the long rant and thank you for even reading my post, I appreciate any and all feedback! :)

I see it's your first night shift, are you sure that's enough!?

Mistakes are going to happen, so go easy on yourself when it happens. As a new grad myself I would suggest to ask questions! There is never a dumb question, especially when it comes to patient safety! Things may seem to be overwhelming at times so ask several nurses on your unit for tips on how they are able to handle different situations and how they are able manage their time. You can incorporate their different styles into your own as you start to get your groove and with time things flow a lot smoother. Hang in there!

Save your money and Run! Otherwise it will have been a waste of time, money, and effort

THANK YOU so much for your insight and advice and I really appreciate this information! I'm very excited about this opportunity and I do work well under pressure so I think I will be a great fit for this unit. It helps me a lot by knowing what they are looking for in a candidate because that way I can come up with real life examples of how I have handled the situations they are looking for. And when in doubt ADPIE seems to be a great starting point in working through the critical thinking process. :) Are there specific patient types, cases or meds that I should be prepared for with an IICU?

Thank you so much Chibi-chan (love that name :)) for your thoughts and input! I like the idea of renting a room before hand so I don't have to worry about traffic or being late or any other disasters. All 7 of your tips are extremely helpful so I appreciate you taking the time to post them on here. I know other readers can also find them useful! Thank you jennafezz for the good vibes!! I hope this works out because it would be amazing to work at this hospital! I pm'd ya!

Hi everyone, I am a new grad as of December and I am super excited and nervous about having an interview later this week at a prestigious hospital for their Intermediate ICU department or their Med/Surg Dept depending on where they feel I would fit best. Nursing school didn't provide me with a lot of opportunities with rotations in an ICU, however my preceptorship was in a CVPCU so I have some familiarity with acute patients. I'm not sure about how to prepare for their interview because it's behavioral based and I don't have a lot of experience with the ICU so I don't know what kind of questions to expect!? I would appreciate any tips or suggestions because this is such a great opportunity, because it is truly my dream job and hospitall!

As mentioned before New Grads do not have the luxury to be picky! If the ER is a specialty that you are interested in then go for it! The night shift is just as busy as the day shift at times so it won't be a slow floor where all of the patients are sleeping. You never know if this may be your only job offer for a long period of time because it takes some new grads months to even get a call! BTW congrats on your upcoming graduation!!

I absolutely love being a nurse, and its a double bonus that it pays quite well in some areas! And it's one of those jobs that can't be outsourced which is a triple bonus!

I want to simply thank the OP for taking the time in starting a very interesting thread that I found helpful. I am a new grad nurse who is currently going through the interview process and just survived my first panel interview. Thank you for sharing your experiences because having an understanding of the thought process that happens on the other side of the table makes a big difference for me, especially since it is such an intense experience being in the hot seat!

Thank you soooooo much for posting these links!! :)

There is some excellent advice here!! Veins are like snowflakes....no two are alike on people which makes IV starts interesting. From your description of the immediate swelling around the site could mean that the cannula isn't fully inside the vein yet, so the blood is flowing out of the vein causing the swelling. Maybe try advancing the needle just slightly more ensuring that it is actually inside the vein and then advance your catheter. You can tell if your in the vein or not most of the time by how smooth the catheter advances. Also don't give up, this skill takes practice and lots of it!! So take every chance you get for IV starts and with time you will get them with no problem. Oh and heat packs do wonders too! :) Hang in there!

Beautiful! Thank you for sharing and inspiring!

Thank you GrnTea for explaining the SATA reasoning, there really is a method to the madness lol. Thank you everyone for the support because this is such a super exciting accomplishment for me! Now if I can only find this elusive new grad job!! It was the NCLEX-RN and I tried the PVT as soon as I left the building on my phone and it worked. I do remember seeing the "delivery successful" on their website, which simply means that PearsonVue delivered my results successfully to the BRN. It worked for me which was awesome because my nerves were able to relax for the two days it took for the BRN to post my name. Hang in there peeps who are studying for this test, it will all be over before you know it! :)

It's official, the PVT trick worked and I my name is on the BRN website today!! Woohoo!!

Thank you so much for the support!! I am super excited and relieved to finally be at this point after Nursing School. Nothing is set in stone yet until my name is on the BRN's website, but it is looking really promising. :) I just graduated in Dec 2012, and wanted to take the NCLEX asap while everything was still fresh (plus I want a job!) My Q trainers ranged from the mid 50's to the mid 60's. My Q banks started out to be high 50's and low 60's...but as time went on with practicing hundreds of questions my Q banks were in the high 60's to the low 70's. I would review each test and go over the questions that I missed and reviewed the content so I had a clear understanding of the material. Looking back I feel like the Q trainers were much harder than the NCLEX questions, but it was helpful in reviewing the content. The Q bank for me was more similar to the NCLEX with their prioritization and delegation questions and of course the SATA's, ugh Good luck, and you should be fine. Please let me know if you have any more questions!!

YAY Congrats!!!! :) Especially after all 265 questions, I would of been a bundle of nerves! Congrats again!

I have been reading a lot of threads on here to prepare myself for the NCLEX and figured I would share my experience to hopefully inspire others in our shoes! I finally took the NCLEX yesterday and for me it was a crazy experience with the questions that I got. Without going into details I had my first SATA at question #7 and remember thinking OMG! Half of that test must of been SATA's for me, and the rest was prioritization and even more prioritization's. I had a few med questions, and I think that you really needed to know your meds to answer those questions. The same goes for the few lab questions that I had too. I expected a lot more med questions then I received, but I'm not complaining with the few that I had. There were a few psych questions and very few OB questions. I did have a few questions with answers that just didn't make sense so it was easy to eliminate those. I could tell that I must of been doing well at one point because there were questions with topics that I never even heard of, and it must of took me a few minutes to figure out what they were getting at, sheesh! Then I went back to the SATA's and prioritization loop I remember reading somewhere on here that if you have a lot of SATA's and prioritization questions, then you are doing well so that helped calm me down a bit while I was taking the test. The computer shut off at 75 questions after 2 hours and the survey screen popped up!! So I was literally in tears at that point and couldn't focus on the silly survey because I had a feeling that I passed and had tears of joy. The personnel there must of thought I was crazy with my smiles and tears! ...I was checking for the PVT as soon as I left the building like a mad women and got the good pop up, so now I am just waiting on the official results on the BRN's website. Hopefully it won't take to long because the suspense is driving me crazy!! I prepared by studying for two weeks straight on top of the 4 day Kaplan classes. I also used the Saunders and Lippincott's book, but found the Kaplan book and content lectures to be really helpful. Kaplan was very dry for me and was really hard to focus at times, and now that I think about it I didn't use the "decision tree" with a lot of the questions. BUT I took all 7 of their Q trainers and used 60% of their Q Bank which helped me review the content that I was weak in which was a lifesaver in the end for me. I think that success on the test requires a combination of knowing the content and how to really adapt yourself to the NCLEX style of questions. Well that is my 2 cents, and nothing is official until my name is posted on the BRN's website but things are looking really good! :) Hang in there peeps and it will all be over before you know it! Now it is time to find that elusive New Grad job which is stressful and exciting at the same time.

Congratulations on such a great opportunity! As a new grad I am curious as to where you are located and how the job market is there!?

I am also new here and a recent graduate myself about to take my NCLEX next week, so I understand the crazy emotional roller coaster ride! Best of luck to everyone! :)