2ndCareer2

Neezy, You're not alone. I have my moments and I've heard other people say similar things. Maybe you really just haven't found your niche yet? There's something in nursing that you like- something that intrigues you, otherwise I'm not sure you would have stuck with it so long (even if it's a family thing)...and also, you say 'it's in you'. Find what calls you to nursing- is it a particular population? Kids, elderly, low-income/uninsured, mentally ill, addicts...or a certain thing about the body- the heart, kidneys, urology...maybe it's a specialty clinic that you could try, or a school, or maybe go into research. Lots of choices- keep looking, keep trying Maybe become an EMT? Try animal nursing? Go into teaching? And if, after really looking at different areas and different populations, you still don't like it then maybe a change is in order. Life is short, find your happiness- if it's in the 'family trait' of nursing, that's great and if it's not, then that's great too. Your happiness is what's important.

There's somewhat of a fine line here- it's absolutely appropriate to offer pain relief to anyone and everyone, regardless of drug abuse hx. As nurses, we also keep in mind the future impact of what we do...by this I mean is giving certain types of pain meds going to cause a relapse (and in this case, a patient needing heart surgery at such a young age could very easily be from her prior- or current- drug use). So, is giving these pain meds going to, in the end, create further health issues for this patient because it causes a relapse? Who can say? We really don't know for sure. And is it ok to hold pain medication on a 'what if' scenario? But detox and getting clean can be EXTREMELY difficult, do we want to have a hand in destroying all the work, the heartache, the patient went through? Honestly, I think it comes down to the patient and the doctors. The doctor has to have an open, forthright discussion with the patient before the surgery- you're going to be in pain and you have a drug abuse history, here are your choices for pain control, what do you prefer? That way the doctor can order appropriate pain meds and tge patient is prepared and aware. My final thought is, did anyone offer or attempt other alternatives to opoids? We know about the Tylenol (which is laughable for post-op pain), but maybe Toradol could've offered some relief without the risk of relapse. The patient is really the one to dictate what she wants- was she able to understand the risks of getting vicoden and morphine? If so and she chose to get them, then that's her choice. I think you made the right decision. It's one of the millions of ethical dilemmas we deal with as nurses!! It's a fine line, but pain control is very high on our list of needs and rights as patients. (And, honestly, if you're still questioning it, talk to the doctor- even if the patient is already gone, just run the scenario by the doctor and see what they say...which will probably be to offer pain relief)

You were absolutely right in your judgement call. 10/10 epigastric pain is rarely going to simply be 'acid reflux'. I'd rather err on the side of caution...have her come back and they say she just has reflux rather than hold her there, in severe pain, and end up with a dead patient. You advocate for your patient, uphold and protect your license by making good calls like that. Well done!

They might allow you to retest. If so, allow enough time for it to be out if your system Honestly, if you needed a Lorazepam now, you will probably need it during nursing school! More stress than you can imagine. That being said, if I were you, I'd get in to my Dr right away and actually get a script for it- then you're covered as you'll have a legitimate script if you need to take it again and you have a script to show them that might work for this instance. I would caution you against contacting them and giving any excuse. It really really wouldn't go over well. Ask for a retest and/or actually get a script for yourself

I would apply elsewhere but stay where you're at for now, not just for the income but it looks better for future employers that you continued to work in the medical field. Working as a tech still gives you nursing experience so value it! You can also ask fir more respinsibility on the floor- since you have your license now, they might let you do more under the nurses (helping with IV's, some meds, etc.) You definitely don't want to burn that bridge. If they "find" a spot for you there, great...if you find another job somewhere else, great- but don't burn that bridge!! It's sucky timing with the write-up but they can't circumvent the rules for you. Try to be patient and let things work out or you may end up makig things really rough for yourself. I guarantee the skills you use as a tech will only HELP you in your nursing career. It's not as easy to find a nursing position as you think- and you want to find one you like, not just anything. I hated LTC- HATED it and was done with it within 2 weeks...looking for another job, bigger loss of income. Stick with it! Apply elsewhere, keep working, ask to do more 'nursy' things, leave on GOOD terms, or wait for a position to open there.

If I were you, I would probably start looking elsewhere but there's a couple of things to do while you search: first, talk to the preceptor and apologize (in my opinion she should apologize to you, but you can be the one to take the high road), then talk to the manager/supervisor and explain that you have apologized but really lay out what's been going on. At least this way you can know that you did the right thing even if it doesn't do anything to resolve the issue. Asking for another preceptor works in some places, but I don't think that will help in this instance. That girl should not have been placed as a preceptor after only 3 months of being there even if she had 15years of ICU experience, she shouldn't be precepting at a new position...that doesn't seem like a great place to work, I would be afraid to have a family member be in that ICU...poor management choices, nurses that sabotage each other to the detriment of patients!! That's scary and incredibly unethical. Go somewhere else, but speak up sooner if you have problems with the preceptor. Don't allow yourself to get to that point again.

You're not alone in your feelings! Many many of us go through this- you have to find an area that fits you better. For the sake of experience and future prospects, try to stick with nursing for a while. Maybe try an urgent care clinic, an outpatient clinic (LOTS to choose from- regular Dr. office, foot/ankle, spine institute, specialty clinics- cardiology, endocrinology, etc), same day or ambulatory surgery center, endoscopy, school nurse, even moving to case management or oversight/risk management. You can definitely incorporate a computer degree and work on the computer side of the mefical community. I have a friend that got a VERY high paying job working for Elsevier (which you may know, does a lot if online things for nursing programs). She works solely on computers/programs, but got the job because she has a nursing degree. Think about what drew you to nursing initially, what passion drove you to go through the schooling? See if you can find a position that capitalizes on that passion and you will find a job you love. LOADS AND LOADS of nurses *HATE* inpatient care like Med-surg, ICU, etc (including me!) But don't give up on nursing. There's a reason you wanted to do it and there IS a position that will be a great fit for you. There's way more to nursing than inpatient care and it's perfectly fine if that's not your area. Don't give up, keep looking!!

Hi, I'm just a few days into my immersion experience and I could use some advice. I was told to give a Morphine injection (4mg /2mL) to a pt. The pt didn't have IV access (I'm pretty used to giving IV pushes) so my preceptor said to give it IM. She got called to a code as we were preparing to give the injection so she had me go in and give it by myself...well, I gave it in the upper arm, but I think I may have missed the deltoid and gave it a little farther back on the arm (not quite into the tricep though). I didn't really think too much about this until I got home and was going over the skills I performed for the day. It dawned on me that I didn't ensure the placement prior to injecting the medication. Is this person going to be ok??? It was only 2mL of meds so I'm hoping it'll be fine, but what complications could I have caused by not getting it in the right place??? Just out of curiosity, my professors in school have gone back and forth on whether we should aspirate before pushing the plunger...CDC says it's no longer required, but some of my professors (that have been nurses for quite a while) say it should always be done with IM injections. I've seen it both ways...just curious what everyone's thought is on that practice.