ScientistSalarian

2-point-something (ICU patient) ... needless to say, they did not make it

An assessment is an evaluation of the patient's current condition, so I don't think it's appropriate to include history just as a matter of course. Sidebar: I'm not a fan of the "WNL/WNL EXCEPT/NO" system. My hospital uses Cerner, so there's a "Systems Review" field at the top and a lot of nurses will, for example, choose "WNL" for HEENT and then leave that portion blank in the detailed assessment below. Quick, clean, easy - I get the appeal. But I attended a presentation from our hospital lawyer who made a really good case for ignoring the WNL stuff altogether and simply charting everything you assessed in the detailed assessment, system by system. It takes longer, yes, but when you chart "WNL" you're attesting that everything encompassed in that "WNL" was a-ok. If part of the reference material for that section includes checking a patient's ears or throat and it's not something you routinely check unless indicated, you're opening yourself up to liability for charting a false assessment. I know not everyone agrees on this but it makes sense to me ¯\_(ツ)_/¯

You have fewer patients in critical care, sure, but if thinking on your feet and dealing with the unexpected aren't your strong points then I don't know that you'll find the ICU to be a "low-stress" experience. Maybe do some shadowing there first to see if it appeals to you, otherwise it sounds like an outpatient setting might be a better fit. I ... can't even, haha. But on a lighter note, if you ever find a job in cosmetics with a nursing license please let me know!

I've been using Blue Apron for a few months now, and on the whole I'm pretty satisfied. The recipes have generally been delicious (there have only been a couple that were "meh," and none that were actually bad) and take about a half hour to prepare, though that includes a fair amount of time cleaning and chopping veggies. The price seems fair to me - $60/week for 3 meals works out to $10/meal between my boyfriend and I. I know that seems steep, but between Blue Apron and the gigantic (but cheap!) CSA box we get every other week our grocery shopping has been cut down to staples like coffee, yogurt, etc. The only downside for me is the calorie count (anywhere from 550-800 per serving depending on the dish) and the fact that many of the options are a bit carb-heavy (white rice, flatbread, potatoes, etc.). I wouldn't say that the nutrition is unreasonable, but due to my own personal eating/food issues I'm sort of glad that it's only 3x/week.

As a fellow introvert I can sympathize. Small talk doesn't tend to come naturally to me so joining in/avoiding conversations with coworkers can be a bit of a challenge. That said, it's worth weighing the annoyance of chit chat against building good relationships with your coworkers. You of course have every right to work in silence if you so choose, but the way you rebuff conversational advances can make all the difference. Making nice with coworkers isn't strictly a part of the job description, but whether we like it or not it's just a part of working alongside other people and can have a huge impact on the working environment. (But asking if you're bipolar? Invasive and inappropriate. And there is surely a special circle of hell for the "come on, give us a smile!" people ... since vomiting all over them probably isn't an option I'd just fix them with my most withering stare as I slowly and deliberately turned my back.)

If possible I would go straight for the BSN, that's where the profession's heading anyway so you may as well take the direct route. That said, BSN program admissions can be very, very competitive. If for whatever reason you're unable to pull the excellent grades you need you might have a hard time getting a spot once you're ready to transfer. Does your school have any admissions agreements with four-year universities? If you're really not sure what to do I'd definitely see a counselor/advisor to find out exactly what your options are.

Okay, I ... think I got all that? I'm sorry you're so miserable about all of this, it must have been hard to be thrown into a new shift without warning. Your night preceptor seems like he could definitely work on better communicating with you about your game plan, and steering you in the right direction when things need to get done. That said, I feel like you might be taking this way too personally. It seems like the main issues he's having with you are time management and prioritization. The educator told you to talk to him; you say you already did twice but have you actually asked him for feedback? From your description those "talks" were just you telling him that you needed to be taking on as much as possible. You asked your manager to change your preceptor, but did you ever talk to him about any of this? You ... you know "rushing things," and above all "all this paperwork" is pretty much the job in acute bedside nursing, right? It's great when you can take a minute and really check in with how your patient is doing emotionally, but that's just not going to be realistic most of the time on a med-surg unit where you apparently have 6-7 patients to care for. You seem to be fixated on having a nurse glued to your side and walking you through every step, but you need to focus on prioritizing and working as efficiently as possible while becoming increasingly independent. Talk to your preceptor, don't be afraid to ask the other nurses questions when you need to, and please, I implore you, add some paragraph breaks.

In my area (coastal CA) we only have one 16-bed inpatient psych unit run by the county as its own facility. None of our hospitals have dedicated inpatient psych units, and it's a huge problem imo. We see patients all the time who could benefit from a psych consult at the very least, but the vast majority are medically cleared and discharged without having their psych issues addressed in any meaningful way.

What?? No. Not only is that a completely bizarre expectation, it's totally inappropriate, unprofessional, and ethically squishy. I don't know if it's somehow more acceptable in a LTC memory unit, but hearing that directive in the workplace - any workplace, really - would make me incredibly uncomfortable. Boundaries, people!

I came to nursing because I like healthcare, was sick of working in a pathology lab, and couldn't deal with the amount of time and and life real estate being a physician would take up. It's a profession that fits well with my knowledge base, skill set, temperament, etc. and offers adequate compensation and mobility within the profession. Basically, it's a solid, flexible job that I know I can excel in and (bonus!) happen to enjoy. Is it my "passion" or "calling?" Nope. It's my profession. I happen to love my job, but it's still just a job, not the entirety of my life's work. To be completely honest I'm still kinda baffled by how many people ~*dream*~ of being a nurse, or speak of their "call" to nursing as if they're entering a convent.

If I'm off that night I try to nap only until 12-2ish and then go to bed at my normal time. Granted, even before working nights I don't tend to get sleepy until around 1:00 or 2:00 am so it's not such a huge shift in my sleep schedule.

Hahahaha stop that. As far as I'm concerned, the day I stop being carded every time I buy alcohol and people stop assuming I'm a baby fresh out of college is the day I will CONSIDER being "too old" for something. Besides, this might be the push I need to get that lounge act off the ground

Fair enough! While I wouldn't be breaking any rules I would hate to spend a bunch of time and money on attaining the perfect shade of purple only to be told to dye it back. Just curious about how other nurses view hair color in regards to "professionalism" and how tightly staff appearance is controlled at other hospitals.

What are your thoughts on unconventional hair colors (purple, pink, turquoise, etc.) in the workplace? I'm 30 years old and I've always wanted to try out a fun, totally unnatural hair color but until recently I've always been far too timid to actually go for it. For a while now I've been dying to try out the gorgeous silvery lavender or baby pink hues I see on other people. My nursing school had an explicit "natural human hair colors only" rule, but now that I'm working for an employer that has no set hair color policy in place (and is also not referenced at all in policies relating to hygiene, general appearance, etc.) I'm wondering if I could actually pull this off. For reference, I work on a tele/step down unit in a moderately conservative area. I ran this by my favorite house supervisor (for generational reference she would be a gen-xer) and she wasn't excited about the idea. Her position was that the hospital environment is where appearing to be "professional" is paramount, and that a huge chunk of the patient population is 65+ and might not look kindly on it. In short, pink hair would undermine my professionalism. I understand her reasoning there, but I also feel strongly that hair color (or tattoos, for that matter) have absolutely nothing to do with competence or professionalism. If everything else about my appearance is boring and conservative as usual what difference does hair color make? Additionally, I think she's underestimating the older generations she's worried about offending. It's a bit of a stereotype to assume that all of our older patients would be clutching their pearls or eyeing me with suspicion just because of purple hair, right? Thoughts?

Heh, my floor director runs a tight ship But honestly I get where they're coming from with the overtime thing. I work tele/stepdown so we can only take up to three patients, and all of the new grads/new hires start out on nights - given those circumstances I could see how it would be concerning if someone routinely wasn't able to chart on three patients over the span of twelve hours. Besides, they're running a business first and foremost so it makes sense that having someone continually accruing overtime would be a big ol' red flag.

Sure, of course we're compensated for overtime (time and a half as an hourly employee). It doesn't happen much, but if I have to stay on the clock to finish up, so be it - simply put, I don't nurse for free But staying an *hour or more* after a shift for charting/assessment/patient care?? That definitely shouldn't be the case unless there are extremely extenuating circumstances along the lines of someone coding. If someone on my unit was having to stay over for any amount of time on a regular basis they would quickly earn a meeting with the director to discuss getting their time management under control.

You're a straight manly-man you say? Definitely not gay? Maybe add that in a few more times, I wasn't quite sure ^.^ You seem to be projecting your own insecurities onto your job here, friend-o. Leaving aside the whole "most male nurses are surely feminine and/or gay" thing (which: how charmingly regressive) why do you even care about how your patients and coworkers perceive your sexual orientation? When, pray tell, would that even enter into your day-to-day work life?? If you were truly comfortable in the knowledge of who you are in your personal life you probably wouldn't be stressing about what random people at work think. Let's leave off the assumption that women going to a hospital for work or as a patient also must be on the lookout for a date, because eww. As a straight cis-gender female I'm attracted to men in general, yes. Am I sizing up each male nurse I encounter as a sexual object? Uhh no. No I don't, because like many adults I keep that part of my life separate from my professional life. If I found out a man I was attracted to was an RN, would I be like "oh noes, he suddenly appears effeminate and therefore probably gay!!!" No. No. Are you kidding me with this?

I will never accept "orientated" as legitimate. NEVER I SAY. "Loose" (for "lose") and "advise" (for "advice") are two that never fail to annoy. The "we're nurses, not writers" thing holds no water for me; this is a site for professionals to talk to each other so maybe refrain from posting as if you're updating your Facebook wall. Not going to lie, when I read a post about wanting to be a nurse/trying to get into nursing school/taking the NCLEX for the eighth time and it's lousy with misspellings and grammatical errors I am judging so hard

What. .... no. Nope nope nope. Re-read the title of your post and ask yourself if that sounds remotely legit. (Spoiler: no, no it does not at all, please do not give sketchy van man your money or your address.) Google your city + BLS. Whatever you find, make sure it A) is the official AHA course, whether done by a public or private entity, and B) does not involve giving money to a dude with a dummy in the back of his van. I'm sure you'll find something; whether you can get in before school starts is another story. (And no, it can't be done entirely online since you'll have to physically demonstrate CPR competency as well as taking the written test.)

It couldn't hurt to interview, right? Just do your due diligence and find out the details of the contract position and how it stacks up with other hospitals in the area. What will your starting rate be? What does the residency program entail as far as training, extra classes on top of your shifts, etc? How does this compare to your other options? If the pay and benefits are comparable, the residency training is thorough, and it's for a position on a unit you already know you like then why not? That doesn't seem like "settling," it seems like a pretty good score for a new RN fresh out of school :)

I'm gonna go with an emphatic "NO" followed by a hearty "gurrrrlll are you crazy?!" You know that the first year can be chaotic and confusing and basically stressful and terrible for new nurses; you acknowledge as much in your post. There are hundreds, if not, thousands of posts on this site assuring new nurses that the first year is usually the worst but that it gets better - and for a lot of people, myself included, this is 100% true. Based on what you wrote I don't think that you're giving your nursing career a fair chance here. I mean yes, you are physically fulfilling the requirements of your job, but focusing your energy on hating it and flailing around for backup plans isn't going to improve anything in the nursing department, you know? You say you're stressed out, so why on earth are you working a second job?? I know you like the place, but waitressing on top of full-time nightshift nursing? In your first few months of actually being a nurse?? Jeez no wonder you're stressed, I would've dropped dead. You said straight out that you're holding on to the job "in case" you quit your hospital job ... if you're really willing to give your nursing career a fair shake why would you do that to yourself? You're an adult and it's obviously your life and your decision, but pleaseeeeeeeee give it a chance before you up and quit. Really. Quit your waitressing job, stop formulating contingency plans, take care of yourself on your days off, and take it one shift at a time with the knowledge that it will get easier. You might still dislike bedside nursing at the end of that year, and that's okay! Once you have that experience under your belt there are tons of nonclinical nursing positions you could go after. I just don't see the point in throwing away everything you've worked so hard for just because you're off to a rough start. Give it a chance for a full year. I have a feeling you're a lot stronger and more capable than you're giving yourself credit for at the moment. Touch bases with other new nurses, grab coffee with an older nurse who's been there and lived to tell about it, vent here on AN, whatever you need to do to tackle the mental block you have going on. Heck, PM me if you want, I'm a fairly new nurse myself on a critical care unit. It can suck. It WILL suck. But give it a real chance, you might surprise yourself

Do you have an ironclad, actual job offer from Dream Job? Normally it doesn't look great to leave a position so soon, but if you have a solid offer it seems fair to weigh that against the risk of leaving prematurely and potentially getting yourself blacklisted from your current hospital. I would just caution you to be sure that the new job is everything that you're imagining it's going to be. Don't let the ~dream job~ halo keep you from really scrutinizing the position. If the new gig doesn't work out - unexpected workload, negative work environment, decrease in pay or benefits, turns out you don't like the place you relocated to, whatever - it's going to be pretty tough to land a third job with two short-term ones on your resume. But hey if you have a solid offer, have done your homework and really vetted the place, are sure that it's an actual step up from where you are now and are willing to accept the risk then heck, go for it. Best of luck, this seems like a good dilemma to have :)

With our pyxises (pyxies?) it's possible to log in with a password instead of your fingerprint - when they say "you had to submit your fingerprint for this transaction" do they mean they know definitively that you were logged in via fingerprint recognition, or was it more of a general statement about how things normally go? Semantics, I know, but if someone had your login and password it would be very possible to pull meds under your name. If, on the other hand, you were logged in with both the correct user name and fingerprint I don't know what to tell you. Seems like that would be incredibly difficult to disprove. Either way I'd lawyer up and make sure to go through your documentation with a fine-tooth comb. Do you have a timestamp that shows you were somewhere else at the time? Did you accidentally pull or administer the med under the wrong patient? Does your facility have cameras that show you were in a different place or at least definitely not at that pyxis at the time? Awful situation, I can't even imagine the stress you're going through. Good luck with everything :)

Would it be possible to change your major or double major? That seems like the most efficient route if nursing is what you really want to do. Taking two years to finish your health administration degree, then two more for an ADN program (assuming you get in right away), then another year or two for your BSN seems unnecessarily convoluted and insanely expensive. You say you don't want to "waste time and start over in nursing" but going the roundabout way seems like a really poor use of you time. Since you're already at a university I'd think getting your BSN now would be the simplest solution. Might add another year or so, but that seems way better than spending 4+ before pursuing the degree you actually want. Good luck with everything :)

Just wanted to say thanks for all of the thoughtful responses ... even if I don't necessarily agree with everything, I appreciate reading everyone's different perspectives. You've all given me some great advice and lots to think about :)