Rn112389

Poor honey! I will never forget that feeling! That is a normal adjustment just stick with it and it will become easier! I would say it took me a year as a new nurse to start feeling confident. Ive been a nurse for 8 years and i have experienced with each new career change i have that “new grad” feeling for atleast 6 months to a year. dont give up now! You will truly get there!!

Curious as well

Just curious if voting has ended and who won? ?

@Jeanniejayne thanks for taking the time to read, I pray everything is going well for you presently!

My background and first true love in nursing is emergency trauma nursing. The ER I worked in, is a 97 bed Level 1 trauma emergency department who services the whole western side of the state. We see 140,000 patients a year and the volume and acuity alone make me a proud employee. As an ED RN, my least favorite type of patients were stroke patients (go figure considering my role now). When I saw the position availability my initial reaction was “I could really change some of the things I hate most related to the process of handling stroke care.” Thus, here I am now, almost a year into this career change and I am still learning my strengths and weaknesses in this role. Our team works up approximately 2700 strokes a year and about 1300 of these patients are diagnosed with strokes. Our ED activates at least 120 suspected strokes a month, last rolling calendar year we gave tPA 127 times and provided emergent thrombectomy 47 times. Yes, I'm the one keeping track of those numbers. So aside from data collection and implication of quality metrics, let's walk through what I do for our stroke patients who come to our ED. On arrival to our ED, I greet the patient and provider team. I ensure the patient gets to CT scan within the American heart recommended target time (20 minutes but our facility are a bunch of overachievers so we promote the magic number 10). If the patient is a candidate for tPA I support the nursing staff by mixing tPA, obtaining a second IV access, ensuring adequate blood pressure control, anything I can do as a second set of hands. Again, only 3% of patients in this ED are strokes so even though we have made waves in stroke care – the nurses are still a bit overwhelmed when they do have to give tPA. Let’s say this patient also is a candidate for thrombectomy, I then coordinate transport to the cath lab, support the cath lab staff, and ensure they receive a clear report on these patients deficits. Regardless if the patient received an intervention, I am following all strokes/ stroke mimics until their MRI is negative/positive. I round on these patients and provide them with community resources, support groups, education, and ensure the family is on board and can recognize signs of a stroke. I am tracking these patients in real time to ensure all joint commission and AHA quality metrics are met. After these patients leave our facility, if they received intervention they get a call from me after their return home from rehab. If they did not receive intervention – I call them within 7 days to ensure they don’t have questions in their discharge plan and to clear up any inaccurate information. During these calls, I gauge their functional outcomes to report improvement. A lot of the people will attend a stroke support group that I host- and it's so rewarding to see the connection from hospital arrival to their discharge out in the community. When I'm not in the hospital – I am participating in community outreach and promote stroke awareness and prevention. We have 80 ambulance services that feed our ED, and I have made relationships with our top 10 by rounding with them to ensure they are comfortable activating a stroke alert in the pre-hospital setting. I visit with senior centers and school-aged children to ensure that education can be provided to all because TIME IS BRAIN! So in summary – I am a stoke program nurse coordinator. I promote stroke awareness in the community, concurrently review charts of stroke patients to ensure the best quality of care, round with stroke patients, support the emergency room staff during acute strokes, support our vascular neurologists and our process through evidence-based research. What a mouthful!

I'm not sure where to submit my entry either - "F.A.S.T. – does not represent the time it takes to explain my role" Stroke Program Nurse Coordinator for AllNurses.docx

That is seriously frustrating. People that dont work nights just don't get it. I've been working nights for 5 years and my body still has not adjusted completely and I don't expect it too. Certain things are left undone untill I have two days off in a row. and I absolutely hate when my manager books me one day on, one off, one on, one off, one on. I guess I vented a little too here :) Im sure if you explain to her the situation she will understand. put your foot down!!

Go for your BSN. Unless you have your foot in the door at a facility working as a nurses aide, chances are most hospitals will only hire you if you have a BSN. Personally, I think its a good idea to start at the bottom and work your way up (to test the waters if you even like nursing as a career). I was a nurses aide for years while I went to school so that helped me in more ways than one. It can be somewhat stressful and demanding at times but ultimately, it's a very rewarding career. Congratulations on your choice to pursue nursing!

Thanks for your reply, I'm looking for per-diem as well! Good luck!!

to all my friends on allnurses, I am asking for your advice yet again! I am beginning to feel as though I am at a crossroad and need to make some changes in my career. A little background, I am a "Resource/Charge RN" on a medical surgical telemetry unit and at this time a complete switch to another department/facility is not in the picture for me. I am still gaining experience on my unit and am looking in ways I can build up my resume and challenge myself. I am interested in specialty areas dealing with cardiac, burns, and dialysis. I would like to find some courses and/or certifications that would be beneficial to me when I do eventually decide to leave my current unit. I'm debating going back to school for my masters and taking on a light course load..however, feel I do not have enough experience at this time to know exactly what to do with my masters degree... (NP, and education is not interesting to me, clinical nurse specialist.... maybe) This is why if I could get more expose from different courses/certifications I feel I might have a better idea honing in on interests. (I only have medical surgical experience and I know many certs. require experience in specialty areas) Any/all ideas are appreciated!!!

I have always admired the input from nurses using this forum so know I am asking for some general advice to help advance my career. To give you all some background information I am still considered a new graduate (less than 2 years), im ambitious and constantly try seeking out new learning opportunities. I work in a small 130 bed, privately owned facility that offers care to surrounding communities. Any invasive or high risk patients are usually referred/transfered to a larger hospital with specialists. My hospital does not offer specialty units (medsurg floor, ER, OBGYN). I currently work on a medical surgical unit and in the future see myself specializing in /something/. I am currently interested in cardiac and community education. I feel as though my education skills are poor and would appreciate advice on strengthening these skills (I review information daily and have a hard time putting medical information into lamemans terms... I often recite text verbatim which I understand isn't helpful to some) On another note I am also looking for ways I can "stand out" from my peers... and looking for courses I can take that will strengthen my knowledge and understanding of information, and also appeal to future employers. I just don't know where to start, especially when i'm not sure 100% what specialty I want. all ideas and suggestions are appreciated, thankyou!

I Started on nights as a new grad in December and am in love. I worked days for a brief period of time during my 8 week orientation and found them exhausting. Days provide more learning opportunities however, I had a hard time organizing myself and found So much thrown at me at once. On nights I am able to organize myself, establish a routine, and research each patient's clinical history/labs/presenting problem. I am connecting more dots and have time to look things up. I don't see myself on nights permanently but it is a fantastic building block in helping me achieve a routine. The only thing I hate about nights is sleeping during the day and waking up late with the posibility of being canceled due to a low patient census. Just remember alot is different from school! Im still questioning myself when I should actually call the doctor at 3am and what can wait until morning. Good luck and enjoy!!! :)

Thankyou for both of your input. My manager did provide the family with a route of communication to me so I agree seeing her for this matter would be appropriate. I also agree with BerryHappy that I should protect myself but I would not like to ingore the gesture. Thanks again

Hello, I work in a hospital and had a patient pass unexpectedly under my care for natural causes. The family went out of there way to send me a card and a small token to show their appreciation for my support during this most difficult time. Am I overstepping any boundaries by sending the family a sympathy card /thanks for this nice gesture? In doing this I would need to find their address from medical records or my manager. What do you think? Thankyou