LibraNurse27

Have others given IV insulin on a Med/Surg floor? When I worked Med/Surg we had to transfer pts to Stepdown or ICU for IV insulin or insulin drip. I was very familiar with giving sub q insulin on Med/Surg but I needed further training when I transferred to Stepdown before I was allowed to give IV push insulin and definitely before being allowed to manage an insulin drip. The order may not have been appropriate for a Med/Surg floor, but either way I am glad your patient survived, and it's a great reminder to slow down no matter how crazy things are, and ask for clarification if you're not sure/have never done something before. I know it's hard because finding someone to clarify an order with, and taking the time to do it can seem impossible on a crazy busy day, but it is always worth it ?

Do you want to try acute care again because you enjoyed it, or because you feel like you should? If it's the former, keep trying! Covid is still an issue, so some hospitals may not have the capacity to train new grads now, but maybe when things get better, and hopefully you can find a teaching hospital or one with a good new grad training program. If you don't think you enjoy acute care and it makes you too stressed, there is no shame in not working in acute care. All areas of nursing are important.

Yes, and since I am not a talented athlete or entertainer, living in Silicon Valley has taught me that second best would have been becoming a software engineer, or better yet a venture capitalist! Unfortunately I also don't know how to do coding and huge investments make me nervous. Now that I'm back to clinic nursing I don't feel taken advantage of as I did in the hospital. It's hard for anyone except those who've experienced it to understand the level of responsibility nurses have. I used to feel upset knowing tech workers who invented phone games like Fruit Ninja (fun game!) make ten times more than me, but I realized I don't HAVE to be a nurse. Now I'm focused on enjoying my work and continuing to advocate for nurses. I think the cap on travel nurse pay is ridiculous, and I hope it leaves a bad taste in the public's mouth knowing fewer and fewer people will want to care for them because nurses are continuously undervalued and disrespected.

I guess the country doesn't believe nurses will keep quitting, although the evidence seems clear. I am afraid it will get to the point where people will die because there is no one left to take care of them. For some reason some people are angry about paying nurses what they're worth. Same with paramedics, teachers, etc. I wonder why our society refuses to value those who raise up our children and save our lives. Some EMTs and paramedics make minimum wage! It's crazy

LOL! Exactly. Unless it's in a foot or neck, which I will be sure to let you know!

I've had patients with a PICC line in the upper arm and a peripheral IV in the same arm in forearm/AC/hand. It wouldn't be in the way unless it's in the same vein they are going to use for PICC (usually basilic vein) or somewhere else in the upper arm that might make placement difficult. And, if it's in the way they can take it out ? No need to worry!

If you have a license that says RN, you're a real nurse!

Surprisingly useful skill, I've found!

I wish I had been given that exam! I definitely would have failed ?

Exactly! I wish I knew this when I took my NCLEX. I answered 70 questions in 25 minutes and passed, yet I am currently on leave from work because I can't handle being a nurse. What would you suggest as a better way to determine if people are ready to be a nurse? I guess clinicals in nursing school, but those can be pretty subjective depending on who your instructor is and how involved they are.

CA is seen as the golden state for nurses (our state nickname is Golden State!), and is known as a beautiful, liberal place. I agree that it's the best state to be a nurse, and the natural beauty and architecture in parts of the state are amazing. However, I would advise not to view Cali through rose colored glasses. We are dealing with lengthy fire seasons that wipe out entire towns, a never-ending drought, and rising sea levels predicted to swallow coastal towns. While we are famous for being a politically liberal state, that is mostly in coastal cities. There is a huge portion of the state where racism is rampant. Even the "liberal" cities are not how they present themselves. I have learned this since marrying a Black person who is treated badly in famously liberal San Francisco, while watching the Black population disappear thanks to racism and gentrification. Not to mention our meth and fentanyl issue and the cost of living = ( I have always thought CA was the best state and I'm still happy to live here, but I now see the downsides and see the appeal of other (cheaper!) areas. I'm not advising anyone not to move here, but do your research on the specific area you're coming to, in terms of climate, politics, traffic, and proximity to fire/drought/sea level issues.

That's my experience too = ( No unit clerk, no CNAs, no transport, sometimes no lab techs. The ratios are great but when you're answering the phones, filing all paperwork, spending an hour at MRI with an unstable pt, doing total care for all your patients, drawing and running your own labs... still stressful =( But yes, there are some golden hospitals!

It seems unreasonable to have you quickly orient to both adults and Peds and then be expected to work both independently. Peds is its own specialty with entirely different skills and med doses, diagnoses, dealing with parents, etc. I would NOT feel comfortable on a Peds unit even though I have years of acute care experience with adults. I would need a long orientation like that of a new grad. Is it possible you can ask for more orientation or not to float to Peds? That sound so stressful!

I wish I could but I have only worked at one CA hospital and heard about a few others from friends. I think it depends on the unit, manager, and hospital. All CA hospitals are obligated to follow the ratios, except those that applied for emergency exceptions during covid. Some follow the ratios but cut corners in other ways, and others follow and also have support staff. Not sure if you're coming to the Bay Area, but I have heard that the 2 John Muir hospitals are pretty good in terms of staffing and ancillary support = ) Hope that remains the case during covid!

Once on psych meds it can be hard to get off, due to dependence and withdrawal. I tried to taper down on my own when I was running out and when I felt my high dose of lamictal was affecting my memory/concentration. Doing it alone while working was stupid, and caused my performance at work to suffer. I ended up having to take time off (ten weeks!) to meet with a doctor and safely adjust to the right dose while not working as to not be a danger to patients. I hope you can find a new job and have time off in between ending your current job and starting the new one to figure out your meds and come off if you can/want to. But if you need them long term there is no shame in that!

I know how I got through school and aced the NCLEX: I am book smart. I know exactly what to do in theoretical case scenarios and have an in depth knowledge of pathophysiology, but once I'm under pressure and trying to multi-task, everything leaves my brain! It would be easier for me to get through a PhD program than go back to a Med/Surg floor. We all have our strengths and weaknesses. Some people struggle in school and then are amazing nurses in real life. Some are great at hands on skills, time management, stress management, etc. and others need a lower stress environment. Good thing there are so many types of nurses and all are in demand right now! If you find a job you are good at and not stressed, your confidence will increase = )

I had a full time and a per diem and only lasted 5 months working 6 days a week. I felt guilty quitting the per diem after only 5 months, but I felt my performance at both jobs was starting to suffer due to fatigue. If you don't absolutely need the money, quit the PRN. Too much! And agree with above, it pushed me into a higher tax bracket, which in CA means I was losing almost 40% of my income!! It came out to a very tiny profit margin LOL

I also did a lot of phone and in person triage, point of care testing (flu, strep, blood sugar, hemoglobin, UA dips, pregnancy, etc), some wound care, IV fluids, IM injections, vaccines, neb treatments, and a lot of listening!

I have all the card I have received from patients over the years, and they are more valuable to me than any gift (although I greatly appreciate those too!) I read them once a year when I clean out my file cabinet, and I also pull them out when I'm not feeling like a good nurse, to remind myself that while I may have moments I'm not proud of, overall I'm good. Heartfelt appreciation with specifics can be really impactful and long lasting, especially as we often feel unappreciated as nurses.

I had to go on leave at the end of August and at first I didn't know what to do with my time either, but by the second week I loved volunteering at the food bank and going for walks in Golden Gate Park near my apartment. I have lived near the park for months but never had time to enjoy it! It's beautiful. I used the time to catch up with friends, call my grandma a lot, learn how to cook, read, watch some shows, and find a job that will be a better fit for my mental health issues. Now I don't want to go back to work! This is my last week off. I'm sure you will figure out how to enjoy your time off. Right now there is a huge nursing shortage, especially in acute care so I bet somewhere would train you if that's what you want. It's high stress though. Maybe clinics, dialysis, case management, insurance companies, Telehealth, MDS... lots of options!

OMG people watching me put gloves on makes me so nervous! I think being in a new setting definitely makes a difference. When you gain experience and confidence I hope your anxiety will improve = ) True! In some countries the 40 hour workweek is not the norm. Here it seems 40 hours would be good but you’re more impressive if you do 80! Yuck

I think logically there isn't much to be concerned about with your scrubs; most diseases don't last on clothing and dirty clothes are not a common mode of disease transmission. Especially if you're following all precautions at work I think you're good! But I totally know mental illness doesn't allow us to think logically sometimes. I'm really glad you're getting treatment from a specialist, and thank you for sharing your experience with OCD.

I think it's great you are taking the time to reflect on behaviors and make improvements. It's a hard thing to do, and I wish you success = ) It always feels better to know you're doing the right thing, even if it's hard in the moment. It's worse to be left with regrets and guilt that last much longer than the momentary discomfort of doing something difficult; I know this from experience. It's great to work on objectivity and fairness. Nice to have workplace friendships and since you have already recognized that you tend to favor your friends, I'm sure you can work on it! = )

Definitely. I'll attest from personal experience! The recent studies about sociopaths/psychopaths (not sure the difference) are interesting in that they have found actual concrete differences in people's brains, so some argue it's not their "fault" that they don't have empathy. But I don't think anyone is suggesting people therefore shouldn't be held accountable for their actions like those who experienced psychosis/delusions. I did watch the documentary! I completely agree with your analysis. It will be interesting to see the verdict of the trial.

Yikes! I'm scared