datalore

"Am I going to have to chart this as patient elopement...?"

I've had an anxiety disorder basically from the moment I popped out the womb! I had to wait til I got mine under control enough to finally follow my passion. Sounds like you're working hard. My only additional advice would be that different care settings offer very different pace and frequency of emergencies. Even different med-surg units within one hospital! Shadow in different settings if you can; see the pace, see how often staff find themselves in Codes and emergencies; etc. Also, not that night shift is great for anxiety (I.e. Sleep deprivation!) but there's very little family conflict at night vs at day shift. As you continue down your path, keep working hard like you are, keep your needs in mind and see as many settings as you can til you find ones that will help you keep your anti-anxiety gains as you follow your passion. Good luck, and know you're not alone

I think it's appropriate on a group-by-group basis; my current work team does it well, but I've seen it crash and burn with other worksites. I go out for dinners when it's a large, all-people-were-invited work gathering and no problems in 2 years (yet? haha).

Among other things, we've all joked before about how doctors only ambulate patients on Grey's Anatomy. We have a surly, nurse-frightening, House-esque doc that not only regularly ambulates our elderly patients, but I also caught this doc helping my pt shave their face despite a full caseload and an aide in the wings able to help instead. It was amusing in an endearing way, because it was completely unexpected and sweet. So, I must ask, what other funny, cute, ridiculous, hilarious, unbelievable, incredible, etc, things have YOU seen at work that you once thought, "I thought that only happened on TV!"?

Most of the questions I got asked (I work tele) were about patient safety, willingness to accept feedback, how you'd handle an emergency, handling difficult patient situations etc, and way less about tele-related stuff. Basically "are you going to be a good, safe, teachable nurse" type questions. Your mileage may vary! Good luck!! Sleep well and eat a good breakfast :)

You're going to see many a coworker do things in a way that you don't prefer and/or that gets bodily stuff on you. It's not always carelessness or being incorrect. I've seen everything on that spectrum, like someone focused so much on the patient that they didn't realize they whipped the pee-soaked gown into their coworker's face instead of the hamper. Accident. Usually it's as simple as saying, "Oops, careful, that's going in my mouth," and that's enough to fix it.

I work in cardiac intermediate care (stepdown) and I'm only "ordered" to do q2-4 vitals and assessments - sick enough that they are moderately septic, bipap-requiring, titrating cardiac drips, unstable angina... etc. (Of course I do as often as clinically appropriate in addition.) At a nursing facility, these folks are definitely more higher-need than independently-living individuals but they are stable enough that they're "at home with help", so I would feel very comfortable with less frequent vitals if I walked by and they were breathing normally. :)

For me it was undeniable interest in an area long before nursing school. Significant family history of strokes and heart failure makes me think that hearts, lungs, and kidneys are cool... so for me the cardiopulmonary unit in my hospital was my only goal. And then once I worked there, my interest continued to deepen -- that's how I knew I chose wisely. Now that I've floated to a few other units, I see other areas I would love to learn in the future. But for now I want to become an expert in my area before I move on. The beauty of nursing is you can move about if different types of nursing interest and excite you. The other side of that coin is that I learned quickly what I can't stand. I don't like post-surgical care, so that eliminated quite a few units! I am severely uninterested in orthopedics. I floated to my ED, which I thought I would end up doing, and hated it. I love kids, but don't like peds/NICU after shadowing there. I did a few shifts shadowing a scrub nurse in the OR; hated it. I still learn a lot when I float to those areas, and I love that, but I'll never apply to work in those specialties. So that helped too! :) Edited to add: If you're not sure what area you'd like, use nursing school to get as many types of experience as you can!! It's ok to not know. It's ok to never find one area to stick to, too! Nursing school is such a unique and wonderful place to get as broad and varied an experience as you can. When I send my nursing students to go see cool procedures and the like, I am always a little jealous! Do as much as you can, in as many areas as you can! And if you think you know your specialty, STILL go see other areas, because you might be surprised (and at worst, it reinforces your decision to specialize elsewhere).

In the grand scheme of things, a NICU preceptorship is not likely to be the resume line-item that gets you directly into a NICU after graduation. So, although it's a serious disappointment as you likely would've loved the hands-on experience NOW, it's not a death-blow to your career path. At all. I promise. It's going to be just as hard to get that job, but if you're willing to put in the time and wait it out, you can get there. I had a similar disappointment in school; desperately wanted a cardiac placement, ended up in PEDIATRICS, to my distinct horror...... ended up learning a ton that I use in my cardiac job anyway. (I'm your opposite: I only want the oldest, most elderly patients! Hehe.)

Good on you for quitting! Watching my hubs do the same and you about-to-be-former-smokers are warriors I swear. Kudos. Hang in there.

I keep a ziplock baggie in one pocket of my scrub pants, one that is covered by my top anyway, but I hide a granola bar or something in there for when I'm on hold on the phone for a minute or charting furiously and I don't want to run all the way to grab something... anyway, I hide snacks on my person like a squirrel. It helps.

For the heart muscle portion of this... Hypokalemia (and/or hypomagnesemia) prolongs the QTc -- in less wonky terms, it increases the absolute rest period of the heart muscles; the time during which they cannot contract again. In hypokalemia and/or hypomagnesemia, it takes longer for the ventricles to get ready for the next beat; by the time they are ready to beat again in a patient with low K+/Mg+, the next ventricular contraction may already have fired, and then you are in danger of going into a rhythm like vtach or Torsades de pointes. It's called an R-on-T phenomenon, and can quickly degrade into a life threatening situation. If someone has low potassium and I need to give them an unrelated drug that also prolongs the QTc, like zofran or haldol or many others, I need to get an EKG and replace potassium or risk having to use my CPR skills on them. Taking it back a step, if I'm giving a patient something that lowers their K+ or Mg+, like some diuretics or some laxatives (or they have diarrhea), and I'm giving them other meds that lengthen QTc I definitely want to know their K/Mg levels first. I deal with this almost daily -- I'm giving lasix and not replacing it, and a potassium level hasn't been drawn in three days and the last one was borderline low, AND you want me to give more lasix? I call the doc and ask for another lab draw, which they are generally happy to have the nurse questioning! We all love patient safety

Wage/salary-wise, I can't give a number because the cost of living is so vastly different all over the US. I make peanuts compared to what other states pay their RNs, but I feel like I have a ton of monetary cushion because I live in a cheap area and I budget around my relatively manageable debts. What I think I'm worth as an RN, though... I think I'm worth adequate staffing ratios, I think I'm worth listening to when administrators want to make changes that make my job harder, I think I'm worth acknowledging when patient outcomes are improving... I think I'm worth at least that.

You're going to age anyway, might as well be a nurse when you get there.

As long as HCAHPS is GONE!... I'm open to options. But not "no" option.