firefly84

I didn't do the "trick" when I took my boards. However, my nursing license appeared on the state website before my results showed up online. Just a little tip. Not sure if that is true in all states or not. This also was several years ago. R.E.L.A.X. You're working yourself up more by continuing to check. It isn't going to change the outcome or make the results show up any quicker. Wishing you the best!

Write what you see; what colors, is the skin dry, chapped, cracked, bleeding... Write what you hear; stridor, audible wheezes, coughing (harsh, tight, loose) Write what you smell; breath is sweet, Write what you feel; perhaps someone has crepitus, Use your eyes, ears, nose, and hands. You have a full assessment kit built in. Do this for your entire head to toe assessment and you will end up with plenty of details. Go online and just do a search for complete head to toe assessment examples and you should find a lot of good info.

First off, don't feel bad at all. I truly thought the first year of nursing school was the hardest. There is so much thrown at you all at once. The other really big adjustment is to take everything you knew about taking tests and pretty much throw it out the window! I'm not sure if you have had any exams yet, but you will soon find out nursing exams are a brand new world. The rules are different, the rationale is different, they try to trick you. Each exam is slowly preparing you for taking your boards. They will teach you how to answer questions again :) Take a deep breath, you can do this. As for all the reading...here is the secret I found that saved me for all of nursing school. Get a review and rationale book for your main classes. These basically give an outline and hit the high points of each topic. You can still do all of your reading in your assigned books, but when it comes to studying, the review and rationale book will save you tons of time. Perhaps if you are in a study group, you could all go in together on them! My other advice to you...baby steps, break this down into tolerable chunks of work. It's the only way to do it. Good luck, one step at a time! I promise, if you break this down into smaller pieces, it will be much more manageable.

Uncertainty is a trait that seems to run through the veins of all nurses. We are constantly wondering if we could have done something different or better. From what I can tell, it's definitely in your veins...seriously. It might not seem like it now, but it's a good trait. When we constantly question ourselves, it is used as a tool for improvement. So, you still aren't sure if nursing is for you, but... you applied and got into nursing school, then... you survived clinicals and developed your interpersonal and critical thinking skills you spent hundreds of hours doing careplans, reading thousands of pages of material, memorizing countless drugs and diseases AND you got a degree, passed your boards, and got a job. That sounds like someone that deep down knows exactly what they want to do. There were a lot of times that you could have stepped aside and decided this wasn't for you. Instead, you kept going. Now you, like most new grads have some doubts. Take things as they come. Approach this with an open mind. Ask questions, ask lots of them. This is your opportunity to soak in a huge amount of knowledge. You are always going to learn. There isn't a magical cut-off date that says you quit learning after 1 year of being a nurse. There is however, doubt and uncertainty, that will occasionally surface again. It happens to the best of us. When you experience your first code, you will wonder why anyone could do this as a career. Then you will see a grateful family who is thankful for you care and compassion. You will remember why you are a nurse. When you hand a new mother her baby for the first time; you will remember why you are a nurse. When someone thanks you for just being there in a moment of need; you will remember why you are a nurse. I have a good feeling about you...

I totally agree with this list. I would add that a lot of the doctors I have dealt with are a little more reserved until you have proven yourself to them. You can always tell once you've met their approval, because they are a lot more open and relaxed. It might be as simple as suggesting a medication or coming up with something they hadn't thought of. One of our docs will quiz the nurses about meds and labs. It's his way of getting a baseline on the nurse and figuring out a trust level. He also turns everything into teaching moments, which is really helpful in return. Along with the brain sheet, make out a mini schedule for the first few shifts. Break it down into 1 hour periods and use it to lay out your day at the beginning of the shift. It helps as a frame of reference for trying to stay on task. Even write in time for charting, for what you can't get done in the room. It will help you get into a habit of organizing your day. My absolute, #1 tip though...DON'T LOSE YOUR BRAINS!!! (the piece of paper with all your notes for the day)! You will look silly as you are looking in garbage cans and patients beds for that insanely important piece of paper. Don't feel bad though, everyone has done it multiple times before and you will too!

My program, although not accelerated, required microbiology and organic chemistry as prerequisites. They were challenging, especially the microbiology, but once you get into your nursing classes it will make perfect sense why. The biochemistry recommendation for your program sounds like a combo class. It will help with explaining not just how and why meds work, but should also get into the chemical basis of how our bodies work. This class would be a nice foundation to be able to refer to, especially when it comes to any of the pathophysiology in your nursing classes.

First off, I feel your frustration. Being a new grad is hard enough by itself, let alone being in this situation. I worked hospice after I had multiple years of experience with ICU, ER, OB, and acute care. I had years of skills to support me. It felt like a natural transition because I could go off of previous experiences and had the comfort level to go with it. Hospice is an area that requires both autonomy and critical thinking on the run. You have to be the best nurse you can be, in whatever situation you may encounter. My best opinion would be for you to switch over to the hospital for at least a year. You will get a huge amount of experience under your belt and get really good at your basic skills (IV, catheters, dressings, etc). Plus you will be in an environment where you will have that extra body to throw ideas around with. Hospital nursing is team nursing, as is hospice nursing. The goals of both are similar...take care of our patients to the best of our ability. We collaborate with other departments and specialties in order to ensure the best outcomes...life and death... Get some experience under your belt and then you could try hospice nursing again if you wanted. However, I would look for a hospice that is more willing to ensure your success, not throw you off the cliff and expect you to be perfect without any reliable guidance. Good luck to you going forward. I hope you are able to love nursing again. You had a bad experience that gave you a bitter taste of the profession. That isn't how it should be. You can do this...take a step back and approach it different. We all have had days that make us question why we are in the field, but then we remember all the good, satisfying days when we really have made a difference. That makes it worth it every time!!

Your first clinical will be a little nerve wracking for a couple hours. No matter how outgoing and ambitious you are, this is still a new experience. Remember why you are there and use every one of your senses to pay attention. The first clinical will be more orientation geared. First semester clinicals are designed to get you comfortable with the facility and to get you comfortable in your own skin. Ask questions and ask to watch procedures. Most physicians like explaining things and helping teach you, same with nurses. Medicine, no matter what position, involves constantly learning and honing in on your skills. The further you get into clinicals and are more comfortable, try working on developing your senses more. Focus on the smells in each room, you will be able to make a distinction between cancers, sepsis, and organ failure, along with many others. Focus on sights and sounds. A minute change in breathing pattern could be something significant developing. These all are going to make your assessment skills grow tremendously. There are a lot of things that books don't mention, that's why we need to go the extra mile to be superb all the time. Good luck!

Honestly, your going to need to know the major highlights of each category initially. Pharmacology is one of the biggest components of nursing practice, along with gut instinct! My advice to nursing students who have been at clinicals, is to look every drug up that you don't know. It doesn't matter that the doctor ordered it, you need to know what you are giving. You might catch something that is a contraindication and save your patient, or at the very least added another medication into your mind bank. But by knowing the major highlights of each category will give you a good baseline to start with. Many categories will have drugs with the same suffixes and prefixes and that helps to immediately identify what class you are dealing with. Beta blockers end in -olol (labetolol, nadolol); fluoroquinolone antibiotics end in -floxacin (levofloxacin, moxifloxacin). Just giving a couple examples. But, I would definitely learn the suffixes/prefixes for drug categories as well. It makes identification a lot quicker. There are always exceptions to the rules with some meds, but this works a large majority of the time. Good luck with your accelerated program! You will learn something new everyday for the rest of your career. One more piece of advice, always listen to your gut instinct, and always be a little nervous. You will pay a lot closer attention to the little things and be able to stop them early from turning into big problems.

I think it's safe to say that a very good majority of us have had frustrating/scary new grad experiences at some point. My new grad experience was similar to many. I was hired by the hospital that I had done my clinicals in. They hired 7 or 8 of us at the same time, pledged that they had come up with a great orientation, and that we would have preceptors throughout the whole process. The orientation was something like 2 weeks of classroom and then up to the floor...that's when things fell apart. When we hit the floor it was exceptionally busy. Our promised preceptors and exceptional orientation, turned into 1 day of, "your assignment is 3 patients, let me know if you have questions," followed by 1 day of, "we're really busy, let's fill out your skills checklist at the end of the day...tomorrow you're on your own!". Whoa! Wait! I'm what?! I didn't like it, it wasn't ideal, but I did it, and ultimately I figured out that I knew a lot more than I thought. No matter how lost I felt sometimes, I knew that the basics could get me through those moments. Here's the deal. If you haven't figured it out by now, you will soon...nursing school doesn't teach us how to be nurses. It ultimately teaches us how to pass our boards, and we pick up skills along the way. We learn to be nurses by having hands on experiences Living and breathing it, is why each and every one of us have completely different knowledge bases. Every single day you will learn something that will make you a better nurse. Some nurses are great with new grads, others...not so much. Remember this...they all have things that you can learn from them. You also have things they can learn from. The initial nervousness of being a newbie probably will show up again each time you start a new job for your entire career. THIS IS A GOOD THING!!! Being a little anxious or nervous makes us ultimately pay attention to details. We catch things, we learn more, we listen to our gut feelings. Those are things we always want to do...every single day... I have a lot of times I call back when I get home to double check things. It isn't reserved for new grads. We all do it...it means we care...that's why we are nurses! Welcome!