bluebirdflyx

Thanks everyone for taking the time to respond. There are lights above the doors, and at one desk you can see on the paging system what room is calling, but from a majority of the seats unless you get up you cannot see which room it is. I will start being more vocal about delegation. I'm new to this role and in addition I still work the floor so I have to work alongside everyone. I think before the next shift starts I will have a huddle and tell everyone up front they need to step up their game and help distribute the workload.

I guess I should clarify that from the nurse's station we only have a visual on a few rooms. Often times when a light starts ringing no one can see what room it's coming from so it makes it difficult to direct a particular nurse. At this point it seems to become a standoff to see who is going to get up and see who's calling.

I would appreciate some feedback on how to get nurses to help answer call lights. I work on a med-surg/oncology floor. I alternate working both the floor and also as charge nurse. Our ratio is typically 5-6 and we have 1-2 CNAs. We have a paging system at the UC desk so we can page back into the room and ask the patient what they need. If the UC is not at the desk (they leave at midnight) and a call light goes off, I have a select few RNs and some CNAs who WILL NOT get up and answer the light. They will not go to the phone to what the patient needs nor will they go directly to the room. I mean they will not budge from their seats. Whether or not it's their patient doesn't seem to factor in, they will let them go and go. It doesn't seem to be an RN vs. CNA problem; it is made very clear at our facility that answering call lights is everyone's responsibility, but some of these people turn into Helen Keller the second an IV starts beeping or a call bell rings. I am not referring to nurses who are busy with other patients, reviewing orders, calling docs, or any of the other tasks that bog us down. I am talking about nurses who are sitting at the nurse's station playing on their phones, talking with other nurses, etc. I feel they are blatantly taking advantage of those of us who cannot sit by while the lights and alarms go off as they know we'll answer them eventually. It's not an option ignore the lights in return because only the patients will suffer. Does anyone have any advice on how to facilitate a change and get these nurses off their behinds?

You should apply for a regular CNA position. Often times those CNAs will get cross-trained to work as Unit Coordinators and from there it will be easier to move into a full time UC position.

^^ I do the same thing as Peihan - come in a little early and get ready. If for some reason I can't come in early that day I'll still take at least a minute or two to look through the chart for some key things I'll need to know for report such as labs or vitals that are out of whack, overdue meds, or STAT orders. I try to catch anything I'll need to address right away or clarify with the off-going nurse. I've gotten pretty fast at clicking through those few screens with the pertinent info. When (and if) I have time to look through the chart I will read the H&P, the consultation notes, and then skip ahead to that days notes. You can get a picture of where the patient started and where they are now. If they've been in for several days I don't normally read through each days note unless I'm looking for something specific.

Maybe I'm the exception to the rule but I don't really mind drug seeking patients. Generally all they want is their Dilaudid (or cocktail of choice) every 4 hours or so and as long as it's ordered and appropriate I'll give it without any issues. I make them request it, I don't turn PRNs into scheduled meds, but once they ask I don't keep them waiting long. I find this keeps them calm and they don't give me a bunch of crap about it. I don't like it or agree with it, I feel for them and hope they get help, but I'm only there for 12 hours and am not looking to make my shift any harder than it has to be. I do make it clear that I'm not interested in watching them put on a show nor am I going to participate in the histrionics of it all. Ultimately I'd like to see the system get fixed but right now it's totally out of control and stressing out over it each and every shift won't change anything. The doctors are going to continue to admit these patients and order the meds; you have to learn to pick your battles.

One of the things that will factor into being calm and confident as a nurse is experience and repetition. Your situation was unique, stressful, and challenging for you, but it's likely the nurses see patients like you day after day and night after night. I know I do. Once you have seen the same patient situation over and over you'll know what to say and how to help. You say you were freaking out but to the nurse it's just par for the course. As I type that it sounds insensitive but I hope I'm making my point. Unfortunately on my floor most patients never seem adequately prepared (lack of education provided by the surgeon BEFORE surgery) for the amount of pain and discomfort they will face. I try to provide as much education as I can immediately into my shift about what they should be expecting. A little education goes a long way.

If you come into work, see your assignment on the board and begin sighing/rolling eyes/complaining and that becomes a reportable offense then every nurse on my floor is in trouble because that's a nightly occurrence.

Truthfully the NCLEX was the easiest test I took in nursing school. Probably because they prepped us so much for it, but there was so much hype and so much build up that when I finally finished it my thoughts were "THAT was it????" I took it with two friends and we were all finished within 45 minutes. We used Hurst and Kaplan and I felt the combo of the two programs was very successful.

There are topics about the Pearson Vue trick on this site ad nauseam. That being said, I got the same notice and I passed.

The NCLEX is a one time deal (granted you pass the first time) and is nationwide. Once you pass the NCLEX you can apply for a license in the state of your choosing. However, that license doesn't follow you from state to state. You will have to apply to have your license endorsed to California, or wherever you want to go. This doesn't require another test, just an application and fee. I don't believe you can sit for the NCLEX until after you graduate from school, so I'm not sure how you plan to take it before graduating. You might want to look into that part.

Are they all connected via the same tracts or separate wounds? For example if one is a large wound that has a fistula and GI contents in it and another is not connected I might dress them differently. But if they're all really part of the same large wound then I'd prepare my supplies, pack them all, and dress them all at the same time.

The floor I work on sounds very similar to yours. I would recommend that you switch to night shift if you can. That's what I did and it made a huge difference. The adjustment to my sleep schedule wasn't as bad as I thought it would be. I'm not as new as you are but I was still feeling very overwhelmed on days and like I had no clue what was going on. There wasn't 5 minutes to slow down and think. I was getting pulled in 100 different directions and my phone was ringing off the hook. I'm able to spend more time with the patients, reading their charts, and looking things up when I need to. There are few, if any, MD's rounding, no PT/OT, no dietitians, and no management asking questions or interrupting me. I'm not trying to work around the patient's three meals and various visitors, etc. Night shift can still get busy but it's a much calmer pace and I'm much more suited for it. I don't foresee going back to day shift anytime soon!

Throughout my pre-reqs I was a straight A student. I was soooo pissed when I got an A- in microbiology. My first semester of nursing school was a real eye opener when I barely made it out of Nursing 101 with a C. There was so much going on with skills labs and clinicals and real human patients (OMG!) that I was overwhelmed. My grades improved with subsequent classes but nursing school really will weed people out and level the playing field. The next eye opener comes once you (and everyone else) has passed NCLEX and you land your first job as an RN. Guess what happens then? Nobody gives two hoots about what you did in nursing school!! You were the best and brightest snowflake who made extra flashcards or took the lead in the group project? Really, nobody cares. Your "elite knowledge" will only impress me if you use it to remember where the supplies are or the door codes so you don't ask me 500 times. Keep your head down, mind your own studies, and fly under the radar. Hopefully you will find a group in nursing school who will be on the same wavelength and you can partner up and get through it together.

Unfortunately there is no guarantee you'll find a job after school no matter which path you take. I graduated with some RN's that were previously LPN's or CNA's and they struggled to find a job. Others got hired right away. A lot factors into getting hired as a new grad and most of it is luck and timing. I don't believe the city in which you attend school will matter, what is more important is where you will be looking for a job. Find out what the market for new grads is in the different areas and try to speak with nursing recruiters about their hiring criteria. I chose to go the ADN route so I could start working as an RN sooner rather than later. About two years later I finished an RN-BSN bridge program. I wanted to be an RN and I wanted it ASAP, however I would not have racked up a huge amount of debt or gone to an expensive accelerated program just to cut 1-2 years off my schooling. If you want to get started with your RN career then I don't see the point in spending 6-12 months working as an EMT. If you had 2-5 years to invest in that career it might give you the network or experience you need but 6 months? You'll barely be off orientation, it won't count for anything. Just my 2 cents.