mickeyrose912

I bet you will rock it! In My opinion a good nurse is honest with his or herself regarding what they know and don't know. You aren't expected to know everything. I worked M/S for a year and came to the ER. I was terrfied, hell sometimes there are still things that i have never heard of, but i always ask. I always go on the side of caution, question things and luckily I have been able to prevent negative outcomes for my patients. I fear the nurse that thinks they know it all. Just know who is your priority. Who will die first? Constantly prioritize and ask questions to keep learning. You got this!

I envy your current situation! I graduated with my BSN in 2014 from Boston, but there were barely any jobs at the time, so i relocated to Florida. I have been working as a nurse about 2.5 year with 1.5 of that being in the ER and I make $28 an hour... You'd be shocked how poorly most of the south pays. New England pays the best, but you also need to calcuate in the cost of living.

Awesome! I am going to take TNCC and then read over Sheehy's mannual and watch some youtube videos. Any other suggestions? Is there a recommended site or book to do practice questions? for those of you that took the CEN what did you do to prepare/think of the test?

Hello everyone! I am currently working in a local 28-bed ER and I plan on traveling after i get two years in the ER under my belt (currently 1 telemetry and 1 ER). I want to make myself more marketable and am preparing to have my TNCC and CEN by the end of the year. I take my TNCC at the end of May and just received my course manual in the mail. What are your thoughts on taking TNCC and then preparing for CEN? Will TNCC help with the CEN? How long should i prepare? Tips? Suggestions? I understand that preparation is individualized, but i'd love some insight from others regarding their experiences.

Thanks for the great tips so far!

Thank you! I am really concerned about going from a local ER to a level 1 or 2 trauma center. I wonder if the acuity is higher or how things are different. I know a nurse that works at the Trauma Center up the street (as a 'regular' Er nurse) and he is always coming home with stories. He has patients die on him daily.

I am looking into taking my first Er travel assignment and would love some insight on what it is like to transition from ER to ER (as a traveler, or job change). I have been a nurse for 3 years (1 cardiac and 2 in ER) in a 28 bed local Er. The facility i work at isn't a trauma center I am concerned about going to a level 2 or level 1 trauma center for travel. Is there a drastic difference in acuity and expectations? How is the transition? What was your experience like going from one ER to another? I worry that I'll get an assignment at a big Er and not be able to handle it. Any advice is greatly appreciated! Thanks

I am looking into travel ER nurse assignments and would love some insight from not Only ER nurses that have traveled, but general information about getting the first assignment and the transition process. I have been a nurse for 3 years (1 cardiac and 2 in ER) in a 28 bed local Er. The facility i work at isn't a trauma center I am concerned about going to a level 2 or level 1 trauma center for travel. Is there a drastic difference in acuity and expectations(i am clearly not a trauma nurse)? How is the transition? What was your experience like going from one ER to another? I worry that I'll get an assignment at a big Er and not be able to handle it. Any advice is greatly appreciated! Thanks

Thank you very much! I really appreciate your honesty. That made me feel much better. I am just going to continue keeping to myself and offering help to everyone else anytime that I can:) even if I am busy, if another nurse has a critical patient then I am one of the first people in the room.

Hello :) I have been a nurse for about 15 months and worked in various departments (OR, Med-Surg and telemetry). I finally worked my way into the ER! I Just finished a 6 week orientation and have been on my own a few weeks. I have not felt stressed out about the pace or workflow, but i sense tension between myself and some of the senior staff. There is one particular nurse who is young, like myself, and anytime she works it seems that people who normally friendly to me will ignore me and/or give me the cold shoulder. I am trying not to take things personally. I have always considered myself an approachable person and I wish i knew what i was doing 'wrong". Has anyone had a similar experience? How was your transition into the ER?

Thank you everyone for your advice!

Hello :) I have been a nurse for about 10 months. I was working med-surg night shift and i fairly recently put in my transfer and started working telemetry days because it was run by the ER and i wanted to work my way up and get tele experience. I was hired as assistant charge on days and am cross training for ER. Ever since i put in my transfer the med-surge unit has been really rude to me. I have left and began my day job on another unit and i keep hearing about how "I will never make it on days, am too stupid, the boss hates me and won't want me back if i screw up"...Etc.I keep trying to ignore it, but i feel like it is constantly thrown my face. I have never had problems with coworkers..EVER.. I am always wanting to learn and offering to help start Ivs, etc. I really don't get it. Is this 'normal' for nursing" I am not sure how to approach the situation Thanks for your help in advance! :)

Hello, I am in desperate need of advice from my fellow nurses. I need to freely talk about my thoughts and feelings with those that would be able to understand or relate. I am not seeking attention, i just really need help. I am a 24 year old nurse that has been working the night shift on a medical Surgical unit in Florida for about 5 months. I love nursing and have had few struggles with learning to be a new nurse compared to my peers, but where i really suffer is with the 7p-7a shift 3 times a week. I am naturally a 5-7am kinda gal. All through college i would be up and at the gym first thing in the morning. I am that friend that falls asleep around midnight. The past 6 months i have been struggling to sleep during the day and even at night when i have a few nights off. I have no problem staying awake while at work, just sleeping in general.I am lucky if i am able to sleep 6 hrs, and that is often with waking up a few times and with melatonin, etc. Some of the chronic things that i have been experiencing over the last 6 months: -nausea and GI issues -short of breath,chest pain -chronic fatigue...i could fall asleep while talking to someone at points or be up all night -constant migraines and blurry vision -inability to focus/poor memory/attention span -lack of interest in being around others (even my supportive boyfriend that likes to visit) -picking fights/moody -constant unprovoked crying and panic attacks that i feel unable to control -random bouts of suicidal thoughts -severe PMS mood swings and psychosis (I have been on birth control 5 years with no problems) I started having the more mild symptoms at first, but thing are only progressing and it is scarring the crap out of me. I feel like i am developing some sort of psychosis/depression/constant panic attacks from lack of sleep. I have no medical history other than some mild anxiety before a test in nursing school,which is normal, but never full blown panic attacks/mental breakdowns. Here is what i have been doing to help myself over the last 6 months: -reading up on how to cope with shift work and journaling thoughts -talking to other nurses -exercising regularly (but not too close to bed) - eating very well and taking vitamins -developing a strict sleep schedule: - black out curtains with ducktape to seal off all light, AC to 60 degrees, eye mask, shades driving home, snacks and water at the bedside, hot bath before bed, no being on the computer, texting, etc before bed, getting herbal sleeping mix from whole foods with melatonin, valerian root, hops. -Not allowing my boyfriend to spend the night after a few shifts or the night before - experimenting with my schedule to see what works best (3 in a row, every other, two and one,etc) -not drinking any alcohol or caffeine at all for months -scheduling myself around these new PMS swings - i have been seeing a dr: been taking 10mg of prozac for a little over a month, xananx .5 rarely and i have 10mg of ambien that i took a twice. I really dont like taking medication. despite all of my efforts i still feel like mess. Last night i had a mental breakdown. I went into work and was smiling, yet crying during shift report. It was an easy night (only 5 pts vs my usual 8) but i had 9 full out crying panic attacks in the bathroom before midnight. I was a mess and so embarrassed. I tried so hard to hide them. A few coworkers saw me and unfortunately the nursing supervisor did as well. He called me in the office for a big meeting at 3 am and we talked about going to day shift. I even spoke with the charge nurse and director of nursing the next morning. They all agree that i need days, but nothing is open right now. What can i do? I am contracted to the hospital for 2 more years. I am a mess. Sometimes i feel like my life depends on it. I never told anyone this ( id be Baker acted) but i get crazy suicidal thoughts and it scares the crap out me (yes, these were before the low dose of Prozac). WHAT THE HELL IS WRONG WITH ME? I was never moody, depressed or anxious before. I really think lack of sleep is making me mentally insane giving me acute psychosis at times. PLEASE HELP! I am worried about my sanity and the safety of my patients!

I am a new nurse working in outpatient surgery. I am in a 6 month orientation from January to July. I am being cross trained in Preop, Postop, Blood Transfusions and possibly endoscopy. I have completed pre and post. Been doing transfusions for 2 weeks. I am months ahead of schedule. I hate to say it, but i am bored. I get up and drag myself into work in the morning. Because of this, i keep questioning nursing/the area i am in. I thrive in a fast paced environment and love to learn. The nurses on my unit are very knowledgeable, and love to have me, but they are all about to retire. I just feel like i don't belong there. I have always wanted to work in the Emergency Room/trauma center. I worry that working on this unit is hindering my skills and making me lazy. In the preoperative setting most of my patients are stable. Many of my blood patients are seconds from being in the ICU (4th stage cancer, WBC of 2, wbc of 150, rbc of 2 etc.) but still stable enough to get there on their own. I am thinking of continuing to get my nursing basics down and transferring to the ER after a year. How do you think the transition into the ER would be? Thoughts? Should i go to Med Surg? ( i would rather not) Also, how do you know when you find your niche? My gut just tells me the ER. Thanks in advance for any advice or constructive criticism!

i am still trying to understand how things work. I was told that my unit is an out patient unit, but yet on the tour i was told that we prep patients for surgery and can take them after as inpatient if there is an overload. My unit takes care of fairly stable patients that come in for day procedures such as Chemo, blood transfusions, hernia repair and circumcision for children. As i said, we do day procedures and prep patients for surgery, send them to the OR and then the patients go to the PACU and a med surge floor or us if they can go home that day. This is at least my understanding of the process.

I just got the call with my first job offer!!!!!!!! So excited, yet terrified! I am going to be working the day shift on a short stay unit off of the operating room. Bonus: No nights, no holidays, no weekends. This is killer, especially for a new nurse! My unit does a lot of blood transfusions, minor surgeries and other day procedures. The unit has never had a New RN before and I am the guinea pig. I have no idea what to expect. All the nurses on the unit have been there for many years and are at least twice my age. I keep telling myself "You were selected out of over 900 applicants. They chose you. They chose you for a reason. You can do this!".... I shall end my excited and scatterbrained rant. I got the call 20 minutes ago and had to let my excitement out somehow! Any advice or tips would be greatly appreciated! I really want to be successful! Ps. if you could recommend a private insurance 'company' to cover my nursing license that would greatly help as well. I know minimal about this, but I hear it is something that I need.

I got the job!!!!! :) They just called me! I start mid January!!!!! So excited, yet terrified! I am going to be working the day shift on a short stay unit off of the operating room. Bonus: No nights, no holidays, no weekends. This is killer, especially for a new nurse! J My unit does a lot of blood transfusions, minor surgeries and other day procedures. The unit has never had a New RN before and I am the guinea pig. I have no idea what to expect. All the nurses on the unit have been there for many years and are at least twice my age. I keep telling myself “You were selected out of over 900 applicants. They chose you. They chose you for a reason. You can do this!”…. I shall end my excited and scatterbrained rant. I got the call 20 minutes ago and had to let my excitement out somehow! Any advice or tips would be greatly appreciated! I really want to be successful! Ps. if you could recommend a private insurance ‘company’ to cover my nursing license that would greatly help as well. I know minimal about this, but I hear it is something that I need.

So... What happens next? Dropped my resume off Monday. Got an interview Tuesday. It went well. It was 2 1/2 hours with a tour. Sent out thank you cards to my interviewers and connections on Wednesday morning. What next?

I got it, I just know I did. I will hear back from them within a week :) my interview was 2 1/2 hours long. The first 30 minutes was them talking to me about the unit and then they gave me a two hour tour. I explored throughout the operating room, pacu and the short stay unit. I met about 40 people. The two nurses that interviewed me were very impressed with my preparation. They said that they have never seen a new graduate nurse so prepared and eager to learn. If they were not really interested in me I do not think that I would've been there that long. Hell, the older nurses kept touching my red hair ( one even sniffed it and said I smelt like fresh coconuts) and there was a cheek pincher too. Interesting, yet very positive experience.

You mean the level of needs? I created my own from review class, what my clinical told me and what my friends were doing. If you want you can delete it. The information I used to prep was from many different sources and I made it my own. Even memorizing lab values didn't come from just on source. I researched a lot.

See my recent thread under nclex. It's called "valuable nursing tips"

Thank you VERY much!

I took my NCLEX on July 23rd 2014 and passed in 75 questions. Honestly, i found the test to be very easy because of how I studied. The practice questions i did seemed much harder than my boards. When i was asked about something i have never heard about i was able to take a deep breath, maintain composure and come up with the right answer using the knowledge that i had and trusting my gut instinct. If i was to sit back in that room i would be able to tell you who would pass and and who would not by just looking at people. Some girls were crying at their desk, bathroom, etc. My experience has taught me what the test is really about:The test is not only about what you know, but how well you can maintain composure under stress and trust your instinct. The testing center security is intimidating as hell and this is why most people crack before they even start the test. Hell, I wanted to run before i even sat to take my test. I got my picture taken before i walked in the building and escorted to the room by security. Once in the holding room they took my ID, Att and phone. They put my phone in a tamper free bag and gave me a key and rule sheet. I put my water, snacks, and sealed cell phone in my locker. I sat down and read the rules. Then they called me up again. I showed them my ATT (again) and ID (again). They fingerprinted each hand two times and took a photo of me. Someone then escorted me to the testing room 10 feet away where they one again... looked at my ID, finger printed me and compared the photo they took 10 feet ago with how i look standing in front of them. It's not like i turned a corner to walk the 10 feet, They saw me in the waiting room. security is that intense. I mean it when i say it is all about how you trust yourself and act under pressure. I was escorted to my seat and the test began. Questions appeared on the screen that i knew nothing about. Are you going to be the one that cries in the bathroom or the one that take a deep breath and says " i have no clue what this is, but i can use what i know to take a really educated guess/ find out." With that in mind, Let's do this!!! Here are some valuable NCLEX Tips I have for you: Before i begin, If you are to remember only one thing from this post know that you NEED to TRUST YOUR GUT INSTINCT and maintain composure! Have i made it clear enough? You have received (hopefully) a solid education and the information is in your brain, but you need to trust yourself!!! GENERAL TIPS -Let me get this out in the open. You don't know everything and the test knows that. You are going to get things wrong. It is life. Learn how to keep moving when you dont know about content. -Do as many practice questions as you can and READ the rationals for right or wrong answers. Not doing so will not help you learn. -Do questions from all different subject areas -Review areas you are weak in -Review course -Memorize basic labs. This is nursing 101. You should already know this. You got this! -Do not second guess yourself ( 80% of the time you are wrong when you change your answer) -Become familiar with the test and how it works. 75 questions min. 265 questions max. unlimited breaks. 6 hours total. -Go to the testing site a few days before and give yourself plenty of time to get there the morning of -Eat a healthy meal. Actually,scratch that! Eat healthy a few weeks before your test. Well fed bodies help build strong minds! -Sleep. You know this. Next. -Do not cram study. Next. -Study 4 hours a day for a month (around there) -When you start do 50% content and 50% questions....slowly get to where you do 10% content (that you need to work on) and 90% questions - Do nothing related to nursing a few days before the test - They have ear plugs at the testing center, take them! -DO NOT TELL PEOPLE WHEN YOU ARE TAKING YOUR NCLEX! Yes, the support is nice, but when you get a million " you can do it messages" you just went to cool and collected to crazy and freaking out. Anxiety feeds on anxiety. Here are some specific prep tips: Here is a good hierarchy of needs i learned in a test prep class: Level 1 ABCs and Pain of a cardiac origin. Level 2 Change in Level of Consciousness Level 3 Change in vitals (unless the change turns into a L1 or L2 problem) Level 4 Change in labs (Unless the change turns into another level. Ex: low blood sugar. sucks, but not critical. Level 4. Low blood sugar with change in LOC now is a L2 Level 5 Pain. Unless cardiac in origin (becomes an L1) Note: if someone comes in complaining of chest pain but they think it is indigestion because they had a lot of spicy food then you still treat it like an L1 until labs rule it out. -Sign up for a review course. I took the Anderson Review in Boston. I found this class to be very helpful. It was a review of information that i have already learned and they taught me how to do questions. Kaplan is also good I recommend getting the Saunder Comprehensive Review book. Reading the chapter and doing the questions right after really help. Kaplan Question trainers 6 and 7 is a big part of why i passed my NCLEX! These are all high level questions and get you to THINK. DO THIS! Go to google and print them out. The Q trainer 6 is 200 questions and the Q trainer 7 is 265. Time yourself when you do these. This was harder than my damn boards! SO WORTH IT! Buy the Kaplan review book! It is broken down in the different categories you will be tested on. Saunders and kaplan are both content review, but presented differently. If you do both and maintain composure than i guarantee you will pass. ATI/HESI review questions help, but meh. They are ok. focus on Kaplan and Saunders That is a start :) HAPPY NCLEX PREPPING! YOU CAN DO IT!!!!

I graduated in May and passed this summer with 75 questions I found Saunders to be much easier than Kaplan. I got the most up to date Saunders comprehensive review. Kaplan i got 60-80% Saunders i usually got 70-100% I would read the chapter and then do the questions for that chapter. It really helped. I also HIGHLY recommend the Kaplan question trainer 6 and 7 ( google it and do it!!!) . After doing those i took my NCLEX and the test seemed so easy! During my test I'd get a question related to a topic i have never heard about. I remember just laughing (sometimes out loud) and thinking " oh ****. no clue what this is, but this feel right" and selecting an answer. Before i knew it the computer shut off at 75 and i walked out with a smile. I just knew i had passed. Kaplan is awesome!!!

Thanks so much! I am very confident that I will be offered the position. When I went to hand deliver my resume to HR I was wearing an express suit and had a portfolio with all my paperwork and a notepad with notes on the facility, unit and administration personal. The HR nurse recruiter took me into her office and told me that my resume is on file, but she would be unable to help me because the director of the unit would need to contact me for an interview. I thanked her for her time and left. Ten minutes later she called me and asked “are you still at the hospital?" I told her I was not, but I would be glad to return. She then told me that she setup an interview with the director and me tomorrow. I am not sure what changed, but she must have saw something on my resume/ I must have changed her mind somehow. Here is a little bit about me that I plan on using to help me out tomorrow: -BSN, RN -ACLS/BLS -Bilingual (Spanish) -Graduated Magna cum Laude from Boston -Awarded merit based scholarships and a member of several honor societies -5+ years experience as a live in caregiver for a family member with Alzheimer’s disease AKA ADLS, provided daily support and advocacy, family education, developed and implemented strategies to ensure safety and enhance quality of life. -2+ years experience in home care for a paraplegic -5+ years experience waitressing AKA caring for diverse people and personalities, prioritizing needs in a fast paced environment, time management, problem solving -3+ years as a recruitment and training manager for a non-profit AKA leading public business presentations, recruitment, training new personal, leading activities, managing delegation of tasks -Talk about clinical experience -Volunteer experience at the VA Hospital, Flu clinics, On a Rehab unit Strengths: -My passion for knowledge: demonstrated through my academic achievement, certifications and volunteer experience. I took the initiative to sign up for an ACLs course while i was in school( i even paid for it). I was the only one in the room not a seasoned RN or MD. -Being aware of when i have the knowledge to ensure safe care and when i dont - knowing my resources and how to use them Weaknesses: -I like to ask a lot of questions and learn things thoroughly. -Gaining more confidence a new RN anything i am missing that is key? :)