MotoMonkey

The fact that you posted this in the ED nursing area makes me wonder if your mind isn't already made up in some way. ED nursing can be very challenging but I think its quite rewarding as well.

I guess my program was in the minority, I wrote a single lengthy care plan during the first year of my BSN. Then never again. Even that one seemed like a silly abstraction of the actual care being provided.

If you don't think that you are at a point financially where you can complete the program and are uncomfortable with taking out a loan, plus it sounds like you have difficulty with online learning, I would hold off. Why spend the time and effort to reapply only to have to quit or flunk out part way through. Im sure its difficult enough to gain reentry into a program after you have failed one, why risk failing twice. I would wait until you are 100% committed to completing a program before you apply.

I personally don't find pocket books all that useful. When I carried written resources with me on shift I never seemed to need them or had time to take them out while working. I would recommend looking into what your hospital has for online resources. I get a lot of use out of Lexicomp, Uptodate, and my hospitals internal procedures. Because these resources are often linked with our EMR it is much quicker to find the relevant info I need. I would, however, recommend "Sheehy's Emergency Nursing" I have it at home and will often look things up that I saw on shift if I want a deeper understanding of the emergency care.

It sounds like youre listening too far down. If ever you head bowel sounds in the chest cavity that would be an emergent problem.

As long as you have a license in the state you wish to practice I don't see any reason you wouldnt be able to find a job. The smart advice would be to land a job offer prior to moving, or at minimum researching the job market in the area you want to move. But I think this is one of the awesome parts of being a nurse, you have the ability to find a job almost anywhere.

One tip I would give to "boost" your resume would be to have a trusted instructor or someone in your college writing center look over your resume before you use it for any job. Having a polished, grammar free, well formatted, and professional looking resume will go far. Ask your instructors what your local job market expects on the resume of a new grad. I know that my new grad resume was very different from any other resume I had written because hospitals around me are interested in seeing what clinical placements new grads have had in addition to things like previous relevant work experience and applicable certifications.

Figure since no one else replied, id try to throw in what I know. I graduated in 2019 with my BSN, so I don't have first hand experience navigating this challenge. My best advice is to look at requirements on the individual hospital jobs pages. I believe that most of the large PDX are not hiring ADN prepared nurses unless you are an internal applicant. Most of the job descriptions I am seeing very specifically state that they require nurses to have a BSN. Providence seems to be the one hospital I've found that states that you can get hired without a BSN but must obtain one within three years of hire. I think right now with many hospitals not hiring, the competition for jobs is higher and you may be competing against more BSN prepared grads.

We have never had pitchers in our ED so I guess I am just used to bringing my psych patients water when they need it. If it becomes a problem I utilize limit setting or delegate the task when appropriate based on how acutely suicidal or psychotic the individual patient may be. At the end of the day I don't feel like a waiter or a maid, it may not be the aspect of my job I most enjoy, but it is my job. It sounds like your facility may be structured much differently than mine since you are having to leave the unit to attend to your psych patients. Guess I would try more strict limit setting if you have patients that are asking for water 12 times an hour.

I know that in my area many hospitals have frozen their hiring of new grad nurses or reduced the number they are hiring. With that said I would say to take what ever sort of position is offered and gain all the experience you can. After a year or so of experience your ability to move hospitals or departments opens up a lot. Observation units are generally set up to take individuals who do not meet other admission criteria, these patients should have a pretty straightforward course of stay and generally shouldn't say for more than a day. Basically it is a unit for patients who are not sick enough to actually be admitted to the hospital but they may benefit from additional monitoring. Think low risk chest pain who needs a troponin redrawn in three hours and additional ekgs. Instead of that patient taking up a valuable ED bed, they get moved to obs. Id say that it is good experience if you are unable to land an ED job, but you are not going to get much experience with sick patients and youll likely not be gaining the same kind of assessment or intervention skills as an emergency nurse.

I would start by looking at the hospitals in your area to see if they require nurses to have their BSN. In my area almost all the hospitals either outright require nurses to have their BSN or it is strongly preferred, that was a large motivating factor when I was deciding between ADN and BSN. Four years for an ADN and five years for a BSN is not at all uncommon, there are some for profit schools where that timeline is shortened, but I don't think they are worth the extra money you will have to pay. Your counselor is likely right and wrong. Some classes have to be taken one after the other. These are either classes that have a prerequisite, for example my college required I take cell biology before I started the anatomy and physiology series. Or they are classes taught in series, like anatomy and physiology where they probably would not want you to take A&P 3 before you took A&P 1. For other science classes it does not matter the order and you can take them whenever offered. At the end of the day, ADN or BSN you are likely to spend about two years working through prerequisite courses before you are even able to apply to a school. I know the idea of spending five years to get a degree sounds kind of crazy, but you can either sit on your butt for five years and have nothing to show for it, or you can go to school put the work in and have a degree and good job prospects to show for it.

I was accepted into a DNP program prior to graduating from my BSN program. The school I was accepted to had never accepted a student without experience. They were hesitant and made it clear that I would be an experiment. I initially accepted my spot but ultimately decided not to matriculate because I felt strongly that I would be doing a disservice to my future patients. I have been working as a nurse for 10 months now and I learn something new every day. I also realize how little I knew about being a nurse when I first graduated. I feel strongly that It would have taken significantly more time an effort to prepare me to be an adequate provider at graduation. NP schools generally use the knowledge you've gained as a nurse as a foundation for which to build.

Ill start by saying that I am not a Linfield grad, but rather an OHSU grad. My experience and the experience from those I've spoken with in other BSN programs is that they mostly feel that they did not get as much hands on experience in their program and felt a bit under prepared when they graduated. I felt the same way. However, I found it pretty easy to get up to speed within the first few months of working. I cant speak to Linfield's instructors, but I think that every program has instructors who students click with and ones who students dont click with. It will be no different than being at any other job where you sometimes just have to learn how to deal with certain personalities. Right now I work with a Linfield grad, they seem to have enjoyed their education, but they are severely burdened by their student loans. Linfiend is extremely expensive and, unless you have someone wealthy paying for your education, you will end up with a huge amount of student debt. Their website states that the cost of the first semester for new students in 2020 is $30,401. I would strongly suggest letting program cost and finances direct your decision between this school and another. Your potential minimum student loan repayment could amount to over $1000 a month for 10 years. That could make a difference between doing things like buying a house or car or saving for retirement.

Are you in a program that does not let you use the computers and charting system at your clinical site? If you have access to the computers at your clinical sites, use them to look up information. They likely have access to services like uptodate and lexicomp. I would always recommend to use the services the hospital has for their staff when looking up information on drugs or procedures rather than searching for information on your phone or ipad.

I have never heard of a program requiring students to be clean shaved, how ever, I am pretty sure most programs will have something in their dress code about facial hair needing to be clean and well kept.

Like speedynurse pointed out. In a smaller hospital there are less staff to do all the different jobs and skills, therefore you will likely be required to be a bit more of a "jack of all trades." Also, while a community hospital may not have a Trauma designation, you never know what is going to roll through your doors. Joe in the community gets his arm caught in the mechanism of his tractor his wife doesnt know that your hospital isn't "trauma designated" she just knows that she needs to drive him to the nearest ED. I've heard many stories of the wacky things that end up rolling through community EDs.

First, congratulations on graduating, this is a super exciting time. I would take the offer that has been sent your way. It would be terrible if you turned down the offer in order to try and get something "better" only to not get anything else and be wishing you had taken the first offer. I don't see anything wrong with taking a first job in a community hospital ED. Personally I think residency programs are a huge benefit to new grads and can give them the support and learning they need to succeed. I understand the feeling of wanting to work in a level 1 and to do all the exciting things, but you have to learn all the little things too, all the skills and assessments that go along with being an ED nurse. A community hospital should allow you the opportunity to learn to deal with all the bread and butter work of an emergency room the abdominal pains, and the chest pains, the respiratory distresses, as well as things like nausea, vision problems, lacerations, diabetic emergencies. As an ED nurse you will have to know how to do it all, so for a first job I would take any opportunity that will teach you your ED nursing foundation because those are the skills that will help you progress in the future.

Smaller level 2 hospital. Starting about 4 or 5 weeks ago our numbers of patients started dropping significantly. Nurses started getting sent home on day shift, or called off prior to the shift starting. We have also been putting nurses on call, though it was rare that they would get called in. In the last week or so our numbers have started to increase. We are seeing more of the minor complaints fill our waiting room again. And we seem to be moving into trauma season. In all I think we are going to continue picking back up, people are only willing to stay inside and socially distance for so long.

I would be very surprised if any hospitals decided to take Summer nurse interns this Summer. Global pandemic, over stressed staff, and limited supplies mean that having non essential personnel on hospital campuses is just not going to happen. With the world the way it is, I am confident that when hospitals are hiring new grads for the next year or so, they will take into consideration that many clinical experiences and activities have been stopped due to COVID. When I was in school I knew a lot of people who were also very concerned about getting the right extracurricular activities and having an internship, because they thought it was necessary to be a good nurse or land the perfect job. But I will tell you, I learned more about how to be a good nurse during my first six months of work than I did in my entire nursing program.

I guess I wasn't so clear with my opinion. I would not reach out to any unit manager during this time of national crisis to ask about work opportunities. If there are job openings on the hospital website, apply and try to use your preceptor as a reference if they will allow it. If there are no open positions currently listed then I would just keep an eye on the website. Members of hospital management have a ton on their plate right now, best case you would be ignored, absolute worst case is that they would see it as a lack of social awareness that could work against you in the future.

What do you mean by work opportunities? Like as a CNA, or work opportunities after graduation? If you are looking for a CNA or tech type position and they are available on the hospital jobs page I would just apply and make some mention of having done clinical shifts on the unit, maybe ask if your preceptor would be a reference for you. And I guess same goes if you are looking for job opportunities after graduation. If this was a few months ago I would totally encourage you to reach out to the manager directly, but I know that right now everyone , especially managers, have so much on their plate that they would either just not respond, or they would say to just go through the normal channels and apply online if/when a position is available.

Nursing code of ethics also addresses the fact that as nurses we need to care for ourselves and maintain self care in order to provide the best care possible to our patients. You need to do what is best for your own physical and mental health.

As discussed above, instructors rely on the feedback of the nurses you work with to inform their understanding of how you are doing. You state that you can only have so many "bad points" and that this makes you borderline. What other issues have you faced in the program, is this more of a reoccurring problem than a one time event? How you described your instructor they sound very frustrated to me.

Do the residency. The research is pretty good that residencies improve new grad nurse job satisfaction, feelings of competency, and retention. If someone is willing to hire you into their ICU, give you the training they believe you need, and support your growth as a new nurse, it would be silly to pass that up. People who still talk about needing a year or two of med-surg experience are often nurses who graduated at a time when there were no residency programs. If you were hired onto a specialty unit you were just kind of thrown in to sink or swim. That is not the way it works anymore in many areas.

As a new nurse who was hired directly to an ED, my advice is always to try to get a practicum in an ED. If you can get a practicum in an ED you want to work in, that's even better. The ONLY reason I was hired to my ED is because I spent six months there as a student and busted my butt to make a good impression. Since that does not seem to be an option, I would look for new grad residencies in your area that hire people to the ED. If this option isn't available, then think about ways your prior clinical experiences can help you in the ED. Understanding, even on a lower level, aspects of ICU care and OB can be beneficial in the ED as you have no idea what is going to walk through the door. Think of how you can present these experiences to an interviewer in a way that conveys that you can apply this knowledge to the ED setting. At the end of the day, also prepare to not get an ED job right out of the gate. Look at where other new grads are being hired in your area, look at how those opportunities can prepare you for working in the ED in the future. It may be discouraging to not get an ED job right from the start, but you have a long career ahead of you and plenty of time to find your niche, even if the path doesn't seem "ideal" right now. As far as being upset about the OB rotation, you are allowed to feel upset or discouraged, but you need to still go into every one of those clinical days striving to learn all you can and being thankful that you have a clinical site to go to, if that makes sense.