el0489

Mine shut off, too, after 75 questions. It was hard and I was nervous, but I passed!

I feel your pain, believe me. I have had it very rough, too, in this career - preceptors from hell, unsafe working conditions, disrespectful and unreliable CNAs, etc. And we wonder why there's a shortage? I've been trying different options and at this point, am mostly avoiding facilities. I love home care but can't get enough hours. At this point, I'm looking at work in medical offices. They don't make as much money but it's less stressful. I can supplement this with per diem and weekend hours doing home care.

Ideally, it would be great if you could get more experience but I don't think it will necessarily hurt you if you end up with less than a year. I got about 3 months experience in the hospital and 5 months experience in a rehab setting. I decided that with the high stress level and high patient acuity, that facility nursing was not for me. I am now doing home care and private duty nursing. I work part-time through an agency and they said they would support me with anything I still needed to learn. Good luck to you.

Thanks for all your input. I do live with my mother so the caregiver situation is generally under control. The times when my mother cannot babysit I do have a babysitter who is often available. People I work with generally understand why I have to leave by a certain time and cannot stay to work a double. Some other people I work with have the flexibility to do that but I do not. I've explained my situation at work and they seem to understand. I make it my business to get in early, look at the assignments, count, get report, etc. If my relieveing nurse is late, sometimes I have to leave report for her so I can leave. Participating in a mock code might be helpful. Unfortunately, at my rehab unit we are expected to be able to manage unstable patients whom the hospital sends our way. It's because of medicare limitations. If someone is really unstable, as in "bottoming out" with vital signs or blood sugars, or very high, we often send them out to the hospital but we are generally expected to manage them. That's why it's called acute rehab and yes, we get some unstable diabetics. I am learning more about how to manage those patients by looking at how their blood sugars generally range and then if they're out of range, acting on it - give the medications or hold them, call the doctor, get vitals, etc. My patient load can go up to 18 patients and then, of course, there's a lot of meds that are given out for 9 AM. And someone could crash right in the middle of your busy med pass. On top of that, I am inexperienced but am trying to learn and grow, sometimes by the seat of my pants! I have a lot to learn, as I said, but I am trying to be courageous. It's just unfortunate that we have a medical system that really is not well-equipped for extremely sick people.

Thanks. Part of my fear probably is imagined but I have made some mistakes that were pointed out to my attention. One of them was a serious mistake. This patient had multiple issues and was suffering from a CVA. I mistakenly gave him insulin when he wasn't eating. His blood sugar was 101 but that was based on his having OJ, which I didn't know only lasts 1/2 hour. The insulin was intermediate acting but he bottomed out and had to be given glucagon several times before he was sent to the hospital. It was scary. As I said, he has had multiple issues, including CVA history, renal failure, but I find the business of diabetes management very complicated.

I am very frightened right now. I have only been a practicing nurse for a few months. This is my 2nd career. I've had 2 months in the hospital and 3 months working on a busy acute rehab unit. I could not handle the stress level of the hospital and so I got into rehab thinking it would be more manageable. This is an acute rehab unit and is almost as bad as the hospital where I used to work. I haven't been a nurse for very long and I feel unprepared for a lot of the challenges we deal with on a daily basis. We get some very unstable patients who can crash on us at any time, we have unstable diabetics who are tricky to manage, we're under a lot of pressure to get meds, treatments and charting done in a timely manner. There's also pressure on me to make sure I leave on time to pick my son up. Although the directors are trying to be helpful and supportive, I feel incompetent and wonder I if I should quit before something happens where I could lose my license. Once you lose your license that's it, right? Maybe I need to chose another type of nursing.