SweetPotatoes

@nurseblaq I meant to quote you sorry-still figuring out this phone lol I gotcha, I see how this looks like a sign on bonus based on the way I wrote this. But I believe those are technically reserved for experienced nurses- I don't know if they have a contract associated with sign on bonuses or not. This was a program I did through my school as a new grad-the hospital gave me 10k through my school in exchange for three years, and I completed my practicum on this unit. The other new grads who did not do this thru their schools are going through what the OP describe, having to pay out of pocket for orientation costs if they leave before the three years. For me, the point was that I still had to sign a contract as a new grad and have the same obligations, even as those who did not get the scholarship through school. But the 10k did make a difference in terms of me choosing to accept the position.

I graduated last year and started at my current hospital last July. I had to sign a three-year contract and I got $10,000 for it. If you leave before the three years due to disability, then the amount is forgiven- but otherwise you have to pay it back. I used some of the money for tuition and set aside the rest in case something happens and I need to leave before my three years. I understand that a lot of new grads leave jobs within a couple of months which is weird to me, to not even try to stick it out a year. That being said, I work in an emergency room that is extremely unsafe in terms of staffing and resources, and things always being broken, not having enough nurses to travel to tests with critical patients, having two icu patients as well as two other patients (ratio 4:1), not having enough techs, getting 3 patients back to back after discharging three to upstairs, etc. this tends to be the reason that nurses leave. but honestly in my facility, more experienced nurses leave more than the new graduates. Because of the unsafe working conditions. I do well in chaos / under pressure so I don't plan on leaving unless something really crazy happens. I understand the need for contracts but on the other hand it does kind of suck having this over my head. however, my contract is a hospital one, not an emergency room one. So technically if I realize that I can't take the emergency room anymore, then I am supposed to be able to transfer to another unit within the hospital. However people have tried and the managers have blocked their efforts 🤷🏾*♀️

I'm brand spanking new to nursing and to the ED. I... Took care of an admitted patient who refused a bed the bed we assigned him so he was stuck with us the whole shift. Quite annoying patient I may add. He was in for infection around a fixator on his leg. Took care of a stroke patient 1:1 monitoring vitals and doing neuro assessment q15 minutes for 2 hours. Started seizing during an X-ray and we gave her ativan and keppra. Took care of a post septic patient who got an infection from an abscess. Got one stick out of like 5 tries but I'm gonna keep working on it!

Where I am ED gets1.40 more than floor.

I sympathize with the poster who stated that their management wants extraordinary levels of proof regarding lazy coworkers. Nurses at my facility complain about some of the techs, but management will not do anything unless there is something in writing. I thought it would be enough if you had 10 nurses complaining about the same tech, but I guess mgmt needs to cover themselves against retaliation... And have documentation of the repeated offenses. I understand that but it's frustrating. Not just them, there's some lazy nurses also who need to go but are still here, for whatever reason. I wouldn't have taken a picture, but if that's all that your facility would believe jn order to finally do something then so be it. She got herself fired.

I got mostly 50s and 3 60s on practice questions and a 64 on readiness and passed in 75. Never got above that 64 and found the actual nclex much easier than the trainers.

Just because it's so fast I guess. But another poster who worked in an ICU also stated that she rarely had time to delve into patho on her own either. I guess they are both fast, in their own ways. In the ER now we just move so quickly and have patients moving in and out so much that I don't have a lot of time to really think about the patient admitted for status asthmaticus or the one with ovarian torsion. But my new preceptor is better at teaching than my old one and asks me patho questions while we are doing things, which has certainly helped!

Wow thanks so much for the detailed response! That's a good idea about the binder and about the discharge instructions. My preceptor also encouraged me to ask the providers why he/she ordered a certain m ed or test, to help me think through the process, so thanks for confirming that. And that's so true about how the ED is a good fit for my comm health goals...thanks for the encouragement about running my own clinic in 6 years When you had your brief stint in the ICU, was that a PRN type thing? Did you find it hard to adjust since the environments are so different?

Thanks for the tip! Are there any ones in particular you suggest ?

Thanks! Any particular ones you like?

Thank you so much. Once I'm further along I'll see if I can do this cross training...I would love that. And definitely good point about taking advantage of our proximity to the providers.

Thanks for the response! How long did you do ICU before moving to ER, and what specific things make you more satisfied?

Hi everyone, I accepted a position as a new graduate in a ED. It is an adult trauma center but has pediatrics which is extremely appealing to me, as I love being able to work with both populations (especially the children!). I'm currently completing my practicum here to prepare me for my impending orientation. I'm one of those students who truly enjoys pathophysiology and pharmacology, and teaching. One of my favorite parts of nursing is teaching, as my first degree is in public health and I eventually want to be a community health nurse or provider. I like when I can explain something to patients and see that they understand it better than they did before. The emergency department is great for teaching, which is another draw. However, over the past several weeks I realized​ that there something that I am concerned about, and was wondering if I could get advice. Because the atmosphere is so quick, I'm realizing that everything is so reactive and very task-oriented... Of course nurses have to use quick critical thinking/assessment skills here, but I see I am not going to get the same ability to delve into patho as I would in the ICU setting. I like the ER, I just wish there was a way I could figure out how to maintain and grow in my level of patho knowledge. I spoke with one of the ER nurses who used to be an ICU nurse, and she told me that even in the ICU, she still had to look things up. So I began keeping a nursing journal where I write down the diagnoses that I encounter...& in in my free time I look them up, as well as common medical treatments. This is no substitute for the learning I would get on in an ICU or even a med surg / tele floor, but I'm just really worried that if I were to move to another specialty in the future I would have a hard time learning everything again. Plus I kind of just want this knowledge for myself so I can understand what's going on in the body. Does anybody have any other suggestions as to how I can keep up with patho and critical thinking skills? I know that I'm going to have a hard enough time adjusting to the emergency department, and that this will not be a priority for a long time...but when I'm ready to return to it after I start finding my way around my new job, I'd like to have some ideas. Thanks so much.

thank you so much for your story! what dedication you have to travel so far! i am also looking at pediatric heme onc positions here in baltimore.

Thanks for the response. I too have noticed, over and over again, how much more adults seem to complain sometimes than children. You're right--it's their normal. I have congenital conditions myself that have caused me to be a staple in doctors' offices over the years but I don't know anything different.

Being able to float sounds awesome. Are there limits to floating? Like would a med surge floor take a L&D nurse? Or would an icu take a med surg nurse?

Haha glad it was an interesting question! I guess I've just seen so many strong feelings from nurses in my short school career about loving one specialty and really hating the other. I am like you in that I am the youngest in my family and I am never around children. I did not want to do peds until I was actually exposed to kids and loved it. I am good at the weight based med calc; my instructor was very good about not allowing us to give a med unless we could say if it was a safe range or not. I also like remembering developmental nuances..like ok this 3 year old needs to be given choices so he feels like he has some autonomy in this situation. This 8 month old should be able to sit up on her own etc. I guess I just worried that I'd be too limited if I started in peds but like you said I can always switch or try to get adult experience in another capacity. I think since I genuinely enjoy both populations, I'd like to keep that flexibility in my career. Thanks for the input.

That's a good point about teaching adults and working in mixed ER. I would love to be able to work peds as my main job and work an adult med surg PRN. I used to do social work jobs and understand what you mean about child abuse. I learned to separate myself because it can be traumatizing if you're not careful. Did you find that 11 months with adults helpful, or do you feel as if you could have jumped straight into peds and been ok?

Cool! When you say flip back and forth, do you mean worked peds for a while, then adults, then peds, etc? Or did you work one as your main job and do another PRN?

Graduating in May but have begun looking at possible places to work. UMMC still starts off with 28 and some change. Overtime pay is killer there if you work several OT shifts in a specific period of time. Hopkins is salaried as mentioned before and starts PACE nurses off at about 61k (includes nights, holidays, weekends), and now they offer a 15k bonus (paid out over 3 yrs) for having a BSN. 7,500 if you have an ADN. So with a BSN you'll get about 66k for the first three years. Not sure if you have to stay on the same unit or not but I do know you have to pay it back if you don't stay. Not sure how much though. GBMC I believe starts you off at 25 ish.

I'm still in nursing school but I haven't seen this attitude towards EMT or medics. Not saying it doesn't exist, but the way your post sounds makes it seem as if this attitude is ubiquitous. I've actually seen the opposite--EMTs making fun of nurses for not knowing how to do certain things and trying to tell the RN what to do when they bring a patient in. IDK. I'm sorry you've experienced this and I am sure there are some douchebaggy nurses who have certainly said things like these because that's just kinda how it is in this field. Like the others said..trying to one up the other or show superiority. I see it a lot too with MDs and PAs at my hospitals. PAs making orders and the MDs rounding with the PAs at the bedside, then the MD making the PA feel foolish for one thing or another in front of the patient. PAs are petitioning to be called physician associates instead of assistants and physicians are pushing back against that. Kinda everywhere. I understand the frustration tho. You want people to know exactly what you can do and not treat you like trash. I just hope you don't get defensive with every nurse before you've given them a chance. I admire medics and EMTs like crazy. :)

know normal lab values for each system!

This kinda happened to me my first semester--but the cuff was actually fused with the rest of the glove. Couldn't even put the thing on if I wanted to. The instructor stopped the validation and discarded the pair I had, and let me try again. IDK why schools are so ridiculous with this stuff.

Hi everyone, I spent a while searching for this specific topic, so forgive me if it's been addressed already. I will be a new grad in May and am looking at the types of jobs I want to apply for. I requested that my practicum be in pediatrics because I grew to love the specialty during school. However, I kind of feel like I'm getting cold feet. I am a CNA on a surgical floor for adults and I like it a lot, and can see myself working there too :/ So I feel anomalous, as it seems that nurses who like peds hate working with adults, and nurses who work with adults dislike peds. I am in the middle. I like both worlds and appreciate their differences. Nursing school makes us all so familiar with adult care and comorbidities, while we only get half a semester working with pediatric patients. Perhaps this is part of my problem--unfamiliarity. But pediatrics has interesting congenital issues and the kids have the most beautiful spirits; I love teaching and interacting with the patients and their parents. Getting yelled at by parents and feeling like you could so easily hurt a kid sucks though. But healthy kids turn into healthy adults (hopefully) and that's so important. I'm able to communicate well with young children all the way to teenagers, I've noticed. The amount of knowledge peds nurses must have about newborns to age 21 is vast and I look forward to that challenge as well. On the other hand, I love teaching adults themselves, as well as their family members. I like the knowledge gained from working with adults and find it applicable to daily life. I love learning about new medications, skills, evidence-based practice for adult care, and more. Do any pediatric nurses feel (or have ever felt) this way? Did you always know you wanted to do peds? Do you feel limited in your skill set, or do you feel as if you'd be able to work with and teach adults if you decided to ever change specialties? I know there are many threads here with questions about transitioning, but I didn't see any from nurses who actually started OUT loving both worlds and kind of just "picked" one to start. Being the extremely practical person that I am, I feel like if I jump straight into peds, even tho I want to work there, I will not have a wide enough knowledge base about adult comorbidities. But I don't want "practicality" to overshadow my desire in this way. My ultimate plan is to be a public health nurse (after working at the bedside for manyyears)--a specialty which encompasses skills from both pediatric and adult worlds. I did see a couple of threads where nurses said they worked in one specialty full time and per diem in another. Is this still a thing? Do any peds nurses here work per diem in the adult world?? Thanks in advance for the responses. Any questions that could help me think this through better are welcome, also. -SP (edited for clarification)

All the nurses on my hospital floor do what the CNAs do...CNA tasks are kinda built into the RN role, but the RN has 879798990 other things to do on top of it--night shift nurses in particular have it rough because there aren't always techs at night and then they have to do all the call lights, bathing, and weights. A lot of the new RNs who were never techs struggled in the beginning with transfers and baths and walking patients and stuff, so it's good experience if you can get over the whole messy work thing. I HATE smells and bodily fluids but since I want to actually do this, I get over it. And launder my scrubs thoroughly when I get home. lol. You may surprise yourself--if you really want to be a CNA you may not mind the mess as much as you think you might!