trustsupplyguy

As the original poster, I thought I'd chime in with a few thoughts in retrospect. - It's best to resign before they fire you, because it will be easier to explain going forward. - If you feel they want to get rid of you, you are probably correct. The more you delay getting out, the more of a problem you become, and the more management will intensify the pressure to get rid of you. - One possibility is to tell your manager, "I'd like to resign, but I need some time to look for another position. Would it be OK if I set my termination date a month from now?" They may be so relieved you're leaving that they'll be happy to give you this consideration. Something similar to this worked for me in a previous, non-nursing job. - No one wants to be looking for a job, especially in this environment, but be willing to take a worse position than your current job. After resigning, I took a job with a lot less pay and a long commute, but I was committed to improving myself. The result was I got a good recommendation from my manager, which resulted in my current job where I'm very happy. I was also willing to do travel nursing if I had to. - Hire someone to check your references. You need to know who you can trust to speak well of you during your job search. Try Googling "reference checking service". - When looking for a job, it's easy to assume that you are the only one who has had problems. But many nurses have encountered problems in their careers, and there is a good chance that one of them is the nurse who is interviewing you! In the interviews I had, no one ever probed deeply into my past situation. Just come up with a general, plausible statement for why you left, and have some positive references. - If you're depressed, which is natural, develop a positive attitude toward yourself. Skim the book "Positivity, " written by psychologist who presents hard facts about why a positive attitude is essential to success. People are better problem solvers when they are in a positive mood; self-analysis is more accurate and helpful. Employers want to hire positive people, and such people recover from setbacks more easily. If you have time, check out "Breaking the Chain of Low Self-Esteem" and some books on the psychology of resilience. - I put Post-It notes on my computer with pearls from my readings, so everyday I would see messages like: "You're getting betting at seeing things in a positive light" or "As your self-esteem improves, you are less sensitive to criticism" or "We learn in life by our mistakes; resilient people stay calm and focus on problem solving." - Learn about your own stress and anger. Both of these can seriously impair your career by triggering your flight or fight response, which will result in dealing with co-workers and managers on a reflexive, negative emotional level. I've learned to recognize my stress / anger triggers (making a mistake, being too self-critical, having to deal with an unreasonable person, getting criticized, not getting a break) so I can take a quick pause and change my thinking. The above books helped me with this. - There are times I get so stressed out, that all the positive thinking and deep breathing in the world can't normalize my heart rate and blood pressure. In those situations, I now take a quick break and self-administer a half a Benadryl caplet (12.5 mg) or an herbal valerian capsule. It makes a HUGE difference. In a few minutes my body calms down, and I'm in a much better mood. Experiment in a non-critical situation with dosages, so you can find the right dose for you. - Try adding some magnesium to your diet. Magnesium is essential for muscle relaxation, and by supplementing it, either orally or via Epsom salt baths, I'm much more relaxed and in a better mood. Most people are magnesium deficient, but do some research to help find the right dose for you. - If you're stress / anger prone, avoid caffeine! - OK, I know I put a lot of emphasis on the emotional part of this, but that's because this piece is critical and it get's so little attention. It's critical in finding a new job, and in preventing the problem from happening again. Most on-the-job problems are caused by attitude, not by a lack of skill or ability. Right now I know a great person who worked her way up from CNA to Nurse Practitioner. She is very smart and caring, yet she was recently forced to find a new job because of personality issues with her manager. If she could have maintained a calm, positive, problem-solving mood when dealing with him, I'm convinced she wouldn't have been forced out! - Finally, once you learn more about your own anger / stress behavior, you'll become better at recognizing it in others. This will help you see how damaging this it is, and you'll deal with it more calmly and rationally. It's easier to keep a good mood when you realize someone's stress or anger is blowing things out of proportion!

I call this type of nurse a Perfection Bully (PB). They are the worst type of toxic co-workers. They start the shift all stressed out, and expect everything handed to them on a silver platter. They are especially hard on new nurses, whom they will nit-pick to death during report. Everywhere I've worked I've encountered one, and I even had one as a teacher when I was in nursing school. I left my last position because of one, and this forced me to do some research on how to handle them. 1) the PB usually chooses the most vulnerable to pick on -- that often means new nurses; it's not you personally 2) you won't change them, so you must change your approach to them 3) reposition things in your mind, instead of dreading them, be thankful to them for giving you the opportunity to practice dealing with toxic people 4) do not try to defend or explain yourself, this is exactly what the PB wants because it puts you on the defensive 5) try to remain calm; this is difficult but critical because when your flight or fight system kicks in you've lost -- your rational thinking shuts down, and the PB will now be able to write you up for anything you said to them in anger 6) as you keep your cool you can now comeback with reasonable responses like: "I don't know that, but I'll be glad to look it up" or "I'd love to learn from you, but please lower your voice" or "I didn't get a chance to do that, but I can help you do it now if you'd like" -- the PB will rarely accept your offers, because the really want to anger and demean you 7) after its over, think about any valid points that may have been contained in the PB's attack -- maybe you need to learn more about diagnostic tests, or how to prioritize better, for example 8) after its over, document the incident and email it to your manager -- don't stall, you must do it immediately because the odds are that the PB will be complaining to the manager about you; focus on the person's attitude and demeanor (tone of voice, volume level, facial expressions, redness of face), things that were said that were unreasonable, and how they made you feel; facts can always be disputed, but your feelings can't be; let the manager know that you felt demeaned and attacked, and that the PB is creating a hostile work environment for you; also, acknowledge specific areas you can improve in, the things you discovered in step 7, and explain your thought processes behind why you did what you did 9) because you kept cool and responded rationally, you will appear to be the reasonable person while the PB will come off as unreasonable and hostile; when you acknowledge things you need to learn, you are furthering your image as a reasonable young nurse who is willing to learn and grow 10) you must keep your self-esteem up; do not get down on yourself; no nurse is perfect and you are not expected to be either; mistakes happen and that's how we all learn in real life; as long as patient safety is not an issue you are OK Did all this work for me? Yes. On my next job I again ran into a PB. When I first started, she reamed me in report for not having prepared her clipboard, among other things. After that, most of my co-workers told me not to feel bad, because they too have been victims of this toxic co-worker's bad attitude. It was like a rite of initiation, and now I was part of the group. My manager told me that she has talked to this employee many times about her behavior, and that she would talk to her again. After all this, the PB is still the same, but she does try to restrain herself, and I no longer feel threatened. She's the one with the problem, not me. Finally, get yourself some books on this topic, you can start at the library, or you can buy used books on Amazon or Alibris. Here's some suggestions: Positivity, Dealing With Difficult People, Emotional Blackmail, Emotional Vampires, Breaking the Chains of Low-Self Esteem, and Whose Pulling Your Strings. I wrote down the pearls of wisdom I got from these books, and put them on a tape to listen to. Also, I put them on my computer's sticky note program, so they pop up as reminders. Good luck, you will learn so much!

Perfection Bullies (PBs) are the worst type of toxic co-workers. They start the shift all stressed out, and expect everything handed to them on a silver platter. They are especially hard on new nurses. Everywhere I've worked I've encountered one, and I even had one as a teacher when I was in nursing school. The PB where I'm at now got booted out of the medical unit, and now she's on the psych unit. When I first started, she reamed me in report for not having prepared her clipboard. After that, most of my co-workers started telling me not to feel bad, because they too have been victims of this toxic co-worker's bad attitude. It was like a rite of initiation, and now I was part of the group. This type of co-worker explains the meaning of the saying, "Nurses eat their young." PB's create a hostile work environment that leads to poor communication, increased errors, stress, poor morale, and higher turnover. I'd rather deal with patients or family any day! They may take up more of my time, but they usually respond well to respect and reason. PB's, on the other hand, are highly irrational, and you are stuck with them!

Here's a few thoughts: Organization is big -- there's a free program for PDAs called Due Yesterday by nosleep software; it was very helpful. Having typed up notes is handy, but not critical. It's nice to be able to share class notes via email. My wife always read & highlighted the textbook assignments. On the other hand, I rarely read the textbook assignments and instead relied on my class notes and on supplemental books -- we both did well. Consider buying used books -- they're a lot cheaper and I rarely, if ever, ran into a problem using them. Amazon has used books and good reviews; Alibris is another great source for used books. Also, check out the library. If algebra is a weak area for you, get a book on math for nurses and work some examples in each section. This is probably a good idea even if you're strong in math. Index cards -- I liked to summarize key lecture or reading points onto index cards. The process helped me learn the material, and then I used the cards for memorization. Finally, nursing care planning (aka nursing diagnosis or NANDA) was a HUGE topic in my nursing program, and many of us had difficulties getting a handle on the subject. The classic care plan has with a nursing diagnosis, a "related to" clause, and an "as evidenced by" clause that lists signs/symptoms. Example: Constipation related to bed rest as evidenced by the patient's statement, "I haven't had a bowel movement in four days and I feel constipated." After that you will list the appropriate nursing interventions, such as: 1) have patient drink 300 ml fluid with each meal, 2) patient will get out of bed and walk to the nurses station and back once a day with assistance, and 3) teach patient that constipation can be caused by lack of fluids and inactivity. The trick to doing a care plan is to gather the signs and symptoms while in clinical, and then later find a NANDA that fits them. Also, you can look up the medical diagnosis (e.g Heart Failure) in your care plan book and get a list of NANDAs that may apply. Here are some common nursing diagnoses that will prove useful to you: Cardiovascular (Activity Intolerance, Decreased Cardiac Output, Ineffective Tissue Perfusion), Elimination (Constipation, Diarrhea, Impaired Urinary Elimination), Discomfort (Impaired Comfort, Pain), Fluid Volume Deficit, Risk for Infection, Respiratory (Impaired Gas Exchange, Ineffective Airway Clearance, Ineffective Breathing Pattern, Risk for Aspiration), Wounds (Impaired Skin Integrity, Impaired Tissue Integrity), Activities of Daily Living (Impaired Physical Mobility, Risk for Falls), and Psychosocial (Powerlessness, Ineffective Health Maintenance). Good luck and congratulations!

Using a computer, or a PDA with a keyboard, will definitely keep you more organized. It also facilitates sharing notes with classmates via email. Just make sure your instructor is OK with using a laptop in class. Most of us either took handwritten notes or wrote on the instructor's PowerPoint handouts. Using Microsoft's OneNote is also an interesting idea. It simulates a notebook with tabbed pages. I used it when studying for the NCLEX to easily sort my jumbled learnings, gleaned from answering many practice questions, into major topic headings such as "GI" or "Cardiovascular." But I didn't use it in the normal course of nursing school, because the info was already sorted for us by the instructor. In other words, today's lecture would be on "GI," the next lecture would be on "Cardiovascular," etc. Congratulations and success!

C & C, You have convinced me! It sounds like you have really learned from your experience, and your insight is excellent. You have taken this "bad" experience in a mature and positive way -- I'm impressed! Your challenge is to summarize your story, deliver it with conviction, and keep positive about yourself and your abilities in front of a skeptical manager. One thing that might help: Try understanding your former tormentor / manager. My guess is that she has low self-esteem which causes her to pick out victims to abuse in an effort to make herself feel better. The stress she experiences on the job is temporarily relieved by bullying. Once you grasp that, your bitterness towards her will begin to diminish. This will come across in the interview, and you've just scored another point! This doesn't mean you need to forgive her. You job is to keep yourself from being victimized by someone like her in the future. Abusers look for vulnerable, "nice" people they can victimize -- if they sense they can push your buttons, they will. By being calm and confident, you will be a less attractive victim. You have probably been a victim in the past, even if you don't realize it now. A positive, problem solving attitude will help you immensely. The trick is staying calm and in problem-solving mode when under attack. There are many books about how to deal with an emotional bully by changing yourself. Two excellent ones are Who's Pulling Your Strings and Emotional Blackmail. Other good ones include: Dealing With Difficult People; Emotional Vampires; and In Sheep's Clothing. Many of the books I've suggested are available at the library. You don't need to read them cover-to-cover. Just skim them and pick out a few pearls of wisdom. Then reinforce the pearls by making post-it notes and sticking them where you'll read them. I have a post-it note program on my computer. I've programmed different notes to pop up on different days. You can also make a tape of the pearls with some soothing music in the background. Play it when in the car, or anytime you want to relax. When you notice an improvement in yourself, congratulate yourself. It takes some time, but gradually you'll incorporate more and more of your learnings. Above all, stay positive! Negative feelings will undermine your ability to problem solve and persevere. Negative self-talk is the main thing that prevents us from making positive changes in our lives. You don't have to be perfect to be a good nurse. YOU CAN DO IT!

Yes, PTSD is not easy to deal with. And new nurses are very vulnerable. So how does a nurse deal with getting a job knowing that her first employer is giving negative references? You must develop a positive story that explains your situation, and through your tone of voice and body language, you must imply that you are a resilient, positive, problem-solving person with good insight. This is the kind of person people want to hire! This is also the type of person that the Nursing Board is most likely to be lenient with. Develop a good story to explain your situation. Admit you made a mistake, what you learned from it, and the steps you have taken to correct it. The story should also mention contributory factors, such as poor orientation and inexperience, but make sure to be factual and non-blaming. This is where restoring your self-esteem and positive attitude will help you, because without them you'll come off as too negative toward yourself and/or others. A main trait of resilient people is that they see things, even "bad" things, in a positive way. For example, this experience has made you a much wiser nurse. It's given you an opportunity to increase your knowledge. Another trait of resilient people is that they view mistakes as part of the learning process, and work to avoid making the same mistakes again. Explain that you've put an action plan in place that will keep you from making similar mistakes in the future. Finally, resilient people are open to new paths. Being willing to consider school nursing is one example, but the job market may dictate your path for you. You must be flexible and positive! You must convince yourself that you can take on new challenges. The book The Secret of Success is Not a Secret by Darcy Andries is about the failures of successful people. A book like this will show you that successful people often endure many failures before they succeed. For example, Soichiro Honda was turned down by Toyota Motor Corporation during a job interview as engineer. He continued to be jobless until his neighbors starting buying his "home-made motor scooters." It's unfortunate that nursing, and life, deal out situations that are unfair, but that's the way it is. Many nurses have had bad experiences starting out, but they have overcome them. For all you know, the person you are interviewing with is one of these people, and they will understand what you've gone through. It sounds like you have already done much of the work you need. If you use this opportunity to improve your resilience, you will have learned something that will benefit you the rest of your life. Remember, the keys to resiliency are a positive attitude and healthy self-esteem! As you improve yourself in these areas, you will be able pass them along to your child. What a wonderful gift!

I don't blame you for being afraid to go back into nursing, you are suffering from a mild case of post-traumatic stress disorder. It sounds like you've taken steps to improve your medical knowledge -- great! Now take some steps to heal yourself emotionally. It's important to treat your emotional state before venturing into the nursing world again. Please read some books on resilience and positive psychology. Resilient people are able to bounce back from negative events and succeed, and the two attributes they have in common are high self-esteem and a positive mental attitude. Your self-esteem has probably been damaged by your ordeal. Unless you address this, it will come out in job interviews and be interpreted negatively. Check out the book Resilience: Discovering A New Strength At Times of Stress by Frederic Flach, MD, or simply look for books with the word resilience, resiliency, etc. in the title. You can learn about low self-esteem by reading Breaking the Chain of Low Self-Esteem by Marilyn J. Sorensen, PhD, but if you're in a hurry skip right to the positive psychology books: Positivity and, if you get a chance, Learned Optimism. Positive psychology uses proven cognitive behavioral techniques to help lift your mood and increase your self-image. Just by learning how important a positive attitude is to resilience and success will jump-start your recovery. One thing I learned is the "self-analysis" done while in a negative mood is not very accurate, and that such rumination actually harms our self-esteem, problem solving, and happiness. Finally, check out some natural medications to help you overcome stress and rumination by reading Natural Medications For Psychiatric Disorders, written by a couple of Harvard psychiatrists. Here's a short list of suggestions to get you started: - inositol -- tastes like sugar, considered a B vitamin by some, it is great for minimizing rumination, and is safe, even at very large doses - valerian -- excellent for stress and trouble sleeping, very safe Take care of yourself mentally and you will succeed! Good luck!

Athena 55, I am so grateful for your responses! You have answered my questions superbly -- thank you! The Army, the VA, and the Nation are very lucky to have you! Speaking of the VA, I was almost hired there in Oct-2008 when the hiring freeze came on. I called recently and they said I'm near the top of the list, but the freeze is still on. Have you heard anything about the freeze being lifted soon? Thanks again, S-guy

Thank you all for your excellent feedback -- much appreciated! A few more questions, if I may: Would I gain clinical experience that would help me get a job when I got out? Based on the above, it doesn't sound like I would. I'd hate to join up with that in mind, and then be unpleasantly surprised. Any feedback? What's the nursing training like? I don't know how to treat an open abdominal wound. How do people that have a normal job make this work? If I went in for two years, about how much of that time would I be away from home? My wife needs to know that. Sorry for all the questions. Thanks for your thoughts, and your service!

Should I join the Army Reserves to gain nursing experience? I'm in my fifties, and graduated nursing school about two years ago. I did my school preceptorship in psych on a locked unit, and then I put in a year on a telemetry / med surg unit. I'm unemployed right now and I'm trying to get into psych nursing, but it's difficult because hiring is so slow. I recently saw that the Army is looking for psych nurses, probably due to suicide rates jumping up among soldiers, according to a news article I read. It would be very rewarding to work in this area. Am I crazy for thinking about this? The ad said they'd take someone under age 60 on a two year contract, and applicants would be officers. Just what would I be getting into? I know nothing about the Army Reserve. I'm married with no kids. My wife works. What do you think?

I respect what you're saying above, and wonder if you recall any examples of honesty that have worked? Thank you!

Jolie, I respect your advice above, and hope you can provide me with some insight on my situation. My manager has been building a case on me, and fortunately I never made any serious medical errors. But I knew it was time to go, so I emailed my resignation in hopes of preserving my "eligible for re-hire" status. My manager responded with the following: "I believe that you will find the right fit for you. You are intelligent, compassionate, and want to do the "right" thing. Please stay positive and the right match will come. Let me know if I can be of help." Should I respond with a request for a reference letter? How should it be worded? Is the manager serious about wanting to help? What if I request a letter and she blows me off? I'm not good in dealing with this type of thing, so your advice is much appreciated. Thank you!

Your responses have been so helpful! I never expected to get such practical advice, and the tremendous support you have given me is simply invaluable. I just emailed my resignation to my manager, and I have 80 hours of sick time stored up, so I think I'll use it. Thanks again!

Hi Racing-Mom4, Thanks for your helpful feedback! I've learned a lot from my "lessons", and I think the core issue for me is to manage my stress and guilt buttons going forward, so that I remain pleasant and helpful to other nurses at all times, especially when I'm burned out and behind at the end of the shift. I also need to better manage my sense of humor, which I have used for stress relief. In general, the patients and many of my coworkers love my joking, but it can get me in trouble with certain nurses. Too, I wish I was faster with everything, so I would have things all wrapped up better at the end of the shift, but I don't have an easy answer for this one, other than to hope it will get better with more experience. Here's a brief synopsis: - a while back I got on the bad side of an assistant manager -- she came up behind me and overheard a joke; my manager at the time said it was just a mistake and didn't make a big deal out of it, but the assistant manager got me back on my eval (ouch!). More recently: - a certain night shift nurse was grilling me in report with questions no other nurses were asking me; eventually I began to feel terroriized of giving report to this nurse and finally I told her, "I don't know that particular thing, but I took good care of the patient all shift; if it's that important to you, look it up." - night shift manager started in on me because I hadn't had time to check the orders on a new admission that came in late on the shift, even though a nurse from another floor had come down to help and she checked the orders (no one bothered to tell me that, however); rather than say, "I agree, I need to improve" and staying calm, I was "defensive." - at this point I was so terrified of leaving anything for the night shift to do, I ended up forgetting to get a pt off a bedpan -- my bad, I handed them this one, and I admitted my error and apologized. - not checking the PCA pump at midshift, although I pointed out that no one on days (where I was trained) or evening shift does that and, sure enough, the copy of the PCA flowsheet the manager was using as evidence against me showed the dayshift hadn't checked it midshift either (and so far this has not changed). In all of the above cases, there was no harm to the patient. My manager actually seemed more upset over the communications issues rather than the medical problems. At her advice, I sought counseling with Employee Assistance, who helped me overcome my defensiveness issue. We had a meeting in the EA counselors office, where I was rational and non-defensive. Even the EA counselor told me she was impressed. However, the manager made no mention of any improvements, and had a list of other problems: - giving in-room report to a nightshift nurse: we entered the room and the patient was not straight in bed, nor was he covered (he was restless like this all shift); the nurse said she wanted to straighten him up in bed, but I asked the patient if he was comfortable, and he said "yes." I looked at the nurse for feedback, got none, we moved to the next room. She complained later. - giving insulin late for a critically high blood sugar; when asked for my rationale, I said I had a new admission and I focused on getting him situated and medicated, because he hadn't had his heart meds for over a day; I know that low blood sugar is an emergent situation, but thought that high blood sugar is a chronic situation; I called the doctor immediately after doing the finger stick, and he said to give the scheduled insulin and do another finger stick in four hours; I gave the insulin as soon as I took care of the new admission, and passed the doctor's new finger stick order to the night shift. My manager told me insulin has to be given within 15 minutes of the fingerstick (I didn't argue, but this NEVER happens on the shift -- by the time the lunch & break nurse does the bedtime fingersticks, gets the info to the nurses, and the nurses give the insulin, an hour has gone by.) - PCA error: the problem originated on the day shift somehow but was not apparent from either the order or the flowsheet; day shift passed it to me, I passed it to night shift, who got a call from the pharmacy about it. It was something that reviewing the order and doing the PCA flowsheet obviously did not catch. Again, in all of the above cases, there was no harm to the patient, and to the best of my knowledge no one else is being penalized. Believe me, I know I'm not perfect, but at this point I feel I'm being held to a higher standard than other nurses, nurses with much more experience than me. That's the main reason I think I need to move on. Thanks again!

Thank you so much for all of these wonderful responses! Sometimes it is difficult to see the forrest for the trees, especially in a situation like this. I had a chance to sleep on it, and this morning 90% of me felt like I should resign. But there was still that pesky 10%. However, after reading all your messages, I know what I have to do. You have been so kind to share your thoughts with me! Thank you for your love and support! Now for the next phase: Any more thoughts on how to deal with this in upcoming interviews? Thank you again, from the bottom of my heart!

I'm in the process of getting fired. My question is, do I stay and make them fire me, or do I resign and move on? I'm starting my second year as a RN. Financially I'm fine, and I'm not interested in fighting anything, I just want to minimize the damage to my future job possibilities. Ideally, I'd like to hang on until I have another job, but I don't want to wait so long that I lose the option to resign. When do you know it's time to resign? Also, how do I present this situation going forward to future prospective employers? I've already applied at one hospital, and from the feedback I've received I think I'm very close to being hired. I also have an application in at a temp agency. I say I'm in the process of getting fired because my manager is building a case against me using errors and problems that others don't seem to be getting in trouble for, and there is little recognition of the efforts I've made to improve. I feel the die has already been cast. My biggest fear is how this whole thing will look to future employers. I'm especially interested in feedback from nurses who have been through similar situations. Thanks in advance!

With all due respect, if I gave meds the way they made us do it in nursing school, I'd be the laughing stock of all my co-workers. None of them do it the way my nursing school taught, simply because they don't have time. Come to think of it, I have never seen a practicing nurse pull meds the way we were taught in nursing school. Never, ever. I guess when you have one patient like in nursing school, you can do things the theoretically correct way.

I could see a potential problem if the Pyxis let me pull meds for multiple patients simultaneously. But it won't. I actually learned this technique from a teacher in nursing school.

In order to save time, I will often pull meds from the Pyxis for more than one patient. For example, I'll get patient #1's meds, put them in a little zip-lock bag, put the Pyxis receipt with the patient's name into the bag and them zip it shut. Then I'll do the same for patient #2. So ultimately I have 2 or 3 ziplock bags containing meds and the related Pyxis receipt. Several nurses have told me this is "bad" and not to do it. But I don't get what the problem is. When I get to the patient's room, I pull his ziplock and check everything against the MAR before giving the meds. The receipt is in the bag so anyone can see whose meds these are and what meds were taken from the Pyxis. Will the meds from bag #1 jump into bag #2 by magic and change what's written on the Pyxis receipt? Seriously, am I missing something (I am pretty new)? Is there a Joint Commission ruling on this? I have never had a problem doing this, and it does save time.

SeekingBalance is right on target. It's not the type of nursing that's getting you, it's the toxic people that hate their lives and are taking it out on you. These kind of people make you feel they way they do (miserable), and eventually you will hate life too. When you are stressed and upset you're more likely to make a mistake that could hurt your career. You are really lucky to be getting calls from hospitals -- take advantage. I too am afraid to be a "quitter," but if you're stuck in quicksand, isn't it reasonable to try to get out? There are good preceptors and good managers out there. Your story will resonate with them. On the other hand, if you stick it out things could change for the better. You never know how it will work out, so let your stress level be your guide. In general, have something lined up at a new place before you quit your old job. It doesn't hurt to look, just don't let your bad experience destroy your confidence in yourself, because that's the main thing you have going for you when you're interviewing. Good luck!

I'm 52 and my previous career was in accounting. I graduated from nursing school in March, passed the NCLEX in July, and recently landed a job on a telemetry floor in a market that is saturated with new grads. My fellow students were fine with me, and so are my co-workers. Nursing is one career where your age will not be held against you. You don't have to be a fitness nut, be should be in reasonably good health with minimal back problems. The stimulation that nursing provides will keep you going throughout the day. Good luck!

I am a new male nurse who recently took care of a 70 year old 400 pound female with CHF who became short of breath with minimal exertion, which is what brought her into the hospital. I was concerned about her ability to toilet without falling. I also sensed she was reluctant to have a male inspect her skin, especially under her breasts and in her peri area. I was too embarrassed to discuss these issues with her openly. Eventually things worked out without incident, but I feel I left myself open to liability, and want to handle this situation better the next time it occurs. Any thoughts on how to assess this patient's ability to toilet safely? Her unwillingness to allow full skin inspection and care? Who needs to be aware of my concerns? How do I document my assessment and the steps taken? What steps do I take? We have a lift team, but they are too over-worked to respond quickly. Thanks in advance! P.S. I am not obese-bashing, this woman was a pleasant person.

Hi! I'll be interviewing for a new grad training program in a neurosurgery department very soon. I'd welcome any feedback regarding how you got into the field, what you like most about it, what you like least, what advice you would give a new grad, what situations do you usually encounter, would this be a good place to start a career, etc. Thank you in advance for your replies!

I have to agree with the original post -- there's a lot of talk about the nursing shortage, but the action is more concerned with raising salaries by limiting supply. Here in CA most nursing schools have not increased the number of students they'll take, no matter how dire the shortage predictions are. They claim there's no money, although they just created a new job, are moving into a new facility, etc. The person who started this thread is an honest person who has the ability to face reality without resorting to maladaptive denial. I love it -- thank you! On the micro level, I'm not complaining. My wife is a nurse, and I'm just about to graduate. So I'm glad that the market is not flooded with nurses (yet). Requiring a BA for entry level nursing is crazy. I guess knowing how to say, "Here's your medication" in French or being able to discuss Hegel and Marx will lead to better patient outcomes -- NOT. Nursing liability insurance is dirt cheap and the price has been stable, which may indicate there is not much nursing malpractice going on out there (according to my textbook). When I attended a Board of RNs meeting recently, I heard stories about nurses who accepted positions they weren't qualified for, ran people over with their cars, or were stealing drugs from their hospitals. I'm not sure having a BA degree would do much to solve those problems. Limit supply too much and look what happens -- legislation to ease the importing of foreign nurses. But whatever. Maybe we should really protect the public and make a master's degree mandatory?