rn&run

Still sounds like a culture problem, not a problem of individuals. My company has a ‘points’ system— lose too many to tardies or call outs, you’re out. As long as you stay under the limit your sick time is yours to use. It’s childish, but it works. You literally can’t keep your job if you habitually call out more than once every 4 months. This makes it a generally pleasant place. Everyone gets their full lunch break, so you’re less likely to fall ill due to exhaustion, anyway. Of course, if you fire people for absenteeism, you have to be able to hire more... and that means offering competitive wages and good working conditions. It’s a complex problem, which I do realize COVID hasn’t helped. I’m sorry you’re stuck picking up the slack.

You did great! You assessed, treated, reassessed, and called for assistance appropriately. I’m sorry you’re feeling down on yourself, but you needn’t.

Congratulations on your new job! Common office procedures might include labs (phlebotomy, urinalysis, finger stick blood glucose and a1c), spirometry, vision screening, ekg, ear lavage, giving IM and PO meds. You might set up for and assist with minor procedures (skin biopsy, colposcopy, joint injections... really varies based on what your providers see). You’ll also probably do a lot of telephone triage— headache/dizzy/pain/sob etc. You’ll communicate with home health agencies, pharmacy, insurance— there’s quite a bit of back-and-forth of orders and paperwork. Again, good luck! Be kind, allow yourself to be new again.

Yes you can! I'm an introvert and doing just fine in a busy urgent care. Social skills can be learned by anyone, not just extroverts. I'm not friends outside of work with my co-workers, and I don't share a lot of info about my personal life at work. That's a GOOD thing! As long as you can be pleasant, polite, and assertive when appropriate, introversion is not a problem. Good luck!

Sending you peace and reassurance. All new grads ever make mistakes -- some that cause harm, most that do not. You are very high risk for errors right now, off orientation but still new. It gets better. As a new grad I accidentally hung D50 instead of NS for a diabetic patient's maintenance fluid. They were fine, but needed insulin correction. I can't remember if I was off orientation at that point, or at the tail end of it. I felt stupid and horrible, regardless. There is no way to become an experienced nurse without going through this. It's part of learning. Be gentle to yourself.

The clinics in my area pay comparable to the hospital I was at. Well, the hospital started me out at a higher rate of pay, but my current clinic is much better at giving appropriate raises and periodic cost-of-living adjustments. I now make more at the clinic than I did at the hospital. If you're interested in OR, look for a hospital that offers the periop-101 course or similar -- something that they provide 'for free' after hiring you. It can be a competitive application process but they exist. The one I did required a 2 year contract, but it came with a job upon completing the program, and was well worth it. I grew a lot as a nurse in the OR.

Ugh, I've been there! I prefer to work in areas that don't have high-volume med-passes for this reason. For me, OR and urgent care are two settings in which I feel I'm a better nurse, vs SNF and med/surg. In the OR, it's important to be meticulous, but you can focus on one case at a time (to some extent), and anesthesia administers most intra-op meds. In urgent care, you administer meds relevant to the situation, without having to pass maintenance meds too. I'm in urgent care these days, and I find that being familiar with our in-clinic meds, doses, and indications has made med-errors a non-issue for me now. It's good that you're self-aware! If you like your unit, keep reflecting and refine your practice. If it feels like a bad fit in more ways than one, it's OK to keep looking for new experiences. Good luck!

Slow down. Take a deep breath. This is a small and accidental HIPAA violation. It's not a terminal offense, or something you'd lose licensure over. Really. It's the sort of thing you do as a new grad, which freaks you out and makes you pay better attention in the future. We've all been there. It's bothering you, so I recommend you let your supervisor know, or your company's HIPAA compliance officer (whomever you have a better relationship with). Tell them you're aware you made a mistake, and is there anything else they need from you to make it right? I imagine the worst they will do is assign you HIPAA remediation training. You'll be fine.

I think four 10s is only better if you get your day off in the middle, e.g. on Mon/Tues, off Wed, on Thur/Fri, off Sat/Sun.

'Scared' is a strong word for a work-related emotion. There are conditions it's appropriate to be... more vigilant towards, or to seek more support in managing. In my experience, feeling scared at work about something it's in my job-description to manage, isn't acceptable quality of life. Perhaps you might consider a job change, or consult a therapist.

Hello friend, I like clinic nursing— I work for a family practice/urgent care instead of the hospital now. It doesn’t have the same need for constant vigilance and aggressive patient advocacy, but I still learn new things all the time. I have major depression and generalized anxiety, and I’m a much happier more functional person no longer working inpatient. It was a really terrible fit for me. There’s a trade off of complex nursing function for a more reasonable workload and being treated better by my patients and colleagues. I think it’s worth it.

I've only worked in one OR, but what you're describing @jamiebell is concerning to me. From the Association of Surgical Technologists: "Wound closure is performed under the broad delegatory authority of the physician, as defined by the American College of Surgeons, the provisions for which vary from state to state and according to state law and health care facility policy. Therefore, it is the position of AST that only the individual who has attained the credential of CSFA has the knowledge, training and experience to perform advanced task functions in the closure of body planes. Moreover, the Association stands against a single person holding the dual role of scrub tech and surgical assist. They claim that "when the CST is utilized in a dual role, effective case management, organization of thoughts and activities critical to safe and efficient patient care, awareness of aseptic technique by all surgical team members, and quality of surgical patient outcomes may be compromised. Long story short: if the scrub tech is busy suturing/incising/etc, he/she is effectively unavailable to function in their capacity as scrub tech. Full AST position statements available here: https://www.ast.org/AboutUs/Position_Statements_Guidelines/ Disclaimer #1: In my brief review, the Association of Surgical Technologists appears reputable and evidenced-based, but I am not a member, nor am I a surgical tech. Disclaimer #2: Workplaces do not necessarily adhere to what is right, or evidence-based. Advocating for EBP against unit culture may get you ostracized, retaliated against, or fired.

OP, so glad your pre-existing gender norms helped you overcome culture shock.

I find that good pay, adequate staffing, sick leave, paid vacation, and good health benefits correlate directly with good morale.

You certainly aren't alone -- and you're not a bad nurse. You are ethical. As a new grad, I was really upset about my first med error. The house supervisor (SNF/LTC facility) told me: "If a nurse tells you they've never made a med error, they're either lying or they never realized when it happened." He was a bit jaded, but it was exactly what I needed to hear. You sound ethical. You report the mistakes. You monitor the patient for adverse outcomes. After thinking about all the things that led up to the mistake (distraction, lack of knowledge, understaffing, etc.) and what you can do to avoid them in the future... you also deserve to let them go. It's OK.