DrKim

Nursing is one of the few professions that provide members with a variety of options. All of the options you wish exist, already exist and prefer nurses with experience. You already know the answer to your own question :)

No. Most good preceptors do not behave in that way. I'm very surprised that he allowed you to give meds without supervision the first day. He either (A) thinks you're very capable, (B) has a chip on his shoulder or © is testing you. There is nothing wrong with having a conversation with him at the end of the week. You can say, "So, I've worked X amount of shifts with you and would like some constructive feedback on my progress thus far." Now be prepared for him to not be nice, if he's a bully, he will see this as prime opportunity to hurt your feelings. Or he may surprise you and do nothing but sing your praises. If he says anything negative, when he's done, thank him for his feedback and say, "I appreciate you teaching me _____________(think 1-2 things you enjoyed learning). One thing I can say is that I was not entirely comfortable doing _______ alone. Would you mind coming with me when I'm _______? That way I can ask questions of you right then and there. I'm still learning all of the technology and how things flow on the unit." He sounds like the type who would say, "well she didn't ask me!" if you make a mistake. So ask him. Plus, it may also make the lightbulb go off in his head that he needs to be a more diligent preceptor. If he still won't help you, nothing wrong with asking another nurse.

First, congratulations on your upcoming graduation. December will be here before you know it! This is a good problem to have so kudos to you! The answer really depends on what you want to do in 2-5 years. If you don't graduate until December and already have job offers, something tells me you already have a 5-10 year plan. Which one will best prepare you to stay on track with your plan?

The manager was not impressed because what you indirectly conveyed was "indecisiveness." It's more likely that the manager was trying to assess: do you know what current best practices are for diabetes management (elevated blood glucose is common in ICU patients due to the presence of infection) and do you know where to look for the best answer quickly (hospital intranet for EBP websites and hospital specific practice policies). ICUs are well known for giving nurses a lot of free reign when it comes to practicing and being a strong nurse capable of making quick decisions is a must. You essentially said too much and nothing at all, simultaneously.

Several nursing organizations and boards of nursing discourage compensation for preceptors. While the preceptor may not be paid directly for time spent with the student, functioning in the role of a preceptor is above and beyond standard performance expectations. So the preceptor could discuss the number of student he/she precepts during his/her annual evaluation with the nurse manager. Precepting a nursing student plus other performance indicators (attendance, relationship with co-workers, taking advantage of leadership opportunities on the unit, etc) could result in a raise in salary and/or performance bonus and/or promotion. So no, you cannot be compensated directly but it would not hurt to mention precepting during your annual evaluation.

The only one that can really answer that question is you. Nursing provides so many options beyond the bedside. If you have time before you apply, speak with nurses who work in different environments, then re-evaluate if nursing is for you.

How about switching to day shift. This could be beneficial for you by (1) increasing the likelihood that you will feel challenged and (2) increasing your visibility with nurse managers, physicians and other members of the interdisciplinary care team. The increased visibility can help you with your transfer in the future because key people (decision makers tend to only work during the day) will know your name/face.

Yes to the address. It shows that you are not transient. Some HR departments will look the address up in Google Maps because that's usually the first thing an unstable person would lie about. It all depends on where you are applying. If you want to work on a peds unit then the summer camp job is applicable. If you want to work in a primary care clinic, then medical billing is applicable. Listing your clinical rotations, especially if they were at good facilities is beneficial. You also want to list any impressive internships too. There's no one way to do this...some more appropriate than others but no hard rules on this one.

You actually have to tell your school because it is so recent. Your program's undergraduate coordinator or dean may have dealt with this situation in the past and the sooner he/she knows the better. I'm sure you're not the first student to make a mistake one summer. Nothing is worse than getting ready to send a student to clinical to only learn from the clinical site that the student did not pass the background check. Also, depending on what school you go to, if you're fortunate to have a Law School most law schools offer free consultation clinics so you may be able to get some help there too.

I would hire an attorney or contact a company like RN Guardian. The disbarment piece can become an issue with future employment because it could be seen as "disciplinary action" taken against you by licensing body. I don't understand why the juvenile record was even disclosed because usually those records are sealed or expunged. But I would seek some expert advice on this.

I am sorry to hear about your situation and recognize how frustrated you must be right now. I would need a clearer picture of exactly what's going on but just based off your post a few questions come to mind: 1. What degree did you get? What kind of program did you attend? 2. Did you apply to hospitals where you completed your clinicals? Usually those are the first to grab new grads. 3. You may be applying to units that typically require at least 2 years of experience. Med-surg floors are always hiring. Are you exhausting all of your options or trying to force a square into a round hole? 4. What kinds of hospitals are you apply to? There is no shortage of nursing jobs. You just need to make sure that you are matching yourself well with facilities. The final hiring decision was clearly not up to the nurse manager and she probably will not answer you out of sheer embarrassment.

With patho, pharm, and careplans, things liven up pretty quickly. Enjoy your "downtime" now.

Florence Nightingale won't notice you're missing but your Dad will. The pin doesn't make you a nurse, the NCLEX does. Most students and their families find the pinning ceremony to be unnecessary.

I second everything in Awesomosity0's post and emphasize "I would not, under any circumstances, do a diploma program." Diploma programs are very limiting. Some hospitals will not even entertain the idea of hiring a diploma nurse. You sound like a strong student, do not limit yourself with a diploma program.

Depending on your gpa, do not dismiss a traditional nursing program. 1-2 more semesters is not that big of a deal. Plus, traditional program students get an entire summer to pursue an internship or study abroad; something accelerated students do not get to do. Accelerated programs are intense and admission committees do not like to accept students who present any risk of not succeeding. The greatest predictor of future behavior is past behavior so you are a risk. Sometimes the committees will reject the application entirely or reject the application for the accelerated program and encourage the student to apply to the traditional program. No matter what, attach a letter to your application owning your mistakes and what you want to do differently. Being passionate about nursing is good but it's not enough. You will have to demonstrate to them that you have a genuine commitment to finishing. Have you looked into therapy or talking to someone about your fears? If you're really going to do this this time, you need to be emotionally strong. Nursing programs are tough emotionally and physically.

You might actually not be in bad shape. Your story is more common than you realize. If grades from your not so stellar years are older than 7 years old, some programs will not even factor them into your prerequisite gpa for your application. Most schools separate overall gpa from science or prereq gpa and weigh the science/prereq gpa higher than the overall gpa. For some students, overall gpa can be inflated from easy courses, so by separating the gpa's it keeps things fair. Worst case scenario, you write a letter to the Admission's Committee or Dean owning your mistakes, provide examples of how you've improved and your plan to stay focused/be successful in the nursing program. You have options :-)

Reporting a faculty member in a prerequisite class to the Dean is pretty bold. I also notice that you responded to every single comment on your post - something I have never seen anyone else do. Students who work for 2 years or more before entering a nursing program typically struggle with the power shift that occurs. Nursing programs are highly competitive and do not subscribe to a customer centered business model. They don't have to because your satisfaction/happiness is not their goal and they will always have a surplus of applicants. And you are expected to come into the nursing program with fundamental knowledge. Your Physiology professor is fair to assume that you should already have a basic understanding of cell structure. Having been a student, nurse, professor and now consultant here are my pearls of wisdom: 1. From this point forward, walk with humility. You never know who you may have to ask for a recommendation letter. They have something you need. Save your complaints for the teaching evaluation at the end of the semester - that's where it actually sticks the most. The evaluations are added to the faculty member's file and are used in their annual evaluation. 2. It will not get any better in a nursing program. Nurses still "eat their young" and they are unapologetic about it. Most nursing programs have a small amount of core faculty. They all know each other and they all talk. Do not be THAT student. 3. Pick your battles. You are going into a profession where thick skin is vital to your survival. Your feelings were hurt but this was not a battle worth fighting. Learn to walk away.

For infection control, that may not be a wise idea. Nurse station's and scrub pockets are petri dishes.

I have to disagree Jensmom7. If I'm interpreting the description correctly, I think Pilot2FNP wants to focus on serving as an independent consultant to the families. The decision to place a family member in hospice can be a very confusing and divisive time for a family. Interdisciplinary team members who all work for the hospice may not give the family the peace of mind that they have exhausted all options for their loved ones. Family members may be looking for impartial advice and Pilot2FNP's company could provide that advice.

I would 1. Read my state specific laws regarding nurse agencies 2. Seek a free consultation with a tax attorney 3. Call my Chamber of Commerce to network for any potential mentors (someone may know someone in a different area that started their own agency. This way you will not be seen as competition)

It looks like they are low-balling you in the hopes to pull you back down to what they want to pay. Before a position is posted, the salary range is predetermined - especially in nursing. So they may not have much wiggle room. If the average in your state is $44-46, then as a new grad how did you calculate $48 to be an acceptable request? Understand their perspective, you're asking for above average pay with no NP experience for an NP job? You shouldn't really compare compensation with benefits to compensation without benefits because that's the equivalent to comparing apples to oranges. Benefits can actually really add up for a company, especially when dependents are added. Keep in mind $86-88k/year with benefits may not leave you with much to take home. Regardless of what she offers you, I'm most concerned that she changed your salary AFTER orientation. If you already signed a hiring contract. If it were me, I would walk away. If the confusion and ineptitude are already showing themselves on Day 2, then that's not a place that you want to work. I would also contact the California Association for Nurse Practitioners and talk to them about appropriate salary options for new grads.

It sounds like a really unfortunate situation. Take a step back: never lose sleep over what ifs. Your manager is there now. You really shouldn't file grievances based off of he said/she said. Signed statements are acceptable to a point. I recommend that while your manager is there and willing to cooperate with you, you may want to schedule a meeting with the physician and have his director and your manager present to discuss the issue. You may even want to request a rep from HR to be present too. If he behaves inappropriately (which I'm guessing from your description he probably will), you will have administrators witness his hostility. Your goal is to keep as calm and professional as possible during the meeting. Then file a grievance. If for some strange reason he behaves in the meeting, then you are indirectly drawing a line in the sand and firing a healthy "warning shot." Sometimes bullies need to know that you are not afraid to tell on them. He may hate you for it; but what you're looking for is his respect. His ability to "like" you is irrelevant.

The answer is "anything you want!" I know nurses with MBAs that have gone into management, consulting, project management of research trials and pharmaceutical sales. The beauty of nursing is it's flexibility. This is your career. Make it what you want. If you want to pursue business full time and still work a few per diem shifts, you can do that too. This is a good problem to have, trust me.

Are you always this hard on yourself? You are a new nurse and oncology is tough, so give yourself some grace. And 7 weeks is not a lot of time to learn anything. I always tell new nurses, do not rush off of orientation! Once you're off, managers are a lot less forgiving. Are you in a Nurse Residency Program? Seven weeks is short for an oncology unit. Is it possible for you to switch to another unit? If you graduated at the top of your class, then you definitely have the intelligence to be a nurse. Something tells me you keep getting stuck in your own head. Are you focusing so much on not messing up that you are unable to absorb new information? Now that you've made those mistakes, you'll never make them again. Time management is the biggest hurdle. Once you can get on auto-pilot with certain things, then other tasks won't seem as daunting. I agree with your colleagues, the nurse reporting off doesn't need to tell you all the meds she administered. You can look in the system for that. Legally, what matters is what's documented not what's said. So don't rely on handoff report. As you listen to report, focus on exceptions to normal. One way I trained myself to think head to toe was I would take my patients summary sheet, fold it in half vertically so the blank side faced me. On the left side, I would list Neuro, Diet, Procedure, Resp, Card, GI, Skin, Pain, IV, Pain, Misc. and would write any exceptions to normal provided in report. On the right side, I would list the same systems again but only what occurred on my shift. The right side is what I would report off when I left. I did this for each patient. After report, always eyeball your patient. Talk to him/her. Introduce yourself. Pay attention to how they respond to you. Do a quick assessment, eyeball any bags hanging. Then go check your medical record. Make yourself a schedule of what meds you have to administer and when. Cluster your meds - use the 1 hour before or after window so you're not running in the patient's room every hour. I did this every shift until I got into a rhythm. Soon my Preceptor didn't have to ask me for things. I was always a step ahead of her. Good luck :-) P.S. Your age has nothing to do with your performance. Don't talk yourself out of being successful. One of the best nurses I know didn't come to nursing until she was 55

The problem with some for-profit schools is that they may only be regionally accredited. This limits where students can be trained and ultimately where graduates can practice. I would call a few hospitals near me or a few potential employers and just ask if they have hired any graduates from those programs and see what they say. Nursing has talked about making the BSN the entry level degree for the last 25+ years with very little progress. When trying to decided between the ADN and the BSN, I encourage clients to think beyond graduation and getting their first job. Personally, I wouldn't bank on my future employer paying for me to get my BSN. The healthcare market changes everyday and funding for those programs are at the sole discretion of CEOs and CFOs. They may do it one year and opt not to do it the next.