joseyjo

I am new to HH (week 10!) so can I ask why you cant write it as 0w1? That is what my HH does... Is it against the medicare rules? I am at a small agency and have found already that there is a lot that we are doing may not be quite right. TIA!

I was a student who, like you, studied almost 24/7. Although I am only 7 months into my 1st year, so far I much prefer it to nursing school. I have time for family, life outside of nursing, and sleep! I could have definitely spent less time studying in nursing school, and made it a more enjoyable experience, but I was dedicated to developing a solid academic base to build on. Looking back on it, it was definitely worth it. This first 7 months hasn't been super easy, but I can see where I want to be and the path to get there.

I'm also a new nurse (7 months) on a Tele floor. About 2-3 months ago I could have written this post! Pretty much every shift I would all but have a panic attack as I took report and realized how much I was responsible for, or when I started to get behind passing meds, with assessments, etc. I cried pretty much every day, and started looking for jobs outside the hospital even though I know that changing jobs before year in my area can really affect my long-term employability. However, I got over it. I am able to handle my patient assignments now without panic attacks and when I get behind I just keep working until I get caught up. I am actually enjoying my job and remember why I became a nurse :) A couple of tips that helped me: 1. When the panic starts to set in, take a short moment and gather yourself mentally and emotionally. Are your patients alive and stable? Then keep trucking. No? Then focus on the immediate need (patient stability). Assessments, routine meds, and even most scheduled IV meds can wait. 2. Ask for help. Utilize your CN, fellow nurses, etc. On my floor people while often walk by and ask " How's it going? Need anything?" I used to just say, "Nope, I got it" (not wanting to look bad), or say "I'm behind but I'll catch up". Now if I am behind at all I'll say "I'm a little behind, are you busy?" I am amazed at how much help it is just to have someone pass 2100 meds to one patient. I return the favor by doing the same anytime I am caught up. 3. Delegate. If you don't have one already, develop a good working relationship with your tech/CNAs. In the last few months I have worked hard at making sure my techs know they can rely on me to work hard, but that I need them to work too. If I am in a room and a patient needs something I do it. But I no longer answer call lights unless my tech is already in a room. I allow them to answer the lights so I can focus on charting, meds, etc. 4. Focus on the part you DO like. I love patient care. I focus on that. If you don't, then focus on what you do like in the day (patho of the diseases, treatment protocols, whatever floats your boat). 5. Be patent with yourself. It's a new job, in a new field. You need to make mistakes to learn your best way. Once you figure put your "groove" for the flow of the day it is SO much easier. Stick with it if you can. You became a nurse for a reason. After a year it's a lot easier/acceptable to change specialities/jobs.

Uworld!!! Passed NCLEX early (before graduation) in 75 questions with 39 SATA!

I wanna work here, lol!

Tele/oncology floor (mix of active chemo, heart/respiratory issues including many trachs/feeding tubes etc). 1:6 ratio days and nights

LOL, maybe I just am happy to finally be a nurse and don't know any better. I do love how my coworkers pull together and help each other out.

Just reading this sounds like a dream come true. I would LOVE to have a 1:4 ratio! What good care I could give my patients... I work on an oncology/telemetry unit. We have 1:6 ratios and as a 1st year nurse I can tell you I can constantly overwhelmed. I have taken a lunch break 2x in my 7 months (both times cut short by calls from the floor). Everyone is expected to eat at their desk while charting (and not let patients see of course). I usually only get to go pee 1 or 2x in 12 hours. I love my job and my floor, but we need more nurses and a lower ratio, for safety's sake.

Our hospital, every unit, not just mine, administers tube medications separately, 30 ml flush between. I can't imagine being in a place where you could just crush them up all together and pour them down It would be much faster though!

What's the best technique for correctly placing a ventrogluteal injection?

When I was a student I saw A LOT of posts about how the 1st year is very hard, crying every day, feeling overwhelmed, etc. Now that I am a 1st year nurse (started on the floor a month ago) I want to try to balance out those posts with one with a different experience. I passed the NCLEX, graduated, and accepted a job on the oncology/telemetry Med-Surg floor in May of this year. I started mid-June and will be on days with a preceptor for 2 months, then nights with a preceptor for another month. Previous to nursing school I had no medical experience. I worked as a home health aide for about 9 months part time during my pre-reqs, then as a CNA very part time during 2 semesters of nursing school. So going into my first job I assumed I would be a little behind the ball compared to some others and expected it to be rough. Surprisingly, the last month has been very enjoyable. I look forward to going into work, and am still amazed to be getting paid for what I was doing for free during clinicals and capstone :) I have taken 4 patients (our typical load) every day, including my very first on the floor. I have made mistakes, but nothing that hurt anyone, and I have learned from them all. Looking back on it, I think the key for me was to go into the experience with an open mind, knowing that at anytime it could get hairy, and that's okay. I swear I ask hundreds of questions of my preceptor every shift! When I get overwhelmed I suck it up and keep moving forward until I get through it, then I de-brief with my preceptor and ask for advice on anything I could have done differently. So far I haven't cried, though I know that day could be coming :) So anyway, I just wanted to tell everyone that the 1st year (or at least the 1st month!) isn't always terrible, and there are some things you can do to make it better. Have an open mind, a humble heart, and a thirst for knowledge. We can do this!

By the end I got my % up to around 70, I started in the low 50's though. I didn't write anything down, I just did tests on study mode so I could take my time and read the rationals for each right and wrong answer. The testing strategies are built into the rationals- the wrong answers say why they are wrong, and help you to narrow down the correct answers on similar questions.

Just wanted to give another great review for Uworld. I used Uworld almost exclusively and passed with 75 questions (42 of them SATA!). The format for Uworld is very similar to the format of the NCLEX, which helped with my nerves. There are a lot of SATA in Uworld (much more than any other test prep I reviewed) and I think that helped me a lot, especially since I had so many SATA on my NCLEX. Uworld also teaches great testing strategies for SATA, safety, and prioritization (by far the most common categories I got on my NCLEX). The testing strategies in Uworld helped me get questions right, even when I had no idea what the answer was. For example, my first NCLEX question was over a drug I had never heard of. The question was something like "What would you tell a patient about the side effects of ____?" I started to freak out, but then was able to use the testing skills that I learned through Uworld to figure out the correct answer, based on the answer choices available. In addition to Uworld, I used LaCharity for the last few days before the NCLEX. I am not sure if it helped a lot, but it did make me more comfortable about potential delegation and priority questions. Anywho, just wanted to give my 2 cents on test preps. I found Uworld to be much more similar to the NCLEX than the other test preps my chohort used, and at the bottom end for the price scale too. Happy Studying!

I am just using Uworld. The questions are both testing strategy and content. I love the rationales, that the ability to review missed questions and those that you choose to flag.

I am really struggling with this and I thought maybe ya'll could help. I start Capstone next Monday and need to develop 3 individual goals for my capstone experience. I am doing my capstone in a small rural hospital about 30 min from the large city I live in. The experience is different there because they don't have assigned floors/units. The nurses on duty split the patients on the floor, while taking turns with ED admits, scheduled outpatient infusions, and laboring moms. They also have a different documentation system than I have used before. My purpose for taking this capstone (as opposed to a hospital in the city) was to get a chance to see more different things during the experience instead of just ER, or just med-surg, etc. That being said, I am struggling with coming up with specific goals to achieve. Thanks for any advice!!