owlhaveyouknow

Accessing a port-a-acth is oddly satisfying to me. Especially when it's tricky and you get blood right away.

Yep, you just described me to a T. It bears repeating that learning to let things roll off your back will really help you. Learn what requires action and what doesn't. Another piece of advice would be to go into an area of nursing that fits your personality. It doesn't sound like you are the warm fuzzy type, but would perhaps do quite well in an ER. Learn your job and learn it well. Become the person that everyone goes to and with that will come respect and it will also negate most of your qualities that you are concerned about.

Go for it! The other posters are right- usually if you want to go back to nights, they will gladly take you back and typically there are more staffing issues/needs at night so it's not usually a matter of staffing. Who knows when this opportunity will come around again? Just from my personal experience, I have been a nurse 13 years and I worked roughly the first 6 years on nights. I didn't realize how bad I felt and how much sleep and life I had been missing out on. I sleep so much better and it's truly so much easier to make appointments/go to classes. And I also felt like I didn't really belong on day shift initially. I didn't know any of the people but as time progressed, they have become just as close as my previous nightshift family.

Yep, sounds like emotional burn out to me. I worked in the ED about 10 years before I started feeling like this. I made a change to an ambulatory care setting and it was refreshing.

As someone who has seen both sides of the coin, here's my little bit of advice: Follow the golden rule before anything else: Keep them breathing, keep them safe. If your preceptor does something that puts either of these into question, then you have the right to speak up and speak up quickly. For the rest of the time, pay attention to your preceptors assessments. Most seasoned nurses (especially ER nurses) have the ability to quickly whittle away useless information/physical findings and hone in on what is pertinent. This will be difficult at first for you but will be a huge time saver as you develop this ability. I would also encourage you to pay attention to their procedural skills and get all of the education/tips and tricks related to these procedures that they will give you. We can all read the procedure of how to place an NG tube, but what separates the experienced nurse and you is experience from having done these procedures over and over again. They will have knowledge that the book simply can't provide. Another thing that I encourage new grads to do is ask why. Some people find this annoying, but there are so many things that experienced nurses do that are like second nature, that they don't even think about or realize they are doing. However, asking them why will give them the opportunity to explain to you, which will help you understand why they are doing what they are doing, which will in turn help you to understand your job better. Go with the flow and follow what your preceptor teaches you and like previous posters have said, unless it is going to cause harm to the patient or directly goes against your hospitals policy and procedure, just pay attention and change your practice as you see fit when you are on your own. Good luck with your new nursing job!

You sound just like me! I worked in the ER for many years before transferring to in hospital endoscopy. It's a small department and typically one where someone has to retire or die for a position to become available. I'm not sure how your hospital functions but we prep all of our patients which includes gathering health history and other pertinent information, starting the IV and placing them on all the monitoring equipment and getting the rooms ready. We typically have techs in the rooms, but that's not always the case. Sometimes it's two nurses, so one will sedate, monitor the patient and chart and the other will assist the provider during the procedure. We also recover our own patients, which includes frequent vitals and assessment as well as patient teaching and discharge instruction. It was a big change. You go from having upwards of 6 patients to only one if you're in the rooms and maybe 2-3 if you're working recovery. You'll still be busy, but it's not the constant mental multi-tasking of thinking of what each of your patients needs or being in triage and having that pressure of patient after patient checking in. Usually, you know how many cases you have scheduled when you come in. There will be add-ons, but there's an end in site. Unlike the ER, there's no waiting to give report to someone and when you're done you get to go home. Please feel free to let me know if you have any other questions and to let me know how you're liking it so far.

Highest was 106.7 on a one week post surgical patient with sepsis. Developed DIC and died. Lowest I've seen was 86 on a patient would got drunk and fell into a creek and stayed there for few hours.

Have you determined what any of your triggers are? I began having migraines when I was in college. I slowly whittled the list of possible triggers down and have realized that my migraines are almost exclusively caused by lack of sleep. I've since put myself on a strict schedule (yep, old lady bed time lol) and have done much better since then. I also take Maxalt at first signs of a migraine and am to the point where I only have maybe one to two uncontrolled migraines a year that interfere with my work.

As an ER nurse, I'll put my two cents in. I don't mind calling report a bit. I work in a hospital that has an EHR that is available no matter what unit you are in. With this said, I still don't mind calling report. I try to give a concise account of all of the pertinent information and answer any questions. I actually like giving report because I agree that some things just can't be conveyed in the chart (i.e. his wife likes to write everything down, they are stealing all of our gloves etc. lol) In the defense of some of the ER nurses, I have been asked many times if the floor nurse can call me back. Usually I don't mind at all if they call me back, but we have been given timelines by administration that we are to follow. I have approximately 30 minutes to get the patient out of the ER and admitted from the time a room is assigned to them. I will also say that unless it is a critical patient that has been coded/trauma services rendered, there is no excuse for their charting not to be up to date. The only times I can justify a patient leaving my care without their charting being completed would be a STEMI or someone emergently going to the OR. I would also like to give floor nurses some insight on why the person calling report doesn't know a lot about the patient they are sending you: Our nurse to patient ratio in our ER is 5:1and we turn patients over very quickly. We often times have a floater who is able to help where needed, usually on discharges/tasks/etc. So say I have a patient who fell and broke their hip and now has a bed on your unit but I am also in the process of receiving a new patient via EMS, the floater will proceed to call report on the hip fracture (again my charting should be up to date) so that I can devote my attention to my new patient to determine whether or not they are stable and attempt to stabilize them if necessary. I know this isn't fair to you, but it is the most efficient way to handle the situation that I can think of (again, I can't let the patient stay in my room if a bed has been assigned to them upstairs). I usually get along well with most floor nurses and report goes smoothly, everyone just has to be prepared for a little give and take.