NurseIndependa

Which one costs more? Because I have read that going to med school in the Caribbean is incredibly expensive, roughly a quarter of a million dollars including food, transportation and accommodations. Attending CRNA school might be expensive too but it shouldn't be as high as $250,000. I would go with whichever would leave me with less debt. And like wtbcrna stated, your residency/employment is limited. You are not guaranteed a residency in the US and without that you cannot practice here.

My dream job is to work for the VA so I would not leave because of what has been happening recently. It is unfair, but you are thinking about getting your masters and advancing anyways so in the long run this won't hinder you.

I would recommend doggie daycare. If it is a good facility, they will be clean. I think it is worth it because when we took my dog, he came home tired and slept the whole next day too. Your puppy will become well trained socially through doggie daycare.

I need to add my input on this part of your statement. There is not always more documentation than med surg, but in my ER there is still hourly rounding and expected patient updates like approximately what time the IN infusion stopped. There's tedious stuff you still have to document too... the psych patient who needs restraints, the patient refusing care. Heck, my ER just started mandating that we document whether an aspirin was chewed or swallowed. We also don't get traumas all the time; some days its 5 or 6, other times we go days without any. We get a lot of abdominal pains, chest pains that are really indigestion or pulled muscles, headaches, pain seekers or unnecessary nursing home send outs. I really wish I had been more realistic about the types of things I would see before I decided to work in the ER.

Honestly, I just applied to a wide range of programs in the surrounding area. All of them were at well respected hospitals, had at least 12 weeks of orientation and allowed me to work on a unit I was interested in. Also, some programs I looked at paid less during the orientation. I did not apply to those programs because I wanted full nurse pay. My experience was very good. 20 weeks of orientation and one on one with a preceptor. I am in the ER, so we did online modules recommended by the Emergency Nurses' Association for new ER nurses. We attended 2 weeks of classes where we were lectured on different topics relevant to the ER. The residency also paid for me to become certified in ACLS and PALS. So overall I can't complain, it was worth the extra effort (studying for certifications) to have those 20 weeks.

Good luck to you!! My husband is military, so I hate that constant state of unknown that you are talking about! It is really hard to make any sort of goal

I honestly think it just depends. I have a friend who is a AGNP, yet she works in a OB GYN office specializing in oncology.

ALWAYS be nice to your techs. They do so much for you. And when you are caught up with orders, offer to help others. They will see you going the extra mile & help you when they can (if they are decent people). Breathe. Always prioritize. I had 4 patients today that all had orders. I constantly prioritized them so I got the most necessary stuff done. So one patient didn't get discharged right away. That's ok because my admitted patient had no outstanding ER orders when the floor nurse came to pick them up. Document like crazy!! Yes, pain is subjective, but when someone says "my abdominal pain is 10/10" yet is laughing when you aren't in the room or sipping soda when they think you aren't looking, it's important to make note of that. "Pt reports 10/10. Pt does not appear to be in any acute distress. Upon entering the room, the RN found the pt eating a bag of chips and taking snap chats". Keep a note book in your pocket to document times you completed tasks if you get too busy to chart right away. That's all I can think of right now. I worked today and my brain is fried.

We are 1:4. If someone gets an ICU pt or trauma, other nurses are supposed to step in to help out with the remaining patients. If we are really under staffed and have to open the back part of the ER, we get 5 patients.

Nursing has a lot of options. Look into insurance companies, hospitals or other healthcare facilities for job openings. You could even go back to school and become a nurse practitioner, informaticist, educator or administrator.

Can we get administration to understand that too? I feel like the obsession with satisfaction scores is the biggest underlying issue. I get that hospitals want to have excellent ratings, but they can't burn out their nurses at the same time with high patient ratios (and still expect me to have hourly rounding live documented, medications on time, etc). It has to be a balance.

The culture shock from nursing school to bedside nursing is INSANE & I can't see myself doing bedside nursing for the long haul. Your post hit the nail on the head.

I would do it if it offers better opportunities in the future (which it will, since you will be a NP). Good luck!!

I do ask for help. I meant I have my go to experienced nurses that I seek out for advice and help, there's always at least 1 or 2 per shift I feel comfortable asking. I should have expanded on that.

I completely agree with your post, OP. I am a new ER nurse just getting off orientation and my anxiety is SKY high. My unit is short staffed and some nurses have such attitudes that I feel uncomfortable asking for their help. I am actually applying to graduate schools in the fall just because I am seeing I can't do bedside forever. Definitely see your doctor about medication. Take it day by day & know that you are slowly getting closer to the 1 year mark where you won't be the new grad anymore. Then you can apply to another unit that interests you.