PedsRN03

I've been an RN working in acute care pediatrics for almost 3 years now. I love the kids, but sometimes feel like the hospital is not where I want to spend the rest of my career. After 3 years, I still get queasy about dressing changes, cathing, suctioning trachs, etc. I prefer patients who are more stable and like patient and family education. Also I feel like the schedule is getting to me. While it does have some advantages, I feel like it is starting to affect me. I work nights and every other weekend and there is no hope in my job of going to days anytime soon and days are way too stressful there anyway. I feel like I am always awake all night on my time off and spend a lot of time alone. It is very hard to spend time with friends, date anybody, spend time outdoors, or feel like I have any kind of life. It was ok for awhile, but doing this schedule for a long time is starting to affect me and I definately can't do it long term. Also working in the hospital lately, sometimes I feel like I am just a number in the staffing rather than a respected professional. I just got accepted to a really good Masters in Public Health program. The program sounds like it fits my interests perfectly. The program lasts about a year to a year and a half. I do like some things about nursing in acute care and am not sure I want to give it up entirely. It sounds like the MPH program is intense and I'm not sure there will be time to work while in school. I'm thinking in the future I could work in a hospital once a week or pick up shifts to make extra money or use acute care as something to fall back on if I am having trouble obtaining a different type of job. If I take time away from the hospital to do the MPH program would it be difficult for me to ever again get an acute care job? I think the ideal soloution would be to do the MPH program and maybe work one shift a week at a hospital while in school, but I'm not sure if that will work out. Also I am in my second job as an RN. I left the first job because I wanted to relocate...leaving had little to do with my abilities or satisfaction with the job. If I leave my second job for the MPH program will it look like I can't hold down a job when I go to get a job in the future? (I will have spent about 1 1/2 years at each job).

Pros: this type of sheet would be useful for continutiy of care Cons: the majority of my shifts I would not have time to fill out the form. and I'm sure if my shift was crazy I would be just as likely to forget something as I do in report.

I agree with KatieBell. Definately take a job as a nursing aide before you decide if you want to be a nurse or not. My roommate was going to become a nurse, and took a job as a nursing aide and then realized nursing was not for her after being told she would have to learn to put in a urinary catheter. I volunteered in the hospital gift shop in high school and shadowed a nurse for a day. (Of course the day I shadowed happened to be unusually quiet and I got the false impression that nurses had tons of time to spend with the patients and families). I had a very false impression of what nursing was like when I decided to major in nursing. Ive been out of school for 2 1/2 years and I do love some parts of my job, but honestly, if I were to go back and do it again I think I would go for another kind of career working with kids. Here's my personal list of pros and cons of going into nursing. Pros: interacting with patients, wide variety in job options, great learning opportunities, job stability, easy to find a job, decent pay, only have to work 3 days a week, can easily pick up extra shifts if in need of extra cash, feeling like you are doing something meaningful with your life. Cons: long hours, inconsistent schedule, have to work weekends and holidays, feeling tired or worn out from the hours and inconsistency, usually have to start on hospital floor as new grad, staffing issues, have to do invasive procudures (foley's, IVs, NG tubes, etc). "difficult" or non-cooperative patients and families, times when things are changing with multiple patients and everything is important and there is immense pressure from docs, families, etc. wanting everything done right now, feeling like a waitress at times, pressure to wear many hats (get a soda, watch the kid, compliants about the room not being clean, the tv needs to be fixed, etc.) while you are busy just trying to get your nursing duties done, when patients or docs act like they are the only patient you are dealing with, trying to get your job done in a timely manner when you don't have the supplies there to do your job (meds, equipment, etc.), having to clean up bodily fluids and sometimes get them on you (blood, urine, stool, vomit, wound drainage, etc.), heavy lifting at times, having to perform skills with dexterity and make sure you remain completely sterile, being responsible for someone's life when you can not constantly keep an eye on them, dealing with patients dying or getting bad news, trying to support the families during these times while dealing with everything going on with your other patients, dealing with unit politics, worrying about tranporting patients to tests when half the time there is no transport person scheduled, not having time to follow up on important things about your patient, (read the chart,routine x-ray results, non-critical lab results, etc.),doctors who don't communicate new findings or their plan of care to the RN (tell the family something but don't tell the nurse), being blamed for things that are not completely your fault (kid doesn't get down to ultrasound for whatever reason, med is late because pharmacy didn't send it up...etc.) feeling overworked and under-appreciated at times. I'm sorry..I dont' mean to be so negative! There are many realities to consider before you make a decision. There are good and bad things about nursing..Some people love it and some don't. Good luck in your decision!

Hi! I've been a nurse in acute care pediatrics for almost 2 1/2 years. I always assumed after graduating nursing school I would work for a year or two and then go to an MSN program to become a Pediatric Nurse Practicioner. However, after 2 years in the hospital I still don't feel like I'm very confident with my physical assessment and clinical skills. Most everybodys lungs sound fine to me. I don't pick up on decreased lungs, edema, IV infiltrates..etc. I can't palpate a liver or a bladder for the life of me. Invasive procedures still freak me out. I try to avoid patients with trachs, deep suctioning, wound packing, and changing central line dressings at any cost. I have yet to successfuly do a straight cath or place a foley (on a boy or girl) after serveral attempts over several years. I don't try to avoid these situations because I am lazy. I just do not feel comfortable or that I am competent in these skills. I used to jump at the chance to do any of these things when they came up to try to improve, but I am tired of feeling like I'm making patient's suffer. I always break sterile technique no matter how hard I try not to and most of these things end up a disaster when I attempt them. I have worked in 2 hospitals and have had an awesome support system in both, I am just getting frustrated with myself. I was allowed to slip through the cracks and pass school and orientation with the excuse that these skills would be improved with time and I could ask a senior nurse if I need help..well they haven't and I am starting to feel like I am putting the patient's health and safety (not to mention my lisence) at risk at times. I feel like I have worked very hard to improve my clinical and physical assessment skills and they have improved a little (I can actually finally insert an NG tube. yay!), but I just dont' feel like I have very much natural talent for this. On the positive side I am good at some things. At my old job I did a lot of patient/family education mostly in Diabetes care and LOVED that part of nursing. I also loved assessing the families needs and collaborating with the case manager/social worker to get them set up with their supplies. I find that my thinking is very psychosocially based in my care. (For example, I had an argument with the charge nurse the other night because I agreed at the parents' request to wait an hour for the parents to be present to replace the 3 year old's PIV. He was due for scheduled lasix..but was in no acute distress). I'm starting to figure out now that clinical nursing is not right for me for the long term. Do you think I've given it enough time after 2 years and trying 2 different clinical areas to come to this decision? I've come to the point where I feel like its the right time in my life to return to school. I feel like the only thing keeping me at the bedside is the nice paycheck, but I don't see myself really going anywhere with this path. My dilema is just about what kind of grad program to apply to. I do like some parts of my job. I love the kids (for the most part) and I can't imaging working for any other cause. I also have an interest in pediatric, perinatal and reproductive public health issues. I am interested in either case management, health education, or public health. I am also interested in eventually participating in research on the psychosocial impact of illness and on stress and depression among nurses. I know I can get experience in all those things through an MSN program and I feel like the natural thing to do would be to go from BSN to MSN. However it seems through my research that most MSN programs are focused on physical assessment and diagnosis and I don't really see myself doing well in an NP program (or being a good NP.) The only thing pulling me toward doing an MSN as opposed to another type of program is that people with an MSN generally make a higher salary. I have done a lot of research and I am considering applying for either a Masters of Social Work with a health care concentration or a Master's of Public Health with a concentration in either Maternal Child Health or health education or a dual degree MSW/MPH program. I know these aren't the traditional route to go from a BSN, but I feel the curriculums of these programs meet my strengths, interests, and career objectives better than an NP program. I also loved the few social welfare classes I took in college and would have taken more if it had fit into my nursing curriculum. Thanks for reading my long drawn out dilema..does anbody have advice on what route I should take? I think I know what the right decision for me is but it is a huge decision. P.S. I'm not really as bad of a bedside nurse as I make myself seem

Hi! I've been a nurse in acute care pediatrics for almost 2 1/2 years. I always assumed after graduating nursing school I would work for a year or two and then go to an MSN program to become a Pediatric Nurse Practicioner. However, after 2 years in the hospital I still don't feel like I'm very confident with my physical assessment and clinical skills. Most everybodys lungs sound fine to me. I don't pick up on decreased lungs, edema, IV infiltrates..etc. I can't palpate a liver or a bladder for the life of me. Invasive procedures still freak me out. I try to avoid patients with trachs, deep suctioning, wound packing, and changing central line dressings at any cost. I have yet to successfuly do a straight cath or place a foley (on a boy or girl) after serveral attempts over several years. I don't try to avoid these situations because I am lazy. I just do not feel comfortable or that I am competent in these skills. I used to jump at the chance to do any of these things when they came up to try to improve, but I am tired of feeling like I'm making patient's suffer. I always break sterile technique no matter how hard I try not to and most of these things end up a disaster when I attempt them. I have worked in 2 hospitals and have had an awesome support system in both, I am just getting frustrated with myself. I was allowed to slip through the cracks and pass school and orientation with the excuse that these skills would be improved with time and I could ask a senior nurse if I need help..well they haven't and I am starting to feel like I am putting the patient's health and safety (not to mention my lisence) at risk at times. I feel like I have worked very hard to improve my clinical and physical assessment skills and they have improved a little (I can actually finally insert an NG tube. yay!), but I just dont' feel like I have very much natural talent for this. On the positive side I am good at some things. At my old job I did a lot of patient/family education mostly in Diabetes care and LOVED that part of nursing. I also loved assessing the families needs and collaborating with the case manager/social worker to get them set up with their supplies. I find that my thinking is very psychosocially based in my care. (For example, I had an argument with the charge nurse the other night because I agreed at the parents' request to wait an hour for the parents to be present to replace the 3 year old's PIV. He was due for scheduled lasix..but was in no acute distress). I'm starting to figure out now that clinical nursing is not right for me for the long term. Do you think I've given it enough time after 2 years and trying 2 different clinical areas to come to this decision? I've come to the point where I feel like its the right time in my life to return to school. I feel like the only thing keeping me at the bedside is the nice paycheck, but I don't see myself really going anywhere with this path. My dilema is just about what kind of grad program to apply to. I do like some parts of my job. I love the kids (for the most part) and I can't imaging working for any other cause. I also have an interest in pediatric, perinatal and reproductive public health issues. I am interested in either case management, health education, or public health. I am also interested in eventually participating in research on the psychosocial impact of illness and on stress and depression among nurses. I know I can get experience in all those things through an MSN program and I feel like the natural thing to do would be to go from BSN to MSN. However it seems through my research that most MSN programs are focused on physical assessment and diagnosis and I don't really see myself doing well in an NP program (or being a good NP.) The only thing pulling me toward doing an MSN as opposed to another type of program is that people with an MSN generally make a higher salary. I have done a lot of research and I am considering applying for either a Masters of Social Work with a health care concentration or a Master's of Public Health with a concentration in either Maternal Child Health or health education or a dual degree MSW/MPH program. I know these aren't the traditional route to go from a BSN, but I feel the curriculums of these programs meet my strengths, interests, and career objectives better than an NP program. I also loved the few social welfare classes I took in college and would have taken more if it had fit into my nursing curriculum. Thanks for reading my long drawn out dilema..does anbody have advice on what route I should take? I think I know what the right decision for me is but it is a huge decision. P.S. I'm not really as bad of a bedside nurse as I make myself seem :roll

Assessments take a long time to have complete confidence with and comes easier for some people than others. I've been an RN for 2 1/2 years and although I feel I've made some improvement, I still don't feel very confident with my physical assessment skills. If you are ever unsure of your findings, you can always ask your preceptor, charge nurse, etc. to take a look or listen.

Hi Jahbing! I have been a nurse for 2 years and went through (and sometimes still do) a similar situation to what you are experiencing. I always got A's in theory in school, but fumbled in clinical. Just recently I passed my PALS course with flying colors missing nothing on the exam, and the instructor was impressed with my performance in the simulation, however in the couple of real situations I've had where patients have become critical I have completely fallen apart (once even to the point that the charge nurse took me away from the patient and assigned them a different nurse). I think it is good that you recognize your weekness and the things you need to work on, but you are being way too hard on yourself. Hospital floors are very busy and very hard places to work, especially when you are just learning the ropes. Have you talked with your educator, manager, preceptor, etc. about how you are feeling? Have they approached you about your performance? 8 weeks of orientation for critical care and only 2 weeks on your home floor for a new grad seems kind of short to me. Especially since some of this time was spent in a classroom and not actually working on the units. If you aren't feeling ready to work on your own perhaps you can ask for some extra time on orientation. If they are giving you patients of higher acuity right now, maybe you can ask for less acute patients while you work on your skills an time management. If you are on day shift, you might want to consider switching to nights for ahwhile. On some floors night shifts are a little quieter. I would still give yourself a little while to adjust, but if you still dont' like the pace of the hospital you could try a different floor or move into another area of health care, such as public health or health education. And please take care of yourself! Seeing a therapist may be a good outlet to help you deal with your stress. Good luck!

I'm glad I read your post about YSN. I am an RN and in my grad school search have considered applying to YSN myself. However I have felt turned off by their elitist attitude...it sounds like it's just the way I imagined it would be and it doesn't sound like I'd be too happy there! I don't care what their name is! If they don't value the experience and expertise an RN has (especially one with several years of experience like you) they are just ignorant. Personally, as a patient I'd rather have an NP with several years of experience working with patients than someone who just graduated from school and their only patient contact was a few clinicals. I would not let these other students intimidate you, because I can gaurantee you DO know more than them. If you feel UIC would be a better fit for you, I would go for it! You sound like you're really unhappy and school will be a much better experience if it is a good place for you. As for reputation, I graduated from another ivy league nursing school. While I actually did enjoy my experience there for the most part, when I went into the "real world" I felt under-prepared and like the ivy league was really over-rated. I actually felt like my fellow new grads who graduated from community colleges and small programs I never heard of were perfroming better than I was. Go with what feels best for you!

Definately!! I moved out here 6 months ago after working 1 1/2 years on the east coast and LOVE it. I'm not sure I can stay here forever because I could never afford to buy a house here, but you should at least try it sometime for a year or two or do a travel assigment here when you have a little more experience. The current starting salary for new grads at the hospital where I work in the bay area is about $35/hour with an 18% differential for nights. I rent a room in a house for $700/month which is about average but if you're looking for your own place it may be between 1000-1500/month. If you're looking for a hospital in VA, I really liked UVA hospital when I interviewd there looking for a new grad job. They had lots of departments to choose from, their new grad program sounded really good, and the people there were super nice. The salary was about 60% of what I make in California, but I believe the housing costs there are a lot cheaper.

Hi Nursebear, Your preceptor can make all the difference. You still have a good 4 weeks left, and if your preceptor is bringing you down it can make this difficult time even worse. I graduated 2 years ago and had a similar situation with my new grad orientation where my preceptor had unrealistic expectations of me and was negative and harsh, and I almost left the unit. I was scared to ask to work with somebody else because I did not want to make a bad impression at my first job..but I finally ended up making that request. Having a preceptor who could provide balanced constructive feedback made a world of difference and I ended up staying and doing very well. As for the time manangement...work as hard as you can on it, but don't let it get you down. With all the things going on and the interruptions and changes in the plan, admissions, discharges, etc. hospital floors are a hard place to work. After two years, I still feel like I'm pulled in too many different directions and have too much to do and too little time most days. Good luck!

Hi Dave, I have been out of nursing school for 2 years now and had a similar experience to what your daughter is having. When I first started clinicals I found I was not good at many things in the hospital such as manual blood pressures, catheterizations, and changing dressings on deep oozing wounds. People assured me my worries were warrented because I was a student and I should just "stick it out" I too was a book smart "A" student, but fumbled when I tried to apply my education to reality in the clinical setting. Now I have been working in the hospital for 2 years. Some things have gotten better and I have become comfortable with (such as blood pressures and nasogastric tubes). However, some things, I feel no more comfortable with than when I was in nursing school (I have yet to successfully do a urine catheterization...and packing wounds or suctioning a trach still completely freaks me out.) During nursing school after I started clinicals I started to worry that nursing was not for me and contemplated switching majors. Honestly, I am still not sure bedside nursing is right for me. From my experience working, I have found that there are many other ways to be in a caring profession or to work for the cause of caring for the sick besides bedside nursing. Now that I have a couple of years of experience under my belt, I am considering moving to an area away from the bedside such as case management, health education, research or doing a program in medical social work. Your daughter may consider one of these areas, or another related field such as school nursing, health care administration, nutrition, public health, or child life. If I were her, I would probably work on her skills and stick it out for at least another semester. If things aren't improving after that, she could talk to her advisors about alternative career paths to bedside nursing. Chances are if she is struggling with her skills in school, she will continue to struggle during her orientation and in her work. Bedside nursing is a great career for those who it is right for, but it is not for everybody.