Mebzone05

I got report from a nurse. Pt hemoglobin low, hypotensive, and dizzy. Labs were drawn hours ago. Blood ordered. I was told that the blood was ready during report. Nurse argued with me that she had too many patients and couldn't start blood. I advised nurse to start blood prior to transport. We went back and forth on the topic for a minute or so. I simply explained why the blood should be started. The other nurse refused and said that the patient was critical and the ICU needed to handle it. Pt is brought to me hypotensive, with one infiltrated IV, critically low hemoglobin, and no blood consent signed. The nurse then reported me to house sup, and I was told not to be mean to floor nurses during report. WOW!? About a week ago, I downgraded a patient to tele. I went back to my ICU and realized that I left pt belongings in the room. I walked the belongings down to the tele room. I walk in the room, and the confused pt that I just transported is sitting on the bed rail seconds away from falling. I get the pt back in bed and hit the call light. Nobody answers. I find a tech and they tell me they will alert the nurse. I stand there for another 5 mins. I leave and find a nurse and explained to them that the patient is going to fall and I need to go back to my floor. Another 5 mins pass before the nurse finally comes into the room. These are just two examples, I could honestly keep going. Would you guys continue to work for a hospital that you find to be unsafe? I've worked at 3 other hospitals and I've never encountered such low standards and nurses that didn't care about their patients.

I work in a medical ICU. This will be a little vague because I know other nurses I work with that post here. Yesterday, I had an issue where an order was never placed. There should have been labs drawn every 2-4 hours because the patient was on a drip that made these labs necessary. I didn't notice until 1800, I work normal day shift hours. The drip was started the previous day shift. So there were no labs drawn on the previous day shift as well as over night. I am not a huge fan of questioning orders. When I noticed, I brought this up with the provider. The provider was shocked and ordered the lab stat. I placed the order then went to gather supplies to draw the lab. After leaving the supply room, I witnessed the provider making fun of me with a nurse in the nurses station. I am not a MD, PA, or NP. The reason I even asked the provider without just drawing the lab is because the order needs to be for timed labs Q2 or Q4 and I wasn't okay with entering such an order without getting permission first. I didn't know if there was a reason that this order was intentionally not placed. This environment has seemed toxic for awhile and this is simply the latest example. I have been a nurse for 5 years and am currently working on my 4th unit. I do not want to continuously job hop but I don’t know what to do. This is the only unit where I have ever felt the need to constantly question other nurses and the providers. Is this normal? This is also the only unit that I have ever worked on where I feel as though my patients have been put in harms way. I hate this feeling and I am at the point that I am uncomfortable going to work. This is my first ICU job. Most of my experience is ED. Is it my job to search the orders for mistakes? Is this normal in an ICU? Also, the only reason I am in an ICU is for experience to get into an ACNP program that I want to attend. I simply don't think like an ICU nurse. My year experience that I need will be completed in May. Should I tough it out? Any advice would be greatly appreciated

Update: Just accepted a job at a level 1 trauma center MICU/neuro ICU. Closer to my house and better pay. Also got an interview for a level 1 trauma center ED but I think that I want to give ICU a try.

Well, a part that I left out is that nearly a year of my ER time was on night shift. The problems started once I switched to day shift. I believe that there are simply too many nurses fighting for the critical care zone which is only staffed with two nurses a shift. The senior nurses, and the ones that have been on day shift for longer seem to get special treatment. One of our techs literally refuses to work anywhere besides the critical zone which they likely allow due to our high turnover.

Yep. We have no clue what zone we will be in until 5 mins before our shift starts.

All I do is study and watch Youtube videos for skills but I don't have any chance to apply anything in real life. I can't retain the information or skill if I can't actually use it in practice. All of this studying has been a huge waste of my time. I'm studying for my CEN right now.

I have been a nurse for almost 4 years. I have 1 year med surg experience, 1 year obs, and the rest in an ER. We have four zones. One is an urgent care type zone, a medium acuity zone, psych zone, and our critical zone. My first couple of months I pretty much had to beg to get into the critical zone. A year later, I am pretty much in the urgent care or psych zone every shift. I feel completely unprepared anytime I am in the medium acuity or critical zone which only happens once every few months. My skills have gotten worse, my time management is worse, and I am scared to work with high acuity patients at this point. I don't know what to do. I don't know if I'm making any sense, sorry If I'm not clear. I am asked to do things that I've never done, give meds I've never heard of, and be a part of codes when I rarely get any experience in them. It's terrifying. I feel as though I need to start all over. I feel like I wasn't properly trained. I am contemplating leaving nursing all together. I feel like I have absolutely no clue what I'm doing with high acuity patients. I feel like I am a danger to these patients. I almost feel as though I need to redo orientation. Any advice would be appreciated!

My wife is a special education teacher and I am an ER nurse. After every shift I rant about my day to her on my 30 minute drive home. She does the same and we usually end up laughing. We both have extremely stressful jobs. Once I'm home, we don't mention work. Imo, having someone to vent to is necessary for what we do. You should have a long conversation with your husband about the stress that comes with this job. If he simply doesn't want to hear about it, find a female nurse coworker that will listen. Medical professionals love to share stories, almost as much as soldiers. It shouldn't be hard to find a coworker with a similar issue.

My ED would never do this. Sounds horrible.

I wouldn't bother with the TNCC. You need to sit down and really think hard about your career. It sounds to me like you are needed at home. PRN as a new nurse is a bad idea. Experience is what makes you a better nurse. You can get a bunch of certs but they are worthless if you don't have any real experience to apply the knowledge to.

This is true. Don't pay to much attention to what level a trauma center is. I have friends that work at a level 1 and I take care of higher acuity patients more often at a level 3.

This will just make things worse. Nothing will happen to the Doc. Either change jobs or deal with it.

I work in a decent size level 3 ER. A week ago they canceled all of our travelers contracts. We have at least one nurse a night get sent home early. Some nights we have maybe 3 or 4 patients in the entire ER, other nights we get slammed.

I think that you need to pick one thing that is most important to you and let that be your deciding factor when choosing a job. You wanted to learn more but chart less, the job has to be day shift, and you have to work 5 minutes away from your house. It seems like you are looking for a dream job. I always wanted to be an ER Nurse. I work nights which I hate, and drive 45 minutes to work. I pass by three other hospitals on my way to work. ER nursing takes a very specific personality to succeed. It isn't something that I'd advice anyone to randomly apply for simply to work day shift. It is nothing like the ICU. If you want to work in the ICU than either work nights, change hospitals, or wait until a day shift position opens up.

I live in Arizona and I'm confused as to what np school I should attend. I read online that for profit and online only schools are looked down upon. Everyone says that you should go to a "real university." Well GCU and University of Phoenix are the only two NP schools in the state that have on campus lecture, both of which happen to be for profit. University of Arizona and ASU only have DNP programs which cost double the price and are nearly all online. There are no non profit brick and mortar np schools in Arizona. For many reasons, I can't relocate. Anyone from AZ currently working as an NP? What school did you attend? Any suggestions or advice would be greatly appreciated.

I work at a level 3. I have several friends that work at level 1's. At the level 1's they have a code team, stemi team, stroke team, trauma team etc. My hospital has none of that. We do it all.

Hello I am an RN with 2.5 years experience. My first year was in a med surg unit and my second year was in an observation unit. My dream has always been to work in the ED. I was recently hired into a level 3 truama center. I hope to one day become and ENP. I just wanted to give some feedback on my first shift as an ER nurse for new grads or nurses interested in the specialty. The first difference that I noticed between the floor and the ED was the pace. The pace in the ED is insane. You will run for 12 hours straight. I did almost as many IV's and Foleys in one day as I have done in my entire career thus far. Charting is far less of a priority than on the floors. Having a doc present makes things move so much faster. I used to hate having to wait 30 minutes for a call back simply to get a patient some acetaminophen for a headache. I love not having to worry about silly things like a K of 3.5 or a bp of 160/80 in an asymptomatic patient. I love not knowing the diagnosis when the pt arrives. My assessment actually makes a difference in the ED. On the floor I always felt like I was assessing the patient for legal reasons instead of it being of actual benefit to the patient. I put 2 units of blood in a patient in ten minutes instead of it taking like 7 hours. The techs are actually helpful, no offense to non ED techs. I've also never worked in an ICU, which I'd assume that techs there would also be pretty good. The techs are proficient at IV's, lab draws, EKG's, Foley's and straight caths. I didn't have to delegate anything all day. I actually had to tell the tech to let me start some IV's and draw labs because it was usually done before I even saw the patient. Call lights are used far less often and almost everyone is npo so I never had to search the entire hospital for a ginger ale. I dont have to chart a full neuro assessment on a 20 year old with kidney stones lol. It's only been one day but I think I made a great decision. I am nervous though, I feel like I have a ton to learn in a short amount of time. The charting system is completely different and just learning that will take weeks. I was always the person to tell new grads to go straight into whatever specialty they wanted to go into, but my first ED shift has changed my opinion. There is no way, without a ridiculously long orientation, that a new grad with no prior ems experience could succeed in this ED. As a new grad, I was pretty terrible at nursing skills. I had no clue how to read an EKG, nor did I know the treatments for each rhythm. My time management was awful, my assessment skills were mediocre. In my ED, I can pull any med I want to out of the pyxis regardless of a physician's order. As a new grad, not being knowledgeable of many medications and their typical dosages, I'd likely commit several med errors considering the fact that we don't scan medication like we do on the floors. We also don't have to wait for pharmacies approval so you better pay close attention to the patients allergies, electrolytes, and med rec. Knowing what meds not to give depending on things such as liver on or kidney fuction is also something I think that 99% of new grads would struggle with. Can most new grads determine whether or not a pt with kidney failure is ok to send for a CT with contrast? This is something that I actually had to bring up to a physician multiple times during my shift. I doubt I could have properly prioritized my patients as a new grad as well. Idk, maybe I was just a bad bew grad. Either way, I loved my first shift. The ED is awsome. All of you ED nurses out there are heroes. I've never been around so many great nurses at once. I am looking forward to a long career in the ED. I will post an update on day 2. I didn't want to go into any pt details because of hippa and I have other posts on here that could lead to someone to being able to guess what hospital I work at.

Wow this scares me. This is the reason so many nurses are hesitant to do their jobs. Patient complaints are often taken seriously regardless of how absolutely ridiculous they may be. I was taught in nursing school not to give two opioids at the same time. The first verbal warning I ever received was for refusing to give a patient oxy and morphine at the same time. I was so confused. Sorry this happened to you. I would probably start job hunting. Seems like a unit culture issue to me. I have to be able to trust management to have my back.

Good luck everyone

I'm in block two in the NAU CEP. It's not too hard. The nau portion is a lot of reading, discussions, and papers. The CC portion is tough imo. Getting used to nclex style questions take a lot of time. Don't get caught up in the patho side of things. That's what seems important at first but understanding the nurses role is more important. When I realized this my test scores increased. It's time consuming but not overly difficult. I think A and P and micro were tougher class than the nursing blocks. BTW...I have a 4 year old and work full time.

I'm in the NAU CEP Block 2, have a 3 year old, and work 36 hours per week. I'm not going to lie to you, it is very difficult. Not only does working really cut down your study time but the nursing program has a ton of changes that happen on the fly. I have found myself having to change my work schedule multiple times already. As of right now, I start clinically is less than a month and am still not sure which day of the week they will be on. Most employers probably won't want to deal with things like this.

I'm finishing up block 1 right now. The only books I really used during block 1 were the fundamentals book and the drug guide. The Med-surg book was only helpful when I was studying Diabetes. Everyone recommends getting them all, which I did, because you will use them in other blocks.