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Registered Nurse (RN)

Content by caffeinatednurse

  1. caffeinatednurse

    I just need to vent

    Your boss seems to have a good understanding of what is going on with her. I would trust that she is handling the situation to the best of her abilities. I would avoid that particular CNA from here on out, and possibly have another coworker stand by when you do have to interact with her.
  2. caffeinatednurse

    New grad need help

    It takes a while to adjust to the chaos of a med-surg unit. You're often too busy to help out your coworkers, and your coworkers are usually drowning just like you. It's not always like that, but it's not uncommon for it to be that way. Being a new grad on a med-surg unit can be super overwhelming, but it is possible to adjust, with some well-intended advice and assistance. But, there are those units that are not the best environment for a new grad to start out. I hardly feel that a 6 week orientation is sufficient for a new grad. The new grads we've been training on our unit have a 12 week orientation, and they always have the opportunity for a longer orientation, should they require it. I would try to stick it out. It looks pretty bad when you leave a job after a few months, unless you already have another job lined up. Is there a nurse educator that you can speak to? Many times, nurse educators can be the go-between for you and your manager.
  3. caffeinatednurse

    What's the best specialty for someone who hates small talk?

    I actually don't encounter much small talk, working nights on a busy med-surg unit. There might be a little bit of small talk and socializing until my patients are all tucked in and medicated. Most of our families leave by 2100 (hospital policy). After that, it's usually pretty quiet. I rarely find myself participating in small talk when I take a patient to the bathroom at 2 am in the morning. Day shift is anxiety-inducing for me. Even when I'm on my way out out of the hospital at 0730, the amount of socializing going on around me is overwhelming. I don't know how our day shift nurses handle it, honestly.
  4. caffeinatednurse

    Recently diagnosed with Sjogren's & possible MCTD

    I'm also youngish (27 years old) with several autoimmune disorders. I have Hashimoto's thyroiditis (autoimmune thyroid disorder), fibromyalgia, systemic lupus (SLE), and inflammatory arthritis. I was diagnosed with fibro, SLE, and arthritis shortly after graduating from nursing school. I currently have three specialists who work really, really hard to keep everything in check. I'm lucky that a majority of my symptoms are effectively managed with my current medication regimen. I've been able to continue working in nursing in spite of my doubts. During a previous flare, I worked in LTC. I worked eight hour shifts, and was able to sleep as much as I needed to. I made more money than I did at the hospital. Shortly after I was hired, I became a supervisor and was effectively off the floor and in an office during the remainder of my time there. But the stress level was really high.
  5. caffeinatednurse

    Is it possible to get my RN while having Lupus?

    Short answer: Yes. It is totally possible to complete RN school with lupus. Being a new grad with lupus is difficult, however, and required some major adjustments on my part. I actually started out in a hospital new grad program, working 12 hour night shifts, had a major lupus flare (though I did not know it at the time), ended up leaving that job, and later found successful work in LTC. I've been back in the hospital environment for over a year now and I do like it, but I would be lying if I said that it wasn't more difficult sometimes because I have lupus. I take a mix of DMARDs, prescription strength NSAIDs, and sleep much more on my days off. Being a nurse with lupus requires extra self-care and self-awareness, and a good rheumatologist in your corner, but it is doable. If you already have a decent amount of nursing experience, consider snagging one of those lovely jobs in case management, clinic nursing, or with health insurance companies. Or go ahead and get your master's. I plan to do the same once my current contract is up.
  6. caffeinatednurse

    Nurses with SelfHarm Scars

    If you're comfortable talking about it with stranger, then I don't see anything wrong with telling the truth. If it makes you uncomfortable, then I second the wearing long sleeves or coming up with a snarky or funny reply that will redirect their attention. While most of my coworkers have visible tattoos, I choose to cover mine up with long sleeves at work. They're deeply personal to me and I don't want to have to answer questions every time a pt or coworker sees them. If you do decide to get tattoos to cover them up, that's something else to consider.
  7. caffeinatednurse

    Starting out in LTC?

    Absolutely not. I worked in LTC for a little over a year as a new grad BSN RN. I quickly climbed the ranks and ended up working as the sole 2nd shift CN. Then I was orienting new grads and new CNs for a while. Then I was their admissions nurse and fulfilling the clinical coordinator duties. Let me just say, if you can handle LTC for a year, you can handle anything...including acute care. When I left LTC and went back to acute care, I had NO problems with time management. You'll also find that you become quickly skilled at things like skin assessments, wound care, and prioritization - all very important things in acute care, too. I've also met many, many nurses who worked in LTC before transitioning to acute care - including my current manager.
  8. caffeinatednurse

    Do FNP's really make 80k to 90k a year?

    "Will work for"? It's not much of a choice, really, unless a nurse wants to move. And not everyone can afford to do that.
  9. caffeinatednurse

    Do FNP's really make 80k to 90k a year?

    Unfortunately, no. The area I live in has a high cost of living and a shortage in affordable housing. What healthcare workers are paid has not caught up with the cost of living yet.
  10. caffeinatednurse

    Is it hard finding a job after graduating?

    I live in a rural area, so I really can't speak to the job market in big cities. Acute care (hospital) nursing jobs are plentiful where I live. We actually have a shortage of nurses at my hospital, if you can believe it. As a new grad, I easily landed a hospital position within a couple of months of graduating. LTC and ALF tends to hire quite a few new grads too, although I know that's not everyone's cup of tea. For me, it was a pay check and valuable experience that landed me my next hospital job. Be willing to work anywhere as a nurse for at least a year.
  11. caffeinatednurse

    Quit while on orientation

    I would not want to burn bridges with a company I had worked for, for years. What if you change your mind later on down the road and decide that you want to work for them? You might not be able to then.
  12. caffeinatednurse

    Nursing with mental illness

    I have yet to be asked about my mental health. I have several coworkers who have a mental illness or two, and take medications for it. While my depression is currently stable, I have had to take anti-depressants for it in the past. I personally wouldn't disclose it even if I was asked about it, but that's me.
  13. caffeinatednurse

    Quit while on orientation

    Been there, done that. Be aware that your current employer could put you on a black list to keep you from taking up precious orientation resources again in the future. This may or may not be a big deal for you. But do keep in mind that even small hospitals are owned by bigger corporations that own other hospitals and doctor's offices...and that they often share a large HR office that processes the same applications. This is what happened to me as a new grad. Either way, it is not a decision to be made lightly. If you're satisfied with your current employer, and the move is just for $ you could be making a big mistake. And "dream jobs" in nursing rarely turn out to be such. Just something to keep in mind. At the very least, give a notice and a decent recent why you're leaving. But don't be surprised if they show you the door immediately.
  14. caffeinatednurse

    New grad sinking fast

    Hand-holding is normal. Feeling uncomfortable in your new role is normal. It's too early to know whether or not you're cut out for this. Remember to breathe, try to learn as much as you can, and ignore the gossip. Chances are, you're being way too hard on yourself. The only people you should be concerned about right now are yourself, your preceptor (since they're the one teaching you), and your patients. Try not to worry about what management thinks about you - they know that you're new and that you're adjusting. Those other nurses? They may or may not stick around, and it matters none to you either way. You've got this.
  15. caffeinatednurse

    Do FNP's really make 80k to 90k a year?

    NPs clear about $80k starting out in my area of NC. Most RNs start out at about $45k per year. I do know of a few RNs who clear nearly as much as that working 2 jobs (one full-time and another PRN job). With overtime, I made around $65K at my last job (I was paid $35/hour for every hour of overtime and was pulling about 35-40 hours of overtime per week). However, I was constantly exhausted and did not have the time to spend or enjoy any of that money. The most exciting thing that I did was buy a car. Most NPs in my area can easily make $90k to $100k after a few years of experience and in the right specialization. Hospitals tend to pay more here while primary care offices usually pay less.
  16. caffeinatednurse

    Best choice for emergent desaturation in COPD

    Depends on their code status...we had this very same issue a couple of weeks ago on my unit. Pt became unresponsive with O2 sat of 76%. End stage COPD. Pt was a DNI (do not intubate). Thankfully RT was steps away from the room when it happened. RT initiated BIPAP, and after the rapid response was over, that was what the pt ended up staying on. Had they been a full code, I could have easily seen the pt being intubated and transferred to ICU. FYI a nonrebreather in an emergent situation is fine if it's all you have and RT isn't around. Your next move should be to call a rapid response or code blue. An MD will always show up to one of those - so will RT.
  17. caffeinatednurse

    Getting back into hospital nursing

    What have you been doing during those three years? If you've been working in another area of nursing, it shouldn't be too hard. I was working in LTC before I decided to go back to med-surg. I could apply a lot of the skills I had picked up there (time management, supervisory experience, being a preceptor, wound care, admissions, etc.) to my new job. The hardest part for me was relearning some of the technology that I hadn't worked with every day in my old job. That and learning hospital policy regarding certain things - my current hospital (a community hospital) operates much differently than the hospital I previously worked at (a regional access hospital and large corporation). If you've not been in nursing during those 3 years, it might be a little harder to get a hospital job immediately. A refresher course might be helpful and might also make the hospital feel better about hiring you. It seems like everybody stays just a year and then takes off, so anything you can do to make yourself look better on resume should help.
  18. caffeinatednurse

    Starting over

    I was in a similar position a year ago. I started out in med-surg, left before my year was up, spent some time unemployed (due to the superior job market in my area), ended up in LTC for a year, worked as an RN supervisor, and then landed in med-surg again. I was lucky and landed in a great hospital with a great preceptor (now mentor) who ended up being one of my best friends. I have learned so much from her, and continue to learn something new every day, even though I've been off orientation for nearly 7 months now. You can do this. Do not psyche yourself out of a great job and learning opportunity. Take each day as it comes. Find your organization style so that you can process the necessary information you need to give and get a decent report. Try to learn something new every day. Find out who your resources are - whether that be RT, PT, your CN, the MD who doesn't mind answering questions, or a seasoned NA who has your back when the census skyrockets on your unit. Before you know it, you will have been there a year and you'll find yourself showing the new nurses and float nurses around the unit. Chances are, you probably already know more than you think you do. You just have to learn to trust yourself and your intuition. Don't be afraid to ask questions. Find a mentor. You can do this.
  19. caffeinatednurse

    Patients & Pet Peeves

    Families that act like their loved ones are the only pt I'm taking care of. Families that ask questions that I cannot answer because, quite frankly, they were meant for the doctor to answer. Families that want me to stay at their loved one's bedside and provide 1 to 1 care all night long. Families that stand there and refuse to leave even though visiting hours are over until I've given their loved one "all of their evening meds" or "all of their pain meds" etc. Pts that are there for observation only, but they bring all of their stuff from home and expect to have all of their home meds ordered even when they're NPO and the MD isn't 100% sure that their extensive home meds aren't the reason why they're there in the first place. Pts that took all of their home meds before coming into the hospital (or multiple doses of), cannot keep their eyes open while talking to me, are slurring their words, but rate their pain 10 out of 10 and will not stay off the call bell on the count of clock watching. Pts that ring their call bell for pain meds, and while I'm in the med room pulling their meds from the pyxis, they hit their call bell again and demand their pain meds. Like, excuse me? I didn't know I had superhuman speed here. Give me at least five to ten minutes to meet your needs before you start hitting your call bell again. Pts that pull out their IV/NG/Foley/etc. and expect that I WON'T be putting it back in just because they figured out how to remove it from their body. Or better yet, when they whine about me putting it back in. Ahem. Maybe we wouldn't be doing this if you had just left it in and followed your doctor's medical advice? Just a thought. I'm sure there's more. That's just my top eight from working on a med-surg/tele/ambulatory surgery/dual dx unit. Sorry if I sound jaded or cynical.
  20. caffeinatednurse

    Hours of sleep before work

    6. But I have a long commute. I'm pretty sure I would get 7-8 hours if I lived closer to the hospital.
  21. caffeinatednurse

    Do 3, 12 hr shifts for weekdays only exist?

    Yes, they exist. We have several NAs and RNs on our unit that work a variance of this schedule.
  22. caffeinatednurse

    Dr makes me feel so incompetent?

    Was it a scheduled dose or a PRN dose? I understand checking the BP prior to a scheduled dose, but we don't commonly recheck the BP a certain time after the dose. What usually happens on my unit is: I check the BP @2100, I give the pt their scheduled dose of BP medicine. Then I recheck their VS @2330 because their Q4HR VS are due. The only time I would recheck their BP earlier than that is if it was unusually high. If it's a PRN dose, what are the parameters? Our providers typically write out parameters such as, "give PRN dose of clonidine 0.1mg for systolic >170 or diastolic >100. Hold for diastolic I'm not trying to make excuses for this provider. I'm sure they were quite snippy with you, and many times, providers do this for no reason at all. But they also receive a lot of phone calls when they're on-call, and I find it helpful to think about this before I pick up the phone and call them. When in doubt, I run it by my CN and pick her brain. A simple, "would you do this?" can save you and the doctor a lot of time.
  23. caffeinatednurse

    Help!! New nurse that hates Med/Surg!

    A couple of things: 1. I find it hard to believe that you hate everything about med-surg nursing. Even though it's the dreaded med-surg nursing that no new grad wants to go into, it's still nursing, and if you're interested in nursing, there's something in your current role that you're interested in or like. 2. I think you're feeling the typical feelings of being overwhelmed, bored, frustrated, etc. that all new grads feel when they go into med-surg nursing. You're just three months in. You don't know whether you like it or not because you're still transitioning from student to nurse. Give your current job at least a year. After a year, you could probably get hired on in whatever specialty you like. You might even find that you like it, if you give it a chance. 3. It's going to be difficult to transfer after 6 months. I only know of 1 new grad who accomplished this, and she was a prior OR scrub tech who worked at the hospital for several years prior to becoming an RN. She also knew all of the OR staff, surgeons, and managers. I don't know of anybody else that has been able to transfer out after just 6 months of med-surg experience. I know that none of this advice is easy to hear, but it's the truth. I've seen multiple new grads come through our unit with the same outlook. It gets easier. You'll find at least one or two things that you really, really like about your job. And there will be those other things that you don't like. That's normal. Hopefully you'll be able to stick it out for the year.
  24. caffeinatednurse

    Help!! New nurse that hates Med/Surg!

    Maybe in the job market that you live in/near it hasn't been a bad thing for you. In the area that I live in, nursing job openings are scarce. I left my 1st nursing job before the year was up, and I did not find my next job for nearly 2 years. Staying at least a year is always a good rule of thumb when it comes to marketing yourself with a set of skills and experience for your next job.
  25. caffeinatednurse

    New Grad Orientation Contracts

    I should clarify: I was not a new grad, but an experienced nurse when I started working at my current hospital. I worked as a nursing supervisor in LTC before accepting this job. To me, the OP's post sounded more like my current contract than the contracts that I've seen for new grads.