WishfulThinkingRN

Make some connections with the nurses in your ICU. If you can get some charge nurse experience under your belt, that's a huge bonus and will open a lot of doors for you. Getting into a step-down unit is also a good option. This shows you can handle sicker patients, and also lets you interact with nurses in the ICU a bit more frequently, ie during report/transfers. I spent a couple of years on a surgical unit in a large hospital, and was a charge nurse for my last year there. I made it a point to get to know a lot of the other charge nurses, not just the ICU CNs, because a) when crap hits the fan, sometimes it's nice to have another CN on another floor to call for help and/or advice and b) I really didn't know where I wanted to go next and figured it would help to know people. When I applied for my current ICU job, I went in for my interview and there were two charge nurses sitting in with the manager. Both of whom I knew fairly well, from meetings and also from calling RRTs/Codes/transfers. I was told later on that they both advocated for me to be hired over other nurses who already had ICU experience. It really is all about who you know ?‍♀️.

I'm sorry you were subjected to this. Based on what you've described, your actions were appropriate and you showed good judgment in having the presence of mind to ask a question and clarify. This was something your instructor should have encouraged. It was certainly not something to criticize or punish you for. This could have been an excellent educational opportunity re: medication administration safety, if they had chosen to look at it that way. And allow me to say what they should have said, both in your clinical and in this meeting. Thank you for putting your patient's safety first and asking a question. Thank you for not making an assumption that could have proved dangerous and/or harmful. Thank you for addressing your concern with the person who is supposed to be teaching you. It's disconcerting, but not entirely surprising, that none of these nurse educators stood up for you in this meeting. There really is no place for politics in nursing, but somehow we always manage to make room for it. I'm so sorry you ended up on the receiving end of it, let alone this early in your future career. Glad to hear that this did not impede your progress. I do wonder though, what are the chances that you'll have to deal with this specific educator again as a clinical instructor? I only ask, because the circumstances surrounding this incident seem to be, in my opinion, somewhat vindictive.

I took both together in fast-tracked summer course and while I did well, I really wish I had taken them separately. That summer almost killed me. I'm legitimately amazed that the amount of caffeine I consumed combined with the insane amount of sleep deprivation didn't finish me off. It's doable, especially if you're older and wiser and more dedicated, but it takes a lot out of you. The other thing you should consider is that unlike a lot of pre-req courses, like sociology, you're actually going to be using what you learn in these classes. Most nursing instructors don't feel like it's their job to go over the basic A&P fundamentals when they're lecturing, they expect you to come to class knowing this stuff. So, it's worth your time to make sure you understand the material being taught in A&P so you can apply it when it comes time for your nursing curriculum.

I really don't understand why you care. It's her life, her business. If she wanted you to know, she'd tell you. I have great relationships with the people I work with now and still stay in touch with people I have worked with in the past. Most of them don't know I have a PRN job and a part-time job on top of my full-time one. It's not because I don't want them to know, or that I'm even remotely worried about how it'll be perceived. I just haven't taken the time to explain it to them and don't care enough to announce it. Don't read into her reply so much. Live your own life, and mind your own business. Your life will be much longer, happier and healthier for it.

Most nursing schools have a grade cutoff between 75 and 80 percent, mine was 78. Some choose to apply this rule to individual tests and others just to your overall class grade. Most have a rule about how many times you're allowed to fail, usually once and then twice you're out. Some have rules about doing remedial work and mentoring if you've failed once, some don't. It varies from nursing school to nursing school, but what you're describing sounds about average. The reason they do this is because nursing school doesn't teach you how to be a nurse, it teaches you how to pass boards. If you pass boards, that's supposed to mean that you know how not to kill people (supposedly), and that you'll be safe to work while you're actually learning how to be a nurse. And you won't learn how to be a nurse until you've graduated and are working. Nursing schools live and die by their NCLEX pass-rates, so it's in their best interest to weed out anyone who can't pass muster before they graduate and are eligible to take boards. This means that there is a huge emphasis on test-taking ability. It sucks, because some of the best nurses I know are horrible test-takers and really struggled in school, but until they come up with a better way to measure safety in new grads, this is what nursing school looks like. Best of luck!

Just because you can shove a blowtorch up your rectum, doesn't mean you should

I've worked through kidney stones, migraines, infections, bronchitis, ear infections, strep etc. I don't like working sick, but I absolutely hate feeling like I'm putting my patients and other coworkers at risk whether it's because I'm contagious or not working at peak level. Ironically, I once got the EyeDiff, also known as pink eye, and people were begging me to stay home.

I'm going to put a positive, albeit long, spin on this. There are a lot of lessons to be learned here, and will hopefully prepare you for your next job. Lesson One: Dealing with conflict appropriately. Not every nurse is cut out to be a preceptor. I'm so sorry that yours seemed to be absent. As the new kid on the block, it can be very intimidating to address this directly to your preceptor, especially if they've proven to be unapproachable. Unfortunately unit managers have no idea if there's a problem unless the orienting nurse speaks to them about it. If this ever happens again, go directly to the manager and explain the problems you're having. I wouldn't phrase it in words that place all the blame on the preceptor as that could be taken the wrong way. But simply saying, I'm having a lot of trouble adjusting, I feel very overwhelmed. XYZ happened yesterday and I really didn't feel like I had the right tools or resources to deal with it. A good manager would've assigned you to another preceptor. A mediocre one may have addressed the issue with the preceptor and hoped for the best. If the issue is not resolved, then it's appropriate to speak with the manager and talk about the possibility of transferring to another unit, even though your six month requirement has not been met. Most managers would rather have a new grad admit that they're not happy there early on and try to help facilitate a transfer, than dump six months of training into them only to have them take off the second their required time is up. And in lieu of all of that, two weeks notice is really the most appropriate thing to do. If you felt like you were making a choice between your own mental health and rehire eligibility, that's fine, I totally understand and agree with it. But just understand that decision does come with consequences you have to live with. You may or may not be eligible for rehire at this hospital. Call HR and ask so you don't have to wonder. If the answer is 'no', then you'll need to move on and don't look back. Decision has been made, can't unring this bell. Lesson Two: Pace Yourself. Obviously jumping straight into an ICU, especially at a level 1 trauama, as a new grad was not the right choice for you. Yes, you could have had a better preceptor, but honestly critical care can be so overwhelming, even to experienced nurses, that even with a rockstar preceptor you may not have adjusted well. Consider a smaller hospital with a medical ICU or even a step-down unit. I'm a huge advocate for working on med-surg floors before stepping foot in an ICU or ED. Having a year or two to establish some foundational nursing skills, learning prioritization and time-management is so helpful. Being able to learn in an environment where patients are more stable is a little less terrifying. I got a job in an ICU after spending a year on a surgical trauma floor and I was overwhelmed for the first six months. But for my experience and the development of necessary coping skills during my first year, I would never have survived those first six months in my ICU, and I had two amazing preceptors. Lesson Three: Goals are important, but don't let them get in your way If your goal is to be a CRNA, that's great. It's wonderful, really. But remember, it's just a goal. You are not going to get there overnight. Athletes with the goal of going to the olympics don't get there overnight. Such a goal requires time, work, dedication, and most importantly: patience. You can't skip a few steps towards that goal and expect to reach it. Put some time into a step-down or med-surg floor and learn the basics. Don't focus so much on your goal that you forget yourself. Lesson Four: Self First, Always Nursing is a physically, emotionally, and spiritually demanding profession. You can't be expected to take care of others if you're not taking care of yourself. It sounds simple, but I feel like those of us who gravitate towards nursing are generally the people who will cut off our own arms in order to help others. Case in point, I got so many UTIs the first few months I was off orientation on my surgical floor. I barely had enough time for a bathroom break, let alone a lunch break. I stopped drinking water so I wouldn't have to pee all the time. Genius, right? I had a long talk with my unit educator one day, who assured me that a lot of nurses, including herself, go through a rough transition before they start learning how to better manage their time. She encouraged me to talk to my charge nurses to get active feedback and constructive criticism on how to plan out my night. That helped immensely. I also started eating better and exercising. My educator took me with her to a kickboxing class and it helped so much with my stress level. I still see her and a few other of my former coworkers at the gym and we have a great time. Figure out how to manage your stress and anxiety. If that means sitting down with a therapist for an hour each week to talk things through, that's what it means. If it means spending a few hours at the gym each week kicking the crap out of a bag, that's what it means. I have a coworker that goes salsa dancing a few nights a week. Another one goes paintballing in the woods every week without fail. Find something that works for you and stick with it. Just take care of yourself and remember that in the prioritization hierarchy, your health always comes first, because if you collapse, then who takes care of your patients? Lesson Five: Learn to forgive yourself. You are human. You are not perfect. Accept it and embrace it. Your flaws make you who you are every bit as much as your strengths. This "dream job" didn't work out the way you wanted it to. Okay, time to pack up and find a new one. It may not be your dream, but is it a stepping stone, even a small one, towards your dream? Does it pay the bills? Yes? Great. Do it. You're going to make mistakes. Accept them, learn from them and move on. As my grandmother was always fond of saying, "If you spend all your time looking back, you'll trip over yourself so much that you'll never get to where you want to go."

Not sure if she's used to relying on PCTs to do vitals all the time? How comfortable is she with multi-tasking? She may or may not understand how busy the PCTs are. If this many of them are coming to you with the same problem/issue then it needs to be addressed by someone in the chain of command. A good PCT is worth their weight in gold and should be treasured as such. Maybe talk to her and find out what she feels is appropriate to delegate? Some correction may need to be done with her. PCTs in ICUs and EDs have, not necessarily more responsibility, but are trained to do more and she may not understand that. If she does and is doing it anyway, then that's a whole other issue that definitely needs to be addressed.

Yes. As a patient. When you're diagnosed with measles.

Most nursing schools have interviews for the much same reasons medical schools and law schools have interviews. Being a good student on paper is only half the battle. Being able to communicate effectively with people and form professional relationships is vital to your future career, whether you like it or not. It would be nice if good grades, a good work ethic, and a few letters of recommendation from your colleagues were all you needed to be a good nurse, but they're not. Communication is what drives nursing. Your ability to speak with people, whether they're homeless or CEOs, is paramount. Your ability to communicate with doctors, respiratory therapists, pharmacists and work together as a team is beyond important. You will be working with and educating people from all walks of life, and if you can't walk into an interview and answer a few fair, albeit tough questions, you will not be able to find a job as a nurse, let alone practice as one. The other part of this is that while you are a student, you will be working with nurses in hospitals in your community. You will be acting as a representative of your school. They expect you to show up to clinicals on time, act professionally, be respectful and learn. Their reputation as a school depends on this. Hospitals don't have to open their floors to nursing schools for clinicals. It's a privilege. A face-to-face interview tends to help weed out people who don't understand this concept. Not always, but most of the time. Is there a chance that you can be passed over for someone with lesser grades and test scores, less experience? Absolutely. Nursing school admissions work much the same way hiring practices work in real life. You submit your qualifications, if they pass muster you're called in for an interview, and sometimes you'll get called back for a 2nd. Whether or not you get the job offer depends greatly on your performance during that interview. On a personal note, the unit I work on will typically get 50-100+ applications every time we post an opening (last time I think we got 140ish). HR will sort through them and will submit the resumes that meet the minimum requirements to my manager. Part of my job is to help my manager weed through these resumes and figure out who to call in. We try to narrow it down to 20-30 people based on what we read. Then either I or another of my coworkers will sit on the interviews with our manager and once the interviews are over we'll make our own recommendations to to said manager who then decides who to hire. I have recommended people with fewer qualifications and less experience because of their performance during the interview, because I know just how important it is for people to have good communication skills in our line of work. I have recommended passing people over for not being on time, because it makes me concerned about how often they'll be late when they get hired. I once recommended passing over a nurse with far more experience than I have in favor of a new grad because I felt like the new grad would be a far better fit for our unit. I don't care what you look like. I don't care how old you are. I don't care if you're bubbly and chippy (I'm not, I'm sarcastic AF). I care if you can use words to get your point across. I care about how you represent yourself. I care about how you react under pressure. I care if you can exude confidence even when you're scared out of your mind. I care if you're going to fit into the team we have and be able to work together or if you're going to be more of a problem and a hindrance than a help. Because as a charge nurse, I'm probably going to be the one who ends up dealing with it. You'd seriously be amazed at what you can get out of one, 20 minute interview. You don't have to like the interview process, most people don't. It's stressful and it feels like you're being judged, because you are. I know it's frustrating when you feel like you've put in the blood, sweat and tears into your pre-reqs while your friends went out and partied and dated and had fun only to face the prospect of being passed over in favor of someone who didn't do as well or work as hard just because the interviewers liked them better. I know. I get it. It's not fair. Welcome to nursing.

Well, the other day I was helping another nurse place a foley and right after insertion, we immediately got sprayed with liquid feces. It came out like a chocolate geyser. I'm not sure that I've ever seen anything quite like it. I mean it was everywhere, our faces, hands, scrubs, feet, the floor, the wall, the ceiling, and it just kept coming. Doc was in the room by the computer, which was about the only place in the room that hadn't been painted in poo, and just said that he'd place an order for a rectal tube.

Deadlines can be frustrating but they are a necessity. Nursing schools are at the mercy of their clinical sites and they have a deadline to keep as well. If you don't meet your deadline, they can't meet theirs and then they'd end up with a nursing student that couldn't go to clinicals, and a nursing school has no use for a student that can't go to clinicals. Most nursing schools are extremely competitive and are beating away applicants with a stick. It's no skin off their nose if you didn't get the paperwork on time, because I guarantee there was another applicant who did and they happily gave away your spot. Failure to meet a relatively easy deadline such as this is not typically a good sign. In the future, please be aware that you don't necessarily have to go to your primary care physician for these things. Most states have health departments where you can get your vaccines, tb tests and even titers for a reasonable price even without insurance and in a lot of cases without needing to make an appointment. And there are always walk-in clinics that could assist you with this as well. True story, I had a friend in nursing school who wound up in the hospital, in the ICU no less, for a couple of weeks d/t the flu and an asthma exacerbation. It was during our break, but she was unable to submit her documentation in time because her TB test was was only a month away from expiring, and she missed the deadline for submitting the documentation. Even though she was cleared by her doctor to return to school, the school told her she was being placed on suspension because they couldn't place her for clinicals. Normally, that kind of thing can get you kicked out, but they just held her back a semester because she was in really good standing and she had some real extenuating circumstances. Life isn't fair, and I'd say this is your first lesson that the nursing world doesn't care about excuses. Welcome to nursing, where even when it's not your fault, it's still your fault.

Nursing school is a beast. You're going to flunk an exam or two, it's okay. The important thing for you to do now is accept it and learn from it. What happened with this exam? Were you unprepared for the material on the exam? Did you feel that you had a good handle on the material, but didn't know how to answer the questions (this can definitely happen with nursing-style questions). What do you need to do the next time around to make sure you are able to attain a better score? My advice would be to go and speak with your instructor and go over your test. Find out if there were specific areas where you have a knowledge gap, or if your study skills need to be adjusted for this class, or if you need some test-taking skills tailored for nursing-style questions. Don't let one crap grade on an exam deter you. Make a course correction and keep on swimming towards your goal. You will get there.

My school used Dean Vaughn videos. They were extremely helpful and the visuals they use really stick with you. Still can't pass a gas truck without thinking about a stomach. Check out youtube for an example