mrscurtwkids4

I think most nurses, especially new nurses, have a tendency to be hard on themselves when a patient of theirs codes. It's so much easier to be overly critical in retrospect than at the time things are happening. Hindsight is 20/20. I'm still in my first year of nursing also. And as new nurses, we have to learn that some patients aren't going to make it no matter how wonderful a nurse we are. So long as nothing was totally missed, we can't always know something is going wrong. We each have to learn to figure out a healthy way for coping with the loss of a patient. Tearing ourselves up over something that we may have no control over is not the most healthy way of dealing with it. Learn from each experience and that way you might have more insight for similar situations in the future. Having a time of reflection and healthy critique with coworkers is a good thing. This can bring more eyes to the situation that can point out things that could be done better in the future. Just know it's not uncommon for you to feel like you are to blame, but it isn't really the truth, just a normal reaction.

After medication dosing, I normally only flush the line that was used. But all the lumens should be flushed periodically regardless of whether it was used in order to maintain its patency. When in doubt, would think it better to flush it anyway. Won't really hurt anyone to get a little extra fluid from flushing.

I graduated from the traditional nursing program and felt it was good. I heard comments from some of the students that were in the accelerated program...let's just say they felt a bit overwhelmed by the schedule. So long as you have the time to devote to it, it's a good program.

I don't really have any advice for you. I'm kind of in similar circumstances with working nights. Except I only have every other weekend off and a day here and there in between 3 and 4 days working straight. So I end up trying to maintain my sleeping during the day and being awake at night even on my "nights" off. It's become a real pain because I feel like I don't near the time I would like to have with my kids and husband. But I try and spend every waking minute I can with them to make up for the amount of time I'm asleep. I feel like I'm sleeping more hours because the quality of sleep is lower than if I were sleeping during the night like our bodies are used to. If you find a better way to keep up the schedule, please pass it along!

I would agree that the individual needs to consult their physician for the advice about the length of time due to the individuality of the situation. I had a placental abruption with my first child at 32 weeks and had to have an emergency c-section due to hemmorhaging. My doctor had suggested I wait 3 to 6 months. After 4 months I was pregnant with my oldest daughter. I had youth going for me at the time though as I was only 19 and still newly married. The subsequent pregnancy with my daughter was uneventful, although I did a repeat c-section due to the short healing time I gave myself between pregnancies. Now I'm the proud mommy of 4 daughters :-)

I have 4 children ages 15, 13, 11, and 8 and a husband of 17 years. I have never been late due to the kids for school, clinicals, or now work. Once I graduated, my husband and I had already decided that my career is a bit more important now than his since I am making more money and am still new in my position (don't want to cause any problems with a new employer). So if the kids have to go to the doctor or whatever, he is the one that calls into work. This is just something that we've been able to work out between us. Besides, hubby is rather sick of his job and wants to find something else, so if him putting his kids first instead of his job is enough for them to want to fire him, so be it. I would never pull the "I have to deal with my kids" bit to my work only because I know how difficult it is to get a replacement in. My floor is way understaffed, especially since we had several quit. Besides, all these years I've stayed home with the kids and have been there for all the school plays, project, etc....and my hubby missing out because of his work...my hubby says he's glad that it's now his turn to enjoy being more involved with the kids and their schedules. It's kind of worked out for the better in the end after all.

Really it seems to me the main reason for TKO the IV's is so that there is still a flow to keep the IV site good without the nurse having to flush the site Qshift. The few cc's an hour isn't really important as far as intake is concerned. It's mostly to preserve the IV site. As for the IV antibiotics, I believe they are given for times sake. The person is sick enough that they need the antibiotic given more rapidly. The amount being given is more precise as well. You don't have to worry about the GI tract not absorbing the medication sufficiently.

I didn't go to any review classes. It was a little hard to get away with 4 daughters at home to take care of. I did the online Kaplan review. Listened to all the instructional videos that is on it, practiced all the tests that it offered, and wrote a lot of stuff down (I'm one of those that remember things better after having written it down). I think the best thing I learned from the first test to the second is to look at each individual question and what it's asking. You don't necessarily have to know the answer to the question. You need to figure out if you have enough information from the question to be able to pick an aswer that is an action for your patient, or if you need more information in order to do something for your patient (assessing vs implementing). I think I went into the first exam looking at trying to pick the "right" answer rather than looking at the questions as whether I need to assess or implement. Also, when picking your answer...remember your ABC's and pick answers in that order or importance. I think this made the biggest difference in passing it the second time through. Best of luck!!!

I, too, didn't pass the test the first time through. I first attempted it July of 2007. I was so bummed. I felt I let my husband down and my 4 daughters down, as well as myself. But I looked at the big picture of everthing else that was going on in my life at the time and thought to myself, no wonder I didn't manage to pass the first time through. I had a lot fo things going on that distracted my attention from the exam. But I made great use of the 45 days that I had to wait to retake the test. I made use of the online NCLEX review course that my employer graciously paid for and studied like it was a full-time job with overtime...lol. I tried to recount some of the types of questions that I had during the first exam and focused on the type that I felt I was weak in. You can kind of tell the ones you are weak in, especially when you keep getting more and more questions that are similar during the test. So I concentrated on them and practiced as many of those types as I could. I also reviewed all of the basic information that you would commonly be tested on. And the second time through, in September, I passed. I am now a Registered Nurse on a telemetry floor and continuing to learn more and more everyday at work. More about the information that you need to know to treat your patients medically...and more about the emotional/mental knowledge you need to be a trully great nurse. Just as each patient teaches me something new, each new experience during the journey of becoming a nurse taught me a multitude as well. Mostly it has taught me patience, tolerance, compassion, and never give up! You will get there!!

I'm a newly licensed RN also and I'm working the night sift of a telemetry floor. I agree that it's nice because of having a little more time to do charting, etc (depending on the night and the acuity of the patients). This gives you less of a chaotic atmosphere to get yourself used to the floor and how things work and what is expected of you. Granted, there are somethings that you might have to do that are different from what those during the day would be doing, but I think it might be a better atmosphere in order to continue learning and growing in skills before jumping in with both feet, so to speak.

I just received my BSN May '07. I have thought about continuing on for my master's and concurrently getting my NP certificate, but still haven't really decided as to whether I really want to do it or not. My husband is supportive of it. I think I am wanting to get some experience under my belt first. The hospital I work for will pay for continuing education so long as you get a B or better for graduate courses (C or better for undergraduate courses). I figure I'd not be too smart to take them up on the offer of paying me to get educated further. I think I only have a couple issues with going for my Master's. First would be trying to do the schooling while trying to work. I work night shift and I would imagine that I'd normally be sleeping during the time that the classes would be held. I also hate doing research...and a lot of the curriculum is research..UGH. I'm able to do it, just don't like it :) Benefits would be furthering my knowledge and opening up other career opportunities that maybe I wouldn't have without the higher degrees. Another plus is giving my four daughters a good role model. They've already watched me go through college for my BSN and I know how very proud they are of me. I feel I'm showing them that it doesn't matter your circumstances...if you set your mind to something, you can do it. So, still up in the air about continuing on for more college or not.

Besides clashing with a few co-workers personalities, the hardest thing so far for me is being hard on myself. I can sometimes get frustrated with myself for not knowing something. Time management can be an issue as well. Seems no matter how I organize things, I seem to run out of time for certain things. I'm not sure if that's me or if it's my workload with still being so new. Even when we do screw up, so to speak, if you can walk away with having learned from the experience, that's a huge plus. Be proud when you do something well and give yourself a little pat on the back...sometimes those moments can come few and far between depending on the night (just do it on the run so you don't get behind in work...lol). Don't be afraid to ask questions. Most of my co-workers do understand that I'm not expected to know everything....and neither do they. Most are very helpful in answering your questions. The doctors that I have run across so far have not been that understanding, except for one in particular. With all the arrogant type doctors I ran into, the one that was actually nice and friendly that conversed with me was quite refreshing. Another thing I had to adjust to was a new schedule/routine because I took a night shift position (11pm to 7am). My body still hasn't fully adjusted to that change. Not to mention the change that has to take place within my household. I've had to release some of my parental duties that I handled off to my husband, which isn't really a bad thing, just difficult when you were the one used to doing everything. (I was a stay-at-home mom prior to starting college and now getting to work.) That's about all I can think of at the moment. Make to-do lists for what you normally have to get done during your shift and mark it off as you go. That way you don't go home wondering if you forgot to do something.

I graduated with my Bachelor's at 33 years old this past May '07

I'm still new to the profession and recently ended orientation on a telemetry floor. I'm curious about how long you would stay after in order to finish your paperwork? What things do you make sure that you complete and what things would you let pass to the next shift for them to complete? I'm mostly asking this because I was assigned 7 patients and several were quite time consuming patients. I didn't have time to go to the bathroom none-the-less get any paperwork done before the next shift was arriving (I work the night shift). I stayed a little over 2 hours past my shift to get the meds lists done and to get my nursing notes done for each of the patients. These I know are things that I must have done. I'm just still unsure of what things are able to be passed along. Many of the other nurses will get done what they can with new admits and leave some for the next shift when the new patient had come to the floor near the end of shift. I had a few issues with a couple nurses about this and I'm not sure if they are just walking over me because I'm new, or if I was doing something wrong. I was getting conflicting information from different charge nurses. It's not that I make a practice of not completing my work, because this was actually the first time that I hadn't had everything done before end of shift. In fact, I hate the idea of leaving any work unfinished. But shouldn't there be a line somewhere for how long I should stick around to get things done? Thanks.

I'm working a Telemetry floor.

I graduated May 2007. I passed the NCLEX on the 2nd try on Sept.17th. I just worked my first day off of orientation yesterday. As far as preceptors are concerned, I love most of the nurses that work on my floor during my shift. They are a big part of the reason that I chose to want to work on that floor. They were very willing to help and answer questions and didn't make you feel like a total idiot for not knowing something. They don't expect me to know everything....heck, they are willing to admit that they don't know everything either! None of us ever will. I chose this floor because of this because I had some terrible experiences at other hospitals during clinicals while in nursing school. They would make you feel an inch tall if you asked something that they felt you should know already. I've found that nursing is a career in which you learn something new nearly everyday, and that every patient is not textbook. And many times, it's best for the patient to combine the knowledge of severeal nurses to figure things out than have one struggling to figure things out. I've found from my experience so far that the nurses that don't feel comfortable in helping more inexperienced nurses to learn and grow are not very comfortable with their own knowledge base and their abilities (that or they just aren't very personable individuals). Those are generally the nurses that have let their career in nursing become just jobs.

I'm so terribly sorry for the pain you are going through. I too lost a child and understand how difficult it can be to get through all the emotions. Don't let anyone tell you how you should be grieving. Everyone grieves in their own way. But I must agree with many of the other posters about finding a therapist or someone to be able to talk things through with. Again, I'm terribly sorry that you have to go through this.

Questioning your choice of a career in nursing due to the postings on here would be a mistake. Granted, there can be many frustrating and hard times in dealing with this career. That seems to be the main thing that gets seen on this board...venting and frustration. Nursing school can be quite deceptive about what it is to be a nurse. They teach you the knowledge you need to do the assessing and such, but when it comes to clinicals, it seems they are teaching us the aide's job with the bathing and care. In the short time that I have been a nurse, I have found though there if I look at this as my life choice, to serve others, and not view it as my job or career, it seems much more rewarding than you would think. Because how you view it, whether job or serving others, can determine how you feel about the work itself. If you are viewing the job in the sense of it being good income, the work you have to do doesn't become worth it. You have to look at the pay offs you get that are other than financial. Like the half smile that a stroke patient that really isn't there all the way mentally anymore because you took the time to be kind to him. Or a patient having an anxiety attack who you take the time to talk with and understand what she is going through. And various other moments that you just can't put a price on. Seems to me it's a matter of viewing your cup as half full rather than half empty.

First off, we pretty much aren't going to be able to remember everything...at least not for a while. Second, believe me when I say that you'll remember more than you think you have. Even if it's only ringing a bell to something you've learned. You just have to know where to find information you may need and take the initiative to look up the things that you are unsure of. Do not be afraid to ask questions! No matter how stupid they may seem. How are you to learn and acclimate yourself to your new position without asking questions? A workplace that is very supportive of continuing education is very important also. What we learn now may not always be the standards and we have to be willing to continuing teaching ourselves updated information. As for all the medications and tests that are performed...as you work in a specific area, your become accustomed to the particular medications and tests that are done frequently. And those you don't know...you look up or ask questions. It's a constant growing process. And as much as we'd like to expedite our knowledge base and our comfort zone, it's a slow and gradual process. Just learn and observe and do as much as possible and it'll will come. I think this is what's hardest about the first year or so of nursing. It's the self-doubt, the lack of confidence, and the fear of messing up that really works on the nerves. Have patience and confidence in yourself and hang in there! Good luck!! Tammy

I remember my very first clinical day in a LTC and the patient I was assigned to was completely dependent. We were taught bed baths and such during our lab time in school and had heard of a bath bed, but had never been shown one. Anyway, we use the Hoyer lift and get this rather frail lady onto the bath bed stretcher and wheel her down to the shower near the other end of the hall. We get her washed the best that we can. You see, every time that I tried to wipe her anal area more crap would come out. So I try to wipe more gently to clean her up and still some oozes out. Grrrr. So I get it the best I can and figure I can't really get it much better than I have. We get her covered and ready to wheel back down the hall to her room. As I'm going down the hallway with her on the stretcher, a nurse catches my attention and points to the floor behind me. As I look down the hall where I came from, there is a steady trail of water following right behind the stretcher. Apparently, there is a "tray" kind of thing under the stretcher that had a drain plug (which was not plugged up) and was steadily draining some of the water from the bath as I was heading down the hall. I was soooo embarrassed. After I got the lady dried, dressed, and back into bed....I stepped into the hall and saw a custodian mopping up my mess. I went up to him and just profusely apologized. I could just see the expressions on the nurses faces looking at me thinking " Dumb nursing students.....geeez!" At least these are the kind of stupid errors that stick with you and your sure not to repeat.....LOL Tammy

I know how you feel about being discouraged with grades that were anything but an A. I got very frustrated when I went to the University level of education. I graduated from a community college with a 2 yr degree in individual studies (getting my english and sciences, math and such done) with a GPA of 3.8 and was Phi Theta Kappa. I hit the university for the nursing curriculum and was struggling a bit with some of the classes. Ended up graduating this past May with a 3.24 GPA. I was a bit disappointed, but at least I passed and was done. My logic in thinking was that if I got questions wrong on the exams, that could have meant doing harm to a patient when I get into the "real" world. You need a little of that healthy fear in you in order to do well and succeed; however, if you keep that in the front of your mind too much, it just might scare you away from nursing all together. Basically, do the best that you can possibly do, and accept that when you have tried and studied your hardest, that whatever grade you get is the best you could have expected from yourself. I know it's hard with getting study time with kids...I did my schooling while tending to my 4 kids. But it sounds like you have yourself pretty organized with your time to equal things out. Good luck with everything!! Tammy

I'm currently 35 years old and just graduated this past May with my bachelor's degree. I just passed my NCLEX exam last week. And I did it with 4 kids to raise, hubby, and house to tend to, ect.. It can be done!! You are never too old to go to school. My mother-in-law was still attending college classes in her late 50's. I started out at the community college and found there were lots of others who were "non-traditional" students. When I got to the university level, there were less odler students, but there were still a good handful. I found that many of the younger students liked having some older students around to talk with and help. There is something to be said for life experiences helping with your schooling. Then again, there were probably those that didn't give a hoot one way or the other. If you are there for the learning, the interaction with the others isn't as important. As long as you can get along with them enough to get group projects done, I wouldn't let age be an issue about attending college. Tammy

Just had to scream it from the roof tops that I have passed my NCLEX-RN and can finally call myself a nurse!!! After all this time and hard work, it's such a relief to finally have it over. Now I just need to adjust to work and get to feeling more competent...lol. It'll come with time. Just had to share!! Tammy C., RN, BSN

I graduated this past May. Received my ATT at the beginning of July. Had a test date set for July 28th. I was in orientation at a hospital that I was hired on as a GN at the time. Then started my internship while awaiting my test day. I ended up failing the first test. So my internship got placed on hold. I was able to cover for PCA's until I was able to test again (45 day wait). My work paid for the Kaplan review and I litterally studied like it was my full time job. I went this past Monday (Sept. 17th) and took the exam again. This time I passed. I originally thought that the faster I take the exam after graduation, the better. You know, less time to forget anything that you learned. However, with adjusting to no longer being a student, dealing with orientation at work, and dealing with my 4 kids, husband, and other various chores....I found that it caused me to get too stressed and pressured to pass. As far as studying...I would recomment any program that gives a brief overview of content that is most prominently found on the exam as well as covering basic test taking skills. Everything is dependent on your particular circumstances. If you have a job, that takes away from studying...however you are able to learn a great deal while on the job, but it's not always the proper way that you might be learning to do things. If you have family obligations, that can cause more time taken from being able to study well. You have to figure out what is right for you and where you strong and weaks areas of knowledge are as well as your test taking abilities. No matter what you choose to do and when you choose to take the exam....have confindence in yourself and what you have learned over the last several years. You'd be amazed at how many things you end up remembering when you see it again on the exam. Good luck to you!!! Tammy C., RN, BSN

What an awful experience to have to go through. I can't imagine how stressful that was for you. On the bright side, you didn't do anything inappropriate, you document well, you have set a good reputation for yourself; all of which helped to prevent blame being placed without investigating as thoroughly as possible to find out where the discrepancy was at for those meds. Even though I'm a graduate student who hasn't officially started work, I know that even during clinicals I was paranoid about giving medications for fear that I would goof something up. Some healthy fear of messing up is what will help prevent me from making mistakes. The instructors always drilled into us the importance of documentation. They would say "DOCUMENT, DOCUMENT, DOCUMENT" and "If it wasn't documented, it wasn't done." These are definitely things that have been drilled into me since the start of nursing school. Doubt I'll ever forget it, especially when I hear these lessons learned by other nurses. Thanks for sharing and glad things worked out!