MayRN2987

Thank you so much for the advice. I struggle with finding valuable resource persons mostly because my shift consists of 80% new grads like myself. The best resource is usually the policy and procedure manuals and I wish I had time to refer to them more often. I am optimistic that with time I will become more organized affording me greater opportunity to utilize the manuals. I agree that I need to stop taking extra shifts but struggle with saying no. I need to work on that because I am losing my ability to balance my personal and professional life. Thanks again for the input.

Forgive the rant, but as the year comes to a close, I need to reflect on what I have found in my first 6 months as a registered nurse. No one told me that nursing was easy; however, the mental, physical, and emotional toll of night shift medical-surgical nursing was not something I was prepared for. Don't get me wrong, I love my patients. The politics of nursing, however, I could do without. A few of my biggest obstacles include short staffing, stocking issues, getting/giving report, and navigating the many personalities you encounter within the health care field. As far as short staffing goes, this appears to be an issue that is not going anywhere anytime soon. When my peers and I were hired on in May, the hospital still failed to fill the staffing needs for the night shift. Since that time, I have watched my peers drop one by one. Everyone is jumping ship, and I wonder if I am a fool for trying to tough it out. Although hired for 3 days a week, I often work 4, 5, or even 6. With only 6 short weeks of orientation before being left to my own devices, the feeling of being overwhelmed still hasn't left 5 months later and is only exacerbated by patient loads of 6-8 per nurse with varying acuity. For example, the other night I had 6 patients with a total acuity of 16 (that was a good night where I felt comfortable). The night before, I had 6 with an acuity of 26 and then took an admit on top. I feel like an unsafe nurse at times because I am lucky if I have enough time to do my head-to-toe assessments and pass meds in my shift. I feel it is a successful night if I get a chance to read an H&P but often that doesn't happen. I fear making a mistake that will hurt my patient or cause me to lose my license when the workload gets so heavy that I can't do anything besides med pass and my head-to-toe assessment. I pray that this will improve in time as I get better with time management and organization, but I worry this has more to do with under-staffing than my skill set. Only time will tell. My next issue is poor stocking. I understand there is a nationwide shortage of normal saline, but it is the basic supplies than concern me. I often find my self running through 3 storage rooms to find necessary supplies such as catheters, wound dressings, correct fluids, etc. This is valuable time wasted wandering the floor looking for supplies that should be readily available. As far as report goes, I feel I have greatly improved on my ability to ask the right questions when taking on a patient and passing off the most pertinent information. Yet I struggle with the politics of report. To clarify, when I come in to start my night shift, I sit down with my patient list and first look up their medications to ensure there are not any 1900 or 2300 meds (depending on my start time) that need to be passed quickly. It also helps me to know exactly what fluids should be hanging and the rate when I do my bedside shift report. Then I seek out 2nd shift for report. When my shift is up on the other hand, I watch day shift come in and spend 10 minutes catching up on their nights, spend another 10 trading assignments until everyone is satisfied, and then they sit down at a computer and start looking up their assignments. I have reached a point where I have determined that I get paid hourly and I will sit and wait for them to come to me for report. It is easier than getting frustrated when, after watching them chat for 15 minutes, being told they are not ready for report yet because they haven't looked up their patients. Perhaps, I am just being bitter, but I am not chasing down 2nd shift and day shift for report. Someone can come to me. I also struggle with all the questions day shift has for me. I do not know how my patient takes pills or eats because I work midnights and don't pass pills or feed a patient very often. Sometimes I don't know what the discharge plan is or even much about the plan of care because I have 6-8 patients and that doesn't always afford me the time to read through the patient's entire chart. Still, I feel incompetent when asked a question I don't have an answer for. Hopefully this too will get better with time and experience as I am beginning to be able to anticipate those questions they will have for me. The last issue I have encountered is navigating the personalities of my coworkers and the culture of the floor. For example, having an aid who thinks there may be an issue with my patient and instead of discussing it with me or the nurse assigned to take over my patient, the aid goes straight to the floor manager. I don't understand this, and the floor manager, instead of directing her back to me, encourages this behavior. Same goes for our 'incident reporting.' In my opinion, if the wrong fluids were hung or an antibiotic did not infuse properly, certainly a report should be made, BUT I feel the filer should also find the person responsible and educate. Otherwise, what is the purpose? If we cannot learn from our mistakes, how will we prevent them from happening in the future? Another example is a charge nurse who won't give me a straight answer for anything. I am a new nurse asking for direction, please help! Sometimes I am screaming inside trying to get a response from this charge. It's like pulling teeth trying to get them to come take a look at a patient I think is deteriorating. I don't know. Like I said, I am a new nurse. Still learning how to navigate the health care environment. I am not sure if these are common problems or not. I just needed to get them off my chest. Hopefully as I progress in my career, I will learn how to handle these situations more effectively than a gripe post, but until then, thanks for listening. Please share your biggest gripes or any suggestions you may have for me.

Thank you for your advice. I am actually only hired for 3 nights a week but I feel obligated to fill in when needed. You are right, I do need to learn to say no.

Maybe this is just a rant, but I am feeling extremely overwhelmed at work. I work midnight shift in a rural Midwestern hospital. I started this position as a new grad in August. I work on a medical surgical floor with a max patient to nurse ratio of 8 to 1 on midnights. I have had several nights with 7 patients bit none with 8 and I still feel so unsafe when I have that many patients. Between my assessments and med passes I have very little time to get in their charts and really get to know what is going on with my patients. In the past week I have worked 6 out of 7 nights due to high census and being short staffed. I am just having a really tough time with it all. Whenever I give report to incoming day shift, I feel as though they are upset with certain tasks I may not have completed such as med reconciliation for a new admit that came in at 5 am and so on. They ask a lot of questions that I can't answer because I haven't had time to thoroughly review the charts and it makes me feel incompetent. In addition, I am often staying late just to complete my charting. Also, I am having an issue with an aid who I feel speaks to me very inappropriately. I feel like because she has worked on the floor longer than I have, she is trying to establish dominance early on. The issue is, when I ask her to do things it's not because I am lazy, I am just very busy and always little behind being a new nurse trying to get comfortable on the floor. She has been very disrespectful and I am not sure how to remedy the situation. I am also going back to school online for my BSN at the moment, and I have 2 young children and a spouse who does not understand why I have no time or energy for date nights and family activities. I am just so very overwhelmed. I was so excited to start my career as a nurse but now I am just physically, mentally, and emotionally exhausted. I don't know why I am sharing this. Maybe I just needed to vent, or maybe I am hoping someone will tell me it gets better. I don't know...

As someone who just graduated nursing school, I really appreciate this post. I recently have noticed several of my peers posting on social media regarding this issue with the stance that addiction is a choice and should not be sugar coated as a disease. Something along the lines of lack of willpower. I found this extremely disheartening coming from a future generation of nurses. I am a recovering alcoholic myself coming up on my second year of sobriety. I also graduated at the top of my class while raising 2 young children, working the 12 steps and dealing with the struggles of early sobriety, and training for and running my first marathon. I can certainly attest to the fact that a lack of willpower is not my issue. My brain simply works differently when it comes to alcohol. How was I supposed to know that when I took my first drink?

Thanks for the input. The advisor I have been speaking with from GCU has been fantastic and is half the reason I am so interested in this school.

I am considering either Grand Canyon University or University of Central Missouri for an online RN to BSN program. Does anybody have experience with either of these programs? Just looking for some insight! Any input would be greatly appreciated!

I was caring for a patient on continuous bladder irrigation after a TURP. I was doing my best to keep up with the fluids and emptying the Foley while making sure that there were no clots forming. I started to notice that a lot more was going in than was coming out. However, what was coming out was watermelon pink like it should be. I assessed the line for clots and couldn't find any. I called the nurse in a couple of times and she said it looked like there weren't any clots either. I was freaking out because at this point 2L had gone in and supposedly not come back out. Long story short, housekeeping came in and was sweeping the floor and asked me if I knew there was a swamp forming behind the bed. The whole time I had not had the foley closed all the way and it was just leaking under the bed. I was beyond embarrassed. I was so scared when I told my nursing instructor that I would get a critical incident report. I guess she could see the fear on my face because she laughed and then said 'but did he die?' I will never make that mistake again..

I will be graduating an ADN program at a local community college in May. I have no healthcare experience, and the reality of that is finally setting in. I am worried about how I will be able to get hired with no experience. It seems to be the general consensus that one must have experience as a CNA/PCT in order to be hired in my area. There is a multitude of reasons for why I never worked as a CNA. To start, I am a mother of two small children and a full time student. I decided long ago that there was no way I could work, go to school, and raise two kids at the same time and do of any of them well. In addition, I receive financial aid for my schooling, and if I had worked I would have lost the financial aid and consequently would not have been able to afford going back to school. Regardless of the reason, it became apparent to me that I had done myself a great disservice by not gaining the patient care experience that comes with working in the field. By the time I realized my folly my license had expired. My question is how will I justify my lack of experience to potential employers? In addition, I was wondering how confident everyone felt on their first job? Although I have maintained a 4.0 GPA, I feel woefully unprepared for the day when I am on my own. I would feel more confident if I could find a hospital with a nurse residency program, but I live in a rural area and there is nothing of the sort around here. I have heard from fellow students that the nurses they know have told them that you learn the most on the first job instead of at school. Is this true? Thanks for listening and any advice would be greatly appreciated.

It is possible to maintain a 4.0 GPA in nursing school. I am a mother of two young children in my last semester and have managed to do it. I read the chapters ahead of class but I am not sure how much this helps. What I found most useful was to wait until after lecture to really dig in my studying and focus on only those issues the teacher stressed. Sometimes you can read the teacher. What I mean by this is of they say something more than once, it will be on the exam. Also, whenever in doubt wash your hands or follow the ABCs. Lastly, I am a note card freak! I use an app called cram and make my own note cards for each unit. I go through those 3-4 times in the few days before exams. I always try to ask myself how these whatever (nursing interventions, signs or symptoms, etc.) could be asked in an exam. Don't give up! It gets better! The further you go in school the more you are able to connect the dots and make sense of things. Good luck!

First of all, I just want to say how thrilled I am to have found this site. With that said, I have about a million questions that I will try to condense to one post. Please forgive me. I will be graduating an ADN program at a local community college in May. I have no healthcare experience, and the reality of that is finally setting in. I am worried about how I will be able to get hired with no experience. It seems to be the general consensus that one must have experience as a CNA/PCT in order to be hired in my area. There is a multitude of reasons for why I never worked as a CNA. To start, I am a mother of two small children and a full time student. I decided long ago that there was no way I could work, go to school, and raise two kids at the same time and do of any of them well. In addition, I receive financial aid for my schooling, and if I had worked I would have lost the financial aid and consequently would not have been able to afford going back to school. Regardless of the reason, it became apparent to me that I had done myself a great disservice by not gaining the patient care experience that comes with working in the field. By the time I realized my folly my license had expired. My question is how will I justify my lack of experience to potential employers? In addition, I was wondering how confident everyone felt on their first job? Although I have maintained a 4.0 GPA, I feel woefully unprepared for the day when I am on my own. I would feel more confident if I could find a hospital with a nurse residency program, but I live in a rural area and there is nothing of the sort around here. I have heard from fellow students that the nurses they know have told them that you learn the most on the first job instead of at school. Is this true? Thanks for listening and any advice would be greatly appreciated.