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  1. Hey y'all. I've been a nurse for almost 9 months now and I'm seriously considering leaving the profession altogether. I graduated in December of 2018 and was ecstatic when I got a position as a new grad RN in a med surg residency program starting July of 2019. Packed up all my things and moved three hours away to a very rural community knowing no one. From the moment I started, I struggled heavily, mostly due to anxiety which I was clinically diagnosed with two years ago and take meds for. I made a lot of mistakes and was constantly on the radar of my nurse educator and supervisor. Two months later, I got called in to my boss's office and she let me go over lying to my preceptor over charting something which I didn't. They felt as if they couldn't trust me anymore. My options were get fired or be forced to resign. I was devastated. Moved back home to my parent's house and began looking for a new position. Luckily, I landed another job in a psychiatric rehabilitation facility. Even before starting nursing school, mental health was my passion. I knew I wanted to work psych in the long term. I started this position late October of 2019 and lasted 3 1/2 months until Valentines day. I worked NOC's and was the only licensed staff for that shift. I was overwhelmed, had virtually no support and had to deal with toxic coworkers. On February 12th, I made the mistake of covering an AM shift and was responsible for pulling meds from a med cart in sheets the old fashioned way and giving them to 50 patients. The next day my boss found out I made a ton of med errors and I seriously thought I was going to be fired on the spot. He gave me another chance to my surprise, but I had had enough and decided to quit. My current position is in an acute psych facility which I started per diem in January of 2020. Here I feel like I have tons of support, charge nurses who are constantly checking up on me. I've only been called into my boss's office once in 5 months over messing up charting. I feel as if this is less hectic than my last job but I am very unhappy with it. Psych nursing is not what I glorified it to be. What I thought psych nursing was vs what it really is is not what I expected it to be. What I feel like I really want to do is more in the line of social work or clinical psychology. On top of all this I screw up constantly and have this fear of getting fired every time I step into the hospital. Today, I made a med error and sort of freaked out and stormed outside the patient's room after realizing I gave meds to the wrong patient. My coworkers tried to comfort me but now I feel like they feel like I can't be trusted. I'm starting to think nursing is just not for me. I'm fed up, burned out and I've come to the point where I just don't care anymore and I feel numb. I've had 3 jobs in 9 months which says a lot. Opinions?
  2. Prolific author and allnurses.com columnist Nurse Beth (Beth Hawkes) is back with another amazing book jam-packed with great advice and insight. As a way to give back to nurses, Beth Hawkes is giving away EIGHT COPIES of her newest work – 'First Year Nurse' With advice on working with doctors, prioritizing care, and time management; this book is a must-have for nurses who are beginning their careers! 'First Year Nurse' isn't available for purchase until May 19th but as part of National Nurses Week, you can win a copy before you can buy it! Click below to complete the form and you're entered to win. Be sure to enter each day to increase your chances of winning. We are giving away one copy for each day of National Nurses Week and another copy exclusively for Nursing Students! Enter to win your copy of 'First Year Nurse'
  3. Nicole Innvar

    The Most Priceless Gift I’ve Ever Received

    Especially in recent times, everybody around the world has been hailing nurses as “heroes.” However, what happens when a nurse needs a hero of their own? What constitutes a “nurse hero?” What Inspired You to Become a Nurse? I only graduated from nursing school in May 2019, so my memories are still quite vivid. One of my vivid memories is, almost every semester on the first day of classes, my professor had my classmates and I tell the class what inspired us to go into the profession. A lot of times, my peers said they had a family member or friend who was a nurse and they looked up to them, which is what brought them to nursing school. I could not relate, as I did not even know anyone who was a nurse (or, might I add, even in the healthcare field). But, I always thought it was pretty nifty. Knowing someone made it out alive and was successful with a career, someone you could turn to for help if needed...deep down, I kind of wished I had someone like that. I quickly realized I would need to hold my own, and tried to push away the nagging feeling that I was an underdog. I’m sure others who were in a similar position could relate. New Nurse Trials After the trials and tribulations every nurse endures in school, I happily graduated, and passed the NCLEX. By September, I started a job in an ambulatory surgery setting. I had no idea what to expect, as the only experience I ever had consisted of my clinical rotations in hospitals and my part-time job at a doctor’s office. (This was one of those times I wished I had someone to ask questions to). Co-workers to the Rescue Just as I expected, it was completely different! But before I knew it, weeks turned into months. Recently, I thought back to how much I’ve learned and grown, both professionally and personally. I then realized I couldn’t have done it without all the help from my experienced coworkers who are always willing to teach me something. They answer my questions (even if it means interrupting what they are doing), and willingly listen to my rants. I was deployed in a hospital for part of the COVID-19 pandemic, and my coworkers constantly texted and called to check up on me. Which brings me to my title...the most priceless gift I’ve ever received is the time of any nurse who has supported me in any way. I finally have nurses to look up to as role models...just like I had wanted years ago. Being a 22-year-old with no one older and experienced in your profession to talk to is not easy, which is why I’m so thankful for now having these people in my life. They are the nurses that I want to be like when I am older. I also have to thank my best friend, who is about to go to nursing school, for listening to my stories about the nursing world (I sometimes even throw in re-enactments for dramatic effect). They are all my nurse heroes. Teamwork and Resilience A healthcare setting would not be able to function without the core of teamwork and resilience brought by nurse heroes. By building this, it makes the hospital or facility run smoothly. I have even witnessed firsthand how it makes patients feel at ease. Many patients in the recovery area tend to exclaim: “Everybody seems so nice here!” “This seems like a friendly place to work!” “I was so nervous about this surgery, but you guys made me feel so comfortable.” My own personaI favorite was one day in the recovery area, I was discharging a patient. She stood up and quickly took my hands in hers. I got nervous and asked if she was dizzy. Instead of answering my question, she gave me a kiss on the cheek and said that I, along with everybody else who had taken care of her that day, was wonderful. She even said we were all “linda”(Spanish for “beautiful”). I immediately knew working as a team with my nurse heroes is what gave her that warm feeling. I guess one can say I feel a lot differently these days than I did even one year ago. I have more pride, more confidence, and very importantly for me...I know I have a strong support system from my “nurse heroes.” ...I guess I’m not “alone” anymore after all.
  4. I’m looking to get advice from nurses this may have happened to because I’m feeling especially blue at the time being. OK, so little backstory - I graduated in December ‘19 with my ADN and got hired at my areas bigger hospital for a new grad position in the mother/baby unit. I was also offered a peds position as well as on oncology. However, I took the MBU because my passion is to be in LDR one day. The first week went well, it consisted of class time and learning the hospital. The second week consisted of a class and two shifts in which I was placed with a preceptor. This is the where my first bad incident took place - I didn’t make it to the 6:45 huddle because my badge wouldn’t let me in through the employee door by the employee parking lot so I had to walk around the building to get in. I made it in by 6:55 before report was given on our patients but that was considered late (which at the time they were sympathetic, but later used it against me.) I spent the two days learning my preceptors routine, figuring how to do the charting, and going solo on the steps she had taught me to do on the mommies and newborn babies. This preceptor was awesome and I appreciated how she was patient with me and helped me find my own way while teaching me. That was about the extent of my “good” experience because the following week, I made the rather unfortunate mistake of oversleeping for a required class. I text a classmate to let her know of my plunder and that I was on the way. The text I received in return stated that they had decided to shorten the class and that the teacher claimed it wouldn’t be an issue for me to reschedule if I so chose to do. I agreed and went about my day until it was time for me to come in to shadow my charge nurse at 4:30. That’s when I received the call from my clinical coordinator wondering why I wasn’t at the class and why hadn’t I told them about it. My exact words to her was that at the cost of sounding ignorant, I simply wasn’t aware that it was necessary to inform them and that I was told I could reschedule the class within a few weeks. I was told not to come in for the shadow and to expect a call from the clinical coordinator as well as my manager the following day. I get that dreaded call and they proceed to tell me that I cannot come to work till after they speak with HR because 1. I was late the first day, 2. I didn’t let them know I missed the class, 3. I “lied” by telling them I was told I could reschedule the class because it wasn’t the teacher who told me that but rather a fellow friend/co-worker. It took them a week to get back to me, they ended up telling me I wasn’t a good “fit” for them, and they cut up my badge in front of me. Now, I am well beyond aware of my mishaps and what I should have done differently - I should’ve set aside time to make sure I could get in and out of the building before my scheduled shift, I should’ve set 5 alarms if that was what it would’ve take to ensure I didn’t oversleep, and I should’ve contacted my employer rather than my co-worker about the blunder. I am taking these unfortunate happenings and 100% learning from them so as to be the best nurse I can. That being said, it’s been a week and I’m terrified I’m blacklisted from this hospital since I have been applying for other positions and have yet to hear anything. Should I wait it out? I was offered interviews at another hospital, however it’s an hour away so I’m hesitant to accept. Do I have to list this on future resumes? I don’t feel as if I got to truly “nurse” and I’m discouraged my skills will atrophy if I don’t use them. I’m also concerned that that was the only time I will ever get to experience my “dream job” as this manager is over both the MBU as well as LDR. Any advice would be appreciated. Thanks
  5. Two nursing professionals explain the importance of staying curious and challenging the status quo to provide the best patient care. By Adrianne Duvall, DNP, APRN, CNEcl, FNP-BC and Chaney Landgraf, MSN, RN, CNE, CCRN In our experiences as clinicians and educators, neither of us has ever met a successful nurse who’s satisfied with the status quo. Nurses share a spirit of inquiry—a drive to know why and a refusal to accept care decisions due to tradition or convention. The skill of confronting "the way it is always done" is difficult, particularly early in your career. However, if the status quo doesn’t make sense, nurses must be comfortable challenging it because someone’s life may depend on it. Here are three skills you should prioritize in your first year as a new nurse—all centered on asking “Why?”—to build the foundation needed for a successful career. Developing Situational Awareness to Prevent Errors Situational awareness is a foundational component of nursing practice that serves as the basis for sound clinical judgment. You must be able to interpret the clinical cues around you and piece them together to understand what is going on with your patient so you can provide individualized patient-centered care. On top of that, you always need to know the reasoning behind your interventions. The heart of being a nurse is advocating for the most effective solutions for your patient—thinking like a nurse, rather than just doing nurse-related tasks. To do this, just ask, “Why?” “Why is my patient getting intervention ‘X’ instead of intervention ‘Y?’” “Why might my patient develop a complication?” “Why do some nurses on my unit perform this procedure differently than I learned it?” It is challenging to speak out as a new nurse. You might also fear that asking questions makes you look like you don’t know what you’re doing. But as experienced nurses working with novices, we find it more concerning when new nurses aren’t asking questions. From a safety perspective, it is imperative that you ask questions in order to develop your own clinical judgment. Research shows that novices make a large percentage of the errors caused by nurses, and the majority of those errors are related to medication administration. The National Council of State Boards of Nursing (NCSBN) recently highlighted a need to improve math education in nursing. Because learning to safely administer medications goes beyond a textbook, it is worth investing in hands-on resources that develop clinical judgment and skills to prepare you for real-world situations. Learning tools, like UWorld’s Clinical Med Math, allow nurses and nursing students to practice dosage calculations without the risk of harming a patient if they make a mistake. Finding Outlets to Reduce Stress Let’s face it—being a nurse is hard. Nursing is physically demanding, with hours of standing, miles of walking, endless patient needs, and often minimal to no breaks. Add the mental strain of being "on" for an entire shift and the fear of missing something or making a mistake, and it can take a toll. To address this stress, start by asking, "Why?" Why do you feel the way you do? Do you feel isolated or lack adequate support? Commit to self-reflection, perhaps using reflective journaling, and search for the “why’s” of your personal and professional experiences. Identifying your emotions and stressors will help you find the appropriate solution or support. Finding peers in your unit to lean on for support is critical. Whether it’s a unit-based educator or a staff nurse, having someone available to provide guidance and answer questions will reduce your stress tremendously. Building relationships with your colleagues outside of work is also helpful. Group dinners where you can commiserate and discuss the challenges of the job reduce stress and help put things in perspective by taking them out with people who understand. If you’re having trouble leaving work at work, going on a walk around a local park is another healthy way to de-stress. Throughout your career, you may encounter situations that make you question why you became a nurse, perhaps an unexpected poor patient outcome or a negative experience with a coworker. We all have unique reasons for entering the field, but sometimes we need help keeping a wider perspective of why we do what we do. Reaching out to former school faculty to share stories and challenges can be helpful. Someone removed from the situation can often provide a helpful perspective. It is also important to practice self-care, which can mean calling a friend to grab dinner after a hard day, or getting a massage after three straight shifts, or even committing to getting adequate sleep. When we take better care of ourselves, we provide better care to our patients. Committing to Continual Growth Becoming a nurse inherently commits you to a lifetime of learning. But how do we truly grow as nurses? It is easy to think that completing the continuing education requirements for our licenses and specialty certifications equates to career development, but growth as a nurse requires engagement and commitment. One of the most effective ways a nurse can become a lifelong learner is to engage with a larger community. It’s so easy to become immersed in your unit’s ways—the behaviors almost become law. Broadening your perspective through different groups in your facility, nursing journals, or external professional organizations will help you find the "why" in your own practice. Depending on your facility, there might be opportunities to engage with people who are creating or implementing research that keeps you updated on evidence-based practices. Professional associations like the National League for Nursing are also fantastic resources. They have meetings and free continuing education modules where you can read articles and test your knowledge. Of course, the most fun sources of continuing education are conferences. It’s fascinating to see what different professionals are doing across the country, and it opens your eyes to possibilities to bring to your facility. Nurses experience so much change during their careers—change in practice, specialties, hospitals, or units—which gives you the opportunity to learn an entirely new skill set and deepen your nursing knowledge. Staying curious and asking questions is the most important thing you can do to be successful as a nurse.
  6. Hello all, I am a new nurse who had two months of orientation at a hospital, and I have been off for about a month now. Someone mentioned to me the other day that I ask a lot of questions. I am curious if I am asking too many questions to other nurses that makes me come off as incompetent? I ask simple questions that I think I know the answer to, but want more clarification or validation that I am doing it right. Other questions I just do not know the answer to. Sometimes with research I can find the answer, other times my mind is going a mile a minute I don't even think to look up the answer and I just ask their advice. I have asked other nurses their opinions on varying blood pressure readings, holding blood pressure medications with no parameters, giving oral blood sugar medications, calling the Dr., procedural tasks such as straight catheterization or g-tube, patient positioning, helping with manual BP, where exactly to put topical medications, which port to use to infuse medications, ect. Sometimes I ask the same questions twice as well because I just completely forget. I am not lazy, just worried that I will do something wrong if I don't ask even simple questions. I don't want to annoy the other nurses on the floor and I don't want to come off as dumb. Any advice on how to better use my critical thinking skills and possibly stop asking so many darn questions? Is this normal to ask this much for advice, or am I over doing it? Also, I started with a few other brand new nurses and they seem to getting a better hang of things then I am. They are calm, cool and collected at all times and I'm over here having a pretty hard time adjusting still. It is a little discouraging to see them advance so fast. Thanks for your advice!
  7. So a lot of you are wondering what your compensation will be following nursing school. I can't speak for each state but in Texas, nurses are paid very well, combine that with an unrelenting passion and proficient skills set, it's money in the bank. (BTW I didn't go to school for grammar and I'm notorious for extra commas) So, where I started working right out of school in July 2017 nurses are paid $24.25 an hour, I started in an ICU. I don't count the full year of 2017 since I was a tech making $11.70 an hour for more than half a year and by the end of the year without OT I made $45,000. In 2018 however, my first two checks were >$5,000 after taxes. How? Well, my base was $24.25, my hospital gives $1.00 raise every six months for the ~3 years for residents plus your annual increase. So after six months, I was making $26 something. I work nights so that is automatically and extra $3.25 per hour for the first four hours of your shift and then an extra $4 per hours for the next 8. So right off the bat, I was making at ~$30 an hours. I worked weekends so my job gives another $6.50 an hour for weekends, so guess what? I worked on weekends. So just for my differentials + base, I was averaging $36 an hour for 36 hours a week. There is always overtime and I only picked up when they offered $10 dollar bonus, which means they tack on another $10 an hour on top of my base, differentials and time and 1/2. I picked up an extra 1-3 shifts a week and for holidays they automatically pay time and 1/2. When you are in overtime and already getting paid time and a 1/2, plus holiday pay + base + differentials + bonus, that's money in the bank because you are getting double base pay plus everything else. Although, I will disclose I had no children and no pets so I was only obligated to myself and my bills lmao. If you have a family or other familial responsibilities it can be difficult unless you have a dedicated partner or support system whom/who are sympathetic to your financial goals. Also, some people love nursing and some people find out it is not for them, I am definitely one of those people who absolutely love my team (physicians, RTs, fellow nurses, social workers, administration, NPs, just everyone) and my profession. I had people who were willing to teach (nurses who were/are 30+ years in the game) as well as a younger nurse who knew the new tricks of the trade. I was never unsafe, for instance, I inquired with my manager about all my OT shifts and she agreed to cancel me if I didn't feel rested enough to work because I was doing the hospital a favor. Your environment has a lot to do with your work satisfaction. I don't mean to rant BTW I'm just telling you all my truth. I never felt burned out and took a 2 1/2 to almost full month vacation every 3 months. I've been to Germany twice, Hawaii, traveled to various parts of the country. Now that I have an extensive skill set, I travel but I still keep my job at my first hospital. I probably will never leave haha I never imagined making almost 6 figures as a brand new nurse and if I can do it, so can you!
  8. I can vividly recall how stressful it was as a nursing student and new nurse graduate to communicate with physicians. I was already intimidated by doctors and it seemed my mind drew a predictable blank when I had to interact with them. As a novice, I had to learn how to organize my thoughts and provide the appropriate information to communicate the patient issue clearly. This is a learning process most students and new nurses will experience and build confidence. There are tips for communicating with doctors and an interdisciplinary team that may make this process a little easier. A study published in the Journal of Patient Safety, by Tija et al, found several factors that can affect nurse-physician communication. These included: Lack of openness and collaboration- nurse feeling hurried by the physician or feeling the physician was not interested in the information the nurse was sharing. Frustration with the lack of professional respect- 16% reported being interrupted by the physician before they were finished communicating important information. Logistical challenges- difficulty finding a quiet place to communicate, finding time to communicate with the physician and not being able to get in contact with a physician when needed. Language barriers- difficulty understanding physicians due to language, accent or use of medical jargon. Nurse preparedness- nurse not being prepared with assessment data or information the physician will need to make decisions and/or changes to patients care. Being aware of nurse-physician communication barriers is the first step in students and new nurses building skill and confidence in communicating with the interdisciplinary team. Scenario One: Jane is a nursing student at clinical and is reviewing a patient’s record at the nursing desk. Jane is approached by a doctor asking for information on a patient and her instructor or another nurse are not at the desk. Jane explains to the physician she is a student at clinical and the physician, frustrated, states “can you not find someone who can tell me something about my patient?”. Scenario Two: Matt is a new graduate and just completed orientation for his first nursing position. Matt is approached by a cardiologist asking why patient X was ordered a cardiology consult. Matt provides background information and the physician states, “What do they think I can do for them? This is a waste of my time!”. What do you do when you find yourself in a situation similar to the above scenarios? Your first reaction may be to go blank or become defensive. Here are some tips to help when you find yourself communicating with a difficult physician. Stick with the facts and leave emotion and opinion out of the conversation. It may be as simple as, “I don’t know the answer to your question but let me find someone who can help you”. Be aware of your body language and stand straight to convey a look of self-confidence. Take a step back to avoid a defensive or aggressive response. Respond in a respectful manner and expect respect will be returned. Apologize when appropriate. Report the interaction with your clinical instructor, preceptor or charge nurse to ensure acknowledgment of the behavior. The physician’s behavior may be a pattern and documentation may be needed to address. Do not accept inappropriate or abusive behavior- walk away, stand silently or ask to be spoken to respectfully. Practice communicating with physicians on a regular basis. The best time to practice is when you are with your instructor or preceptor. Take notes on how your preceptor approaches, answers questions and communicates with physicians. Be prepared before calling or talking to a physician about a patient. Write down pertinent information to clearly communicate the patient situation. Having information available and organize may help minimize problems. For example Patient’s name and room number Reason for call Health history Lab values that relate to your reason for calling Recent vital signs Medications related to your reason for calling Allergies Effective nurse-physician communication is key to providing safe care for positive patient outcomes. Fortunately, there are steps nursing students and new nurses can take to improve their communication with physicians. With practice and experience, the novice nurse will become confident, even when dealing with difficult physicians. What tips would you like to share to support students and new nurses? Resources: Institute for Healthcare Improvement: The SBAR Tool for Communication Tija, J., Mazor, K., Field T., Meterko, V., Spenard, A. & Gurwitz, J. (2009). Nurse-physician communication in the long-term care setting: perceived barriers and impact on patient safety, Journal of Patient Safety, 5(3):145-52. Patient Safety and Quality Healthcare (2012).  Nurse to physician communication: Connecting for safety.
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