What is your day like?

michael79 · Mar 5, 2008

I think the answer to your question is in your post. It has only been 2 weeks and you are only in your 2nd semester! Give it a chance. And, if you can breeze through 3 patients as a 2nd semester student you are probably rushing through your care routine. You sound as if you think nursing is below you. You need something more 'cerebral'???? Come off it! We nurse work very hard. Your implication is that rehab nursing or anything that isn't critical care doesn't require intelligence. Give it longer than 2 weeks before you decide that floor nurses are morons.

locolorenzo22, BSN, RN · Mar 5, 2008

I posted this same thing on the ICU page and would love to heare from the ED RNs too.
I'm feeling very discouraged with nursing after only two weeks of clinical. I'm in my 2nd semester of my BSN program. My clinical instructor thinks that I am way better suited for ICU (I'm thinking ED may be better for me) so I'd love to hear what your day is like (in general) in the ED. So far I've been on rehab, which I hear is the least acute it gets, and I'm SOOO bored. I NEED to use my brain more or I'm sure to go mad. I precepted last week and had three patients, was able to do all but pass meds myself (acuchecks, i&o cath, showers, vitals, all the charting, changed the beds) and was still craving more action. I'm thinking that's a bad sign as I'm "supposed" to be overwhelmed and nervous my first real week with multiple patients. We go back to only one patient this week. I'm not sure what I'll be doing the whole time if I was bored with three....
So that got long! =) Please tell me it gets crazy busy in a more cerebral way. So far they act like critical thinking is holding insulin if the bs is 40. The thought of never knowing what is going to happen and needing to "turn it on" in a moments notice sounds like heaven! My passion and interest lies in wanting to figure out what is wrong and then fixing it. Do you think the ED is a good place for that? I've worried lately that I may need to go the M.D. route to fulfill this need of mine but I'm thinking and hoping the ED (if not the ICU) may do the trick.

Ok, so since I take your post more seriously than someone who just got here...I'm in my 4th semester of my ADN. I've had 4 patients in acute care(med/surg) and sometimes got a little behind....but never bad. Now in LTC I'm going to have 6-7 pts...I think it'll be ok....but you HAVE to be organized and at first it can be overwhelming or boring. Why not spend your free time looking up patients disease process, or what new concepts are going on with them? Look up the meds, etc...actually see if the clients need anything extra. Don't worry, about the time it takes to actually get things down is when you'll have a SUPER demanding client....lol.

Good luck.

locolorenzo22, BSN, RN · Mar 5, 2008

Hey, and Klait? Calm down....OP's a student....just take it with a grain of salt and be CONSTRUCTIVE...that's what we're about here on AN....

michael79 · Mar 5, 2008

My point is exactly what you said...she is a student. She should be there to learn. Not to judge all the other nurses she thinks are so beneath her.

jjjoy, LPN · Mar 5, 2008

Often what makes nurses crazy busy is the sheer amount of work. As I noted in another post, much of that busy-ness students aren't exposed to. But that depends on how your clinicals are run and where you have clinicals. Do you get to work one-on-one with a nurse or is it like most nursing school clinicals and you share a clinical instructor with other students? How many other students? In this particular rotation, do the nurses look busy? Or do they seem to get all of their word done? Are you only responsible for baths, vitals, I&Os, accuchecks, making beds? Since this is your first rotation, they may just have you focusing on basic nursing tasks that you likely would have a CNA to help with (but if you were the CNA, you'd have 8-15 patients not just three). That's how our first rotations were, except for the ridiculously long assessments (4 pages! how unrealistic is that?!) we were to do with the patients. In fact, in my two years of various rotations, we NEVER had the full experience of ALL that a floor is responsible for and just what a juggling act it is (tests post-poned, unexpected admits, angry family who want you NOW, delayed delivery of meds, etc).

As you noted, this rotation is with a relatively stable patient population so much of the nursing care is focused on maintenance. No major medical mysteries there. Sometimes nursing can be like lifeguarding - though MUCH busier between jumping in to save swimmers. The nurse is there 24/7 to catch things if and when they go wrong, but on many units, there's more hassles with admits, discharges, getting pt X a pain med and dealing with pt y's emesis all at the same time.

So the floor nurse does need to know lots about different disease and about pathophys and pharmacology to be able to catch problems and antcipate MD actions, but they are also responsible for ensuring that patients get the proper diet ordered, that the right meds are delivered from pharmacy, the MD orders are carried out in a timely manner, that a patient is NPO before a test, etc. Not highly "cerebral" though it takes quite a bit of skill to pull that all off with so many competing demands! AND be vigilant for patients who take a turn for the worse AND know enough to give safe care for a wide variety of patients. (And as an editorial aside, I don't think most BSN programs like to draw attention to the fact that nurses are often bogged down with "menial" tasks because that might somehow give the perception that nurses aren't "professional". You're not just ordering a meal tray, you're actively engaging in the nursing process related to patient nutrition, intake, feeding status, etc).

Have you looked into shadowing on an ICU and/or in the ER? It may float your boat or it still may not be what you are looking for, but they definitely aren't the same as rehab nursing, so check it out before making any decisions!

rgroyer1RNBSN, BSN, RN · Mar 5, 2008

Come to my SICU or ER and Ill work your you no what off, I somewhat agree with klait, I was a floor nurse first as an Lpn then and now an RN, but dont pass the floor off as it can get more challenging then you are thinking give it some more time.

maryloufu · Mar 5, 2008

If you are in rehab then are all of the patients busy with Rehab activities most of the day? Believe me, on my unit 4 patients will run your legs off. Between new doctor's orders, pre op and post op activities, discharges and admissions- you are not going to be bored.

Look through the charts and see what these patients were like when they were newly admitted.

johnnrachel · Mar 5, 2008

I can just say my two cents worth...... As a student you do NOT have the same responsibilities as a registered nurse, you are not talking to 50 doctors, dealing with ALL the families, critically ever changing patients, etc. I now work in the ER (love it) but I did work the floor for over a year. I can just say give nursing school and nursing in general much more time to make any judgements just yet. Better yet just keep reading allnurses and you will learn the real world of nursing. Good Luck in your schooling.:thnkg::prdnrs:

FuturoEnfermera · Mar 5, 2008

come to my sicu or er and ill work your you no what off, i somewhat agree with klait, i was a floor nurse first as an lpn then and now an rn, but dont pass the floor off as it can get more challenging then you are thinking give it some more time.

that is pretty much what i'm hoping to hear. i feel like i must be missing something! i'd rather hear that my boredom is more related to naivety than i've chosen the wrong career. i'm very worried and upset that nursing may just not be right for me. at this point i don't think i'd continue if i didn't have my kids to look out for. make fun if you will but i do need that "cerebral" challenge to feel satisfied. and yes, my day at rehab felt (in someone's words) "beneath" my interest level. i'm happy to bathe, clean up poop and vomit, and whatever else, but i need intellectual stimulus to go along with that. i realize that it would be extremely satisfying for some to see their efforts directly affect the lives of the rehab patients, and to watch them improve, etc. my passion, however, is more about the puzzle. i have plans to shadow in the icu and will be working on a scheduling a visit to the ed too.

i was simply looking to hear about whether or not the ed was more in line with my interests. i feel like crying about 22 hours a day since starting clinicals. no good at all.

michael79 · Mar 5, 2008

As a former ER nurse I can tell you that you will be somewhat 'cerebrally' challenged at first in the ER or ICU. Then once you learn the pathways or whatever your hospital calls them, some things just become second nature. You can almost look at some people and tell what is wrong with them. Try exploring one of the more obscure fields of nursing during your senior year. i know we had the option of interning in a sub-specialty my senior year and I did a forensic nursing rotation. Have you thought about doing nursing research?

FuturoEnfermera · Mar 5, 2008

as a former er nurse i can tell you that you will be somewhat 'cerebrally' challenged at first in the er or icu. then once you learn the pathways or whatever your hospital calls them, some things just become second nature. you can almost look at some people and tell what is wrong with them. try exploring one of the more obscure fields of nursing during your senior year. i know we had the option of interning in a sub-specialty my senior year and i did a forensic nursing rotation. have you thought about doing nursing research?

that does make a lot of sense, like anything you do all the time it would become a kind of second nature i suppose. i'm just really missing the science and problem solving that was involved in pre requisites. nursing school seems so superficial compared to that. i think i really need to work on my attitude because it's mostly up to me how in-depth i think about my patients. it just felt like i was so busy with mundane tasks that i couldn't focus on the more interesting things. i bet this is a common complaint of those who want to get to know the patients and diseases better.

thanks for the research suggestion. i take that class this summer and i'm looking forward to it. i love learning so it may be a good fit. we'll see!