the first three shifts....

I've had 3 shifts in the big city ED so far. It's a very different place than my small town ED that I did my final student placement. One, this emergency department is set up in Pods. What that means is that there are clusters of beds in certain areas, and as a nurse we are assigned certain beds for the shift. In the rural ED, it was a free for all. You would have a mix of patients, some very sick and others were walkie-talkies who would leave within the hour.

At the big city hospital, you get those few beds, and that's it. You could have 4 admitted patients there the WHOLE SHIFT, because there is no room upstairs for them. I have spent a day in Resus, and have spent 2 days in the "A" pod, which is supposed to be the step down from resus, and have quite sick patients. It's not exactly what I expected, but I think the days I have been working have not been the "norm", as that is what the other nurses are saying. I have found myself counting down the hours to when I can go home. Nothing really interesting has come in yet, and I have been looking after 90+ year olds with dementia (thankfully DNR), former strokes, UTI symptoms, and resolved chest pain yet admitted.

Well as a new grad, i feel like an idiot most of the time. I have had some doozy days where I swear the nurses are rolling their eyes at me. I don't feel confident with my skills, and I'm forgetting simple drugs and procedures. Luckily I'm paired with a preceptor so they are showing me where things are and helping me maintain some form of organization. But I still don't feel ready to be out there on my own, and I'm realizing how much more I will have to learn in order to feel comfortable. I'm also still not sure of me being part of the nursing process in general. I don't' know when I'll feel completely comfortable calling myself a nurse.

I also don't really know anyone yet, so I'm bombarded with new people, and I don't' know where everything is. It's frustrating, and I'm hesitant and slow with tasks I have mastered during nursing school. I'm not dreading my next shift, but I'm not thrilled for it either.

I guess there is one consolation...... I'm getting paid.

I'm at the lowest end of the nursing-salary spectrum, but I can't believe how much entry-level nurses make. We work our butts off for the money we make, but wow! My bf has been working for two years and he's making 15k less a year then what I will be making. Yikes. (I am, however, highly aware that in about 4 years I'll be complaining about the money. Please remind me of this post later.)

Downside: student loans. They suck. So much for the extra $$, it's going to the bank and the government.

Change of Shift

Welcome to the newest edition of
Change of Shift.

I am incredibly proud to be a first-time host of Change of Shift. I'm new to the profession of nursing (graduated in April!) and am learning the ropes of becoming a good nurse.

This edition will allow you to go back in time to your days of nursing school and thinking about your first experiences as a nurse.

These nursing students look happy while learning to measure medication for their patients. If only all of nursing school gives people that much joy!

Mofo at nerdy (not quite) nurse is in the thick of nursing school. She's finding it not what she thought it would be. Head over there to give her some support! Don't worry Mofo, wanting to become a good nurse is the first step. Keep with it.

RN and continuous student and ED nurse Disappearing John hates losing, especially when it is a young patient. Check out I hate losing... .

Nursing school and nursing itself is not just about the bedside, it's also about fun! Mother Jones at Nurse Ratched's Place, being the amazing nurse she is, can't decide what to wear to a banquet.


It has been said that the first few years of nursing is some of the toughest. Jane at New Nurse Jane doesn't have much time to breathe as she describes her day as a busy telemetry nurse. Just reading her post makes me dizzy!

NP's save lives is a new NP whose challenge lies in NP/physician Can't We All Just Get Along?

Newly graduated nurse Locolorenzo says it all when he quotes. "Hands that heal, hands that love, They lift you up, when you're not strong enough." Check out this post.

Not suited for bedside nursing, or want to explore additional and holistic health practices? Check out Kate at Alternative Nursing Careers.

Jacob has been busy! Check it out: He's finished preceptorship, obtained a RN position, moved, graduated, signed up for NCLEX, worked a temporary position doing computer work, got a new cat, etc. Phew!

Sometimes we are intimidated by our professors. Caroline at Brain Scramble was surprised to hear about the personal life of her professor, and how the news thus changed her perspective.

Nurse Laura covers some new grad nursing tips and welcomes nurses in the nursing world in her blog on NurseConnect titled, Welcome New Nursing Grads. She also has great insights on Difficult Patients.

Have you heard any of these Nursing Superstitions yet?

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Not within the theme but fantastic posts:

Jose DeJesus MD presents Medical Care Funding Crisis posted at Physician Entrepreneur.

Dr Penna discusses new proposals by FDA to change blood donation rules for those tested positive for Hep B in 1980s and 1990s

Alvaro Fernandez explores brain training in the elderly Brain Health Business Grows With Research and Demand posted at Sharp Brains.

Jennifer Bunn, RN asks the question: Should doctors be able to turn patients away if they disagree with their lifestyle choice?

Want some tips for taking care of your back? Dean Moyer has a great article on What To Do If Your Back Goes Out.

Finally, ERMurse discusses the use of Technology in nursing, specifically the Emergency Medical Record.

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I hope you've enjoyed this Change of Shift. The next addition will be June 12th at Nurse Ratched's Place. Submit your articles to nurseratchedsplace at yahoo dot com.

Image/Photo credits:

Nurstoon.com

Nursing History Digitization Project

Advance Healthcare Shop

A quick note

Change of shift submissions are fairly steady. Don't forget to send them to me at misselaineious1 at gmail dot com.


Again the theme, if you can provide it, is about being a student nurse or a new grad.

I'll post more soon.

E

Update on my knee

So I have a diagnosis: I have a patellar fracture, but the pieces were small enough that I don't require surgery. I can weight bear (need to build up strength... I can't believe how only 1.5 weeks on crutches can reduce my quad to nothing), but start gradually by walking with crutches. I'm still hoping I can start my shadow shifts on time, but without any lifting. Rehab starts next week.

(Photo taken out for copyright reasons)
Here is an example of my type of fracture (ok radiologists out there, yes you will note that this particular image is from a 10 year old). If you look closely on the left hand side of the image, there is a small chip away from the bone.

While I'm still sitting on my ass, in the meantime I'm trying to jam some medical directives into my brain.. I'm thinking I'm fairly saturated now!

Change of Shift

Is over at Parallel Universes.

AND I'm proud to say that I'm the NEXT HOST of Change of Shift on May 29th. As a new grad emergency nurse, I challenge you to think back on your first few shifts as a nurse. If you're a student, talk about your experience with preceptors, or how you are learning to find yourself within the nursing profession.

I'm not picky though, so if you have a great blogging week feel free to submit that! You can submit your article at misselaineious1 at gmail dot com.

Oh and for the Canadian folks (at least, in Ontario), HAPPY NURSES' WEEK. We received a free Timmie's coffee and a donut (how Canadian is that!?).

Nurses Week

So I dont' normally give kudos to other bloggers, but this particular article touched my heart.

Thanks Movin' Meat for a great article on the dedication of nurses. Perfect for Nurses week.

Enjoy.

I'm a sucker.

I'm a sucker for these quizzes...


77%LUSH

Not gonna lie, I was drinking a beer while completing the quiz.

Nursing orientation

Nursing orientation can be described as a combination of all the boring nursing courses you have taken over the past few years, plus some embarrassment as to what you have forgotten and are now reviewing.

This orientation is no exception, although it's nice to finally get paid to sit, study and review!

The first day was corporate orientation. This is the organization, this is where to get your parking pass, this is where you park, you need to get an ID badge here, these are the corporate values, this is the corporate image, these are the foundations associated with it, etc, etc, etc. 4 HOURs of time I'll never get back, especially since I have worked at these hospitals before as a grad student.

Anyway, that day finally finished, and then all the nurses in the group (including myself) u78went to central nursing orientation. What that does is review all the generalized nursing information that we should know that is specific to the organization. Examples include crash carts, oxygen administration, glucometers and diabetes, the IV machines, infectious disease precautions and the policies surrounding isolation, code whites, restraints, wound care, lifts and carries, and much more. If you are working in a more critical care area, you get another 2 days that include chest tubes, telemetry, ABGs, etc.

Not only do I get this centralized training, I also get Emergency specific training. Today was triage, airway and breathing.

I can understand how triage can be both easy and extremely difficult. Although I won't be doing triage for a while, and have not taken a course in it, we need to know how it is done so we can understand the priorities, and fill out the forms if a triage nurse takes the patient right to the back. We had reviewed some case studies together, and sometimes I triaged down when I probably shouldn't have, and triaged up when I didn't have to. I guess I'll have to keep on working on it.

My take: I love getting paid to sit and learn. This is great material for the nursing exam, and it's also good to know that things are common between the rural hospital and the big city hospital. Tomorrow is advanced cardiology and circulatory disorders. Wish me luck!

Knee continued....

CT scan 1, diagnosis 0.

Who says you can't get a CT scan quick (3 hours) in Ontario. Or a specialist appointment (4 days), or a surgery consult (during the specialist appointment).

One thing I do have to say... being non-weightbearing sucks.

I would like to start my shadow shifts on the 26th. Looks like it might not happen.

Updates

Graduated.... check.

Moved... check.

Started nursing orientation at the new job... check.

BUT UH OH! can't be all that great in the world. Nope.

I never really said this but I love playing sports, particularly soccer. There was a soccer tournament this weekend. It rained the whole day and was cold. Now I look like this:Gotta love the plant+twist. Doc seemed to think it was my patella as he said that my ACL is still there. Well, I have an appointment with the sports meds guys on wednesday. I'll keep you updated.

The carer becomes the patient. Thank God I have 2.5 weeks of classroom orientation before I have to start shadow shifts! I hope I can walk by then.

CoS

Change of Shift is up at Life in the NHS. Go check it out!