As a result of the dismissal, I am seeking employment and am trying to get into another program. I know that I am older, but really want to become a nurse.

Does anyone have any suggestions?

Sincerely,

EO

I am currently on monitorig with the board and recently passed my boards for RN. I have applied at hospitals, nursing homes, rehabs with no luck of getting hired because

1) I can’t work nights;

2)I can’t work per diem;

3) because I’m on monitoring!

I almost feel like giving up. There is so many stipulations to the boards monitoring I can’t get a job. I know Im the one that made the mistake but I was not at work, I have never been in trouble and it will never happen again! A DUI is very serious.

Luckily the only person I hurt was myself. But am I not allowed to make 1 mistake without my life being ruined?

Doris

Our initial orientation was supposed to be 8 weeks, but I was thrown out on my own a little sooner than I would have liked. I started at my hospital June 1st doing orientation and by the fifteenth they had me on my unit with a peceptor. I did that for two days and by my third day I had two patients by myself. the next day three, next day four, five and so forth up to six which I am now at. (I think thats the limit) It was extremely stressful As soon as I felt comfortable with my time management and felt like I was finally getting my “niche” (as my co-workers called it) I would get brought back down to reality again when I had an extra patient.

I of course struggled the most out of any day so far the first day I had my own patients. I had not created any kind of system for myself…I was still searching for one. I found myself passing meds like an hour late and having patients who were supposed to have procedures done in the AM and I didn’t have any of the paper work done for it. I also got a phone call that night from the cardiac unit telling me my patient had a pause in their rhythm strip. I was in the room with the patient when this was supposed to have happened and he was totally asymptomatic I checked his VS’s and reassessed him and everything. I asked a new of my co-workers what had happened and what I should do about it. my shift was ending in less than 30 minutes. They recommended I just chart my findings and mention it to the oncomming shift when I give report so they will be aware of it. Well when I did this the nurse I gave report too flipped out and yelled at me and embarrassed me in front of the whole team. Telling me I was crazy and I should have “called the DR!!!”

She ripped my papers out of my hands and stormed off. Now if thats not a bad way to end your first day I would like to know what is! Here I was passing meds and having two patients by myself and its only my third day on the Unit! I’m still supposed to be precepting for another like 4 weeks here! On top of that My pt. with the critical lab (low K+) Is leaving for a CT scan and needs to have her IV K+ hung STAT…all the girls are yelling at me telling me hurry hurry hurry… I had never hung an IV bag of K+ at the time and was still trying to even figure out how their IV equipment even worked. After what seemed like an eternity I got someone to come walk through it with me and she was able to be sent on to CT. I was scared becasue I was in a hurry and I didn’t want to go do somethign I didn’t feel comfortable doing for the first time under that much pressure and stress. I have heard far too many horror stories about IV’s getting put in the wrong port and people getting a bolus rather than a drip rate. I was a nervous wreck! Well that morning when I went home from my shift I felt like crying the whole way home. The nurses on my unit are very helpful and they come and help me whenever I need it. That particular night they were all just very busy. If I ever ask a question or ask for help and I notice that fabulour eye roll or I feel like I am getting on their nerves I just tell them thank your for helping me and I have to remind them that this is still new to me. I usually mention that I would rather ask for help and get something done correctly than to do it alone and mess up and have an even bigger mess than if I woudl ahve just asked for help. They usually agree with me, smile and are more than happy to help walk me through something I am not comfortable doing…thank god! lol….AFter that terrible shift I felt hopeless…like I was never going to be able to make it. I figured I needed to come up with a routine so that this sort of night will NEVER happen again! I went home and wrote down all the things that eiher I over looked, or got behind on, or just didn’t understand well and I reviewed it. I created my own little “care plan” of what interventions I can do the next shift so that I can fix all these mishaps. This is what I came up with…

I created a little page with 6 blocks on it and I typed it up so it will be neat. I take a sharpie and put the pt.’s name and room number by each section and I made the copies on Yellow paper so it will stick out when I get a big load of papers and find myself fumbling through them. I have the time labeld on the left hand side… 2300, 0000, 0100, 0200..etc. with a line out from it I label the time everything needs to be done so I will have a quick go to guide when I get behind or confused. I also have a section saying what PRN’s have been given and what time. What their O2 is set to…what IVF’s are hanging and what rate..etc. I dread leaving stuff for the morning shift to do becasue they give your “the look” and make you feel like you didn’t do your job. And being the new kid on the block I don’ t like leaving feeling like someone else is picking up my slack. So I try to not let that happen as much as I can. My routine as of now is I clock in go get my report on my patients then I go assign each of them to me on the computer and look up everything that needs to be done on my shift for each patient. Labs, meds, xray, procedures, etc.

Once I fill that out I make my initial rounds do my assessments and pass any meds that I might have to give. I started asking them their pain scale while I’m doing my first rounds so I don’t find myself running back and forth to the med room 10 times when they call out for pain meds, or nausea meds. After I get all that done I get to my charting with hopes of getting it all done by my 3AM Chart checks. This method works great for me unless I get critical labs adn have to call the MD or heaven forbids one of my patients gets bad and needs some extra TLC. It’s those little surprises that can totally get me off track and feel stressed out. I talk to my co-workers and they all tell me my feelings are totally normal for a new nurse and that alot of them felt that way when they were new too. They always tell me it gets easier with time and once I get my “niche” I will be smooth sailing. I long for the day when I can actually go to the bathroom or sit down and have a lunch break and not feel like I am missing precious time.

How long will it be before I feel totally comfortable as a Nurse?

When does that “Reality Shock” finally wear off?

And does anyone have any tips for new nurses to help us find our “Niche”?

Any advice or tips would be greatly appreciated!!!

I work night shift so we have a little extra paperwork than the day shift does. The big stack of charts I have to go through one by one bogg me down so bad. I have a goal every night to get to them by 3AM if I can manage to sit down and start at 3 and not have interruptions I can get it done and go on and get ready to give my morning meds and make my next rounds. If not I get overwhelmed and feel like I’m not going to have time to get everything I need to get done.

Thank You!

Brittany

I have to tell all potential employers what happened (which is something I have no problem with)and am constantly getting back things along the lines of “thank you for being honest and upfront…but we don’t have the support system in place to help you”

How do I get employers to realize that although I have made errors previously (and I do tell them what I have done further along to change my practices), I am fully capable of doing the job at hand and that I would be a welcome addition to their facility/ward??

It’s getting frustrating to know that there are places screaming for nurses out there but that I, a fully capable and qualified nurse, am basically being stopped before I can show what I am capable of.

Then Wednesday night hit.  It was the beginning of a 24-hour period that had my adrenaline in overdrive.  One thing after another kept happening, and I was at my wits end by Thursday night.

Here is a brief overview:

The camp pastor fell on a horseshoe stake and injured his leg.

A 12-year-old boy fell off a 10-foot platform face first.

A 10-year-old boy was brought in on a back board after injuring his neck inner-tubing.

Another 10-year-old boy fell and injured his arm and ended up in the ER.

Now, between these injuries were several bee stings, a sprained ankle, a minor eye injury, and all the minor stuff mentioned above.  Those were easily dealt with and forgotten moments after they happened (for me, if not the patients).

It was the others that had me reeling a bit.  Three of them I was alerted to before I saw the victim.  The fourth happened in front of me.  I watched the fall through the lens of my camera.

In each case, my stomached dropped.  Remember, I’m a Family Practice nurse, NOT an ER nurse.  It’s amazing what comes to your mind when everyone is looking to you to deal with an injury.  Honestly, after the “Oh crap” thought left my head, I went into an immediate prayer.  It went something like this: “God, please help me to be sufficient for this situation.”  Short and sweet. 

I was completely aware that I might not have the experience needed to care for the injured party, but I was all they had in that moment.

I am smart enough to know that my very first responsibility is to remain calm.  If I don’t, no one else will either.  It’s all an act, of course, but they don’t have to know that.  Beyond that, I just start doing whatever comes naturally (or supernaturally in some cases).  I take control, ask questions, and pretend they are in extremely capable hands as I start attending to whatever need they have.

If you’ve been reading this blog for a while, you may remember that my first camp nurse experience didn’t go so well.  Actually 99% of it went fine.  It was the 1% named Tony that was the killer.  Tony was electrocuted by a fan in the camp kitchen and died.  He was 17.  I did everything I knew to do, but he died anyway.

We all face situations as nurses where we aren’t sure our abilities will be enough.  Where we don’t know if we know enough.  Where we feel insufficient.  Sometimes, in fact, it’s the truth.  But more than likely, we have everything we need to do the right thing for the patient.  Tony died because he was electrocuted, not because I did anything wrong.

And our patients deserve our confidence.   What could be worse than feeling terrible and have the person who’s supposed to be taking care of you acting like they don’t know if they can?  Talk about adding insult to injury!

So the next time you have to do something you aren’t sure you can,  fake it.  Even if you have to get some help, ask for it in the most confident tone you can muster.  You are a professional.  Other people assume you’re qualified.  Act like you are.  And if you’re still a little uncertain, you can always try my approach and pray.  Who wouldn’t want to believe there is a higher power who can bridge the gap between what they have and what they need?

I’m fessing up: I did not pass the NCLEX the first time.  I had heard from teachers and nurses alike that the exam could potentially shut off at 75 questions, 240 questions or somewhere in between.  If it shut off at 75, you either passed with flying colors or you failed miserably.  If it shut off at 240, you barely passed or barely failed.  Mine shut off at 75 on the dot.  Two days later I found out that I failed the NCLEX exam.

The days that followed, I was disgusted, disappointed, depressed, and any other “d” verb you can think of.  I seriously wondered, Am I cut out to be a nurse?  Have I just spent all this time in school and still don’t know or understand enough to be a nurse? I despaired.

That’s when my aunt, who was a nurse, offered a story about a nurse she once knew.  This particular nurse was one of the best she had ever seen as it pertained to the care of patients.  An example to follow, emulate. Someone who understood the dynamics of health care and what it took to be not only a nurse, but one of the best.

Then my aunt laid the bombshell: This nurse had failed the NCLEX SIX TIMES!  Here I was fretting over one bad exam, and this poor nurse had to take it SIX TIMES before she got it right.

That story was motivation enough for me to reconcile my differences with a teacher of mine in college and ask for help.  I can honestly say my time spent with this teacher tutoring me made the difference.  It gave me motivation to strive for a goal that obviously I wasn’t able to achieve on my own.  The second time around I was ready. And this time the test went to question 76.  After 120 questions the test ended.

A seemingly infinite two days later I found out I passed!

The best advice I could offer anyone out there who has yet to take this exam isn’t fresh; it’s as old as the advice your 9^th grade geometry teacher gave you: Study your hind end off!  Don’t listen to those who tell you how the test was that have taken it, or those who took it years ago and speculate what it might be like today. Expect your case to be unique; expect it to be tough.

So, study hard, set a goal, partner with a tutor, and always remember that nurse who failed six times. Because if she can succeed after that many failures, you can too.

Looking back, I realized I could have died.  They should have held me in the hospital-or at least offered me some kind of resource to help me address my addiction.

But they offered nothing.

The problem with addiction is that it is viewed as a moral deficiency instead of a disease.  If I was diabetic and was diverting insulin and was in DKA, would they have treated me the same way? Absolutely not.

I received no support from the hospital. I lost my position immediately and all health benefits were terminated. Rehabilitation was dependent upon what I could finance. On average, rehab can cost anywhere from $5000-$30,000 per program-and that was more than I was able to pay. I had to turn to my family for help.

The hospital was completely negligent in how they handled my situation, just because they had bought into the stigma.

Jail Time

When I walked out of jail on July 13, 2004, I had a trash bag with my personal effects from when I was arrested. I had no home. The clothes I had on were sagging, because I had dropped 20 pounds in jail. I had no driver’s license and, most devastating, no nursing license.

I had nothing.

But what I did have was a second chance and hope that the best was yet to come. I promised myself in jail that the addiction would end and I would never live another day in regret. I’d go back to school; I’d recover my license.

And that’s what I did.

Before the Board

In March of 2006 I was given the right to practice nursing again, and I will never forget it. It was a battle hard fought.

During my hearing there were over 60 nursing students present, while all the dirty details of my crimes were put forth for public record.  However, if it raised the awareness of just one of those student nurses it was worth my humiliation.  It has taken me years to work through the shame and guilt of what I did and how I ruined a career I loved.

Nursing after a Felony

I gained back my license after lots of documented AA meetings, working with the voluntary state monitoring board for impaired health care professionals, performing random urine screens, working with a sponsor, getting treatment, attending aftercare-doing it all one step at a time.

I currently do not work in a hospital because I’ve been barred from working in any facility that is funded by Medicare (Medicare forbids convicted felons from work). So that narrows down my options significantly.

In May of 2010, I will graduate with a Bachelor’s degree in health administration and policy and will be applying to grad school to pursue a Master’s in public health. I may even focus on policy, because a lot needs to change in the way health care handles nurses’ addictions.

We must abandon the secrecy that hides an epidemic that no one talks about but costs the healthcare profession thousands each year.  We need to stop hiding. If we don’t support our own colleagues, what are we doing to our patients?

Now that’s the real crime.

I am an RN who has been licensed since 1990. In 2008 I got arrested for petite theft, a Class 2 misdemeanor.  I went through pre-trial diversion and later had my charges nolled processed.

I researched every day for hours trying to find peace of mind that I would regain my license.

I moved from Florida to Arizona and applied for an Arizona license. I self-reported the arrest to the board.  I was worried for months.  I had to send in the arrest record and all the court depositions; I even had to meet with a board investigator.

I was so scared and stressed for months.  I even took a voluntary drug screen for the board.

Let me tell you some good news: I got my license in Arizona with no discipline, but it took much longer than it does for most (4 months).  Follow my advice, don’t lie to the board! If you don’t self disclose then you violate the Nurse Practice Act and will at minimum get a civil penalty; this is a discipline against your license.

Always cooperate with the board and be honest. It may work out for you like it did for me.

On my first shift with the new preceptor she pulled me aside and told me that her last resident had failed and that she didn’t want me to feel blindsighted if I failed so she was going to have really high expectations and was going to be very blunt with me. She also told me that I shouldn’t be surprised if I didn’t make it through residency either. Great way to start out huh?

The person in charge of the program gives goals assigned to each week, and the week that I’m currently on is to take one stable patient, key words being one and stable, from start to discharge. So she gave me two stable patients on my own and then when I would ask questions, she’d tell me I need to problem solve on my own. Then when I discharged those two, I got thrown a critical patient, which she helped with a little, but not much.

The second shift I ended up with two critical patients and got talked to about how I need to learn to prioritize and focus, which is very true, but I haven’t had a chance to practice on a stable patient yet. I’ve cried after both shifts and now totally and cringing about going back to work. I tried to talk to her and told her I was frustrated about it, and all she said was that I was doing a really good job and that she was impressed, but I still feel like I totally can’t do this job! Has anyone else had an experience like this?

What would you recommend?

Amy

I spent some time reviewing what the “hot topics” have been.  We certainly have covered a lot of ground–that’s for sure.  We’ve talked about drug addiction, the NCLEX exam, impossible co-workers, and delegation.  We’ve covered making mistakes, insecurities, and being let go after only a few weeks of orientation.  I, myself, have written about goal setting, facing our fears, relieving stress, and being “perfect enough.”

I have a few thoughts after re-reading some of our community’s comments:

1) We’re serious about what we do.

2) We are encouragers.

3) We have a stressful profession.

4) We’re all doing the best we can.

5) Some of us like to swear a little too much.

All said and done, I’d say we’re a pretty amazing group of people.  I count it a privilege to be one of you.

I want to hear from you: What were the highlights of your year of nursing? And what do you look forward to in 2009?