#nurse intern

[star-shootingz]

MORE OC INSERTES YEAAAAAA

MOUTHWASHING OC THIS TIMEEE!!

[er-bsn-rn]

I just want to talk about the absolutely FANTASTIC day I had in the ED recently! (As a short back story, I previously had a terrible day in the ED and I wanted to leave, quit, and never go back. I was actually hesitant to try again.)

First of all, most of the hospitals in my area are on saturation. That essentially means that we are all full and then some. That means we have boarders (patients staying in the ED who have been admitted to the hospital but we don’t have any empty beds). I am so thankful for the Flex ICU nurses who came and helped us - THANK YOU. I know there can be a “beef” between ICU and ED nurses but we all worked together and it was beautiful.

As always, my preceptor asked what my goals were for the day. A little scarred from last time, I said, “I would like to take on my own patients again.” She said, “Okay, let’s go get report.” Since we had extra hands, we were only assigned two rooms. Now, we were actually assigned the most critical of the rooms in the ED, so don’t think that sounds easy. 

Room 1: level 2, sad case (ineffective breathing), difficult family, ineffective coping/grieving.

Room 2: level 3, acute pain, received terrible “customer service” overnight and insisted we cater to every need.

Alright. I can actually handle this. I’m in charge. The only task I cannot do alone is medication administration, so my preceptor just charted and did homework until I asked for help. Let me tell y’all some things I did for the first time (in the ED):

1. I stayed on task. Usually in the ED, I am running around with my head cut off with no sense of direction. I learned the art of writing things down and setting alarms on my watch. I delegated to our awesome, amazing, wonderful tech’s. They all deserve a raise.

2. I called/paged doctors and used SBAR on the phone. I have never actually done this. They teach it to us all the time but I have always been afraid to do it. My tip? I wrote down my talking points. Doctor did exactly what I recommended and I felt like a superhero.

3. I got involved in hospice/palliative care. Some of you ED nurses out there might be like...wtf..? Well you know what. The situation warranted it. Saturation = no where else for this family to go. I cried with the family. I sat with them. I took extra time with the extremely uncomfortable patient to make sure the bed was made perfectly, all trash was picked up, and that the family always had fresh ice water. 

4. I confidently asked for help from my preceptor. Instead of saying, “I don’t know what I’m doing,” or, “I’m really sucking today,” I said, “Hey, it’s time for morphine, could you pull that for me please?” and “Could you please page respiratory?” She knows my limits, and I FINALLY felt like a real nurse.

5. Targeted patient education. How often have I ever stopped to thoroughly explain something to a patient? Never in the ED...that’s the RN’s job, or I let the doctor do it. Well gosh. I can explain insulin/blood sugar during illness. I can explain a sliding scale. So yes, that sounds so simple, but I’ve always been afraid to take that initiative!

I am absolutely SO proud of myself for this shift. I really needed to take this time to reflect on it and put it into words. And you know what? I’ve been rating how my day is going by how many IV’s or sticks I hit or miss. That is such a stupid way of assessing my own nursing skills. I got some, missed a few. I definitely still need practice regardless. I also caught a murmur that the doctor missed, so that was kinda fun. 

I love this life 💉❤️

[trainingscrubs]

Hi! I’ve decided to study nursing and am trying to decide on a program. What’s the difference between getting an associates at a community college and a bachelors other than the obvious degree difference? Can I still take the N-CLEX with just an associates? Thank you for the help! I love your blog xx

Hello! My apologies for the really late response, but I hope this information helps! I’m currently in a BSN program so my answers may be a little biased but I know plenty of ADN-RN nurses!

While I’m not super well-versed in all the little details between the two different degrees, this is what I do know.

First off: You CAN take the NCLEX as an ADN (associates degree nurse). My preceptor at the internship I was just at was an RN after getting her associates degree and she’s been working for a little over 15 years. However, she is currently in school to get her BSN.

ADN is the minimum for nursing requirements, but takes shorter (2-3 years depending on the program)

If you are looking to get the basics out of the way and jump straight into the workforce because staying in school for a long time is not something you’d like, then an ADN works just fine! You get the basic nursing fundamental classes and some specialty classes (like pediatrics, behavioural health, basic pharmacology etc). However, being an ADN-RN means that you’re limited to just basic nursing care.

BSN opens up more options for better positions, different jobs, higher pay but takes longer (usually a 4 yr program at an institution)

The difference between the classes of ADN and BSN is that these go a little more in depth. While ADN gets the basics, they’re also a little more focused on care while BSN classes go deeper into more critical thinking concepts. 

For example if you see a patient is failing and their Oxygen percentage is going down, a first instinct is to give them oxygen. But critical thinking pushes you into delving deeper such as why is it going down, what could possibly be causing it, and what components of their entire health do you have to factor in that could be a reason as to their oxygen going down. It’s a lot of mental exercise, admittedly!

However, it does take longer and you have to take pre-requisite classes at the school beforehand and more often than not, take an entrance test as on top of a review of your pre-req grades to get into the program.

A lot of people with ADN’s ive noticed are getting their BSN. 

If you end up decided to get your ADN for now, just know that that’s not the end! There are plenty of RN to BSN programs at multiple schools where people that are already RN’s are choosing to get BSN certified in it. So if that’s something you’d think you’re interested in further down the road, just know it’s a possibility!

BSN opens up the doors to being: nurse educators, clinical instructors, nurse managers, specialty nurses (specific age group, disorders, critical care, neonatology, etc), and is the first step in going onto be an Advanced Practice Nurse (APN) where you can be a Nurse Practitioner, Nurse Anesthetist, Nurse Midwise, and even higher roles in administration. Also, higher pay.

Ultimately:

I personally will advocate to get your BSN, because even though it takes a little bit longer than an ADN, it’s better to get it out of the way now and it opens up plenty of opportunities right at the start of your career. BUT! If your life situation makes that difficult and ADN is your choice of path, you’ll still definitely be able to take the NCLEX and still be a Registered nurse. In many cases, ADN-RNs are great nurses and unless you’re looking up new jobs, if you’re good at what you do, no one cares how you got the degree. (I didn’t know my preceptor was an ADN but even with that knowledge, she was still the best one I had!) 

Good luck with choosing a program and good luck with nursing school once you enter it! Let us know how it goes :)

[er-bsn-rn]

My First Code Blue

[er-bsn-rn]

Pharmacology – Anti-Parkinson’s Quick Sheet

– “Parkinson’s disease (PD) is a chronic and progressive movement disorder, meaning that symptoms continue and worsen over time. Nearly one million people in the US are living with Parki…

[trainingscrubs]

I start an nursing internship with a preceptor RN in the hospital on Tue. I feel completely unprepared and incompetent and afraid constantly. It’s my first health care job, and I’m two semesters from graduation. I’m so scared. And I’m tired of being scared.

Hi! A huge huge good luck on your upcoming internship! I recently just finished my own last week so I can tell you a little bit about how I prepared for that. 

It’s perfectly alright to feel scared and nervous! For some people (myself included), I felt like it was going to be a completely different ballgame since this wasn’t a ‘clinical class’ anymore. I wasn’t doing this for a ‘grade’ but now it was basically a job. However, a lot of people find comfort in that as well because now you don’t have an instructor trying to push you to do certain things, now it’s your chance to see what you’re comfortable with, what you need to work on, all under the mentorship of a preceptor that is dedicated to helping you learn. 

Remind yourself, you are not unprepared and you are not incompetent and even though you may be nervous, that does not make you a bad student or future nurse. You’re two semesters from graduation! That means you’ve been doing something right along the way :) So definitely keep it up. 

Some tips before you start!

Find a need, fill a need. 

In the health care world, there is always something that’s needed to be done. Even if there isn’t and you find yourself sitting at the nurse’s station, don’t hesitate to ask your preceptor or any of the other workers if there’s something you can do to help. If none, that’s fine and just kick back for a few seconds, but make sure you ask again! A lot of times people are just hesitant to give the student nurse an important job. But once you keep showing that you’re willing to help and be of assistance, they’ll take it on gladly.

Don’t bash the PCT/CNA work. 

You are the patient’s advocate first and foremost, always remember! We’re never above aiding the patient, so if someone needs help bathing, cleaning, walking the patient, remember that even though there’s other people, if you can do it, do it. Plus it gives you experience whether you know it or not. (And the PCT/CNA’s will be forever grateful.)

Push your comfort zone.

You’re going to be nervous no matter what. No patient is the same, no nurse is the same, but the care is. Haven’t done injections in a while? Jump at the chance even if it scares you. Because you know you’re going to need to! Have a chance to insert a foley? My heart was racing the first time but I stepped up to do it anyway (and still felt palpitations like, an hour after). Feel awkward to just sit and talk to a patient during downtime? Remember, they’re in a very difficult part of their lives and we’re supposed to be there to comfort them. 

Remember: You’re still new at it all, and your preceptor knows and understands that. They will be kind and guide you, so don’t be afraid to make mistakes as long as you understand and can recognize the solution. You’ve been learning all this time so don’t underestimate yourself!

Good luck at your internship and let us know how it goes! :)

[er-bsn-rn]

last week was all classroom training...today I am in the ED!!!!

and then school starts tomorrow!

[nursekanika]

I need to make it tumblr official... 

I will officially be spending my summer as a student nurse intern at Mount Sinai Hospital in Manhattan and I am BEYOND ECSTATIC.