lady-doe asked:

What are your thoughts on NP programs that require no RN license/experience/degree? I am having a hard time grasping the concept of a nurse practitioner with little experience in nursing outside of clinical rotations.

I personally am not a fan of them.  If someone is master’s prepared, they should have extensive experience within that field.  It takes so much work to obtain your RN license, work for a while, and then go back to get your degree.  And with that you gain knowledge and experience you cannot obtain any other way.  I think a master’s level nurse should be a master with patients!  You can’t do that if you’ve never cared for them before.  I agree with you, it’s difficult for me to grasp that concept.  It would be interesting to sit down with people that have gone through that program as well as advocates for it to see their side of the story.

boluscoffeestat asked:

So I just started my new role as a ICU RN in the Trauma/Surgical ICU. My first day was yesterday and it was AWFUL. I'm not sure if I'm just that slow and that incompetent or if my preceptor is just not the best person to have with a new grad. Is there a way to ask my preceptor, without sounding like a complete boob, if she can slow down a smidge? I know it's the ICU and it's fast pace and I will need to get with the program, but I feel so incredibly lost and confused.

Something that’s great about ICU nurses is that they’re experts in what they do. However, the downside of that is once you become an expert, you do everything so fluently that you sometimes forget about the why or the steps you take to complete various tasks that you no longer have to think about it anymore.

I have a sneaking suspicion that this nurse doesn’t realize she is going fast.  Learning how to be a nurse is one thing.  Learning how to be an ICU nurse is another.  I think she doesn’t realize that you need direction on everything, including the small things she doesn’t think about anymore.  Like how to drop a dobhoff tube, how to start an IV, which meds are compatible with which, how to interpret telemetry strips, etc, etc.  On top of that, you have to learn the culture of the unit.  The physicians, the phones, your support staff, etc.  

You could always say something to the effect of, “Clearly, you are an awesome RN.  There is so much for me to learn in the beginning and I’m really overwhelmed.  I’m really just learning how to be a nurse right now on top of learning the ins and outs of critical care.  I just want to warn you that I may ask a lot of seemingly obvious questions, but it’s just because I’m trying to get my feet wet and it’s hard to tell right now what’s important with so much information being thrown at me.”  Or something like that 

And whenever you have questions where you need to slow her down during the day, start with, “I know this might be obvious, but can you explain this to me?”  If you do that enough, she should realize she needs to back peddle a bit.

Seriously, orienting a new grad in critical care looks different than orienting an experienced nurse.  There is quite a difference and it sounds like this preceptor isn’t aware of this.

Here’s an article I wrote on allnurses.com about time management in critical care:  http://allnurses.com/critical-care-nursing/time-management-tips-921708.html

Also, my book should be out within the next month or two and I have a whole section on time management and scenarios specific to critical care.  Stay tuned for that!

Anonymous asked:

A peer was with a dad and son, Dad says "oh kiddo, you know you want her to give you your bath right?" and then "I mean it could be him" (gesturing at me). Bear in mind that this kid is 10 at the most. So in two sentences, he harassed a fellow student, sexualized the job (esp concerning since it's paeds), and tacked on the homophobia thing at the end. She didn't seem troubled but I wanted to say something. As a student I also want to keep nonconfrontational too. Do you often get stuff like this?

You’ll see so many crazy/weird things, it won’t phase you anymore.

You’ll start to figure out when and how to address those situations.  You have to handle them delicately, especially in peds because you don’t want to embarrass the father or the son but you do want to maintain a level of professionalism.  

People will say some ridiculous things to you.  I find it’s good to try to defuse things with humor first and if it doesn’t work, then get more serious.   Sometimes a facial expression can speak louder than words and they watch what they say the rest of the day.  I would ask the nurses in peds though if they have any specific recommendations for how to handle it when patients/parents say weird stuff.  You probably have to handle it a little differently than you would in adult with kids around.   I’m no expert there!

Anonymous asked:

Hi! Love your blog/twitter! I've wanted to be a nurse my whole life and I've been working in a hospital for 8 months which I love. I just started nursing a school about a month ago and am incredibly overwhelmed with all there is to learn. I just want to be the best that I can be. The RN's on my unit frequently tell me not to become a nurse and it's worrying me even more. Is it ok to have second thoughts? Do you think becoming an RN pays off in the end?

Yay for starting nursing school and boo to those discouraging you!

Seriously, I love my job.  I love my patients.  I am so, so glad I am a nurse.

It’s a tough job.  It will test you mentally, emotionally, spiritually, and physically.  But it is so, so worth it.

shinin-like-fireworks asked:

Hello! Just wanted to say I love your blog so much, and greatly appreciate all your thoughtful and generous advice. I have a question - I've been asked to orient a new hire for the first time. I'm obviously so excited, but also nervous because I want to do a good job. Do you have any advice or tips on how to be a kick-ass preceptor?

GREAT question.  So great, in fact, that I’m going to just write a post today about it!  

I wrote one a while back about orienting a struggling new grad, but I really think I need one with tips on orienting someone in general.  Stay tuned - I’ll try to have it up this weekend!  

Here’s that post in the meantime: Orienting a Struggling New Grad 

Coworkers, and employers with a shared work ethic are a sort of life jacket in health care. If you’ve got respect and synergy between management, doctors, nurses, techs, nursing assistants, transport, dietary, respiratory, physical therapy, housekeeping, dietary, clerks, and all members of the health care team - you can survive even the most brutal of days, ideally with a little humility, and humor at the finish line. A shared work ethic may not mean you’ll always agree, however, the basis of what you stand for ought to be in balance. When the mission and vision of an institution radically departs from what’s manifested in actuality - significantly compromising safety, quality of care, and job satisfaction; it is perhaps time to acknowledge the learning opportunity for what it was, wish them well, but recognize not all connections are built to last, and look on with no regrets to a change in journey.

Nurse X (via dancingnurse-ed)