Posts Tagged ‘nursing student’

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Are Job Prospects Improving for New Nurses?

May 17, 2012

Image via Wikimedia

Back in 2010, we ran a post by our then clinical editor, Christine Moffa. It was called “Prospects for New Nurses: Thoughts On Graduating During a Downturn” and it generated quite a few comments. Below is a sampling of excerpts. Some people were pretty distressed, wondering whether they should take jobs that separated them from their families, facing criticism from people who expected they should find a job easily. After all, they were nurses! And we all know they are always in demand.

We’ve been hearing anecdotally that the prospects for new nurses are getting better overall. Is this your experience?—JM, senior editor

“It costs a lot of money to train nurses, especially new grads. Many employers want experienced nurses. The best piece of advice given to me was to stay with same healthcare system/unit floor I worked with as a student nurse. Even that prospect, however, seems to be circling the drain for the same reason I hear over and over again: EXPERIENCE REQUIRED!!! Relocation may not be an option for some people….I’m sure I will eventually get a job, but it’s the uncertainty of my future that frustrates me. It’s quite aggravating to have worked so hard in school only to be disappointed in the end.”

“I just graduated in March and am really worried about getting a job. Thankfully I will be able to stay at my current job as a RN- I worked there as a LPN for almost a year.”

“I won’t give up; but I’m definitely discouraged. It has been a year since I graduated. I have followed all of the advice in the book – I’m volunteering, I’m looking for a job in a SNF, I network everywhere possible, I go to hospitals and shake hands with nurse managers, I follow up, I’m persistent with hiring managers to no avail. I’m desperate for some good advice regarding my circumstances and I’m not really sure where to turn.”

“No one has everything they need to be the perfect candidate, and many are far from it, because we are fallible human beings. We must keep the knowledge that we CAN do this! Someone will look at us and say, for whatever reason, that they want us. It will happen!”

“The difference between this downturn and previous year’s downturns are that there are 50% more new grads entering the market than previous years.”

“Certainly the recession is a major factor, but the lack of nursing leaders willing to demand that hospital administrators provide optimal staffing levels,is the primary problem. Only when nurses are able to provide the level of care that they have been educated to give, will retention improve. This would only be feasible with lower nurse: patient ratios. It seems that when most nurses achieve top positions in large hospitals, the staff nurse and the true quality of patient care is forgotten.”


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On Euphemisms and Learning to Be Present

November 28, 2011

By Alicia Marie Hinton, who is a BSN student at the College of New Rochelle School of Nursing in New Rochelle, NY. This is her first post for this blog.

by grepsy, via flickr

My senior year preceptorship was an assignment on a palliative and acute care unit at a busy medical center. When I received the assignment, I prayed that no patient of mine would die during my time on the unit. Every nursing student is afraid of their first patient death. Simulation and course work prepare students in various ways for this experience, but nothing can really prepare you for the emotions you’ll feel. Some students experience a patient death during an undergraduate nursing program, but for others it may not happen until their first year or two working as an RN. I hoped to never endure it, but knew it was inevitable.

During report, working alongside my preceptor, I listened anxiously to the status of the various patients. Since my first day on the unit, I’d practiced my therapeutic techniques and researched different cultural needs pertaining to the death of a patient. I felt culturally competent and well informed about what a nurse should do when a patient dies, but I couldn’t shake my fear. What would I say to the family? Would they value my presence?

Finally, during morning rounds on my third day on the unit, I was told that a certain Mr. P wasn’t doing too well and might “expire” that day. Our focus would be to provide comfort for him and his family.

How did they know he was to “expire”? Was that the politically correct term for dying? I was familiar with “passed away,” “deceased,” or “gone to a better place.” But the word “expire” didn’t feel right. I’d cared for Mr. P since his admission and interacted daily with his family, and news of his impending death hit me hard, increasing my anxiety about how I’d respond when it happened. While I was anxious about my own feelings about the patient’s death, I was preoccupied with my ability to comfort that family. Read the rest of this entry ?

Posted in nursing students, palliative care, professional identity | Tagged , , , , , | 7 Comments »

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When Do You Know You’re Really a Nurse?

August 18, 2011

There’s an imaginary line that one crosses when becoming a nurse. This line divides the floundering nursing student from the confident and experienced nurse. After four months of nursing, I found myself wondering where it could be found so I could cross it. Everybody around me already accepted me as a bright and talented nurse, yet I had doubts. I could manage patient care assignments calmly and efficiently, but I sensed that nursing wasn’t as superficial as checking off items on a list. Sooner or later, I’d face a more complex situation, with no instructor nearby to give me confidence.

That’s the first paragraph of the August Reflections column, “The Letter,” which was written by Melanie Patterson, a mental health supervising RN at a hospital in the Pacific Northwest. It’s about making the extra effort for a patient who might otherwise have been forgotten in his isolation.

Was there a moment, an event, a time when you began to feel confident in whatever your nursing role might be?—JM, senior editor

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Posted in nursing perspective, professional identity, writing and nursing | Tagged , , , | 4 Comments »

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The Sacraments of Nursing

May 26, 2011

At the center of Sister Thecla’s demonstrations was an old manikin that lived all its days on the hospital bed at the front of the classroom. I can still see its chipped, painted face—the trust in the eyes, the unreadable thin lips. I can see Sister Thecla turning that manikin on its side, taking care so the blanket wouldn’t slip and expose any imagined privates. And Sister Thecla’s hands—how they were all tenderness, and how somehow, right before our eyes, they transubstantiated the cotton backside of that manikin into the feverish, aching flesh of a real sick person.

Every month, as you may know, we publish a personal essay inside our back cover. This month, our Reflections essay is by Madeleine Mysko, the coordinator of that monthly column. Madeleine, a novelist and poet who teaches writing in the Johns Hopkins Advanced Academic Programs, is also a nurse. She helps us find potential writers and reviews most Reflections submissions. I edit all accepted submissions before publication, but I sometimes call on Madeleine for another point of view, especially if I’m stuck or if I sense I’m missing something crucial. She invariably has suggestions that make the essay flow more elegantly and cleanly—and strike home more powerfully.

The excerpt above is from her piece in the May edition of AJN. “The Sacraments of Sister Thecla” (for best reading, click through to the PDF version) describes a kind of mystical visitation from a teacher Madeleine had back in nursing school in the 1960s. Clearly, teachers do make a difference.—Jacob Molyneux, senior editor/blog editor

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Notes of a Student Nurse: A Dose of Reality

May 4, 2011

By Jennifer-Clare Williams, who is a student at Cox College of Nursing and Health Sciences in Springfield, Missouri. This is her first post for this blog.

Doyle Alphabet by fdecomite, via Flickr

It’s been said before that we are our own worst enemies, our own worst critics. I can’t imagine a time when these phrases are truer than during nursing school. Little more than a year ago, when I was starting my prerequisites for admission to the BSN nursing program, I was giddy with excitement. Images of what life would be like played in my head like episodes of Grey’s Anatomy, or, on a day I was feeling a bit more goofy, reruns of Scrubs.

I took any opportunity I had to share with friends, family—even new apartment neighbors—that I was well on my way to nursing school with the confident smile of a person destined to save the world, one patient at a time. I scoured discussion boards and nursing student forums late into the night, anticipating the day that I, too, would have something profound to contribute.

I laughed off those who warned me that the path was difficult and ridden with challenges. There was no bridge I couldn’t cross, no task I couldn’t do, and no test I couldn’t pass with flying colors. The world was mine. Now, I’m living those moments as a first semester nursing student—but a funny thing happened on the way to the present, a thing I will lovingly refer to as reality.

And reality has an uncanny way of making sure you’re well aware of his presence. The truth is, most days I feel more like the character Steve Urkel in Family Matters than like Meredith Grey in Grey’s Anatomy—awkward, unsure, and out of my element. My excitement masquerades more as fear. And those scrubs? Hardly the superhero cape I’d imagined. Yes, the truth is, for the first time in my life, I don’t have the definitive answers to anything, my “natural aptitude” for test taking continually disappoints me, and that confident, poised, straight-A student has somehow disappeared, leaving a nervous, uncomfortable rookie in her place.

I replay my mistakes (“No wonder your patient was uncomfortable—you put the bedpan under her backwards!”), I cry more than I ever have in my life, and I continuously wonder how on earth I will ever learn everything I need to know.

But there is good news. Read the rest of this entry ?

Posted in nursing students, professional identity, writing and nursing | Tagged , , , , , | 18 Comments »

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Laundry

March 10, 2011

By Marcy Phipps, RN, whose essay “The Soul on the Head of a Pin” appeared in the May 2010 issue of AJN. She’s written several previous posts for this blog (here’s the most recent).

An eager third-year BSN student was assigned to me yesterday. After introducing herself, she told me quite enthusiastically that she’d already decided she wanted to work in a trauma ICU after she graduated.

I love that. I remember feeling just as wide-eyed and excited as she looked. And I like having students with me, especially ones who are so teachable that they soak up everything around them like a giant sponge.

My student’s willingness to do “everything” served her well, as far as learning experiences go, and she approached tasks without trepidation. She was elated with success (insertion of a nasogastric tube) and mortified with failure (insertion of a rectal tube; she actually vomited). There were moments of fascination (touring the ICU and helping settle in a trauma admission) and boredom (attending a pain management process improvement meeting).

There was also frustration; at the end of the day, she ruined her new scrub top with a spill of dark orange rifaximin.

by adria richards/via Flickr

I’m not sure what her favorite part of the day was (although I’ll bet it was her nasogastric tube success), but my favorite part of her day was overhearing a member of the SWAT team, who was armed and stationed at the bedside of a nearby patient, tell her, in all seriousness, that Dreft laundry detergent would be her “best bet” at getting the medication stains out of her scrubs.

Now, I suppose that SWAT team members, like nurses, have a lot of first-hand experience in getting unusual stains out of work attire, but I must admit I’ve never given the matter much thought. I don’t think of tough guys doing laundry. I never imagine tough guys in the detergent aisle, shopping for Dreft.

I didn’t get to ask my student if she still wanted to work in the ICU, as she was running late for her post-conference, but I’ll bet she still does.

It’s not always pretty, but I can’t imagine someone not wanting to work in a place where rectal tubes and SWAT team laundry advice are punctuations in an otherwise ordinary day.

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Posted in nursing students, professional identity, writing and nursing | Tagged , , , , , , , | 7 Comments »

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No Explanation Required: A Preceptor’s Tale

October 20, 2010

By Marcy Phipps, RN, whose essay, “The Soul on the Head of a Pin,” appeared in the May issue of AJN. She has also contributed a number of thought-provoking posts to this blog (here’s the most recent).

puddle reflection/by joiseyshowaa, via Flickr

I’ve been precepting a new ICU nurse intern, which I generally enjoy doing. The only downside (from the preceptor’s perspective) is that I’m obliged to call ahead and request “unstable” assignments. This is meant to enhance the clinical aspect of the internship, and it definitely does.  Considering that I work in a trauma center, though, reserving the sickest patient in the unit feels a bit like ordering up a large serving of chaos. And although I can request the assignment, I can’t predict what will be learned.

Our most recent patient was a new admission with a traumatic brain injury. At the start of our shift he had a grim neuro prognosis and was hemodynamically unstable. His condition deteriorated throughout the day and he was eventually diagnosed as brain-dead. His family chose to donate his organs.

Taking care of an organ donor is difficult. Brain-dead patients are inherently unstable, yet certain parameters must be maintained to ensure adequate organ perfusion. It’s tedious and meticulous.  It also requires a shift of perspective—ironically, even though the patient is legally dead, the medical interventions are aggressive and the stakes feel higher than ever. Despite the fact that for the patient, at least, there is nothing left to lose, the potential organ recipients weigh heavily on our minds. Read the rest of this entry ?

Posted in nursing perspective, nursing students, writing and nursing | Tagged , , , , , , , | 6 Comments »

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A Nurse So Cold

August 16, 2010

Al is weak, frail, and most important, scared. At 55 years of age, after 34 years providing care, she finds herself in a major medical center— on her back, staring at ceiling tiles. The woman who’s always had skin as pure as a china doll now ironically has a porcelain hip. She’s just 36 hours out from a total hip replacement, and she knows something is wrong. She feels her heart pounding, she can hear the beating in her ears, feel the pulsing on her pillow. She rings the call bell to ask for the nurse to check her. An hour comes and goes, and no one comes to her room.

That’s from the August Reflections essay, titled “Miss Orienting Nurse.” The author is Linda Pellico, an assistant professor at the Yale School of Nursing, who tells of her chagrin at witnessing rote care provided to a hospitalized friend by a former student of hers. We hope you’ll read the essay and let us know your own experiences as a nurse or patient—or both. How many of us will someday have to rely on such cold and distant figures as the nurse and MD portrayed in this essay?-JM, senior editor

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Posted in nursing perspective, nursing students, patient perspective, professional identity, writing and nursing | Tagged , , , | 2 Comments »

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A Nursing Student Learns the Trick of Reassurance

October 27, 2009

NovemberReflectionsI wasn’t sure why Mary Sue was in long-term care, but I could tell she had dementia. She spent most of her time in a recliner near the nurse’s station, asking anyone who walked by why she couldn’t go back to bed.

“It isn’t time yet, Mary Sue,” the staff would reply. I asked one of the nurses why they didn’t just take her back to bed. “When we do,” she told me, “she asks to return to the chair. Out here we can keep an eye on her. She can look out the window. She smiles more often.”

But I had yet to see a smile. This was my first rotation as a nursing student, and I tried to use techniques I’d read about to distract Mary Sue: towel folding, cards, books. But she remained on target, reaching out to me and repeating her request with a distraught look on her face. . .

Read the rest of the November Reflections essay,  written by a nurse looking back on her first nursing school rotation five years ago. The basic human need for reassurance is shared by all of us, whether we are patients or providers. What do you do to stay centered during the day, to remind yourself of your own value, to focus on what really matters . . . or just to stay in the game?

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Role Reversal: Remember That Nursing Student You Almost Failed?

August 14, 2009

AugustReflectionScreenshotI was having trouble breathing as I lay on that gurney in the chaotic ED. Was it a result of my fear? Or did I have an unseen pulmonary injury?

I had been in a car accident. I was in pain, and the cause of my pain was obvious. My neck hurt, my tibia poked through the skin on my right leg, and my right foot looked mangled and bloody. The reason for my fear was more complicated. Although I’d been a nurse for more than 20 years, this was the first time I had been so completely dependent on the health care system. I felt vulnerable. I knew too much. I needed to feel confident that the ED nurse assessing my injuries would do a thorough job and give unqualified support to a fellow nurse-turned-patient.

Read the full August Reflections here (click on the PDF version in the upper right hand corner if the link takes you to the less attractive html version instead). And let us know if you’ve ever experienced a reversal of roles that’s in any way similar.

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