#preceptorship

[bluebienycheesecake]

Saw some old friends and colleagues

Small talks

Enjoyed good food

Had a great time

Officially done with another preceptorship

[sanguivores]

Any other ND people fucking hate shoe shopping? It is like sensory torture.

[ysabelmystic]

LMAO at least I think I’m mostly safe if I stay in psych nursing like the thing Im more worried about is “could the patient grab the thing and use it to harm themself or me”

I’ve told this story ten thousand times and I will tell it for the ten thousandth and first: whenever I think about wearing a costume to work on Halloween, I remember the time I saw a doctor breaking what must have been devastating news to a sobbing patient while the doc was dressed as a ketchup bottle.

[myangelhaven]

I FINISHED TERM 7 OF NURSING GUYS HEHEH WHOOHOOO

[sungtaro]

THANK YOU 🥰 honestly I'm so excited for the next year,, just like you said you learned so much im fr looking forward to everything. I'm still a bit worried about NCLEX and looking for jobs (nothing rn but two that MIGHT be pending but a little later in the summer). But I'll make sure to celebrateeee, it legit doesn't feel real yet tbh, I still feel like a student 😭

— ANONYNURSE ❤️‍🩹

ahh yeah i'm sure it's a whole lot of emotions between being excited and also nervous. but you're gonna get through it !! if there's anything i can help u with to ease your mind about nclex, let me know 🥹 and tbh take your time starting a job if you can ! relax a little ! i graduated in may and started my new grad job in november. i needed time to well . move really far away . but also just take a BREAK after studying so hard, i think it would have been burnout city if i went straight into the overwhelm of the first few months of my residency. you have a long and exciting career ahead so once your boards are done, def enjoy that time for just you, it's such an exciting moment ! and you deserve to celebrate it 💖

[auratold]

Today I completed my last day of clinical for my RN BSN, it's just preceptorship left and then boards.

Several people on here I've been mutuals with since I was a teenager going through surgeries and hospitalizations so this is a milestone I wanted to take a moment to share <3

[tragicallyuncreative]

not a question just wanted to say im sooooo excited for the new chapter of ATEOTR and i hope nursing school is going well!

This made me smile like an idiot. It has been a ROUGH past couple months and I've felt so guilty that my writing has been so delayed, so glad that people haven't lost interest and are still looking forward to reading! I know I've been saying this a bunch, but SO close to being done with next chapter- just need to fine tune and edit. It's quite long and I debated breaking it up to get a chapter out quicker but I like longer chapters and feel ending it anywhere except where it is now would ruin the flow.

Nursing school is going great, it's just a lot. I purposefully chose a school where I would have to commute over an hour each way (sometimes up to 2.5 depending what hospital I'm at) and haven't regretted it as it is the top program in the state, but is also ranked as one of the most difficult. I'm doing well academically, just absolutely swamped. Last clinical of the semester is Friday and I am so glad- been in ICU for the last 2 weeks and had 4 of my patients die on my shift/ watch. There was nothing more we could have done, not unusual and unfortunately something I'm very used to working as an EMT, but it's very different as a nurse- as an EMT I do my best to save them, give my condolences, and for lack of a better term, "peace out" and don't have time to dwell before my next call. As a nurse, I get attached to my patients and families, have to be the one to deliver the news to the families (I'm always the scapegoat for that as it's "good practice"), do postmortem care, take them to the morgue, do a shit ton of paperwork, etc, etc. Had a 20-year-old pass unexpectedly after an accident and spent almost 40 minutes with his mom just sobbing in my shoulder and felt horrible for her.

Sorry that this turned into a downer, lol. I LOVE everything about nursing and healthcare and have been accepted to a pediatric hospital for my preceptorship next semester (my last one) which is AMAZING and greatly increases my chances of getting accepted at a peds hospital upon graduation. Just very ready for winter break, which is in 2.5 weeks! I will be writing a ton then, so keep your eyes open for chapter updates and little drabbles on here. Ideally will get chapter 4 of ATEOTR up sooner than that, but no promises. Thank y'all so much for your patience and engagement- your comments and messages motivate me to write so much more!!

[tiktaalic]

I hope these questions don't annoy you, but whats it like working in a lab?

I'm considering the same career path cause I really like my lab classes so far

Not annoying! from what ive seen there are 3 or so types of labs, which are labs in the hospital, which are obviously a faster pace (did half of my preceptorship in one), reference labs, which get a fairly high volume since they're doing testing everybody's sending out for (did other half of my preceptorship in one), and privately owned labs which pick up samples from clinics urgent cares nursing homes etc (both of my jobs have been with private labs).

I like it! It's very routine. I have my set of tasks i do when i clock in and my set of tasks i do at the end of the night and in between I'm just sticking samples on the machines and releasing results. and there is imo enough variation to it to keep it interesting - troubleshooting failed qc, or double checking criticals, or having to do manual difs. if you're liking undergrad lab work I'm assuming you're doing stuff like pcr and gels and micro plates? which is a lot of what molecular departments do in a lab besides micro which is micro. I currently work in the core portion of a lab, which is hematology, coagulation, urinalysis, and chemistry. You really only break out the microscope for urinalysis and hem. we have a micro department that handles all the cultures, and a molecular department that does molecular testing. lots of labs have small micro factions and do lots of micro send out instead. the last lab i worked at did that. the hospital i did my preceptorship at would do plating, but then send all the plates out to be read and send out all the blood culture tubes to be cultured elsewhere. the lab I'm currently at does most cultures in house.

re: education to work in a lab you have to be ASCP certified. After I got my biology degree, I enrolled in texas tech's CLS certification program, which was 3 semesters of classes (preceptorships were the majority of the coursework the last semester). I didn't mind doing it because I was a fresh graduate and I didn't want to Career Hunt or go to grad school. so 3 sems to get a guaranteed job sounded great to me. Since I had my bio degree, I had most of the baseline credits out of the way. chem biochem ochem cell bio genetics etc etc. And the 3 sems I did were lab specific courses like blood banking, clinical chemistry, molecular methods, immunology, phlebotomy, lab management, clinical micro and hematology. there are tons of post bachelor's cls programs, and tons of them are delivered online so that you can chip away at it part time while working.

A nice thing about it is that you can get work literally anywhere. I moved to a town with a population of 90k. Applied for 3 jobs as a brand new graduate. and got 3 offer letters. the payscale's pretty variable, depending on where you are, but it is nice to know that i'm certified in like. 47 states and could get some sort of job in any of them no problem. i think once you've been certified a year you can get cali state certification, which is the route a lot of people go since cali is on the high end of the pay scale. it'll depend on what the lab you're at is like, obviously, but it is pretty difficult to get day shift positions since what a lot of places do is open internal applications for any night/evening shift people who want to move up. I work an evening shift of 2pm to 11pm and i really like it. A very common complaint i see is that there's no like... career ladder. if you're a bench tech. you're a bench tech. which sometimes gets parlayed into section leader, or section manager, but that's a years of experience thing.

My plan is to work in the same place for a couple of years so I feel more experienced, and then to take a few travel contracts which are shorter term higher pay. again, they're available pretty much anywhere, but sometimes the tradeoff is lower compensation or a worse shift or being in the middle of nowhere america. but i think it'll be fun to get paid to bop around the country for awhile. I like my job and I like that it's very secure, but I do plan to go back to school for Something Else at some point and probably shift careers. My review: good thing to do in your twenties! good thing to have under your belt in general. very dependable.

if you have other questions in general or about anything I said you can 100% msg me! Ik I had a lot of trouble finding info when I was looking into this as an undergrad

[sernstudies]

11.16.24 ; term 7 week 11

this week was rough not gonna lie. clinical is challenging for various reasons but its a good learning opportunity (i keep telling myself this). this week i missed my meds on wednesday night so i was so dizzy for most of thursday when i had a presentation. still rate effexor 6/10 for making it possible for me to function at all. please don't ask how my paper is going. it's going. honestly at this point i'm pretty over it you guys, i'm already planning what i'm going to do in september after i finish preceptorship. yknow give myself something worth getting up for.

[theboardwalkbody]

So I think I forgot to say:

I passed the final exam (that was Tuesday) for nursing 4!!! I am about to upgrade from LPN to RN!!! It still doesn't feel quite real. 😅

I think I should be proud, but it's an interesting mix of feelings right now. I think once the surreality wears off then I'll be proud. I know these last few months have been a struggle and I'm so glad to finally see the light at the end of the tunnel.

Now we enter the last portion of the semester, Professional Roles. Four weeks of preceptorship (where I was able to get a preceptor for Postpartum!!) combined with multiple weekly assignments so it's going to be busy but at least by Christmas Eve I will be completely finished. I also feel like I'll be able to breathe a bit better since the exam portion is done.

Towards the end of December they're also going to walk us through how to register to take the NCLEX. Hopefully they'll have appointments for January because I'd love to take it and get my license in ASAP.

I am both nervous and excited for the last stretch! We had orientation for our final 4 weeks today and tomorrow morning is day 1 of 8 twelve and a half hour preceptorship shifts.

[ysabelmystic]

I need my existence to chill out I stg

I am still waiting on word of my preceptorship (aka if l get to graduate) and on top of that the parking garage elevator tried to kill me and two of my classmates and fucking fell like 4 floors total (2 at once, then up one, then dropped another floor before I pulled the emergency stop button). I had to call security and then 911 to break us out.

Thankfully it was stopped almost level with a floor so we were able to get out once they forced the doors open but also having calmed my classmates down and been so damn chill about the whole “elevator falling” thing, I now feel slightly more alive and extremely sexy-cool-guy-butch.

This is also like my third or fourth near death experience so I’m feeling awfully smug about God’s evident failure to properly kill me.

That said, I will henceforth be taking the stairs

[andhumanslovedstories]

Hello! I love your blog very much. I too am a second degree nurse. I just graduated from an ABSN program and I'm struggling to get my foot in the door anywhere despite good grades + honor society membership + in state license already secured. I live in NYC and the nursing shortage here is CRAZY but for some reason no one wants to talk to me. Would you recommend home health nursing for someone in my situation? I did my preceptorship in the ED and that's 100% where I belong, but the bills are really piling up and I have no prospects. How long did you do home health before you went bedside? Thank you for any advice you have!

(Disclaimer though for all this, I'm across the country from you and have no idea the landscape of nursing jobs in NYC.)

I worked in home health for 18 months. If my goal was to get to the hospital as quick as possible, I didn't need to be there that long. I wasn't in any particular rush to move on. Plenty of people worked less than that and got hired at a hospital, I think something like a year was the average. I know the different between sending out my new grad resume and sending out my home health nurse resume was night and day. As in: literally anyone wanted to interview me.

I'd encourage you to at least apply and see if you can interview. You get to interview the company right back, and that'll let you know the kinds of work they expect from you. There are two main types of home health: the kind where you visit a lot of patients in a day and the kind where you're with one patient for the entire shift. The first kind is doing stuff like dressing changes, medication management, or periodic assessment. The second kind is more like general caregiving with nursing related requirements. I mostly did the second one, and worked night shift. So I fed a patient dinner, I gave them a bath, I got them dressed for bed, then tucked them in and stuck around until morning for their needs in the night. But within that was trach management, seizures, G tubes, medications, central lines, ongoing assessment, all that stuff that got this person nursing hours. I'm not gonna lie--it was often very very boring. I read a lot of books.

(btw west coast disclaimer again, but if you're willing to work nights, you'll get hired more easily. Everyone everywhere in the world doesn't have enough night shift coverage. also, oops! this got long and became an essay on home health!)

For downsides, in home health you can get limited training and orientation before you're alone, responsible for a patient. And then it's all on you. I had some gut-dropping moments early on where I encountered something I didn't know how to handle and didn't know how urgent it was. There's supposed someone you can call at all times, but multiple times when I did call, no one picked up. It can be super stressful and frankly dangerous as an inexperienced nurse. Luckily, many times you have the patient's family as a resource. It's likely they've been doing this years longer than you have. Though it's worst thing in the world when you wake someone up at 3 am because you're unsure and concerned, and then have that person explain in a really supportive tone of voice that these frequent, very brief seizures were probably just hiccups. Hypothetically speaking.

You can get too entwined with the patient and family's lives. It's hard to call out sick because you know no one can cover you. It's easy to cross emotional boundaries. Imagine spending 40 hours a week with someone and their family. They'll occupy a spot in your brain.

And I don't think it's a great place for a new nurse to stay for years and years, just for like professional development reasons. You won't get exposure to a variety of patients (unless you work that other type of home health in which case enjoy seeing eight different patients a day, hope traffic doesn't suck), so it's easy to forget stuff you just learned. I never had to think about transfusion reactions until I started at the hospital and shit now it's relevant all the time. I had to completely relearn how to hang an IV piggyback. Plus, since you work alone, you don't get the chance to see how other nurses work. It's hard to figure out a profession when you practice in complete isolation. It's easy to learn bad habits and have no one ever correct you.

But there's a lot I like about home health. You really do have a perspective on patients and patient care that is unique to home health and long-term care. In the hospital, you don't always get that long-term perspective. If you work with someone for a while, you can track how they progress or decline. Why do some clients stay at home for years and others keep going back to the hospital? What's different about their conditions and cares? You see all the work it can take to keep them steady. That's perspective that easy to lose. It helps you put the patient on a timeline that extends beyond the hospital. If you click with a patient and/or family and work with them for a while, it can be very satisfying working with them because you see so clearly the impact you're having.

Also! I read so many fucking books! I listened to so many podcasts (played so so softly). I knitted and learned sudoku and practiced yoga, looked up vacation spots, put in my grocery orders, and organized my playlists. I also could research and research and research. I had time to look up everything about every condition my patient had, and once I felt more comfortable with those, I moved on to looking up whatever other disease process and patient experience seemed interesting. I'd make myself a little curriculum and, after my patient was tucked in, and be like "tonight's class is vlogs about having a trach."

There were plenty of shifts where I bustled all fuckin night, and sometimes those shifts seemed to be in one endless hellish row, but often I had a lot of time to myself that I could spend however I wanted, as long as I was still in the room with the patient, able to meaningfully hear and see them, and keeping up with the night routine. I fucked around a lot and got paid for it because the job is to be available when needed, and you're not always needed. (I'm not saying slack off! I'm just saying even colicky babies sleep peacefully now and then.)

Anyway jesus christ that got away from me, but like please know that I was in your exact place, and I know how much it sucks and how crazy it makes you feel because I THOUGHT WE WERE SHORT ON NURSES DON'T ANY OF YOU FUCKERS NEED A NURSE, and know that all the other job hunts after this should and will be easier than this.

[orcinus-veterinarius]

SO UM. I GOT A SECOND PRECEPTORSHIP. AT A VERY LARGE VERY WELL KNOWN AQUARIUM.

[aroundmyscars]

I GOT A PRECEPTORSHIP AT MY DREAM BIRTH CENTER

[s-a-u-l-o-f-t-a-r-s-u-s]

promising to take on a student for their preceptorship and then taking time off and flying to canada without any notification is such nurse behavior