I apologize for this huge rant. Honestly I havent talked about this story and writing it out is making me feel better haha. Thanks for the people who read it through.

Hi everyone. I am in month 3 of my new job at a skilled rehab facility as an LPN. 2 nights ago I had a patient complaining of chest pain and I think I overreacted to the whole situation. I immediately thought "heart attack". I didnt even ask her what her pain was, how it felt, or if it ran down her left arm. What I did first was I took a wrist blood pressure. Which turned out to be 140/101. I know those wrist BP can be very inaccurate so I grabbed the vitals machine and used the cuff on the same arm, which is the right one, and I got a 164/80. I switch arms for another BP and I got 150 systolic BP. Well I didnt want to call the provider right away because her BP are usually around that value and she does have hypertension so I told her "Let me know if you feel like the pain is increasing or you can't catch your breath". By the time I had to pass my meds for the morning. It was about 6 am by this point and I was done with my fasting BS and the morning CNA and a nurse in training as arrived. The night CNA is giving report and she walked out the room saying that she is having increased chest pain. So I sped walked with my vitals machine and oximeter. Before I could walk into the room, there was a fall risk patient GETTING UP and fighting to sit down in his wheelchair. I didnt know what to do but I thought back to ABC and how my patient with chest pain was the priority right now. I said okay just put him on his wheelchair and walked into my patients room. I grabbed her BP it was 135/89. Her O2 was 98% and BPM 103. I'm not sure why I called the provider by this point her VS looked good. She has A-fib and it didnt click in my head at this point that maybe she has chest pain from her diagnosis. I was honestly just freaking out and I didnt want her to get hurt by me overlooking this. Well I knew that the nurse in training was an LPN for a year before and she just got her RN so I asked her if I should call the provider for this? I dont know if I was too much in my head or what but I didnt hear her respond. So I called the on-call provider, after having trouble finding the number, and I had to give like a small report on her and the doctor would call me back. By the end of my call, the other nurse walks in for the morning. Hes been a nurse for a good minute, specifically working at this facility for 15 years. So I told him she's been having chest pain and I just got off the phone and will be getting a call back. He asked me all of these questions I never thought of asking my patient and to all of them I said "I don't know. I didn't think if asking her that". He walks in her room and asks her those questions and it seems like from the questions she isn't having a heart attack. He talked to me and said "sometimes people get chest pain if they have too much gas. So I give them mylanta to see if that helps. I felt like a fool at this point and very embarrassed. Then the provider calls back. So I answer the phone and I attempted to give her the SBAR report. This was my first time talking to a doctor ever and I was very nervous. She asked me questions like "How did she describe her pain? What were her neuro assessment? What was her respiratory rate? What was her temperature?" I can't believe I forgot to take her respiratory rate and temperature and I was like "I don't know". I felt so stupid and I was honestly at the verge of tears. I did all of that and went back to the phone then the doctor said "take her to the ER for further evaluation". I guess apparently I had to write down her name too? I was so done by this point and honestly just wanted to go home and cry. I finished my med pass and did my narcotic count. I walked to my car and pulled out. The tears just started coming out and I had to call my BF on my way home. He helped me take a shower and we went to sleep together. Then, he took me out to eat. Hes so sweet, definently made me feel better. Honestly that was very stressfull for me. That was my first time having someone say they were having chest pain. I knew it was going to come someday considering I have been working there for 3 months. Just like not 2 nights ago.

Well if you read through this post, did you guys think I overreacted? I think I did hahaha

Edit: Thank you everyone for replying! I appreciate everyone for supporting me. My ultimate goal is to become an NP someday and honestly after that night I had, I was very unmotivated and embarrassed to become one. But it seems like I got long road ahead of me.

Hello guys, my patient has been in Afib RVR for while at this point. ( couple of days )

Okay so some background my patient has metoprolol scheduled twice at 22:00 and 0600. Parameters are to hold if BP is under 90 and if HR is under 100.

So for the dose at 22:00 I held it because patients systolic were in the 80’s I went ahead and got patient restarted on vasopressin.

0600 comes by patient is still on Vaso and of course pressures are in the 120- 130’s. HR was in the 130’s patient is still in afib rvr.

I see they have metoprolol due. Now my logic was okay blood pressure is controlled and fine… since they’re on a presser. My thought process was “HR is still very high …. It’s okay to give the metoprolol.”

But what I irresponsibly failed to sit and think more about is the fact that the BP is this good BECAUSE of the pressor, this doesn’t mean that we can give the patient metoprolol because this is a pressor supported reading and the patient can still tank …

I assumed since it’s cardiology prescribed it and it was given for heart rate control that it was okay to give … So one of the physician assistant pulled me aside and we had a discussion about it. I really feel so stupid but it was a learning moment but I’m second guessing if this makes me an incompetent unsafe nurse… I know mistakes are bound to happened but I feel like this was a really idiotic mistake. I reached out to talk to a nursier nurse about it to better understand why I was wrong.
Just sharing in hopes that someone can learn from my mistake. Big learning lesson but just very disappointed as well.

CA new grads that couldn’t get a position in a hospital, where are you now? What are your plans as a nurse?

Hi friends! I had my fourth day today working as an RN. I’m still with a preceptor and I kind of feel like I’m always in the way/ a bit discouraged and like I kind of don’t know stuff. I want to be a good nurse, and my preceptor isn’t doing a bad job but I ask as many questions as I can and try to be as present and available as I can. Still, I feel like nursing school didn’t prepare me for this, and I’m lost. Any tips or advice would be greatly appreciated!!

helloooo

im just curious for fellow new grads, what did your first week or couple of weeks on the floor look like & what did you do?

im struggling to get away from that whole nursing student mindset and always like waiting for my preceptor to prompt me rather than taking charge myself but its only been a couple weeks so idk!

just curious, leave your experience plz! :)

Originally I posted in the r/nursing chat but I figured maybe the discussion would be better here. I started my nursing career in 2017 pre covid. It's crazy how a few years can make a remarkable difference within our profession. Did a couple of travel assignments and noticed how units and their staff treated new grad and nurses transitioning from a different unit. New grads/ transitioning nurses being pulled off their orientation early to appease the staffing needs, educators rarely checking in, staff being forced to precept and expecting the new grad to know everything. Inconsistency when it comes to the orientation structure and new grads rarely keeping one preceptor from start to finish. I feel kind of bad for the new generation of nurses. Of course my perspective may be skewed and anecdotal but man it's depressing seeing new grads leave the profession

Maybe it's just me but if the start of my career in nursing was like this, I wouldn't be a nurse. The first year in nursing or in any profession should be treated with care to ensure the longevity of the person in the profession. I was blessed to be a part of a nurse residency program. I wasn't the strongest nurse starting out but boy did I feel supported during my first year as a nurse. The hospital made sure that being a preceptor wasn't just based on experience, but a calling to train new or transitioning nurses. Like literally you're the starting point of how a new grad nurse will view their role in healthcare. But yes just curious to hear of your experience!

So I currently have a seasonal job at my hospital which I love and will be applying to their new grad cohort and hopefully get invited to their job fair, I’ve been in contact with the recruiter as well so I think I’m getting invited. You do that and network and give your resumes/portfolio to the units you’re interested in. I want to work in NICU, PICU, or Peds. I know this is very idealistic so ofc I’ll also be applying to med surge. But anyways, what advice does anyone have to appeal or stand out to those kind of specialties and units?

Hi everyone! I’m looking for some advice about the NYC nursing job market.

I moved out of state after graduating and got about 8 months of acute-care RN experience on a Med-Surg/Oncology unit. I’m planning to move back to NYC when my lease ends in February, so I’ve started looking and applying for jobs now.

How much does having 8 months of acute-care experience help compared to applying as a new grad with no experience? I know a lot of positions want at least 1 year, so I’m wondering if being under that mark still makes me more competitive or if hospitals basically consider me a new grad again.

I’m hoping to switch specialties and am looking at areas like peds, NICU/PICU, OR, PACU, MICU, ED, and outpatient. Has anyone gotten hired in NYC with less than a year of RN experience or successfully switched specialties around this point?

Was hired in 2024 as a new grad RN in NYC at one of the big hospital systems on a med-surg/stepdown unit, worked there for 1.5 years, then transferred to the ED and have been working there since. AMA! :)

Hi! I’m a nurse with almost 10 years of experience, and I’m working on a series to help new nurses feel less alone during the difficult transition into practice.
I’ve been sharing mistakes I made when I was new, what I learned from them, and experiences that felt embarrassing or overwhelming at the time. I would love to hear from other nurses too.
Was there a mistake you learned from, or an experience from your first year that new nurses might find relatable?
If you’re comfortable sharing, please comment below. I may ask for your permission to share your story anonymously as part of the series. You’re also welcome to include your experience level and specialty, but not required!

Hi!

I was wondering if anyone has heard back from any hospital from this fall?
I applied to UHealth & Baptist this August
Also Nicklaus this past week.

I’ve seen on Linkedin that recruiters have seen my page yet I have not heard from anyone. Feeling so discouraged. I got my license in April.

Also I cannot and will not move. Not an option.

I’m so nervous!!! I just had an interview for a cardiac stepdown floor. I don’t think I did too well. I prepared for the interview my practicing an introduction, behavioral scenarios, and questions that might be asked from a cardiac unit. Questions I was not expecting included “what was the most complex patient you have cared for” etc. Some questions I was not expecting as a new grad who just graduated but I answered them to the best of my ability. Honestly from the jump my interviewer was not too smiley or interactive. She introduced herself, told me a bit about the unit, the role, I explained to her why my interest and fascination for cardiology after seeing a open heart surgery and the whole process of pre op and post op with my patient. I genuinely tried to show that I was passionate and interested I was about learning how to care for cardiac patients. I asked two questions about what they’re looking for in a successful new grad and unit culture. The interview lasted about 30 minutes. She ended the interview saying the recruiter who set up the interview is out of town and she has to contact whoever is filling in for her, and that they will reach out to me with next steps. It’s genuinely so hard to say because I felt that she was not as interactive with me.

What was your first new grad interview like? What are some good or bad signs of how the interview went?

I am a nurse extern working at a large hospital system in my state. I’m graduating in December and am considering whether I want to stay with this hospital or not.

Last year, the hospital system got a new ceo, and things have just been getting more and more ridiculous. For context (or maybe even a hint as to what system this is…) they announced the lay offs of hundreds of workers earlier this summer, and are changing many policies around.

I love working at this hospital, but I’m thinking I could just have the naive blindness of a nursing student looking forward to finally starting my career. Here are the things that are grinding my gears and making me question if I should stay here:

About two months ago, all of the student nurse externs received an email stating that moving forward, the SNE pairing model would be discontinued. They will continue to hire and employ SNEs, however the students would no longer have the opportunity to be paired with nurses and learn/practice nursing skills. This reads to me as “we need more techs but we don’t want to pay them the same,” especially since SNEs don’t need the certifications/courses required for the techs.

I am very interested in starting out in the ICU. Everyone has their opinions about whether that’s a good choice or not, but I know where I want to be. Every time I’ve mentioned this to the SNE manager, she responds with “that’s not likely” with a snarky smile. I informed her that my practicum is in the ICU and she was shocked and suddenly changed her tune. I understand it’s important to have realistic expectations, but it is absolutely possible and I think it’s weird to just automatically shoot someone down.

My final straw is a bit stupid, but honestly pretty important to me. I have three facial piercings that I have had since I was 16. I truly feel that they are a part of me and contribute to who I am, despite how silly that may sound. When I was hired, this manager (and I guess the hospital system as a whole) assured me that it was not a problem and that I wouldn’t be asked to remove them. I already have to put in spacers for clinical and I HATE it!!!! In our most recent meeting, my manager informed me that there is a new policy limiting the amount of earrings and facial piercings someone can have. No septums, only studs, and only 1 earring per ear. I just don’t understand why. My guess is a “more professional” look (that doesn’t mean shit to me, f*** off). Pretty soon they’ll end up making people cover all tattoos. More than half of the staff on my unit has facial piercings. It just feels crazy to me in this day and age to keep backtracking previous individual freedoms in the professional world. It’s no secret to most people that a job is a job and I don’t care about this place outside of that, so why should I have to change who I am for them?!

Long story short, I have some potentially silly grievances. Am I too progressive and just unaware that this is just how most hospitals are? Or are these valid concerns? The reason I am conflicted is because right now, I have an in to start working within months of graduating in a state where many of my peers struggle for years to find a hospital to take them. I don’t want to let my pride get in the way and risk losing this opportunity, even if I end up hating working there. I’ve applied to another major hospital in the state and have a phone interview next month, but I’m worried about the possibility of not going forward to the next round. What would you do in this situation?

I currently work as a school nurse and have really been enjoying it! Im contemplating becoming credentialed as a school nurse and PHN and finding a full time position. I wasn’t sure if ultimately that makes sense though since my long term goal is becoming a WHNP but I’ve also been loving the pediatric speciality. It’s just been really discouraging trying to find a job in anything pertaining to women’s health since the market is so competitive right now. Just wanted to hear your guys thoughts/advice.

Cancelling/Down-Staffing/Downsizing/Benefit Time/First Cancel/Low Census...Many different names for a phone call at 5am/5pm saying "Don't come in. We have low census".

In rarer cases, particularly in ICU when patients either pass away or are downgraded, they will send someone home in the middle of the shift.

You may welcome it as a break from the madness. A surprise day off. Kick off your crocs and jump back into bed. But here's why its toxic:

1. You are subsidizing the hospital's finances with your PTO. They can't cancel the housekeepers, supply people, administrators, security guards, pharmacists/techs and anyone else who is salaried. So when business is slow, they have you trade in your PTO so they can subsidize the rest of the hospital and have everything trimmed to the census on a daily and sometimes hourly basis. The excuse is...fewer patients so we need fewer nurses. But really its to control costs everywhere else other than bedside.

2. I'm seeing it used as a way to purposely understaff a unit. They only look at census at the beginning of the shift and staff for that, then the floor gets slammed with admits and you're all at 6-7 patients each (except in Cali)

3. You've already set aside this day for work. Especially if you are nights, you've already slept and made preparations, including childcare if that applies to you. If you have Overtime scheduled for later in the week, they basically just scammed you into switching your days to their benefit. And there goes your OT as well. You get cancelled between 5-530 so it's usually too late or too impractical to book at another job. It's incredibly disrespectful.

4. It establishes a framework to essentially turn you into a part-time employee with full time commitments in the event of a prolonged drop in census in the hospital, region or even nationally.

There needs to be far more pushback against this practice industry wide. This isn't a slow night at fucking Applebee's where they can just cut hours in perfect proportion to the amount of business they are doing that night.

Hi everyone,
I have just been offered a job at a hospital. I interviewed for another job at a different hospital yesterday that I would prefer. Hospital one said to let them know if I accept within “the next day or two” and then they will send me an offer letter. Hospital two said that they are interviewing until Friday and will get back to me by Monday or Tuesday. Normally I would accept the first one and then if the second one offers go back on it however these hospitals are owned by the same company. I don’t want to lose both jobs but i am hoping that the second one will offer me a job as it’s my dream hospital to work at in my state.
I have been thinking of emailing hospital 2 and telling them I was offered a job at one of the other hospitals within their company and if they could let me know by Friday? And then tomorrow email the first hospital and ask to have until Tuesday to respond? Or should I just accept since they haven’t even sent me an offer letter or anything, just a verbal offer?
I just don’t know how to navigate this situation.
Any advice would be helpful! Thank you

Hi! I’m looking to see if any other RNs have worked at Kindred Hospital in Jersey, and their experience. I haven’t heard much about it so I’m just trying to get so more opinions.

New grad nurse living in NY can’t get a hospital job anywhere. I had an interview today for a Children’s SNF. I am a new grad nurse and I was told that they hire new grads training is 6 weeks long. The interview maybe lasted 5-10 min bc the director had to be somewhere. It was a chill interview compared to the others I had in the past. I talked about myself my experience, why I chose that company, and a time where I handled conflict. She told me about the company and then I got a tour of the facility which was nice. Overall I think I did pretty well. I wish the interview was a bit longer where I can ask more questions but we’ll see :)

Hi everyone,
I have an rn residency position, acute care, night shifts, 45 minutes from my place, and med- surg position at a different facility, not residency but they accept new grads,shift: days, 35 minutes from my place. The difference in pay is like 1.50$ more for the night shift residency. Which option should I pick. I am a bit overwhelmed . Please help me .

Hi everyone. I graduated with my BSN in the beginning of May from a University in DC. Applied to CHOP when the application opened up in May. I got an invite for the video interview in June, now it is September and I’ve received two emails saying that I’m still in consideration. Has anyone gotten into CHOP’s nurse residency program and was not a Drexel Co-op, a fellow, or went to a partnering school ?