Latest Likes For PacoUSA

Latest Likes For PacoUSA

PacoUSA, BSN, RN 33,615 Views

Joined Mar 25, '09. Posts: 3,506 (33% Liked) Likes: 3,347

Sorted By Last Like Received (Max 500)
  • Sep 18

    It has been about 6 months since my last post, so I thought I'd write a little update. I am not even sure if anyone is following my thread but the info I am sure is good for anyone who chooses to look for it later.

    So as of right now, I have started the ED preceptorship at the same hospital at which I am currently completing my travel assignment (I hesitate to post the name of the hospital where I am at this time due to anonymity, but what I can say is that it is one of the top 10 hospitals in the USA based on US News and World Reports). My current hospital did not have an existing relationship with UCSD to allow their students to do preceptorships there, so I had to go through a little red tape to make this happen.

    I started the process by contacting the nurse educator of the ED, who in turn referred me to someone else, specifically someone whose job is to arrange student externships and clinical experiences. She was spot on the person I needed to speak to. She explained to me what was needed to establish a relationship with the hospital and the school. She forwarded me the information and I in turn sent it to UCSD. They already knew what to do with the information, having already done this with other hospitals, so as far as my legwork this was done. My only problem was that I discovered that this process would take about 12 weeks (!!!) to complete, and was told that their affiliated school's nursing students would take priority in clinical placement before I would. I understood that. So what I ended up doing was extending my travel assignment another 3 months so I could accommodate simultaneous preceptorship and work. It was a success.

    I was later informed by mid-summer that I was able to start in late August (after all the nursing students completed their summer externships) and was given the name of my preceptor. She and I got in contact and arranged a schedule around her. The beauty of the 60 hours is that I can complete them in five 12h shifts. I have already completed one shift with her, and tomorrow will be my next. As long as I complete them before I leave (but according to UCSD, complete before the current quarter ends in Dec), I am good. So far, the one shift has demonstrated to me that I am on the right track in choosing this specialty. I really enjoy the dynamic and the fervor of the ED and I am sure I will enjoy working in one in the future.

    BTW, I must make mention that I am happy to report that I have ALREADY secured a full-time RN job in an ER back home! This will start 2 weeks after I leave my current assignment. I have been blessed to have gotten a job even before I totally earned the certificate. They were actually impressed that I was pursuing this certificate as it shows that I was committed to ED nursing and that it shows my eagerness for advancement and learning. So even though I have not fully earned the certificate yet, I believe it served the purpose I intended it for, and that makes the cost worth it to me in this competitive environment.

    In my next post later on, I will talk about what I have to do paperwise to complete my preceptorship aside from attending the 60 hours.

  • Sep 18

    Wanted to post an update to this thread. Since writing my last post I successfully completed the two online courses for this certificate program. I will soon begin the process of seeking a mentor for my preceptorship, the last requirement for the certificate which is 60 hours in an ER. I am hoping to arrange this at the ER at my next assignment (I am a travel nurse and work currently in telemetry/stepdown).

    The courses are taught by an experienced nurse in San Diego. They consist of pre-recorded lectures (with Powerpoints) posted on Blackboard from a previous live version of the course. Each course has five or 6 lengthy lectures covering a variety of topics and conditions that can be encountered in an ER. Although some of the information will seem repetitive from what you may have learned in nursing school, the lecturer injects anecdotes and tips from her vast experience which many will find good learning. Along with the lectures are 5 assignments in each course which must be submitted to the lecturer for grading (she is good with getting your assignments back quickly, graded and with comments). The assignments consist of case studies, multiple choice exams or short essay answers. They are not immensely difficult but by the same token they do require some thought to complete. Along with the lessons and assignments is a discussion board, which to be honest was not used much at all to interact with other students during the course, except to introduce ourselves at the beginning. Outside of that, I felt like I was pretty much on my own with the learning with no interaction with other students. That is probably the one disappointing part of the whole experience. The lecturer however was very responsive to questions during the course.

    The courses are offered every quarter so it is possible to start the course sequence during any of the four per year. The preceptorship from my understanding does not need to start with a quarter, it can start anytime as it is arranged separately from coursework. You are also required to complete the requirements of the certificate within 5 years of filing your intention to pursue the certificate.

    I have yet to start the actual process of finding my preceptor. I have been sent the paperwork required and will have to likely wait until I am on site to speak to ER staff in person at my next hospital. If I were in San Diego, I would likely have had an easier time finding a preceptor as I am sure many have completed their preceptorships at the UCSD Medical Center. I however am on the East Coast and not sure the program has enough ties outside of California to assist me with locating one.

    This certificate is not something that is required or guarantees to get a job in the ER of course. I decided to embark on it on my own just to have as something on my resume so that my future employers can see that I am serious about transitioning to the ER as an experienced nurse. I also learned many things along the way, so in that respect it was worth the time, money and effort I put into it. The coursework also offers a generous amount of CE credit, so that was also a plus towards the RN licenses I have that require them.

    I will update further on my progress as things get rolling, especially with regards to how my preceptorship goes and whether or not the certificate was a plus to have on my resume in landing my first permanent ER job.

  • Sep 18

    Since I am quite eager to change my specialty next year to ED nursing, I have decided to bite the bullet and begin this certificate program. I have just enrolled in the first online course and it starts next month. Seems quite interesting and reasonable, and I have to do continuing education anyway so I might as well kill 2 birds with one stone. I will keep you all posted on how it goes.

  • Sep 16

    The last time I was a staff nurse, ED nurses called the floor to give report and I thought it was a BIG waste of my time (of course, they always tended to call when I was in an iso room in the middle of pushing Dilaudid, but that's another story). As soon as I hear I am getting a new patient, I read their chart and already know what I need to know. My Kardex is completed with hx of patient etc etc. I don't need an ED nurse to reiterate everything I just read and wrote down, just tell me things already that are not in the chart. Where I am now, we don't get report from ED and they just roll up to the floor. I much prefer that actually! I then have more time to tend to my existing patients!

    We do however get report from cath lab and PACU, which is fine with me considering not everything they report on can be accessed in the EPR.

  • Sep 14

    Quote from fathertod
    Honestly, alot of the advice you are getting regarding holding back and waiting until you get a certain magical amount of experience is probably from individuals who are simply jealous that you are trying to follow your dreams. You need to just try and get it done so you don't regret it later. You don't want to be one of those people who just puts up barriers to their own dreams.
    .... thanks for the laugh of the day ...

  • Aug 28

    Quote from flyersfan88
    I have a friend from school who has had about 5 different careers....she's 37. She seems to be unhappy no matter what she does.
    When I was unemployed 6 years ago, I completed a computerized career battery test at the local state employment office. It basically asks you all of these weird preference questions and it results in a printed report explaining the industries where your skills would be best utilized. Ironically, the career I was trying to leave was my lowest ranking industry, and among the top were health care and business. I started volunteering at a hospital a couple of months later and discovered nursing. 6 years later, I could not be any happier being a nurse!

    Your friend might benefit from this assessment tool.

  • Aug 15

    Quote from NedRN
    Good synopsis!
    Thanks Ned! It's through your guidance that I was able to become so savvy

  • Aug 15

    I am personally avoiding southern states for travel assignments, particularly Texas and Florida. Those states dont seem to be worth my time and effort, particularly in the sense that travelers have not been treated well there from what I've heard, and the staffing situation is not good. I know people will pipe in as being exceptions to the rule, but popular criticism is enough for me not to even consider going there. Besides, I lived in Florida for 5 years before I became a nurse and that experience alone validates my desire not to return as an employee there.

    California however is not only one of the best paying states, particularly Northern California, but it's popular due to the mandated nurse-patient ratio law, the only one in the USA at this time. Definitely work on getting a license there ASAP, as it does take a while to get. And there's also the nice weather which is a bonus.

    Other states that I am considering for assignments are Colorado, Arizona, Maryland, Connecticut, and Hawaii. These are due to personal interests and are balanced out by good reviews from other travelers.

    I'm currently in NYC on my first assignment, actually on an extension. NYC is also well paying and worth the experience.


    Sent from my iPad using allnurses

  • Aug 13

    I am personally avoiding southern states for travel assignments, particularly Texas and Florida. Those states dont seem to be worth my time and effort, particularly in the sense that travelers have not been treated well there from what I've heard, and the staffing situation is not good. I know people will pipe in as being exceptions to the rule, but popular criticism is enough for me not to even consider going there. Besides, I lived in Florida for 5 years before I became a nurse and that experience alone validates my desire not to return as an employee there.

    California however is not only one of the best paying states, particularly Northern California, but it's popular due to the mandated nurse-patient ratio law, the only one in the USA at this time. Definitely work on getting a license there ASAP, as it does take a while to get. And there's also the nice weather which is a bonus.

    Other states that I am considering for assignments are Colorado, Arizona, Maryland, Connecticut, and Hawaii. These are due to personal interests and are balanced out by good reviews from other travelers.

    I'm currently in NYC on my first assignment, actually on an extension. NYC is also well paying and worth the experience.


    Sent from my iPad using allnurses

  • Aug 11

    My first job was on a med/tele unit with an inordinate number of patients with heavy psych co-morbidities. We were not an official med psych unit per se, but it turns out we were a dumping ground for these kind of patients because other med surg units refused to take them. Found out some of the doctors at the hospital nicknamed our unit "The Abyss" because of our reputation. It took a toll on the staff, working with these patients was tough and naturally the turnover was incredibly high.

  • Aug 11

    My first job was on a med/tele unit with an inordinate number of patients with heavy psych co-morbidities. We were not an official med psych unit per se, but it turns out we were a dumping ground for these kind of patients because other med surg units refused to take them. Found out some of the doctors at the hospital nicknamed our unit "The Abyss" because of our reputation. It took a toll on the staff, working with these patients was tough and naturally the turnover was incredibly high.

  • Aug 10

    Age is just a number. It should reflect physical and mental capability. Some 60 year olds still run circles around 20 somethings.

  • Aug 8

    Quote from paramedic-RN
    Lol I'm curious exactly what you said.
    Conversation more or less went like this ...

    ME: "What? Absolutely not! I don't do that."
    PATIENT: "My feet hurt, I'm in pain. You're saying that you won't massage my feet to relieve my pain?"
    ME: "Nope. Not doing it."
    PATIENT: "The other nurses have done it."
    ME: "You're dealing with me tonight. And I'm not doing that. Good night!" [shuts door]

    I used to be the type of person long ago that had trouble saying NO. Something snapped along the way, I guess I got tired of people using me and now it's not something I have problems doing. Especially this woman. And had she complained about my refusal it would be attributed to the craziness she had already established with staff. I was never approached about it lol.

    She was extremely demanding and was always on the call button. She would come out into the hallway and yell out "Where's my nurse?" (Mind you, she was isolation too), claims she's been waiting 20 minutes since the call bell was rung, when it was really 2 minutes. Always complaining about staff not giving in to her outrageous requests and ridiculous meal orders. I remember once telling her (had her multiple times during her 45-day stay): "If you hate it here so much, why don't you just go to another hospital? You have that option. We are not the only ones in the area." Her reply: "Because I'm here."

    The way I was with this patient mind you is definitely NOT typical of how I treat my other patients! That woman was a serious mental case. I've never had anyone else in my career so taxing in patient care.


    Sent from my iPad using allnurses

  • Aug 8

    I once had a patient who requested to have her feet rubbed before sleep. I flat out refused. She said other nurses did it (because they didn't have the courage to say no). I still refused. She happened to be one of the nastiest patients to staff I've ever encountered, so nasty that staff had to be rotated every day. The DON even screamed at her once out of frustration. It was my pleasure not giving in to her Waldorf desire, and at that point I couldn't have cared less about Press-Ganey scores!!


    Sent from my iPad using allnurses

  • Aug 4

    Age is just a number. It should reflect physical and mental capability. Some 60 year olds still run circles around 20 somethings.


close