Losing your license in Nevada?

U.S.A. Nevada

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I recently informed my clinical instructor that upon graduation I planned on moving to NV and practicing there. Her mandible nearly hit the floor. She was concerned that because Nevada has the highest patient:nurse ratio, I'd be setting myself up for a situation wherein I'd lose my license.

I know that many responders to this thread will say things like 'well, if you're good, you shouldn't have to worry about it' or 'if you are afraid to practice, then you better not', but instead of saying those things, I'd like to get a feel for how it actually is day-to-day in the hospital setting.

Are you caring for more than, say 4 patients per shift on a med/surg floor? That seems to be the going rate at the clinical site this year.

I welcome Nevada nurses thoughts...is my instructor out of line?

Just curious :)...your public profile says your birth year is 1981, but you say you're 33? 1981 would make you 24. Just wondering. I noticed you mentioned that you were young, so I just wondered, which is why I read your public profile. I'm 32 & I wanted to see what people considered young. For some reason, I think of myself as "old" but when it comes to someone else who is my age, I do not see it that way. Strange, I know. I don't know why that is.

I'm 32 also, I felt old in nursing school, since many couldnt legally buy alcohol; but in the scheme of things, I feel like I am just getting started in life.

After reading these threads, I realize I'm screwed. It seems I won't be able to afford a home in a neighborhood that is safe. My plans were to move there next summer. Oh well, maybe I'll choose Alaska instead.

After reading these threads, I realize I'm screwed. It seems I won't be able to afford a home in a neighborhood that is safe. My plans were to move there next summer. Oh well, maybe I'll choose Alaska instead.

I've been seeing buildboards everywhere here advertising condominiums starting at $150,000, some cheaper than that & in nice neighborhoods. That's if you want a condo though. Who knows, by next summer, those could have gone up to $3,000,000. It sucks!

505 - How is the job going? Would love to hear how things are working out.

505 - How is the job going? Would love to hear how things are working out.

jayrelic--I pm'ed you.

There are alot of houses here, for around $250,000 that are in decent neighborhoods...just gotta look.

I am moving to Las Vegas, too, once I graduate next week. I keep hearing horror stories of 11:1 ratio. I rotated in AZ; worst it got was 6:1 on the Med-surg floors. Isn't there anyone in Las Vegas on this board who can support or deny this claim? I interview at Valley Hospital next week; I'll post the scoop there....

Have heard nothing but horror stories about Las Vegas by fellow travelers won't go there but have traveled in Washoe Medical Center in Reno. It is nothing to have 5-1 in Stepdown and 2 sometimes 3-1 in ICU when its really short plus they demand floating to areas your not familiar with. Floated one night to Oncology started with 6 pts at 1900 thought this is cool then ended up at 2300 with 5 more. NOt cool at all. Was giving blood products to 4 people, scheduled q2hr pain meds (IV) instead of pt having PCA's to all but 3, was not a great experience at all. Wouldn't go back to Reno either.

Really liked the Hospital(Northeastern Nevada Regional Hospital) in Elko, Nv, nice, new, sometimes high ratios but averaged 5-6/1 on the floor and 2/1 in the unit. Would go back there again. Check it out.

Specializes in ICU, psych, corrections.

I work at Washoe Medical Center in the ICU and in the 1 1/2 years I've been there, I have seen 3:1 ratio's twice. I also know that they give GSU (General Surgical Unit) RN's 9 or 10 patients on night shift and I believe up on Med-Neph, they give the NOC shift 10 patients as well. I have done clinicals in every part of Washoe and I can say that I picked the right place for me. I love the ICU and wouldn't want to work anywhere else (for now). I thought I would really enjoy Oncology but that floor drove me nuts. I can't stand having a satellite phone attached to my hip that is ringing off the hook....for 12 hours. I didn't really enjoy my clinical time there and am glad I didn't apply for the job in Oncology.

I'm sorry to hear you had a bad experience at Washoe. Out of the 3 major facilities in Reno/Carson City, I like it the best (but my experience is just from doing clinicals at the 3 hospitals...I have only worked at Washoe). Travelers do seem to get frustrated sometimes (our traveler status is about 75% in the ICU), but we do have those who stay on for assignment after assignment. We had two married couples who were asked to extend their assignments and ended up staying a full year in our ICU.

I have actually considered the hospital in Elko. One of our nurses just graduated from the school there and moved to Reno to work. She said that Elko is a pretty nice place to raise kids (a lot better than here) and that the hospital is a nice one. She just didn't care for the administration there. My hubbie works for the Department of Corrections so he can't really transfer to Elko as there is no prison there. But once he finishes his Bachelor's and tries for Parole and Probation, we might consider it. Glad to know you enjoyed it.

Melanie = )

I say we should educate everyone, not only the nurses, but especially the users of healthcare themselves. Wouldn't it be nice to read an article where people asked what the staffing ratios were and the actual staffing levels were, and THEN told the facility "No, I will go elsewhere, because you don't have adequate staffing to cover my or anyone's needs adequately, and it makes the nurses and CNAs very overworked and I am not going to participate in that!"

Bet the facilities would listen then. I have always had this 'fantasy' of writing articles and publishing them with the newspapers, etc, regarding just that. Too bad I am self supporting and so very tired that it remains just a fantasy.

The reason California nurses have it good is because they did strikes and sickouts, they stood up themselves and for safe staffing levels. I was a CA nurse, now I am a Nevada nurse, and it was a rude awakening, and here in Nevada, they come in, do the job, and don't say a word. Thats as far as I have seen in the two years I have been here. I was told before I came to Nevada, "Are you sure you want to move there, nurses have it really bad there".

Like I said earlier, I am on my way elsewhere and have already applied and paid for yet another state's license. I will be gone from here in less than 3 months. I only have to subject myself for a little while longer. Truly, I feel sorry for the nurses here, for all nurses who are abused by money hungry corporations, and to the people and families they try to help and serve. Corporations know that nurses are overachievers and no matter what will get the job done, and they WILL laugh all the way to the bank.

In Long Term Care figure about ~5000 a resident/month, 76 residents, you do the math, two nurses and 3 CNAs(3 if we are lucky). That's bad math in my book.

Most respectfully, to all of you,

Gone in 90 days RN -- Misscus

Warn: (0%)

Specializes in ICU Case mgt. homehealth,subacute.

Jayrelic

California's nurse patient ratio isn't always low. I think nursing everywhere can be difficult. What you have to do is, know you abilities. since you have just graduated, you should know what you like. Start on med-surg, get a good orientation. Ask lots of questions. If the orientation is nearing an end and you don't feel quite ready, ask for more time. always follow policy and always get help. Be confident, you will grow. Hopefully, you can work somewhere where there is a mentor after orientation, to groom you professionally. Write everything down, take good reports and ask questions. Organize your sheet, check orders and double check the physcian orders with the rmed rand. After a few months of med-surg, go for the area you like. Make it known at the interview. Say you love ob, tell them that. Med-surg can help organize you. If you are moving to Carson city, apply at Sierra Surgery, a nice place to work or Northern Nevada Medical Center in Reno. I hear that that is a great place to work, where everyone works together as a team.

I really have hurdles to overcome, trained in NE ICU, made mistakes in 2 CA ICU's. Now, I found out I have a disability which caused the mistakes. My fingerprints have been rejected because I have worked hard my whole 52 young years. so, I am on probation with CA, have not obtained a job there, have AD/HD that is now managed. I don't want to give up because I am a good nurse. I was inducted into Sigma Theta Tau in college. I recently rejoined. I would like to join the NV Nurses' Association. I alos have been writing senators and representatives to support the nursing bills in the senate and finance committee. Looks like you wrote your post a while back. I hope you are doing well.

granna94

Washoe is trying to get magnet status. I'm not sure how they are going to do this with pt. ratios like they have on GSU.

Re: California's numeric ratios...

I've heard that this had bitten nurses in the butt at several hospitals. First of all (I'm told) that the 5:1 includes LPN's. Therefore, the RN covering for an LPN has 10 pts for whom he/she is (ultimately) responsible. Second, I've heard that hospitals made up the budget difference by dumping ancillary personnel. So in some units, RN's are doing RT work, transcribing their own orders, transporting patients and so on.

The Union is going to try to push a similar bill in Nevada this coming legislative year (2007). I don't think I like it.

Specializes in ICU, psych, corrections.

I don't like it either. My nursing instructors are all against it as well. When I was going through school, they stated that it had problems that needed to be worked out, just as CA does. We spent an entire class discussing the probable patient-RN ratio bill and the pros/cons of it. I DO think something needs to be done (although I am not affected much by it being in the ICU) but before we go passing bills, we need to really sit down and think about it. Because from what I've heard from CA nurses, the ratio works in theory, but in real life, it's not such a simple solution. I can't imagine our ICU without our RT's, unit clerks, etc. I'm pretty good about putting in my own orders, etc. but I can't begin to think about being responsible for my own vents. Those things still freak me out from time to time.

I experienced the horrible patient-nurse ratios during school when I had clinicals up on Med-Neph. The nurse I was with during those 3 weeks consistently had at least 5, and up to 8 patients during the day. And they were fairly high acuity patients. I was exhausted, scared, and beat up by the end of the day. I still don't know how those nurses do it. My hat is off to any of the floor nurses....they have one of the hardest jobs out there.

Melanie = )

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