Challenging Situation

[RNSKI999, BSN, RN]

Just looking for some guidance.

Due to my husband's job, we had to relocate. It has been difficult finding a job that I like as much as my old job. Finally, I did find a job that is great. To supplement the income, I also work per diem at another facility.

My issue is that I came from a top 10 children's hospital. Policies were clear, well followed. Magnet hospital. Overall, great nurse and doctor relationships.

This new per diem position is pediatrics, but part of an adult hospital. Does not seem anyone follows policies. When I ask about policies, they say they are hard to locate. The methods/practices seem very outdated and not evidenced based practice. I am just conflicted because I see so many issues, and want to protect my license/patients. The hospital is not bad, but just outdated in practices, at least to me.

Thoughts?

[Hoosier_RN, MSN]

I would ask specifics about location of policies. Explain that it's hard to follow policy if you don't know exacts. To me, that would be scary!

[RNSKI999, BSN, RN]

completely agree

also though, the "policies" they follow are very outdated. But I guess a starting point would be at least locating them....

[Wuzzie]

What Hoosier said and also resist the temptation to start making suggestions because they. will. hate. you!!! Never, EVER, say anything that even remotely sounds like “when I worked at top 10 children’s hospital we did...fill in the blank”. They will run you out on a rail. Trust me they know they aren’t the same as where you came from. I seriously doubt your license or the patients are in danger. Your best course of action is to close your mouth, establish yourself as a team player, be an excellent nurse and once that’s accomplished then tackle the other things. A good approach would be to start a journal club. It’s not so in your face and if there’s buy-in changes will start to happen.

[Hoosier_RN, MSN]

On 7/18/2019 at 7:19 PM, Skigirl978 said:

completely agree

also though, the "policies" they follow are very outdated. But I guess a starting point would be at least locating them....

they may be outdated, but at least if state walks in, you can say you are following policy-state may even direct them to update P&Ps. As Wuzzie said, resist the temptation to go in and change things right off the bat. Especially since you are prn only...wait to bring up small things here and there once you are a trusted member of the team. I think that it would be hard to work like this

[RNSKI999, BSN, RN]

Agree to all the above. If it gets to a point that I think things are unsafe, even if it is policy, I will leave. Fortunately I have a full time job, I was just doing this for additional experience and some extra money.