HELP!! I am stuck in a situation! - need advice from experienced nurses

[MegRyanGirl]

I am writing for some advice from people with experience. I am a new grad and I have been working in a LTC for the last 3 months. The facility is sponsoring my green card and they made me promiss to work for them for 2 years, although they haven't made me sign any agreement yet.

The problem is that the management is so horrible that I am dying to leave the place, but I can't until my green card is approved.

For example, I didn't get the basic fire safety in-service the first 2 months. The first week the DON and the assistant DON told me to spy on all the floors and tell them what I found the nurses do wrong. When I came back with a list of things that were wrong, after a while they didn't want to hear it any more and labeled me as a complainer. Then the nurses on the floors where things are done wrong, they don't want to work with me because I want to do things the right way, and it makes them look bad.

A nursing supervisor complaind about me to DON that I was annoying because I requested a drug book (which every unit is supposed to have) a couple of times.

We have to punch in and out every day and the time clock is unfair and inconsistant. I always get paid anywhere from 15minutes to 1 hour less than I am supposed to. Lunches are not paid, and over time is not paid.

The DON told me not to take BP on cardiac meds because "it takes too long and you won't finish all the meds if you do BPs." She says "you sort of have an idea of your residents' ranges" although the MD order read that BP ranges had to be 60-100 and that MD had to be notified if it wasn't within the range. In fact, when I took the BP like I was supposed to, it was so low that I had to hold 3 medications and call the MD. Imagine what would have happened if I had given the meds??? The DON laughed when I insisted on taking the BP saying that I was young and inexperienced.

Then, a family complained about me that I "ask too many questions when the patient wants a pain med (which is actually an anti-anxiety med)." The DON asked me what happened, and I said I normally go through the standard protocol when a patient asks for a PRN med. Typically, when the family comes, the patient says "can I have my tranquilizer?" I say "what's going on? how are you feeling?" pt says "I am feeling anxious" and shakes her hands to make herself look anxious. Meanwhile, pt's hands are shaky all day long and I ask her if she is aware that her hands shake all day. She says she didn't know that. I go and get her ativan. So the DON and the assistant DON told me that I should not ask any questions and just give the PT the med. I explain to her that as per protocol, I have to document why I am giving a controled substance and I have to ask why the pt needs the med. IT's not a tylenol or a vitamin we are talking about here. It is a double locked controlled substances that each shift counts to make sure no pill went missing. And the DON tells me "just give it without asking questions" ??? I told the DON maybe she could explain to the family that I am just following the protocol to give the pt the best care, but she didn't want to do that. Her and the assistant DON both said "We don't side with the nurses. With side with the families because that's who brings the money! There is so much competition among nursing homes and we have to make the family happy so that they stay with us!" They told me that I was impossible to work with and that they are going to write me up for insubordination.

I like caring for patients and always want to do the best I can. I don't think I did anything wrong. I would like any advice on how I can handle the situation while I am stuck at this place for another 1 year and 9 months (unless I get a greencard fast or they somehow decide to terminate the verbal contract ). Leaving the place is not an option. I just would like to figure out how I should behave to make the situation somewhat bearble. By the way, there are some nurses that feel sorry for me and side with me, but they are scared to say something for their own sake...

Any advice will be appreciated!!

[ghillbert, MSN, NP]

A position in nursing management or a nurse supervisor qualifies for H1B, but you must have a BSN, and the position has to require BSN.

Perhaps, but that's not what you're doing. You said you're working the floor in a LTC facility. Bedside nursing, even if you act in charge, is not "nursing management", and does not fulfill the specialty position requirements - because any RN without a BSN could (and does) do it.

Just because your visa application was worded cleverly and approved does not mean it's not fishy. Hope none of your antagonistic colleagues calls USCIS for an investigation.

[suzanne4, RN]

Still something fishy - you shouldn't be able to transfer a H1B if the new position doesn't meet the specialty occupation requirements, which I'm sure an LTC position doesn't.

________________________________________________________________

So, what kind of nursing does qualify (a specific position or a specific employer)? I have just graduated with BSN here in the States and I am trying to apply for a job in the area (I have received my OPT card as well)? Can anyone share a little bit more about this part as it is still very much unclear to me?

Chances of getting an employer to hire you with the H1-B is quite slim to say that least. You are also a new grad that makes it harder as most entry level jobs do not require the BSN in most areas to get hired for it.

Depending on the state that you are in as well will have something to do with it, those that have strong unions do not even permit the H1-B visa for the bedside nurse either.

There are also a limited number of H1-B visas per year, actually 65,000 and they are usually gone within a few hours, the number of applications far exceeds what is available even before lunchtime on the day that it opens to accept them.

There are already many other threads that discuss the different types of visa, recommend that you check those out.

[Bosnianstudentnurse]

Thank you all for your replies (especially you Suzanne with so much patience to answer all of the questions). Now the things are much more clear to me, and I can only hope for something to change by the Spring of next year, although that seems very unlikely at this point.

[suzanne4, RN]

Thank you all for your replies (especially you Suzanne with so much patience to answer all of the questions). Now the things are much more clear to me, and I can only hope for something to change by the Spring of next year, although that seems very unlikely at this point.

You are quite welcome. But it is going to be almost impossible for anything to change as there were more than 800,000 petitions submitted last summer when the US did not have any visas available but got pushed into accepting them. When you figure that there are only 140,000 total green cards under the EB-3 category and that is what you would be under; and with that number of petitions, you do the math. And that does not even take into account all of those that are under CP processing currently. That is why we keep stating that it will be more like five years at the earliest for anyone to have a change at a green card now, and even longer if they are not already in the petitioning process.

Best of luck to you and please keep my posted as to how things work out for you.

[Nov2007_LPN]

I don't care how many patients/ residents there are I would want to know the BP if I was giving the med.

Id have the CNA's get the vitals if there low hold the med

I find as a new nurse most new nurses try to do things the way we are taught. The problem is when everyone is used to doing things the wrong way -they will have a problem with you for doing it the right way. If you cause any harm doing it the wrong way they won't be there to back you up in court.