mzjones6 2,387 Views
Joined: Aug 30, '07;
Posts: 89 (17% Liked)
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I've been a pediatric nurse for 4 years now, with a small stint in adult outpatient. I have my ADN and a bachelors in health science. I'm not sure where to go at this point in my career. I'd like to do more with peds in terms of tackling the obesity epidemic in young kids and do work with diabetes, but I'm not sure if I should go ahead and get my MSN, or MPH, or even my MHA. I'm not interested in teaching, and not interested in being a FNP. I would like to do something like help run a clinic, or program for obese kids, or do research with childhood obesity/diabetes. Also should I even bother getting my BSN since I already have a bachelors in health science? Any and all feedback is appreciated.
I'm getting ready to start agency nursing because I just relocated and want to get a feel for the facilities in the area. As well as the no weekends and scheduling. I appreciate all of your thoughts and experiences with agency/travel nursing. I personally have worked with several agency nurses and they always seem to be on their game and know their stuff.
I'm exactly sure what I should do about this situation. I wanted to hear from other nurses who've worked in the small office setting before and get some feedback on if I'm wrong, or if I"m just not understanding the way the doctor's office is run.
I've been working for this otoneurologist for about 3 months now. This is my first office job as a nurse, and it's a small office, with two doctors, myself, an LPN, two receptionists and a medical secretary. A couple of weeks ago the doctor asked me to help him catch up on his dictations because he's like 3 weeks behind. He wants me to dictate the appointments for his new patients because we have new patients 4 days a week through February. Well he sat down with me for 20 minutes one afternoon, and I watched him do one dictation, and now he expects me to be up to his level of dictating and I know that's not going to happen. He wants me to have it down to a science after one 20 minute session with him and I told him that was impossible because I have no idea on how to do dictation. The other doctor even said it took him years to have dictation down really well, so it shouldn't be expected of me to do it the way he does it after 2 weeks.
He swears up and down that RNs do dictation all the time for doctors, but I had never heard of it before now. I checked with my state board and they say its fine, as long as I receive the proper training, but if I'm not comfortable I shouldn't do it. The other side of this story is I asked if I could finally have my benefits, and he told me that if I don't do his dictations, I won't get my benefits, which I thought was a little unfair and illegal. He thinks I don't have enough to do in my role as his phone triage nurse so I need to be put on part time, but if I do the dictations, he'll keep me on full time and I get my benefits. I already do phone triage, all disability and SSA paperwork, PAs, and help out with scheduling and other office duties when I have the time, but he wants me to make the dictations my priority.
So I would like to know if this sounds on the up and up with any of you. I'm already uncomfortable in the office because the doctor has no real social skills, is very awkward, and the epitome of passive-aggressive. He's great with his patients, but has a hard time speaking to us as employees, and has every done through emails and the office manager.
Any thoughts, comments, and observations would be appreciated. Thanks.
So I plan on moving to Houston next spring and will start looking for job at the beginning of the year. I have an ADN, with 2 yrs experience, but I also have a Bachelor's of Science in Health Science. Does this help my chances of finding a job? Or does me not having a BSN look bad...even though I have a Bachelor's in a field not related to nursing?
I graduated from the first BR accelerated program in Aug '08 and I 100% agree with the above posters. You have to accept the fact that you will do nothing but basically eat and breathe nursing for 10 months. Its a long 10 months but when its over you'll look back and it'll all be a big blur. We started out with 40 and finished with about 22, and yes, the pharmacology class is what did most of those people in. But all you have to do is study your notes and read the book as a supplement really and you should do just fine. We lost a couple more later in the program and those people went to the 2 year program and did just fine. The schedule that I read above looks pretty accurate. Lots of late nights doing care plans and going to the bookstores and studying nursing exam questions out of the books in the store. Be prepared to feel rushed and pushed through the program because that's why its called accelerated. Our class was mostly 20 something singles with BF/GFs, and the rest were early to mid thirties, only a few were married. I don't know about the other posters, but our program felt rather disorganized at times. I don't know if it was because we were the first class the BR branch or what, but at times it was very frustrating to deal with the adminstration when it came to scheduling to classes and things of that nature.
As a side note, I recommend taking the Hurst review when it comes time to begin studying for the NCLEX. Its well worth it. Most of our class all took it and we all passed on our first try at the NCLEX. Its one book and its all you'll need.
Can you tell me how the job market is is Houston right now? I also live here in Chicago, living here for a year and my boyfriend is ready to leave. We've settled on Houston because I'm originally from Louisiana and his mother is in San Antonio, and its perfectly situated in the middle So we were hoping to move sometime in 2011-2012. I'm Peds RN working at pediatric hospital, so peds is where I would like to stay. Any advice or info would be greatly appreciated.
Thanks everyone for the advice, it was all good and constructive and I'm going to take everything you guys said to heart. I decided to file a grievance with HR about the write-up because I feel the situation wasn't looked into enough. The only issue I have now is that I have anxiety when I go to work, and at times I'm more concerned if I'm about to get fired as opposed to doing my job. I'm considering looking for a new job and just leaving, but I'll wait and see how the grievance process goes and weigh my options after that
Again, thanks everyone, you guys were a big help.
This is a rather long so bear with me on this. I'm not sure what the do at this point, if I should file a grieveance or just suck it up, keep on moving and improve on my performance. I've been working at this hospital almost a year and love working with the patients, but my fellow co-workers seem to keep getting me into trouble and in the end it appears that you don't get written up for giving bad advice, but only if you take the bad advice.
The first warning I got was understandable and deserved. I had a patient coming in for questionable febrile seizures and she became febrile overnight!! I paged the resident at least twice waiting for an order for tylenol, but she must've been dead to the world because she took a very long time to call me back. While waiting for the resident to call, another nurse told me to hurry up and give the tylenol or my patient would begin to have a seizure. I waited and waited, still no call back. All I needed was a T.O.R.B and that would've been the end of it. So this other nurse proceeded to write out the telephone order before the resident called back, since she, and we, all assumed the doctor would just write the order anyway when she arrived. To make a long story short I ended up giving the child tylenol before the doctor arrived and was written up for working out of the scope of my practice. My manager counseled me on going with my gut and if it feels wrong don't do it. She understood that as one of the new kids I was under a lot of pressure from the more senior nurses, but that if it I feel it in my gut, don't do it. I don't know if the other nurse got reprimanded or not and I didn't ask.
This last written warning came from a combination of things that happened on just one night, with different patients. This is the discipline that I feel should be partly be grieved because I feel like I was the fall guy. My first patient was a newborn admitted for hypothermia but ended up having hyperbilirubinemia. Now I've only assisted in setting up bili lights one time, so I knew I would need help. I asked for help and was told to print out the protocol, but the blanket under the baby, put the googles on, and set up the lights so many inches away from him, with the temperature measured with the bili meter. To make a long story short I fumbled with the lights and the dad asked that someone else set up the equipment because he didn't feel I was capable of doing it. I didn't take offense to it, I just said that's your right and I understand. Again, I asked for help and was told to call the NICU. The NICU nurses did it, and felt themselves that the dad was a little uptight, but they were older first time parents so I didn't fault them for anything. Well apparently afterwards, the parents kept asking if the NICU nurses to do everything, but we're not a NICU floor, and the baby didn't need the NICU, so it became an issue. The parents even met with the director of our unit to discuss what was going on with their child and the bili lights and NICU, so even the director knew (this isn't unusual, the director from time to time does go and listen and talk with the families on the unit to see how things are going). Another issue with this patient was that the Admission Screening Tool was not completed, which is done on admission. I discovered this at 5am that morning and passed on to the next nurse that it hadn't been done. Mind you the patient had had two nurses before me and neither had done the AST. I wasn't going to wake up a breastfeeding mother who was already up every 2 hours feeding, to wake her up to ask her 30-35 questions about her child.
During that same shift, I got an admission, and was so busy with a rectal irrigation and a transfer that I missed my own AST!! So I passed on the next nurse that it wasn't done and they didn't seem to care. Also this new patient had an order for a pulse ox and no EKG leads, and I had the patient on EKG leads and no pulse ox. I also realize this was my boo-boo and I should've corrected it, but I have walked into countless patients rooms and patient isn't attached to anything and should be. I just told the nurse and thought she could take the two extra seconds and stick the kid on a pulse ox.
So my write up was for all these combination of things: I was basically blamed for not doing 2 ASTs, when in fact one AST went through two nurses before me. I was also written up for leads and pulse ox monitors being backwards, and written up for asking the NICU to set up the bili lights when I could've utilized my resources on the floor. If I asked for help initially before the set up and after the parents asked for someone else and I'm sent off both times, what was I suppose to do? I don't know what my next step would've been. Apparently the charge nurse that night was capable of setting them up, but she was either too busy or didn't want to bother, either way I was disciplined for it. IN FACT, the nurse who told me to call the NICU is the same nurse who told me to give the tylenol to my febrile patient above. The monitors and pulse ox issue was could've been corrected the the day nurse, it take two seconds to put a pulse ox on, but instead she thought she'd report it. I go through countless pulse ox and lead stickers in a night, and alot of times because the day nurse before me doesn't have them on right, or not at all, but I don't report it everytime. As for the ASTs, I don't understand why I'm being held responsible for something that went through two nurses before me and neither one of them could do it during the day shift? As uptight as these parents were, would it have been wise to wake them up and ask them to answer a bunch of questions for me at 5 in the morning? Why am I the fall person because the previous nurses slacked off?
Now don't get me wrong, I understand all this involves some self-reflection on my part and I need to look in myself and see where I need to improve on my performance. My manager told me herself that some of these issues were simple tattle tales, but I get in trouble nonetheless. Now I'm in danger of losing my job all because I did things that I've seen done all the time. I've had the reporting nurse tell me the AST is incomplete, or that they didn't bother to put the child on monitors because they look good, but there are doctor's orders for monitors. At one point, some nurses were worried that I wasn't asking enough questions during my orientation, but now I ask questions and ask for help all the time and when I do what I'm advised, I'm still at fault. Please help me understand what it is I'm doing wrong and what I need to do to correct it. I've considered finding another job due to my co-workers and their attitudes towards me at time ( I feel ostracized at times, and left out of the cohesion of the group, a whole separate thread), but I really like my kids and want to make the best of it. AT this point, I'm so on edge from the fear of losing my job that I'm afraid I won't be able to do my job.
When you go for the interview just be open and honest. I actually applied for the PICU and they decided they wanted me on another inpatient unit, so be open to perhaps going to another unit unexpectedly.
If they haven't called back after a week or two, call or email. If no decision has been made another week or so after that, call or email again. I did that about 2-3 times in the month and a half that I waited to hear back. You have to stay on top of them, and make sure you're always on their mind to be hired.
Ask lots of questions during the interview and during your tour (you will shadow an RN on the unit you're applying for). I also sent thank you notes to the two HR personnel that I interviewed with, and the director of my unit, who I also interviewed with. Just remember to be proactive in the process.
I've been working at childrens for 8 months and was hired in March as a new nurse. My floor just hired 7 new nurses, 4 that are new grads. They only hire during certain times of the year, in groups, new and experienced I believe because all our new hires started within a couple of weeks of each other. If you're an experienced nurse, I don't think you necessarily need experience in peds. I know there are postings for experienced nurses all the time. I would call HR and ask, but as of August we were still hiring. Keep in mind that the recession has hit us, for instance we didn't get a raise this year and the company can no longer match our 403Bs. But I love it here, I love the kids and its a wonderful place to work. We're in the process of building our new $1 billion hospital by Lake Michigan in downtown chicago, which is suppose to open in 2012. I would just keep an eye on the job postings on the site and apply. Also keep on HR about your application. I interviewed in the beginning of December and they didn't tell me I was hired until close to the end of January. From what I understand they are notorious for taking their precious time getting back to you about your application.
I just got a job at Children's Memorial in Lincoln Park and I have an ASN.
I'll keep you posted on that...I start on March 23rd in the Neuro/Endocrine unit....excitement!!!
I should point out that the HR person that I would be a better fit for an inpatient unit and then move over to the PICU...so all these questions were asked by the director of the Neuro/Endocrine unit. But getting an internship at this children's hospital was the ultimate goal, so I'm extremely happy with the end result.
Those are actually the same questions that I got asked at the interview in fact. I was offered the job a few weeks later and I accepted, so I'm excited. Thanks for your help though.
These are some really good tips for working the night shift. I'm a new grad that just accepted a night shift position and the main thing I'm concerned about is that life is going to pass me by while I'm sleeping the days away. I love being outdoors, whether is grocery shopping, shopping, or going to museums, so I'm hoping this won't be too hard on my body.
I did most of my preceptorship of nursing school doing the night shift because my preceptor worked nights. It was hard on me and I failed one of my last exams of nursing school due to working 3 nights in a row and having an exam on Monday. I know I won't have any exams to worry about this time, but I'm still concerned that on my days off that I wouldn't be able to get anything done.
Its not good at all. I had been looking for a job since October of 2008 as well and never got a bite. Then Children's Memorial called me for an interview. They offered me the job and I've accepted. Out of all the jobs I applied to, which was about 12, they are the only one that called me back.
Just keep looking is all I can say, it can be frustrating, but just keep going forward.
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