jrwest,
Wouldn't it have been nice if nursing school prepared nurses for the REAL WORLD of nursing? I loved nursing school. I was so fascinated with the anatomy of the human body, pharmacology, nutrition, and helping others. You are correct though...nursing shortages and the other BS that goes along with it (that only other nurses would understand) can really cause you to rethink things, or ask the question that I ask myself frequently, "What did I get myself into?"
I have thought about persuing the radiologic technology program. I just have to find time to do it. I recently bought a house which has forced me to increase my work hours. Yes, I probably tell my friends and family members on a weekly basis that I hate being a nurse. Isn't that so negative? It's not at all about the patients I care for. I love to administer medications, communicate with the clients and help them in every way that I possibly can. I just thought before I graduated nursing school that I would have so much more time to spend with patients. Boy, was I wrong, lol. I am just here to say that I know what your going through.
This was so cute I had to tell my sister nurses! One of the earlier posts asked what we were doing different to get the word out about the swine flu... Well, I wanted to put up NEW REMINDER posters in the halls and bathrooms to WASH THEIR HANDS! I thought I should have a poster contest amongst the Web Design Class and then choose a winner. The posters came back were SO GOOD that I couldn't even pick a winner! They are very eye catching and I have even heard kids out in the halls talking about them. I wish I could show you some of them. I gave everyone in the class a candy bar and soft drink for their efforts. They all came up and gave me a HUG! (no diabetics in that class LOL)
i think this is unsafe especially for a new grad, if this is only offer especially in this job market, take it and keep applying elsewhere when u get another offer, run don't walk
I was the lone licensed nurse in a facility with 52 residents on the night shift. My problem was with CNAs who stayed away from work to get their way and who wouldn't do much work when there. That is what happens when a group wants to insure that their friends get hired. I had some hectic nights there, but as I said, my problem was the nursing assistants, not the mix of patients.
I shudder when someone says they want to go into nursing for the financial benefits. Yes, nursing is a fairly secure profession, but nothing is a given. If the only reason you want to be a nurse is because you think you will be able to get a job in hard times, then it may not be the job for you. Nurses work long hours, nights, weekends and holidays. If you are a stay at home mom, you need to realize all the time you will give up with your family,if you go into nursing. Of course there are jobs in nursing that don't require shift, weekend or holiday work, but they usually are hard to get and they don't pay as well. I would suggest that you try working as an aide or volunteering to see if you like what you see. I believe that to be a GOOD nurse, you have to have the heart for it. I have worked with nurses that are just in it for the money and believe me, they are NOT GOOD nurses. They may have the knowledge they need, but not the heart. Sorry, I will get off my soapbox now
Don't go into nursing because you think you'll be guaranteed a job. Take a look at the many threads here about the so-called nursing "shortage" -- many of us consider it a myth. Also take a look at all the current threads by recent graduates who can't find jobs.
I'm a new grad, started working on a DOU (step down from ICU) floor in early February. About 75% of the time, I feel good when I go home from work. I feel like I did a good job and was on top of things, felt my patients were safe and had competent nursing care. Some days though, like yesterday, make me want to quit and never come back.
One of my patients went into V-tach as I was receiving report, first thing in the morning. The previous nurse noticed his IV was going bad, but didn't take care of it. After numerous attempts by multiple people, and even trying to start an IV on his feet, it was determined he needed a PICC, but our radiology department doesn't put them in on Sunday. It took the entire day for this guy to get a central catheter placed, and he was septic and not receiving his antibiotics or the electrolytes that were prescribed to treat his V-tach. Meanwhile, he was also incontinent of bowel and bladder, and had to be changed (bedding and gown) at least 6 times during my shift. Icing on the cake was that someone kept stealing his IV pumps since they weren't being immediately used, rather than contact central supply and get their own pumps. I had to put in orders for IV pumps 4 times, knowing they would eventually be needed, and I am quite sure they now think I am insane over in central supply.
My second patient went bad around 11:00. Her O2 SATs and blood pressure dropped to the point that we had to call a rapid response team. After trying for a couple of hours to stablize her, we ended up transfering her to ICU. She should have gone sooner, but there wasn't any room, and we had to wait for someone else to die.
My third patient was a lovely little old lady with a horrific, huge hematoma and wound s/p fall while on coumadin, with mild dementia and a hairline fracture to her ankle. (Incidentally, her IV was also no good, and she was another hard-stick.) She was fine unless you left her alone for more than 5 minutes, and then she'd be trying to climb out of bed so she could go home. Fortunately, her family was with her when my 2nd patient was crashing. I hate restraints, but at 6:00, overwhelmed with all of my other responsiblities, I finally had to get a doctor's order for a posey vest because I didn't have the time to stay close by.
My 4th patient was an isolation patient (MRSA and C-diff) with a recent BKA and poorly controlled pain. He didn't speak any English, and was (I suppose understandably) hostile each time I went into the room. (His doctor knew about the pain being poorly controlled.)
Icing on the cake was that I was so overwhelmed, that I actually welled up in tears when the charge nurse came to me late in the day to ask me a question, and now I am humiliated because I am normally a pretty hearty girl.
I hope these kinds of days will diminish in number as I gain experience, and that I am not so overwhelmed when they DO occur.
10. You won't have to hear complaints about why the pharmacy "stopped stocking drug ____".
We have no idea of what the pharmacy used to stock.
9. You don't have to hear complaints about, "why don't they have more CNA's working this floor".
We have no idea of what it was like when you did...or IF you did.
8. We don't fuss about how bad the computer system or how the old charting system was better.
We've never seen it.
7. We don't try to look for equipment in the "place where they used to keep ____"
We only know the NEW place.
6. We don't get involved in the floor gossip.
We have no idea of who is sleeping with who...and who isn't supposed to be sleeping with who.
5. We are nice to all the physicians.
Because we haven't got to know them yet...and will call them with all confidence and without hesitation at 3:00 a.m.
2. We won't talk about how the Nurse Manager wasn't such a witch until she got promoted.
To us, she always was, and we just deal with it.
1. You'll never, ever hear us say, "Oh Gosh, why can't we do things like we did over at ______________, it was so much easier!"
We have no idea of what they do at the other facilities.
I hear you, and all the posters who said you have to set limits and demand the respect you deserve are exactly right.
We had a lady on the vent for 60+ days with pulmonary fibrosis, and every day you could tell what her family had looked up on WebMD the night before. Asking detailed, questions about vent setting trivia, acting angry the split second it seemed like she wasn't the center of attention at all times. Her husband yelled at one of my co-workers one afternoon about how "no one has been taking care of her". I went in the room and told him to google pressure ulcer when he got home and then ask himself how she had been laid up here for 2 months without having one....then see if he still thinks no one's been taking care of her.
He must have done it because the next day he apologized and that was the end of them acting like that. Miraculously, without us ever taking care of her, she managed to survive her admission and went back home.
They are just killing me. Why is it that so many of them feel so entitled to sit in their aging parents rooms and just boss us nurses to HELL and back, while they sit there, fully able to do much of what we're doing for their parent, but simply do NOT have the time to do when we have other patients and issues to deal with. i MEAN -- can't they get mom up at least perhaps ONCE during the day? Does it have to be a nurse doing it every single time, ten times a day??
I just came off a shift tonight where I literally waitressed all day long, making and fetching coffee and water and 100 millions cups of juice for these patients (because we're always short a tech) -- and a patient's daughter was literally screaming at nurses at change of shift to come in and do something or other for her mother. It was absolutely NOT an emergency. (She was actually screaming -- "Good thing it WASN'T an emergency!!" These people have been on our unit for over 2-3 weeks, running every nurse on the unit ragged. Their mother is far over 80 years old and is only going to head to weeks of rehab after being on our unit. They want a private nurse -- that is what they want and need. But they can't get that on a floor. I think their call light was on for perhaps five minutes, max.
I am just SO tired of family members not understanding what we do -- and our managers from the floor to the corporate headquarters not backing us up to explain it to them. We are simply to treat everyone as our "family members" and go above and beyond 1000 percent of the time. Who goes above and beyond FOR NURSES??? DOES ANYONE???
We have no private space to do our charting, we are like fish in a bowl for these family members. If they see you at the nursing station -- that's it. They are ON YOU like flies. If they don't have a reason to bug you, they will find one. So, you don't get your charting done on time and are left to stay after a shift for an hour.
I am just so tired of it. So burnt out. Is it any wonder why they can't keep nurses for long? I mean -- come on, management -- take a LOOK at what you are doing to nurses nowadays. Put some LIMITS, please, on these family members. It is OUT OF CONTROL.
Many of you are great, dedicated employees. I know you work HARD. Yours is a physical job, and I've done it myself a few times, and I was exhausted. I see how you are pulled constantly, not only to do your job, but to assist all the nurses you have assigned to you. You also do a job that many in our lazy society would turn their noses up at. You are special people -- and your work is invaluable. You should be paid more. We should ALL be paid more.
Many of us nurses are new, are not that great at time management, and so you are left to pay for it -- we call you in, pull you here and there, and it must totally drive you nuts some days.
Other observations: Some CNA's seem to be in their own world sometimes, and not interested in pt care. They can't seem to understand priorities. I will say, "can you please place this IV now as this patient needs a drip started STAT," and some will say, "sorry, I have to do all my accuchecks now." Sometimes you have to go with the flow and realize nurses and patients have priorities. I just LOVE the techs who will say, "Yes -- let me get to that for you, and be pleasant about it.'
And I also have to make one wish: that texting on the job, cell phones and other devices should not be allowed. I can't carry one and fool with it all day -- but I see our techs constantly on their phones, texting and reading messages. Drives me nuts when I'm running like crazy and could use a little help.
I have been placed on the floor as a tech, and it helped me to have a lot of compassionf for CNA's. Id just like ONE day, however, when I could drag my techs along and allow them to totally understand what I'm dealing with day to day. I would like them to stand with me as I get chewed by a manager , or a doc, or a patient for letting something slide. Yes, I earn more -- but not all THAT much more -- and I worked really, really hard to get my license.
And I don't ask you to do something because I'm trying to make your work too hard -- I'm practicing the art of delegation. I need you to do these things so I can provide better coordination of care and perhaps ALSO get out of my shift within the hour. I have filled SO many water pitchers today, covered SO many pts with blankets -- all things you could have done -- so I'm behind now, not to mention, exhausted.
For those of you who can hang with me, work with me, communicate well with me, be a team member -- you are worth your weight in GOLD!!! Those of you with superior IV skills -- I worship at your feet!!
To clock out -"no break" we are required to notify the supervisor during the shift that we will be unable to break, give adequate (in her opinion) reason why and fill out appropriate forms when asked to document that the "no break" was approved. I will spend my entire break arranging to clock out "no break". Not to mention, if you do clock out "no lunch/no break" it will end up in your evaluation as evidence of poor time management- "subject to progressive discipline including suspension of dismissal". The end result 90% of the time we do take a break/lunch, but 85% of the time it is on the unit , managing our patients, and answering the phone, charting our VS...
Leave the unit for 30-60min- not once in 20 years. Don't ya love Nursing?!
When the economy is bad and lots of people (nurses) are looking for work then hospitals like to take up the experienced nurses. When the economy is good and there are not a lot of workers to choose from then hospitals have to take new grads in order to staff up.
We are in a recession now and lots of nurses who used to work part time are taking full time spots because their spouses are laid off. Also hospitals are cutting budgets and tightening the ropes.
Right now is a trying time for nurses and if you have a job keep it and wait till things get better.
If you don't have a job then you will have to keep looking and try to take any thing there is just to get in.
I am sorry you are experiencing this...I remember hitting that same wall when I was a new grad. Personally, when I was looking for positions, I disregarded the "you need a minimum of this much experience" and applied regardless. Network and find out there will always be places where the turn-over is high so the employers dont have a choice BUT to hire newgrads. Obviously, the turn-over is usually higher because of some issues with management or what not but I think in the times of recession even if you get your foot in...it helps. You can always do inter-facility transfers...hope this helps
it is a very open job market for our profession right now .. but it does not mean that you only look for jobs in the hospitals, there are LTC facilities that will hire new grads .. it just depends on the choice you want to make if you are willing to work for an LTC for the meantime, while applying for hospitals once you gain the experience ... it would be to your advantage.... i myself just graduated last april from my BSN degree and went on to pass my Nclex exam this january... am presently employed in an LTC, for competitive pay i might add... and im looking to expand my horizon to the hospital in the year but .. for now to gain a little experience and gain floor time ... which is helpful before the hospital where the staff will eat you alive if you dont have experience .. opt for the LTC....
jrwest,
Wouldn't it have been nice if nursing school prepared nurses for the REAL WORLD of nursing? I loved nursing school. I was so fascinated with the anatomy of the human body, pharmacology, nutrition, and helping others. You are correct though...nursing shortages and the other BS that goes along with it (that only other nurses would understand) can really cause you to rethink things, or ask the question that I ask myself frequently, "What did I get myself into?"
I have thought about persuing the radiologic technology program. I just have to find time to do it. I recently bought a house which has forced me to increase my work hours. Yes, I probably tell my friends and family members on a weekly basis that I hate being a nurse. Isn't that so negative? It's not at all about the patients I care for. I love to administer medications, communicate with the clients and help them in every way that I possibly can. I just thought before I graduated nursing school that I would have so much more time to spend with patients. Boy, was I wrong, lol. I am just here to say that I know what your going through.
This was so cute I had to tell my sister nurses! One of the earlier posts asked what we were doing different to get the word out about the swine flu... Well, I wanted to put up NEW REMINDER posters in the halls and bathrooms to WASH THEIR HANDS! I thought I should have a poster contest amongst the Web Design Class and then choose a winner. The posters came back were SO GOOD that I couldn't even pick a winner!
They are very eye catching and I have even heard kids out in the halls talking about them. I wish I could show you some of them. I gave everyone in the class a candy bar and soft drink for their efforts. They all came up and gave me a HUG! 
(no diabetics in that class LOL)
i think this is unsafe especially for a new grad, if this is only offer especially in this job market, take it and keep applying elsewhere when u get another offer, run don't walk
I was the lone licensed nurse in a facility with 52 residents on the night shift. My problem was with CNAs who stayed away from work to get their way and who wouldn't do much work when there. That is what happens when a group wants to insure that their friends get hired. I had some hectic nights there, but as I said, my problem was the nursing assistants, not the mix of patients.
I shudder when someone says they want to go into nursing for the financial benefits. Yes, nursing is a fairly secure profession, but nothing is a given. If the only reason you want to be a nurse is because you think you will be able to get a job in hard times, then it may not be the job for you. Nurses work long hours, nights, weekends and holidays. If you are a stay at home mom, you need to realize all the time you will give up with your family,if you go into nursing. Of course there are jobs in nursing that don't require shift, weekend or holiday work, but they usually are hard to get and they don't pay as well. I would suggest that you try working as an aide or volunteering to see if you like what you see. I believe that to be a GOOD nurse, you have to have the heart for it. I have worked with nurses that are just in it for the money and believe me, they are NOT GOOD nurses. They may have the knowledge they need, but not the heart. Sorry, I will get off my soapbox now
Don't go into nursing because you think you'll be guaranteed a job. Take a look at the many threads here about the so-called nursing "shortage" -- many of us consider it a myth. Also take a look at all the current threads by recent graduates who can't find jobs.
Note: this is just a venting thread.
I'm a new grad, started working on a DOU (step down from ICU) floor in early February. About 75% of the time, I feel good when I go home from work. I feel like I did a good job and was on top of things, felt my patients were safe and had competent nursing care. Some days though, like yesterday, make me want to quit and never come back.
One of my patients went into V-tach as I was receiving report, first thing in the morning. The previous nurse noticed his IV was going bad, but didn't take care of it. After numerous attempts by multiple people, and even trying to start an IV on his feet, it was determined he needed a PICC, but our radiology department doesn't put them in on Sunday. It took the entire day for this guy to get a central catheter placed, and he was septic and not receiving his antibiotics or the electrolytes that were prescribed to treat his V-tach. Meanwhile, he was also incontinent of bowel and bladder, and had to be changed (bedding and gown) at least 6 times during my shift. Icing on the cake was that someone kept stealing his IV pumps since they weren't being immediately used, rather than contact central supply and get their own pumps. I had to put in orders for IV pumps 4 times, knowing they would eventually be needed, and I am quite sure they now think I am insane over in central supply.
My second patient went bad around 11:00. Her O2 SATs and blood pressure dropped to the point that we had to call a rapid response team. After trying for a couple of hours to stablize her, we ended up transfering her to ICU. She should have gone sooner, but there wasn't any room, and we had to wait for someone else to die.
My third patient was a lovely little old lady with a horrific, huge hematoma and wound s/p fall while on coumadin, with mild dementia and a hairline fracture to her ankle. (Incidentally, her IV was also no good, and she was another hard-stick.) She was fine unless you left her alone for more than 5 minutes, and then she'd be trying to climb out of bed so she could go home. Fortunately, her family was with her when my 2nd patient was crashing. I hate restraints, but at 6:00, overwhelmed with all of my other responsiblities, I finally had to get a doctor's order for a posey vest because I didn't have the time to stay close by.
My 4th patient was an isolation patient (MRSA and C-diff) with a recent BKA and poorly controlled pain. He didn't speak any English, and was (I suppose understandably) hostile each time I went into the room. (His doctor knew about the pain being poorly controlled.)
Icing on the cake was that I was so overwhelmed, that I actually welled up in tears when the charge nurse came to me late in the day to ask me a question, and now I am humiliated because I am normally a pretty hearty girl.
I hope these kinds of days will diminish in number as I gain experience, and that I am not so overwhelmed when they DO occur.
I actually wrote this myself. Hope you enjoy it.
10 Reasons for hospitals to hire a NEW GRAD
10. You won't have to hear complaints about why the pharmacy "stopped stocking drug ____".
We have no idea of what the pharmacy used to stock.
9. You don't have to hear complaints about, "why don't they have more CNA's working this floor".
We have no idea of what it was like when you did...or IF you did.
8. We don't fuss about how bad the computer system or how the old charting system was better.
We've never seen it.
7. We don't try to look for equipment in the "place where they used to keep ____"
We only know the NEW place.
6. We don't get involved in the floor gossip.
We have no idea of who is sleeping with who...and who isn't supposed to be sleeping with who.
5. We are nice to all the physicians.
Because we haven't got to know them yet...and will call them with all confidence and without hesitation at 3:00 a.m.
2. We won't talk about how the Nurse Manager wasn't such a witch until she got promoted.
To us, she always was, and we just deal with it.
1. You'll never, ever hear us say, "Oh Gosh, why can't we do things like we did over at ______________, it was so much easier!"
We have no idea of what they do at the other facilities.
I hear you, and all the posters who said you have to set limits and demand the respect you deserve are exactly right.
We had a lady on the vent for 60+ days with pulmonary fibrosis, and every day you could tell what her family had looked up on WebMD the night before. Asking detailed, questions about vent setting trivia, acting angry the split second it seemed like she wasn't the center of attention at all times. Her husband yelled at one of my co-workers one afternoon about how "no one has been taking care of her". I went in the room and told him to google pressure ulcer when he got home and then ask himself how she had been laid up here for 2 months without having one....then see if he still thinks no one's been taking care of her.
He must have done it because the next day he apologized and that was the end of them acting like that. Miraculously, without us ever taking care of her, she managed to survive her admission and went back home.
They are just killing me. Why is it that so many of them feel so entitled to sit in their aging parents rooms and just boss us nurses to HELL and back, while they sit there, fully able to do much of what we're doing for their parent, but simply do NOT have the time to do when we have other patients and issues to deal with. i MEAN -- can't they get mom up at least perhaps ONCE during the day? Does it have to be a nurse doing it every single time, ten times a day??
I just came off a shift tonight where I literally waitressed all day long, making and fetching coffee and water and 100 millions cups of juice for these patients (because we're always short a tech) -- and a patient's daughter was literally screaming at nurses at change of shift to come in and do something or other for her mother. It was absolutely NOT an emergency. (She was actually screaming -- "Good thing it WASN'T an emergency!!" These people have been on our unit for over 2-3 weeks, running every nurse on the unit ragged. Their mother is far over 80 years old and is only going to head to weeks of rehab after being on our unit. They want a private nurse -- that is what they want and need. But they can't get that on a floor. I think their call light was on for perhaps five minutes, max.
I am just SO tired of family members not understanding what we do -- and our managers from the floor to the corporate headquarters not backing us up to explain it to them. We are simply to treat everyone as our "family members" and go above and beyond 1000 percent of the time. Who goes above and beyond FOR NURSES??? DOES ANYONE???
We have no private space to do our charting, we are like fish in a bowl for these family members. If they see you at the nursing station -- that's it. They are ON YOU like flies. If they don't have a reason to bug you, they will find one. So, you don't get your charting done on time and are left to stay after a shift for an hour.
I am just so tired of it. So burnt out. Is it any wonder why they can't keep nurses for long? I mean -- come on, management -- take a LOOK at what you are doing to nurses nowadays. Put some LIMITS, please, on these family members. It is OUT OF CONTROL.
Many of you are great, dedicated employees. I know you work HARD. Yours is a physical job, and I've done it myself a few times, and I was exhausted. I see how you are pulled constantly, not only to do your job, but to assist all the nurses you have assigned to you. You also do a job that many in our lazy society would turn their noses up at. You are special people -- and your work is invaluable. You should be paid more. We should ALL be paid more.
Many of us nurses are new, are not that great at time management, and so you are left to pay for it -- we call you in, pull you here and there, and it must totally drive you nuts some days.
Other observations: Some CNA's seem to be in their own world sometimes, and not interested in pt care. They can't seem to understand priorities. I will say, "can you please place this IV now as this patient needs a drip started STAT," and some will say, "sorry, I have to do all my accuchecks now." Sometimes you have to go with the flow and realize nurses and patients have priorities. I just LOVE the techs who will say, "Yes -- let me get to that for you, and be pleasant about it.'
And I also have to make one wish: that texting on the job, cell phones and other devices should not be allowed. I can't carry one and fool with it all day -- but I see our techs constantly on their phones, texting and reading messages. Drives me nuts when I'm running like crazy and could use a little help.
I have been placed on the floor as a tech, and it helped me to have a lot of compassionf for CNA's. Id just like ONE day, however, when I could drag my techs along and allow them to totally understand what I'm dealing with day to day. I would like them to stand with me as I get chewed by a manager , or a doc, or a patient for letting something slide. Yes, I earn more -- but not all THAT much more -- and I worked really, really hard to get my license.
And I don't ask you to do something because I'm trying to make your work too hard -- I'm practicing the art of delegation. I need you to do these things so I can provide better coordination of care and perhaps ALSO get out of my shift within the hour. I have filled SO many water pitchers today, covered SO many pts with blankets -- all things you could have done -- so I'm behind now, not to mention, exhausted.
For those of you who can hang with me, work with me, communicate well with me, be a team member -- you are worth your weight in GOLD!!! Those of you with superior IV skills -- I worship at your feet!!
To clock out -"no break" we are required to notify the supervisor during the shift that we will be unable to break, give adequate (in her opinion) reason why and fill out appropriate forms when asked to document that the "no break" was approved. I will spend my entire break arranging to clock out "no break". Not to mention, if you do clock out "no lunch/no break" it will end up in your evaluation as evidence of poor time management- "subject to progressive discipline including suspension of dismissal". The end result 90% of the time we do take a break/lunch, but 85% of the time it is on the unit , managing our patients, and answering the phone, charting our VS...
Leave the unit for 30-60min- not once in 20 years. Don't ya love Nursing?!
When the economy is bad and lots of people (nurses) are looking for work then hospitals like to take up the experienced nurses. When the economy is good and there are not a lot of workers to choose from then hospitals have to take new grads in order to staff up.
We are in a recession now and lots of nurses who used to work part time are taking full time spots because their spouses are laid off. Also hospitals are cutting budgets and tightening the ropes.
Right now is a trying time for nurses and if you have a job keep it and wait till things get better.
If you don't have a job then you will have to keep looking and try to take any thing there is just to get in.
I am sorry you are experiencing this...I remember hitting that same wall when I was a new grad. Personally, when I was looking for positions, I disregarded the "you need a minimum of this much experience" and applied regardless. Network and find out there will always be places where the turn-over is high so the employers dont have a choice BUT to hire newgrads. Obviously, the turn-over is usually higher because of some issues with management or what not but I think in the times of recession even if you get your foot in...it helps. You can always do inter-facility transfers...hope this helps
Good luck!
it is a very open job market for our profession right now .. but it does not mean that you only look for jobs in the hospitals, there are LTC facilities that will hire new grads .. it just depends on the choice you want to make if you are willing to work for an LTC for the meantime, while applying for hospitals once you gain the experience ... it would be to your advantage.... i myself just graduated last april from my BSN degree and went on to pass my Nclex exam this january... am presently employed in an LTC, for competitive pay i might add... and im looking to expand my horizon to the hospital in the year but .. for now to gain a little experience and gain floor time ... which is helpful before the hospital where the staff will eat you alive if you dont have experience .. opt for the LTC....