karmyk, BSN 4,643 Views
Joined: Oct 19, '05;
Posts: 318 (4% Liked)
; Likes: 20
8 year(s) of experience
med surg, icu
If we were anticipating relocating from one area of California to another (i.e. NorCal to SoCal), how far in advance should I apply for jobs? I know it's hit or miss with some markets (i.e. sometimes it's hot, other times it's stale... it took a couple of months before getting callbacks for jobs when we first moved to Northern California, and I came with ICU and med-surg experience), so timing is a big factor.. but does anyone have a good, tasteful time range recommendation?
I was making 41/hr with 6 years experience, but we'd rather move north and kill our student loans (in order to live coastal) than live in East County (and the heat).. But to each their own-- I can see why people would live there, so it's all good. With 3 dogs and one child, I think it's perfectly doable, and you can live comfortably and still be coastal. We did fine with two kids and were able to afford being 5 minutes away from the beach, and we were at the beach practically everyday. The paycut is the price we paid to be able to bring the kids to nice family beaches like fletcher's cove, Cardiff state beach, etc. I'm willing to take the paycut again once the loans are more bearable. I cant stand being away from the surf this long.
Lesson learned: nursing degrees from private universities suck.
Ahhhh I stand corrected then.. I think most of the nurses I know who have wanted a position with either the VA, Balboa, Pendleton, or UCSD have primarily been concerned with retirement/pension on their minds.
Scripps La Jolla just built that huge, new cardiac center. Scripps is generally a great system. I've only worked at Encinitas and Green, and the people, including the doctors, are all really nice and awesome to work with. If you're going for scenery, I think Scripps Green wins (nothing like looking out one of the ocean view rooms in the ICU-- it overlooks the Torrey pines golf course, and on clear days, you can sea hang gliders in the sky).. Though I've never seen the new Camp Pendleton hospital's view, which is probably also ocean view. For cardiac, there's also UCSD med center (I believe they even do the heart transplants for the area.. Not sure if its the la jolla or the hillcrest location).
The big hurdle is getting into a new grad program. Scripps has a very informative webpage for interested recruits. I'm on my phone so its difficult for me to post the link, but it's easy to find on their site. It's a great all-around program. They don't hire new grads directly into ICU right now, but you can easily apply for their ICU internship program after you finish the year-long new grad program.. And their in-house ICU internship program is EXCELLENT.
It's true at just about any hospital, but positions at ucsd are pretty coveted amongst rns in the area due to the benefits (mainly pension/retirement)... So I know quite a few who have accepted per diem positions in anticipation of being able to pounce on the very rare full time openings once they open up.
It's called the sunshine tax. If it weren't for student loans and the insane cost of daycare, we'd still be in San Diego, even with the paycut. I miss living 5 minutes away from the beach (and surfing warmer water... Especially since you can trunk it in the summers).
Correct me if I'm wrong... But I always thought the rumor was that you usually needed to start out per diem to get into UCSD, and from there you find a way to slip into a full time position once one of them came up...
...at least that's what I've heard from other nurses who I worked with when we lived in San Diego...
Sac isn't bad. It's more of a family town-- lots of family-friendly stuff here. Most people who think it's boring either equate "fun" to a crazy nightlife scene or have never lived in the middle of nowhere before (being military, I've been stationed in places that have helped me appreciate what Sac has to offer).
You'll have to be patient with the job search-- it's pretty slow here right now... Though some of that is related to union contract negotiations. I've heard that a lot of nurses in the Kaiser system retired recently, and they haven't been "replaced" yet. Once Kaiser gets back to hiring again, it may move more quickly on their end.
I have a little more than 6 years experience, and with Sutter, my pay is around the ballpark Nicki is listing. For California, you probably get the most bang for your buck with Sacramento. Cost of living is EXTREMELY reasonable here when you compare it to the rest of the state (especially the coastal areas).
I didn't start out in dialysis, but several of the dialysis nurses who work with patients in the acute settings at the hospitals I have worked at started out as new grads working in the clinic/outpatient setting. They later transitioned into the acute setting. Many of them are excellent nurses who have had the opportunity to get to know different floors at different hospitals and could most likely easily be hired and trained into those settings, especially since they also have gotten to know many of the floor supervisors and managers. Many of them end up being very satisfied with their jobs as dialysis nurses as well.
I have never worked there-- I worked at Scripps Encinitas (the local hospital in competition with Tri City). I did know several nurses from Tri-City, and I know an ED doc who has worked at Palomar, Tri City, and Scripps Encinitas.
All the nurses I know who work there love it. Per their report, Tri City underwent a major change in leadership a few years ago, and it really made a difference in workplace satisfaction.
The E.D. Doc I know describes the Tri City E.R. (in comparison to Scripps') as a "well-oiled machine." He seems very satisfied with his experience there.
I believe you will run into a lot of psych and a lot of homeless at Tri City... That has always been my perspective of the hospital... But I may be wrong, as I only worked at the competition, and you know how that goes.
Hi! Have you tried going through the Kaplan review book for ESL (English as a Second Language) NCLEX test takers? I think it does a pretty good job of explaining why certain answers are correct in the practice tests. The NCLEX can be pretty tricky, but one thing I've found as I went through a lot of review questions is there is a big emphasis on safety, prioritization, ABC's, and Maslow's hierarchy of needs. If you can look at the questions with those things mind, it might help make the "most correct" answer stand out more clearly.
I actually just sat in the bookstore and read this book from beginning to end, so it didn't really cost me anything other than a coffee and time.
UCLA pay is not representative of California as a whole. Pay rate drops the further away from San Francisco that you go. Starting pay is actually lower in San Diego. I started as a new grad in San Diego at $29/hr about 5 years ago. I live/work coastal, so cost of living is quite high. My cousin works heme-onc in Oakland and is making much more than $50/hr... But the cost of living in the bay area is high as well (I went to nursing school in the Bay Area). The reason why pay is so low here is the "sunshine tax"... Weather is lovely, we're close to the beach, we have all the benefits of being on the mainland, so people are willing to give up a lot of pay and deal with a high cost of living to be here. Orange County/Los Angeles pays slightly higher, but you really have to want to be in the thick of the LA culture and lifestyle to want to be there long term.
I've seen nurses use the plunger to administer the meds... they always tell me they feel like they have more control over the medication and can stop it if they want to..
..I've always done it by gravity because it will go down fast enough anyways (as long as you don't have a humongous amount of residual backing out... but you always check that first). I figure if I want to stop it, I just pinch/clamp the tube.
Also, flush thoroughly after administering the meds!!!! It's already torturous having an NGT be forced down your nose/throat once... the last thing I'd want to do is have to extract and reinsert (a new) one because I let the meds clog it. ><
Has the head nurse discussed this with the doctor at all? IMHO if a patient is refusing to take any critical medication, it's the nurse's responsibility to inform the doctor to see if the doctor can write an order for an alternative method of giving the medication or an alternative medication/approach altogether.. I'd discuss it with the doctor if it feels like you're getting nowhere with the nursing staff.
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