Nurses eat their young - now I understand why.

SHGR, MSN, RN, CNS · Mar 25, 2012

Core measures are a JHACO standard for treatment of certain diseases, shown to improve patient outcomes. If you don't know what they are you best get to learning them. They are required to remain JHACO certified, which is required for top tier Medicare reimbursement. Which means other insurance will follow suit soon in requiring them. They add more every year. The newest one that came down the pipe just this week is a requirement to give the pneumonia vaccine to all diabetics. Makes the head spin.
Mentioning a planned vacation comes when an offer has been made and compensation is being negotiated. Not in the first interview. At least not if you want the job offer.

They may know this concept but not by the name "core measures." I know the recommendations and keep up on the new stuff, but I would have asked for clarification on what the interviewer meant by that term.

oldenurselady · Mar 25, 2012

I am guilty of not reading all of the posts in this thread. I am having a difficult time now with some of my new manager's (who seems ok) new hires. I literally think they were asked if they were the biggest, most-high maintanance diva in the class and hired if they said yes. We have several "young" nurses hired within thr past year. Most are nice, but... The most recent hires include a very arrogant 45-ish, person from a med-surg floor who has 15 months experience, a know it all traveller who cannot let anyone finish a sentence, and a brand new late 20's RN grad who tells people she isn't doing this or that and arrives late all of the time (because she has kids, isn't that unsual?. It must just be her who has kids, right?). The last gal was hired for nights, but "there is no way" she is doing it. She figures after they orient her for 16 weeks, they won't waste their $ and so they will give her what she wants! These people chart incorrectly, leave things they do not tell others about, and despite their stellar self-assessments, have made some pretty significant errors. I know people can lie in an interview, but these three are pretty obnoxious. I do not see how she could miss their personalities (they do not hold back) AND she had traveller on contract for 12 weeks. My biggest pet peeve is that the two newer nurses constantly ask "what do you do about xyz?" I tell them what I do. "No, I don't think so. i think you do this." Ok, well why did you ask? If you give a rationale for your actions or even show them a policy, it doesn't matter. They do want. One left meds at the beside and I told her the next day, that she should not do it. She got a foul attitude. I explained i did not write her up, but wanted to help her. Then she told me she did not do it, her preceptor did it. Sorry, the patient gave your name specifically and described you when I said..Who left them for you? We usually don't do that. "It was ___, that new girl with the glasses and ---colored hair. I will be in trouble for not writing her up, but that will be the last time she gets a pass from me. I wanted to tell her what an arrogant fool she was, but it is not worth the bother. She needs a time machine to take her back to age 3 to fix her problems. No one should be bullied when they are new. However, when you come on the scene acting like a bully, you endear yourself to no one. I am seriously waiting for a long lost rich relative to die. I have been a nurse for more than 25 years and this is it. There is more to it than these newbies, but it is a lot of stress.

dudette10, MSN, RN · Mar 25, 2012

OP, you have seven pages of people saying the same thing: reconsider the vet tech. If what you posted was the only thing "wrong" with her, you could probably do a LOT worse.

martymoose, BSN, RN · Mar 25, 2012

just an observation, but it just isnt in nursing- general society is this way now too. after the day i had with the psycho patients on the floor- ive come to the conclusion that the world indeed is going to helena handbasket.

MJB2010 · Mar 26, 2012

I am wondering OP, if you are qualified to interview applicants? You seem to be lacking the basic skills of hiring and getting to the meat of the applicant. I think the one that mentioned the vacation was being honest and upfront, of course she could ahve blindsided you with that info upon getting an offer but she was honest about it. That is comendable. ANd the vet tech would probably have a lot of useful skills that could help her pick things up a little quicker than someone without that type of experience.

OP how much nursing experience do you have? Think back to how you were as a new grad and how much or little you knew. Think back to the first interview you had and how scary it was. You seem to have forgotten. I am willing to bet you are not perfect either.

obprof · Mar 26, 2012

Ok ok.. I have to intervene here. Having been a Vet tech and starting MANY IV's on dogs and cats.. I must say.. it's WAY harder to start one in a dog/cat than in a human. The techniques are very similar. But you have a squirming animals trying to bite you oftentimes... Perhaps it was her attitude that made her seem "ignorant".. but in my experience.. much easier in humans. I understand the attitude in new RN Grad's is often times one of "know it all-ness".. once they start doing the actual job.. they're going to realize just how much they DON'T KNOW.. perhaps that will humble them. We can only hope. p.s. I still don't think anyone should "eat" their young, or old.

I disagree...starting an IV in NICU is REALLY HARD too! :)

Merlyn · Mar 26, 2012

I started working for a sub-acute LTC as the DSD last week. The DON and I hit it off because we have the same vision on what we need to do in order to solve the problems we current have.
Early this week, we posted an ad for RN charge nurse with no experience required. We feel it's best to have trainable nurses even though they lack experience. I was tasked to interview for the position as I will be the one training them for the first 36-hours.
Needless to say, I was flabbergasted with the array of applicants we had and now know why the some nurses eat their young.
- New
RN
grad said she's been working as a CNA and knows she can do the job because there's not much difference between being a charge nurse and CNA
- New
RN
grad said that she'll consider our offer, so I asked if she is being offered another position (as we need someone full time). She said she's expecting an offer any day now since she finished the online application earlier this week (and she was not kidding).
- Someone coming into the interview with a wrinkled nose and irked expression and said that she can smell the BM from the floor
- Someone who wrote "expert in IV medication preparation"; when asked what's their experience on it, she stated she's been a vet nurse and she's been doing those a lot.
- Someone who said they are not available for the first two weeks of April as they are going on a cruise
- Someone asking for the pay, end up telling me that new grad RNs in LA are paid $34/hr starting at the beginning of the interview.
- When asked about core measures, all of them couldn't deliver one intelligent answer.

and a lot more...
Looking back, I asked myself if I ever acted as arrogant and privileged as the ones I encountered. Most of the ones the new grads I interviewed have this air... like they have mastered a craft. Like I should be rolling out the red carpet for them.

Welcome to the wonderful world of Nursing School. These grads were told that they are kings and Queens. the world will open up to them, that nurses are so needed that all they have to do is to wave their licenses and hundreds of jobs our theirs. NOW they graduate and are pushed into the real world. Reality slaps them right in the face. You see it on this board all of the time. There are no jobs. But the attitude. I worked with LPN's who went on for RN. When I see them now don't even say hello.

MJB2010 · Mar 26, 2012

I am also curious as to why, if you found the resume so comical and outlandish, did you invite her in for an interview? I am guessing you limited your applicant pool by stating no experience necessary and "charge nurse" in the add. A lot of people with no experience would realize right away that it is a red flag to want a charge nurse with no nursing experience.

Double-Helix, BSN, RN · Mar 26, 2012

I disagree...starting an IV in NICU is REALLY HARD too! :)

Yeah- kind of like starting an IV on a chihuahua. :-)

allnurses Guide · Mar 26, 2012

Reading through this and other recent "you won't believe what the person I interviewed said/did/wore" threads lately I wonder if people are not told about the 'people skills' portion of having a successful interview? That only advise selling yourself and turning every experience you've ever had in your life into a marketable skill as a new grad but not how to effectively bring that into the conversation or describe it on your resume?

When someone discussed what to wear so many people brought up excuse after excuse why the interviewee should be able to wear whatever they want. The candidate who told the interviewer that she should lose weight probably was trying to showcase her skills in patient education - but in an utterly clueless manner.

I guess I don't see it as a philosophical argument about anything other than having that person connect with you and believe you are the proverbial "good fit" they are looking for?

OP, I'm quite sure that in Orange County you should be able to have a boatload of qualified people apply for your job. It's a mistake to narrow your search to new grads. Experienced does not mean inflexible.

MJB2010 · Mar 26, 2012

I am guessing they are looking for new grads because they are not willing to pay experienced rates.

PetsToPeople · Mar 26, 2012

Let me give you an idea of what she put on her resume, and what she is trying to tell you she is capbable of...

A good vet tech (emphasis on good and vet tech as in one with a degree) can make an awesome nurse. Compared to my fellow students, those with or without nursing experiance, I have a strong advantage. On the furry pt side, I would come in prior to my shift, check supplies and re-stock when needed and prep the sx suite and prepare my anesthesia machine (same types of inhalant anesthetics as human side), trach tubes and calculate my induction meds, I pre-med my pts as I go, get them induced, intubated and on the table shaved and scrubed, hooked up to ekg, spo2, co2, temp and bp monitors (we use the same type of monitoring equipment as the human side) while I am calling in the vet. Then I monitor, assist if needed, I can go and find any instrument they need by name, or because I am so good lol, I have the instrument ready that I see they are going to need in five, four, three, two here you go doc as they raise their hand to ask for it. I fully understand sterile field which for some reason many of my fellow students still struggle with. In an emergency, my vet doesn't even have to ask, I have another person in there to monitor while I do a quick scrub and sterile gown/glove and I'm in the blood and guts helping my vet with little instruction because I am aware of the anatomy, the disease/trauma/injury process, I am asking for what the vet needs such as suction, extra sponges, more hemostats, etc. If my vet is tired I can also do the closing sutures, not the internal (peritoneal) sutures as that is not in our scope of practice. Sx include neuters, spays, splenectomies, c-sections, tumor removals exploratories, intussusception repair and so on.

I personally also have experiance with detailed necropsy, histopathology, laprascopic procedures, thoracic and endoscopic procedures as well as one-lung intubation, digital x-rays and I have also done lectures on how to interpret ECG readings.

Dental procedures are also included, same procedure above w/premeds, intubate, induction and monitoring, then I have to scale and polish their teeth, do any minor extractions, show the vet any problems I found and what I think they need to extract.

While this is going on, I am also helping, directing and/or managing pt's that are in our ICU unit and the boarders. Fluffy the boarder started having v/d last night, probably related to stress and/or change in diet, get a fecal so I can read it, and NPO til I check with doc. VS on all the ICU pt's, IV's patent, re-do any that are not, calculate and dose oral, SQ or IM injections and IV meds, make sure IV pumps are set correctly (we use the same IV pumps and IV fluids as the human side), do tube feeds/force feeds, changing beds, cleaning up poo/pee, out to walk if they can. Report any pertinent info to the docs, of which I usually have multiple ones, all who like things done a certain way that can be opposite of their fellow vet, but I make sure each vets pt is done the way they want it done. I know which vet's prefer which meds, like doc so and so always wants metacam for post-op pain but doc pain in my behind will only do torb in vitamin mix.

And as sx has ended by around lunchtime, my ICU pt's are cared for and I am scarfing down a little lunch while I review the afternoon appts...vax, vax, hit by car and didn't have time to bring pet in til now, bleeding from rectum, v/d, vax, new puppy or kitty (for anyone who is a vet tech these are adorable but time consuming), sx pt discharges and so on. I can juggle all six exam room, do my exam, part of my pt education (go to break it up or they get overwhelmed and are less likely to follow what I tell them), collect my blood samples, fecal samples, urine samples, ear swabs, and remove sutures etc before the vet even gets in the room, this way they can see more pt's and what little time they spend with them is quality time.

At the same time I am reading urine samples, running blood through the machine, reading fecal samples, staining and reading ear cytologies, taking and developing x-rays, barium series, etc. Some of my pt's are sweet and adorable and I just want to eat them up, others are straight up waiting for their opportunity to take my face off, but they all get the same tx because it's not their fault I have to stick a thermometer up their butt, so I totally sympathize Then I am getting medications counted and labeled, putting together info packets for new puppy/kitties, putting the charges in, putting in my SOAP notes, doing my closure pt education about med side effects, follow up appt, potty training, incision care, post anesthesia care, etc. I am also helping to manage issues with staff, inventory, equipment problems, client complaints, helping with overly aggressive pets, people calling on the phone with questions that the front desk can't answer, if the phone rings too long I have to answer it and set an appt. Same issues go on in the office with staff, such as bullying, gossip, arguing, lack of team work, slackers and so on.

Appts will last til closing time and almost always go over, plus clean up time (we don't have janitors) which everyone chips in vet tech and assistant, almost never get out on time but that's the job and we LOVE EVERY DARN MINUTE I am sure I am forgetting some stuff, but this is a glance into the life of a vet tech in a small animal vet practice, then you have your research vet techs, ICU vet techs, emergency vet techs and so on.

So when that Vet Tech listed those things on her resume, as you can see from what I have just posted, she knows what she is talking about, and you'd be darn lucky to have her! Especially since your getting a whole lot of experience in the form of a "new" nurse, so you can take advantage of her by paying her a new grad salary.