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Cheechwizard BSN, RN

Neuro, med surge, Jack of all trades
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Cheechwizard is a BSN, RN and specializes in Neuro, med surge, Jack of all trades.

Cheechwizard's Latest Activity

  1. As it says: a facility out in the middle of nowhere is hiring for a staff med surge post and a travel post. In the past decade it's almost always been postings for multiple travel nurses. And I've avoided that because I want to live in the area and had never travel nursed. My excitement at being offered (not yet accepted) the staff position quickly waned when they offered me less than the state average pay for a graduate nurse. By comparison the travel nurse pay is $12 more per hour. I think I understand that the weekly rate a travel nurse is quoted includes a housing stipend and food and travel costs. I get it. Doesn't matter. What does matter to me is that the agency is actually making 2x or 3x the weekly rate listed for the nurse compared to what the facility wants to pay me. So the facility pays out, say, $120/hr for their contract, but barely offers me over $25/hr to relocate and work wide by side with the travel nurse. Do they think we won't inquire or ask questions? I mean, $120/hr, heck, they'd save lots of money just offering me $40/hr. Well, I brought this up to them and now they're reviewing the entire facilities pay rates to offer me an average. Yet, I feel my point still stands: if they're willing to pay 4x or 5x what they offer me for a contract, why not just offer me more to stay and be happy? Seems whacked. I actually applied for the travel gig anyway. We'll see who comes back with more money first. Why do they do this, other than greed? Because it's not cost effective when your new hire staff nurse learns they're being robbed and quits then you have to rehire someone in an isolated area, or go back to travel nurse agencies paying 4x to 5x more.
  2. Cheechwizard

    Why do RN's avoid LTC positions?

    This sums it up. I made the mistake of taking a LTC job and just quit tonight. I'm the only RN working the unit, the other RN is the DON. I was doing night shift 10-6. Normally I'd have 2 units, 36 residents. Tonight they tried to pile me with 55, and they wouldn't budge. So I quit. As an RN I have to worry about my license first. It's how I make money. These facilities, mind you I worked in one that is considered the best of the best in the state of Texas, are understaffed. They rely on LVNs to do the nursing care, but it's pure task work. An LVN with 30+ years experience will spend 4.5 hours dropping meds and taking vitals on an 8 hour shift. The thing is they take shortcuts everywhere that will cause state to throw a fit, give you a ring on your license or worse. It's all unsafe shortcuts. Now with covid-19 it's an additional hassle. And these facilities absolutely do not abuse by state guidelines. Rather because there are no firm mandates these places do what they want. Patient gets covid-19, they won't move the patients belongings to their isolation room. They don't clean the patients room even though the individual has a roommate. Staff goes in and out of the room and so it spreads. Staff gets covid-19 and they don't clean the facility or the break room. And so it spreads. Gloves? What are those? Rare to find even the oldest LVN wearing gloves much less handwash. Remember, this is a top home here in Texas. Patients will sometimes have cameras in their rooms so the family can watch and complaining from home. Equipment is ancient. Ancient oxygen concentrators, tube feed pumps that must be over 30 years old. They're usually broken and not maintained properly. No pyxis, rather medications are checked out by hand and paper records document taking of narcotics. It's all honor system. Part of my training, all 2 days of it, included learning to steal medications from one patient to administer to another if they were out of a particular drug. Drug rights? Nope. Just line up cups, drop pills of varying types, and hope you remember who gets what. The only patient identifier was a photo on the EHR. As a bonus the software they used was incomplete, and you'd have to look in a mar and a "nmar", literally two different mars just to make sure you're getting all their medications because their software was unable to reconcile them. Paper charting at random. As for computer charting, every patient has tasks listed in triplicate. Charting on 35 people takes a while. It's just nonstop. And then there is the guilt. As an RN I felt horrible that I wasn't able to provide the sort of care I got into nursing for. You have zero time to visit with residents. You have zero time to come back and assess them. 24 minutes per patient is what Texas says, but that would take us 13.5 hours. We're given 8 hours. It's not an environment for proper nursing. It's a shame. People complain about nursing homes and LTC facilities, but why do we not have legal standards in place? Why do people not press our government? They run off low paying medicare. I get it. But why do folks need to suffer? I would rather die at home or in a gutter than have to be admitted to any LTC care. It's so low quality, it's just awful. Waiting to die in filth. And if you're an RN you cannot work in such an environment within feeling awful. Like you're doing something unethical, because more than likely if you're not reporting where you work to the state, you are unethical.
  3. I need help, please. Last year in December I started a new job. A dream position. The only male in a decade to work this unit. The first 30 days were the absolute best, and my review was probably the best review meeting ever for any profession with my preceptor and manager laughing and thanking me for being apart of the unit. I felt welcomed and secured. Context: I've been a nurse for 3 years now, this isn't my first rodeo. I'm also male, and nearly 50. Anyway, I then switched to nights with a new preceptor. I was forewarned by my manager that the folks on the nightshift are not very kind or empathetic, and that she had been working on changing their disposition for a year. In fact when I first started the position I was given a choice of days or nights, and was told that nights would be harsh. Still I went in excited. My preceptor was keen on knowing my age, right off the bat. I refused, politely, to answer. This went on. Then work started and everything was fine. I asked if I could have more patients than I had on days and things went smoothly...until night 2. On that night a new patient and their family arrived. The son and his wife were not familiar with the small city and we're hesitant to leave the father's side as he was actively dying. Another aside, this is palliative care. They ask for some sodas to drink and so I went to fetch them with cups of ice. When I brought them in my preceptor poked her head around the corner of the room, made a gasp, and ran out. Once I was finished in the room I was greeted by the charge nurse on the way out. She opted to dress me down in front of the family. She tore into me and said that our unit rules kept us from giving soda for patients to the family members. I explained the situation. She said it didn't matter. Well, the family was besides themselves. One that the charge nurse would do that in front of a grieving family, and second that she would tell me to act without compassion. The son pulled the charge aside and went off on her. He just completely unloaded all his anger and grief on her and my preceptor as he knew that she was apart of it. After that moment everything changed, but I didn't know it until later. No one treated me poorly, I was simply ignored and left on my own. That was pretty great, to be honest. I was never once disciplined or told I did anything wrong. Fast forward to my final night of my orientation. Everything went fine. My first shift solo was 3 days away. At home, the day before, I was told to come meet with the manager before my shift. I thought it was to go over my orientation stuff and talk about me being solo. Next thing I know I'm before my manager and the CNO. My manager said I was a very good nurse and especially excellent with patients and their families, but that for the good of the unit I was being let go. I questioned further and all she could say is that I, apparently, didn't work well with my night time peers or vice versa, but she had to let me go. I reminded her that she told me the night shift was harsh and she was worked to change them, and that I had never been disciplined or told that I had done anything wrong. That's when the night 2 episode came up. The nurses involved, the charge and my preceptor, took it that because I acted in a morally sound, humane, manner that they felt I was better than them and they worked it up so much that they couldn't work with me. I realize this is one sided, and one may believe this is hyperbole. I assure you, sadly, it is not. I loved that job with all my heart. It's still unbelievable to me. To be sitting there and being told I'm a good nurse and excellent with patients, but they have to let me go. Now I need to look for new work, and I am uncertain how to explain that I didn't make it through my orientation, as my manager and CNO say. For their part they told the unemployment people they laid me off. Nice of them. What can I do? I've spent time wondering if I should even be a nurse. I feel like there are too many games. I love palliative and hospice, I love interacting with patients and families. I interact and am social with my peers. Anyway, what do I tell folks interviewing me? I didn't make it through my orientation. Why? Because my peers didn't want to work with me (because they're petty)? And what was the issue with needing to know my age? My preceptor asked me throughout my night orientation. Strange. I need help. Thank you.
  4. Cheechwizard

    Kaplan, Hurst or UWorld

    I think people like uworld because it's formatted to look identical to the nclex screens. Additionally, knowing that you're not alone in missing most of the questions males people feel good. But it shouldn't. Uworld costs quite a bit, and they do not vett the questions/answers. There are over a hundred bad questions with incorrect answer options. More with incorrect information in the question. And nearly half of the entire 1980 question bank are repeated questions with different rationales. It's fairly horror show. But, as a way to study rationales quickly and maybe (maybe) more in detail than, say, Saunders online (which is superior), it works. Dont go into uworld thinking you need to get questions correct. Be sure to mark the more interesting or esoteric questions for future review, and know that it's a common, known, problem with rationales contradicting answer options. That said, if you have your Kaplan review book, use that and Saunders online. I'd not, try uworld, but go in with eyes open. I'd you're curious I finished the test bank twice at 95%, which means I got 69%-71% of the questions correct.
  5. Cheechwizard

    Fall 2017:UT Health Science Center Houston

    TWU's program is superior to UT's, I feel, having been through UT's, and helping my close friend get into TWU's program (he's 1 semester from graduating, I've been helping him the whole time). It's paced better, which makes a huge difference, but there is less emphasis on erudition. Take that as you will. UT wants to prepare students for the NCLEX with every exam you take. TWU seems to focus on just getting concepts down. They both suffer from ego-infused/anecdotal examination questions. TWU does a lot of hand holding, which UT does not. I really would have enjoyed that. Further TWU has a remarkable track record for research, where UT lacks (despite having an entire department dedicated to that). But, that's my opinion. I hope you enjoy your time at TWU. The sad thing about TWU is the ugly as heck scrubs. Hahaha, but know that TWU students in their final semester have a golden rep in the med center. But those scrubs. Haha
  6. Cheechwizard

    Fall 2017:UT Health Science Center Houston

    Actually, UT Health Science Houston does have standards by which they allow people in their program. I had a 96.6 on my HESI, a degree in biochemistry with a 3.92 GPA, and I almost didn't get in because they only have 1 (sometimes 2) people that verify your entire transcript, course by course. They were concerned that an alternative history course I had taken did not meat the requirements. I received a rejection letter, proved that the course did meet the requirements, then received an invitation. Turns out I was #2 for my HESI. #1 was 1.4 ahead of me. I never met a single student that had a low, near-80, HESI. I met a few with mid and upper 80 HESI's. Many had perfect 4.0 science/math pre-reqs. 80% is not competitive for UT, I promise. After grades, HESI scores, are factored, they also look at demographics of the class. They won't tell you this if you visit them, but if you are fortunate enough to speak to one of the people manning a booth at one of their college sessions, you'll get a quick run down. Remember: the UT system is the last system in the state of Texas to apply race as a qualifier for entry. This isn't news, or shouldn't be, given the lawsuits of the previous years against UT, which have all failed. An interesting note: during our information session, we were told males were given a slight preference. Perhaps the good doctor spoke too openly, or hypothetically, but I want to believe that may be true. My class had 10% males, and the class after me about 14% male. Finally: Brace yourself for starting in the Summer- it's the most difficult experience ever. You'll be taking Physiology and Pharm at the same time, most students have a problem with that. The other courses are cake. Take heart, though, in knowing that your final semester will be in Summer, and all clinicals, crammed, but more relaxing, and you'll only have 1 exam to prepare for. Summer is the absolute worst. My advice: study hard, learn to excel at labs (they offer open labs sometimes- practice makes perfect, don't waste the opportunity, or to practice skills with an audience, because you will be asked to do complete skill assessments later on, in front of everyone, solo). Make friends with Dr. Yu, and Dr. Hanaman (sp), and whatever instructor seems to take an interest in you. Instructors at UT, and being friendly with them can make an enormous difference in your experience. Know that the group you start with will not be the group you end with. Your cohort will be whittled down further and further until, having passed through the most painful crucible, you stand with those who had the fortitude to get through it all. The UT experience is vastly different than the other schools in the area. It is far more difficult in many ways.
  7. Cheechwizard

    Being Gay and a Male Nursing Student

    Your post is actually playing up stereotypes about gay males in nursing, and accordingly, downplaying what heterosexual male nurses can bring to the profession. Are you saying that straight males lack certain attributes? Why should our coworkers treat straight males differently? Would you say, then, that this is preference for one orientation over another, and accordingly, is that passive discrimination in the workplace? Something systemic? Very interesting.
  8. Cheechwizard

    2nd attempt tomorrow, 5/11/2017

    Tried the Pearson Vue trick? I did my first two times, failed, third NCLEX, the other day, I got the good pop up. I remember the second NCLEX, I had 265. like 80 Alzheimer's questions (like, what's the best diet/nutrition source for such a patient, ignoring current studies). This last one, which I passed, I had 5 math questions, no charts, 1 Alzheimer's question. The thing is, you can actually detect when they switch sections on you. There's a flow to the whole thing, and they'll come back and ask something from another section to mix it up now and then, but out of 75 questions, it was very delineated. Oh, and I had 5 drag n drops. But they were very logical things, took my time, visualized the process. Think I got them all right. I hope it works out for you. Just remember- at 265 they're not sure if you're golden or not, so it means you knew something :)
  9. Cheechwizard

    Nclex fail 5 times , pleas help

    I just passed on my third attempt. I thought something was wrong with me. I have a BS in Biochemistry, a minor in mathematics, and a BSN. But the NCLEX was something else. My first attempt I didn't think I needed to study. Wrong. The second attempt I used Uworld at the insistence of my friends. Was around 51%, which amounts to roughly 47% correct questions. Ended up getting all 265 questions. The room was noisy with conversations through the walls, despite headphones and ear plugs. It was bad. Third attempt, still used Uworld, but Uworld really is a horrible way to prep I now realize, but it is good as a quick resource for review (then again, so would be Saunders online). What helped for me was picking a testing center without construction going on (yes, that actually happens, and we're given the choice of sucking it up and taking the NCLEX with active construction going on in the same room, or rescheduling), absolute quiet, and just thinking about what seems most logical. Pearson and the National Council are surprised that having a quiet testing environment, free from loud construction, shouting, etc, seems to actually benefit students (I'm absolutely not being sarcastic here- they really were surprised). So many questions I had doubts over, treatments or approaches I had not considered, but I slowed down (I tend to go very quickly), carefully thought about why each option would or would not work, and selected appropriately. Somethings become just obvious once you remove the other options. Take your time. Take your time. Take your time. If you're curious- I did about 30 Uworld questions a day, a few days a week. The 2 days before the exam I did about 50 a day then relaxed. I kept a 95% avg on Uworld, which is roughly 69% correct. After the first 1000 they became so repetitive. Uworld is rife with bad question/answer options. Things they refuse to correct, items stolen verbatim from Wikipedia, a few obscure disorders and treatments so obscure that there's no way they'd ever appear on an NCLEX, and psych options which completely contradict themselves (and Uworld won't correct, even when pointed out). So their test bank is dubious, but if you go in knowing this, and getting the most that you can out of the rationales, take your time, read the entire question, look for key phrases, you should be fine. Use other sources. The big Saunders guides are great, except for their practice questions (which are so simple as to be a waste of time). P.S. Don't forget on SATA questions- every answer can be correct, so if you believe it to be so, select them all. I had one like that. I also had another SATA with one logical option.