ICUnurse990

I am an nurse manager. There is not a snowball’s chance in heck that I would offer a per diem position to a new ICU nurse who just finished orientation and now wants to travel.

Hello all, I am looking for suggestions. I’m a nurse manager in critical care. I’ve been in the same unit for quite a while, and I think it’s time to move on. My question is, what’s next? I have enough experience that I’d have no problem getting hired as a bedside nurse, but I don't think that's what I really want. The three 12's per week, weekends and holidays, and planning my life around the scheduling timeline was really starting to wear on me before I accepted my current position. I think I would enjoy something related to quality/outcomes, because I'm pretty analytical and I enjoy researching and working with data. But my state is deep in the throes of (yet another) covid surge, and those types of jobs aren't really hiring because everyone’s getting redeployed anyway. So do go back to a bedside job (maybe in a different specialty) just for the short term? Do I keep looking for something else? Those who've left inpatient nursing, what are you doing now and do you enjoy it? Any insight is appreciated!

Hello all, I am an ICU nurse manager, and I’m hoping to get some ideas on how to celebrate my staff in a way that is safe and physically distanced. My hospital postponed our Nurses Week celebration for July because things were still pretty crazy in May. Normally, we have a different little celebration every week day. It’s usually food-centric, because we don’t have the budget to buy gifts for our whole department and buying food is (relatively) cheap. With COVID-19, I’m hesitant to a) bring in food for everyone to share, and b) encourage folks to congregate in the break room to eat. However, with a large staff (over 150) and a very limited budget (it’s usually enough to buy pizza one day and then the leadership team personally finds the rest), I am running low on ideas! Any suggestions?? What do your facilities do for Nurses Week, and/or did anything change this year due to the pandemic?

It doesn’t seem like the best idea. But are they any less socially distanced while hanging out than all of you are while at work? During a typical shift in my unit, there’s 18-20 nurses and 4 techs working, and there’s no way to stay six feet from other people at all times. These people (and you) are already together for 36ish hours a week anyway. At the end of the day, you have to focus on what you can control and let go of what you can’t. And admin is correct- Unless your coworkers are breaking laws, they (and you) can’t control what employees do on their own time.

Evening, yes. Night (as in overnight), no. Not as much happens at night in many settings, so the clinical experience would be limited. And not a lot of faculty and staff would be interested in teaching classes or clinical overnight.

I know what you mean. My grandpa couldn’t stand just sitting around at home. Even with severe COPD, he managed to get to church and talk with his friends, drive to Starbucks for coffee, or go to the to local park to sit at a picnic table and read a book. If he were still alive, he would be at a very high risk of dying from COVID-19, assuming the shelter-in-place order didn’t kill him first. I miss him like crazy, and yet somehow I’m glad he’s not around for this.

I wonder about this too. I’m a clinical nurse manager in an ICU. My staff will, at minimum, get overtime for any extra hours they work. No discussion of hazard pay/crisis pay yet, but my hospital system already has incentive pay that’s used if we’re really short staffed. As a manager, I fully expect be at the hospital well over 40 hours a week, probably taking patient assignments if this goes the way I think it will. But since I’m salaried, it will all be part of my “normal job duties” for which I’m paid a set amount. Not that it’s all about the money, but...

Do you ever see this manager in person? If so, the best approach might be to talk with her in person and say “Hey, I had a few questions about applying for a job after graduation- is there a time we could meet for a few minutes, or could I email you, or is there someone else who could answer my questions?” How long have you been trying to reach her? It’s possible she’s not communicating well, or she’s been out of town, or she’s not interested in hiring you, or she just doesn’t have the bandwidth to answer one more email right now. I’m not making any excuses for poor communication, but please understand that nurse managers are stretched pretty thin right now. The COVID-19 situation is changing by the hour, and as leaders, we’re involved in a lot of updates and process changes at a very fast pace. (It’s not just the bedside staff who are facing uncertainty and change right now!). And frankly, even on a normal day, it can be hard to keep up with the constant stream of texts, emails, and requests while we’re doing all the normal things in our job description. In a perfect world, I would reply to every call, text, email, note on my desk, and in person visit immediately. In reality, I’m only human, so sometimes things fall through the cracks while I’m triaging my communication. If you really want to work here after graduating, maybe try connecting with her in person, or see if there’s another person you could reach. I would advise to stop with the emails and calls at this point though.

A med error like accidentally giving 80 mg instead of 75 mg probably wouldn't have been a huge issue. There would probably be a warning of some kind, especially since it was a controlled substance, but that would probably be about the end of it. Now making that same med error and then falsifying a waste to cover up said med error... that's bad news. Hopefully you learned your lesson.

Anecdotally, I'd say that a large percentage of sick calls in my unit are actually sick kid, grad school project is due, hungover, decided to leave a day early for vacation, "mental health day"/want a day off, etc. I work night shifts in an ICU, so I'm not sure how that compares with sick calls in a clinic.

Without hearing the RN's version of events, it's hard to tell what really happened. Was the nurse being rude to the patient? Yep, sounds like it. Was she medicated inappropriately or having meds withheld for inappropriate reasons? Not necessarily. Again, I'd have to hear the nurse's version of this story before coming to any conclusions. I will agree with the previous commenter though. You violated HIPAA by reading the patient's chart. You are employed by the hospital as a CNA/sifter, and your job was to sit with the patient. That did not require accessing her H&P, MAR, etc. The fact that you are also a nursing student is irrelevant.

This probably isn't what you want to hear, but yes, that sounds like a fair schedule. At my hospital, the "holiday" for night shift is considered the shift going into the holiday, not the actual date. So the night before Thanksgiving, Christmas Eve, New Year's Eve, etc. are holidays but Thanksgiving, Christmas Day night, and New Year's night are not. In the past, we worked the holiday shift for our assigned holidays and the shift before or after the holiday shift for our holidays "off." (So if you were assigned Christmas, you worked 12/24. If you weren't assigned Christmas, you worked 12/23 and/or 12/25.). We later agreed to work the holiday shift and the shift of the actual holiday on our assigned holidays in exchange for not working either on our holidays off. (So if you were assigned to Christmas, you worked the 24th and 25th.). That's pretty much up to unit policy, but what you're describing doesn't sound unusual. Halloween and Black Friday aren't even part of the holiday schedule, so that's kind of a moot point. I know it's a bit of a rude awakening the first year you work holidays as a nurse. There's no way to sugar coat things; you will miss holidays, you will miss events, and you will miss family time. That said, you will figure out that Christmas can be celebrated on Dec. 26th, you can still get together with friends and family if you plan creatively, and nobody does a holiday potluck like a bunch of nurses.