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I am an ADN nurse and have 30 years' experience in various areas of nursing with most of my experience in maternal child. 2015 I was working on a mother/baby unit and had been for 10 years. I was ready for a change and saw a job in our internal audit department for a nurse auditor. As a nurse auditor I participated in process and charge audits. Insurance companies like to review patient bills for accuracy and our department was responsible for auditing all of the charges on a patient's bill and verifying they were billed correctly. We also help our customer service team investigating patient complaints about our bill. I enjoyed the work a lot. After about 4 years our audit team transitioned into a denials team and that is what I still do today. We review insurance denials of claims and try to get the denial overturned with a formal letter to the insurance company. To enjoy this type of work you need to be inquisitive, creative and love digging into medical records and insurance medical policies and know how to use Word and Excel. You also have to like sitting in front of a computer all day. I work all types of denials and had to learn things about surgery, oncology, cardiology, dialysis and much more. When I started working denials I was in an office setting. This changed with Covid and I have been remote since 2020. Working remote you have to be organized and be able to work alone. We use Teams messaging and my teammates and I routinely message each other questions and suggestions. We also can team call each other and share our screen to help explain things. Search for jobs with "appeals nurse, denials nurse, clinical appeals nurse". Also create a profile on UnitedHealthcare, Humana and Aetna websites and upload your resume.

I think precepting would be a great opportunity for you and your preceptee. 1) you will have help with your patient load. 2) You both can brainstorm together. 3) If you don't know how to do something your charge nurse, unit educator or manager could be resources. 4) It will give someone brand new a chance to see what it is really like to be new in the profession-good and bad. I loved precepting and got to do this for 5 years on Mother/Baby until my degree (ADN) was not good enough even though I was certified a certified maternal newborn nurse. All preceptor's had to have a BSN unless you worked at night-no BSN nurse available that worked at night.

I am currently working M-F 8-5 job and have done this for the last 11 years. I did take a $5.00 pay cut in addition to shift diff/holiday pay when I left the bedside 11 years ago. I feel like the pay cut was an even trade not to have to ruin my health working 12 hours with on call that required me to work 16 hours or work a night shift when I was working day shift. I did not miss the shift differential or holiday pay at all. I have no regrets leaving the bedside for M-f work.

I understand why the person over the fellowship program made this statement" It is not a good fit for someone approaching retirement age and looking to take it easier.". Fellowships are generally programs that provide extensive long-term training. This type of training costs employees a lot of money and they want a return in their investment. Say you did get the fellowship and two years in you decided that you did not really like case management and regretted your decision. At 67 you have the option to retire or semi-retire whereas a younger person without that option might be inclined to stay. What about Case Management interest you? There are many case management and utilization management jobs with all of the major insurance companies that would probably love your critical care experience.

My entire bedside nursing career which was over 20 years from the age of 22-mid 50's I used a small portfolio notebook kept in my pocket with everything I was required to do that shift. As I did things, I checked them off. At the end of my shift, I put the paper in the shred bin. That is the only way I could keep organized and on track. However, there will be days that the plans we make for our shift goes out the window and then you have to wing it. I find in chaotic times taking 5-10 minutes to prioritize what needs to be done and writing that down to be tremendously helpful in not forgetting something. Somedays you cannot possibly finish everything which is why we have shifts.

28 years at my facility. I accrue 10.2 hours every pay period. Max number of hours anyone can accrue is 420.

One of the best nurses I ever worked with was an LPN. She taught me, a new ADN nurse working Oncology how to function as a nurse.

Hospital in my area only hires BSN and LPN. I am an ADN nurse with over 30 years' experience and a certified Mother-Baby nurse. Thankfully I did not have to find a job when I moved because my remote non-bedside nursing job came with me!

Appalling behavior! In 30 years of nursing, I never "mocked" a patient. Have I complained about a patient? Sure, to my co-workers in our breakroom or after work as probably every nurse has done. The nurses who did this have something seriously lacking in their character to have done this.

I am a nurse of 30 years and have precepted quite a few nurses-those with experience and those fresh out of school. Every preceptee I oriented had a list of skills that were to be observed by me the preceptor. As a preceptor I never assumed someone knew how to perform a skill. I would always discuss with my preceptee the skill we were going to do using our hospital policy/procedure guide. Then we would gather any supplies we needed and go to the patient's bedside. Then we would do the skill together. After the skill was completed, I would discuss with my preceptee what I observed and give feedback. It sounds like the ED manager assumed because you have experience you would not need much "training" which is a huge error on their part. In my opinion managers should always plan for more orientation and if it is not needed then adjust accordingly.

I have been a nurse for 30 years. I left the bedside 10 years ago to work in medical review/denials management. I still liked my bedside nursing job in mother/baby but was tired of being on call and working 12-hour shifts. I worked on mother/baby for 10 years. The local BSN program rotated on our unit and we had Summer externs. At least half of the students told me and others on our unit that they only planned to work bedside nursing for a year before moving into management or going to NP school. I imagine the last two years of Covid have exacerbated this situation.

I have 30 years nursing experience. I worked with some wonderful LPN's in my career including one that showed me how to be a nurse as a new grad. I have also experienced being the only RN on a floor with LPN's. I was not only responsible for my patient's I was responsible for the LPN's patient's IV meds and assessments and being in charge. This was on a mother baby unit and we had a lot of fresh C/S that required PCA's and IV pushes. The LPN's I worked with were in ADN school and they were wonderful to work with. It was just a lot for me to be responsible for. I am sure there are some older nurses that can relate with this situation.

I am a nurse with 30 years of experience. In that 30 years I have taken care of many patients with intractable pain due to cancer, chronic pain due to pinched nerves, Sickle Cell Crisis, intractable migraine, acute post-surgical pain and many more. I learned that every patient is different when it comes to what works for pain. People with chronic pain do know what medications work best. I always asked my patient's admitted with chronic conditions what medications work best for their pain. I also learned that a patient can be asleep and still be in pain. This happened to me during childbirth. I was given Stadol during labor. This made me woozy/sleepy and did nothing for the pain. In the situation you were in I would have called the physician again after the Morphine did not work. If the physician refused to change the pain medication or come examine the patient I would have gotten the charge nurse and nursing supervisor involved.

In the week before my mother died she would at times raise both of her arms up reaching toward the ceiling and say "James (my deceased father) take me on the boat, I am ready". I had worked on oncology for a couple of years and patient's talking about "going on a trip" and "going home" were pretty common.

I had a similar experience working in a Level lll NICU. I was not a new grad and had experience working in L&D and Special Care Nursery. My preceptor was nice and everything seemed to go well on orientation. Then I was placed on night shift after orientation. Whole different type of nurses. I have never felt so alone as a nurse in my entire 30 year nursing career. I got no help from anybody and the nurses and respiratory therapists were very "cliquish" and shut me out entirely. One hellish night I was the only nurse in one of the NICU rooms (the unit was not divided into individual room and had several NICU beds in each room) and I wanted another nurse to listen to a baby's breath sounds. I found the nurses from my room and the respiratory therapists all taking a break in the doctor's chart room adjacent to the NICU. I walked in and asked for help and told them what I needed and was laughed at by the respiratory therapist. One of the nurses begrudgingly got up to help me. I had nights in that NICU where I had patients in 3 separate rooms and my assignment would change multiple times in a night. I lasted 2 months after orientation before leaving. The nurse manager had the nerve to tell me I had "wasted" their time and I would never work at that hospital again. Well, I left there and went to a hospital across town to another NICU and loved it and stayed there 4 years. You don't have to put up with a toxic environment!