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  1. HomeBound

    kaplan exit exam bank?

    You mean that qbank that costs $99 to order from Kaplan? If you want "free" go to quizlet or some other "study cards" website and download the content people put up for public use. Asking in an online forum for access that you didn't pay for, to proprietary information...isn't really a good start to your nursing career. Unless you're planning on selling the qbank to others, which is another bad idea. Just sayin'.
  2. HomeBound

    Help with ACLS

    Yeah, I agree with Meriwhen. Once upon a time, full grown men would be sweating bullets and on the verge of vomiting during ACLS scenarios. It's crept (thankfully) in that you are rarely alone during a code. They want you to know the material, yes...but they also are acknowledging that the team isn't just standing there like automatons waiting for you to give the correct command. Practice is the only way to keep it fresh--reviewing the acls website, reading your manual and having someone quiz you if you have someone to help. If you're really stuck, go to your nurse manager or someone on your crew---have them do a mock code or two with you--it even shows that you are trying and really serious about learning how to run codes effectively. I had a supervisor on nights when things were slow...."HEY! Let's do a MOCK CODE!" or "Let's pull out the Level 1 and go over MTP!" ...far better than sitting on fakebook or shopping for chainsaws online. It's also team building. So...maybe suggest this in your unit if it's possible?
  3. HomeBound

    Any way you could stay over and work a few hours

    Passing meds is a different skillset--yes---however---are you seriously going to tell me that somehow doing CRRT is the equivalent of passing the 0700 docusate and life saving tylenol to bed 2? Yeah, no. meant what I said. A Nurse Manager hasn't lost all of her wits that she can't read a MAR and apply the 5 rights. I would stay over my daggone self if my patient needed CRRT and the only person between that procedure getting done and my patient dying is an RN Mgr who has a. never done CRRT or b. hasn't done it in 18 years. Passing meds is not "easy", by any standards, but there is zero equivalency here between difficult and technical procedures and giving tylenol.
  4. HomeBound

    Tennessee Nurse RaDonda Vaught - Legal Perspectives of Fatal Medication Error

    Um.....its hyperbole, not an actual event. Please. With the over the top emotion. I think you may want to save your outrage for something really scary, such as drunk drivers, high drivers or road rage. Geezus.
  5. HomeBound

    Tennessee Nurse RaDonda Vaught - Legal Perspectives of Fatal Medication Error

    "If you find yourself of the opinion that “yes”, RaDonda should be criminally prosecuted, keep in mind that this could be you!" This could apply to driving my car, then. I shouldn't prosecute the guy who is distracted texting and kills my kid. Because it might be me next time, i text and drive sometimes too. Not. A. Legitimate. Argument.
  6. HomeBound

    $750 CA RN License??? No way!

    Thank you. Just a few on this thread with some actual experience living and working in CA, as you and I have had. Gotta love armchair "experts" with QVC cred to chime in about how they know because....sitting in front of google. I can say....maybe....75% of the nurses I worked with in Sac were foreign born---but had been here for more than 20 years, working as nurses. At UCD, foreign born, at least in the ED, were a rarity. I worked PRN in northern CA at several other places, and the smaller the hospital, the larger percentage of foreign nurses. I never heard or saw any shenanigans as far as licensing--but I do know that several of my Philipino colleagues would definitely work management on an applicant that they had in mind--and it was usually a family member or friend that had emigrated. There is absolutely no illegality or "unfairness" about it-it happened all the time where I've worked with US trained nurses. My RN Mgr had his daughter hired in as unit secretary on another floor. His wife worked in registration. It is what it is. Call it nepotism or protectionism---the VA practices a form of this as well as other places "we only hire from within" until no internal applicants are found, and then the job is posted outside. Explain this, expert poster. We only hire from within. Meaning....all you people out there? You're not welcome to apply for this job, because we only offer these jobs to our own. But noooo. This is "discrimination". I think someone may need to take that expert knowledge and file a class action suit against California, The US Government, any employer that has internal postings, most countries with immigration laws---and just sue the pants off them all....because she googled it. And she knows. Back in 1995, there was a huge influx of Irish and Philipino nurses who were willing to take the night shifts that supposedly could not be filled with US trained nurses...that was in Philly though. I have no idea what the rest of the country was experiencing. I was grateful to be employed, frankly, as the situation back then was what the situation now is approaching. Tight, tight market---and yes... The very definition of "filter" and "selective"---is protectionism. An employer, state, country---makes it's own rules about who to allow in, based on criteria that they are legally allowed to use. Think immigration. This country only allows those who follow the process, and even then, they may not get in. Australia would not allow (when I wanted to travel there as a nurse) anyone that wasn't on the "critical need" listing that they put out (yet another thing dr. google can educate even the most expert here on)---to come and work. They protect their own workers. Canada does the same thing. Their rules and regulations are such that you have to have a BSN, and you have to pass their exams, even though you've passed them here. There are fees that are absolutely exhorbitant to be a nurse there. If a fee filters out workers, then there is more of a chance that nurses that are already there, or nurses that will simply bite the bullet and pay (a revenue generator)---are going to apply. I can tell ya....when I paid for CA, the license was $100. I'm sorry for those nurses who are going to get whacked with $350. That sucks. Renewal for me is going to be the same as renewal for you, but...the initial is steep. It may have given me pause if I had to pay $350. I may have thought...meh....I don't really need to travel to CA. The license process is tedious and very fraught with mistakes you can make that prevent you from being licensed. If your verification "expires" before all of the other paperwork comes to them? It gets kicked out. And they don't tell you. You find out 4 months later when you sit on hold for 4 hours (if it doesn't go to vm) and find out you did it wrong. California can be a beastly license to get---and I have renewed mine every time---because of that. Here's a simplistic example---but my dad was a Teamster, working in steel mills in the late 70's. Protectionism is what a business does in order to keep jobs local---with local people working there. We do what we have to do in order to keep our jobs for our people, tax revenue stays here, because there are families and roots being set down. As far as the totally ignorant of the actual facts poster that doesn't seem to understand how to interpret statements correctly-- California requires a transcript to be sent---because they have a standard to which all nurses must be trained (yet another way to filter applicants out and protect those that are trained in CA)---why doesn't the ignorant person who claimed this isn't true---apply for a license in CA and see for itself? I did---and I submitted my application---it took 12 weeks, on the dot to the day that the Board said they were processing my submit date. I had to give them an original school transcript (not one that is sent by you, even if its official. it must come from your nursing school or the clearinghouse that handles your school transcripts) Two other travelers in my group were denied because of the "MicroBiology with separate Lab" requirement. The CABON was amazingly nice when I went there in person--two people in line--I paid my $100 for a copy of my CA verification to be sent to another state for processing. Some states require a verification---and most people have licensure that the NCSBN handles--CA is not on the quick verify list. You have to go and pay CA $100 (it may be more now, because....oh....you know.....revenue needs) to send the same verification that the NCSBN handles for most other states. So by this thinking---you're saying that employers that require a BSN for you to be hired---are all discriminating against ADNs? Employers, landlords, countries, states---all have the right to put into place rules that they feel are necessary in order to achieve whatever goal they have in mind. If it's a staff of all BSNs? Then that is what they are allowed to do. If you want on the staff there? Then you pay the price of admission---get your BSN.
  7. HomeBound

    $750 CA RN License??? No way!

    And yes. I agree Jed, it's protectionism. Each state is now implementing more and more stringent requirements for nurses that are trained and licensed outside of their state. They want to train and keep the nurses that they have. California has an educational requirement as well---denying US trained nurses based on a microbiology w/lab and other minor courses a license there. Is this "discrimination" Jory? How about the fact that other countries also have very, very, very stringent requirements for foreign (read: US included) nurses--and will only permit work VISAs with sponsorship, yearlong residency of the country without a job, retaking their equivalent of the NCLEX?
  8. HomeBound

    $750 CA RN License??? No way!

    CALPERS is 1 trillion dollars in a hole for pensioners. SF just instituted a new tax....another one....on top of the city tax if you work there and the highest income taxes in the country. This has nothing to do with "discriminating against foreign nurses". They raised the licensure by endorsement for US TRAINED NURSES as well. https://www.rn.ca.gov/pdfs/regulations/isor1417-2.pdf So are you saying they're discriminating against us too? No. It's and easy revenue generator. The fires in California have wreaked havoc, the rents and property taxes are at the upper limit for the poor schmucks living there and stuck-- do your homework on California before you say something as inflammatory and ignorant of the facts as this. Race and nationality baiting is not cool. When I worked in CA as a traveler....the nurses who were licensed there are the ones who are willing to pay the licensing fee. That included Philipino, Chinese, Indian---all nationalities and ethnicities were included.
  9. HomeBound

    Already feel like giving up

    Yes, way too soon to give up. There simply may be more experienced nurses applying for the job. Unfortunately, in this business, internal applicants don't always get the job just because. If I, coming in with 20 years of ICU, apply to the job you, New Grad with no experience, wants? They'll most likely choose me. I agree you need to work on anxiety issues. Practice with your family members or other nurses/friends. Get a list of questions for "interpersonal questions". You don't have a lot of stories, like when they ask you about a time when you had a conflict with a coworker or an irate family member of a patient....so you need to find stories from when you were a student, and customize them for the question being asked. I do believe that the common lag between school and first job is 3-6 months. I know residencies take months to navigate just thru the application and interview process. You are an employee, correct---but you have to consider who you are up against for that position from the outside (or even co workers). This may be as simple as, we have an applicant that doesn't need to be trained. Try to stand out with your answers. Recall all of the crazy stories you had from your clinical days and tailor them to these standardized "so tell me about a time...." questions. You'll get there. If you don't get something in your own facility within a reasonable amount of time, perhaps going to another facility---explaining to HR at your facility that you would "love to stay" but you cannot continue to wait--and maybe that will spark someone to consider training you in a unit.
  10. HomeBound

    Hospitals paying for your stay?

    LOL...yeah....I didn't work FTE for anyone in the UC system, I was travel. I heard it all from the employees---and it wasn't in the SF area, but they had the SF "union contract". It was astonishing to me that every time I walked into any area where more than two RNs were talking---they were talking about money and how to game the UC system in order to get more in their paycheck. SF has a tax for just working there... So. Federal Income tax, marginal, is 25%--that is the bottom. If you make more, expect your tax rate to go up up up very quickly. CA state, local, and city sales tax rate for SF is 8.25% https://smartasset.com/taxes/california-tax-calculator CA state income tax is the highest in the country. Marginal is 8%. SF has a city income tax as well of I believe 5%? The gas taxes are the highest, I paid $4.00/gal when the rest of the country was paying mid 2's. Rents are some of the highest in the nation, all over CA, not just in SF. In Sacramento, a 1BR apartment in a verrrrrrrrrrry sketchy (and it's literally one block is okay, next block a shooting gallery, next block is okay....) area is around $1700/mo. The union dues for the CNA are $120/mo. Parking is an automatic $48/pay whether you park there or not. It's to help them pay for their overhead. "just in case" you ever park there. There is zero parking available if you don't have it attached to your rental. None. Zip. Unless you want to live in one of the inland cities, you are not going to own a car or be able to get around effectively. SF has almost gridlock traffic. Read up on Oakland crime and that's a stone's throw from where most of the hospitals are located. Getting to "the beach" from outside the coastal areas? Hours. Hours and hours and hours and hours of sitting in bumper to bumper traffic to get there---and if you want to spend the weekend? Expect to pay $500-600 per night for a hotel room miles from the beach. The fires in the summer are legendary--and this past summer is just an example of how bad they are getting. PG&E is going under, filing bankruptcy. Two of the other utility companies are in trouble. Because of the fires. Infrastructure is being destroyed very quickly and the money isn't there to rebuild it. The rates will be going sky high, and rolling blackouts like last summer will be the norm--from the fires. It's 105 degrees during the summer routinely anywhere but the coastal areas. I couldn't go outside if I wanted to in that heat...my pets suffered horribly and I couldn't even ride my bike without feeling like my brain was boiling. People didn't go outside unless it was midnight. Even then, it was in the mid 80s. If you live in an apartment, chances are that water is not included in your rent. I saw multi million dollar homes in the Monterey/Carmel area built and standing vacant, because they are on a list for water rights. The owners cannot live in them because there is no water allowed to go to the home---there is a limit to the amount of water each municipality is allowed---and once that is reached, homes cannot be occupied. CALPERS is almost 1 trillion dollars in a hole. They cannot and will not ever have any type of ability to pay for those pensioners and they know this. I was there when the word was coming down that the nurses that are starting now and a few years ago---will never see that money as a pension. I was offered and I refused--I made more as a traveler in the UC system--and that is actually the exception to the rule in California. Most of the time, the staffers do come out ahead of travelers. It's a weird thing. Anywhere else, we make double what a staffer makes. Not so in CA. Except at the UC system....you make more as a traveler---several female nurses that I knew---they were broke, hooking up with guys just so that they could move in and have a break on rent--moving in with parents and friends, living on couches---and their base pay was $64/hr. I saw the paychecks of those staffers--because I wanted to know what I'd be getting into for that "high rate of pay"---and effectively, their income was cut by 51% with taxes, union dues, parking fees and other miscellaneous fees UC managed to tack on. So the hourly rate was cut to $32/hr. Now live in one of the highest COL areas in the country. I can live on $32/hr in Ohio. I cannot live on that in CA. That was my point. I applaud you for being able to command a much higher rate of pay as a NICU NP. You worked hard for it and that is really a great thing for you. However. You admit that you live in a very tiny space and "maybe can retire someday". I want a house. And a yard. I don't like paying thousands of dollars for someone else's mortgage in order to live cheek to jowl with some crazies that call the police for your dog peeing on their petunias. I also don't like drug addicts sitting in the doorways of the street where I walk, and nobody does a thing. I also don't like when my door gets kicked in, in a "nice" expensive (for me) neighborhood---and the police tell me that they won't investigate because "you weren't raped or murdered". I am all okay with not paying with my life, my health and my savings account in order to just see sunshine. The idea that I am "trapped indoors" because it snows? I am from a state with feet of snow---l learned how to snowboard and ski. There is no reason to be trapped just because it snows. Too hot, on the other hand....California is on fire most summers...and the Valley had the worst air quality in the WORLD, even above Shanghai, China. People were wearing masks when going outside. Trapped inside? Yep. Just my take. This is a primer for those who would just take a job because of money. If you want quality of life, you need to assess all of the factors.
  11. HomeBound

    Hospitals paying for your stay?

    Keyword being "should". I've known a lot of nurses and other healthcare providers that are shocked...shocked I say...that they cannot make it in Fresno at $75/hr. Never thought about....oh....that CA state income tax is the highest in the country practically. Another shocking thing to some is that an employer will unilaterally take parking or union or retirement--whether you want it or not. The UC system does that--you can't even fight it--they have to have that pyramid scheme for Calpers going strong, so they need new blood coming in to pay for the retirees. The bottom line is--if the offer sounds too good to be true, especially for a NEW GRAD? I probably is--check deeply and thoroughly. Don't be afraid of boundaries and breaking points. If you know you will be living paycheck to paycheck, one broken down car away from losing your rental? Don't do it. Getting something on your resume is laudible--if you have a year that you can spend on something truly fabulous that will just be the golden ticket for the rest of your life---go live like a frat boy eating ramen noodles until you get that year in--but a career? You cannot go to these places with high taxes, high rents, and "reasonable" payscales. There are always hidden costs--you just have to screw your head on straight and find out what you're willing to put up with to get what you want.
  12. HomeBound

    Hospitals paying for your stay?

    Greenville is also a very expensive town to live in, remember that if you think it's such a cool thing. It's a college town with a huge teaching hospital. Try and look at the rentals there and see why they'd offer anything like this---and then remember---the starting pay at Vidant is around $23-24/hr. Parking at Vidant is....how shall I say it nicely---well, I can't say it nicely. They will spend an entire day on threatening you about parking. Boots on cars, tickets, etc. There is also the "bait and switch" there--they offer high salary for "Tiered PRN" schedules---and say you will get a $40/hr Tier for committing to a certain schedule, and then yank it out from under you at the last minute--saying there are "no more positions of that category left"---and tell you that they can offer you $29/hr for PRN. Then there's the predictive testing--PBDS--that has you going through vignettes of patient scenarios...you have to write down everything you see, what your diagnosis is of that patient, what labs you would anticipate being ordered, what diagnostics, etc....and it's timed. There are 8-9 of them. Plus some version of the BKAT and an arrhythmia exam. They assure you that this is all just to "see where you are" and how they can help. Not so. A friend went all the way thru the weeklong orientation, and was told that her offer was rescinded because of her poor performance on the predictive test. This was, by the way, for a Med Surg position. These are questions that you need to ask ANY prospective employer, New Grads---what are the requirements? What is the schedule? What about rotating? How about floating? Do you get a solid, permanent preceptor (not 5 different ones, depending on who shows up that day)? Is there a structured teaching program for you as a new grad orientee? What about parking? If my shift is an off hour one, will the bus be there to take me to my car? What are rents like in the area? How about state income taxes? Reasonable hourly rates can turn very quickly into minimum wage jobs if you aren't paying attention. It's always so cute and romantic to live in downtown NYC or SF---but when the reality hits---you are either being recruited to a HIGH COL area for a seemingly "high rate of pay" or a toxic hospital where locals or internal candidates can't be found because they've caught on.
  13. HomeBound

    Hospitals paying for your stay?

    Same here. I interviewed at a place in NC--flight was paid, nice nice hotel, and a car. NC and the Southern tier states seem to be famous for this "but you don't like snow. you should pay us in order to work here!" and it doesn't pass by me that they are all red red red states, longing for the labor laws of the 1900s and as rabidly anti-union, anti-worker's rights as you can possibly get. It would have been the job from hell. I could not have sat down and penned a more horrible schedule or pay package if I had tried. 4-10s or 3 12s, solid week of call every three weeks, you work your 10 or 12 hour shift, go immediately on call (it was cath lab so ....you're staying)--do all cases after your own shift, and then....surprise!! you get to come back in the next day. you don't get a day to rest. In other words, in one week, you may likely have been working 36-40 hours straight with no rest. All for the bargain price of $24/hr. "Because this is the way it's always been done here. The nurses here do it, so why can't you?" Uh....this is why they had to recruit 3000 miles away--nobody in that area, and there is a huuuuuuuuuuuge number of new grads who would have jumped at that job---will take it. They were so desperate, there was an RT, and ARRT and an RN on staff. Not even all nurses. It was, literally....the job from hell. I wasn't a new grad, but the thing that you need to remember is---if a hospital is willing to fly you out, bypassing a skype interview---and pay the airfare/hotel and maybe relo? It's a toxic place to work. Nobody in the immediate area will touch it. They have to recruit from far away....and they want to lavish gifts on you to butter you up---I was offered at the end of the "shadow" shift. They wanted an answer right then and there. It's a guilt trip after all of the expenses they lay out and they know it. I negotiated relo in my most recent job--$5000---but it had a rider that if I left before 2 years is up, they get a pro-rated amount back from me and can hold my last paycheck in order to assure they do.
  14. My question is---if RV didn't do anything actionable, why did Vandy fire her? Why did the new hospital suspend her? Seems to me that Miss Well Liked is a liar too---she didn't reveal why she was fired from Vandy to her new employer. Perhaps she knew she wouldn't be hired? Qui bono. Who benefits most? Who had the most to lose by publicizing this girl's actions? Think Vandy doesn't have board members, committee members and shareholders that had a serious stake in keeping a lid on this---covering it up and smoothing it over? Think that the BONs are just an island unto themselves that they can't be as inept or corrupt as any other regulator? Stroll on over to "recovery" and ask them about their experiences with the BONs and how torched their lives are over a momentary "brain fog" on their own time, in their own home/car--talk about a stupid mistake---and yet their licenses are suspended for five years or are revoked altogether--drug tests, ETOH tests--all on the nurses' dime...this is the BON. I worked in the South. It's the Good 'Ol Boys' Club with a wink and a nudge for the rich corporate types (like Vandy). You can't swing a dead cat without running into the "six degrees of separation" phenomenon. My first warning when I moved there? "Be careful what you say. You never know who is someone's cousin, and they're all related somehow." Healthcare is big business. BONs are part of the state legislatures. You think politics had nothing to do with this?
  15. HomeBound

    When Nurses Make Fatal Mistakes

    and here she hits the nail squarely on the head. "The difference is---one nurse recklessly (and in Vandy case, WILLFULLY) does not follow procedure---and the other makes a mistake despite doing so (follow policy/procedure) I'm not quite sure why people here can defend someone who...oh....forges signatures, charts something done when it wasn't (and it ends up in harm to the pt), purposefully bypasses safety checks in a pyxis, purposefully bypasses reading a label (while reading other parts of the label?!), purposefully defies policy on procedures... Well...all I can say is that since some here have zero problem with me forging signatures---and that I can just get off with a slap on the wrist---can I borrow your blank checkbook? Because in reality---that's a felony.
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