HomeBound

No. You are not a coward. Know who's the cowards? Admins working from home spewing the edicts that we have to reuse N95s and there are no iso gowns...because it will blow their budget and their year end bonus. I thankfully was PRN as a nurse...notice I say....WAS. When this started...I had a few pts in Dec that I literally was like...yeah...Flu. Nope. Tested neg. And we all went about our business with no PPE on AT ALL because of that negative flu swab. So when this broke...I resigned. I was threatened with all sorts of weird "emergency powers" these idiots thought was legal bc Cheetoh says it's an employer free for all now. Everything is legal when it comes to businesses staying solvent. I have another job in the hospital that is direct pt care but not like ER nursing. We magically have all the PPE we need....why? Because we are the money makers of the hospital...our department bills directly for the exams we do. Yeah, the outpatients are less...but we are doing a lot of these "r/o" pts...and THAT is what is overwhelming hospitals right now. NOT actual infections. It's the insane "r/o" activity...with no real evidence these patients have anything but normal, everyday pneumonia. But no. YOU are not the coward. We signed up for SAFE WORKING CONDITIONS. This is not some backwater third world country where we know that drinking the water can cause schistosomiasis and kidney failure or sleeping without a fine mesh wrapped around us can end in malaria. We luve in the wealthiest country with the "best economy ever!!"....and after WEEKS....and 2T of banks and hedge funds getting bailed out...WE STILL HAVE NO PROPER OR CONSISTENT PPE. I wouldnt go back to nursing now if you paid me triple time. and its nothing to do with the virus. it's EVERYTHING to do with how we are seen as entirely expendible.

Infection does not equal illness. Period. About the thieves. I see empoyees stealing every day. Even when this hysterical nonsense wasn't happening. Watching co workers lift everything from gloves to bottles of purell and betadyne to iv setups and saline. I have even seen a few pocketing tamiflu and some antivirals. Because they aren't narcotics and our system at my hospital doesn't scan meds. unbelievably, we chart that we gave the meds on the honor system. Masks and purell in the lobbies were disappeared weeks ago. I go to the store now and it's literally as if people have lost their minds. Banning congregating over 50 people? I work in an 88 bed ER. do the math. Why is it that no healthcare workers are dropping and being admitted to the ICU? We see them before we know what's wrong. hmmmmmmmmm. A little critical thinking might go a long way here... https://www.zerohedge.com/health/visualizing-history-pandemics

At the risk of sounding flippant---because I know you're being serious---the only way to make Cerner (a.k.a. the EMR from Hades) more like EPIC? Is to change jobs where the facility uses EPIC. FWIW--I know travel RNs who will choose their assignments based on EMR and not location---because if a facility uses Cerner or Meditech or McKesson? They won't go. No matter the money. And I think you're seeing why. I know RNs who are literally in tears and wanting to shoot themselves bc their facility uses Cerner and they can't relocate and all of the hospitals in their area uses it or something like it. I quit a travel job once because I was lied to about their EMR--it was McKesson and the recruiter stated clearly---EPIC. There's a reason everyone wants to tell you that they have EPIC---because it's a great EMR. There's a reason some of the hospitals I've come across in my travels may be so desperate for nurses---because they insist on using something other than EPIC. As you know---EPIC makes your life as a nurse much easier. If admin is going to dump all of this auditing garbage at our feet----and basically make us cashiers and billers for the hospital? Give us decent software so that we can "capture" all of the charges in one fell swoop. It also cleans up patient care to use EPIC. I've had experience with McK, Meditech, Sorian/EDIMS, Cerner and EPIC. When I chose my last (hopefully) place to land---"facility must have EPIC" was top of the list tied with location in the country.

OP, the contract is a bait and switch...you would be willingly signing on as an indentured servant. Their will is what counts and they clearly stated this in the offer letter. They know. Nights are almost impossible to fill on some units...therefore "floating". If you wanted to be a float nurse, you would have applied for that...not to mention you have zero experience. floating takes a great deal of experience and flexibility...not something a new grad has. the way this contract reads to me is that they know if they tell you the truth, you would never, ever accept it. not for any amount of money, yet I am sure they offered you base new grad rate, right? then you would be stuck on something you don't want, can't do or do poorly with....and you quit or are fired. both bad scenarios and lemme tell ya....any facility that would do this....will bad mouth you on the way out if you dare quit them. you DO have leverage, that is another thing nurses want you to think....this is how it is, you're a new grad, I did it so you have to do it....nonsense. nursing school brainwashes you that there is a system in place and if you don't do it their way, you won't work. bahhhhhloney. especially if you are willing and able to relocate. if not, you still have leverage. nurses are fleeing for the exits in acute care. en masse. NP. CRNA. Teaching. outpatient. dialysis. pharmaceutical. insurance. case management. OUT of nursing altogether. its bull puckey that managers and hr want you to believe. jobs are a dime a dozen....ergo....the facilities are now willingly shoving the bait and switch to the forefront of recruiting. It's also a sign of a crap facility as a whole. all you need is 18 months to 2 years of NURSING EXPERIENCE. anywhere. doing anything. to become a traveler. want great experience to do travel in pretty much any specialty except for OR? go the the ER or the cath lab. ACLS experience trumps "can handle 9 patients at a time" because they know....nobody actually HANDLES 9 patients...they muddle muddle thru. practicing acls on emergent patients gives you street cred. I can travel doing PACU, Pre op, cath, er, icu, med surg and a plethora of other specialties bc I have ER (and thats how I got into icu, btw). ypur letter is a good one....but never apologize to someone who needs more from you than you will ever need from them.

s'OK. He was arrested years later for assaulting a woman he was dating. I dated him for about 6 months. THIS was the least of my concerns ? I think the biggest takeaway from interactions with people like him---choose your circle wisely. Loyalty and honesty is going to become such a value principle, that even money loses it's supposed "worth". Take care of the people you love. Try to do good. Be generous, but don't be foolish. If people don't reciprocate, you ditch them mercilessly. Nobody needs a leech. He got what he deserved. I believe that the universe settles all scores---just not always in the way we want.

IKR. I heard a great advert once about using TP and paper towels---and I have banned PT from my house altogether because of it (and my mother is one of those old timers who simply CANNOT EVER use anything OTHER than a paper towel for EVERYTHING---so it has led to multiple confrontations)-- the advert gave the statistics of the energy it takes to make a roll of paper towels---from the diesel of the loggers' chainsaws, trucks and equipment--to transportation of the timber--to the caustic and toxic chemicals needed to reduce the wood pulp--to the billions of gallons of water that can never be reclaimed to process the pulp---to the plastic packaging that also goes right back into a landfill or swallowed by some poor creature---and then finally to your house where usually, they end up in a landfill anyway. Let's not go into the animals displaced and killed in the harvesting of timber or the pollution in the air that effects all of us. In the end...the narrator says, "USE A RAG". Geez. It's not rocket science. Just like people who insist on the whole Pampers thing. Just far too much trouble for the average person to RINSE A CLOTH DIAPER or reuse a rag by rinsing it. Yeah. I get the whole "but but but but but.....water." thing. But until the taps run dry and there is no longer any ground water for wells---I don't think we're in danger of running out of water to rinse a dirty rag. One positive thing may come out of this mess though---people may just start WASHING THEIR HANDS and keeping their immediate environments clean. I don't get the butter thing, either. Maybe they think they can consume it like the Iditarod mushers do?

I don't get it either. I had a boyfriend years ago who was in the "bullet" camp. His philosophy was that he didn't need supplies....he just needed to know who has the supplies (as evidenced by the ones coming home with the dumptruck of cases of water and toilet paper)---and he had the bullets to get those supplies when TSHTF. Nice, eh? Americans. Afraid of absolutely every thing, every one, at all times. The media makes sure of it.

You are not soulless. One thing though. We already do ration care. I think you need to step back from this hysteria about 20 whole people in the us supposedly passing from corona (no evidence to support that corona was the primary, single cause of death, either)....And take a look at how many people do and have died from just flu a and b....And how many of those we sent home with a dose of Tamiflu or admit and bed them in multi patient rooms. We already dispo people from ICU, extubate and push to step down...When they are not completely stable. How many rapids I have gone to in step down and med surg bc some patient was turfed for the bed. How many codes I have gone to for the same reason. We are rationing care already. Let's not even go into medicare and medicaid, the uninsured and under insured, the ones that are unfortunate enough to be on those old model HMO plans.... Corona is not going to overwhelm the healthcare system. We are doing that to ourselves every day already. This reminds me of one of the most succinct lines in any movie I've seen---one that reels people back into reality from all of the alarmist and wild speculation and fear---it's from "Contagion". An army officer is speaking to the CDC guy played by Lawrence Fishburn and he is anxious and fearful and has a very "Militarized" way of thinking (because this is what he is trained to do---see threats in everything, always, everywhere)- Officer: "Is it possible to weaponize bird flu?" Laurence Fishburne: "No one needs to try, because the birds are already doing that." We're living in an age where everyone wants everything to be done, no matter what. Teevee has told the average american that drastic and extreme measures can and will be taken on everyone. This simply is not true--not in theory and certainly not in practice. However...We have the lawyers and the average american being so willing to sue---the doctors do pretty much everything that a patient or family demands, to avoid these outcomes. Therefore, we are rationing---because those patients that should have been dispo'ed and should have been booted out because they simply know what buzzwords to say to be admitted---take up beds from those who should be there. Patients who come to the er "With a plan" every week so that they can get to the front of the 80 deep waiting room and a 3 day stay. Patients that come to the er for prescription refills because they sold the last one to buy meth or used it all up early so they come with "Vague" symptoms and force us to do 12-24 hour long workups with expensive tests like cts and mris. Patients who are dumped by family because they "Just want a break" and make up all sorts of vague complaints to keep aunt mildred from coming home for a long weekend. These patients hold us up from providing care to people who actually need it. This would not be a worry---rationing care to the critically ill---if the sword of damocles wasn't held over our heads every single day in the form of lawsuits.

exactly. this OPs comment was demeaning and degrading, not to mention openly hostile. OP did one of the pretty mean girls in your unit micturate in your cornflakes this morning? I was on dance squad. does this count? I guess I should recuse myself from running your loved ones' code or responding as my side job as a medic because I just isn't intelligible enuf to do dat job because I danced and had skool speeerit. geez. some of the finest nurses I know not only were cheerleaders AND nerds (they can be both you do know that, right?)....but someone with a bit of energy and thought about unit morale goes a long way in easing a very harsh job. being invisible and just coming in to do the minimum isn't really gonna cut it if everybody does it, now would it.

Davey, I believe you are cherry picking thru my comment to something that seems provocative to you. you missed the point. your behavior, especially after you clarigird the entire scenario...was as unprofessional and incendiary as Clark's was. You are not his superior. You do not "get confrontational " in a public forum unless you want to be judged right along with Clark. You do these thing in private. You throw out "lines from CPI and thr code of conduct book"....and in a very childish way just keep thing going. If I, as a manager, had watched this interaction, in public, I would have deemed it a disruption (whether you like it or not, you do not get to act however you see fit) by BOTH OF YOU and you both would meet me in HR. I get your frustration. But you do not tell another team member to "leave" unless they are a threat. Even then, you call security. Clark is an orifice. If the situation is "yearlong", why have you not beought him into the manager's office or to HR? you seem to have documented acts of harassment, profanity and disrespect....so.....HR time? Manager's office? Get it on record? It's not your fight if this guy is really as disruptive as you say. It's up to management because you are not the authority there. The first time he offended you should have been the warning shot. the second time is the final warning. the third should have landed both of you in management's proximity to deal effectively with the situation. to allow something as horrible as you are saying is happening to you....to continue....for a year? as a manager i would question the veracity. not that uou are lying. but if it takes a year of open disruption in a unit for anyone to say something....then i am questioning if its more case of simply not liking this guy's style. i don't like several of my colleagues, but that has nothing to so with their skill as a nurse, their ability to meet the conditions of their employment. in fact, i see a homogeneous unit...where everybody is somehow connected...school, family, friends...as a problem. dealing with difficult personalities is part of being an adult. you dont get to exclude people because you personally cannot deal with them or dont like them. maybe they feel exactly the same way about you. this is the basis for the management of difficult personalities classes we take. if he is harassing you....you have enough experience and are of an age that you know to document document document...and then rid the unitnof a harasser. if the episodes are mainly that he talks when you want him to be quiet....that is not harassment. what is harassment, however, is telling someone to leave an area when no authority exists to do so. if he has no business in report huddle you can report him to the charge or management with the additional information that he is disrupting flow as well as in a conference he has no business being in. i am not not trying to make you out to be thr bad guy here. you are, however, experienced anough to know better than to act as disruptive with the verbal crap that went on in that incident.

In my experience, and I was also married to an Asian guy...it's a Philipino cultural thing. I was referred to as well as all female patients as "Mama" at one particular facility that employed almost all Philipino nurses. I was offended by it at first because I felt that it was too familiar towards ME, but I got used to it. However. My patients loathed it. The other thing my patients loathed is being treated by a nurse who speaks a foreign language, is spoken to in English, and if another nurse who speaks the foreign language is in proximity....the nurses speak only the foreign language. Talk about disrespect. I have called that behavior out on more occasions than ANY "offensive" profanity. I am not offended by profanity and I only ask that it not be used in feont pf patients. The reason being is that if you want to use it...you have to be ready to be judged for it. This is a free country the last time I checked...and if someone is being an orifice and I have gently used "euphemisms" that clearly go over their head (ergo no change will be appreciated)....I will call an orifice.....an orifice. Therr are times when someone needs being pulled up short in the most blunt way imaginable...because they refuse or simply cannot...understand gentler language. I don't, however, use my patients' first names. I don't call them hon or sweetie or kiddo. I don't make them my friend because not only am I not their friend, it can cause significant problems down the line if they think you are. Davey I respect your beef with this guy...but when he said move closer to nurse reporter....you shot off a remark that if you had said that to me in a mixed forum instead of BEING A PROFESSIONAL and pulling me aside? especially when you are not my superior? I would have had you in HR for that comment alone. yes. clark escalated. but your initial zippy comment was uncalled for and provocative. you disparaged him first and in front of colleagues. that was the first unprofessional punch thrown. I think you both need some counseling on keeping your personal feelings out of the workplace.

Stop monetizing every aspect of nursing, thereby incentivizing the hyper-competitiveness. Stop bonuses for Nurse Managers and Directors that incentivize stripping nursing staffing to the bone. (this is NOT about safe staffing. this is about an almost criminal enterprise to maximize profit over people) Knock off the "divide and conquer" techniques--you know the ones---pitting nurse against nurse by allowing favoritisim, nepotism and cronyism. Fairness documented with actions and consequences for all. "The law applies to thee, and not me." Cut the cord between the schools and the hospitals---cut off the pipeline. Instructors that inculcate the nursing students to the politics of "the only way to be a 'good nurse' is to spend thousands you don't have on an education you don't need". Bring in unbiased public scrutiny to the "residency" programs and the hiring processes ---as in, a public member board that oversees the fairness of hiring qualified nurses. Nursing has become one big club---and if you aren't in it, or you pi$$ someone off for any reason, you can literally lose everything you have. End the Boards of Nursing as "public protectionists"---make them independent of the state legislatures---where there would be an equal number of public, professional and legal members to oversee the profession in each state---answering to a centralized, standardized body that is fair, free of political money, and as unbiased as possible. Knock off the constant, unrelenting push to do nothing but learn how to pass the NCLEX on the first try with nursing schools. Cutting good people who would most likely make excellent nurses---because they aren't predicted to pass the NCLEX on the first try. NURSING SCHOOL IS NOT ABOUT NURSING. Which begets the problem that NEW GRAD NURSES ARE BURNING OUT AND FEELING WORTHLESS when they become nurses----because they were never taught to BE nurses in school! Get this garbage OUT of the schools. I stringently object to the question and the caveat---I want to improve nursing but don't ask me to do the obvious---treat the nurses with respect and pay them a fair wage. What the blahblahblah ever. How about deal with THOSE basic human rights FIRST and we can talk about "how to improve nursing". The fact that nurses are treated like cattle is the problem that begets all of the other problems like rampant bullying, favoritism, soaking the students of every penny out of fear. Which goes back to monetizing the entire field of nursing. You must have the CEN. and then the AACN. and then be a member of the ANA. and then do another certification. and another. and buy another book to be a better nurse to pass another test. Knock that garbage off---and deal with the basic things you want to ignore---SAFE STAFFING and ADEQUATE PAY---and you'll improve nursing.

As far as I know---in my 20 odd some years---unless and until you receive report on someone---you are not responsible. Would you characterize your fear as "if someone sees me" (whether or not you're clocked in)---and then I decide I don't want the assignment and then I protest by going home---as some type of legal violation of your nurse practice act? Because it's not. Until you are willingly accepting the patient as your responsibility--you aren't responsible. If this were the case---every nurse in the hospital is now responsible for every patient in the hospital. Just because your body is in the department---doesn't mean you are there to take care of anybody. Will it be bad for you administratively and with your co-workers? Probably. Just as the orifice sucking nurse who gets all of the plum assignments because they're pals with the CN is resented and eventually causes a lot of strife in the unit---you would be seen as the diva (wrongfully, but have you not learned that people don't really care whether something is true--it only matters if this person wants to believe it's true?) that gets her way by throwing a tantrum and walking out (thereby screwing over her teammates)---you do understand that admin will throw you under the bus when it comes to blaming you for the chaos that ensues when you refuse your assigned duties? I've had NMs do the assignment 5 minutes before walking out the door (with their coat on)---and running for the exit---so that things like this don't touch them. Resentment? Yeah. And most NMs' thought process is----so what you gonna do about it? Quit? I'll badmouth you. Transfer? I'll prevent that. Refuse? I'll make sure everyone knows you are Diva Nurse Who Believes She's Special. It's a no win situation. NMs usually choose to force the person to do a distasteful job that has no choice but to accept it. Can't quit. Can't transfer. Can't speak up. It's not abandonment. And if someone accuses you of this? I would start rethinking where I'm working.

read "the sociopath next door". it is estimated that 1 in 4 americans are wither malignant narcissists or outright sociopaths. we are training them from an early age. also read sam vanknin web blog and watch his youtube videos. he IS a sociopath and freely admits it. he gets off on the centrality of being able to give people a glimpse of what sociopaths are doing. hevalso gives very direct and invaluable advice on how to effectively deal with the sociopath in your life. IF you are willing to take it. the end advice is usually...... DISENGAGE. if you cant do that completely....go grey rock. only contact as a professional requirement and never as a personal one. i was married to a full on sociopath. glib, cunning, calculating your worth to him, dangerous. he is a physician. he once put e.coli around the rim of a coffeecup of a roommate in medical school....because she complained about his bringing very perverted Media magazines to the breakfast table in mixed company. he would do these shocking things for effect. do them, stand back and watch the chaos and suffering. i could go on...but we all know about physicians and high functioning sociopaths. bankers. lawyers. ceos. doctors. priests. nurse managers. nurses. people who climb thru the ranks BECAUSE they are sociopathic. the ones that will do whatever it takes. use whomever to reach their goal. they usually have no friends. meaning....when you meet them, they have no high school buddies, or girlfriends to invite to the babyshower. the ones who claim they are "just not close with their family" or always have to be in the room when you are near anyone they know. the ones that talk smack about this one and that one...but seem very friendly with that same horrible person....because they are saying ABOUT YOU to the horrible person...what they are saying TO YOU about said horrible person. we all know at least one. if you say you dont have anyone like that in your life? look at your own behavior (sociopaths and narcissists rarely think that maybe the problem is THEM). i wont get married or even date because of my horrific experience with my ex. i heard these stories and this important FACT never really sunk in... what they do to others....they WILL do to you when you arent of use. you are not special. i wish we had a mechanism to weed these people out and put them on an island somewhere...but banking and other corporate entities select for sociopaths. its documented. just keep your business out of the workplace and be professional to the point that you suspect everyone around you will behave this way eventually and you are fine. besides. work is not a way to meet new friends. its your job.

You're being disingenuous. The statistics are including drug overdoses and suicides in the US. This has zippo to do with cleanliness or health on a a physical level. Another thing? I know you understand the absolute openness and transparency of statistical reporting of governments---especially Communist countries obsessed with appearances. /sarc The fact of the matter is---because I was married to a Philipino and spent many vacations in the Phillipines---the open air markets are absolute waste holes. Why not just wipe your rear end with your hand and not wash your hands before dinner? Same thing as Gregg is describing. How about some staph with your boiled bat? I know all of those rural (and you don't know rural until you've been outside the cities of some of these countries. I do. try visiting some of them before spouting "statistics" that you google.) communities that having meat on the menu means butchering the family dog. Gregg is making an excellent point because he had the up front and in person experience. I'd think that working in a hospital would have given people the clue that washing your hands and keeping your workspace clear of feces and urine decreases sickness and the development of deadly pathogens.

Reframe how you're thinking that hospitals are somehow different from any other transaction in life... Do you search the sale ads in the Sunday paper for the best prices on food? Do you drive a few miles out of the way (thereby wasting gas) for .02 cheaper gasoline? Do you negotiate your salary when you change jobs? It's the reverse when it's an employer. They are looking always to cut costs. Somehow. Those new nurses---you may think that they are getting this awesome pay increase, but you don't know anything for sure. Did they stick that new nurse with higher benefits costs? How about little to no tuition reimbursement or loan forgiveness? What about that nurse being targeted as "never getting off of nights....EVER" (even though they were promised in the interview that it might take a few months...but historically...nights only lasts a short time)? You don't know. The costs are not going to rise for any employer hiring new staff. They want to keep the costs the same or lower. Anybody who thinks otherwise is looking at one single variable---the payrate. There is also something else to consider here--you do realize that there is such nepotism and cronyism in nursing that it's almost impossible to get a decent bargain if you're not one of the players? If you're just some schmuck looking to do a job and go home? Don't depend on your education to get you the best deal. What about the fact that corporate entities collude on pay rates? Happens all the time---and yeah....go ahead and quote all of the federal law you like that that this is illegal---but when you have 3 kids in school and your husband or wife cannot change jobs easily---these employers know this. They also know when you want a big name on your resume. You will take the job. At the rate they quote you. Or else. I've watched nurses think a lot of themselves and flip the hair and snap the finger "Oh no you won't!" Thinking with their BSN and a year of experience, they'll just be so able to "go down the street" for higher pay. Then fall flat on their faces---because HR does something else that is illegal---they network and have lists of names that they share amongst themselves. Don't even get started on VMS hospitals. You get flagged with them? I don't care if you're Mother Frakking Theresa. You are not getting hired in that or any other VMS system. OP---your job sounds horrible. I would leave and even if it meant a pay CUT---I would get the hell out of that situation. Sunk Cost Fallacy is strong with nurses. I don't know why. I was just tagged in a "working style" survey in my MHA program---that I am "extreme". Meaning---that I will do whatever it takes to achieve my goal. If that means moving to a new area? I will. If that means taking a job that might pay a little less, but will get me the experience I need to achieve my goal? I will do it. If this means that I take a night shift job so that I can get that ICU experience? I'm there. But I don't stay in the s#itty situation. I get what I need---and I GET OUT. Once you achieve your goal of getting whatever it was you wanted----YOU LEAVE. Inertia is NOT your friend. This whole martyrdom thing that nurses have going is what shoots them in the foot. Your life is short. You do what is best for YOU and your FAMILY. These people would replace you in a microsecond if you fudge up or you quit. Don't think you're that essential at ANY job. Employers are there to make money---not do what's best for you.

What DT said. I'm going thru a class right now about "mindfulness" and some other types of "energy dynamics"---and honestly? If I hear one more time about how "being more passive" and "not being direct and confrontational" is the best way to deal with horrible situations.... Most people are conflict avoidant--you don't know the reason they are the way they are---until you come into direct conflict with them. What I'm trying to say is that your manager, your corporate people, whomever---don't want waves. In any way, shape, or form. This isn't just nursing. This is the world we live in now---hyper correct and critical of anything out of the "established norm". Corporate functions for one reason. Profits. Period. As soon as you internalize this, you will understand the "why" and the "how could they" of what they have done to you and about you. Did you make them look bad in any way? Are you costing them money--as in--you want special accommodations for something (going out of their way for you means that they may have to do that for others and then.....OMG!!! we might have to spend money on making the workplace a decent place to be--and we won't even discuss what those things...I mean patients....need or want) Your manager may have seen what you did or did not do as making them look bad as well. I don't know your demeanor when you reported what you did--I am still very unclear as to what actually happened. If your report or your discussion takes on what this "edited post" did? I would not be surprised if your presentation alone pi$$ed them off. Not trying to be harsh---but more than one very literate and intelligent person here cannot distinguish from your "editing" ---the situation. Be clear and concise. If you don't want to name names...don't. But be clear in what you are trying to communicate. If you have anxiety issues---my advice is to seek help for them. Panic attacks are not something that nurses can have as a rule while caring for vulnerable people (patients). It is what it is---and unless you are willing to go to a physician and start treatment in some way for anxiety---the ADA does NOT cover you. That company has NO obligation to "accommodate" your requests. As for the "accusers". What accusers? What did they accuse you of doing or not doing? Did you blow the whistle on the accusers or did you blow the whistle on a situation of abuse you witnessed? Answer these questions clearly and concisely and you may have a chance at getting some good advice here.

Take ACLS, PALS, ENCP. Get certified before you graduate. Sign up for a community college course for EMT. You will do a few clinical hours on a truck and you will learn all of the basics for trauma pre hospital. Network. Show your face in the ERs. Get to know the charges and the managers. Show them that you are motivated (because you got your ACLS, PALS and ENCP and your EMT license). Networking is the big thing. A CNA in our 90+ bed Level 1 ER--she knew all of the ins and outs and the EMR. She did this for her 2 years of nursing school. However. She was not well liked--she was a spaz, she was bitc#y at times and thought she knew everything. She was a CNAII, where they are permitted to cath and draw blood in addition to EKGs and other helper duties---but she came across as abrasive and a know it all. When she came to her practicum---her nursing school instructors asked her about her choices and of course she said "ER"--they made inquiries (because this is how they match students to what would be the best fit for both)---and the ER said....absolutely not. They never told her that it was the ER that blocked her---and she ended up doing her senior capstone in the PACU at a totally different hospital. All I heard from her while she worked in the ER was bitc#ing about how the instructors "hated her" and were "out to get her". Nobody set her straight, because it's pointless with someone like her. She tried to get into the ER after she graduated---but she was successfully blocked. She, to this day--still works in the PACU at another hospital, and continues to call and try to get into the ER. Your attitude counts---not just your grades or your credentials. Credentials help---and an understanding of what goes on in the ER helps too.

No---you aren't being told what the actual costs are to work at any hospital in California. 1. Union dues are automatically taken out. $120/mo 2. Taxes of 13% for state and federal doesn't take into account all of the other expenses you have---so you are in a high tax bracket from the get go--so your after tax income is approximately 45-52% of what you gross. 3. Housing costs are double and sometimes triple that of other states, along with property taxes if you own. 4. Parking fees. They automatically take parking out whether you use it or not. Some places have >$150/mo for parking. 5. Commute times double and triple gas expenditures. If you want to live close in to your work--high rent and high crime if it's inner city--like UC Davis or anything downtown SF. Commute times can be anywhere from 1 hour to 3 hours one way. Time is money, remember. NoCal is not the cashcow you think it is. There are also other considerations---such as the wildfires, lack of water resources, immigration problems (free healthcare when immigrants do not have insurance), every single item is taxed at the grocery store and else where (adding yet more to your output burden), water costs are more than some people's car payments.... I could go on. There is no equal balance for "nice weather" and "I can golf and wear shorts all year long". I like eating and I like having a nice savings account. I do not want to spend all of my hard earned money getting out of the city so that I can have a little R&R. DEFEATS THE PURPOSE. The retirement system in California is $1TRILLION dollars in a hole. YOU, tax and pension contributor donkey---are paying for the present retirees. When it comes to be your turn? You ain't seeing that money again. Period. Some employers there have caught on and "auto deduct" a certain percentage of your pay to "help you" save for retirement. Read: We will take the money for our pensioners, whether you like it or not. You cannot opt out. The "ratio laws" are a joke. The Charge RNs already know how to game that--they fudge the ESI. You get 4 criticals that are supposedly now 4 lower acuity patients. You work harder, risk your license more and are abused continuously---for basically a few dollars more than you might make in a decently run non-union hospital elsewhere. The wildfires have made breathing next to impossible. The heavy metal poisoning in the entire mid valley from rice growing (such a water intensive endeavor...it's amazing that nobody notices that regular people have no water...yet the rice growers get all the water they want)---goes airborne when the fires torch the valley every year. Displacement of those people---where do you think that they go? They all just leave? No. Yet another reason rents are so high--people displaced from fires, tax hikes and job losses all flood into "more affordable" areas---driving wages down and rents up. California is a hel#hole---you couldn't pay me 5 times the amount I made there for a year---to go back.

What I found absolutely hilarious is "Everglades" and the whole "Well, mommy and daddy paid for my education, and I've never had a need in my life---so I get to dispense advice to people about whom I know nothing and cannot even relate" And Everglades' assertion that "MD2U" is some sort of Godlike employer? https://homehealthcarenews.com/2016/07/agency-faces-21-million-penalty-for-extreme-medicare-fraud/ You mean this "MD2U"? Yeah. I mean....all that high standards and s#it--only the best NPs for you guys, eh? Bunch of frauds. Anybody telling me they didn't know fraud was going on---yet they're part of the "hiring team" and in the business side? Yeah. Can't wait to work with a bunch of NPs with all those high standards. OP=== If you want an online FNP or Psych NP program that is "easier" to get in and doesn't have their collective heads up their own orifices thinking they're just "all that" because their tuition is ridiculous, their name is recognizable and their curriculum is just so very esoteric--- Midwestern State University. Even out of state tuition for online NP is base in state tuition cost plus $50. So it's about $150 per credit hour. Accredited. Eastern Kentucky University. Again---total tuition is about $30K. Easy to get in and not a bunch of egotistical jerks who will just take your money and spew all of this "quality education" crap---only to have you graduate making barely more than a floor nurse with craptons of debt. NOBODY CARES what school you graduated from---only that you are competent at your job. It's for these orificeholes that think a lot of themselves who love to throw around "brand names" as if that means something. Worked at Duke. Bunch of egotistical and barely competent jerks. I wouldn't go there to die and I wouldn't trust someone who trained there. I know what it's like on the inside of that place---so I don't want to hear about how I don't know what I'm saying. I think those of you who believe that a big pricetag and a brand name makes you better---you need to get over yourselves. The best MD I ever knew failed general medicine at a cheap state university medical school. The best RN I ever knew got C's all through nursing school and had to take A & P 3 times to pass. Get. Over. Yourselves.

So, they should be offended at every single medical show I've ever seen--where when the SHTF--the very first word out of the MDs mouth is..... NURSE!!!!!!!!!!!!!!! Yep. Binge watch "House" or any other decent medical drama and yeah, it's always the doctor at the bedside, consoling said patient---and when the inevitable crump comes---they yell for the NURSE. Why? I mean...if we're such dunderheads and do nothing but sling meds and take their orders, why are they calling for one of US? Do it yo damn self, if you're so good at it. I have other things to do. The show "ER" always portrayed the "smart" and "skilled" nurses as the ones that "should go to medical school". Why?? Seriously. Why would I ever, EVER, want to do that? So I can prescribe? So I can intubate (most can't do this anyway)? I can prescribe as an NP. I can intubate as a paramedic. The smart ones are nurses. We actually have a chance at a decent work-life balance. Doctors don't. At least, not for the 16 years they're battling through med school, residency, fellowship and then baby years as an attending. Nope. I think that's the dunderhead. For the most part, the ones I have known are passive aggressive and only marginally competent. I used to love rounds in the ICU when 3rd year residents needed to have me explain how to read an EKG. Or when I had to calmly and carefully lead one of my senior residents through a CF of a central line insertion (the fellow didn't know how to do it properly either, and he was "teaching" the resident. when the pt went into VF, I calmly told the resident to pull the guidewire. Neither of them did one thing right when the pt went into arrhythmia. They just stood there. Dumb as a bag of hammers.) Or the 3rd year ER resident who ordered 10 mg of morphine for an opiate naive elderly gentleman with back pain---when I stopped him---he swore that this is what he wants!!! I strode over to the attending, without a word, showed him the order. Said resident was no longer in the program the following day. They don't remember these things, and will deny them if you remind them. There are good doctors and there are bad ones. Just like there are good nurses and there are bad ones. This is the same as it is in any profession. Television tends to glamorise doctors because it's good for business--for the portfolios of the 1% to have people "trust the doctors" and go to them for every tiny teensy ache and pain. Which is precisely why we're in the mess we're in right now.

I think what is bother OP the most here is the verbiage and perceived indifference of the ER RN giving report. "her brain is fried from drugs" is never appropriate. And I think that's pretty much where the "inappropriate" care stops, in my opinion. First. Are you a stroke center? Do you have neurology on call or in house at all times? Big stroke centers have different resources. Sad, but truth. You will receive different and possibly "better" care at a stroke center. Second. So the CT showed an "acute subacute" bleed. Did you check any priors? Did she have a history? If the stroke was an old one with new changes, and it was read as hemorrhagic--what is it that you would have liked them to do? The protocol even in stroke centers doesn't include q15 min mini HSSs. Third. ERs don't have 1:1 RNs except for critical ICU holds. If the decision was made that this patient wasn't a candidate for tPA and this stroke was not acute--and the MRI didn't need to be done immediately (there has to be a reason that this decision was made. you need more information than what you're giving us, if this is all you have)---then there are underlying reasons that there wasn't an army converging on her in response. I don't believe for a microsecond that this woman was treated "differently" because she was positive for meth. If you believe that, and you have evidence of it, then you most certainly should talk to the Medical Director and see what they say about your evidence. I get that you don't like the ER RNs indifference and flippant response. That has nothing to do with the quality of the care this patient received. The only thing an MRI would have shown differently was maybe an AVM. But again, if you did not check this woman's priors, you have zero idea what her brain looked like before her current admission. Ischemic strokes---yes---different pathway. Immediate care if in the window, still a wait and see if not in the window. My guess---this woman has previous brain injury that made it hard to impossible to detect whether this was anything new---and if it was new, it was hemorrhagic---and it's wait and see. The ER was most likely holding this patient until an appropriate bed became available---and since there is no reason in the case I think happened---to sit and watch her 1:1, she was monitored by tele and rounds, as appropriate.

Happens everywhere, all the time. The bottom line is, people are ******** for the most part. I do not believe, as some here do--that people for the most part are kind. They're not. Watch the news. Read comment sections in any forum, newspaper, blog, or anything online. Drive in traffic, break down and see what happens. Live in a community where there are more than 2 houses, including yours. Leave $10 on a table in the cafeteria. I could go on. People are neither kind nor honest when it comes down to self interest. If it's in that person's self interest---you are going to lose. Period. Everyone has their own reasons for why they do what they do, their rationalisations for being an *******, and they believe they are right. Why do nurses act like this when they are supposed to be the "nurturing" profession? Because they're people. You cannot control how anyone else around you behaves, you only control how you react to their behavior. My personal advice is to avoid ********--but if necessary, you fight fire with fire. I'm known for being a relentless ******* to those who will just not leave well enough alone. I also defend those that are victims of the "gang mentality". I was driving last night, coming out of my townhouse community. The husband of the manager zoomed up behind me (the speed limit is 30mph and they are always calling the police on people who break this rule) going so fast I really though he wasn't going to be able to stop before hitting me. I stopped at the stop sign. The rule. I turned left. He didn't stop and just followed me out onto the road. Speed limit is 35mph. I set my cruise control because in my little town the popo love to give tickets. This guy sat on my rear bumper with his bright lights on---beeping the horn for a mile. No passing zone. I stayed the course. Another stop sign. Same. He followed me for 4 miles on my ***, bright lights on, beeping the horn. He knew precisely who I was---and he knew that I live in the same little townhome community where his wife is manager and I see them every day. I am also a nurse at the local ER, which they know, and it might behoove them to be a little....oh....kinder to someone who might save their life one day? Nope. Guess where he was off to in such a hurry? The liquor store. We all have stories like this. This is people. They are not relegated to nursing only. This man behaves this way to the guy who does the landscaping. He drives around incessantly---doing little else all day long---spying on residents, having his wife write nastygrams to residents about bird feeders being "too close to the ground" or someone has left their garbage bins in front of the garage instead of inside. Nurses don't have a corner on that market. Yeah, they do eat their young in instances that there is no real reason for being "as big of an *******" as they are in some circumstances---such as embarrassing colleagues in front of patients. But again, this happens in every job. Getting rid of them is really the only solution. Working to find ways to make their lives as miserable as possible so that they move on. So yes and no. yes, nurses can be bullies. no, nursing isn't unique.

No, I'm not surprised at all that the trend is towards being more humanistic and family oriented. Medicine as a global force scared the bejeezus out of pretty much everyone in the past 40 years--that you have to go to the hospital for everything so that you can get a pill for it or some type of "help". We've been turned into a nation of helpless and fearful victims that can't seem to do anything for ourselves. Deliberately so. A helpless population is a weak population. Fear mongering is a great control mechanism for large populations. Fear of sickness. Fear of getting old. Fear of dying. You must be young and vibrant and beautiful, or else bad things happen. I am happy to see the trend reversing. "The wise man lives as long as he ought, not as long as he can." Marcus Aurelius (Meditations - Book II, 167 A.C.E.) People may do well to begin practicing a little of the Stoicism that brought our ancestors through famine, disease and war. You can't control anything but the way that you react to things.

We are not permitted to assist in diagnosing patients. Diagnosing is not in our scope of practice. This is your husband and that is even more inappropriate. He needs to see and speak to his physicians and if you want a second opinion you need to seek one from a qualified medical practitioner. Sorry to be so blunt but even if we had an opinion, it is out of our scope of practice to offer advice.