dhbrn

Thanks everyone!

Hi Allnurses, I am curious as to how you count the magical year (or other specified unit of time) of experience. Do you count it to the day i.e. January 25, 2019 to January 25, 2020; or is January 2019-January 2020 specific enough? Basically do you feel it’s required to be a full calendar year to state you have a year of experience? Thank you in advance!

Get out of there STAT. Sounds like you’d be safer working as a unicycle performer on a freeway during the middle of a rush hour lightning storm. Any future employer who would view you negatively for removing yourself from an environment where you’ve been repeatedly assaulted isn’t any employer you’d wanna work for. Love and luck to you, I’m so sorry you have been put in this position.

Hospice can be such a special job if it ends up being the right fit for you. Any kind of nursing that involves home visits like working for the state/county in public health, case management through insurance companies, etc. Good luck!

Humans. Just in general.

Home health/hospice nurse... even if you don’t get to spend a ton of time being outside on a nice day with your patients because of all the charting you have to get done, you’re on the move for a good part of the day. Granted, you’re in the car but you could always roll the windows down.

I’m seeing a theme of establishing boundaries, being direct and straightforward. This is something I’ve really struggled with in the past, always worried about not being “nice” enough. As I have been implementing stronger boundaries, I’m seeing pts who are needy but not necessarily toxic react in a more productive manner when they have someone directing the interaction. The toxic pts by and large realize they can’t manipulate you, and move on to more susceptible victims. Not buying in to unrelated complaints has turned out to be the “nicest” thing I can do for the sake of being able to have energy to dedicate equal effort to all my pts. It also allows me to be kinder to myself and makes it easier to let go of what I cannot change or fix.

Leaving your relief at shift change with a bleeding pt with bad IVs and systolic in the 70s because you can’t be late for NP clinicals.

Quite frankly the people you told who reacted negatively should be relieved that you’re bringing some high falutin’ NE culture to the poor, low-quality state of Louisiana. Sarcasm aside, go into your new situation with an open mind and open heart, and embrace the culture. Bring back some wisdom for those who doubted you. Who knows, give it a chance and you might enjoy Louisiana so much you never bother going back to prove the doubters wrong.

Food service gloves?! Jeez, that facility gives a new meaning to cheap. Those clear gloves NEVER fully keep out liquids, I’ve tried many brands for food service. Hard to say how you could attempt to explain this to management, they strike me as folks who have never touched a pt. Perhaps a hands-on demonstration of the gloves failing with some creative props/food coloring?

Thank you for the great tips, everyone. Really needed this today ?

Starting IVs for sure. I’m one of those people who drools over nice looking veins. I love how diverse the responses are. Reminds me of my old floor where we all had our own strengths and loved working as a team. We all pitched in to get the pt the best care possible. One of the biggest things I love about nursing is the variety!

I’m kind of torn on this. Decks of cards between nurses/nurse allies is hilarious. Your hospital could have been trying to be “down with tha kidz, yo” like they totally get the nurse struggle, but it’s pretty tone deaf. They could have at least written notes or something joking around about the cards, while letting you know they have your back and are not the kind of hospital a certain politician “advocates” for. As for your husband, does he care enough to bring you chicken soup and/or playing cards when you’re sick? There’s your answer ?

I keep hearing informatics is the next big thing but not yet in my area, sadly. I think population health, “care coordination”, and other forms of case management are growing.

Dialysis will sometimes hire newer grads, family practice clinics/urgent care, home health. Keep networking while you build your skills in the hospital. Find the job that panics you the least at the thought, then go for it. I’ve never had any regret about leaving bedside, and even if your first job out of the hospital isn’t ideal, there are so many other options. Love and light to you.

I think unit-themed gifts are lovely and promote team building! Are you listening, management?

This is one of the myriad reasons I got out of bedside, probably one of the most unsafe reasons for risk of errors. It is especially disabling if you’re an introvert whose longer neural pathways require more time to take in and process each new interruption. To maintain a high standard of care for pts and keep my own sanity intact, I think the only way I could ever go back to bedside would be with a rolling soundproof bubble, big enough for me and one patient. Someone let me know when this gets implemented, I really miss all those differentials ?

I have read quite a bit lately on the topic of empaths and energy vampires (check out books by Dr. Christiane Northrup and Dr. Judith Orloff for some fantastic insights.) I’m all for paring down toxic people in your life, but what about when that’s not possible? How do fellow ED nurses, case managers, home health nurses, etc. cope with patients you have to interact with on a regular, (often frustratingly) repeated basis who happen to also be “vampires”? What are your favorite strategies for boundaries and self-care?

This is great advice. Only you can decide whether to stick out your full contract. Points of consideration that come to mind are being able to swing paying the penalty charge, and whether you’d need/want to work for this particular hospital/system in the future as most broken contracts=do not rehire. That being said, I know plenty of people who have left floors like this, broken contract and all, and never looked back. They are ALL healthier and happier today. Regardless of your decision, please keep reaching out and getting support. You are not alone. You will find your place to thrive in nursing and be such a strong nurse for what you have already accomplished and conquered.

Definitely a good point, thank you! I think eventually I will look into traditional inpatient case management positions. Just a quick follow-up, I decided to go with the job that involves a long-term caseload. I am really enjoying being able to see my pts grow and blossom over time and reach their goals.

Thanks for the insight!

Good evening, all nurse folks! I'm trying to decide between 2 different job offers I've received. Ultimately I'm looking for what will provide the most relevant experience for landing a utilization review or quality improvement position in the future. I feel that working from home/for an insurance company would be a good fit for my personality. Job #1: care transitions RN, following pts from hospitalization to 30 days post-discharge. This job is strictly short-term care coordination and transitional care management, no long-term caseload. The focus is on establishing pts with primary care and resources in the community, with the goal of preventing unnecessary readmissions. Job #2: case management RN, includes elements of the above, but working with with a traditional outpatient long-term case management caseload. This includes home visits, monthly pt meetings, and goal setting/long term planning with the pt. Any suggestions would be very much appreciated, thank you!