Keshet

You do have to be careful to define exactly what they mean. One hospital where I applied had both PRN and Per Diem positions. As it turned out, the PRN positions required a minimum of 6 shifts per month and paid a great differential although they didn't guarantee that they would GIVE you six shifts, they implied that you would get them. The Per Diem position, on the other hand, required only 2 shifts a month, but without the differential, and no guaranteed shifts. They did not explain that in that application process, only when you interviewed did they clue you in! So do ask for a definition!

I once had both of my two prescriptions refilled at the same time, one was synthroid and one was benicar. When I got home, the meds were in the wrong bottles. It took a minute even for me to realize it because I had just started taking the benicar. When I opened the benicar bottle, I thought, "That's funny, this benicar looks just like my synthroid tablets." Then I realized what had happened and there was no harm done. But for some little gramma, it may not have been had such a good outcome. Another time I caught a really major one by our hospital pharmacy. I was working in the ER and a young lady came in with an infected tonsil. The MD ordered clindamycin IV, which we usually just hang as a gravity drip over 30 minutes. The med came down from pharmacy, and I checked the label, which read "clindamycin 300 mg give IV over 30 minutes". Luckily for the patient, it was mixed from one of those vials that screw into the solution set, and when I checked THAT vial, it was actually DILTIAZEM 250mg!!!! My coworker said my face got beet red when I showed it to her. Can you imagine running that in over 30 minutes? Even a healthy patient like this one would probably not have survived. Needless to say, it wasn't given and an incident report was generated. We all learned to check and double check every med you give, even if pharmacy mixes it for you. You just never know.

Well, yes, they did show taxes of over $3000 deducted on the first check, which also had 12 hours of work, so it would be hard to separate the work tax from the bonus tax. The replacement check they gave me for the work hours only did not have any tax deductions or adjustments. I haven't had a subsequent check yet. I will wait and see what shows up on the next paycheck. If it's not there, I think you're right. I either need to see an accountant or a lawyer, maybe both! From what I've seen, I really don't think HR/payroll has a clue how to run a hospital, or how to do the right thing. Thanks for the advice!

Thanks for the responses so far! That confirms for me that turning it down (and giving it back when they gave it to me anyway!) was the right thing to do. The HR guy tried to tell me that "all hospitals" do it this way! I didn't think so!

I would be interested in hearing the contract terms other hospitals offer on sign-on bonuses, after my own recent (bad) experience with one. I recently accepted a full time position in this hospital. At the time of interview, offer, and acceptance, there was no mention of a bonus nor of any commitment. When I started work, and filled out all the papers in HR, they said I was "eligible" for a sign-on bonus with a 4-year commitment and to speak with my supervisor if I was interested. I did, and she wasn't even aware of it, but checked into it and then came back and said I was eligible and gave me a contract and a separate promissory note, both already signed by 4 administrators of the hospital. I looked it over for a day, and there were terms that made me very uncomfortable. Such as: "Recruit agrees to execute a Promissory Note made payable to in the amount of bonus which will expire unpon the completion of the four years of service." "If prior to the completion of four years of service, Recruit resigns, quits, self-terminates or otherwise leaves the service of for any reason including forced termination initiated by , Recruit agrees to pay the $7500.00 Bonus that he/she received in full within 90 of separation." "If Recruit is terminated for just cause prior to the completion of four years of service, Recruit agrees to pay the $7500.00 Bonus that he/she received in full within 90 days of separation". Well, my problems were many! First off, they would tax the you-know-what out of it, so that I would net maybe only $4000. Not really a lot of money for a 4-year commitment when you think about it. Secondly, there was no proration clause. This was my first sign-on bonus, but I have worked several seasonal contracts where they have a monthly stipend bonus and there is always a proration clause, where if you don't finish the contract, you owe them a prorated amount based on how much time you did finish. Thirdly, I was hired for a newly created position in this hospital. What if they eliminated the position and did not have another comparable full time position? What if I got sick with some longterm illness or injury and had to leave? Not only would I be cash-strapped, but I would have this debt to the hospital! Lastly, a legal promissory note? In my mind, that then makes it a loan, and not a bonus. In fact, there would be interest (at an unspecified rate) if not paid back within 90 days, and clauses about having to pay their legal expenses if I defaulted and they had to collect. This was not a bonus!! I asked them if we could modify and reword the contract, and they said no. So I told them that I would decline the bonus, thank you very much for the offer, etc. I kept the original unsigned contract in my possession. There is more to the story. In a nutshell, they actually paid me the bonus by direct deposit to my bank account, after I had verbally declined it! And then (I felt) the HR guy tried to coerce me into accepting it and signing the contract, even after I had declined it. (I gave the net amount back, and they finally agreed that, since it was their "mistake", to be responsible for getting the taxes back from the IRS. (I hope it doesn't screw up my taxes for this year!)) My question for you is this: For those who had received sign-on bonuses, what kind of terms did they give you? What was the length of your commitment? Was there any kind of prorated schedule if you left before your commitment? Could they initiate a "forced termination" and then demand the money back? Did they make you sign an actual legal promissory note? I'm really interested in hearing how other hospitals handle this. Thanks!

When you are on vacation to a dude ranch in another state, never say, "Hey, guys, want to see my cool horse trick?", and then get on a horse, head him straight for a tree at high speed, and then grab the tree trunk with your left arm while giving your famous Tarzan yell as you swing off the horse. It will leave you with pulmonary contusions, flail chest with hemo/pneumothorax, multiple fractures, and a long stay in the ICU. BTW, the 28-weeker was born in the snow alongside the highway, where we found him blue and cold. On the helicopter flight back, he was intubated and warmed, and he did survive. We nicknamed him Frosty, and unfortunately saw him often during his first year when he was brought in for respiratory problems due to his traumatic birth.

Never use det cord as a fuse to light your illegal New Year's eve fireworks. But IF you do, don't wrap it around your wrist a few times before you light it. Don't get drunk, get in the shower with a knife and screwdriver and try to remove the screws in your ankle yourself because you can't get an appointment with your orthopedic surgeon until next week. When you live in a very rural area, don't go out in a snowstorm and try to hitchhike 60 miles to the nearest town with a clinic when you are 28 weeks pregnant and you start having abd cramps. Don't "lose" a long vibrating object in your rectum, and then come to the ER and tell them you are having "abdomenal pain".

Speaking of clumsy! I was once prepping a lady for a cardiac cath, and while shaving her, got the bed a little wet. So, she got up to go to the bathroom, while I went to get new bedding. I came back in the room (it was a double, separated by a curtain). The patient had just come out of the bathroom, and I was in a hurry so I could change her bed and get her back in it. There was a visitor chair on the other side of the curtain that I didn't see. As I was walking by it, one of my feet got caught between the chairlegs. I had an armload full of bedding, and I didn't see it coming, so I wasn't quick enough to even attempt to break my fall. I landed first on my knees on a hard concrete floor, as my face slammed into the side of the bed. The other nurses came running in, thinking from the loud crashing noises that the patient had fallen. The other nurses saw the patient standing there pointing at me on the floor, and they all just laughed and walked away. Meanwhile I was still writhing on the floor in real pain! No real injury, but I got a beauty of a black eye, and it took a few weeks before my knees stopped hurting!

Yes, I too have done it twice, when I was working night shift! The hospital provided the vaccine but nobody at night to administer it! We just had to sign it out for ourselves. Both times I did it in the deltoid, using a big mirror in the bathroom. Just like giving one to someone else, except it hurts more! (Glad I'm not the only one!) Never drew my own blood though. Now, that's gutsy!

Don't you guys have lockers? I don't carry anything back and forth between home and work unless absolutely necessary. I even keep my shoes in my locker. Pocket stuff? Clipboard? Reference books? It all stays in the hospital. Maybe I'm just paranoid, but why risk carrying any more little nasties home to the family than we probably already do? And who really needs any that stuff at home?

I went to a nursing seminar once , and one of the breakout groups was on managing stress. The seminar leader, Nancy Suazo, suggested using what she called the "broken record technique" when someone is hounding you to work. The conversation would go like this: Can you come in and work tonight? No, I can't work tonight. Why not? You're not doing anything special tonight, are you? I can't work tonight. You haven't been able to work extra for a long time. We really need the help because we are short 3 nurses tonight. I can't work tonight. You said your husband was out of town at a seminar this week. So I know you're not busy tonight. We really need you! I can't work tonight. Etc. etc. They finally get the message, you don't feel guilty, because you haven't had to make up a bunch of excuses, and eventually they learn to respect that when you say no, you mean it! She demonstrated this broken record tecnique in many other situations too. Essentially, state your position politely but firmly, don't make excuses or try to justify it, even if they hound you about it. Just keep repeating your position until they get the message. That technique has come in handy for me many times. Hope it helps!

I had that happen to me once, a place I had worked for over 10 years. TI called the ER manager who I had worked for before, but he was no longer in charge of ER, and they were in transition looking for a new manager. So I went to HR through the "normal channels". I left several messages, online applications etc., and said I would be interested in ER or float pool, where I was told they both had openings. The ONE nursing recruiter never called me back. Ever. So I called someone I knew in HR, and she called the DON, who I've always gotten along with, who was really ticked off at the nursing recruiter. Unfortunately, by then I had taken a position at another hospital, and I actually like it much better. There are lots of nursing jobs out there. I tend to go with the ones who are polite and who call you back in a reasonable time. If they treat you badly before they hire you, I think it says a lot about how you will be treated if you go to work for them. OTOH, you can't always judge a hospital's working condition by one lousy nurse recruiter who doesn't do her job.

Dear Medic2ERNurse2B, Thanks for your post. I was a paramedic before I became an RN too. Paramedics often feel underappreciated, I know, not necessarily from the patients, but from other medical staff in the ER. To them, you are the one who brings them in, and then leaves. To some extent you have to develope a thick skin. While some ER staff will thank you and respect you for what you do, unfortunately many are too busy with the serious patient you just brought in to express it all the time. They may really respect you, but you never hear it. On the other hand, some have never been in your position, and they generally don't know that you are the highest level of care in the street, and the kinds of decisions that are made as a team, primarily with an MD in the room, in the ER, are the same decisions you often have to make alone on scene. Tubing a blue premie born out in the snow, sticking a 14g in someone's chest, all kinds of these like this that take a lot of assessment skills and then boldness to do what needs to be done - immediately! I even had to cric somebody once, on a rollover off a mountain road outside of radio range to the hospital. Not fun, but you do what you have to do, and just hope the doc agrees when you do get back to town. As a nurse, you will be part of that ER team, and while it is still possible to make mistakes, you have others around you to help. It may not be less stressful, but just a different kind of stress. If anything, you will at first be frustrated that you no longer are the one calling the shots, sinking the tube, etc. But what you will be doing is just as rewarding in a different way. I can tell from your post that you will be a great RN! You have compassion, skills, and already know how to manage stress. You'll do great. Most of the nurses I know who were good paramedics first, like you, are some of the best nurses I know. If you really like what you do as a paramedic, think about keeping your paramedic license and work toward a place on a helicopter crew. There, an experienced dual RN/paramedic, is highly valued! More advice than you probably need! Good luck with your studies!