CynRN

I would consider your regrets you had in passing up the initial offer you spoke of. It sounds as if you seriously regretted not doing it. Keep in mind, once you have a job in a field each day you spend gives you more time and experience with that specialty. It will make it easier to find your preferred shift in a short time. You mentioned going back to school, night shift will allow you free time during the day for phone calls, appointments, paperwork and grant/loan applications, onboarding etc that may be required for school. Speak positive to your bf about going back to school not ask him his opinion. If your future is to be together the job and salary you will bring in going to school will pay for itself over and over. If you end up not being with him then you have such a huge regret of not going for your goals and have huge resentment towards him mixed in with whatever broke you up.

Do walking rounds on each patient. Look at dressing etc and ask the new patients did you get in last night or this morning? She can not dispute what you both see. And, it removes blame away from you without confrontation.

I have been a nurse since 1994. The changes I have seen are mind blowing. As a medical professional we can pick apart each other, but the primary problem is insurance. I remember when insurance companies started changing medications on patients because that was now their formulary product. I actually laughed the first time I saw that because I thought no way can they just change a doctor's order on an old inexpensive medication that works for a new much higher cost medication that is not effective for the patient. Many years since and over a decade of case management later, I understand that insurance is the beast that feeds the beast. Customer satisfaction is a key role in getting insurance contracts and being a preferred choice for many insurance companies. Length of stay: this becomes where the administrative and supervisors now exceed direct care staff on a daily basis (not the staffing pool numbers they whip out with this conversation). For payment purposes the amount of oversight on making sure documentation and all t's and I's are crossed, minutes treatment /care performed, all assignments finished, aide documentation, meetings with medical director, etc. now mix in medical equipment and supplies and what insurance will pay vs what America's litigious society mixed with government regulations required for each problem the patient has or could have and you get another imbalance. Now to all the executives that make unbelievable salaries as well as bonuses. These people make this money by making a penny scream. To them it is almost like a SIM game or some such. They push to have the customer rating documented, assessments completed, all the mandatory items required they delegate to executives to CEO to CFO and down to you. They utilize their own facilities to incentivize better compliance throughout. Making the CEO of the facility have to push all of their staff to reach these benchmarks and if they are in the top numbers they get bonuses if not they have to find another job. Insurance pushes this behind the scenes. The days of travel to US for medical care is going because we are becoming an assembly line of medical standard to fit all of these rules. Length of stay is short. No nurses around to give special care to them. Rushed doctors who do not have time to coddle. Other more wealthy countries are now getting those people. I remember as a child at the dinner table, the phone would ring. My dad would stop the kids mad rush to answer saying 'Don't get that it's an insurance company' This country has went from that to now insurance is required and difficult to get or waiting a year for preexisting chronic illnesses to be covered. It is grossly expensive per paycheck for premiums and then you have deductibles that exceed what the average person spends on medical care annually. And you cannot add or change except at a magical time of annual re enrollment or life changing events. Until a spotlight shines on them, they are in control of our medical system. Nurses need to find their lobbyists and utilize them or someone better than them to began our change. It would make such a difference for our issues to be addressed because of the huge workload we are placed under because of this.

Hopefully by now the situation is resolved. But, if advice still needed: since she is being so negative and resisting your efforts, perhaps someone said you said something about her. You seem to have no problem facing a situation, you could tactically ask her if you had said something to upset her. That is the only suggestion I have to further investigate the matter. I agree with many of posters, do not continue doing extra projects everyone applauds you but does not remember it when it counts like this situation. It appears she, like many managers, likes her power and has too much time to think to put malice into situations. Step back and let her have the joy of helping others instead of having a happy unit by delegating this vital job to others. Good luck!