pattchez

Chandler Regional Hosptial and Mercy Gilbert Medical Center pay 20% diff. for nights and 10% for weekends.

I do not work for the Banner System but at my hospital there is a 20% night shift differential plus a 10% differential for weekend -- which applies to either day or nights. We do 12-hour shifts for both days and nights.

Hello! I am a nurse who woked lived and worked in ND from 1971 to 1989 and then moved south to Colorado and ended up in Arizona working full-time as an Adult Health Clinical Nurse Specialist in Phoenix, AZ area. I check this link every so often to see what is being discussed in ND from a nursing perspective. I am grateful for the nursing education and work experience I had in ND as it continues to serve me well in my CNS position. Thank you.

we went live with computerized documentation and e-MAR/BMV last year. Currently students cannot use the e-MAR/BMV as we do not have access for them. Our computerized documentation system will permit students to have basic access to things like ADLs, vital signs, and I&O. Our IT people are working on creating a broader access for students ....but that wont happen soon. We encourage the students to follow the nurse and see how she/he gives meds with this new system but, for now, that is really all they can do.

I am from AZ. The SBON recently changed the regulations for CNS including the required 500 hours, national certification as CNS which effected several CNSs in the state who do have the CNS tract in their MSN program to be elgible to sit for the national CNS certification. AZ inacted a one-year "window of opportunity" (11-05 to 11-06) for practicing CNSs to submit a portfolio to provide evidence of their CNS role & responsibilities -- but this CNS recognition is only good in AZ. Fortunately, I took my CNS program in 1980s and obtained my national certification as an Adult Health CNS prior to these issues. I believe it is important to provide prospective CNS students with "all the information" possible to ensure they will be otain the degree they need in order to be recognized as a CSN -- no matter what state they choose to work in.

It is great you have made the decision to return to school for a CNS degree. I agree with the previous posts about making sure you understand what kind of degree you seeking and does it match your expectations of working as a CNS. Your masters program, as a CNS program, should have at least 500 hours of clincial experiences or you will not be eligible to take the national certification as a CNS. In addition, the CNS program should have a grad. level patho-phy course as well as a pham. course. I am involved with a state CNS group and there continues to be discussion about CNSs completing a masters in nursing program ...only to discover they are not elibible to take a national certification for a CNS. Your clinical area is certainly in demand -- a NICU CNS is needed in large hospitals and I would encourage you to continue in that direction. Best wishes on your education and future career.

I work for at Chandler Regional Hospital and not a registry. For example at my hospital, a RN working in the flex. pool can make $35/hr, without benefits -- including med-surg. They just started a benefits included float pool -- it is your salary plus 10% & benefits which is good deal too.

I know that hospital regularily check the salary market in the phoenix area and adjust salaries if needed -- I suspect the hospital salaries are not greatly different. If you are not interested in benefits, then you can make a better hourly rate working at hospitals and you could check that out too.

In my state, I have found that nurses interested in the MCH CNS tract are going into the Adult Health CNS tract because the schools of nursing do not offer a MCH tract. What the student does is focus the clinicals in MCH in the Adult Health Program. If you want to work as a CNS, then I would encourage to go to a program that provides you with the clinical hours and elective courses that will make you eligible to take the national CNS certification. Best wishes on your search.

As a staff nurse I have taken PBDS at two different hospitals in two different states. Now as an educator, our hospital stopped using the PBDS, last year, because it was not measuring "competency" but rather teaching people to remember senarios. From an educator standpoint, the PBDS is a time comsuming test answers plus the PBDS senarios could be subjective in certain cases. It was frustrating to me to take the tests as a staff nurse and grade the tests as an educator -- a lose/lose situation. I am glad we change to something different. That is my thoughts.

At the hospital where I work we do hourly rounding. It is shared with the nurse and CNA from 6am to 10pm ...and then from 10pm to 6am it is Q2H rounds, again shared between the nurse & CNA. We started this hourly rounding last April and it has reduced the number of call lights because patients know that someone will be back in "about an hour." It is a shared responsibility ...and it a nurse is busy then she/he could ask someone else to check on the patients.

Thanks for your advice and suggestions. Nurses at my hospital don't always do the "double check" the right way too. I keep thing if we did the "5 medication rights" with all our meds, including insulin, then there should not be a need for a mandated second check. If a nurse would like to double check I think that is fine -- and it is something I have done at times. I am trying to find policy or references that will support this idea. If there is an agency or place I could check for information for policies or best practice articles, I would really appreciate your help, Thanks. Pattchez

At my hospital nurses are expected to "double check" their sub-q insulin with another nurse before giving it to the patient. I am wanting to find out if anyone does not have to the "double check" at their hospital and it so how was that decided to change the practice? Do you know of any best practices or have policies which illustrate this? Was there any changes in medication errors when this change was made? I am interested in making this change at my hospital so I would appreciate any information you can share with me. Thanks!

At my hospital, we are considering dropping the second nurse to check a sub-q insulin administration. If you work at a hospital that does not require you to have a second nurse check the sub-q insulin before it is given to the patient -- would you be willing to share the process or policy or references? Any help would be greatly appreciated. Thanks. Pattchez

If you want to go out to eat there are several great places around the Chandler Mall...the Elephant Bar is great. Also the Keg is great place to eat at the Mall. Chandler...has a winery in the downtown area...with a small resturant...if you like that kind of place....fun. If you like plays...the Hale Theater is great ...has great seating. There are so many wonderful places in the valley...it will just take time to enjoy them all!!

It is great this is topic creating a lot of discussion about externs. I encourage students or LPNs to examine the SBON advisory opinion about RN supervising externs ...as it does speak to students -- (do not have a nursing license) wishing to work as externs while in their nursing program. If a student in a RN program opts to take the LPN option become licensed as a LPN then the SBON will hold them to the standards of practice of their LPN license. If the hosptial wishes to call this person as a "extern" that is a hospital label but I assure you the SBON will see you as a LPN if you have that license and something happens. I served on the SBON Scope of Practice commmittee for 4 years (2001-2005) and the "extern advisory opinion" was discussed at length in this committee. My understanding is that the extern role was developed for students in a nursing program who wished to get more exposure to the clincal setting. Hosptials support the extern role as a recruiting tool with the plan to hire the extern after graduation from the RN program. It can be a win-win situation as long as the extern has a good preceptor who is willing to facilitate learning experiences for the extern.

I think there is some confusion about the extern role. The Arizona State Board of Nursing describes the role of the extern in their advisory opinion titled "Supervision of Unlicensed Nurse Externs by a Registered Nurse." If one has their LPN license ...then they are legally obligated to follow the rules as an LPN ...not an extern. So if one works under their LPN license then they are no longer working as an extern as described in the SBON advisory opinion. The key thing is that externs are considered "unlicensed" whereas LPN are licensed. Here is the web site to the Az SBON and then go to resources, advisory opinions.

Thanks to everyone who answered. I will share this information with my manager to standarize routine times on the 3 M/S unts.

I am looking for your advise and learn what time of the day and how often do your medical-surgical unit take vital signs when it is "routine?" We have 3 Med-Surg units and routine vitals are done at different time of the shift/day -- and I am wondering what is considered a standard time for rountine vital signs. It is confusing when I float from one unit to another so I would appreciate your comments on how it is done where you work. Thanks.

I agree with the previous comments about Good Sam & Banner Desert -- as I have worked at both hosptials. I work at Chandler Regional Hosptial and really like it there plus they have great benefits. Best wishes on your search. On a side note, I was born in Miles City, MT many years ago and really love it down in AZ now.

These type of courses are needed to understand the chemical changes that occur when a patient is ill. For example, if a patient has kidney failure, it is important to understand the lab values of the BUN and Creatinine as related to the damage to the kidney -- it is pre-renal, intra-renal or post-renal causes? If you understand the micro including the chemistry ...your will understand the changes going on in the patient's body and the symptoms you see.

Yes, I am a Nephrology CNS....I have worked both as a Renal CNS and Nephrology/Transplant CNS. My educational background is Adult Health CNS but my work experience has been nephrology in recent years. ANNA does not have an advanced certification in nephrology as a CNS so therefore I got my advanced certification via ANCC in Med-Surg. Nephrology CNS is a interesting field -- best wishes to you.

Hi!. Jobs are great in AZ. Yes, I do understand your looking forward to the sunshine as I grew up in ND and remember the -98 below with the wind chill factor. If you would like a smaller hosptial there is a brand new one opening up in Gilbert in June called Mercy Gilbert Medical Center. The reason I know this is that I work at Chandler Regional Hospital -- their sister hospital. Where I work they have great benefits, staff and salary so I am happy where I am at. Something to consider. Good luck.

There is a difference between NP and CNS careers. NP is focused on individual patient issues via thorough assessment and diagnostic skills. The CNS looks at patient populations -- groups of patients -- and it not focused necessarily on a specific patient. Education coursework is a component of a CNS program because teaching is an important aspect of this role. I agree that research is an important component of the CNS role and should be taught in the CNS program -- doing a thesis. Both roles are important in the health care system but each have different focuses.

Yes, I did. I worked in acute hemodialysis and the call-back was terrible -- working 24 hours non-stop. Not all M/S units have nurse to patient ratios of 1 to 12. Where I work the nurse to patient ratios are usually 1 to 6 or 1 to 5 on days and usually 1 to 6 or 1 to 7 on nights. I know there are places where staffing is awful but thre are place were staffing is okay. With patient safety being an important issue in hospitals, I believe changes are happening to address this issue -- including increasing staffing on med-surg units. I am sorry to learn that so many nurses were treated badly on M/S as that is where I learned by excellent assessment, critical thinking skills as I had not monitors to help me diagnosis. If you are thinking about working on M/S ask questions during your interview -- interview them Ask: what are the nurse/patient ratios and what kind of patients do you usually have on this floor. Ask to talk with staff nurses and ask them how they like working on that floor. Walk around the nursing unit -- see what the staff look like ---are they smiling, rushed, ??? Good Luck and best wishes.