DNPStudy

Hello, I'm in the post-graduate program. If anyone else in the program, or supposed to already have access to CAPS, have you had issues? I have been calling and emailing the past several weeks and they have poorly handled it . I still can't have access to check for placement sites.

Do you have a list of the places you would like to apply? If so, start looking at their requirements. I only wanted to work in ICU at trauma level 1 or 2 and I was willing to travel anywhere for it. During my last year of nursing school, I researched all the ICU new grad residencies at hospitals.that met my criteria and made notes of their requirements and especially deadlines. For any questions, I contacted the recruiter or department in charge. I even started getting thing ready (portfolio) and applying if the start date was after but the deadline was before my NCLEX. Some programs allow you to apply before taking the NCLEX and your job offer will be contingent on passing. I applied for 20 programs at major hospitals that I thought would give me good ICU foundations. so I recommend to read how the residency program is run, and if it matches your desired criteria. During my time, it was very competitive. To stand out, I did a 10 week ICU externship for the hospital where I worked during nursing schools and where I did my clinicals. Yet I was declined a job there when I applied for their ICU residency program. After many rejections, I had only 3 interviews out of the 20s applications sent, 2 job offers (one interview was for PCU and ICU but I got offered PCU so I declined). The only other job offer I received was a blessing in disguise, at my desire ICU which is the MICU. I was declined for Mayo, Duke, UCLA etc..and there was no way I would have been accepted at Hopkins with just an ADN. And yet Hopkins was the only one who offered me a job. Hopkins has its own nursing school with MSN prepared nurses. The position required 120 hours of ICU externship. I only had 100 hours but I still applied. So my advice here, apply to places where you meet most of the criteria but not all, it won't hurt. I came to the interview with a nice portfolio. I flew from Colorado to Baltimore for the interview and the manager called me right after the interview to offer me the job as I was on the plane. He said that he hired me because I came in prepared, and that my extensive community work stood out. In addition to the ICU externship, I also got my ACLS , became a certified phlebotomist during nursing school so that my resume already has skills the ICU needed when I came in as a new grad. But as you can see, I also didn't have a lot of interviews. I may have been overtly ambitious. I am at Mayo now, knowing what I know now, I am glad I didn't go to Mayo as a new grad because Mayo nurses have many resources and I would have missed out on getting the crucial ICU nursing skills that would have served me during my travel nursing jobs. If you just want a job, then don't mind what I said ? but if you want to go where you'll have great ICU foundations, make sure to research the program. Hope this helps! Good luck!

I know this is a 10 year old post. So what are your thoughts on the new federal rule for minimum staffing ratio for LTC? The new rule states that there must be 2-3 RN and at least 10 CNAs each shift for 100 residents, which to me still seems a lot. I don't work in nursing homes therefore I don't know if this is a decent ratio?

Good for them to try to make a change because nurses working in the South needs better pay and working environment. But not all unions are great, really depends on their priorities and how they're going to fight for their nurses. I'm in the middle of the road about unions because of this. Unions in California and mainly the West Coast are great, unions in the Midwest not so much.

I don't know work in that environment so I'm just curious to know. It seems to me that it would depends on your state and the scope of practice given to the MHT. For example, in Colorado a CNA can take the QMAP course and be allowed to administer medications as a certified medication aide. The CNAs I have worked with in MD were allowed to do trach care, place IV, Foley, draw labs etc..while CNAs in other places cannot even perform a blood glucose check. I read that MHT are responsible to evaluate patients' physical and mental states, taking VS, be involved in crisis resolution and management as well as admitting patients, and that licensure is not required by most states despite such responsibilities. I'm sure the facility do not want to get sued and have already looked into ways to be legally compliant. Why don't you ask management? I would question them especially if it makes staff uncomfortable. Advocate for yourself, your team and your patients.

Understood but I'm also answering concerns in #2 where the OP asked "This would put the nurse on 3 consecutive shifts in a row. If you refuse the mandate, can you be reported for abandonment? Certainly I would never leave my patients unattended, however, at what point is the nurse allowed to say that they feel unsafe providing care/administering medications without reprimand? " If she feels that mandatory OT is unsafe putting the nurse working 3 shifts in a row at that same facility and refusing the mandate or assignment for fear of abandonment but feels it unsafe, can be challenged under the Safe harbor which is only a law in Texas that I know of.

What state are you in? Laws may be different. For Q2, If you are in Texas, there is such a thing as invoking Safe Harbor: "Safe harbor is a legal process that protects nurses from employer retaliation if they request a nursing peer review of an assignment or conduct they believe could violate the Nursing Practice Act (NPA) or Board rules. Nurses can invoke safe harbor in situations where it's not in the best interest of patients for them to accept an assignment, such as working mandatory overtime or accepting expanded patient assignments."

There are different ways to look at this. First, there are a lot of nurses willing to work under better conditions. Second, relative to the growing and aging population, yes there are not enough nurses for the volume. The same goes for other industrie.its a matter of semantic. The problem is how do we keep nurses in the profession, not so much about "producing" nurses. I consistently hear people being wait listed because there are not enough spots (therefore issues here is to increase programs and instructors), and new grads leaving the profession after a year or two due to stress and toxic culture (therefore improve working conditions).

Sometimes legislators are willing..then come in a powerful healthcare organization that throws in a tantrum, and legislators give up...in the case of Minnesota safe staffing laws and Mayo Clinic...

It saddens me. Nurses are the biggest healthcare workforce and we could make the change we want if we all work together. But speaking with a few, nurses are afraid to speak up, afraid of losing their job, and so busy with work that the last thing they want to do outside of work is to do nursing related things.

I have worked in California at a level one busy trauma center and then at a local small community hospital with 8 bed ICU. Having a ratio is great but shouldn't necessary be a strict statewide requirement. I could have taken 3 ICU patients in that smaller ICU with lower acuitu patients. I agree with whomever said it should be individualized. The Massachusetts Safe Patient Limit in ICU Law has some merits compared to the California ratio mandate. This is a study I am working on for my DNP

I lived through this. Post pandemic, having 3-4 patients in the ICU is unacceptable. I'm glad Oregon has passed their staffing ratio law similar to California. I'm currently doing a research on the topic.

Don't give up, keep up the good fight!

I agree with this piece. Nurses continue to experience increase responsibilities and workload under an unsafe work environment for low pay, especially post pandemic. I keep hearing complaints but very few are willing to speak out and be a voice for themselves and others on a bigger scale.