IntegrativeRN

I applied and was notified by email that my application got pushed through to the hiring manager. Is anyone else in the process of being hired by the VA or have any experience with the process or timeline? It's the timeline I am especially concerned about given all the gov't upset of late and I am uncertain how that translates to the VA healthcare realm. Does anyone have any experience with the general timeline from that email to next steps? If anyone has any experiences to share, I'd be grateful!

Congratulations! I'm not in critical care, but still wanted to say congratulations and I appreciate your sharing the experience that helped you. I'm sure so many others will benefit for what you just shared!

Agree and disagree. If patient's presence in the hospital implied consent, there would be no consent forms to sign. Consent is an ongoing right. A patient may be on board with one aspect of their care and balk at another....leave, seek a second opinion, refuse a life-saving treatment even. Many times the patient is not the expert. However, they are the expert of themselves (as in have the right to exercise free will throughout their stay, and often, they have had the best education on their condition prior to showing up, compliant or not.) I keep reading that one's expert role versus the patient's novice role equals the right to exert force over their free will. Problematic when we're speaking of a vulnerable population in an imbalanced power situation.

This gave me pause. I haven't read this whole thread or even your position on the issue at hand, but I think it's asinine to assume everyone knows you. For instance, my name may say "0" but I've been on and off this site since 2006 under usernames tethered to now-defunct email servers. In 19 years perusing here, I don't know that I've ever encountered you. With so much traffic and constant new faces, I would never assume I'm known even if I was a die hard regular.

With you on this. I'm thankful for every patient willing to be educated and to abide by medical advice as far as FR, but we are dealing with basic physiologic needs, adults, and free will. Our position is often one where there is a natural tilt in the power balance...our patients are not meeting us in their strongest, most empowered human moments and instead, are dependent on us for many of their needs. If they exercise their right to refuse medical advice, even the most defensible evidence-based advice, that is their right. Anything else is us insisting they let us fix them. We can decisively convey the risks/ likely consequences of their choice, but it remains their choice. There is a lot to be said for creativity and compromise in this too. Some nurses just have that je ne sais quoi & seem to be able to get patients on-side without too much trauma. I really admire those nurses!

As someone who has been out of nursing for far too long and who has had multiple interviews lately, I say: keep trying! You have a year of nursing and that is a good launching point to transfer. I understand their ask for intensive care to build on med-surg skills given the mix of acuity needs in the ED, but fair point on "they take new grads.” The thing about new grads is that they are a blank slate. So, emphasize your recent experience but really emphasize your humility and willingness to learn! Passion for an area of nursing is palpable too. What kind of questions were you given? My latest were a mix of triage scenarios, how I handled a difficult situation at work, an example of cultural sensitivity, a time I lacked confidence and what I did about it, and how I would handle an issue with a coworker, teamwork questions, so on... Anyhow, don't give up! I wish you the best!

Can I ask where you are located? I earned a masters in Integrative Health Science after my holistic BSN program and I am not having any success finding employment in my non-health freedom state on the East Coast. I had a rough start in cardiac med-surg and was definitely frustrated with the insane level of poly-pharmacy and the band-aid style medicine we could offer in the short time we had to address serious health conditions, so I decided to branch out into the holistic realm after my personal autoimmune battles cost me my first job as a nurse. I have LOVED the education. Trailblazing is required. I also do not want to lose all clinical skills and I believe in a blend. Even my most passionate naturopathic doctor/ master herbalist professors know and recognize that there is a line with what can be reasonably treated (evidence-based) with natural means and what they must refer back to allopathic providers. Most patients will still mix the two if they found themselves seeking a naturopath 1st. Anyways, following along on your journey and hope it is going well!

I feel for you! Don't give up! Everyone deserves to be supported as a new nurse!! Keep applying to other jobs and fighting for yourself. If asked about the prior position, put a positive spin on the learning experience and do not, under any circumstances, speak ill of anyone. You can bring that here in anonymity but it's a red flag for hiring managers & you probably already know that haha. I had one phenomenal kind/ patient/ funny preceptor and one very toxic/ angry/ impatient preceptor (to the point other nurses were calling her out on the spot saying, whoa, why are you so angry?) when I was orienting to my cardiac med-surg floor. It later came out that it irritated her (@ 25 y.o.) to precept me when I was older (35 y.o.) but a new nurse with less knowledge. She was also angry because I was a patient on the floor when I was offered the position and she had a friend who was about to finish school who she was hoping to convince the manager to hire. It did suck. I had chosen to stay home after passing the NCLEX years prior because my husband was on repeat cycles of deploying overseas. We were on an army base across the country from my family and support systems with little kids. My daughter had high acuity health needs and I put my career on hold out of necessity, so yeah, I was older and I felt totally unwelcomed by her between the two issues. I didn't find out about the friend she wanted to bring on-board until I was released on my own a few months later. Thankfully, the other preceptor more than made up for her lapses. I just wanted to assure you that it is totally normal to be the nurse with no breaks when you start out! It takes time to develop time management and task proficiency. Just know that even in your next position, you'll likely get the same sense that everyone else has time to sit when you don't. You're still getting your sea legs. I definitely experienced that feeling that high acuity cases I wasn't ready for were thrown my way too....I think it they do it to most new nurses to teach us. Not at all cool that they didn't support you through those cases though, because they shouldn't assign the teaching cases unless they plan to be there for you if you need them! It was the first time in my life I experienced panic attacks and was regularly choking on my panic on the way into work, fearing I'd be thrown something I truly couldn't handle (looking back, my health was tanking too and I just didn't know it yet). My floor had a couple of amazing seasoned nurses always willing to answer a question, quite a few snarky eat-your-young types, and lots of singles who partied together (of all ages). My manager was half business/ half kind and personable. Unfortunately, she played favorites with some of the party girls who were her after hours drinking buddies and they had an in-road to talk to her anytime and preferential shift choices. I didn't feel like I could go to her with much of anything and was just trying to keep my head above water. Instead of going out and networking, I went home to my kids and tried to sync with their day schedules on any days off (I was on nights with no set days of the week). I ended up sinking under unanticipated health events spurred by the deep life stress both at and outside of work during that time and I lost my first position just shy of a full year in too. Looking back, I wish I felt like I could go to my manager and talk to her about a return to work plan. With what I had going on, I couldn't communicate well or anticipate the "when" part and it would have been unfair to ask them to hold a position when I was unsafe to practice due to my medical issues at the time. I'm sharing because you are not alone. We don't all have a successful start out of the gate. I stepped away for 9 years and am just now coming back to active practice. You have a lot going for you though! There's no crazy work gap and you have skills from your time in the military (thank you for your service!) You just need a soft landing in the next position with enough good people to outweigh the unsupportive ones!

Hi, I don't have a record, but I have a major time lapse since I last practiced and that's just about as dam*ing in the career hunt. I'm currently near the NC/VA line and there are some small fry home health companies in North Carolina that encourage people with a record to apply. Recently saw one on Glassdoor. I studied criminal justice alongside my late husband for awhile and it struck me how much our system ruins people's lives. I didn't agree with everything labeled a felony when the stats show that gravity of charge can lead to a loss of options and inability to come back to society and do well. While I don't know your charge or the gravity of it, I hope one mistake doesn't define your life and that in any position you hold as a nurse in the future, you rise to the trust placed in our profession.

Thank you for sharing. Fascinating read! Sad, too. I don't imagine her name will ever be disentangled from the horrifying allegations. Some bells simply cannot be un-rung regardless of what is revealed after the fact.

I totally agree that night shift is a different beast for fatigue. Are you able to take naps at your facility? I have never heard of that for night nurses in the US. Typically, everyone who doesn't smoke stays on the unit at all times, even if taking a break. No one naps, as lovely as that sounds. Sorry to hear about your close call with the lorry! Your walk to work through the park sounds idyllic.

This story hits home for me. I totaled my vehicle on the way home from my 3rd 14 hour shift, because as a new nurse and night RN, I found most days were 14's, not 12's. I would go in early to read up and get my footing on my cardiac patients and in-services/ delays with the oncoming, would push me beyond 12 regularly. I was a single mom (recent military widow) and I couldn't keep the same schedule on off days because kids are day dwellers. I crossed a lane of traffic 10 minutes from my house (I thank God every day there was no one in that lane), slammed into a concrete culvert in a ditch, and woke to utter shock, bruised but otherwise unscathed. At the time I thought I fell asleep, but I now question that. A few weeks later, I felt like I was in a stupor. I was flagged by occupational health at my birthday check-up for MRSA on my knee and told to go home. My immune system was pitching a fit and within month it was discovered I was borderline myxedemic and experiencing Takotsubo cardiomyopathy. Of course, that took awhile to nail down with specialist referrals, etc. My job was toast. They understandably needed to replace me. My brain was mush being so deeply hypothyroid and I couldn't adequately explain myself to management as a new nurse with that as my life frame. I felt so guilty because they had just trained me and they really drove home how much they invest in a new nurse. I was just so physically/ emotionally wiped out from life stress that my body didn't handle the night nurse schedule, new nurse stress, and that swap back to day shift for my kids' sake. I think I passed out behind that wheel. The event changed my life. I stayed away from bedside & am just now looking to return 9 years later. I love nursing, but it can be brutal. Ultimately, my heart just aches for any nurse going through the wringer of non-24 as well as the families impacted by this utter tragedy.

Love this! As a nurse who is stock terrified of making med errors, we don't get a pass "Go!”, collect $200, on every patient med error out there. Some med errors, like RV's, are just grossly negligent and we should be scared! Scared enough to do the rights and get it right to avoid the establishment of criminal negligence. We don't get to kill people, blame it on a shift-blame scapegoat culture exhibited by a hospital, and keep our license intact to perpetuate the same. If the negligence level is that egregious, it is CRIMINAL! I saw that there is fear for the backlash of how nurses' will respond to criminalization of med errors and subsequent failure to report. That view places the nurse above the patient and ignores patient rights. The nurse gets off with a lost license, and patients and families henceforth get to fear that a busy nurse could nonchalantly murder them and walk?

I'm sorry for your very real stress and burnout when you are giving 1000%. It is palpable through your post. To me, you sound like an absolute hero for even attempting to fill both absent nurses' shoes and function as charge at the same time and yet, it is an unsustainable situation. At my last hospital, Charge could step in on a single patient that was tanking (cardiac) for brief periods but was not permitted to accept full patient loads. On call or float would come in to keep Charge free. You may not single-handedly be able to change the for-profit nonsense and party call-out culture on your floor, but you must protect yourself. If the powers that be are willing to "blacklist" you for not taking on a doomed management position, they are willing to burn you when a patient situation goes south because of your split attention. Your only real choice is to hold their feet to the fire to provide an acceptable float when on call calls out or insist they will lose your many years of experience and deep patient care.

Yeah? That's awesome! Prior experience makes all the difference. Sorry you feel the loss of autonomy in the decision tree, but it's awesome that you were such a natural to ortho trauma! I was told not to sweat my educational experience because hospitals re-teach what they want you to know/ how they want things done anyways, but considering all that nurses face when they're released to practice, not having to question the adequacy of their education should be a given.