montroyal

This situation opens ER nurses up to several legal issues. First, check what your ER's policy and procedures cover in this situation. If there is no policy, your hospital can(and will) say you are acting outside of hospital policy if there is a bad outcome. Secondly, if you have no trainning, you open yourself up to legal action againts you for preforming outside of your scope of knowledge ( I'm sure the BON would have something to say about that). If this situation presents itself and you are not trained or covered by hospital policy, stabilize the pt the best you can in the vehicle and call 911 so trained professionals in this situation can give the pt the proper help they need and you you don't overstep the bondaries of your profession.

Finally, someone has hit the nail on the head. When any of us start a job, you do agree on a compensation package. Would any of you agree willingly to a paycut? I don't think so. To be angry because someone doesn't pay for health insurance and you do, is sad. If your company doesn't provide free health insurance and that is a benifit you want, then quit and go find a company which will provide you with the compensation package you want. Why are so many nurses willing to work at a job they only ***** about. Life is to short to be unhappy.

I started voluntering on the number 22 Winston (OPPS Now Nextel Cup) race team three years ago. I now work fulltime for Bill Davis Racing as a tire specialist. Even a bad day at the race track is better than the best day I ever had as a RN.

I have worked in the medical field since 1980.Became a RN in 1992. Looking back on it now and seeing how the health profession has taken the downward spiral, I would definitely say I would not become a nurse again. I found a career that brings me the sense of accomplishment and pride I thought Nursing would, and I never felt happier. I still work part time as an RN, but I'm down to working a single four hour shift every three to four months. I am only doing this to keep my license incase any of my family members need to be hospitalized, I can do private duty nursing for them and ensure they receive the proper care most hospitals are unwilling or unable to provide.

RN PA I wish you the best of luck with what ever you do. Have you considered looking for another job? Sounds like your work enviorment is causing you all the stress. Medication can help with the the effects but not the cause. Before taking any benzo's or any other narcotics, call your BON and ask what the legal remifications of taking those meds could be. Several states require a medical review of your case before you can take these meds and work. What ever you decide, I hope things get better for you soon.

Any patient who verbally abuses or threatens you, or sexually harasses or touches you is a criminal! Talk to your supervisor first,but if that does work,call your local police and press charges. Several states now have laws which protect nurses from these criminals.

You should make pretty close to the same salary. I still work per diem in Winston Salem NC occasionally and my base py is 26.00/hr before my perdiem pay. I have 11 yrs experience as an RN. Charlotte has more hospitals, therefore more competition to recruit nurses. Their wages should be a little better.

There are very few hospitals anywere in the US that offers true sign on bonus. A true sign on bonus comes with no strings attached(ie. time comitment). Alot of hospitals offer retention bonuses that they try to pass off as a sign on bonus. " We'll give you $2000.00 but you have to stay for a year or two, if you leave you must pay us back". Take this as your first warning sign that management will play games with you! Also, remember that bonuses are taxed at 40% for federal income tax. You are better off negotiating a higher salery which will give you alot more money in your pocket in the long run. A full time nurse works 2000 hours a year. A salary increase of a dollar or two will have you earning more money than that falsely advertised sign on bonus can give you. Any nurse who accepts the initial salary offer without negotiating for a higher one probably pays sticker price for a new car also.

This only goes to show how inferior your school is by assigning student nurses to hospital staff who are not employeed by your school and have not choosen to become nursing instructors. Staff nurses have enough to do in their job description without adding clinical instructor. If a nurse wants to assume that additional responsibility, thats their decision. To have an instructor force these extra duties upon an already busy staff nurse who has not choosen to assume these additional responsibilities or liabilities, only goes to show why nursing is not considered a profession by a majority of the public. You are paying your school to provide you with an education and the experiences you need, not the staff nurses. Where did you get the attitude that it is the staff nurse responsibility to train you for free? Being a student nurse does not give you the right to be forced upon anyone with RN after their name. Would you be willing to pay these staff nurses for their time and knowledge? You pay your school and nursing instructors for this, why not the staff nurses? Your attitude of forcing more responsibilities upon nurses without compensation only goes to weaken nursing as a hole and is the core reason so many people are leaving the nursing field. There is no nursing shortage, only a shortage of nurses who are willing to work in substandard professional conditions. Preceptors for new nurses who are employed by the hospital are trainned and paid extra by the hospital. They choose to assume these duties and have them included in their job description. Having the ability to choose is part of a professional attitude and working enviorment.

jfpriutt, you thread title "Lazy Student Nurse Preceptors!" shows poor judgement and your lack of understanding of the nursing profession. Hospital staff nurses and agency nurses are employed to care for their patients, not to be nursing instructors. Who decided the agency nurse was to act as your instructor. I'm willing to bet it wasn't the agency nurse. You pay your nursing school to provide you with an education, you need to be writting about their lack of providing what you are paying for instead of critizing a staff nurse for not providing you with a service you neither contracted with him/her for or are paying him/her for. I realize nursing school can be diffucult, but you must remeber, it is the schools responsibility to provide you with the training you are paying for, not the staff nurse. I have never work in a nursing position which listed instructing student nurses as part of my job description. Each time I accepted an assignment as a nurse, I accepted responsibility for the care of those patients. I would feel uncomfortable assigning any of those care responsibilities to anyone I don't know, have limited knowledge of their knowledge level, and who is not employed or accountable to the facility I was working in. Were the heck was your nursing instructor? The procedures you were looking to accomplish should be completed with your instructor, not a staff nurse. I for one am willing to allow a nursing instructor to supervise patient care with a student nurse. They are afterall the nurse who's liscence you are working under. They know you and your knowledge level and are able to make an informed decision on what you are capable of doing. They are also working under the contract your school has with the hospital, so they have the accountability regaurding you. You may be an outstanding nursing student with a great knowledge base, but I know this cannot be said of all nursing students. To all of you who state there aren't enough instructors, you need to go back to your school and demand they provide you with the services you are paying for instead of demanding the staff nurses provide you the service for free.

Does the DON wear one? It sounds like big brother.

Document,document,document. Pts have the right to refuse treatment, but that comes with accepting responsibilty. Most insurance companies including medicare/medicaid, will refuse to pay the bills of a patient who has refused to follow medical advise. I can't tell you how many patients have come back to complain about their bills because the insurance company read non compliance or AMA on their chart and therefor refuses to cover the bill. With choice comes responsibility.

Here is a copy of a newspaper article which ran last week. Without having a teaching certificate, your prospects are looking dim. To have a full time teaching job plus complete the required class work and testing in three years or less is a real challenge. Also, you can only teach the subject you majored in, while working on your teaching certificate. Hiring new teachers could become harder under federal education law THE ASSOCIATED PRESS RALEIGH The state's plan to hire 100,000 new teachers over the next 10 years could be complicated by tougher regulations governing how long teachers without education degrees may take to get a teaching certificate. Under requirements set forth in the federal "Leave No Child Behind" law, "lateral entry" teachers - people who become teachers with a four-year college degree but no teacher's certificate - will have three years to complete the requirements for a teaching license. Currently, North Carolina's lateral-entry teachers have five years to take the classes needed for a license. Within two years, they are required to pass a subject-testing requirement called a Praxis II test. The state has promoted lateral entry, which allows people to move from the private sector directly to the classroom, as one of several alternative teacher-licensing programs. "It will be a significant change," Brock Murray of the N.C. Department of Public Instruction said of the federal requirements. "There may be more people who will not be able to teach." Traditional programs at the 47 North Carolina schools that offer education degrees haven't been able to keep pace with the state's demand for new teachers, graduating only about 3,200 new teachers each year. The state needs to hire about 10,000 new teachers a year to keep pace with increased enrollment, lower class sizes and normal attrition. Kathy Sullivan, also of the of public-instruction department, said that about a third of the state's annual new teacher hires come through lateral entry. Lateral-entry teachers generally teach in middle and high schools. In addition to compressing the time frame that lateral-entry teachers have to complete their licensing, the new federal rules will require them to have majored in a field connected to the subject they are teaching. For example, a math teacher will be expected to have majored in math. "The federal government is trying to make sure that for the most part, that regardless of any other training, the teachers have knowledge of the content," Murray said. Carolyn Anderson of the Lenoir County schools said that her system hires many lateral-entry teachers to work with children who have disabilities. Few education students specialize in that area, Anderson said.

EMTLA( what was cobra) covers the law regarding direct admissions and transfers. If a patient is transfered from a in patient facility, they cannot be brought to the ER of the receiving hospital unless they have had a life threatening status change while enroute. Nurses to Nurse report must be called prior to the patient leaving the original facility. If this is not done, the sending facility is liable for $ penalties, and the sending nurse can be disciplined by their BON for patient abandoment. The transfer form must have the name of the RN that received report and the room which is available for the patient. No inpatient can be transfered from a facility to another without an avialable bed. This does not prohibit ER to ER transfer., but nursing report must be completed prior to the pt leaving the original facility. A patient sent from a MD's office or clinic is different. If the patient has an order to be admited to a hospital, the admiting MD must write any orders he/she wants done in the ER and the patient must be evaluated by the admiting MD prior to being moved to the floor, not the ER MD. The admiting MD must also have privilages in the ER. Most ER MD's do not have admiting privilages and therefore they can not write orders for an admited patient. ER MD's also can only be consulted for life threatening emergency on inpatients when the facility has written protocols inplace. As always, there are some facilities that have special procedures which contradict these rules. Any patient who is a direct admit that is inapproriate for the unit they are to be admited to should have several things done. First, the admiting MD should be contacted and the situation explain to him/her. Orders to DC the admission and have the patient sent to the ER for re-evaluation and proper disposition should be obtained. An incident report with all the details should be completed. This will ensure the patient is properly cared for. But keep in mind, the ER is not a place to have IV's placed, labs drawn, xrays done, or admission paperwork completed. ER's are for the treatment and care of patients who have life threatening or life altering processes which require immediate treatment. I realize this is not always( almost never) your typical ER patient, but that is the way ER's are supposed to be.