carrie13

Hi everyone - I work for a small community hospital (non-profit, non-union). We had a staff meeting today where a new hospital-wide vacation policy was introduced. This policy does not cover "prime-time" summer vacation (Memorial-Labor day). It only applies to time off from Sept-May. Prior to this policy the protocol for requesting time off was to fill out a time-off slip and submit it to the manager. You could request vacation time months in advance and usually would receive approval within a few weeks of request. The only limitations were no more than 2 consecutive weeks and you could not request your assigned holiday off but could find coverage for your holiday. The new policy as of today is that time off for vacations or random days off can only be requested during the "schedule planning period". So for example the next schedule is 11/8-12/19. The request forms will be available 9/13-9/26. On 9/27 the schedule is closed and no more requests can be made. Management then has 2 weeks to finalize the schedule and it will be posted (and vacations approved/denied) by 10/12. Is this a common vacation policy? It will be pretty much impossible to plan any vacations more than 2 months in advance. And then to find out only 1 month prior to the vacation whether or not you are approved. I'm curious to hear if anyone else has experienced this and how you go about planning your vacations...

I've worked for the past 8 years part-time in an acute setting (telemetry/PCU) and the past 3 years part-time in homecare. Like others have mentioned there are skills that you perfect in homecare which you do not get as much exposure to in the hospital setting. In homecare I have had patients with trach, ostomy, feeding tube, etc. In the hospital setting those patients (at least on my floor) are not very common. Also at my hospital we have Respiratory therapists, IV nurses, wound nurses, etc. In the hospital I have never given a nebulizer treatment, started a peripheral IV or developed a wound care plan. All of those things I have done in the home setting... As a fellow Boston-area nurse I would say take whatever job is offered to you because this area has a very tight job market for new grads. Any experience is better than no experience. If this agency does not have Pedi homecare - get some experience through them and in a year transition to another agency that allows you to work with pediatric clients.

I work per diem at two ambulatory endoscopy centers. Both require patients to be able to walk in and out of the facility on their own. Occassionally we will have a patient that requires a wheelchair ride to the car but minimal lifting in terms of pre-op and post-op care. In our procedure rooms you may have to help roll or reposition a patient - keep in mind that these patients are sedated and are not able to assist too much with moving. Also - depending on how your doctor's scope - the stretcher will most likely be elevated to their standing position so it can be hard to get the right body mechanics to move a patient without straining yourself too much, especially if you are short like me :) We do have the MD, 1 RN and 1 tech in the room so rarely will you have to reposition someone without help. You may also be required to push the stretcher from the pre area to the procedure room and then to the post area. I also work 7am-7pm on a busy telemetry/PCU. I've found sometimes that my back hurts more when I work per diem in the Endo center. Probably because we are standing 90% of the time and when in the procedure room not really moving around too much as you are monitoring the patient.

My tele unit has regular tele beds and 6 PCU beds. The PCU trained nurses will occasionally have to float to the ICU but if you are not PCU trained they will not float you.

My unit has 25 tele beds and 6 PCU beds. Tele is a 4:1 ratio with 2 aides and 1-2 secretaries. PCU is a 3:1 ratio with 1 aide and no secretary although the tele secretary will help out if she has time. The PCU nurses also watch the monitors. There are 2 PCU nurses on every shift and each has to watch the monitors for their own 3 patients plus the monitors for half of the tele patients.

I've worked all shifts at my hospital. I started out 3p-11p and really liked the work of the shift - fast paced with lots of admissions and discharges. But I had no life outside of work - all of my friends work a normal M-F day shift and I was missing out on so many get togethers because I was always at work. I tried nights for a while but I found that I can't sleep during the day and was always dragging. Just couldn't adjust to the schedule. I still pick up a few overnights here and there but couldn't do it on a regular basis. Right now I'm working 7a-7p. The day shift is crazy busy and very fast paced. Of course it was a pay cut since I'm losing come of the 3-11 differential but I have a normal life now and can actually meet up with friends after work. I picked up a 3p-11p shift last night and walked in to 2 discharges, 1 admission and a patient who had to go monitored to a test so I had to be off the floor for 90 minutes with my patient. All at change of shift. I definitely don't miss nights like that!

Type of Hospital: community Type of Unit: cardiac telemetry, occasional surgical tele overflow from another unit. Number of beds:25 telemetry - divided into 2 wings (12 pts and 13pts per wing) and 6 PCU beds Number of patients each RN has:usually 4 pts per RN except one nurse gets 5 patients since we have 25 beds. We try to rotate who gets the 5th patient. For PCU the ratio is 3 pts per RN. Do you have a nurse's aides and/or at what census level do you downstaff an aide: We have 1 aide for each wing plus PCU. So the wing aides get 12-13 pts each. PCU aide gets 6 pts. Very rarely do we downstaff but a lot of times our aides get pulled for 1:1 observation or we are short an aide. Do you have a unit secretary and/or at what census level do you downstaff the sec'y: yes, never downstaffed.

We don't get holiday gifts at my hospital. For nurses week we got dinner served and candy delivered to our breakroom.

At my hospital anything over 40 hours per week or over what you are hired to work in a 24 hour period is overtime. So if you are hired for 8-hour shifts and work a 12-hour shift you would get 4 hours of overtime for the extra 4 hours worked. So in your situation it would be overtime from 11pm-midnight only. Then the next 24 hour period would start and it would be base pay from midnight til 7am.

I'm in a small non-profit hospital in the suburbs of Boston. I make $25.50/hr. Evening differential is 12.5% and an additional 10% on weekends.

I'm on a cardiac tele floor. day and evening shift is 4 patients, rarely 5 if we are short. Night shift is 6 patients. We have aides that cover 12 patients.

I work on a cardiac floor - we have 4 patients per nurse on days/evenings. On nights each nurse has 6 patients.

I make $24.75 base with a 12.5% differential for evenings and an additional 10% differential for weekends...so about $27.80/hr during the week and $30.32 on weekends. That is for a community hospital outside of Boston. I have about 6months experience and work on a cardiac tele floor...

I felt tired and had a temp around 101 for a couple days after my flu shot this year.

just a guess but maybe "direct observation unit" ???

I'm going to a cardiac tele/PCU floor. A lot of my fellow classmates got jobs in telemetry. A couple were paramedics and went right to the ER. Some went to nursing homes/rehab and the rest ended up in Med-Surg.

I interviewed for a job in a medical telemetry/PCU. I can tell you a little about the medical floor from what was discussed in my interview. It is a 24 bed unit for medical telemetry and 6 beds for PCU. The ratios for the medical part are 3:1 or 4:1 max. The PCU ratios are 2:1. Techs usually have a ratio of 8:1 but they don't cover the PCU beds. The unit is pretty heavy so lots of sick patients. It is considered a step-down from the medical ICU. Lots of post-ops that can't go straight to med-surg, respiratory problems, etc. They do stable vents on the PCU but unstable vents go to ICU. I accepted a position at this hospital in cardiac tele/PCU. But my friend will be orienting on the medical floor next week. I'll let you know if she has any more info to share.

There were volunteers on the floor where I did one of my clinicals. They escorted visitors to patients rooms, helped the secretary with shredding, filing, making copies, etc. Did supply runs if transport was not available, helped to re-stock supply rooms or linen carts. I think how much they helped depended on the volunteer. There was one woman that had volunteered on the same floor for years and knew the routine and what to do. There were others that needed lots of direction and got in the way more.

I was 28 when I graduated in December '06

I will be orienting on a cardiac telemetry floor that includes a PCU (progressive care unit). My unit is strictly cardiac so lots of MI, CHF, etc. It is organized into 2 wings with 12 telemetry beds in each wing and 6 PCU beds directly across from the nurses station. The tele ratios are usually 4:1 on days/evenings and 6:1 on nights. The ratios for the PCU are usually 3:1 but sometimes 2:1 depending on the patient acuity. The PCU on my floor is considered a step-down from the CCU...and also as a stepping stone for nurses who want to get into the CCU. The CCU won't hire internally unless you've worked at least 1 year on the PCU. My hospital also has a medical telemetry floor which may be similar to what you were offered. It is basically anyone who comes to the hospital for a medical reason that requires cardiac monitoring. So you have post-ops, respiratory, etc that also need telemetry. Basically everyone who needs telemetry that is not admitted for an acute cardiac event. This unit also has a PCU and the ratios are better but the patients tend to be sicker. I think the max is 2:1 on the PCU and 3:1 on the floor days/evenings and 4:1 on the floor for nights. It is a very heavy floor but gives lots of experience and exposure and is a great transition place to get into ER or a medical ICU. Good luck!

I don't want to hijack the OP's thread - but I am starting orientation on a tele floor in 2 weeks and have had some reservations about not getting as much exposure to all the different conditions I would see if I started in Med-surg. Thank you deeDawntee for your post. You have *convinced* me that tele is the right place for me to start. I am printing out your advice (and kind words) to take with me to the hospital. Thanks again!

I am a new grad and will be starting orientation in 2 weeks. I've been talking with many of my classmates about their orientation experiences and not one person I talked to has had more than 1 patient in their first 7 days. One of my classmates has been on orientation for almost 6 weeks and just now got bumped up to 3 patients. I think you are doing extremely well to be able to take half of an assignment after only 7 days of orientation! Hang in there....you are doing fine! Good luck with the rest of your orientation!

I work for a healthcare IT company. We have an office and I split my time between working in the office and working at home. My schedule is M-F 8:30-5:30 but I rarely stop working at 5:30 - usually work til about 7pm and then check in a couple times for email, etc from home.

Yay! Congrats!

My current position in nursing informatics is salary. When I start my new job on the floor in a couple weeks I will be hourly. I work in a business setting so some of this may not be applicable for the hospital setting but here are the perks of salary at my current position - guaranteed pay - allows for easy budgeting because pay is consistent, not scheduled to work weekends/holidays, fairly flexible schedule - no penalties for missing work due to doctor appt, etc, don't have to clock in/out, I'm not relieving anyone when I come in so if I'm a couple minutes late its not a big deal. The biggest con (literally) of working salary is that you don't get overtime. I can't tell you the last time I worked only 40hrs in a week. We are so busy (and understaffed) that I'm often working at least 50hrs/week. I can also share my mom's experience. For many years she was the salaried director of the OR at a community hospital. She was paid very well but was on call 24x7 for managment issues and usually worked 9-10hr days. She had many nurses under her who were making more than she was because of all their overtime/call pay. There was one nurse who made almost twice as much as my mom because she picked up overtime and call whenever she could.