Tami707

Thank you everyone for your replies. We, all the Charge Nurses, have requested a meeting with our Manager, the DON, and CNE to discuss this. The consensus among us, is that this is an unsafe, as well as a license jeopardizing practice.

Wondering if anyone else has run into this and what you have done. I work in ICU and am frequently assigned as a Charge Nurse. In addition to unit resource, Charge nurses are a member of the RRT/Code team. But they are also responsible to break other nurses when there is not a break nurse. Previously, when there has not break nurse, we have called the house supervisor and let them know that we will have a patient assignment and will not be able to attend the Code or RRT until the other nurse has returned. This past week, both the DON and CNE have stated that it is their expectation that Charge nurses leave and attend the code regardless of breaking another nurse. They stated that Title 22 (California) allows for this in emergencies. There is a section in Title 22 that reads: "The hospital shall plan for routine fluctuations in patient census. If a healthcare emergency causes a change in the number of patients on a unit, the hospital must demonstrate that prompt efforts were made to maintain required staffing levels. A healthcare emergency is defined for this purpose as an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to healthcare delivery requiring immediate medical interventions and care." The BRN however, does not have any such allowance. If one has accepted that assignment, then severed that assignment without first giving "reasonable notice to the appropriate person (eg. supervisor) so that arrangements can be made for continuation of nursing care by others" that is patient abandonment. Neither ICU staff or our manager is comfortable with his new expectation, but our manager feels their hands are tied, and we must follow the directive. I disagree. I believe the argument can be made that RRT & Codes are not unpredictable or unavoidable in a hospital setting. We are not willing to put our license in jeopardy; I know I will flat out refuse to leave patients under my care, but know others won't. Has anyone run into this problem before? How did you handle it? Thanks in advance.

Do you have any type of Professional Performance Committee or Staffing Committee that nurses sit on? At my hospital, the Charge is a, mostly, rotated assignment. Some senior nurses won't do it, and new grads are not allowed. The Charge does not have an assignment, but we are the Code team, Stroke team, Sepsis team, etc. Not only do we resource and manage bed control in the unit, but we also resource the other units in the hospital. Except ED, occasionally, we may get called to a code there, but it depends on their staffing. We do not take an assignment for those reasons. And are to call our manager if the House Supervisor wants us in the count. Sounds like it's time to start a petition among nursing staff about the Charge position not being utilized in an appropriate manner, or start a PPC or Staffing Committee to change this to a more resourceful position.

I work in a mixed med-surg unit, so we get pediatric patients occasionally. One of our surgeons, will leave the open appys open after surgery and have us clean them qXhrs. Usually this means re-opening the incision when we clean it. I've tried searching for a benefit to this technique but am unable to find anything. Any hints or pearls? Thanks.

I finally have an interview scheduled, and I've done the research on the typical questions (thanks for the stickies!!!) But, this hospital is going to have me walk around the floor with another nurse - not delivering patient care, but I am trying to anticipate how that may go. This is a 30-bed med-surg unit, with a good mix of patients. More critical cardiac, neuro, etc are sent to another hospital an hour away. There are some chemo and dialysis certified nurses that work there as well. Any ideas? p.s. I graduated in May, I have my license (yay!), and I am scheduled for ACLS in September. And I am extremely NERVOUS...

I just have to add my two cents. I've lived in Cali my entire life. I'm currently in Nursing school, my husband is our sole support and we are raising two kids on less than $35,000/yr in a rental house in Northern California. We literally scrape by each month. BUT, when I graduate, I know that my starting pay will be at least $40/hr. and life will be much easier. California is doable. I can't even think of living anywhere else, it is definately, to me, the most beautiful place on the earth. Good luck, you CAN do it.

Thanks for the slap, I stopped hyperventilating long enough to think again. I ended up writing most everything as an abdominal mass, but I did pull out the information that doctor used to come to her conclusion of colorectal cancer and focused the patho portion on that. I hope my instructor apppreciates the effort! T

UGGGGHHHHH, I received a ptient today with an admitting diagnosis of Abdominal mass. I need to do a pathophysiology on that diagnosis, with all the related stuff: diagnostic tests, etiology, signs/symptoms, medical management, nursing imlications, and health care deviation requisites. My problem is; is that I know what the end result was, but I need to do the patho on the admitting Dx, and that (abdominal mass) is too braod that I am having a hard time narrowing the focus inot something that is clear and concise. Any kind words or suggestions. Or even a slap on the face to tell me to get over it? Thanks, T:uhoh21:

I had to take Bio before I could get into Anatomy, and Chemistry before Physio or Micro. I took Bio one semester, chemistry the next, followed by Anatomy, then Physio, then Micro. It took me longer to finish all the prereqs but by taking only one science class at a time, I found I could focus on difficult concepts better. At our school, having Anatomy before Physio definately helps. Hope this info helps!

HI BPO93, I took Micro last summer. It was 5 hours everyday (mon-Thrus), 3 hour lab, 2 hour lecture, with a two hour break between them. I spent the time between lab and lecture studying (and eating dinner), as well as using every moment when I was not in class, also studying. My daughter had swim lessons, and I would take my book along to pre-read the chapter, then afterwards we would go to the library, where I would do my homework - my family spent A LOT of time at the library last summer! My advice would be to structure your time so that you are spending adequate amounts in both classes. I just finished terminology this semester and it was more work than I had anticipated. If your book comes with a CD, use it. Mine had exercises and pronunciations on it. If you find that you can not spend enough time studying for both, drop the terminology class and take it at a later date. But really structure your time and STICK TO IT. If you have family, make sure that they know your schedule, (so that they can see the light at the end of the tunnel) as well as scheduling in special family time in as well. SUmmer classes can be a challenge, especially if you take more than one, but are definately "do-able" if you plan.