LadyMonteCarlo

I am a phone triage nurse for a very busy cardiology practice. If triage you want, then, you will definitely get in cardiology. We have a very high acuity level. Yes, managed care especially for the chronically unstable CHF patients, B/P issues out the wazoo, arrhythmia heaven, AND you even get to break open the crash cart every now and again. Hope you find what your are looking for and best of luck.

I think that most of us older nurses originally got into this business because #1 We like to help people in need of care, #2 We would be able to find a job, #3 The rewards of seeing a gravely ill person recovering, etc. Money was never in the top 3 for me personally. However, looking back over the more than 35 years I believe the higher ups certainly have preyed on the compassion of nurses. In general, it has hurt the profession monetarily. No other profession requires the technical expertise, powers of observation, critical thinking abilities, flexibility, and team spirit required of nurses. With a nurse, you get the whole package that many professions only possess one or two of these qualities and tend to make much more than our female dominated profession. Patient dynamics have certainly changed in today's microwave society. Patients, families, superiors want it NOW or YESTERDAY. Rarely anymore do we received a simple thanks or I appreciate what you have done for what we do. Do you remember when those simple words meant more than any raise ever could? I do and it's a shame that plain 'ol good manners is a forgotten expectation in today's world. No wonder nurses are becoming more focused on "the money" than the service. I for one am in the twilight of my career and look forward to departing the profession and could not recommend the field to anyone anymore. Sad..

From the description it does not sound like a "code" situation, but rather a urgent response situation. There is a 4 hour window of opportunity for stroke symptoms to be treated with the clot busting drugs. Yes, time is of the essence, but if the patient is not experiencing cardiac or respiratory distress or absence thereof no code situation exists at that moment.

I applied for a position with WellMed / Optum via United Health Group in Texas. The advertised position is for Health Coach. Perhaps I have been a nurse for way too long, but to me a health coach assists chronically ill patients manage their disease by various means on a one on one basis. The advertisement said pretty much the same thing. Well, had my phone interview and i must say the recruiter was quite evasive. I asked if the health coach functioned as a separate entity in the office. (No their in the mix.) I asked if I would be taking all patient calls. (Yes) I asked if I would be expected to room patients (No, the CMA does that.) I asked if I would be handling all refills, test results, etc. (Yes) I said this sounds like a regular office nurse position. (No, it is a different posiiton.) Uh, what? Call me cynical, but it sure seems they have put a fancy label on a regular office nurse position. Now, that I think about it I guess I am a health coach because this is what I do everyday as a office nurse. No place in the ad does it describe office nurse duties, but focuses on the teaching / coaching aspect only. I consider this to be very deceptive, IMO. Anyway, the recruiter said she would move this forward and I should get a call from the hiring manager. I have no intention of leaving my current position for the same position elsewhere, but I am interested if they possibly will prove this position is what they are advertising.

I work in a cardiology clinic and have been there for more than 10 years. It does seem that after a long period the powers that be just seem to take you for granted, just feel no love and you seem to be invisible when it comes to raises (haven't had one in a few years), etc. Decided it's time to move on and have actively be sending out resumes for the last week. Landed a phone interview scheduled for today at 1230 with an insurance company for a telecommuting position, etc. (It went very well.) THEN At 1100 this a.m. - 2 dozen beautiful roses showed up with a card addressed to me personally and also included notable mention to the other staff from a patient thanking me for all of my help and professionalism...........damn...., just when I was ready to go they pull me right back in. At the end of the day, those roses and kind note were worth about a million bucks to me.

Insurance deductibles and overall coverage is holding up a lot of procedures. Wonder how many of the emergent STEMI cases had positive nuclear studies and did not schedule a cath? In any event, it does seem cath cases fluctuate and just when you begin wondering where all the patient's are, they show up and you are slammed.

One thing I forgot to mention that all nurses considering taking to plunge with Maxim should be aware of, there are some things they won't tell you for sure. I am in Austin, Texas and when I accepted my first assignment with Maxim it was working in an Assisted Living Facility. I received one day of orientation with another nurse working, of course, side by side with this nurse for this large facility and after that I was on my own. Well, when I got my first check, guess what? For that day of orientation, I was paid minimum wage!! Man, I was ticked off and when I confronted Maxim about it they said, "Oh, we didn't tell you about that? I'm sure we must have." Yeah right, and I am sure the rest of you nurses would be more than happy to do any shift for minimum wage, orientation or not now wouldn't you :)? When I am passing meds and rendering patient care regardless of the circumstances, I expect to be paid nursing wages, IMO. After all, if I screw up it IS my license. That should have been more than enough for me, but hey I'm a real die hard and love being taken advantage of until it is obvious it will never stop. Maybe this only happened at that one office in Austin, but it may be happening all over too. Never know if you don't bring it up.

We have all been there many times over. One thing I have certainly learned over my 30 year career is that sticking it out and hoping things will get better just won't happen, unfortunately. Considering leaving the profession because of your current circumstances is, also not an option. Well, it is if the only reason you became a nurse was because of being able to get a job. It's tough to become a nurse and only the tough students make the grade and get through it. None of us labored through all that crap we went through in school just to have our license flash before our very eyes every time we walk into a patient's room. No need to throw in the towel just yet unless, of course, you really hate being a nurse. If you are miserable in your job, then, get another. Explore your possibilities, but never, NEVER burn bridges. As a nurse, the world really IS your oyster, IMO. There are so many areas to delve into with this profession and there will always be the really bad experiences. In the end, you WILL find your niche and leave each day behind with a sense of fulfillment in the knowledge that you have done your very best to render the best care that your assigned patient's could possibly receive. It's tough, I know, but you must remember in school you were taught with idealistic approaches. Now, you are in the "real" world and it is nothing like you dreamed of, right? Of course not! However, those instructors were producing nurses with the thought, "AS IT SHOULD BE." Make it so, for your profession, for yourselves, and above all - FOR YOUR PATIENT's. Your patient's need you fulfilled too and if you are not happy how can you truly fulfill their needs? You will get there, but not overnight and not quickly though you may get lucky. However, wallowing in despair has destroyed the compassion of many so get out and move on. Accept defeat PRN and prosper in the knowledge you gained from the experience. Best of luck to you all! Now pick yourselves up and dust yourselves off. Then get out there and kick some serious butt by taking care of those in dire need of a NURSE! I have been there on more than one occasion and I'm STILL HERE.

Maxim picks up posted resume's from Monster and Careerbuilder, etc. Then, they start "cold calling" nurses. I mean they call like a debt collector would call -- everyday, sometimes several times a day. No need to be flattered about the call, they do it to everybody that they can get their phone number from. They put a lot of pressure on and refuse to take "No Thanks" for an answer until you finally tell them to stop calling. This should be a definite warning to all nurses that you don't want to deal with any business that has this type of approach. Several years ago, I actually bit and signed up with them for about 2 months doing some assisted living type visits on the side during weekends. I found that during the work week they would contact me at my full - time job quite often. When I told them I was working and would have to call them back, their instant response was always, "Oh, this will only take a minute." Then, they would proceed like some kind of telemarketer and bend my ear for 15 minutes about some potential assignment without one bit of concern that they were disturbing me at my regular job. I told them I had to have one weekend off after 2 months of every weekend without relief for personal reasons. Well, it seemed that it was just IMPOSSIBLE for them to do anything about it and I HAD NO CHOICE, but to work for them that weekend. So, I basically told them to stick where the sun don't shine and never went back. To this day, these clowns will still occasionally call me to see if I would like to do some shifts with them. Complete LOSERS. I have been on the playing field for over 20 years and this was one of the worst employment experiences of my career.

If you work in a doctor's office you know that you are the one that writes the prescriptions, fills out all of the disability paper work, etc., and the doctor simply signs on the dotted line. I would like to throw out this scenario that happened recently in my office. Patient calls and reported that both she and hubby take the same medication, same strength and wanted a new prescription. However, she only wanted one prescription with double the strength so the both of them could split the pills. This way they only needed to pay for one prescription. Now, granted, this at first appears to be a reasonable request. If a doctor writes a prescription knowing the strength is double the prescribe amount to save the patient money, is it legal? But wait, the doctor never writes the prescription they only sign it, the nurse writes the prescription. I am all for helping saving patient's money, but not at the cost of potentially jeopardizing my license in the process. To go one further, if the doctor writes the prescription for one patient at double the strength knowing that this prescription will be shared by two patient's ??????????? It is against the law to take medication that is not prescribed for you. I really dislike being put in the position to say NO, but ethically / legally I feel this isn't right. What say you all?

We had an elderly dementia patient in an assisted living facility with a wrist fracture that slipped his cast off of his arm. Obviously the swelling had subsided enough to allow this self removal. Slipped off as easily as a glove. What would be the best immediate action to take?

This company has no probationary period. Once hired your theirs and they are yours. However, I am in Texas and their handbook does state that they are an "at will employer" which means either party may break ties at anytime for any reason with or without notice. That's what it says in the handbook in one part and then the other requires 3 weeks notice.

I have been a nurse for 27 years and have always given proper notice when I left a position. However, I signed on as a Resident Services Director for an assisted living facility about 3 months ago. Before I accepted the position I was told "what a contrast it was from long term care", "would be able to go home at night and actually have a life". Nothing could be further from the truth! ALF is in fact much worse from a liablility standpoint for a nurse. I'm working 11 -12 hour days and usually get my first after hours calls within 3 blocks of the community when leaving. I have had 5 full days off in 3 months. I am dealing with a much less than professional or qualified staff than in LTC and I keep seeing my license flash before my eyes repeatedly. I was deceived into accepting this position. The wool was most definitely pulled over my eyes on this one. I've decided to throw in the towel before I do in fact lose my license. The company I currently work for requires 3 weeks notice minimum for a person in my position. In my opinion I don't and won't need them as a reference with my extensive experience and long work history with former employers. I plan on returning to my previous employer. However, I do need to give some notice because ethically it is the right thing to do. Just can't justify the full 3 weeks. I was thinking more like days. The question is: How much notice should I give? They advertised for literally months before I was suckered into accepting the position. I'm sure that they won't replace me in 3 weeks time. I'm ready to go NOW!

It was reported to me recently that one of my staff has voiced concern in more than one instance of resident's on their unit being racist. Now mind you this is a special care unit with dementia and Alzheimer's residents. My immediate thoughts on this matter is that the staff member is most likely not suitable to work on this unit. Yes, perhaps remedial training may be benificial, but not likely as this staff member has been there for more than a year. Management team members have said, "Employees have rights too." Yes, this is true, but we all must remember the type of resident we are caring of in this instance. I am very new to my position and have continuely encountered instances of the absence of training which I'm sure I can correct in time. For now I need an immediate resolution to this particular issue. What say you all?

If you would like to try LTC I would go with SNF rather than ALF. New nurses are not ideal for AL due to lack of experience. It takes a very healthy knowledge base that can only be gained with years of experience to properly assess and care for AL residents. However, SNF's would offer you plenty of hands-on experience such as: tubes, catheters, pumps, treatments etc. I wouldn't recommend remaining in a SNF as a new nurse for more than 1 - 2 years simply because things become quite repetative after a time. Explore all of your options. The door is wide open in most areas. Best of luck.