RNchemo

Hi Susu08rn, I haven't worked at WAH, but was a patient on one of their med-surg units. From the perspective of an RN who was a patient (it is the closest ER to my house) I have to say that there were many areas that could stand to be improved. However, they will be moving to a new facility (White Oak?)in the near future, and that will likely change things. The nurses who cared for me ranged from having terrible practices to being quite good. There were 2 RN's during my 3 day stay that I felt "safe" with and could relax and not have to watch them like a hawk. I had to ask several to wash their hands and watched one loop my IV tubing into and unclean port and then try to re-hook it without cleaning my hub. Not cleaning IV hubs before attempting to attach IVPB tubing or flush was observed as well. Yikes! I would advise you to look before you leap. If it works out at WAH then be selective in your preceptor. Good Luck!

Hi AAMC nurses, I was hoping that you could take a moment and share a little bit about your experience. I know that AAMC has a very nice new facility, that morale was low during the expansion due to a salary freeze, but that raises have been re-implemented and the new units have opened. So, how is it now? What is the computer system like? (I'll admit that I love paper charting, it's so quick!) Is it easy to use and can you do it in a timely manner? Is the "nursing environment" nice? Ratios, pay, PRN rates etc..? Of particular interest is the oncology unit, but I'd be happy to hear from nurses, CNA's or students on any of the units. TIA!

Like anywhere, hospitals here are different unit by unit. For example if there are 3 different ICU's there may be no turnover in one and some problems in another etc.. Visiting is key! I have a friend who did her senior preceptorship at WHC's cardiac ICU and LOVED it. She said that it was impossible to get in though and ended up at a community hospital ICU. I would not recommend the ICU at Holy Cross. She was often given 3 critical patients, the charge RN almost always had an assignment, and they got rid of the techs. Yikes! If I were you, I would investigate: GWUH George Washington University Hospital (university hospital, on the metro, some scholarship avail) have heard that the ICU is quite big and there is some floating/ moving around as opposed to a small cohesive niche type unit. It is right smack in the heart of the city and an exciting geographic location. Apply online, they will e-mail you and schedule a phone screen, they then fwd your info to the mgr, and e-mail you to schedule an in-person day. Nurse Career Battery exam is required and given on site. You could go ahead and set this up pretty far in advance I think. GUH Georgetown University Hospital (university hospital, magnet, great education benefits, outstanding clinical ladder) it is not a trauma center, but having been around the block a few times since I worked there as a new grad, I have come to really appreciate the environment at this hospital for nurses. Lots of opportunity for learning and sweet sweet education benefits at a top uinversity. When I left they were building a lounge for RN's. There is emphasis on best practice, nursing research shared governance etc.. Mostly BSN educated RN's from middle and upper middle-class backgrounds. Of course there are the usual nursing headaches. I've learned that there are problems everywhere, but not necessarily the same benefits that GUH offers. The nurse recruitment office is very friendly! You don't have to apply to speak with someone on the phone. Nurse Career Battery required; done at home via link e-mailed to you a day or so after submitting your application. If you pass your file is then sent to the unit manager and a visit is scheduled. PS There is no cardiac at GUH, hearts go to WHC WHC Washington Hospital Center (trauma center, cardiac, huge urban hospital) located in a grittier part of town and I have heard vastly different things depending upon the unit. Some are AMAZING and others pretty bad. I haven't applied and would encourage you to visit etc... because there is plenty of critical care here. They have shuttle service from the CUA/Brookland metro station I believe. Pay is supposed to be the best in the city r/t being a union hospital. INOVA Fairfax, big hospital big trauma center in NOVA which is a very nice family friendly place to live Finally, if you love trauma, you can't beat Baltimore Shock Trauma Hospital. They are one of the best in the nation as I understand. You could live east of the city and commute to Baltimore easily. Typically I would advise you to live in NW DC, NOVA, or Montgomery County Maryland. However if you went the shock trauma route, then I would be happy to tell you the nice pockets in PG county that would make b'more/ washington flexibility possible. Good luck! Sorry so long.

Recently I realized that most hospitals in my area require the NCB Nurse Career Battery exam prior to granting an interview. The test is designed to identify non-clinical aspects of an applicant such as dealing with conflict, communication, and work ethic etc.. I was surprised to find that there is not much information available about the exam. Neither Google nor searching this site turn up any substantial information besides a link to the company's PDF DDI research, best practice articles and case studies | DDI that explains the gist of the test. We are all in this together, and I think that this thread should be a place where people can share information, discuss the exam etc.. One question that I have is wether the test considers going to the nurse manager negatively or positively. For example, one question asks about how you would deal with being oriented by an impolite co-worker who doesn't handle admissions and discharges effectively. One choice was to ignore the behavior and continue working as usual, the other choices involved various changes or interventions. Do they want to see that you can just get on with it/ grin-and-bear-it, or that you are pro-active in appropriately altering the situation to get the learning experience necessary (ie- ask mgr if you may have the opportunity to go through admission/ discharge with another unit nurse)? Another aspect that the exam coves is how nurses deal with uncertainty. In the exam there are questions about how you feel about ambiguity (ie- do people who take a long time to make decisions bother you, is it troubling to you when someone says something that can mean more than one thing, do you have to know why something has happened right away etc.) It is unclear to me what they are looking for precisely. I think that uncertainty is tolerated very differently depending on the circumstance. It is a huge problem if a provider's instructions for patient care are uncertain. At the same time, being flexible and willing to quickly adapt to new clinical units and situations where you need to work well with unfamiliar team members is desirable. If anyone has a handle on what they are looking for in this regard, please say so! Also, is it pass/fail or are they looking for a certain score? Please contribute to the discussion. As nurses we need to help one another and keep up with what's coming down the pike!

OK, I should have asked if you are concerned with schools or not. Generally, DC public schools are quite bad. There are some excellent charter schools in the district though, and some of the schools in affluent NW DC neighborhoods are good as well. In Virginia, Arlington, and Fairfax counties both have some great schools. In the MD suburbs Montgomery County has many good public schools. Salary wise I am not sure how much someone with 8 or 9 years of experience is paid. Several years ago new grad pay at Georgetown I believe the pay was $28/hr. I am confident that both critical care and years of experience would bump that up but have no idea exactly how much. When I worked at G'town, I loved living in Rosslyn, VA. It the the part of Arlington immediatly across the Key Bridge from Georgetown, Foggy Bottom, and the bottom of the National Mall. Just a bit further up in Rosslyn is Clarendon which is great too. These ares have mostly condos, apartments, and a few super expensive town houses and homes. There are nice amenities, it is quite safe, and you are one stop via Metro from GW, the G'town shuttle picks up at the Rosslyn Metro station as well. GW is hands down the most convinent location, but I haven't worked there so can't speak to the pay or environment. Georgetown is a place that I didn't fully appreciate until I saw a bit more of what is out there. They are a Magnet facility, and do a lot in terms of staff education and having opportunities to advance without leaving bedside nursing. Check out there clinical ladder. There are 2 or 3 ICU's and I would visit each unit to check out it's culture. The facilities are old and outdated. G'town is in an excellent neighborhood, but not easily accessible except by car and you have to pay for weekday parking. Neighborhoods close to the hospital are Georgetown, Foxhall, and Glover Park. All expensive, and all nice. Suburb wise, in close-in Virginia, prices are around $800K that goes down as you get further out. The Maryland suburbs really aren't as convenient to G'town and GW in my opinion. GL!

Hi, Well, yes the DC area is pretty expensive, and the pay is not as much as in CA. To get an idea of rent, I suggest looking at Craigslist. If you are looking to buy and can afford it, this is actually a good time as housing prices are down. If you write back about which hospital you are thinking about or where your family member will be working I would be happy to give you a better idea about the areas near that location that are good to live and an idea about prices. If you have 2 incomes you will be fine. Also, not sure if you are looking to be full time, PRN etc... GW pays critical care float pool RN's $55/hr.

My take on Magnet is that for the most part it is steam mgmt loves to blow. There are some good things that have come of it, however, such as a new clinical ladder that ties annual financial bonuses to each step you go. Also, Magnet has forced the admin to make a place for advanced practice or masters degree specialist type nurses by having a position levelfor them and pay. Previously, nurses would take advantage of the tuition program at GU, receive a MS and then have to work somewhere else because the hospital had no position for such nurses! Those who stayed continued on in their same capacity on the floors in my observation. The change has not occoured yet, but at least there is a plan and things are starting. There are also different 'shared governance' councils and things of that nature. That said, it is not a magically different placce. GUH faces the same problems as many places. How many times as a nurse have I fet the frustration of wanting to ensure patients receive my time and attention to the details that keep them clean, happy, and informed, but have to settle for hitting the highlites as I am faced with one urgent task after another. Three patients on the call bell at the same time that someone is waiting to be discharged and a physician is on the phone wanting to give a verbal order or follow up on a more acute patient. Oh, and routine meds are all due too. Who needs and deserves the nurses attention? They all do! Can I do it all at once? No! This is where prioritization comes in, and if your need is ranked last, (often routine oral care checks fall in this catagory) it is undertandable that this is unsatisfactory. Nurses, patients, and families everywhere face these challenges.

Hi RNing, One or two new grads were hired into ICU last year, so 1 year of stepdown experience should be even better in my line of thinking. AT GUH they do have a orientation/ preceptor time on all units where you are not counted in the staffing and have a 1:1 preeptor. Anytime you switch to a new area or higher level of care you should receive this.( They usually want 2 years of service in exchange for the training but it is a 'verbal understanding,' not a contract that you sign.) I am not sure the length of orientation time for ICU. Also, there 3 ICU's Neuro, Medical, and Surgical. I am not sure how 'strict' the segregation of pt's is, but they are physically seperated, not one long unit. GUH is a "srtoke center" and patients are flown in from outlying areas. I would suggest visiting and shadowing. They will let people shadow so you would need to get in touch w/ the manager or have nurse recruitment set it up. Then you can talk to the RN's on the floor and get the real skinny. Also, at this time of year spots may already be filled by newbies, so I would call. DC affordability depends on wether you are supporting only yourself, single parent, have a spouse who is working also etc.. Most of the nurses live in Arlington. You can get a feel for the high rent rates on Craigslist. Goodluck!

Hi Yall! Trying to find out the staffing ratios for mother baby couplet care at dc metro area hospitals. If you know please post or ask a friend who works in that area:):redbeathe Thanks! I'll start with what I know: Sibley 1:4 or 1:5 couplets

Thank you for your post smile123! Technically I do have a preceptor for the first 3 months, but I am really on my own. Each nurse has 5 patients, which sounded great when I interviewed, but I did not understand the acuity. Community hospitals send us difficult cases, and many people who have been failed by their treatmen come. Anyhow, my "preceptor" gives me three patients and she takes two. Then unless I hunt her down that's pretty much it. A few times throught the day she will say "how are things going?" except she is irritated unless I say things are fine. She sometimes shows me technical things like D/C ing the PCA but is very hands off. Yesterday was my first big dressing change and even though I asked her to come with me, she was busy and said that I could do it. I was in there pulling silver dressing stuff out of a crater going down to the bone, and re-packing it for 45 min. I'll just see how the shadowing goes and check on the pay issues that you brought up. Thanks again.

Hi yall. One month in as a new grad. Thinking about a unit change and want to hear what you think. Here's the situation: Feel overwelmed by the acuity of my pt's (solid tumor onc @ busy teaching hospital) and that I just run from one task to another and am totally unable to have time for the big picture. Today and everyday by 10am there are long lists of new orders on everyone. I haven't had a day without one pt going down and needing ny undivided attention and stat PCXR, EKG, and so on! When I am with them, everything else scheduled for others goes to pot. Our unit staff is predominatly nice with a very few brisk people on staff & very nice managers. It is not the staff, it is the STRESS. When I am in the shower, lots of hair literally falls out. I have lost weight too. Today I got home and realized I did not chart one of my pt's assesment! Spent the day titrating his O2, drawing stat labs, starting vanc dealing w/ pain and it is not written down. Called the charge and talked to her. Will late entry tomorrow. I was first in my class, a real type "A" and screwed up nursing 101! Move downstairs to radiation. They are inhouse and do radiation onc for both in and outpatients and are looking for some new nurses as the facility is expanding. Main tasks involve pt and family education, some basic IV fluid rehydration, nursing assesments, and more office style nursing. I worked outpation onc as a student and loved it. Love the pace and continuem of care; seeing pt's and families over time. I am going to shadow for 2 days. Talked to my nurse recruiter (they're awesome!) and they said that past new grads felt that they "lost skills" not being bedside RN's. I am still interested. Thoughts anyone?

Hi all- I am glad to hear that jenrn11 had a good experience. I, however, was NOT impressed with George Washington University Hospital's HR this past week. I asked about the nurse to patient ratio on the different medical floors and was told that only the managers knew and that it was different everywhere; perhaps 1:5 or 1:6 -I could ask if I had an interview. My next question was about their use of primary nursing model on the onc unit . Could she tell me about how this nursing care is implemented at GW and how it is unique in their facility? She did not know anything about primary nursing and, once again, said only the managers knew. This frustrated me. On the premotional CD-rom about nuring at GW Hospital (which is also posted on the website) they say that surgical onc unit offers ' a low nurse to patient ratio and utilizes primary care nursing.' I would not call 1:6 a LOW ratio and feel that if a hospital is going to advertise a specific model of care or low ratio, that they ought to know about it and actually have it! Do you think that I just caught the wrong person at the wrong time? When I spoke with Georgetown, the difference was night and day. Their organization, knowledge, and response were phenomenal. The recruiter was cheerful, efficient, and put me right in touch with the correct people. I am looking foward to interviewing there.

Scully, Thanks for the information about George Washington's ICU internship. It sounds like a great challenge. I am moving to DC after graduation this May 2007 to join my soon-to-be husband:) It is difficult to get a "feel" for the programs and hospital culture without being able to attend those open houses or do clinicals in the area! A candid opinion from someone who has been there is tops! Any staff nurses, agency, students or others who have additional information, please, feel free to post about the internship program or GW in general!! -Thanks

Hello, I am interested in hearing from anyone who has done a new graduate internship at George Washington Hospital. Specifically, I am interested in the critical care internship. Are interns supported throught the process and given an apropriate amount of guidance and time? Is the program organized? Thank you in advance for your responses. I look foward to hearing from you!