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  1. zacarias

    Arizona may require hospitals to check citizenship

    How would they reconsile this law with EMTALA? Giving hospitals the right to do this is just another way Arizona wants to lead the US in becoming a mean-spirited and inhumane place to live. I would think the federal government would step in if this went through, who knows though. The number of illegals in this country is a major problem, but that is separate. Hospitals are supposed to be safe havens for anyone needing care. Plus, immigration status is the job of BORDER PATROL, not police officers, and certainly not hospitals.
  2. Hello all, I hope someone can help. I've recently moved to the hottest place on Earth, the Imperial Valley and need a job urgently. I'm a nurse with six years experience in hospital nursing with CA and AZ license, BLS and ACLS. I've applied at several places, nursing homes and they're not hiring. I applied at the Yuma hospital and one of the Imperial Valley hospitals here. I can't work at El Centro Regional for reasons I will not disclose. I'm an excellent nurse and realize that not being in a large city in this economy makes this difficult, but there never seems to be any urgency on the part of people who hire. Everything seems to go at a snail's pace. I know the unemployment rate is hight but I am a highly trained, skilled person who was in demand at one time. I am also bilingual. Anyone about the situation or have any leads? Obviously I'm willing to commute to Yuma even to work. Thanks all! Also, is there any per diem agency that staffs nursing facilities in this area or Yuma area? I haven't found any... Zman
  3. zacarias

    Do nurses still get signing bonuses?

    About the Rio Grande Valley area: I think there are a couple reasons why there is a reputation of being unsafe for nurses' license. First, there is no metropolitan big city there and thus "best practice" is less likely to take hold and fewer of the "awesome" healthcare practitioners of our country are likely to go there. San Antonio is a great city but it's hours away and is not considered in the Rio Grande Valley. Secondly, there are for-profit hospitals there which have a bad reputation. I personally try to to given them a chance but to quote an allnurses.com member, "Tenet is shady at best." Just as a side note, even larger cities can have a bad name. Las Vegas has a horrible reputation as being unsafe for nurses; This is no surprise as the healthcare situation there is dominated (almost monopolized) by for-profit companies.
  4. zacarias

    NG/OG tube placement

    One thing I'd like to add: Checking pH in my opinion is better than the auscultatory method, however, it is still not best practice. pH testing could still give equivocal results. Best practice would be bilirubin testing strips but this is still not readily available to nurses and facilities. No matter what, xray shoud always be done prior to feedings.
  5. zacarias

    Do nurses still get signing bonuses?

    Rilo Grande Valley undesirable? I love the RGV area. Love the people, climate, hospitals aren't the greatest but I do like Valley Baptist. I tried to move there years ago but for various reasons, never did. I still would in a heart beat though.
  6. zacarias

    Advice on Chest Tube & mistakes by colleague

    I vaguely remember something about not using vaseline gauze for chest tube dressings. I wish I knew an article or something. I remember in nursing school that you always needed to have clamps in the pt's room with a chest tube in case the tubing dislodges from chest tube drain. Then I learned early on from a PA that you never clamp a chest tube like that or you can cause a tension hemothorax which makes sense. I guess the only reason you would ever use the clamp would be to assess where a leak is coming from, but you would leave it clamped for only a SHORT period of time to prevent positive pressure buildup.
  7. zacarias

    Sharp Grossmont/ Sharp Memorial Hospital

    Hello there! You will love living in San Diego. Sharp Healthcare overall is a great organization. I worked at Sharp Memorial for a short time and it was great! They have a brand new building that is absolutely beautiful! The nurses I worked with were very nice folks. The pay rate at Sharp is VERY competitive. Sharp has several hospitals and even more clinics, so you have many options in San Diego County. Highly recommended as a not-for-profit hospital system. Z
  8. Thanks all to you, I decided to not go through with the interview. I understand all your points and actually part of me is still unsure of the decision. But, I have to take care of myself first which is the most important and if three days a week were difficult for me because of anxiety/depression, five days would be much more. Thanks again! Z
  9. I am also looking to move to Canada to practice and this news that there are not that many jobs for us looking to move to Canada. What if I was looking at Yukon or north British Columbia?
  10. Thanks for your responses guys. My worry is that if I take the job, what I do if a hospital job comes up in two weeks!!!! I have another interview for a med/surg job at the end of January. But it's quite a commute. Maybe what you guys are saying is that I should go for this job, or any job I can because of our unstable economy and then take a hospital job when it's almost the perfect job for me. What I mean is that I won't quit that "security blanket" job for just any acute care, but only if it was the unit that I wanted and with the benefits I need. Again, I just hope they look at my past experience and don't discount me for the hospital when I finally do change over to a hospital job. well, I haven't even officially been offered this Adult Day Center job, so this all may be moot. I will let you know. Thanks again!
  11. zacarias

    Having trouble with understanding lasix use

    This was always something that I also never truly understood in my years of practice. I truly believe it is such something that MDs use because they think it can work. I don't think it's best practice or anything. Obviously is Lasix helps produce more urine and if the creatinine goes down or doesn't get worse, than why not. More urine is usually good for the oliguric patient. However, if Lasix is given and urine output doesn't increase and/or the creatinine goes up, it is obviously contraindicated and damaging to the patient.
  12. zacarias

    Do you push Fentanyl on the floor?

    Again, as licensed professionals, RNs should be allowed to push Fentanyl IV just like other narcotics. I remember a patient that had horrible wounds all over her body r/t to something strange. She screamed like bloody murder when dressing changes were done. We used fentanyl IV for the dressing change. While she still screamed occasionally, it did help. What I like is its fast half-life; After the dressing change, I don't have to worry about it staying in her system too long and risk oversedation.
  13. zacarias

    Pt Bites Nurse

    When I think of a bite, I'm worried about tetanus and staph infection as potential sequelae. I think the risk of other bloodborne diseases is so little that they don't often draw blood in these cases. That makes sense to me, although I'm wondering if somewhere on the CDC webside there is a definitive answer...
  14. Hello all, Recently I wrote a post on being really anxious and scared to go to work in this thread: https://allnurses.com/general-nursing-discussion/scared-go-work-446096.html The tips everyone gave were wonderful. Now here's the thing. There is this RN job offer in a community clinic at a brand new Adult Day center. The benefits are so so in that they offer medical, dental, and no vision. There is 401K but no matching. Now I don't thiink they're cheap; it's just the way it is as they are a federally-funded program. The adult day center is new for them and I'd obviously be in on something new, and maybe there would be opportunity for advancement. It is five days a week job, and I've always been spoiled with three days a week. It is day shift. I will making less than in a hospital. It surely will be less stress than working in a hospital. I don't want to accept a job like this and then run into a hospital job soon and quit the former. Neither do I want to lose my acute care skills. And if I work for a year in a setting like that I mentioned, how quickly and how strongly is it going to affect my chances when I want to return to hospital nursing. The other thing I can do is just continue to wait for a hospital acute care position.
  15. zacarias

    Physical test for RN

    I've had to do physicals for nursing jobs and it generally just is a basic physical where they check your weight, BP, U/A, cranial nerves, and basic stuff. The last physical I had came out bad because of my blood pressure. They wouldn't pass me. I had to go to a doctor who prescribed me BP meds and said I was OK to work. I am so happy that my blood pressure is controlled now. Z