glasgow3

I've heard of the requirement (one year away from the bedside eliminates consideration for a travel contract.) In fact, I've heard that a year away from the hospital bedside is a deal breaker for ANY future acute care nursing positions. Hospitals come up with this BS because they are ageist. They discriminate against seasoned nurses in employment as they realize such discrimination is most likely illegal, but they do so anyway and with impunity. The travel agencies go along with all this because, they know which side their bread is buttered on.

I hate to be the bearer of bad news but hospital leadership doesn't really want to retain experienced, frontline nurses. They have a kind of "wish list" much like you'd see in an online dating profile and they are absolutely convinced that anything over 5 or so years experience represents overkill for a position at the bedside. (That ideal experience number can go up somewhat for critical care nurses since their initial training cost is so ridiculously high.) Now this pandemic situation obviously is unique, but in more normal times hospital leadership would be happy as proverbial clams to have 5 years experience or less at the bedside, just so long as they have an adequate supply of replacement fodder in the pipeline. They certainly don't want people with responsibilities at home which might interfere with the ability to work at least 12+hours shifts, or in some manner interfere with your availability to pick up additional shifts on your scheduled days off as needed. Keep them too long and they might start having more illnesses or injuries, can't have that. They might even start realizing that they may want to retire someday.

"......I don't want to be put into a situation where I am overworked and burned out within a couple of months either." I think that sufficient credible information is available (both here and elsewhere) to make a valid determination; disregard that information at your peril.

Thank you JBM for the thoughtful and kind response to my post. But for the record, I am quite familiar with the predominant EMR systems (and others) in this area including Epic, Cerner and Meditech. Also, med (& supply) pyxis' have been around a long time and I've used both extensively in the past.....a review of the current software/user interfaces , and I would have been good to go. The same might be said for smart IV pumps, CRRT machines etc. Excuse the phraseology, but several commonly used machines have actually been "nurse-proofed" when compared with earlier versions/models of those same therapies/diagnostics etc. Anyone else here old enough to remember what it used to take to derive a single cardiac output and/or to calculate other hemodynamic values, or to keep a CRRT or an IABP machine running safely and efficiently etc. back in the day? Now please don't get me wrong---I know things have changed dramatically and I had no illusions that I could in any way replace any current bedside nurse at any place on the continuum of care, but surely I could have been taught to do something to take the load off the overwhelmed nurses to some meaningful degree after a reasonable amount of review during a pandemic.

Do I think you're crazy or too old? Nope. I myself considered a return to acute care nursing in response to the near nonstop media articles/stories that the beds were filled to overflowing, the nurses were overwhelmed/distressed, staff vacancies abound etc. But the reality is despite having been certified in both critical care and rehabilitation for decades before moving to Documentation/QA/EMR etc. positions I found zero takers. At least in this area, except for new grads, hospitals are unwilling to provide any sort of refresher/orientation beyond three shifts in length one of which included the computer stuff + the usual general orientation stuff....and after those three shifts I would be expected to float anywhere in the med/surg "cluster". In fact, in most cases the "Talent Acquisition" folks who weren't even nurses responded to my offer of help during the pandemic by ghosting me. Also, a local Return to Nursing practice program (primarily online Zoom training followed by a couple weeks shadowing a staff member etc.) which I was scheduled to attend early in November was cancelled at the last minute by the partnering hospital system they said due to lack of interest, the very same week the chief nursing officer was on TV bemoaning the fact that their current nursing vacancies were double the norm. Point being, you've hit the big 5-0 and in many hospitals even a year away from the bedside is a "disqualifier" these days, let alone after an extended absence. I would see what the hospitals are actually willing to offer you before I spent too much time pondering the crazy/too old question.

"Did you ever get to look the Director in the eyes after that? Lies like that deserve to be confronted.." Oh sure. The day we were informed, HR representatives, Nursing Administation members etc. and other "suits" showed up on our unit en masse to break the news and deliver their spiels. When my Director's turn came up, I interrupted her as though confused with "Wait a minute, does this mean that this unit is closing?" When she answered affirmatively, I told her (in front of everyone) that was "impossible" because I was told not two weeks ago that was not going to happen and this was obviously in the works weeks ago. You could have heard a pin drop. Also, a couple years later (against my better judgment) I accepted a position similar to hers in Nursing Administration for the Med-Surg floors. One day out of the blue she began a conversation with "I know you think I'm nothing but a liar and can't be trusted...." to which I replied "Donna, (name changed) where would I have EVER gotten such an idea?" and then I walked away. I was well aware that certain things had to be kept under ones cap so to speak for various reasons if you're going to be a manager. But once the cat was already out of the bag, I would have appreciated an "I'm not at liberty to discuss further" rather than being lied to.

My thoughts? LOL Reminds me of the time when an agency nurse shared during shift report that her agency couldn't extend her contract because the unit was closing. Like the OP, I asked the Director directly for the truth; Similarly she downplayed my concerns saying that there were going to be a few changes but the unit certainly was not being closed. Less than two weeks later, all of the nurses assigned to that unit had 30 days to find a position elsewhere in the hospital (or be terminated) because it was being closed. I agree that online job announcements can be inaccurate, but I also think the OP perceives something in the Director's explanation/body language/tone/verbiage etc. doesn't pass the "smell test."

"This 'hospital' allowed the nurse to work after the first 3 deaths, what the heck made them investigate and fire the nurse after the 4th?" A bad Press-Ganey maybe?

A lot of steaks involved? emmmmmmmm sounds yummy

Mandatory minimum staffing ratios with significant financial penalties for failing to adhere to those ratios at all times.....this is the ONLY answer. Anything short of that is a waste of everyone's time.

In a perfect world employers would be fully transparent and explicit with regards to the expectations for a given position; Unfortunately, that is often not the case in the Long Term Care industry. ADONs are typically classified as salaried, exempt (from FLSA) positions so facilities have no legal obligation to compensate you beyond your salary for being on-call, working overtime, working multiple shifts, working weekends, performing additional duties/roles, etc.; One could find themselves literally working 24/7 in that framework. My point: YOU must be especially PROACTIVE during your interview and otherwise in the course of your due diligence for a LTC industry position. I think it's obvious that your current position is unworkable and you need to find other more suitable employment. Sadly, what you have experienced with your current employer is not at all unusual. There are plenty of "troubled" facilities who are all too willing to expect you to do the impossible.

Intraosseous (IO) Line/Access /Insertion What you'd do in an emergency if you couldn't get an IV in--------as opposed to trying to trying multiple IV starts when the patient has "no" veins

I can't believe what I'm reading here. Seriously, I just can't. All I can say is if this scenario ever "played out" at any school or facility that I've ever heard of, both the OP and the other student would be out of their program and the school asked not to return. (And trust me, one way or another this episode WOULD come to light eventually.)The lack of judgment of all involved including the patient's assigned nurse has me dumbfounded. This is patient abuse plain and simple. I can only hope that this story was just that: a complete fabrication posted to get a reaction.

As several posters have already mentioned, California overtime laws are a different "animal" entirely; Fortunately for you, the differences between California regulations and other states' favors the employee. In general, in California, working over 8 hours in one day or over 40 hours within the facility's specified 7 day work week (the employer can't keep moving the starting day around to avoid paying overtime) will get you Time and a Half; As calculated by your employer for a base pay of $42 in general you would receive $63/hr. HOWEVER, in general if you work over 12 hours in one day you should get Double Time for the excess. California has a government entity called the State of California Department of Industrial Relations and their website contains an Alternative Workweek Elections Databank. You can easily search that database by your employer's name to find in some detail even down to the exact employee vote as well as the alternative schedule agreed to. If your employer never had an election and/or never filed the required information, they would potentially have a real legal problem if they were paying no overtime for all that time over 8 hours worked by their 12 hr/day employees. But likely as not there WAS an election and the employees voted for a 3/12 alternative workweek schedule; in that case just be aware that even with an alternative workweek, if you go over 12 hours on a given day, my understanding is you should still get the double time rate for overtime computation not the time and a half rate noted by your employer. I think a valid labor union agreement also can result in some differences/exceptions to the general rule. If you have any remaining questions/concerns after determining your alternative week status and following up Department of Industrial Relations, you will need to seek the advice of an employment attorney.

My take as an old AF nurse who has experienced a similar situation (or two or three) and has observed several like situations in the course of a very long career? OK then. The Nurse Management should feel shame, however, they likely haven't had the capacity to feel shame for a very long time. What on Earth is an "Evening Manager" on a Med-Surg. Floor anyway? I suspect that it's little more than what was called a 3-11 charge nurse back in the day. Excuse my insensitivity, but that slot was open the first of June and it is for all practical purposes November, (five full months later). We aren't exactly talking about filling a Chief Nursing Officer position of major medical system here---and I've seen such CNO positions filled with greater expediency than that many times. In my opinion, the Nursing Management in this case cruelly used the OP. I say cruelly because I would bet that they knew all along that the OP took that "manager" position seriously and would rise to the occasion, yet would never be seriously considered for the lofty position of 3-11 charge nurse of XYZ hospital's Med-Surg. Floor. My advice to the OP? Well, simply put: Keep up the great work: You now have 3 years' experience in one of the more difficult nursing specialties in the acute care nursing, you have advanced your education, and you have demonstrated ability in team building... So update your resume to that and get that well deserved promotion elsewhere. ASAP. And when you do, take your supportive coworkers with you.

Just curious: Does this new policy include all of your Nursing Leadership including your Chief Nursing Officer/Executive(s)?

I would have to agree with those respondents who feel that you could handle a full time nursing position as an age 50 plus new grad.......but that's not really what you asked. I entered nursing 30 years ago at age 42 when the energy industry collapsed taking virtually all of the local accounting/administrative positions along with it. But fortunately there was a genuine, far reaching nursing shortage in progress of the sort I've never seen since. (This wasn't a "projected" need for nurses based on demographics etc., it was the real deal. When I graduated there were available positions in every region of the country, on every shift and in every specialty and the training for a new grad was extensive.) But you on the other hand would be voluntarily leaving an established career in an established position where typically your earnings should be peaking. We now have unprecedented levels of unemployment as you are no doubt aware. And then there is the health care industry/ nursing profession environment: Nationally hospitals, nursing home and assisted living companies have been consolidating for many years now and many health care entities have been taken over by private entity firms and with all of that comes the expectations of increased profits and growth. **So will you have a hard time finding a full time job with benefits? There aren't any here. All of our "big players" have frozen hiring, frozen merit raises, stopped retirement plan contributions, instituted furloughs, reduced paid time off and other benefits and they are doing the same wherever they have a presence. Further, when I retired a few months ago I was in a position to know that significant layoffs were already planned long before the coronavirus pandemic was identified as the catastrophe it's become. I'm admittedly a pretty conservative guy and I also don't know your overall resources. Maybe you're already all set for retirement etc. But that said, I'd be very cautious about making any major changes in these uncertain times.

Of course this is all about massive transfers of wealth to the oligarchs. Do think that all of the world's developed nations (save Sweden) immediately decided to take the unprecedented action of totally shutting down their economies and then in virtually lockstep fashion began the process of "reopening" them up? I'm shocked that we aren't left with negative interest rates at this point. But no matter, the middle class was well taken care of----just don't spend that one time $1200 stimulus check in one place, and try not to go on a wild spending spree with that extra $600/wk enhancement to your unemployment checks (which ends in July) out of the TRILLIONS of dollars that was printed up to be redistributed. And as many previous posters have already noted the financial markets (and in turn your retirement/investment accounts) have likely taken hit. Where do you think all that wealth went? And that's just an intermediate step I can assure you; Many people are totally unaware that those retirement accounts are uninsured as well as subject to market losses. Oh, and I see that several of the major hospital systems wasted no time in stopping their retirement contributions/matches. But no matter, the federal government is reimbursing the hospitals billions of the costs of coronavirus patients. and I'm SURE that money will be passed along to the caregivers and.....ooooppps I forgot....In anticipation of the influx millions of coronavirus patients which in many parts of the country never materialized, the "Powers That Be" preemptively closed down all nonessential surgeries/procedures creating a huge hit to their bottom lines. Oh well, guess now we're forced to send our hero caregivers on furlough for a while during the pandemic. And so it goes. ?

It's difficult to determine whether or not this nurse should have been tested on a timely basis without the relevant assessment information. At present this thread contains six pages of posts; I've read them all and yet I STILL don't know how many points per game she averages, how many rebounds she's made, how many triple doubles she's had so far this season.....or even how many movies she's made or produced, or what political office she or her family holds or has held or even her millionaire/billionaire status.

Well, maybe for vampire attacks.

But, but, but how could that possibly be true? For years I've been hearing from those same folks that BSN preparation should be the minimum for entry into professional nursing practice. Where else will nursing students learn to think critically? .......and to embrace evidence based nursing practice? ........ and to differentiate between Benner from Orem? With this news I fear that an epidemic of "failure to rescue" is inevitable with the attendant negative morbidity and mortality outcomes.

There is an excellent article which I "googled up" entitled "Understanding the Basics of Medication Administration" by Nancy Brent, MS, JD, RN. Despite the rather broad subject matter implied by the title, the entire article focuses upon the matter at hand. I believe you will find her credentials and experience (listed in an About the Author section appearing below the body of the article) quite impressive. Simply put, my takeaway from the article is that nurses should not routinely be giving IV medications drawn-up by another nurse, nor should a nurse routinely draw-up medications for other nurses to administer. Now obviously, first and foremost we want what's best for our patients, however, we all practice within a legal/regulatory environment as well; I would not want to be in the position of defending myself in the context of a process which violates what this author describes as a Cardinal Rule. Actual administration aside, there are also potential legal issues arising from this process with the medication documentation which I didn't even consider until reading this short article. And lastly, if I were a betting person, I would bet that there isn't even a written policy addressing this unique medication preparation/administration process at the OP's facility; Sadly, I suspect that they would throw the OP under the bus in a proverbial heart beat.

I would encourage the OP to research/Google up "counter-offer". I believe the recommended course of action in cases such as yours will be quite obvious.

As a new grad ICU nurse who worked the night shift I was initially thrown into an internal panic when asked by the oncoming nurse, "...And was that a LEFT subclavian or a RIGHT subclavian?" But it wasn't all that long that my response would be, "First check the area of the left subclavian...if you don't see a central line there check the right side." Shortly thereafter, the such inquiries decreased dramatically.

"While only having a bachelors (or less)" I believe that you are referring to those who have earned a "bachelor's degree" (or less); Ordinarily, I would not point out the lack of an apostrophe, however, I would have thought that an individual in possession of an advanced degree might at least use snarky comments in a grammatically correct manner. And yes, I am very well aware of how not for profit entities work. They hide behind their tax exempt status to enrich the few at the expense of the many. Simply put, many, if not most of them should lose their status in my humble opinion because in real terms they provide very little community benefit or charity care. And yes, hospitals are exceptionally expensive; I think we all know that the money "goes somewhere" as you put it. But some of us believe that the money could be better spent on caring for patients, rather than making a handful of leaches fabulously wealthy.