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My best advice for you is NOT to contact nurse managers directly. As one, I can tell you the numbers of emails I get on a daily basis can easily top 150. That's in addition to the number of people who "pop" into my office to talk about something, plus meetings, my ACTUAL job of managing budget, hiring, etc. if I answered every email I got (plus called, plus set up a time, plus went through the tour...) i would be late with every deadline I'm given. So hopefully you can see why "Cold calling" nurse managers for shadowing information isn't you best bet. However, I understand why you'd like to visit a hospital before you invest! I would recommend searching websites on potential shadowing opportunities instead- or if you can't find out anything there contact the HR department and ask instead. Hope this helps a little and good luck!

Unfortunately, what you needed to do was give at least a two week notice, this is considered standard and professional in almost all areas. PLEASE don't stick a note under the door, that's even worse than unprofessional. You need to get into contact with someone from leadership and preferably apologize for the late notice. You don't ever want to burn bridges with a former employer. You never know when you might need their help or at least a positive reference someday.

I'm a manager that "grew up" on my inpatient cardiac pediatric cariology floor after coming to it from the adult cardiac world, so I understand! I'll give you my thoughts as well as some interview advice. Peds is definitely different. The two biggest clinical differences I noted was (obviously) need to really know different vitals, lab values, and developmental levels. This last one is vitally important. You can look up VS and labs, but it takes a lot more time to understand how to treat a adolescent vs a toddler. The second was understanding that you're treating the ENTIRE family, not just the patient. Everything the parents do affects the children, so if they smoke/don't care well for themselves/don't have a job/don't understand the kids meds/etc etc etc that really can affect the child's medical outcome. Not only that, but you're dealing with these people's (hopefully) most valuable thing in the world to them. So emotions run very high and expectations are sometimes even higher. You need to be to communicate with everyone, at their level, wherever it is! My advice for inteviewing is to really know why you want to make the leap. Please don't say that you "love kids". Everyone says this, and it's definitely true, but doesn't explain everything. Better things to say for the change is that you want a challenge, love the idea of the variety of ages (unless a nicu!), or find yourself wanting to work in a different culture (cause it definitely is different). Take what I've told you above and decide what would be your biggest challenges and really speak to them. Will you need to focus on leaning normal vitals? Dealing with families? Whatever it is, be honest and forthright. Most managers dislike "fake" sounding people. Everyone has challenges, the truly confident people can speak to and overcome them. Be ready to answer behavioral based questions (tell me about a time when you had a conflict with a patient and how did you deal with it?) which demonstrate past behavior, which is the best predictor of future success! I hope some some of this helps you. Good luck and I'd love to know how it goes. Jaime

Kudos to you for still trying. One thing you have not mentioned is what your test taking skills are like. Do you get nervous? Do you "change answers" at the last minute and then find out later you were right all along? Do you hurry through the question so it leads you to the wrong answer? Looking at strategies to improve your test taking skills, or your nerves, or your confidence level in your first choice answers (which I realize may already be a part of some of your reviews) may be the way to go. Good luck in the future. Don't give up.

Hi everyone! I am a pediatric nurse wanting to present and write about the great strides our area has made in physician/nurse bedside rounding. However, I've had several docs tell me that bedside rounding is not a priority in the adult world! In my literature and web searches, I've been able to find only that general consensus is that it should be occurring and giving a lot of great evidence for why - but cannot find evidence that it actually IS occurring. I'd love to get input from those of you who work with adults in all various specialties to see what the trend actually IS. Thanks SO much for your valuable time and help!! Jaime Columbus, Ohio

Hi everyone! I'm a fairly new nurse manager (since September) who works in a pediatric hospital. I've worked on the same unit for years so I'm intimately familiar with the ins/outs of the unit and staffing required. This year is one of the first that our unit has not met budget, and after meeting with finance, we have found that the biggest overage expenditure is regular labor hours; and we are not meeting budget not because we overhired, but because our average daily census has not met what we budgeted for. I am being asked to "get rid" of approximately 4.2 FTE's in assistant staff (nursing assistants, unit clerks, monitor technicians). Short of terminating people or requesting reassignments, (both of which I refuse to do), I am looking for ways to trim the overages. We have already cut out OT and put serious limits on PTO usage. Of course I will be looking at tightening up staffing, but we hired to our budgeted FTE's so even then, may have staff who cannot get in their hours in a given week! I am welcoming ANY ideas, advice, or simply good wishes that anyone has. We have a wonderful unit and everyone really works together for the good of the patients. I absolutely hate to be in this type of situation and want to do what's best for the unit. I have a great boss who is helping out, but want to be creative and get as much input as possible. Thank you so much for your time! Jaime

My hospital managers are looking into what our official stance should be on our PCA's (patient care assistants- they all have their State tested nursing aide certification - but otherwise all experience is on the job training) addressing alarms. (We are mainly interested in pulse ox alarms). Right now, it is acceptable to a PCA to address and respond to an alarm, and then let the RN know if there is concern. This is extremely helpful in getting to the alarm quickly, and reducing alarm fatigue in our nurses. But obviously this can bring up some issues, not the least of which is that it is an unlicensed person "deciding" if help is needed. Of course, if the patient is disconnected and simply in the bathroom, that does not require help. But what if the person is just sleeping but desatting just a little? Should they call the nurse, or make the decision that help isn't needed? Can anyone give me some feedback on the policy in your institution? Thank you!!!

I'm a fairly new manager who came up through the ranks, I.e. was staff nurse, than clinical leader, now manager. So I know all of the staff well, some better than others. I'm finding that rounding on the unit, (asking how things are going, generally talking to people, letting them know I care about day to day things..) is very awkward, for me and them. I think they feel like I'm "checking up on them." What can I do, ( and what do you do?) to make this better? I've looked in numerous places for info on this subject, there isn't a whole lot out there. Thanks for your help!

Hi and good luck! When our unit has many applicants we occasionally use this method. Basically a panel interview consists of different people (the makeup can vary) all being given the opportunity to hear your answers to various questions at once. It's the questions that I think you really need to be on the lookout for, because if the panel is not given a "set" of questions to choose from, their questions will all reflect what their particular roles are. A doctor might ask you a very fact based " how would you handle this communication from me" question, and a manager might ask a " how would you handle conflict?" Question. So you REALLY want to be prepared with answers. I personally love seeing a prepared nurse come in to interview, even someone who has their answers to questions written down for reference! It speaks to their willingness to do some work to get the job. Here's some of my "do's" 1) do know as much as you can about the position and the institution. Use the hospitals website, and refer to it. "I saw and your website that you are a magnet hospital. I really respect the work that must have gone into getting that prestigious certification." Call hr for info, ask people that work there, etc. 2) this one goes without saying, but please DO look professional. It's amazing to me how many people come in in frumpy clothes or scuffed up shoes or hair in ponytails. 3) do spend time thinking about your answers. It's ok to give questions thought or even ask if you can come back to a question in a few minutes. 4) do have the basics down, strengths/weaknesses, why you want the job, what can you bring to it Donts 1)don't ever bash in any way another manager or coworker, no matter what 2) don't be so anxious that you don't ask questions when you're asked. My favorites are; tell me about your orientation, what are you looking for in a candidate, and how are your nurse to patient ratios. Those are safe, easy questions for the interviewers to answer but still show you came prepared. 3) don't use cookie cutter answers. I can't tell you how many times I've heard, " my weakness is that I try to be TOO perfect, or too thorough, etc etc." I want to hear a REAL weakness, and what you plan on doing about it. Time management isn't a good one, every new grad is working on time management. A good one might be that you are working on reviewing pharmacology or physiology, or making sure your communication is clear during report, etc. 4) dont work yourself up to the point that you almost cry. This actually happens a lot. You'd be better off asking for a break to the restroom to collect yourself. Take a deep breath and slow yourself down. The more prepared you are, the less nervous you'll be! Good luck, I hope this helped a little!

I am a clinical leader on a busy pediatric unit- and conduct interviews along with my manager. I certainly would not think any less of a nurse with a corrections background. Around in my area, jobs are getting somewhat scarce, and we hire a lot of new grads. So I think if it's going to work for you, go for it! -Jaime

I'm cross-posting this from the nursing management board for more replies. I'm a clinical leader in a busy pediatric hospital. Lately we've realized that we do very little to reward or recognize our more tenured staff. We want to be able to let these people know that we really do appreciate all their hard work, willingness to precept, be a resource, serve as charge RN, etc. Monetary rewards are really tough for us to do, but we're willing to consider anything. What has worked for you, or what have you seen/received that really made you feel good? Thanks for your time!! - Jaime

I'm a clinical leader on a unit in a busy pediatric hospital. While we do have a "younger" staff, lately it's been brought to our attention that we do very little to nothing to reward or recognize our tenured staff. (our "tenured" staff runs from 5-13 years). Considering that our hospital has been unable to have any cost of living raises or significant increases in pay for over 4 years now, we want to provide them something that says they mean a lot to us! What kinds of ideas have you implemented? We were looking at schedule related items, but I'd like ALL types of ideas. Thank you for your time!!! -Jaime

We have EPIC where I work. The implementation was huge, and everyone associated worked long hours but was very valued. I think it would be a great opportunity. It is a very good program that has a TON of room to grow, no matter what versions go live. Good luck with your decision!

Anne- I took your survey, good luck with your dissertation! I'm sure you are terribly busy and may not remember, but I would love to get a copy of what you find out and come up with! I work on a busy pediatric cardiology floor and we are looking at changing the way we do handoff. Your information could be very helpful. Thank you! Jaime [email protected]

I just wanted to say that I'm a clinical instructor for a local college and have had numerous over 50 students. (I'm 33). Each student has taught me so much and has blown me away with their commitment to becoming a nurse. They bring so much life experience to our groups. So I say, whatever your age, just go for it!! Good luck! -Jaime