outcomesfirst

Thirty years later, same sad story - but not every place is like this. You can do something about this. First - nurture yourself. When you are off work - be off. Go to the gym, read novels, fish, hike, swim, watch TV. Eat healthy. Have a variety of friends and interests outside healthcare. Next, every shift - have a smile and have a plan. Outline your priorities/must do's. Who is getting discharged? What time are meds? Dressings? Feedings? Be as organized as you can. Plan in time to chart - DO NOT MAKE A HABIT OF PUTTING IT OFF UNTIL THE END OF THE DAY - know what must be charted versus fluff - read hospital SOP. Start work on time and leave work on time - Everytime, unless you are in the middle of a code. Round on every patient at the beginning - eyes on, if only for a minute. Let the patients know you will do your best to see them every hour. Stay flexible, your plan will be constantly changing - based on needs. But know what you will be doing every hour - rounds, turning, meds, bath, what ever - plan it out as best you can. Plan in lunch/a break/ a drink of water/the bathroom. Most Med SOPs allow 30 minutes before/30 after, so if meds are due at 09/12/14/16, your window is 0830 - 0930, 1130 - 1230 etc. - read your SOP and make this work for you and your patients. Find something to appreciate every shift you work. A patient discharge (finally), a smile, a thank you, a sucessful foley insert, an IV start - anything that makes you feel good and productive. Always be honest. You do not have to buy in to the manipulation/complaining, but you do have to deal with the fallout. Do not join your co-workers coping/cover with laughing off issues - You do not have to participate, and you do not have to comment - smile and walk away, you are too busy and your patients need you, you do not have time to participate. Do help your co-workers when they need it, see one struggle to transfer a patient - help, do not wait to be asked, and ask for help when you need it - can't get the IV? Start asking for help now. It does not sound as if this culture is a new/recent event on your unit - you can be sure that the people who have been there for awhile have reasons for staying, and you can be sure the management/HR are aware of everything - complaining/anoynmous messages will not help you or your patients - and this behavior and the drama it will create will make it worse for you. Remember, you are part of the problem or part of the solution, you cannot have it both ways.Start planning your next move - where do you want to be? What is your interest? How will you get there? Research opportunities. Use this experience as a learning time/ladder out. You can do this for a year, be a great nurse and plan your next move. This time is invaluable and will serve you, and your patients, for the rest of your career no matter where you go. Chin up!

i urge you to continue looking hard in ca. i was a grad there and worked a few years before leaving - it really cemented who i am as a nurse today - and i do plan to return to ca. as a military spouse i have worked all over the states and out of the country - california nursing continues to lead the way in professional clinical practice. also born and raised in ca, no other state is the same... because you hold a california license, all boards will accept your credentials - you will just have to pay the fees. if and when you must accept a position in another state, your employer will not be held up if you tell them you have applied. turn around is much quicker these days. good luck!

For the first time I noticed 14 people viewing "research" thread at the same time. Where are you and what's up?

I am also curious. My spouse is getting ready to retire from the army after 26 years. Our last child enters college next fall. I am 48 y/o, an RN MSN with (OMG) 28 years experience (with the army life, you name it, I have done it.) Certified CCRN, CEN, CCRP, CNAA ....eligible for a few others. Love research at present. In shape, think I can pass physical no problem. Could I get in? What rank? What bonus? We have enjoyed the military life, too young to retire - maybe time to change life roles..............any thoughts?

Consider strongly a MSN with a major in leadership. CNO roles are now being redefined. Magnet now requires DONs/CNOs to hold a masters in nursing. MBAs came up in the 80s-90s, when hospitals became profit driven - yes a MSN will get you what you need to understand enough about business tools capital/direct/indirect, but for the most part every hospital now has sophisticated accounting departments to do this level of work, not to mention COOs and CFOs - hospitals need innovative leaders, particulary for nursing (which at this level incorporates all patient care areas...) Also, you want to set yourself up to expand as our health care system evolves. Good Luck!

Thirty plus years and the rhetoric has not changed..........when will nursing get a grip on this? Innovate, redesign, think out of the box, and change this self destruct pattern.

Breathe. Be kind. Be quiet. Get a small journal and carry it with you - write notes to yourself about issues/problems/change. Identify the top 3 priorities of your leader and contemplate how you can influence them to the good for everyone. Identify your top 3 goals in the role and how you can acheive them. No changes for 90 days. Think before you respond. Do not make promises you cannot deliver on. Catagorize the immediate/emergent from the might be good. Put your critical thinking cap on and hang tough - it is a right of passage.

A 'Research Coordinator' may mean many things. Read the job description carefully and research those you will be working for. A physician? A Site Managment Organization (SMO)? A Hospital? Acadamia? Look at each institution - how long have they been in business? Doing research? What kind of research - medical/pharma/device/operations/outcomes/epidemiology? What is the primary and secondary goal of the institution/individual? (Financial/Outcomes/Knowledge/Publication)? Do they have any warning letters? (Search FDA Website). What kind of training is provided? Human Subject Protection? ICF Process? Regulatory Requirements? Do they offer support for certification? What is the environment - is it a clean, organized, well lit offices with access to needed equipment and supplies? Is it a mess - paper everywhere, phones ringing, people moving quickly? Is there a library? Computers? Internet? Copier/Fax? Pens? Will you have to drive to see subjects? How many other people will you work with? Will you be completing all regulatory documents? Will you have suport staff? Will you assess/complete/propose Budgets? Will you be screening, enrolling, and managing subjects? (Think part sales/part medical knowledge/administrative/organizational skill set) How many studies will you work on at any given time? What is the therapeutic area? Acute Care? Field Based? Outpatient? Will you be completing case report forms? How is your time accounted for? And, if you are not a fan of documentation/writing and rewriting this may not be for you - Research is all about perfection in the details - again as it should be -. Clinical Research/Study Coordinator/Research Assistant/Research Nurse all have many definitions. Be sure you know what is expected. There are may great internet sources and books - search clinical trials/ICH/FDA. Check them out. A word about sponsors - yes, many are happy to help you learn - that said - the clinical trials of today have been evolving for about 20 years now, expectations are climbing (think vioxx/haldol) the environment is becoming increasingly competitive (for the better) and sponsors want to work with sites that provide high quality data and timely turn around - they do not want to spend precious, expensive hours monitoring/mentoring document completion - and they will not hesitate to let a physician/SMO know if something is not working. Also, study coordinators are being held accountable by IRBs and the FDA - if you are working with a professional license - standards must be met (again, please read warning letters issued by the FDA). All this said - this is a terrific evolving nursing specialty that has a very bright future!

I hate to be negative, but this is the reality. Your physical problems are probably an issue already...I would not discuss them with anyone...You need to examine your physical issues, but that is another discussion - no employer is going to want to work through them with you....unless you have been there 20 years and are a star. Yes there are laws, etc. but that is not the way employment works. For whatever the reason, you are not viable in this institution. HR is not going to help and neither is recruiting...Someone (s) want you to leave. If they were going to help, you would not be in this position. Find a new job, outside of this facility - now, before you are teminated. It is much easier to get a job, when you have a job. Your reason to your new employer is - it is not a good fit for you - end of discussion. Good luck, please move forward and put this behind you.

You must leave this position. You are in a no win situation. You have talked to the manager and HR - if they were going to help, they would have. Now you are a target, and let me stress this, by everyone. I'm sorry, this is how it is. Be happy, do not struggle. It is up to you.

Pure nursing research is very difficult to find. In my experience, nursing research - i.e: intervention testing/evaluation, efficacy measurement, outcomes, theory...etc. is conducted by academic nurses - professors etc. in addition to their teaching duties, or by grad/PhD students, in addition to their studies; or by nurse executives, in addition to their other duties. Many academic researchers receive grant support through professional organizations (AACN, WIN, ANA, etc) and the NIH; and use the funds for tools, assistants, statiticians, document/poster preparation. I have never really found a position as a pure nurse researcher, as an a assistant - yes (many of my mentors came from this role). I now struggle to try to conduct independent research, and write, but find myself time strapped - full time nursing research in a paid position would be nirvana.

Also look at what references the author used in the article. Read those articles. Are they opinion leaders in the field? Has the work been validated? Is this a peer reviewed journal? Does the article answer questions or leave the reader wanting to know more? Does the article make sense? Are the conclusions understandable?

I would encourage every student seeking clarification on how to write a research problem, understanding qualitative versus quantitative, or searching for a research topic to speak with their instructor. You are paying for an education and if you are not grasping the material you need to speak up. That said: As much as I appreciate qualitative research, unfortunately it rarely translates well into sustainable practice. The ability to objectively quantify a practice, intervention, or a standard lends itself to creating an evidence based practice. I believe as the US moves forward into a health care environment that sincerely places emphasis and value on high quality, cost effective care, the demand for objective solutions will be great and the implementation easier. When choosing a subject to conduct research on I believe it must be something you feel passionate about. Research is time consuming, often tedious, sometimes dissappointing, and always labor intensive. There are no shortcuts. If you do not have a passion for the subject matter, you will not connect, much less enjoy the hard work. Think long and hard about what interest you. Surf the net on key words and see what comes up. Keep your focus narrow and realistic. For example if you are interested in improving nurse satisfaction, choose one area. Shifts. Pay. Stress. Nursing Model. Then drill down. A few examples: Pay - hospital versus outpatient; hospital versus academic; Intensive care versus med surg etc...Shifts - Day versus night; 8 versus 12 hours; rotation. Stress - patient care; family life; professional relationships. Nursing model - primary versus team; professional relationships; leadership style. Just keep it tight and focused and dig in for the long haul. It is all about identifying what you can measure and then measure it. Most importantly, after you have done the research share it....discuss with your peers, offer to present, publish!

The SOCRA website has some practice questions. http://www.socra.org/ I would not buy the book, but when you register for the exam they will send it. The same material is also available on line at the FDA and ICH The FDA CDER web has easy access to the relevent regulations 21 CFR 312, 50, 54, 56, 318. See: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm The ICH recommendations (esp E6/GCP) has all the information and easy access. See: http://www.ich.org/cache/compo/276-254-1.html The exam was very basic and if you are comfortable with the regulations, a medical back ground and some common sense you should easily pass the exam. Also any book on Clinical Trial Management will cover the basics of research as interpreted by the CCRP exam. Good luck!

I have worked in two union facilities and my conclusion is that union rules trump health care delivery. From the basics of who and when trash cans get emptied to the model of nursing care delivery and mandated overtime - unions (in my experience) hurt, not helped nurse and patients. Instead of one parent the nurse now has two - "Administration" and "Union". Unions are a step backwards for nurses. If a nurse cannot independently decide on what a safe, effective, quality, rewarding environment is...I am not sure if they should be a nurse today.