Anagray

Hello, dear friends. I am Planning to leave NY state, as I ve had enough of it already. I am in adult/Gerry NP Program and it has been horrific. We are expected to find our own clinical rotations sites, starting with ADN degrees. The quality of education is not good where I am, and you are extremely limited where you can apply for NP Program. I am wondering if this is the same in NJ? I am planning to move close to Cranford, NJ and transfer my credits to finish off my degree in NJ. any words of wisdom would be appreciated.

Hello everyone! I currently live in NY state and work for the department of veteran affairs as RN care coordinator, I have 17 years of experience. I am currently enrolled in Adult NP Program in NY. I will be moving to Cranford,NY and will be trying to get a job at Lyons VA. I need to transfer to a NJ NP Program. Can you recommend a college that is good ? Also - in NYS it is nearly impossible to find clinical rotation sites. Is it fairly easy to find preceptors, hospitals to do clinicals? I have never done this before and don’t know where to start. thank you in advance for any advice ! best wishes

I think I have an idea who your employer is because I work in “ specialty clinics “ also. This particular employer fostered the culture of punitive measures against nurses for decades. When employees do not finish work and make mistakes, it is largely a reflection of inefficient management. As soon as you started having problems, it was your boss’ obligation to begin mentoring you to help improve the situation in your work area. Of course, instead you were blamed for all the problems. If I am correct in my assumption on who your employer is, your best move would be to find another area with a better manager, who knows how to empower his or her staff. you can certainly file a complaint with HR, but you can’t fight the machine of corruption alone. I am so sorry for what you are going through! Please know that you are a valuable member of our profession and don’t let one *** manager discourage you from practicing and retaining your professional self esteem.

Thank you all so much for compassion! I considered going back to the ER. At this point they have me by the balls because they paid for a part of my BSN and I owe 2.5 years of service. I had a meltdown at work today and ended up taking sick leave and going home. I have PTSD, which has been under excellent control until the hands on neck incident. I am scared to make waves because there is still a lot of stigma against healthcare workers with mental health issues. I can’t imagine what nurses with BPD or depression must be feeling. I am considering requesting to have a camera placed in the office. We do have a union and I am not a member. Not sure if they would want to get involved.. but I can ask. I have an excellent reputation at the hospital - I had some awards and a nomination for another big deal award. Maybe it can help me.

2.5 years ago I transferred from acute are into a multispeciality office in the same hospital. My old boss assignment me to a very busy area and I basically began managing my own area. Before I arrived they had 2 RNs, now I am by myself. My area has a poor design and is the only one like this. My desk is against the wall, in the area of traffic. I triage patients in this area and they also pass me by when existing and entering physician rooms. I experience constant harassment from male patients. Some is innocent, some is slimy and direct. On daily basis i am being touched by male patients from the back, among slimy comments and questions. A few months ago a patient snuck up behind me when I was not paying attention and put his hands around my neck. It took me 20 minutes to come down off a panic attack. When I brought this situation to the attention of my new supervisor and her assistant, I was asked : “ well, why is this only happening to you?” And “ we can reassign you to a different area to give you a break”. I feel like I am being punished. It took me 2 years to make changes in this department to make it run like a well-oiled machine. I possess certain expertise in areas which other staff members do not, such as administration of certain biological and immunotherapy. I am friendly, but in no way my appearance warrants this kind of attention from patients. I wear loose scrubs and my hair is always up, but even then make patients find some ways to comment on my accent and blond hair. It is becoming unbearable. When there is another staff member next to me, this behavior from patients goes away. I feel the problem lies with inappropriate layout of the office, where I am often left 1:1 with a patient and they can do and say whatever they want without witnesses. I was told that I am not going to receive a second staff member and my area will not be redesigned. I made it known that I am no longer happy at my job and I dread coming to work. I feel traumatized and jumpy. I deal with military personnel.. likely the same individuals who made it miserable for female service members to serve in the military. My choices are - either to suck it up or leave the department and go back to acute care. However I also wonder what legal action I can take to protect my employment position? Any suggestion would help.. thank you.

I feel that office and hospital are completely different settings as far as patient safety goes.

My biggest concern is that this high alert drug is administered in an office setting without a protocol in place, no baseline labs and only with a blood pressure cuff and a manual pulse recordings. My co-workers and I had a meeting about this with our supervisors and feel like our concerns are being basically presented as exaggerated and unreasonable. I am an experienced nurse and giving this drug in a hospital setting is a completely different experience. We at least will get our wish of having a protocol established but i am not comfortable with this at all.

Is it safe to administer 1 gram IV over 30 minutes to migraine patients with no monitoring and no baseline levels? Having a meeting today with our supervisor to disuss this. If you know of any documentation I can present to defend our point of view, please let me know!!! Thank you .

I'm not sure what the requirements are in your facility, but in NYS where i am it is not easy to find and retain a good ER nurse. Many of my co-workers just have AS. In my hospital it was much preferred that an aspiring ER nurse has at least 6 months of med-surg or critical care under her belt. My normal assignment was 6 patients. It required quite a few different clinical and interpersonal skills to manage that load and provide good care.

This is a neurosurgery patient. Typically PATs want LFTs addressed before the surgery happens because of anesthesia and the amount of drugs that will be given to patient pre, intra and post op, and most commonly primary docs will order a liver ultrasound or other bloodwork to rule out hepatomegaly, hepatitis, etc. The physician was not in the office when I interviewed the patient in preparation for surgery. We have a social worker/substance abuse counselor on site who typically provides counseling. I was going to discuss the case with my surgeon when he came in to the office but people got involved in this before I had a chance to speak with him.

Thanks for replying ! 24 pack per DAY. The appointment I made was not necessarily for the substance abuse but as part of his pre op physical. I am anticipating a liver ultrasound, so I wanted to get it taken care of before he was booked. Then, of course, the issues of DTs after surgery.

Is it in the scope of nursing practice to counsel a patient on substance abuse? I have incidentally identified a patient with a substance abuse problem ( habitual 24 pr more pack of beer) and elevated LFTs, interviewed him about his drinking habits, he told me he is going to quit, I advised him not to suddenly stop drinking, made an appointment for him to see a physician and referred him to a substance abuse counselor on premises ( which he declined). The counselor accused me of practicing outside of my scope of practice and reported me to my supervisor. I feel that the counselor made a borderline defamation of character accusation. Any throughts?

It could be really good for you to have a goto person, a friend you can call with questions before calling the doc. I know that we should be able to call a doctor any time we feel like it, but sometimes they are just jerks and there is nothing you can do about it. Sometimes it is learning how to ask questions that can help too. For example, if I know a doctor is a jerk and the pt's BP is marginal I would call and say : " this pt is on 4 medications for blood pressure. I have no parameters for any one of them. I need some numbers. He BP is 110/50 and she is symptomatic but I need to know what her target range is "

I have an interview for admissions RN position with VNA. I have almost 6 hears of acute RN experience - med surg, ER, dialysis, hospice, LTC, psych and amb surg. I am wondering how long does a typical assessment take, is 80$ a good pay per assessment? I am seriously looking for a change - I need day time hours, I am worn out by ER work and I am interested in obtaning some case management experience. Any advice would be appreciated.

Thank you so much, it was very helpful! a lot of what you are talking about is familiar and I agree, most people have a story behind their addiction. Thank you again and I am glad that patients have such a patient and caring nurse as you are.

I am looking for some advice on what to expect as far as tasks and duties in an outpatient addictions facility. I've been a nurse for 5.5 years , worked med-surg, dialysis, LTC, ER, psych, but never in a detox setting itself. We start detox in the ER when patients are in acute withdrawal (by given them banana bags and stabilizing their other medical conditions) and administer various medications - librium, ativan and suboxone at times. We have a detox scoring tool, which is basically vital signs and pt's symptoms/behavior. As a detox nurse, what are my goals and responsibilities for the shift? What are things like on a detox floor or in a facility? Are patients allowed to have visitors, to smoke, go outside, make phone calls/use cell phones? Are families allowed to bring packages to patients and if so how do you deal with potential sneaking in of drugs and alcohol? Are there any concerns with elopement or can patients go as they please? In which cases would a patient not allowed to leave legally? If there is anything else you can suggest, I would appreciate it very much.

So very true. The other day I walked into a room of a patient to get vitals (never have been to this room before) and his 40 year old son, thinking he was really hilarious (fool), said out of nowhere: "Hi. I need a steak, mashed potatoes and a coffee." I answered without a delay: " well, then bring some for me too!" I, frankly, felt insulted. I am wearing scrubs and a badge. Do I look like a waitress to you?

Where you should go probably depends on how you learn and your personality type. For me med surg was the right choice, because I learn best in an organized, consistent environment. I need to read first, then do a hands on activity. I a busy ER like mine it is just impossible to do. On med-surg I recieved personal attention and a really great orientation. In ER our preceptors have a patient load of 5-8 patients as well as a new grad to train. From my med-surg expreience I've gathered a huge amount of information, perfected my skills, got charge expreience and when I came to the ER all of it was just icing on the cake. For the cake part i had to go to critical care classes and take ACLS and PALS. Some new grads do really well in ER. Shadow in places where you want to go and speak wth other nurses who are new. See how they like it. Good luck!!

Hello everyone. Have you helped anyone while off duty? Do you feel comfortable giving medical help before 911 comes around? I would love to read some of your stories. Thanks!

ER is a great place to work. I think some people are ready after 1 year and some are not. It all depends on your personality and skill level. It took me 6 months to be able to function on my on on med-surg, 2 years to get to being a charge nurse on med-surg, but the slow-going paid off, because I became very good at what I did. In ER I transitioned very well, no difficulty. I've seen new grads came right to the ER and they were very good as well, but this is very rare. Good luck! Nat

Hi, guys. I am an ER nurse, I'm 33 and I just got diagnosed with new onset fo a-fib. My life and my job are completely screwed up now. If possible, I'd like to know about any online support groups or any other resources, because I have some questions and I can't ask them here and I don't feel comfortable talking about these things with co-workers who see me every day. Thanks in advance. Nat :heartbeat

We are required to do head to toe on ALL patrients, even those with stupid reasons to visit ER, such as - " I ran out of Lortab " or " My arm hurts for no reason x 3 months". Social assessment is a must, even a brief one, because we need to know if the patient is safe for discharge and has adequate supports at home. It is impossible to do everything all the time, so I admit, I skip on some parts of assessment, when I have too many critical patients.

:rotfl:

I started agency in April and i also still work in my "home" hospital as an ER RN. I go to a couple of different hospitals in the are as agency (med surg usually) and every week I end up either in unsafe or terrible patient assignment and/or stafff or supervisor has a serious attitude problem. Is this something that is just the nature of agency nursing? Should I suck it up and continue? Is it the med-surg environment? I do have good days as well, don't get me wrong, but I also see how agency RNs are treated in the ER where I work - it is such a big difference. We all help each other and respect everyone. Any advice is welcome.

I am so happy that something good is going to happen for you! When I read your post I thought you were talking about the ER I work in. Everyone quit, they call me 3 times a day to come in to work. I heard they are planning to form a group for " ER nurses retention". I think they should form new management! Good luck with your new boss!