sheluke

Forgive my intrusion...but thought since this was an active thread and about Chemistry, might get some response. It's been a while since I took any Chem classes/labs (ok, a Looong while :-) and I have a friend who has gone back to school and is just starting a chem class. Last night was first lab and she told me today they had to stand the entire lab (nearly 3 hours)-because the instructor said it was against OSHA rules for them to have any chairs in the lab. This sounds bizarre to me, and certainly didn't used to be that way-nor can I imagine that every professional chemist stands all day long to work either-has anyone else seen or been told anything like this? She was hurting today, not like when you are moving, it's hard on the body to just stand for several hours. I told her I would certainly challenge that one and ask to see it in writing... Anyone? thanks!

If you like a more 'country' life, with some hills and beautiful views, but still reasonably close to home, look towards Charlottesville perhaps-you have the mega system sorround UVA, as well as Martha Jefferson. And Jersey is truly not too far to drive-we are down nearer the Beach area, and can get up that way in about 6 hours. C-Ville is about 3 hrs from us... VA is not known for having the best salaries for nurses, but for many of the other important things in life, has some rich benefits-beach or mountains in couple hours drive; some great school systems and variety of educational opportunities depending on where you live; overall most Va areas are typically rated well in all the great places to live listings. (crime rates, environmental factors...just not nursing salaries, lol) Best of luck!

Agree, and work on the managed care side, that's a pretty good rate for family! Much of it is to do with the employer group itself and it's 'buying power' like anything else; have a sis in Florida who pays over 400 for her family! And from what I've heard, when they had needs, coverage was not as robust as what I have for less than half the cost.

Have not yet seen though plan to, but wish had been around when I still taught CB classes. Was a firm believer (still am) that giving birth is not a 'medical procedure' unless there are extenuating circumstances or risks. Loved helping those new parents who wanted to be fully educated and learn all the options along with all the reality of risks associated with interventions. I could be retired today if I had a dollar for every time I heard: "Why didn't my doctor tell me that?" or "Doesn't everyone have an epidural"

Don't give up! It seems there is a lot of competition for OR slots and it takes perserverance to get 'in'. Which truly is a great thing, because hopefully that means people are happy there (as opposed to some places that have such high turnover they are constantly filling new positions). If you really want to do ped OR, make contact with the nurse recruiters at the other hospitals and find out if they do an internship, etc. Let them know of your interest and have your name at least. I am in a situation similar, have watched the Childrens hosp for over a year, they did one training for new OR nurses in the fall, by the time I'd found out, and sent in app, they weren't even interviewing anymore. So, sent a very polite and interested note to recruiter, asking for heads up on when they might do again, she graciously emailed me back and said she'd keep my name on file. But to also go ahead and apply for open OR position, and in cover letter note the interest in intern program. I thought she was just being polite, but sure enough she both emailed and called me day they posted the new internship (actually I didn't even see it posted yet when went online! ) called her right away and have interview this week! So, if you are willing to be patient a bit, it may be worthwhile. Now, I realize that again this internship is going to be competitive (interviewing all month and probably accepting no more than 6 RNs) but I've learned much from the 'lurking' :-) here, and have had opportunity to speak with the recruiter, she knows I'm experienced and even have management exp but really want to do this, and is aware of the fact that I know will prob even have to take a paycut at first as well. So, at least I know I have a chance and will have given it my best shot. Best wishes!

Wow, that actually would have been great! We were required to wear business casual (no jeans) during class time. Scrubs might have been easier.

Funny when I worked in exclusively peds, almost all the docs were 'DR first name', it was easier and friendlier for the kids mostly. But also seemed more casual for staff, while still keeping the title. When in big teaching hosp-was same as most have said, mostly residents/students first names, and attendings were 'Dr ___' Some that you'd worked a lot with or a long time, were first name less formal times (ie night, no family around, or committees, etc) but always 'Dr' in front of patients families.

In our area, I have occasionally heard of special deals offered related to mortgages, and usually offered for firefighters, police, and teachers. Our 'hometown heroes' etc. Or sometimes there is incentive to draw these folks into certain neighborhoods. Which is great, and I am thankful every day for each of those people in our community...however have heard much discussion on why it is nurses seem to be left out or forgotten on the list of these much needed civil servants... Good luck though!

Is your heart set on being an LPN? If it is, that's great but if you are staying in the area, you are going to need to resign yourself to the fact you will take a pay cut, at least at first and plan accordingly. The area is not great for nursing salaries, period. If your heart is in 'nursing' however, you may want to go ahead and push ahead the relatively small amount of time extra and do the associates RN program. In the long run, the time is not a lot more, but you will start out at least 'lateral' once a nurse. Not to mention, that if you are able to stay within Sentara, you may be able to keep some seniority, etc. Best of Luck!

Sounds like there should be more room or 'levels' available. There can be a solid "meets expectations" or similar to indicate someone does their job and does it adequately. There should be a level that indicates a high quality performance, while alllowing for continued improvement OR as mentioned, maintenence of the high quality performance (ie to maintain this level, goals may be to participate in x number of CEU opportunities, or to mentor or precept new staff,etc) There are ways to fill in space on an eval for 'goals' without it meaning there are any deficiencies. We do have a 'walk on water' level, and it is rarely given but for an absolutely incredible year, perhaps having lead a new process, program, exception outcome, etc. But that doesn't take away from the many staff who are still great at what their job is and get the 'exceeds expectations' or 'highly effective' etc that still shows they go above and beyond just knowing the job. Oh, btw, just wanted to add, we have no actual limit or quota on how many of each to give-giving certain scores just requires documentation (WHY the person deserves that score, whether very high or very low) and that is certainly reasonable. It gives me an opportunity to put in black and white some great feedback received (thank you notes, positive comments from someone who appreciated good care, etc)

Other thing you may consider to help be a 'tie-breaker': 1. Retention rates-if in one hospital it is common for nurses to have longevity (been there for years) they may be happy in general; as opposed to if one or the other has a high turnover rate (why are they leaving?) 2. For what kind of reasons do they have openings now? (similar, but is it expansion, several retirements, or did nurses leave for other reasons? 3. Total compensation package; ie if two hospitals offere you $25/hr each but one also offers 20 days vaca and the other offers 30 days vaca, the second has greater value (benefits, tuition reimbursement, vaca and sick, holidays, any shift diff, etc) Look at the bigger picture 4. What kind of orientation will you receive? One may be more suitable to your learning style or preferences. 5. driving distance, traffic, etc Best of luck!

Have to agree with the others and urge you not go give up after one place-first year (or two) in nursing are such eye-opening times anyway because the 'real world' is often so different than what is in textbooks and clinicals. I would bet if there were a poll, many of us have one of those early positions that didn't end well, or cause worry for one reason or another-twenty years from now, it won't matter as much because you'll have the security of experience, right now it's out of proportion a bit as to the importance of it because you have only the one nursing experience on your resume. An interview is an excellent opportunity to shine, use what seems negative to you right now to your advantage! For example, a former employer can only give HR info (dates worked, if eligible for rehire, etc). But when I have been hiring manager, I always ask the candidate why they left or are leaving, interested in the reason but honestly also in how they present the information. As in, complaining and everything was terrible, etc (may be true, but may also be an indication of attitude, personality, etc). However, you can take it and roll with it by explaining what your perception was in the beginning ("I was a brand new nurse, and since there was a contract, I fully expected a thorough orientation, preceptors working with me until I was 'safe' ") and then go the step beyond and explain what you've learned, you will appear responsible, mature and professional ("I still learned a lot from the experience, to ask more questions, to take charge of my own information, in addition to gaining some in the trenches nursing experience in a less than ideal situation-and I survived!") Wordsmithing any situation can make all the difference in the world-chalk it up to experience and you'll be fine. Best of luck-you have chosen a truly noble profession, it has a lot of bumps in the road but will never be dull!

Ok, once again may resent this, and I am not defending BC, but saying there is a due process that can be followed to ensure this is resolved appropriately- Though I am all for a good appeal when a decision seems wrong...I would discourage anyone from flooding the case manager at BC with calls. I assure you, the case manager does not have authority to have denied this surgery, and is a nurse too and needs to spend her day working with her patient population to do whatever she can for them. She cannot change the decision either, that's not the way to go. The BC policy is actually quite clear about what is considered investigational still with this procedure, and since the article about Ms Kutcher does not go into the level of disc, etc, we really have no idea if the policy was followed in terms of meeting criteria or not. The family and the physicians need to file the appeal, with good documentation of why this is necessary. Most insurance companies do technical assessments of new treatments, new devices, etc, based on many resources other than just FDA approval. There are minimal trials necessary big companies (for profit) know how to do a trial and get through the fda process. There are other clinical sources as well. Believe me, I am absolutely not a fan of any of the 'Blues-however, we do not know the whole story and I have in my experiences elsewhere seen too many occasions where documentation wasn't provided by the surgeon when requested, or newer treatments were being requested that were truly not the standard of care commonly accepted in an authoritative body of physicians (ie one may be wanting to do a procedure and saying he/she is innovative and cutting edge, while the rest of the story may be that the other 9 out of 10 physicians do not believe procedure safe, or have concerns long term, etc) This is putting a foreign body into your spine, nothing to be taken lightly. Anyone that is interested in the actual Blues policy-here's what they say: http://www.bluecrossca.com/medicalpolicies/policies/mp_pw_a053354.htm

Thank you much for sharing this little story, I think that is about the most positive thing I've been privy to all week!

I have been out of that particular path of practice for few years-however as a former IBCLC of several years, my recommendation is to get involved in working with moms wherever you get the chance. There are LC's in hospitals, in Pediatric offices, and of course, many also work with LLL. As with many opportunities-start networking! Do you have a local BF task force? Or a good Women's Health program that has new parent classes? They may be thrilled to have some assistance-you will prob have to 'volunteer' your time at first, but would be well worth the efforts. Find a LLL group locally and see if they need some help as well, their are many that are both LLL supporting and IBCLC- Since LLL leaders and counselors are more in the community, it may be easier to get to know someone whom you can tag with and learn and help at the same time. Get on an LC list serve too-let them know your willingness to learn and your desire to gain the experience towards certification. There may be some that would rather not have a shadow, but prob many more who are willing and happy to have you on board! Don't give up, it does take time and is quite a bit of work, as in anything that is worth it

Ok, chalk this one up to also idealistic a bit....but have you tried the direct approach? As in, you are up to your elbows in something with a patient, nurse B pulls herself from the internet to come find you and let you know your other patient needs assist to bathroom-have you simply said "I am going to be another 10 minutes to finish this, would greatly appreciate if you could help Mrs Jones". Some people will never think to offer, but respond to direct approach-esp if truly not that busy. Then after she wipes the surprised look off her face and does it, make sure once you are both finished to say thanks for having my back! Preferably in front of others, with a little luck and good conscience, it may be contagious!

I really hate those stringent a policy where after missing one day you are expected to bring in a Dr note. There are illnesses where you would not want an employee at work spreading germs, with fever, etc, yet a day or two in bed may be sufficient, as in most viruses and it is unnceccessary to go to a Dr. Why on earth would we insist on someone going to a Dr when they do not need to, with the drains on family practice and lack of appointments already? What I have seen and mostly works is that 1 or 2 days comes out of pto or pal (paid annual leave) and then after that the 3rd day out of a smaller actual 'sick' bank and at that point it is at manager discretion to request a note, ie if you are out more than 3 days it is reasonable to request a note clearing you.

good chance it will be tough with no experience, but one possibility would be Dr office. Though some are open some weekends, it's often only rotation and a Saturday morning. Another alternative if you can get a little experience under your belt first, is managed care/insurance companies. good luck!

May I ask where you are in VA? I am in Va too and know there are probably experienced nursing positions away from the bedsise in our area- Btw, agree, never burn your bridges, someone may have just not had the best morning, may have had back to back meetings immediately after, or any of a myriad of other things going on-sometimes hard to get a realistic feel over the phone. You did the professional and adult thing by still thanking via email.

Unfortunately, that 90 days is pretty standard for benefits to kick in. If you have insurance you can keep (even if COBRA, as expensive as that can be!) until then, do so!

Just one addition to this interesting and very insightful thread-amazing the different opinions! Whether ER or anywhere, I believe it is your attitude 'cweeks' that has garnered you everyone's support in the ER. I mean that entirely positive-as nurses, (not everyone, of course) there seems to be frequently many who takes things too personally, or are a bit oversensitive to any criticism. I think some learn through the years to not be defensive but to listen and see if there is validity and room for growth, learning while others decide to 'take a stand' and place the accountability elsewhere whenever criticized. As a new nurse, your willingness to accept criticism, to learn from your mistakes (which we all have made at some point, none are perfect) and willingness to continue working hard, will take you far, whether you stay in the ER for 20 years or try ten different nursing arenas. You've 'survived' this and persevered-that also often gains respect amongst your peers. Best of luck and keep giving your best wherever you are!

How does it feel to be middle management? Often painful. Yes, I would agree many of us took one of 'those' positions with fully great intentions, wanting to make positive changes and improvements and feel like I am in touch with the 'real' nurses and other staff to be a solid voice to the upper echelon. Unfortunately-what many of us discover is that we are not often in the loop of actually making decisions, but more often are expected to operationalize decisions already made, often without regard to if we have the staff to do so, or the other resources available (right training, $, etc) I'm sure there are some (I could name a couple 'colleagues') that want to do as little as possible and move on up or over and up or whatever...however that's one of the reasons I am still where I am-disillusionment aside, I fear that if I leave my wonderful and dedicated team, they will have someone 'worse' (ie someone who is just climbing and doesn't necessarily at least look out for and appreciate the team) So, I rejoice in small victories, try to focus on the things I and the team can control (staff flexibility in hours, assignments, recognition program, etc) I do believe sometimes the small things still count. But there are certainly days I consider who has staff openings in the hospital...

No actual clocking in or out (and getting paid wrong because 'forgot') No stressing over being outside the allowed 5 minute window if traffic makes you a few minutes late On the side from those advantages, even 'salary' means different things at different places-ie leaving work sick or missing time may still mean you have to enter as PTO/PAL whichever your system uses. Often depends on how much time (maybe a couple hours are ok to make up but half day has to be entered) Salaried is not always cart blanche to work whatever hours you choose just to = 80.

Just want to say I do not know any nurse (regardless of experience) at any hospital in the VB/Norfolk/Chesapeake areas (which covers most area hospitals) that makes a base pay of 35.00 an hour! Perhaps at the top of the scale, plus diff.? Or someone in management. I just don't want anyone to get the idea that's the normal pay-it is most definitely not for the area.

One of the things we do that is similar is also to encourage peer to peer recognition; so for example if someone goes above and beyond in covering or helping out another nurse (or support staff) that person can turn in "sea dollars"-short term it's a sincere pat on the back but we went a step further and these can be kept and accumulated to 'buy' a token of appreciation you choose for yourself. Not a huge budget issue or anything, most of the items in the so called catalog (a box that sits under my desk, haha) are company logo or donated from marketing, or movie tix, small items but things everyone loves!