All Content by 86toronado
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Manager wants us back in office...
Those of us who did not/could not work remotely throughout the pandemic received no such differential. I worked in a closed unit with all COVID positive patients for months and received nothing above or beyond my usual pay for doing so. What makes you think that having to go back to business as usual now that the risks are much lower entitles you to some kind of reimbursement now??
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Conflict of Interest?
I work in a LTC facility. We have several medical providers that have patients in our care. One in particular literally never sees his patients. Instead he has an LPN who works for him who also works PRN in our facility essentially practicing medicine in his name. This LPN has access to our medical records at home, and has been known to call staff nurses on their personal cell phone when she knows they are working to ask why orders that “The doctor” entered into the system aren’t done, etc. My question is would it be considered a conflict of interest for this nurse to be working in our facility and working for this physician at the same time?
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New Unit Manager - short term
I took a position as a unit Manager in a LTC facility last year. I had no LTC experience whatsoever. It was scary, and then we got to deal with a COVID outbreak in our facility on top of everything else! I have been muddling through. I have found that my staff nurses are my best source of information when I don’t know something, they usually do, LOL.
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What kind of shift report was that?
This is why I love ER nursing. Report consists of something along these lines: "Okay in room 1 you have a 65y/o male no cardiac history, chest pain for 3 days. Line, labs, EKG done, doc hasn't seen him yet. Room 2 is a 48y/o female abdominal pain, vomiting for 3 hours. Line, labs done, meds given. Waiting for CT and still need urine. In room 3 you have a 2 y/o with a fever and cough. Tylenol given, and the temp is down, he's up for re-eval. Room 4 is empty. Any questions? No, okay. Have a good day." This is a perfectly acceptable ER report. You're used to knowing nothing about patients when they roll in the door, and having to do some digging, and they turn over so quickly, you really don't need to know much more than what's been done, and what's pending. I went back to work the floor briefly after having worked in the ER for two years, and remember being one of the quickest report takers, because I would rather just look things like labs and new orders up for myself.
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What is so difficult about this question?
I don't know. If it were me, I'd want the healthcare provider taking care of me to know all about my medical history. For example, I've had pneumonia 3 or 4 times in my life. I've had at least three concussions. None in the last 15 years, but still pretty important, I think. These are all things that I don't take medicine for every day, but they are something a provider would probably want to know if, for instance they were ruling out pneumonia, or a head injury.
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What is so difficult about this question?
As an ED nurse who works triage a lot, I find it incredibly frustrating that when I ask most patients if they have had any medical problems in the past they give me a blank stare, and sometimes ask "What do you mean?" Most then proceed to give me their surgical history. Sometimes after I get the blank stare, and then the surgical history I ask if they have any problems that they take medication for every day, but that doesn't cover everything, like they could have had an MI in the past, but not necessarily be on any meds related to it. Is there some other way to ask people that would make it more clear what I'm looking for? I work in a busy ED, and see probably 50 patients a day come through triage, so I guess that's why it's bothering me so much lately.
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Poll: Do you wear your wedding band to work...?
I wear mine, but it's just a plain silver band, no crevices or anything to get stuff caught in. And when I wash/sanitize, I routinely push the soap/sanitizer onto/around/under it. Most of my married co-workers wear their big diamond solitaires to work, though.
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Is there a line floating?
I've worked in float pool, and was expected to float anywhere except ICU, ED, and OB. That said, since I had PALS, I suspect I could have been asked to float to OB if it had been necessary. And I did regularly float to ICU, and took "step-down" paints, even though I knew they weren't really... Not that safe, but I never complained.
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Do Nurses Earn Big Money? You Decide.
It's all about perspective... Does a doctor, or a lawyer, or an engineer think that my $60k a year is big bucks? No, of course not. But the people who say that to me are not doctors, lawyers, or engineers. They're waiters, retail workers and of course, our patient care techs who work with us. It sure looks like big bucks when you make $9/hr - trust me, I know this from experience. As far as whether I feel like I make good money, in short, yes. I drive a new car, I own a home in a nice neighborhood, and go on vacation several times a year.* I am able to do all of this by working 3 or 4 days a week. There is no other job I can think of where that would be possible. Oh, wait. I could be a firefighter... Nah. I'll stay a nurse. *disclaimer: I don't have kids, and my husband is an RN as well
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what's your take on this?
I have been threatened by patients when working in the ER, so I could see it from that perspective. I don't know why the med-surg nurses would need to watch their backs though...
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Shift differentials?
Three months was the norm in the hospitality industry, where I worked before healthcare. Not ideal, but if you need coverage, you can always choose to pay COBRA rates for the interim period. I usually just wing it, but I don't really have any chronic health issues.
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New grad at a non-skilled nursing facility?
Um... to be blunt, it wouldn't even be a question for me. If I were in a position where I needed to borrow money for rent, I would take any job I could get to put food on the table for me and my family, even if it was waiting tables, or mopping floors. (Both of which I have done by the way, which is probably why I have never been in the situation to need to borrow money to pay the rent)
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Shift differentials?
Wow! 35% on nights??? That would be amazing! I hear Orlando pay is a little higher than the rest of the state, though... I have a couple of friends who have transplanted there in the last few years. But my husband is intent on living hear the ocean... so any thoughts on the Gulf coast anyone??
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"When Was the Last Time I Wow'ed a Patient?"
I love this topic!!! I just had to meet with not one, but two managers of a unit I floated to after working a 12 hour shift, to answer about a patient complaint regarding my nursing the night before!! The patient, who waved me away when I attempted an assessment, said that I failed to assess her and her roommate. Said roommate, whom I got no report on, was very unstable, and I actually spent the entire night following up on her lab values, vitals, blood sugars, etc. The other patient (ie: the complainer) was the most stable of my 7-patient assignment, so excuse me if I didn't get in to assess her until 2145. So, unfortunately, the patient I "wowed" that night was unable to speak for herself, so instead I had to answer to the management regarding the alert, oriented and independent complainer.
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Shift differentials?
My husband and I (both RN's) are planning a move to Florida, specifically the Sarasota area in the next 6 months or so. I hear all the time about how FL nurses don't make that much money, but according to their online job postings, Sarasota Memorial Hospital's pay rates are very similar to what we are getting paid here in upstate NY. Considering the slightly lower cost of living, and no state taxes, we may actually come out ahead. Unless the shift differentials less? Is that what everyone is complaining about? Here we get about 10% on eves, 15% on nights, and an additional 10% for weekends, it varies only slightly by facility. We both plan on working nights. I've done a couple of web searches, and haven't really found any definitive information on shift differentials in Florida. So I would like to hear from people who are actually working there, not necessarily in Sarasota, but a general idea would be nice. Thanks ahead of time for your help!
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Sleep deprived due to nightshift
Like some of you above, I am naturally "programmed" for nights as well. Prior to starting nights, I was never a "good sleeper" I would take hours to fall asleep at night, and then never feel rested when my alarm went off. Now I've worked night shift for almost 5 years and have the opposite problem from most. I feel like a zombie when I have to be up in the daytime for something. But my husband is a natural morning person who works nights, and here are some things that have helped him out: -We keep the bedroom cool, about 65 degrees -We have curtains on all the windows (it used to be blackout ones, but now that he's more acclimated to nights, it's just regular curtains.) -There is always a fan on in our room, even in the winter. -A sound machine, or some other kind of white noise is essential As far as supplements/medications for sleep go, I've never tried anything prescription, but have used the following (usually when I need to go to sleep at a "normal" time for a class or something in the AM) -Benadryl made me more zombie-like than if I hadn't taken anything at all. I took it when I had to be at an ACLS class all day, and had to go take a nap in my car at lunchtime just to get through the day. -Melatonin I've found to be very beneficial in helping me fall asleep, which is sometimes an issue for me. But I still sometimes wake up after a couple of hours -Valerian root, on the other hand doesn't help with the falling asleep, but is fantastic for the staying asleep aspect. Gives me weird dreams though, so I only use it once in awhile.
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Would phlebotomy skill be helpful to get a job as an RN?
Yes. Go for it. Even if some hospitals don't have RN's drawing labs, some do, and all that I know of consider IV starts a nursing responsibility. If you are competent at drawing blood, starting an IV will be that much easier for you, and that could make you more employable, especially into a position where you do that more, ie: ER, pre-op, urgent care, etc.
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ED RN possibly relocating to Hudson Valley area
Hi there! I live in the Albany area, so I can break down those hospitals' ED's for you: -Albany Medical Center is a level one trauma center. Very busy, lots of transfers in and holds. Doesn't pay that well, RN's start at $21 and haven't gotten raises in a few years, but they have a bonus program as well as a clinical ladder. -St. Peter's is a smaller ED, still pretty busy. They use alot of agency staff, but they've been cutting back. Pay is a little more than AMC, maybe starting at $22 but no bonus program. Recently merged with Albany Memorial and Samaritan, so I imagine the pay at those ED's would be similar, although Samaritan used to start RN's out a little higher, maybe $24 prior to the merger. -Ellis (in Schenectady) has 2 ER's, one is very busy, the other not so much. They don't use any agency, they are chronically short staffed, and they don't have additional resources to call in. Pay starts a little higher, maybe $23 for new grads, and they are union, so raises are automatic. I don't know anything about Poughkeepsie hospitals, although I'm working with an agency nurse tonight who is from there, and is driving up to Albany for work, so that might say something...
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How long does the "new nurse anxiety" usually last?
I never had much anxiety, but then I am not an anxious person in general. My husband, however is, and he said it took him about a year to not have the anxiety. He also said it really went away once he started precepting other.
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How do you deal with these types of patients?
I am so glad to be out of the ER, because I think this type of patient made up 50% or more of our patient and family member mix. And maybe it is un "nurse-like" but as another poster stated, no one short of someone who has an IQ less than 80 can be completely unaware of how much time they are taking away from other patients with their frequent requests of "can you move my tissue box four inches to the right?" The only way to deal with this is to set limits, stick with them, and make sure all of the staff on the unit does as well.
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Tampa General...any thoughts
For those of you working directly for baycare, do they contract people year-round, or just for "the season"? Just curious for my own personal reasons, not trying to hijack the thread...
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Best job for new grad?
Where you decide you want to specialize is a very complex decision, and not one that needs to be made right at graduation time. If NICU intrigues you, by all means apply there, but as someone already told you, it may pigeonhole you down the road if you decide to try something else. The best advice I could give if you really have no idea is to work on a med/surg floor with telemetry, as that will give you a great foundation for anywhere else you want to transfer.
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Night shift better for shy personalities?
I too am an introvert, and I definitely prefer night shift, to the point where I would not consider working days, even if it paid more (which it doesn't ) That said, there are still going to be situations on nights when you will have to step out of your comfort zone. Someone above mentioned calling MD's, which is something I struggled with alot when I first started, but now am very comfortable with. What helped me with that was having all of the information necessary right at my fingertips before picking up the phone, that way when there are inevitable questions about why you are calling about this now, you have info to back up your decision making.(funny side note; as I am writing this, I am listening to the hospitalist gripe about a nurse who called her to report positive cultures, but then didn't know whether they were blood cultures, urine cultures, how many there were, or what the growth was...) Another thing to be aware of, if you are working 7p-7a: there will still be family there when you arrive at work, and they will start calling you before you leave in the morning. Just remember that in this situation, you are the expert. They are looking to you for information, and empathy. They want to hear your input on what their family member is going through... like someone above said, it's not like striking up a conversation at a party. And, finally I would suggest that if you really feel that if your shyness, and difficulty working under pressure will hinder you in a high pressure job, maybe try starting out in long term care, or some other position where you have your patients for a long time, and really get to know them and their families. That may help relieve some of the awkwardness.
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Realistic take home
Where in south FL is this? I don't need hospital names, but city if you don't mind would be nice... also what unit do you work?
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Curious about Exit interviews
I am about to resign from my first nursing position on Monday, and am curious about what goes on in these exit interviews that I hear about. Are they mandatory? Who usually conducts them? What types of questions do they ask, and more importantly should I answer them honestly? Just a little background info, I have worked for the hospital that I'm leaving for almost 6 years, 3 1/2 of those in an RN capacity. I am leaving because a much better opportunity came up for me, but there are also some things I would like to get off my chest before I go. Is the exit interview the appropriate place to bring these issues up?