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If you're interested in pursuing this program, beware that you are going into a program that will leave you scratching your heads as to how unorganized it is. Course content in pathophysiology and nursing care for the adult client lacks a lot to be desired and instructors disappear into cyberspace for a week at a time or more without any correspondence, if they even bother to return emails at all. Certain instructors are just coasting off of material available for previous classes and literally doing nothing to earn their paychecks. The bottom line is that some of the online instructors put virtually zero effort into enhancing the learning and then wonder why test scores are so low. We consistently have to ask for homework assignments due that aren't even posted and exams posted on the website in no way translates to what material exactly is being covered. If you want to a lot, this is the program for you.

Attorney contacted me about a civil suit about a case filed against the hospital. I was not at fault, but they're literally trying to bring everyone involved. This happened over 2 years ago and no longer work for the hospital being sued. The attorney asked that I meet with him at my convenience and I said I have no interest in meeting wirh him or being "prepped" in any way. I've advised him the people they need to be talking to have MD, NP, or PA after their names, not RN. I work nights to the tune of 60 hours a week and have zero interest taking time out of my sleep for which I won't be compensated when it's not of my doing. If I must appear in court, I will be in scrubs and sleeping. What would you do?

I'm not willing to testify on behalf of anything outside my scope of practice or to anything they don't present to me that I charted about this patient, so any other specifics, I cannot recall or I don't know will be my answer to anything that can't be answered with a yes/no question. I recognize my care follows me no matter what state I live in or what hospital I work for, but as I said, this case is about an MD's failure to diagnose/treat and their malpractice/negligence, which has nothing to do with my direct care for a patient. If that seems hostile or whatever other term you want to use for it, so be it.

And by the way, I'm not a "she". Spoke with my friend/attorney last night and he supports my position-no talking with either side period until there's an actual subpoena. I'll tell the attorney my availability is only between 1-1:30am on a lunch break if he wishes to discuss the matter with me any further.

This case hasn't identified me as being negligent or identified me as a malpractice complaint. Thus is against the MD'S that saw the patient named in the complaint filed in court for failing to diagnose and treat. I recognize this will go to trial and meeting with the defense attorney will have no bearing whatsoever in whether I'm called to testify. I already know that I will only agree to what I charted about the patient, nothing more and nothing less. I will have no contact with the plaintiff's counsel in the matter as well. But I do like the idea of telling the attorney that if he wants to talk to me bad enough, he can show up at 1am when I take a lunch break.

This is the hospital's counsel. The plaintiff has evidently named every person that documented something as a witness, so meeting with this attorney will do nothing to alleviate getting a subpoena. The risk management department made 2 earlier attempts to contact me and I didn't return their calls. I figure I no longer work for them, they've done me no favors since I resigned and I don't owe them anything.

What do you hate to see/hear the most? Mine: 1. Ambulances for clearly non-emergent conditions (my personal most notables are of dental pain and a "possible UTI" but I know they're used for far more silly complaints than that. Just the two I've seen myself). 2. Chief complaint of fever, yet they have not so much as taken a temp at home, and if so, even taken tylenol or ibuprofen 3. Mom who brings in all 3 kids because they all have colds at the same time. 4. I'm allergic to tylenol, ibuprofen, codeine, aspirin, hydrocodone, oxycodone, morphine, and zofran. All of them have caused anaphylaxis. 5. The patient that claims their police report PROVES their medications were stolen.

I've been an RN for 3 years now. First 1.5 years was spent in the ER and the last 1.5 years has been in critical care at a different hospital. After spending a full year in critical care, I realized it just isn't the best match for me. I get burned out a bit on having the same patients for 12 hours/day, 3-4 days straight. I get bored with the amount of downtime we have and the nights drag on for what seems forever sometimes. Additionally, the current situation I'm working in is one I cannot tolerate much longer as management is just ridiculous. It seems as though they actively encourage the day staff to really look for stuff to complain about to ultimately write us up over. After awhile, this really got to me and has caused me some serious anxiety issues the past 6 months. I am so over the idea that our managers prefer to deal in gossip than ultimately attempting to get staff to talk to one another. There are numerous instances that I could have chosen to complain, but I'm actually an adult and would rather sit down with that person myself and ask them about it rather than just try to get them in management's office first. I received an offer today in another ER. The dollars and cents of it aren't as good, but my sanity at this point isn't without a price. I've applied for a transfer to our own ER, but haven't heard back on that just yet. I think other than anything short of getting a transfer at my current hosptial, I need to take the new job. What would you do?

First and foremost, I don't like art lines. I find them in patients coming from PACU with no real need for them in the first place in almost every instance. That said, I had a patient last week with an art line that was frequently moving and had significantly elevated pressures. I zeroed the art line myself as well as 2 other RN's, both of which were more experienced than I am. The pressures on the art line weren't correlating with pressures taken from the cuff, as in they were reading 200-220's while his SBP's were running 150-160 for the most part. I couldn't find the culprit and neither could the other RN's that looked into it. The thing I should have done is discontinue the art line altogether because there was no order for it from the MD in the first place. The much more experienced ICU nurse said "not to worry about it". When I gave report to the day shift RN, I commented that the pressures weren't correlating and that I should have just had the PACU RN pull it prior to bringing the patient to our floor. The day shift RN went to management and evidently complained that I just increased the parameters up to 250 (which I didn't increase that high). It appears management wants to talk to me about this and I feel like I may have done wrong by not either discontinuing the line in the first place or not demanding the MD put in an order. That said, I did seek additional input and attempted to troubleshoot the problem as to why the pressures were reading so high. Long story short-can anyone explain why it would seem art pressures would seem to be substantially different when everything is positioned correctly? I can see variance of 10-20 with no issue, but I'm talking pressure differences in 50-60. I will tell them I attempted to troubleshoot the culprit with other RN's, but what else could I have done differently in the future (short of just pulling the stinking line in the first place)?

I have a bit of a different track into nursing as I decided after 10 years in a prior career that I wanted to something more meaningful in my life. Admittedly, this prior career was more heavily dominated by men and had much less drama. Anyway, I just started a job at a new hospital on an inpatient unit. I previously spent 18 months in the ER at a different hospital. I've been meeting with the dept manager every couple of weeks so we're all on the same page which is a good thing. I still have yet to really sort through who is staff or resource in the dept, let alone physicians et al. I'm focusing on my time management as our charting system absolutely sucks and I'm busy for 12 full hours while the veterans have play time. I was told by my manager the feedback from the staff has been that I'm tough to read(hint - I'm too busy trying to do my job at this stage first, not be coffee or smoking buddies). I get it and accept I'm more introverted. Co - workers as questions about what I've done and what I want to do in the future and I answered that I'll probably end up back in the ER at some point after getting critical care experience. Now it is a rumor I just wanted to come to get in the ER there and it's been presented back to the manager and she called me on it. Men (at least most that I know of) can take such info and not get caught up in some drama. After this kind of stuff goes around, it makes me want to give them no ammo for their drama machine. Do I just have to be so explicit working in this field that there is absolutely no room for error or what? I feel like I'm screwed either way.

I work at a hospital and was contacted last week about an exposure at work from the occupational health department. After working this past weekend, I was disgusted to find out what happened. As the story goes, an ICU patient was undergoing continuous dialysis. The machine evidently leaked waste and said waste somehow managed to drip down into the pizza oven and then end up on the pizza I ate. The hospital's initial communication seemed to be rather "nothing to see here", we've fixed it, and we're open for business again. This detail wasn't revealed to the entire hospital-just those determined to consume the pizza from the video/receipts from those using direct withdrawal from theirr checks to pay and showing those who purchased the pizza. As it tuns out, the patient was positive fo Hep C. I'm an RN with just 1.5 years of expeience and know vitually nothing about dialysis. What exactly have I been exposed to from a biological or chemical perspective? I'm really put off by their attitude about this being no big deal, but it's a big enough deal I now need to go in and have blood draws done now, 30 days, 90 days, and 180 days. To top it off I'm transitioning to a new hospital and will no longer be working there a month fom now. I'm contemplating contacting an attorney to pursue damages. Am I overreacting? Granted, in this field, I'm subject to exposures and need to take precautions, but this is a situation that I had no chance of preventing. Thanks for any advice you can give me.

I'm a new RN-I changed careers as a way of somehow being able to give back to others for what I was unable to do for my parents. It was 6 years ago (yesterday) that my dad passed and today is every bit as rough for me as it was then. It seems to me that you did everything that you knew to do for him and he got the peace of being with you rather than an ECF. You tried to make the best of what you could do and I don't know there was anything mroe you could have possibly done other than being there with him.

I'm not asking for medical advice. The only problem with going to my PCP for this exposure is that the visit/co-pay as a result of this comes out of my pocket. I'm told I will see a NP when I go in for the blood draw tomorrow at the occupational health center. I'm mainly interested in knowing whether I'm out of line in seeking out my legal options for this as this is going to be a burden on me down the road, not to mention knowing how nasty this is. People have sued restaurants for nastiness appearing in their food-how is this any different?

I should have been more specific. The ICU is on the 3rd floor and cafeteria on the 2nd floor. However it happened, the runoff went into the oven.

Yeah, I don't get the concept of people giving something for every fever. I think our pediatrician doesn't even really encourage meds until you're at least 102. By treating the fever, you're not allowing the immune system to do what it's supposed to do. Speaking of meds, it also drives me nuts that we have some doctors who will give scrips for the tylenol and ibuprofen so the patient's "insurance" will pay for it. You just came to the ER for free and you can't so much as dig out $5 out of your own pocket?

Seems like a stupid HR policy then-giving out free educations and then not recouping their investment. Don't blame them for taking advantage of it. I'm planning on enrolling in NP school and the hospital will pay for most, if not all of it. I'd have to stay for 2-3 years afterward or pay back the funds. The hospital doesn't guarantee a position in that capacity when I complete it and the heck of it is, I couldn't be in the NP role and work for the hospital. How dumb is that?

Hope you have better luck than me. Granted, I'm a relatively new RN, but in all of the OR postings, I always see "must have prior OR experience". It's not like anyone is willing to train you.

If they said it, quote it as such. If someone calls you out on profanity in the charting, they have issues, not you.

We all have these patients- They don't pay a dime for their "insurance", they call 911 for the "free ride", and they claim they're having (insert random symptom of the day) with 10/10 pain. They claim they're on home oxygen to warrant the "free ride" home in an ambulance because they didn't bring their home O2 tank, despite the fact the patient refused to wear the oxygen in the room. The service is never fast enough, the pain meds are never strong enough, and the harder you bust your butt, the more they'll make you work, and the words "please" or "thank you" aren't even in their vocabulary. I do NOTHING out of the way for them, I take my sweet time, and the more you inconvenience them than you go out of your way for them, the less likely they'll come back.

Most tuition reimbursement plans would call for you to stay X number of years upon completion or you'll repay it. By saying you want to go back to school, it should indicate they're more likely to lock you in for a longer period.

I would think you should already know what patients they typically see and what their trauma level status is. It shows you're already doing some homework. As far as not mentioning a desire to go back to school, I don't see that being an issue. I think many hospitals see that as a plus and if you're an ASN by chance, most of the hospitals are requiring new grads to complete a BSN within X number of years or they're gone. Going from a BSN to MSN, NP, etc will only enhance your practice and further your clinical skills as a new grad because the more exposure you have, the more/faster you'll learn.

In the ER, it's always best to use the AC in the event they might need a CT scan with contrast or get phenergen. It's a no-brainer if it's available.

In my market, many hospitals have stopped back filling weekend option positions or eliminated them altogether as was the case with me a couple of weeks ago. We work 24 hours every weekend and given the benefits of a F/T employee are now being cut back to regular part-time status. The political climate is to strip out and devalue health care in such a way in the name of "affordability" that the financial reward doesn't come close to wait we have to deal with on a daily basis. I'm still new (BSN grad May 2012) and have worked weekend option for my first real job since then. I work with a great group of RN's and of all the night shift RN's in the ER, they are by far more experienced than the night shift during the week. Even as a new grad, my base cut in pay is expected to be $15-16k LESS next year, let alone those who make far more than me in their base pay. Personally, I picked up a lot of extra hours and OT this year that I'm now only expecting to make 40% of what I will make this year because other weekend option nurses will be picking up shifts they normally wouldn't work to help make up for the difference in pay. As a result, I've started applying for other F/T positions and there is still a hospital in my market advertising for weekend option and regular F/T nights. It's quite surprising given this hospital receives much higher percentages of uninsured/medicaid than all the others. They've called to set up and interview, but I can't help but be gun shy to take an offer for a weekend option position knowing how many others have done it. Part of me likes working fewer hours at a higher rate of pay, but then I'm also burnt out already for missing out on Sunday mornings at church with my family. Seems if I took regular F/T, I'd likely have some sort of weekend rotation anyway and if I wanted to pick up extra hours, they'd likely be available. Would you take the risk of a weekend option offer today? Either way, I know that going forward in my current gig is nothing more than 0.6FTE in my current role and being offered a 0.6 WEO gig would still be better than what I have going forward, but just how long would it last is what I want to know.

This is too easy. Take your current stub, multiply out times # of pay periods in a year to get yourself an annual salary with a breakdown of your taxes. If you know what the additional pay is for for 2 weeks at 48 hours/week, use those rates. Come tax time, you'll get a breakdown and see where you're at with what you're declaring in deductions. It won't be exact, but it'll get you close. For example, I learned of my weekend bonus being eliminated and getting cut to part time. I've already determined based upon my anticipated income for 24 hours/week how much I'd expect back with the EIC "free money" and how much disincentive there is to pick up any extra hours at a certain point as a result. At my current base, I'd get the equivalent of 20 hours/month at PRN pay to NOT work. I"ll add up and see what happens by adding in another 8 hours/week and see if I'd still get all of that money back or not.

I said it because it's going to make it even worse. If you think it's going to help the field, you're sadly mistaken. I've never see massive layoffs for nurses in my area until local hospitals started dropping hundreds of jobs in anticipation for the implementation of this crappy law Jan 1st.