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  1. everthesame

    OB narrative nursing notes

    For just an hourly round note, I chart what they are doing and whether or not they have any needs. If they do, I state what it was/how it was met. Some examples: Patient sitting up in bed talking with visitors. Denies any needs at present. Perineal cold packs given per pt request. Pt resting in bed w/ eyes closed. Appears to be sleeping. For baby I would put something like "Baby remains in mom's room, sleeping in crib." Or "Baby being held by mom/dad/visitor." Just a quick little note to indicate you laid eyes on the patient. Our current charting system has boxes you can tick off on an hourly rounds screen plus it has a narrative field so we can chart stuff that may not be addressed by a tick box. I don't work labor room so I can't speak to what they would be charting hourly.
  2. everthesame

    How is the job market in Indiana?

    Congrats on the new job! I have been a nurse for many years and was looking to get back into a specialty I had plenty of experience in. I applied for many positions but was not getting any calls for interviews. I hadn't burned any bridges at any previous jobs. I was considered "eligible for rehire" at my previous hospitals. No gaps in my employment record. I was starting to wonder what was going on. Finally, after about three years, I scored an interview in my preferred area of nursing. I later learned that when my director posts a position, she is only sent the first four or five "qualified" applications to review and interview. So, even if she knows someone who would be a great fit for our unit, if that nurse isn't one of the first people to apply for the position, my director won't have the option to interview that person. My advice would be to stalk the job openings several times per day. If you haven't already signed up for an account on their site then do so right away so that when you see an opening you can apply quickly. But before you apply for a specific position, tweak the resume you have saved on their site so that you are using keywords specific to the position you want. Most places use software that scans applications looking for specific keywords that might indicate you are a qualified candidate. If the computer deems you a potentially qualified person then it will spit out your resume for a human to review. Good luck with your job search.
  3. everthesame

    L&D nursing an NICU

    A hospital where I worked had resource nurse positions. The perinatal resource nurses worked in nicu, l&d and postpartum. They may be scheduled for a certain unit but could be pulled to one of the others units if they were needed more on another unit. This was a non benefit position but those nurses earned a higher hourly wage. They were also first canceled if census was low. We also had float pool nurses. They were floated between the above units and also the GYN med-surg unit. Float pool nurses were benefited positions and were never scheduled in advance to a specific unit. They would call in a couple of hours before the start of their shift to see where they would be working that shift. Not every hospital has these kind of positions and they usually want experienced nurses. Right now it is hard to get into nicu or l&d as a new grad. The ones I have seen recently were either capstone students on the unit or had a student nurse position on the unit prior to graduation. You might have more luck getting a position on a mother baby unit and then trying to get some cross orientation to one of the other units.
  4. everthesame

    Do not like L&D!!

    Where I work the moms are kept in L&D for 2 hours after delivery. However, sometimes when things are busy they may pull a postpartum nurse to L&D to do recoveries. Of course, the recoveries are done in L&D and their staff is always nearby in case of any complications. What my postpartum job entails: Assessments, pt education, pain management and LOTS of breastfeeding support. I work nights and that tends to be the prime time for breastfeeding meltdowns. Sleep deprivation, hormonal changes, and a baby who wants to cluster feed can really send a mom over the edge. Or baby is sleepy and does not want to eat and mom is worried the baby will starve to death. It helps to educate the parents in advance about what to expect from the newborn during the first 48 hours. Pt education can also be a challenge due to time constraints and the abundance of visitors many moms have. Also, we do a few newborn tests...hearing screen, transcutaneous bili checks, pre and post ductal O2 sats, required blood tests. And again, that can be difficult to get everything done when that abundance of visitors in mom's room are there to see and hold the baby. I am sure there is much more, but I am getting a little tired and need to go to bed soon. Whatever you decide to do, I wish you the best!
  5. everthesame

    Oh my goodness....!

    Congrats on the new position and welcome to the "club"
  6. everthesame

    feeling overwhelmed...

    I learned a long time ago to carefully check my schedule whenever I needed to take a class during the day. Sometimes the people who do the scheduling are day people who don't realize that a nocs person needs to be off the night before a class. They may see that you have class on Monday the 3rd and not think twice about scheduling you on Sunday the 2nd. Personally, I would not have come in. I would have told the charge nurse to contact the manager who sent you the e-mail saying you were to be off for that shift. If I had to be at the hospital for an 8AM class, I probably would have already taken some Tylenol PM by the time the night shift charge nurse would have called me. I wouldn't have been able to work anyway. At this point, I would not call in sick. It would look unprofessional and as someone else pointed out you could get into trouble for calling in sick for a shift you requested off. Just know in the future to make sure the schedule reflects any changes made to your work hours and if the schedule hasn't been changed, contact the manager and scheduler about getting it changed.
  7. everthesame

    RN Salary Survey 2013: Post here!

    Indiana 15 years exp Postpartum/Newborn Nursery $32.00/hr base $5.25/hr nocs diff, $4.75/hr weekend diff No union Rent for a 3bed/2bath apartment in a nice area is $1000/month
  8. everthesame

    PRN pay vs. full time pay?

    The PRN was at the job I was leaving. I did not really plan to stay PRN and really did not think about wages when I told them I would pick up some hours when I could. My old boss had always seemed to be fair and honest with me so I was a little shocked to see the difference in pay without a "heads up" from her first. Now I feel like she kept forgetting to get the PRN contract letter to me so I would not find out that the pay was so much less. Fortunately the new "dream job" is everything I hoped it would be and then some. Oh, and they pay more.
  9. everthesame

    PRN pay vs. full time pay?

    I recently landed my "dream job" at a local hospital. I stayed on PRN at my old job more as a favor to them then for any financial need on my part. They were giving me first choice of available hours and begging me to pick up as many hours as possible. My old boss was supposed to leave a PRN contract for me to sign in my mailbox but she kept forgetting to do it. Well, I just got my first PRN paycheck and discovered I am earning almost $4.00 per hour less than I did when I worked full time. I have worked PRN a couple of places in the past and PRNs were earning a little more per hour than full time benefited nurses. I know I should have asked about wages before agreeing to stay on PRN but when the request came up I was starting the new job and pretty busy with getting through orientation and getting some old credentials up to date. I have decided I will not be working PRN at the old place anymore. I have one more scheduled shift and that will be it for me. I was a little curious though about PRN pay. Do other facilities pay a little more hourly for non-benefited PRNs or did I just get lucky with previous positions?
  10. everthesame

    I can't sleep!!!

    Unless I am off the next night and have something to do after work in the morning, I stop the caffeinated beverages around 3AM. Also, I wear sunglasses for my drive home unless it is winter and still dark when I leave work or if it is raining or snowing. I find that the sunlight "energizes" me on the drive home, even on cloudy days. I make sure I put the sunglasses on before I step outside the hospital. Another thing, for me, a cold room to sleep in helps. It may be 40 degrees outside and I will have my bedroom window open and a couple of extra blankets on the bed.
  11. everthesame

    Haven't found my "place" in nursing.

    It sounds like you are having a rough time. It does take time, maybe about a year, before you really start to feel somewhat confident in what you do. Also, night shift is very hard on a lot of people. You are living the opposite of the sleep-wake schedule nature intended your body to live. Hormones get out of whack and that can lead to mood disorders, depression, anxiety, etc... Then throw in the stress of having to learn a new job in which people's lives depend upon you. I do not work in a clinic but I do know from friends that working in a clinic can be every bit as hectic as working in a hospital. I currently work in a prison. The acuity is usually lower but when things go bad they can go really bad and a rapid response team is nowhere in sight. My rapid response is EMS and it can take a long ten or fifteen minutes to get them there. Is there any chance of transferring to a days position on your unit? You may find it easier to handle the challenge of being a new grad on a med surg unit if you are not also trying to adjust to the night shift lifestyle. Having just a few months of nursing experience could make it difficult to find another job in this tight job market. If at all possible try to find a way to hang in there for a few more months. Or maybe look into transferring to another unit in the same hospital. I am convinced there is no "easy" nursing job. They all have their own special stresses. You just have to find the area of nursing and the work schedule that is the best fit for you. Whatever you decide to do, I wish you well.
  12. everthesame

    Acute care nurse surveyor questions

    Is anyone out there a nurse surveyor? I have an interview set up for this position at the end of the week. I applied so long ago that I forgot all about it until the woman called me yesterday to see if I was still interested and to schedule an interview. What all does this job entail? What sort of questions might I expect during the interview? I understand there will be a lot of travel involved. That isn't really an issue for me since my child is grown. I think one of my biggest concerns is that this is for acute care facilities and I have been out of the hospital setting for about five years now. Any information and/or tips would be greatly appreciated. Thanks!
  13. everthesame

    RN some experience looking to change hospitals advice needed!!!!!!

    I would absolutely apply at a hospital closer to my new home. With that as your reason for changing jobs after six months, I don't think that would be held against you. Fifty miles is quite a long drive and gas prices sure aren't going down. Perhaps you could somehow put into your cover letter how you recently moved and are looking forward to serving your new community. Or if they have a nurse recruiter, call them and mention that is your reason for changing jobs so soon and that you have a strong desire to stay in telemetry and that you are just looking for a shorter commute.
  14. everthesame

    Tips on how NOT to appear like a Drug seeker

    And who are we helping by continuing to give narcotics and benzos to people who are not following up on whatever it is that brings them to the emergency room? Prescription drug abuse is a real problem. When you have someone who is in multiple times for some subjective complaint of pain without any objective evidence of disease or injury then perhaps the problem that needs to be addressed is that of drug abuse. Once your million dollar ER work up comes back with all tests negative and the ER doc tells you to follow up with your PCP then that is what you need to do. If someone is having issues with chronic pain, they need to be followed by a PCP. The ER doc is not your PCP.
  15. everthesame

    How to respond after shadowing experiences

    I currently work nights so another position on nights would not be an issue for me. The openings occurred because of a couple of nurses who are leaving. One of the nurses I shadowed will be leaving due to her husband's military post changing. Thank you for all of the suggestions, now I better get cracking on that response!