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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.

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.

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.

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!

Congrats on the new position and welcome to the "club"

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.

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

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.

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?

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.

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.

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.

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.

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!

I recently interviewed for a position I applied for so long ago I forgot I had applied for it. Seriously, I applied to this hospital eight months ago and didn't hear back until a few days ago. I heard from them Monday and interviewed Tuesday. I thought the interview couldn't have gone better. Near the end of the interview, the department director let me know she was hiring for both night shift and weekend option days. I have now shadowed on both shifts and have to e-mail her this weekend and let her know which shift I would prefer. I think I want the weekend option position. I plan to return to school for my MSN next year and think it would be easier if I am on that schedule. But I also wouldn't be too disappointed if I were offered the nights position. I am looking for suggestions on what to say in my e-mail so that I let her know my preference while still letting her know I would also accept the nights position if offered. But I don't want to come across as desparate. Any help would be greatly appreciated.

Where I work we seem to have a high turnover. A lot of nurses decide it just isn't their cup of tea. It does wear you down when you are constantly dealing with people who are confrontational with you. And the lies and drama you have to deal with. I can't tell you how many inmates get sent out to the ER for chest pain and other textbook MI symptoms. After getting the "million dollar" workup, none of them had anything wrong with them. Not one. Inmates tend to test the new nurses to see if they can get the nurse to give them things the more experienced correctional nurse would not...whether it is meds, a bottom bunk restriction or a note to get out of work. We always try to warn the new nurses to expect this but even with fair warning it still can be overwhelming. After all, we are nurses and our default mode tends to be accommodating to our patients. Only, in the hospital it doesn't really matter if you give your patient an extra drink or dessert with their dinner (assuming no dietary restrictions) but in prison you can find yourself in big trouble for giving something extra to an inmate. My employer often hires new grads. This is not the best environment for new grads. Because you often cannot believe what an inmate is telling you, you have to have developed great assessment skills. While the inmates often lie, every once in a while you do come across one who really is sick and you have to be able to recognize sick...even in an inmate who has cried wolf numerous times in the past. Assessment skills can only come from experience. And you have to be confident in your skills because a lot of inmates will argue with you if you do not tell them what they want to hear or give them what they want. Also, unlike a hospital environment where there is often another nurse or two nearby, in a correctional setting the new grad nurse may be the only medical person responding to an emergent situation and not have another nurse nearby for a second opinion. Most new grads don't stay long. Out of the numerous new grads we have hired, only one has stayed more than a couple of months. And she is, in my opinion, pretty useless as a nurse. She is lazy as can be and any time someone might need something more than a bandaid, she will find a way to pawn that inmate off onto the other nurse working...even if that other nurse is stationed in a building nearly half a mile away. You can't build up your skills if you never do anything. She is also extremely disrespectful to the inmates. She talks down to them all of the time. Not only does she talk down to the inmates, she also talks down to the correctional officers. I am not "friends" with any staff or inmates, but I do treat them all professionally and respectfully. You never know when you may find yourself needing help out of a sticky or even dangerous situation. While I have never found myself in such a situation, I have heard of inmates coming to the rescue of an officer in trouble. If you have been disrespectful everyone around you, they may not respond as quickly as they could have. Don't get me wrong. There are plenty of nurses who stay. Many of our nurses have been there for 15-20 years. Me, I have been there for 5 years but am looking to move on. I want to pursue my master's degree and I don't really see room for meaningful advancement in line with the area I want to study. Plus, my company's tuition reimbursement sucks. I interviewed for a hospital job that has a fantastic program for RN's who are going for their masters degree.

I used to work for a hospital which was bought out by a Catholic hospital. While I am Catholic, it was not a requirement to work there. Most of my co-workers were not Catholic and even the chaplain who worked for the hospital before the buy out was not Catholic and was able to keep her job. I know a lot of folks feared they would be let go because they were not the "right" religion, but that never happened. I doubt your religion or any lack of religion has a bearing on whether or not you are selected for an interview. They are probably looking for experience in a certain area or may not be considering you until you have your RN.

I would imagine they use the plastic applicator type of tampon and pour the alcohol inside the applicator.

I am currently employed. While my current work situation isn't ideal, I don't want to make a hasty decision and find myself in a worse situation.

I was just wondering if anyone here works or has worked on a medical observation unit. There is an opening at one of the local hospitals and before I applied I was wondering what working on such a unit is like. What kind of patients do you typically see? What is the average length of stay on the unit? What are any pros or cons of working there?

I work in corrections so yes my work self is different from my home self. Although sometimes my college age child would beg to differ, especially when I let her and her friends know they are being a little too rowdy. I have to be very assertive at work. My home self is much more laid back.

I am looking for a little advice here. I had an interview recently and later this week I will have the opportunity to shadow on the unit for a few hours so I can get an idea of what the job entails. While I think I had a good interview, I don't think I hit it out of the park. I think where things didn't go so great was when they asked me what I have done on my own, classes, certifications, etc..to enahance myself professionally, I really haven't done anything. I have spent the past two years dealing with a divorce and a resulting bankruptcy due to actions and deceptions by my ex-husband, Add to that a sick child and my mother being in a near fatal car accident and long rehab and I simply did not have the time or energy to try to take on any extra career building opportunities. But now, I feel like I am back. My personal life is all squared away and I am ready to focus more on my career now. How can I make a great impression on the people on the unit? I don't want to seem too desperate. I currently have an "okay" job but it is in an area I do not want to be working in forever. I have 15 years of nursing experience and have been frustrated by this whole job search process. This is the first interview I have landed after nearly a year of applying to various positions. I have 15 years of nursing experience and I think that may be working against me. It seems like hospitals are mostly looking for someone with 2-3 years of experience so they have a nurse who is not longer wet behind the ears but still low on years of experience so they can be offered less money. I will say that I have been picky about where I am applying and what units I am interested in. After all, I do have a decent job...just no real opportunities for growth and advancement there. Any advice would be greatly appreciated.

I got report one night on a postpartum mom who was on methadone. The off going nurse had given her nubain for some reason early in the day. I understand it was not pleasant.

"throw yourself on the alter of the Goddess of Float" Love that!!! My opinion is that you do what you feel is best for you.

Why not call the old manager and explain the altered form was not acceptable and ask if he would please call and talk to them. If he was willing to go to all of the trouble of printing the form and even trying to correct it for you I don't understand why he wouldn't take five minutes to return their call.