crossbow

Retrogression and the present state of the US economy is affecting everyone. For those that plan to work here...the wait could be longer than you think. As of the present, no one knows when the economy will get better but on the other hand, most US hospitals need nurses...experienced nurses especially. So my unsolicited advice would be to grab as much experience first(while waiting) before trying to jump the gun and get into the US...and for pete's sake keep your options open to other work possibilites.

Are you in NY now or in the continental US?

Its heavy on a med-surg/tele floor. but where I work, I am usually charge and I take patients. You know what you guys are right! You cant do justice to both roles.

I dont like taking report from the ED but I have to. BUT I don't get upset at my Charge Nurse...For the ED, the patient in the ED needs a bed and the ED needs to be decongested. For my Charge Nurse, she has a job to do and this is part of the job description. Sometimes our ED do not triage very well or do not do a lot of things right......thats when I blow a fuse. When a patient is bumped up to the ICU after spending 15 min with us in my unit. I have a mental checklist of questions that I ask depending on the diagnosis. If not properly answered....I call the Admitting Medicine Resident (while the ED nurse is on the other line)to ask him to order whatever needs to be done to the patient before going up. He'll be the one to go and order that nurse to do something. I know how it goes..I used to be an ED nurse and I hated dong shortcuts. So I know the tricks of the trade when they try to palm off a patient to my unit. but as charge nurse, I know there is a reason for a patient assignment. Its not just for the numbers but also the right staff to handle the patient acuity. You dont give a heavy district or patient group to a new nurse who has been here for 2 months. You gotta ease them into the workload.

there will be times that you might feel like that this specialty may not be right for you, but hang in there! remember!! you only need do this for 12 hours and then you get to go home. sometimes i've had three transfusions started and running at the same time, sometimes a patient goes bad at the end of the shift. stay the course!! things will come and go at a dizzy pace, take a breather and focus! good luck!!! lmk how it went and if you need anything just pm me.

Didn't renewals use the Drop-box method? Just curious.

Go with the grind. Be quiet and learn. hospital policies, unit policies and do not be afraid to ask questions. Acuity LTC may have so many patients but med-surg has an increasing acuity that ebbs and flows on a drop of a hat. Do not be alarmed because you are not alone. Admissions I work on a med-surg/telemetry unit that has on many occasions reached 10 admissions on a shift. (learn to admit correctly and swiftly.) Documentation In a very busy unit, a lot of things slip through. Whatever happens do not forget to to document (using hospital's correct procedure)

6 years ago During nights we would have 1: 10 3-4 years ago During nights we used to have 1:7 or 1:8. now we are down to 1:6 Colleagues, a low patient-nurse ratio is not the entire picture 1. Our Patient Acuity level has gone up 200% from 6 years ago 2. Turnover rate has doubled in that 6 years 3. less experienced RNs per unit has increased Advise: please stay in your unit for a couple of years. Help the new ones get used to the grind.

If you are going to Long Island anyway, how about hospitals in Suffolk county like Brookhaven, Mather, SUNY Stony Brook, Southside, Southampton Hospital? Suffolk is laid back and not hustle and bustle unlike NYC Yes. Nurse recruiter to Human Resources

Time Management is the key. I work nights and usually we are understaffed in terms of support staff availability. After getting report, I check all my patients (initial nursing rounds) and environment of each patient (IV access and lines, feeding tubes and foleys, diapered or not, a quick mental assessment by talking to patient and seeing how he/she responds to my verbal stimuli - usually introducing myself as the nurse for the night. Fall risk or not) Then check the charts and reconcile what you got in report and what is in the chart. (I call it "truth or consequence" game. If the previous nurse that gave you report told you the entire story...you're well off. But if the previous nurse report is lacking....the consequence is that you will have to do the research.) Reconcile chart orders with MAR and Medication Profile of the patient in the computer. Check med cart if all patient's meds are available to you in time for your Med pass. Then take it from there. A tidbit. When you have an isolation patient, before gowning up, make sure you have everything you need and you do all that needs to be done in order to avoid making another unnecessary re-entry into that room.

Question #1 How about Long Island? Question #2 Have you like applied for all positions or are you concentrating on applying into a nursing specialty, like say, Peds or Cardiac Cath? I think most Med Surg floors are always open. Always the best way to get one's feet wet IMHO.

AND WHERE DID YOU SAY THIS FACILITY IS LOCATED?

Depends on your facility/hospital. 24 hour chart checks and medicine reconciliation. Sometimes, put in a new IV on a patient if IV access is expired (good for 4 days), AM labs if patient has a central line. If a patient has a trach, trach care and resupplying the bedside stocks of suction caths etc. Accu-check and making sure the daily dose for basal insulin is done and calculated correctly by the bone head intern. OR prep, cardiac cath prep, NPO for procedures. Wound dressings, thats just some of the stuff I can recall off the top of my head.

Bravissimo Zuzi!! Grazie!!:yelclap::yelclap::yeah: This is what this board should be all about!!

Buona Fortuna Babyj9396!!