AZO49008

My partner and I are seriously considering a move to Asheville, which would depend on me finding a job. I'm an RN with cardiac care and ER experience. It seems Mission Health is the only gig in town. I would appreciate if anyone could give me an insight to working for Mission. Specific questions I have are: What is culture like there? LGBT friendly (from employee perspective)? Union or non-union? RN to patient ratio? Thanks!!

Oh good grief. This comes up every year. They need to just get rid of the caps, period. News flash: it's almost 2013. Nobody wears them EVER in practice so why some people get so strung out on the whole cap thing I'll never know. I'm a guy though so maybe there's something about it I don't get. That being said, I would chose to not participate.

Well, I'm 1.5 years in as well and here's my 2 cents worth. First of all, I think your age is a big factor. I'm 47, started my 2nd career as an RN at 45. I look back at how I thought, acted and processed things when I was in my early-to-mid 20's and I strongly suspect I would be in the same frame of mind in which you currently find yourself. Fortunately, starting from scratch in a new career - and a challenging one at that - at 45 brought one huge benefit: life experience. Usually by the time you reach your 40s you have learned what to not worry about and what to really get worked up about. You just don't have that in your 20's, despite the fact that you sound like you have your head on straight enough. So, I think your emotions and perspective are being partially colored simply by the fact that you are for all intents and purposes still relatively young. That's not a personal jab at you, it's just a fact. As it is, even with my self-proclaimed life experience, there have been a handful of "WTH did I get myself into?" moments. I think anyone has those moments when they are embarking on their career, no matter what their profession. Personally, I think nurses probably have a fair share more than other professions. I was always told by my nursing instructors that the first one to two years in are often the most challenging times. By that time frame, both you and I are still pretty much new RNs...or at least new-ish. This is my second (and last) career. I don't hate it, but even if I did I don't have the luxury of time to reinvent my career path. But if I were in your shoes, this is what I might consider doing: First, hang in there. Lay off the job search for a while. It's a tough market out there and continuously applying for positions and not getting them is going to make you feel more trapped and desperate and eat away at your self esteem. Just take a breather for about 6 months. Next, try to separate the things you have no control over from the things you do. Don't worry about the ones you have no control over and focus on the things you do. Identify the things that you think make you a good RN and remind yourself of that. As a matter of fact make a list of the things you think make you an good RN. I'm willing to bet that list will at least in part reconcile with the list of things that initially attracted you to the field of nursing. Next, identify one or two things you would like to be better at as an RN and then set out to work on them. It will give you a sense of accomplishment and satisfaction and hopefully be noticed by your managers. Use the time you have been job searching to consider other areas of healthcare/nursing that might interest you and investigate them. I guess what I'm saying is just give it some more time. Take a breather from trying to flee. Get introspective, readjust your expectations, readjust your perspective and after another 6 months to a year you're still feeling the same way, then focus your resources on transitioning into another job or career. Best of luck!

Thanks for the comments, and even though I wasn't soliciting them, thanks for some of the suggestions. I was more or less just blowing off some steam. I hope I didn't make it sound like I was working in a den of misanthropes! It's just two RNs out of about 30 on the day shift. I've never encountered the behaviors I described from any of them but these two. I actually work in a very supportive environment, with both a good director and assistant director whom I respect, and who respect us. As a newer RN there have definitely been some "teaching moments" where during report RNs taking over have professionally pointed out things that I did or didn't do or things I could have done differently or more efficiently, and done so in a friendly, supportive fashion. I have no problem with that whatsoever, and as a matter of fact, I WANT that type of feedback I've never been the type to run to the manager and complain about something or someone, and really have only ever done so once when a patient's safety was being compromised. I'm sure as heck not going to run to the managers over this...unless I get backlash from my confronting these two RNs. I actually bent the ear of my assistant director on this and told him very briefly "here's the deal, here's how I'm planning to deal with it so if one of them comes running to you, you know the rest of the story." He was cool with it. Thanks again!

Here's how I see it. In addition to studying hard and knowing your stuff, it's also all about jumping through the hoops. Some of those hoops seem ridiculous and pointless. I found that the students were "singled out" or "picked on" were the ones who didn't just shut the heck up and jump through the stupid hoops and be done with it. They either wanted to argue about the validity of the hoops or sidestep them all together.

I would rather eat glass shards then work in LTC. When we did clinicals in LTC I literally felt like running out the door at the end of the shift - couldn't get out of there quick enough. Mass chaos, mis-management, under-staffing, all sorts of bed alarms going off, incontinence, pureed food. Nope. I will always sing the praises of people who can work these positions, but I cannot. Will not. It's not a "I'm better than that" sort of thing. I think the whole LTC industry is criminally mismanaged and I would be frustrated in a job where my best efforts would still feel like one step forward, five steps back.

Meh. I used to have a thing about being called a "nurse" but I got over it once I actually became one. I refer to myself as an "RN" to my patients and when identifying myself to others on the care team. What others choose to call me is their preference, as long as it isn't late to dinner. That being said, I do rather disdain the term "male nurse" but I only ever hear it from elderly patients for whom we're still apparently a novelty.

Newer RN here - 1.5 years as an RN, work on a busy cardiology unit on nights. My plan was to migrate to days but have since changed my mind. We have been required to take a 5th patient, which is a lot on a busy cardiac patient who have some pretty high acuity rates. Day RNs are seeing sometimes 6 to 7 patients a day when you factor in admissions and discharges. They are less able to help their fellow RNs because they are all so flipping busy. I have had day shift RNs cry during report out of pure stress. Nights can be hectic as well, but we usually begin with 4 patients and get an admit during the night. We don't have to do any discharges. We can find the charts when we need them. We don't have to deal with many family members, management, and disruptions to patient care due to having to "share them" with PT/OT, speech therapy, dialysis, etc... I started out not liking nights but now I love it. I work with an awesome team of RNs and we all pull together and help one another when the **** hits the fan. Finally, THREE WEEKS? That isn't an orientation period...that's a throw you in the deep end and see if you sink or swim period. That in nowhere near enough for a new grad. If you had some experience, that would be another thing. But as a new grad? They are insane and I think it's just setting you up for potential failure. I had 8 weeks on my floor and I still felt like a bumbling idiot until about 6 months in. Best of luck!

Yesterday morning I accepted my last sigh, complaint, or roll of the eyes from a couple of the day shift RNs I report off to. I started a year and a half ago and these two were very unhelpful and unforgiving to a new RN. They clearly still think of me as a less-than-proficient RN, which, thanks to a healthy self-esteem, I know is not the case. I usually let it roll of my back and forget about it. It's not worth getting upset over...besides that gives them the upper hand. If I don't respond to their little jabs, then they aren't getting any satisfaction, right? Yesterday morning I had a fairly involved admit come to the floor at 0610. Due to computer glitch, patient was not in the system to enter the admission health history when I was doing it, so I did on a paper form and when I was done with admission at 0640 patient was still not on my system. At that point I had to give 0700 meds and prepare for report. I handed her the paper form with the health history on it and mentioned she would need to enter it. She flipped out. Didn't come out and accuse me of being lazy, but her inference was clear. Refused to enter the history. I entered it after report because I did not want to risk it not being entered. In hind sight I should have handed it back to her and told her that I did what I could, and if she chooses to not enter it that it will be on her hands and then emailed the director. This RN as well as another one are habitually dismissive and haughty to newer RNs during report and I've taken the last of it. The next time this happens, I'm stopping report and in a firm but professional voice explaining that I expect the same degree of respect and professionalism that I give to them when I receive report from them. And if they don't like it, they can take it up with the director. I'm sick of this crap and it is going to cease in 2012.

Well, I officially passed my one-year mark of working as an RN. From some of the stories I've read on here over the past year I think I have to count myself very, very lucky. I got the exact job I wanted (Cardiac) in the right hospital before I graduated from nursing school and have been blessed to work with an amazing staff of fellow nurses and PCAs, all who have helped me grow enormously in the last year. Yeah, I had many deer-in-the-light OMG moments when I fleetingly thought "what did I get myself into?!" But after I recovered from those moments, I recovered my confidence and kept plowing through. Love cardiology, love my coworkers, and most nights I really like my job. May all of you newbies be as lucky as I have this past year!

Congratulations! So here's your assignment: between now and August, work on that self confidence. I'm a May 2010 grad and started on a cardiac floor as well, and am really enjoying it. I'm not trying to scare you, but cardiac can be pretty stressful as a new RN. Be prepared to feel like a complete idiot, but do not allow yourself to believe that you are one! Private message me if you are interested in some tips and suggestions on starting out in cardiology.

Exactly. I'm gay, and I'm agnostic. But ironically I work in a Catholic hospital. I have a huge list of reasons why I should not want to work in a Catholic hospital. They broadcast morning and evening prayers over the PA system, which I find pointless and distracting. In addition to of course not providing abortions, they refuse to write scripts for birth control, and they will not allow vasectomies to be performed on males. I think abortions should be rare and legal, and I feel strongly that birth control should be available to all who request it. And, we all know what the pope believes about homosexuality. But when I go to work, I leave that list at home. I like my job, I like my coworkers and for the most part I don't have too many axes to grind with my employer. It is my responsibility, both ethically and professionally, to not allow my personal beliefs to influence how I do my job or how I treat my patients. I really had to consider if my value system was too far at odds with a Catholic worldview to be comfortable working in a Catholic institution. In the end, I allowed my ethics to weed through all of that stuff and realize that the patient is my ultimate concern, not the Vatican and not my personal belief system. It's a different situation than a JW RN hanging blood, but not completely dissimilar.

Everyone gets their panties in a bunch because when you look at the ethical requirements of those working in the medical profession where you have another person's health and life in your hands, you give the damned blood. I'm gay, and when the patient I was caring for the other night launched into a crude, anti-gay screde when he saw on the evening news that a gay marriage law had passed in NY, I didn't refuse to treat him. I said nothing in reply to his comments, and went on providing care for him in the same capacity as I do for all my patients. My obligation to ethically care for this patient overrides the fact that I was deeply angered and insulted by his comments. Another patient kept complaining about "that negro nurses aide" I didn't correct his obvious racial prejudice. I simply reminded him that she had a name and continued to treat him no differently than I did any other patient. And, when I once had to perform CPR on a patient who was a prisoner serving time for murdering three people who was transferred from the prison for care, I was ethically required to try to save the life of a man who had taken three people's lives because he was a full-code status. I'm not saying it was easy to reconcile my ethical responsibilities with my emotions and belief system in that situation, because it wasn't. But my profession requires me to set my personal beliefs and biases aside and let ethics guide me in treating all of my patients. So, if I and other nurses and doctors don't get to pass on treating patients with whom we have some pretty significant philosophical and ethical differences, you shouldn't get to pass on hanging a couple bags of blood. If you aren't prepared to make that sort of ethical distinction and understand the ethical requirements required of those in a medical profession I suggest an alternative career choice.

Before I transitioned into nursing as a second career I worked in a energy and soul-sucking job that my B.S. degree got me, and was bringing in around $45,000. I got some surprised looks and snarky comments from some of my peers when I decided to pursue an ADN at the local CC. Now that I am making nearly $60,000 (with overtime) and have four days a week off they aren't laughing any longer.

Oh wow, this brought a flashback for me! I started at a new school when I was in 8th grade. It was about a month into the school year and I went to school not feeling very well. After lunch I was feeling very green around the gills. Almost before I could realize what was about to occur I projectile vomited all over the place. Took out three of my fellow classmates, as well as our algebra textbooks and the front of my own shirt and pants. There was a chorus of EEEWWWWWWWWWW! and one girl in the class started to throw up as well from the sight/smell. I felt better, but I was MORTIFIED. I got some teasing and ribbing, but most of it was in good nature. Some of my fellow guy classmates thought it was "cool". I think the worst that happened was that my new nickname was Barf Vader (it was the late 1970's and Star Wars had just come out). It's terrible the girl got teased in a mean way. I was definitely teased, but it I never got the feeling that my classmates were trying to be mean. What a way for the new kid to get noticed, lol.

Same issue, different thread. Sigh. Seriously, this is 2011 dude. Worrying about being identified as being gay if you are a guy and a nurse is sooooo 1975. I'm gay. 6'5", #220, played rugby in college. There is nothing about me that screams out gay in the stereotypical sense. I was the only gay guy in my nursing class (there were 6 of us). I work in a large 420 bed facility and as far as I am aware, I know of only two or three other gay men who are nurses. The majority I know are straight. The kicker is, I am often mistaken for STRAIGHT, lol People assume because I am tall, built and burly and wear a wedding band (my partner and I are legally married as one of us is a European union citizen and we were married in Spain) that I am straight. Patients start asking about my wife, if I have kids, etc... It's really none of their business so I simply state yes, I am married (I'm not lying) and no, I don't have kids ("just didn't work out" if they press me on why not). I figure my personal life is not something I should be sharing with patients whether I'm gay or straight. All of my colleagues know I am gay, and I have absolutely no problem with it. One guy who had previously thought of himself as homophobic even told me that working with me has totally changed his mind and we actually go out jogging and hang out once in a while outside of work.

I work in a 420+ bed Level 1 Trauma Center teaching hospital, so don't start thinking this is some small community hospital as you're reading this. For YEARS, the cafeteria has been open from 1:30am until 3:30 am for staff. Being a large facility, a fair share of patient families staying the night also avail themselves to the services of the cafeteria. Next week they are ending cafeteria service and will have vending machines with sandwiches and salads available. Needless to say everyone is in a tizzy over this. It's supposedly a cost-saving measure. If closing the cafeteria saves my job from being cut, I guess I'm not going to complain too much. But if they are cutting that deep, what's next certainly begs the question. Our competitor hospital across town, also a Level 1 center, has a coffee shop AND a cafeteria open until 3 AM for their employees. There is a separate cafe in the Children's Hospital as well that is open until 3AM. I'm just curious what night shifters working in similar sized facilities have available to them.

We discussed this in nursing school. From what I remember JW physicians would not be permitted to "order" a blood transfusion for a patient. However, a JW nurse - since they are not participating in the decision-making between the physician and the patient (or their proxy) - could, in good conscience, administer a blood transfusion. BTW, physicians don't usually do the "administering" of a blood transfusion. They write the order and the nurse administers it. I think it's appalling that someone would knowingly embark on a profession that would put them in situations that create such an unprofessional level of conflict. It's not a huge deal to administer certain blood fractions (like WinRho or RhoGam for new mothers) but to pawn off a blood transfusion to another colleague (which requires HOURS of monitoring and follow-up) and not offer to take on an equivalent workload in exchange is expecting a little too much. Nurses are already running their butts off with the level of care that patients require, and to dump at least 4 extra hours worth of assessments and monitoring that administering a blood transfusion entails on your colleagues is going to go over like a lead balloon. Especially when the patient's informed choice to accept a blood transfusion is none of the nurse's personal "religious" business. That being said, if you are still gung ho about not administering blood transfusions could you consider becoming a dialysis nurse? The blood isn't being transfused, just "cleaned" and put back in the body. It seems like that wouldn't be a prohibition.

Had the same exact situation last year when I graduated from nursing school. By October there were rumors of a lock-out. I had never been a union member, joined the union after 90 days (required) but was not covered by the previous contract. Lockout never happened, contract was settled just after the first of the year. If the contract wasn't settled in January after the recent round of negotiations I thought it might get really ugly and considered contacting an employment attorney for advice/guidance in the event of the worst case scenario. Thankfully the contract was ratified and I didn't need to worry about it. Good luck!

Hi Cruzer - I would think that we're entitled to the same HI. PPA protections as our patients. I am unclear as to the legal requirements when an RN has a communicable disease that is not easily transmitted. I'm not sure if you are straight or gay, and don't want to assume that you have HIV because you are gay. That being said, a gay organization or HIV prevention organization may be able to steer you to reliable information as to the legalities and your rights as they pertain to this situation. You may even want to go so far as to consult an attorney who handles employment law. Good luck.

Heart palpatations? I can definitely relate to that, dude! I started fresh out of school on a very busy cardiac unit with high acuity patients. I had externed on the floor during my last year of nursing school and thought the transition would be simple. HELL NO. I would frequently feel my pulse pounding, slip on a pulse ox machine and discovered that I would frequently have a pulse in the 120's or 130's. Resting pulse at home would be 70's, maybe low 80's. One of the docs had me wear one of the telemetry monitors on a shift. Nothing like looking at the monitors, on a cardiac floor full of very sick cardiac patients, and have your rate be the highest on the floor. My colleagues were threatening to spike my coffee with Cardizem. About 6 months in, I started to be less freaked out, more focused and more confident. I started to work out before I went to work, instead of focusing on what life and death scenario I might face that night. I limited my coffee to one cup a shift. Now, a year later my heart rate might hit 100 on a bad night. Some things to think about: 1) What is your heart rate when away from work? You should check it. If it's tachy you should see your PCP or a cardiologist and get an exercise stress test to make sure you're not having any ST segment changes with that tachycardia. 2) Limit caffiene 3) Take ten minutes to find a quiet place and completely disengage from work. I know some shifts that is hard to do, but it's easier to do than you think. 4) Consider shifting to another unit if you think that will help, but take a good look at what is causing the stress and see if there aren't some alternatives before committing to a change. Good luck.

I'm not even going to address the "gay looking" comment. The other responding to this thread have already done that. My hospital requires RNs to wear the ugliest color in the world: Caribbean Blue. I bought matching scrub tops and pants and quickly ditched the Caribbean Blue tops and reverted back to the white Landau scrub tops we HAD to wear in nursing school. I swore to the gods that I would never wear white scrubs in my life. Ever. I switched back because the Landau white scrub tops come with front pockets on each side, in addition to the chest pocket. Although my Carribbean blue pants have cargo pockets, the material is flimsy and don't adequately contain all the stuff I carry with my on my shift - scissors, pulse ox machine, extra flushes, pen light, etc... Landau doesn't make the Caribbean Blue men's tops with front pockets, so back to the whites I went. FYI, I'm gay but trust me...the scrubs tops have nothing to do with that, lol.

Im a new grad working on a busy cardiology unit and quite frankly the though of working on a different floor that doesn't routinely use telemetry scares the bejeezus out of me. Each patient is on a heart monitor. We can view each ECG and HR at the central desk, plus there is a room of people whose job is to constantly monitor the patients rhythms and rates. This doesn't alleviate the need for me to do hourly rounding, but I rest more assured knowing that if I'm tending to patient A and patient C down the hall starts going south I'm going to get a call from the monitors alerting me to the fact.

I'd quit worrying about it, actually. I ran into the same thing a couple times during clinicals. I think they are worried students are going to slow them down. I'd just do your best and show them that they can trust you. One particular nurse was sort of frosty, though, and midway through the day I just asked her "Have I done something that has upset or angered you? The reason I ask is because I get the feeling you're frustrated with me." She was very polite after that, so I don't think she was even aware that she was acting that way.

I'd tell you to calm down but it won't do any good. There's no way you can start as a new nurse and not be a huge bundle of nerves. Just know it gets better. I just completed my third full week on my own on a busy cardiology floor and just within this short time frame I am MUCH more comfortable and relaxed than I was three weeks ago. This past week I even had my first rapid response which I handled well. Three weeks ago anxiety was literally oozing out of my pores and I wouldn't have predicted I would be this confident at this point. I think it has a lot to do with the culture of the unit you'll be working on. I literally hit the jackpot with my unit and shift. I have been encouraged to ask questions and every night I have worked I have had veteran nurses asking me if I needed any help with anything. I feel very empowered to ask lots of questions and I have been doing that. I don't just ask the questions, though. I think through the question and arrive at what I think the answers are and offer that up when asking the question. I don't want someone to always just give me the answer. Some of the times I have been off track, but surprisingly I have been on the right track which has boosted my confidence. I am also very honest about the fact that I know what I know and I know what I DON'T know. I'm not going to fake it because I fear others will think I should know something already. If I don't know, I ASK. As for calling doctors in the middle of the night, you'll get a feel for how to deal with that. It's nerve wracking the first couple of times but if you use the SBAR format first before you call you should have no problem. I hope that in a few weeks you'll be feeling more confident like I am. You'll get through it okay. Hang in there and welcome to the profession!