Jacobero

No, that wouldn't be it, we don't have different hospitals. We have different departments, for example, Dept of Medicine, Dept of Women's and Children, Dept of Surg At least I'm not the only one that thinks this is odd. My hospital has done a few sketchy things since I've started working there, like cutting the accrual of paid leave time (and then "giving it back") and changing the weekend track program and cutting pay of people who have been working weekend track for a while. This apparently has been going on for years, and I think it sucks. Personally, I would bail and find a new place to work, but I'm 2 months from having a baby and now is not the time. I may jump ship once I'm off of maternity leave tho.

I recently transferred from a med/surg floor to the NICU, and found out that now that I'm in the Dept of Women's and Childrens, that my shift differnetials are reduced by 10%. When I was working med/surg I would get 20% of my base rate for evening diff, and 25% for night. Now it's only 10% and 15% This wasn't explained to me when the offer was made...the only thing I got was from HR that said "NICU is offering you this job, here is your rate of pay" followed by the typical HR crap of me being a valuable member of the hospital community. This just seems wrong on many levels, but was curious if this is a common practice in other area. I am contacting the director of HR tomorrow to discuss the fact that this information wasn't presented to me when the job offer was made, something that I think should have been done. Needless to say, I'm irritated, as I turned down another position at a neighbouring facility as I didn't have all the information. Thanks everyone in advance for thier input.

Dutchgirl... Those are my thoughts exactly! I

I'm glad to hear this, as a nurse with nearly two years of adult med/surg vent expirience, it's disheartening to hear that some think that having that expirieince is a barrier to being successful in the NICU. As for the original poster, I wish that I had more constructive information for you...good luck on finding a position that meets your interests!

Yes, I was a tech at a hopsital while I was in nursing school. I feel that it helped reinforce some of the knowledge learned in school, gave me practical expirience with patients (how to deal with them!), and I would help out in any way I could, so I got to see alot (oh, you're giving blood...can I watch? What are you using on that dressing? etc)

Does it bother you? The sister of my SIL is in nursing school, graduating soon (I think) but since she started taking nursing courses, the entire family- including this girl talk like she is a nurse. It drives me insane. Yes, you are in nursing school, and this is great, but you do not have a licence to practice, you have not passed the NCLEX,you are restricted on what you can do in clinicals, and your expirience is limited to what you have seen in school. Therefore, you are not a nurse, and in fact have alot of learning to do once you do graduate. Please stop telling people and letting other tell people that you are a nurse. IMO, being a nurse is a privledge and sometimes even an honor. Many people respect nurses of our knowledge. To let someone think that you are a nurse is deceptive. Just curious if others feel the same way, or if I just have bigger issues on board

I look at it this way...the womb is pretty dark and quiet...sounds are muffled, and the predominant sound the baby in utero hears is mom's heartbeat, blood and bowel sounds. The more we can re-create that setting for a baby who really is supposed to still be in that environment, the better. I wonder if there has been any research on artifically re-creating those sounds for the premature infant and the effect on their growth and adaptation?

Well, after a couple more days I'm feeling a little bit better. Next week I start my "real" orientation - I had been between my old unit and the NICU doing a few days on both. I have the hang of doing an assessment and vitals and getting the hang of the schedule. Everyone I've oriented with thus far has been very nice; I've overheard or been around conversations where I've heard a few things. two of the three docs are exceptionally approachable and nice, one is a little standoffish, but whatever. Nurse Manager is consistently approachable. I did notice that there isn't too much intershift complaining, which is good! I hate hearing that "nights doesn't do ...." or "days just thinks they do everything...." crap It also helps that I had a great day on Friday! Helped with a discharge, and did alot of corificeat safety teaching, did some breastfeeding/pumping teaching with another mom (I'm working on my LC cert!), helped out a mom who has a baby in the NICU and was admitted to another floor with a PE with her pumping, talked to the neo's about if she needed to pump and dump etc. Two of the other nurses commented that I had alot of good breastfeeding/baby/safety knowledge! So, I'm ready to dive in! Thank you to everyone who replied....I have discovered that I really, really hate being new and that is my biggest hurdle. Off to read my Essentials of Neonatal nursing!"

Ok, I've been working in the NICU all of two weeks and I'm shocked that this is allowed to happen. This wouldn't have been permitted on my dirty-old med surg floor...for many reasons - infection, narcotics. I'd try to bring this up the chain of command, and if it goes nowhere, maybe the state DOH? Then run very far away from this place.

I replied that niether parents alcoholic, however, my mother is from an alcoholic family, and later (after I left home) developed some dependency issues. Some could argue that my father is dependant on alcohol, because he does have one beer a day on most days, but he never "had to have it" - as in if he couldn't have a beer, or when he wanted to loose weight it was not an issue for him to not have a beer. So, I guess I'm saying this was a little hard to answer completely.

We have an hour each way. I do try to combine as much as I can, like if someone is perscribed a multivitamin and the nurse before me puts it at 4pm, I might go ahead and give it with the 6 pm's as long as there is no contraindication. Or I'd just change the time on that. We have a nurse who is notorious for putting meds at really strange times, for no clinical reason.

I never timed myself, but we do walking report, and that helps a little to get a first time visual on a patient. Then, while giving 8 am meds, I listen to lungs, check how much o2 they are on (I work on an adult pulmonary) or do the vent check quick. Glance at the foley, or ask how everything is going with the voiding/bowels, ask about pain, other concerns, how the breathing is going. then look at the ankles/feet. With the adult alert patient, there's alot you can tell by looking/talking. With someone who's not alert, you'll have to spend more time assessing because you have to find the info. If it's a patent that I know that I'll need to really look at their bottom, I tell the aide to let me know when they are getting to the bath, and assess the back and bottom then. It also helps me participate in their ADL care as well, and the aides like it if nurses can take a quick moment to help with a bath too I also check/flush IV's/central lines/ports on first contact because I want to know first thing if there is a problem. The more you can combine things, the better and quicker you will be it, but it takes practice. In a few months of practice and doing these things every day, you will be amazed at how much you can accomplish in a 5-10min encounter with a patient.

Thanks for adding the Ellis and Samaritan programs...I forgot about those!

I never give out my phone number. Then again, I don't think that I've ever been asked. I'm not that nice of a nurse! :) Seriously, although it hasn't come up, there are those on my unit who do have social/personal contact with pts/pts familes and I'm not comfortable doing that. The most I would do is give the number to the unit, or a company email addy.

See, that's what I've been saying on my unit since I got there!!! When I'm working on the adult pulmonary unit, people are wickedly paranoid about giving anti-hypertensives when the BP is borderline (like SBP 95-99 and asymptomatic!). It's just frustrating, and I wonder if everyone is understanding the pharmacology behind a medication like lopressor or coreg, esp in a post MI patient.

Thanks for your perspective. I'm in for another day tomorrow and am definately keeping my ear to the ground as far as how the group interacts with each other. The unit that I'm leaving actually is really great from a interpersonal perspective; very supportive and overall great people, so I'm a little spoiled. However, I really have no interest in adults! However, I do feel that if this is a toxic unit than that's worse than working with a patient population that isn't my ideal. I'm working really hard to not let my "new girl" anxiety get the best of me - and I really appreciate your validation!

I usually see for SBP Alot depends on the person, and what else is going on in the clinical picture. If there are no parameters set by the MD, and I take the BP befoe giving and it's borderline, I'll call and ask for parameters, that way it's clear what the MD wants.

I'm not a super new nurse, but after nearly two years in med-surg I finally felt comfortable enough to take a job in the NICU (levelIII) in my hospital. the issue is that I'm having some major anxiety. There are days when I'm incredibly excited and thrilled, and other days when I wonder what the heck I'm doing. I'm the youngest nurse there, most of the others have been working in the NICU for 20+ years, and have been nurses since I was a fetus myself (and I'm 30!). I've had one day of orientation, and it went well....I'm a smart person and pick up things quickly, but sometimes I feel like I'm never going to know everything that I need to know. The other factor is that I wonder if the there are interpersonal issues on the unit. There is just a vibe there, can't put my finger on it, but there is definatly something going on with the staff. Lots of call-in's (insert red flag) and I really felt like an outsider, that I'm going to have to prove myself before I get any respect. Are these feelings normal? How long does it take to feel competent in the NICU? Or am I just having some "new person" anxiety???

If you can find someone to watch the kiddos on weekends, definatly find a weekend track/premium job. I have been doing weekend track since Oct ( I have three, 7, 5 and 2) and it has been a godsend. The only reason I'm taking something else is because I want to work in a different specialty.

Actually, no...I currently am transitioning from pulmonary/med-surg to the NICU. I go by nursing nurse because when I registerd for this site, I was breastfeeding my daughter (we nursed for 2 years), and it's kind of a silly joke in our family that I'm a nurse that was nursing (a baby, that is...). Although I honestly would love to work in OB/GYN and still might someday after the NICU wears me out :) Right now I work down the street at St. Peter's a like it. It's smaller, but it's not a small hospital...we have around 450 beds (that's an estimate). Our ICU is smaller, don't think that there is as much specialization among the floors. Cardiac stuff is the big thing. I think pay wise we might be just slightly higher, and I really mean just slightly. Benefits are about the same. It's a werid place, becuase it has a community hospital feel without actually being a community hospital, if that makes sense. Best thing about AMC is that one will really be able to learn alot there, and if you don't like the floor you're on, it's not a big deal to find something else. They have a very well organized, regimented orientation program that I think more hosptials should follow. Once you have some expirience there, you'll be able to get a job anywhere. Worst might be all the interns/residents floating around. A close friend of mine that is working there feels that she spends alot of time chasing people down for stuff and trying to figure out who to call is frustrating for her, but she's fairly new there as well. I turned down the position there because even though they offered me more money for my base rate, the differentials there are a flat rate, where at my hosptial we do ours as a percentage of your base pay. So I'd make more working where I am now, because of the way that shift differentials are calculated. I'm really sure that you will like albany med, and will find that you will learn alot. There are ton of opportunities to train/learn and alot of additional classes that they offer at a low cost to employees. I actually paid to go to a conference that they put on and it was really work the $150 for all the CEU's I got in one day. Good luck!

Well...it's small. I did my clinicals there while in nursing school, so maybe I'm not the most reliable person to talk about it. I didn't like it much, but they do have computer charting and have had it for a LONG time, so there's prolly not alot of kinks with it. I have heard that the pay is pretty good. The units are very mixed, unlike Albany Med where everything is pretty specialized, so it's a good learning opportunity as a nurse would have to know alot about alot of things, kwim? They are unionized. - don't know if that is a factor for you or not. I did like their OB unit - I had two children there and that was a nice floor. Hope this helps.

There are a few nursing schools in Albany: hudson valley community college in troy (SUNY so not badly priced), Maria in albany (expensive), Russell Sage (4 year private, expensive). I went to Columbia Greene in Hudson (SUNY 2 year, cheap!) and liked the program alot. Alot of folks work as a PCA or tech while in school. Albany Med used to pay nursing students more $$ after they finished nursing I. It was managable. heck, I was a single mom with two kids and we survived the expirience without too much trauma. Good luck to you!

When I started at St. Peter's a year and half ago, they gave me $20.10. I beleive that it is now $20.67 or some other wierd number like that. We just did a "market adjustment" so everyone's pay went up a little bit over the summer.

Albany Med is not unionized, but many in Capital District are not. I know that Ellis in Schenectady is. Parking: employees part off site during the day, and take a shuttle in. Plan for 10-15 min on your commute time. There is a parking garage for visitors, and certain staff, and I belive that night workers can use the garage. Benefits: Medical for a single person is cheap, think that it is an HMO, where you use Albany Med services first. Not entirely sure. Dental used to be Delta Dental and was $40/family. I was a tech when I worked there, and didn't bother with the medical as was covered by my husbands insurance. The units tend to work well together inside themselves, there is some inter-unit bickering. Everyone think they're the smartest and provide the best care :) Most of the units are pretty specialized....the 6th floor is all OB/GYN, L&D, mother baby, and gyn surg and antepartum. 5th floor is vascular surg, neuro, and pulmonary/renal (used to work there). There is a MICU, SICU, PICU, NICU, HTU (heart transplant unit), and CPS (Cardio-pulmonary services). There is a renal transplant unit (worked there too), and a locked unit, a blood/cancer disorder unit, a cardio-thoracic surg unit (c8), two ortho (at least when I last worked there) units. I know that figuring out who to call doc wise was confusing for some, since there are residents, interns, fellows and attendings. I never figured out the system, but I never really had to either as a tech :) Phlebotomy, Resp thrapy, EKG are centralized, and pt's usually leave the floor for dialysis and go to C2. I don't know about computer charting, but know that meds are scanned/computerized MAR's. Pay is comparable to other hospitals. Most of the time AMC is compared to St. Peters (which is right down the street). I was offered a position recental at AMC and they offered me $22.80 as an RN3. A colleugue that works there told me that recently the tuition reimbursemet was increased to $2500/year. If you have any more questions, I'll check in. Hope this infor helps!

1:8??? Right now, on the med/pulm floor I work on, during the day it's 1:4 or 1:5. Unit secretary, 1 RT (we have up to 8 vents plus HFNC and other respiratory stuff). At night, it's 1:7 or 1:8 with an RT. The tech's have about the same patient ratio as the nurses. The other hospital where I used to work was 1:5 on all shifts, techs 1:10. No dedicated RT.