nurse2it

Thanks to all who replied, I appreciate the advice/info.

Angela, thanks for your thoughts. This will help me figure out what the next step is, I truly appreciate your comments and welcome any further suggestions/advice you may have.

I am a student in the ONC HITECH program and will soon be "certified" to perform as an implementation specialist or as tech support. So far the program has been heavy on the soft skills. I worked as a bedside nurse in acute care for almost 15 years and have used Epic emr but have been out of the pt care world for almost 3 yrs. Knowing how quickly change occurs in IT and healthcare, I suspect the IT training I am getting will be inadequate. Most of the job postings I see want experienced analysts/trainers, build experience, etc. I am not an IT expert. Can anyone shed light on what the actual duties of an implementation specialist/analyst are? What skill sets are employers looking for? I know I need further IT education but which courses? I don't want to pursue a degree since I am not interested in a leadership/management position. Any info welcome, honesty appreciated!

Yes it really is that bad! Direct care nurses who do not work in critical care are expected to do the impossible. You might find this informative... http://www.linkedin.com/news?actionBar=&articleID=608454864&ids=0PdP0Se3wPejoIejkScjwQcPASb3oVc3sSc3cVdyMPejwOc3k

The state of our economy has made all employers skittish about adding to their workforce. Networking is crucial. You must make yourself stand out from the crowd. Consider volunteering where you want to work, that way you will get to know people on the inside who may be willing to hand your resume to the hiring managers. Join a professional organization, attend their meetings and get to know/talk to people who are in the know about job openings before they are posted externally. The old way of looking for a job just does not work today, it really is about connections and people skills. You probably will not get your dream job right away, but take anything to get your foot in the door. Finally, try not to appear desperate. I know how frustrating a job search can be, but having a good attitude is key. If you land an interview, write a thank you note, even if you don't get the job. Ask for feedback on how you can improve. Talk to hiring managers and ask what qualities they are seeking in a nurse. It may take a while, but your persistence will pay off, don't give up! Best of luck to you.

I must be out of the loop because I just came across this article that may be of interest to direct care nurses, what are the chances it will pass? http://www.travelnursing.com/news-and-features/news-detail/federal-staffing-bill-pending-in-congress/30936

Hi AngelNicole, You may get some answers to your question by reading the threads in this forum... If you want to work in a hospital, you will have a very hard time finding a job as an LPN. If you know anyone who is working as an LPN, talk to her/him to get a good idea of what the job entails. If nursing is your passion, then go for it! Best of luck to you.

One facility I worked at kept a loose leaf binder at the nurse's station where we could make quick notes about labs, falls, new orders, etc. the oncoming shift would read it after getting report.

Contact the DON and tell her you won't be back. If the thought of going to work is making you sick, what more proof do you need that it's not the place you should be?

I worked in LTC for almost 4 yrs where this type of behavior is common. I was called every name in the book, slapped, kicked, spit on and more by pts with dementia. If this is coming from pts who are "normal" and management does not intervene, then it will continue. It is so difficult to work in this type of environment, I chose to leave and took a large pay cut.

check with the hospital pharmacy, they may have one for free!

Readers, i saw or heard this somewhere (oprah?) and i'm paraphrasing--forgiveness is being able to let go of the idea that the past could have been different. it doesn't mean what happened is ok, that we need to have a relationship with someone who has done us harm. letting go frees us so we can move on. i'd love to hear your thoughts/definitions

i don't know if this has been addressed but i think alot of the bitterness, rude behavior, poor customer service or whatever you want to call it stems from the fact that many of us have been working in an environment that has left us feeling powerless, helpless, and angry, causing us to turn on each other and behave badly. nurses get "blamed" for things we have no control over, pts and families scream at us because we are the ones at the bedside. administration demands we do more with less to control costs. nursing is tough under ideal circumstances. how many of us have had a pt crash because he was shipped out of the unit too soon after open heart? why is it that the people who tell me how to do my job have no idea what my job entails because they haven't touched a pt in 10 yrs? i recently read about a very wise ceo who explained that one of the reasons for his business success was that the majority of his employees were happy to work for him. he tried to make their environment as pleasant as possible, provided excellent benefits, listened to feedback, implemented change when necessary. the man took no salary for several yrs to avoid layoffs! the point is this: happy workers=happy customers.

not being a hater, unfortunately the things you describe (and more) are not uncommon. have you seen this thread? https://allnurses.com/geriatric-nurses-ltc/why-ltc-so-580353.html

:no: as others have mentioned, staffing can sub contract to cover, respite care is available, etc. DO NOT let the parents GUILT YOU out of time off, be assertive. if you allow people to treat you like a doormat, they will.

Angelfire, you're a rock star, wish i could have worked with you!

to the penile implant pt, dude! i will not adjust your scrotum elevator, if you can hold a mirror to check it, you can do your own adjustment to the druggies/alkies: you have a problem. if you really want to get/stay clean like you keep telling us when you're admitted every other week, then do it

way back in the day before pagers and cell phones, docs were paged overhead housewide. whenever they paged dr. dicke (silent e), everyone would just about lose it, sometimes the pts busted a gut laughing! no, he was not a urologist.

i started nursing about the same time managed care came along. i remember when the pbx operator announced the end of visiting hrs at 8pm, visitors left. imagine what would happen if that was done today! let's face it, healthcare is an industry/business where the #1 priority is the bottom line so that hospital ceo's can collect a 7 figure salary plus bonus for "managing costs", meanwhile the nursing dept has a wage/hiring freeze. the ceos of the largest insurance companies make 8 figures while their "enterprise" policy makers and corporate attorneys create loopholes to deny coverage. the health insurance lobby is one of the most active and powerful groups in dc, hard to believe, right? The focus on customer satisfaction has had an ever increasing negative effect on the ability of direct pt caregivers to do just that, give care to the pt. how many times have we all seen groups of visitors camped out in a pts room and had to squeeze through to hang fluids, pass meds, tried to assess breath sounds in the middle of the pizza party? Of course not all pts do this, but the ones who do make our jobs harder than necessary. i've even seen this happen in critical care units, which would have been unheard of 20 yrs ago. This type of behavior continues because it is tolerated and encouraged by hospital administration who use press gainey scores as a marketing tool. Hospitals will continue to recruit customers by building new facilities, that look more and more like hotels, providing VIP suites with flat screens on the wall, mini fridge and microwave, laminate wood flooring, custom art. The brand new hospital in my area also has a grand piano in the lobby.

Dear Deetermined, haven't read the whole thread so i don't know if these are repeats but make sure the tourniquet isn't too tight and i always had better luck using angiocaths instead of butterflys (intimas?), they are much sharper i think so you don't have to stick as hard. on people with fragile veins i would usually not thread the catheter all the way in, less chance of going through/blowing the vein. make sure you have good bright light, i have used a gooseneck type floor lamp and positioned it over the pt's arm many times. use your thumb to stretch the skin and stabilize the vein. elevate the bed so the pt's arm hangs down. if your hospital has an iv therapy team maybe you could shadow one of the nurses and pick up some tips. don't get discouraged, you can do it!

my personal biggest gross out was when i walked into a room and the suction canister was almost full and had black fuzzy mold growing on top, had to clamp my teeth to change the canister! one night i was working in the er and the squad guys were talking about a run they had earlier that evening. an elderly pt had to be cut out of a chair because skin had fused to the chair. someone had cut a hole in the chair and put a bucket underneath. pt had a terrible wound with maggot infestation. they said the stench was unreal and when the finally got the pt out of the chair they saw mice scatter :eek; these were seasoned squad guys who have seen every kind of trauma you could think of and 3 out of the 4 said they vomited. the pts daughter was prosecuted and received a prison sentence, don't know what happened to the pt. just when you think you've seen it all...

Several years ago I was working as an agency nurse on the 7p-7a shift and received an admit, a gentleman in his 40's with dx cp r/o mi, a&ox3. At this hospital the standard iv tubing was about 6 ft long with an extension set approx 18 inches long attached to the angiocath. After getting the pt settled, I pulled up a chair to his left and started entering the standard admission info into the laptop, his iv was in his right hand. Finished the admit in about 20 minutes and left to call the md for a clarification, tube orders to the pharmacy, etc. This probably took about 45 minutes. I went back to check on the pt and label the iv tubing, somehow the extension set had become disconnected distally to the site, blood dripping and what looked like about 2 units of clotted blood on the floor! Called the lab for a stat draw, changed the tubing, called the doc to report that the pt's hct had dropped by 3 pts and what had happened. Got the mess cleaned up, somehow the pt remained calm and went back to sleep shortly afterwards. Through the remainder of my contract, the first thing I did when I got a new admit was make sure that the iv tubing connections were super tight. When I think about what could have happened I get chills, in the incident report I suggested they get rid of that particular tubing, nothing changed. Does anyone else have a story to share?

Dear Sister, If you are miserable and feeling stuck, that probably won't change since it seems you've already explored other options available w/your current employer. Weigh the pros/cons of staying/leaving, put it on paper. Seems simplistic but it helps to look at it in black & white. You are obviously an intelligent, educated, experienced nurse with great written communication skills and clever to boot as evidenced by your username. If you are not on linkedin, join asap! Once you post your profile, I bet your inbox will be overflowing! Good luck to you.

If there is a nurse who hasn't made a med error, I never met her/him in almost 20 yrs as a bedside nurse, I made a few of my own. I worked as an agency nurse full time for almost 5 yrs and for the most part encountered hostility/resentment from the staff nurses from the get go, everyone knows that agency pays more. Occasionally the staff resentment was so blatant that I asked the staffing office to send me elsewhere and they did, no problem. Of course this was before the economic meltdown, demand for agency is not what it once was. Going into a new facility and having to pass meds is one of the most difficult tasks ever! If you are able to find a place that you like, as the staff gets to know you they will warm up. The most important thing is to always be truthful. All of us have made mistakes, the pressure we put on ourselves to be perfect just adds more stress. It's done, let it go and breathe...

ZOMG! moogie, nursemike, and others have said it better than i could. the OP mentions a degree/tons of experience. reminds me of the nurse who told me about her bsn, msn as we were introducing ourselves to each other during a shift, then asked me if she should microwave the prbcs before hanging because they were so cold as a student, you don't yet know what you don't know, remember 2 ears, 1 mouth...