PetuniaRN

We have surgeons who regularly run two rooms at the same time-both patients are in rooms next door to each other and each have their own anesthesiologist and separate circulators. The surgeon and PA leave one case for the next as soon as they can leave a RNFA to finish.

I think this is unfair to say. How are you supposed to transport a pt to CT AND care for your other 3 patients? You will be on another floor! Long enough for a heart pt to have chest pain, or go into sustained V-tach, or go brady and need to use those pacer pads, or stroke out......And asking another nurse to "watch out" for yours makes him/her have 7 pts. Ancillary staff is crucial to safe nursing. She shouldn't be told to reconsider her career because she wants support staff!!!! I would not work somewhere that didn't have pt safety as a top concern. BTW, I definitely WORK HARD:yeah:

If you are looking to move to Orange County, Saddleback Memorial hires out of state people with not a lot of experience. I do want to reiterate previous responses:There is a definite slump in the economy here in CA, and even though they pay a little better here, it doesn't make up for the increase in cost of living. Be prepared for that. The salary here is about 30-33/hr with a year or two of experience, and night shift gets a 5/hr shift differential. :idea:Definitely worth it when getting adjusted financially as a newcomer here!!! Hospitals DO hire out of state people, my 2008 new grad group was 5 from out of state, and the one other was from somewhere pretty far from here in CA. We have PCT's here that are assigned to pt rooms. Typically, they have an assignment of anywhere from 7-11 pts. On MedSurg the ratio is 5:1, Tele 4:1, and ICU 2:1. ICU and ED also have PCT's. There are transport personnel to move the pt's to testing or change floors, and STAT nurses who transport pt's who need ACLS and insert PICC's and start difficult IV's. We also have Rapid Response Teams along with our Code teams. (And we do work hard here, even with the support staff help. I thought that was an odd statement someone made. Hmmmm. I don't fault you for asking about the support you need to help you be a safe nurse) Good Luck with your search.

Just a thought...ambulation doesn't have to include roaming all the hallways. walking around their room, or a secluded piece of a hallway with the guard is sufficient. Also performing ROM and having PT come work with them in their room has many of the benefits of ambulation. I worked at a hospital with many prisoners, and while they are patients, they are also prisoners. They don't get all the same privileges as everyone else. They deserve medical care, but not special allowances. And attempting to give them the same priveleges endangers their guard, and anyone else in the hospital. One inmate/patient told me it was better not to unshackle him while I gave him the bed bath, because he was in for life without parole, and he would do anything to even get a few minutes of freedom. He then said,"and I sure don't want to have to hurt you. So let's eliminate the temptation, ok, sweetheart?" He taught me an important lesson. So just my two cents here.

I recently witnessed a nurse being told by the charge nurse that they were taking a patient assignment away from her because "she couldn't stop being hateful" to her patient and talking down to her. Ummm...this is our current employee of the quarter. How is that possible? I am sorry about what happened to you. I know it seems you got punished for doing the right thing, but perhaps that is the last place you want to work anyways. Hope you find the right "fit" soon, and hope karma starts making its rounds soon.

Hi, don't despair! True, there are extremely limited new grad jobs in south cali, but experienced nursing jobs are much more plentiful. It took me forever to get a new grad position (graduated May 08, started new grad program Sept). Just don't set your sites on one floor, be flexible. Regardless of where you work, you will be getting valuable nursing experience. I think one of the problems with this whole "nursing shortage" thing is that it is a shortage of experienced nurses. The hospitals in my area (OC) are all hiring, but want someone with 1-2 yrs experience. They don't want to have to train a new grad because it is so expensive to do. I realize that won't help you from the get-go, but once you get that first year out of the way and can drop the label "new grad" you won't have any more trouble finding a job. Nursing is a great career for job security. It also helps that most of the hospitals are phasing out using traveler's and registry...which opens more positions. I tend to be more optimistic--the economy will look up. There have been nursing shortages and overages fluctuating throughout the last few decades. In the meanwhile, do all that you can to start getting noticed early on. It would really pay to network when you are doing your clinicals. If someone likes you enough, they may help you get a job. Good luck.

What are your hours when waitressing? I work three 12 hr shifts per week. I also have about 80% of my insurance paid (including dental and vision), I get like 180 hrs PTO a year from the start (which is over a month of paid time off), and bonuses (3000 sign on) and regular raises. My take home is usually 4000/month after everything with me pulling in about 2-3 hrs overtime total. So, yeah, it isn't a lot more than you bring in (good for you!) but I bet you don't get those kind of benefits. And that is consistant pay-I never make less. So it might be worth it. You can always pull an extra shift which ends up bringing in about another 600/night. Not to mention job security.... Good luck in whatever you do!

Unfortunately we do have the higher cost of living here, but the payrate certainly doesn't make up for it! I lived in SC and had a 4 bedroom house, 2000+ sq ft, and my mortgage was about 1200/month. Then I moved to the OC, California and got a teeny tiny 2bdrm apartment for 1600/month. Am buying a 1700 sq foot 3 bdrm home here and my mortgage will be 3000/month. So my paycheck is basically obliterated!! However, I do think it should be taken into account that we have such great nursing ratios. I have 4 patients maximum, and if I don't have a PCT, then I only have 3 maximum. That is worth not completely making up for cost of living. Back in SC there were times the nurses had 8-9pts each! No way!!

Orange county, CA: Telemetry New Grad days: 29.70 New Grad nights: 34.70 Unfortunately the cost of living eats a lot of that right up, *sigh*. I suppose the gorgeous weather and beaches make up for it though....

Well, you certainly are correct about not turning your back on a psych patient for your own safety. As you mentioned in your posting your patient was depressed AND schizophrenic. People with mental diseases that can include hallucinations, (auditory and visual) may have no hold on reality and are very potentially dangerous. They may get what are referred to as "command" hallucinations in which they are literally hearing a voice (that they may believe is God, or the president, or someone they CANNOT disobey) telling them to do things directly to you, others in the vicinity or even indirectly to you as a means of escaping. If they think they are "being held hostage" they may think you are the enemy. Or they may think they are the "sane" ones, and you are in fact a person with mental disease since you are not believing them. If you enter a room with them, always align yourself in a position in which you can access the door first. I will never forget a situation in which I (as a student nurse) went to interview my paranoid schizophrenic patient in a tiny room, and I sat at a table accross from her...and the door was closed BEHIND her. She actually laughed at me and said in a very threatening voice, "You just made a huge mistake. I could kill you and no one could help you. Didn't they teach you anything at that fancy nursing school? I hold the power of this meeting." Which brings me to the next point, never underestimate them even though you may consider them harmless. On the other hand, they are people, and deserve respect. That patient of mine was actually trying to warn me about other patients. She got up and left the room and told me I wasn't ready for an interview--and she was right! She taught me a lesson for sure!! Sorry to go off on a tangent, since your thread was also about depression... Don't forget that depressed people come in many different packages. They don't all look disheveled and unable to function. They don't all admit they are depressed. A sign to watch for possible impending suicide attempts includes them giving away favorite items/clothing/jewelry. It may be a sign of them having a plan and knowing they won't need those items if they are successful. Also remember that being overly cheerful and saying contrite things like,"I am sure everything is gonna be fine," or "It can't be that bad!" can turn the patient away from you and make them decide not to confide in you. You can't fix their problems so you shouldn't offer advice, but you can listen, give educational information, and encouragement. You will learn all of this in school, but it is helpful to have a heads up in case you come in contact with psych patients in a regular hospital. Good Luck.

I have an issue with one particular nursing aide at my hospital. She says she used to be a nurse in her home country (maybe Russia?, not sure). If I ask her to help me out in any way, she tells me why I should or shouldn't do that particular thing. In many instances it is an outright, "No" when I ask for help!! She frequently tells the nurses her "professional" opinion, but it is so often not appropriate. She especially loves to say, "When I was a nurse, my patients got pain medications when they needed it and I told the doctors what the patient needed." I really want to ask her why she doesn't pursue her nursing license here if she is such an expert! She will let a patient sit in their stool until I "suddenly" smell it when I go in, but she swears it JUST HAPPENED, and yet she will hunt me down to tell me a patient needs me for pain meds. I often think she makes a point of saying it in front of other people so she looks good. I have brought this up to management, but they want me to write each episode down, with a date and time. Who has time for that? Grrrrr.....BTW, it isn't just me....

It took me soooo long to get a job, and I applied to every hospital in my area (OC). I applied for every single job opening in which they would consider new grads. I applied places I had no desire working and for positions with crazy hours. Funny thing was after months of nothing, I finally got called for an interview, and while I was sitting in my car about to go to my one and only interview, another hospital called me to interview me. It was weird to have those two hits suddenly after months of NOTHING. I got offered the job at my interview, and accepted. I told the second place to call someone else and make their day! This may seem odd, but one thing you can do is volunteer at hospitals near you and "get in good" with the staff. We love our volunteers! Networking works wonders, even in nursing. Another thing you can try is calling the nurse recruiter directly and asking him/her what they think will help you meet their needs (making yourself stand out may be as simple as going ahead and getting your ACLS or PALS or whatever so the hospital won't have to pay for it). Just call the main number and ask for the recruiter (although some places have eliminated them in this economy:down:) Good luck guys!

As a former new grad at Saddleback, I would have to say it is a good starting out point. The new grad program is pretty thorough, and the support staff are helpful and readily available. As for the support from other nurses, I suppose it depends on which floor you work . I also found that as they continued to eliminate travelers, the supportive environment seemed to improve. The hospital is certainly aimed at geriatrics--the average pt load is 75+ with lots of DNR's. It can seem as if you are in a skilled nursing home at times--pretty much every pt is a fall risk, has pressure ulcers, and lots of various stages of dementia. That is why I say it is a good starting point. Except for the veins of course--old veins are not good practice!! I am happy with my experience for the most part. Since you are asking about cost of living in the area, I assume you may be from far off or out of state. The hospital is certainly not "up to date" and at times seems old-fashioned. (Downright ghetto at times, but nothing compared to Western Med. Center in Santa Ana, which you will see firsthand with some of the new grad educatin classes being held there) I personally had expected a state of the art facility with it being in the OC and all. Hope this helps a little. Oh and pay tends to be around 25 for new grads. Give or take a little.

We get to take the lunch break for sure, but we did away with the resource nurses so now the charge is "supposed" to cover us for our 30 min lunch. Unfortunately, that means everyone is alloted a specific time, regardless of what time they want for a break. So usually we just cover each other instead of waiting for the charge. As for the 15 min twice per shift, well...I take one 15 break. I really don't need the 2nd one, and I feel like sitting at a computer doing charting is sort of like a break. it helps that we have a 4:1 ratio. To answer someone else's question, they ask nurses to voluntarily break the ratio (in dire circumstances) and usually they make sure that person has a lighter load of pt acuity. Also, we had to sign a waiver giving up our other 30 minute break that we legally are supposed to have. They told us if we took the break, we'd have to work a 13 hr shift to be able to clock out for one hour. And they try to convince us no one wants to work longer, so with only one 30 min break we work 12.5 hr shifts. It is a mind game, but I realize we are luckier than other states!!

Mission is a trauma center too, but I don't know what level...I do know it has a good reputation and is the highest paying hospital in this area (but Sharp isn't considered in this area so it may be higher, IDK). My concern about Sharp is similar to yours. They put TONS of classified type ads out on all kinds of sites. Almost flooding the job search sites. It just makes me wonder if they can't keep anyone or what. I mean, all places have a turnover, but a high rate indicates something bad. Not to sound simplistic, but why not call and ask what the turnover rate is? And what the acuity of the ICU is. I am sure the nurse recruiter would know that info. Good luck. (I do know that I think San Diego is a great place to live, but Mission Viejo is a good inbetween with tons of stuff surrounding it. I live in Lake Forest which is right beside Mission Viejo. The perks include being close to several cool beaches-Laguna Beach, Newport Beach, Huntington Beach, being almost midway inbetween San Diego and LA, and a safer, smaller, more relaxed locale. But San Diego is an exciting and big city. So depends on your taste. I guess I didn't help nearly as much as I'd like. But I hope I gave you something to think about!!