Work in Progress

190%. HPSA of 16 at an FQHC. I am a CNM in CO, it is my second year applying.

I got notified today that I am a finalist! I can't believe it- this late in the game I was sure I was out of luck!

Me too. It sucks.

Nope, still waiting. At least we'll know by next Wednesday no matter what. This is a frustrating process.

I am tier 1 and >200%. I am really annoyed that it does not seem like the funds are awarded as described in the handbook. Unless I made some sort of mistake. Given that I read that handbook about 5 times front to back and pored over my application for errors, I don't really think I did.

I am a CNM waiting. I do think it is a lost cause, and have pretty much given it up.

I am giving up hope. It looks like last year almost everyone who was a finalist knew at this time. I'm a CNM in tier one with a facility score of 18 and a debt to income ratio >200%. It would be nice to just see the final "no" and get some closure.

Congratulations! Good to know they are starting to get the ball rolling.

Mine is unchanged as well. Curious if anyone has hearD anything. This wait is agonizing!

Statistics Happy Nurse Shows how superior her intellect is by stating and questioning everything in terms of obscure statistics. "What percentage of people have a spinal headache following a botched epidural?" "What is the most common cause of an unexplained lady partsl hemorrhage in a 12 year old? The second most common?" "What percentage of women actually follow the Friedman curve when in labor?"

I am officially not a new grad anymore as of 2 days ago, but I had a similar experience to yours. I spoke with the L&D nurse manager right after I passed my NCLEX and she stated that she couldn't accommodate a new grad at that time and that I sounded like a great addition to the floor, and to reapply in 6 months to a year after I had some other experience. I worked on a med/surg/tele floor. I resented it. I dreamed of L&D every day. But I learned what I needed to learn and did my best for my patients. Recently I transferred to that same L&D that I applied to a year ago, and looking back I am extremely grateful for my time on med/surg. The other new person on the unit is a New Grad and is struggling a lot with basic skills, critical thinking and time management. She will get there. She has the support and she is an intelligent person. But I have it a lot easier. I never believed the mandatory med/surg mentality. I still don't believe that is the only way, but having lived through it, I am happy for my experience. I am already the go to person when someone has an odd medical problem, etc as most of the nurses DID start as new grads on mom/baby or L&D. I am sorry you are having a hard time getting into the area you have a passion for. But because of that passion, you will get there eventually! Just get the most from whatever job you do end up landing in.

Colace, heparin, oxy, tranxene and synthroid are the ones I give every night (or morning) without fail. Other common ones... metoprolol, reglan, vanc, zosyn, prednisone, omeprazole, miralax

I am a new grad and I am currently working on a Med/Surg/Tele unit. I fully plan on finishing out my first year in med/surg and I am dedicated to learning what I need and want to learn there, but L&D is where my heart is and I want to start working on things that will make me a competitive candidate for Labor and Delivery when it is time to apply. Most hospitals in the area state they either require one year of hospital nursing, or in some cases one year of labor and delivery specifically. So, what trainings/certifications/skills would help me stand out among many other nurses with floor experience that are trying to get into OB? My *current* education, experience, etc: BSN from well respected University (4.0 GPA) (will, at that point, have) 1 year of med/surg/tele experience at a teaching hospital 2 years prior to that as a CNA/Nurse Intern on a med/surg/tele unit ACLS BLS Member of Sigma Theta Tau Volunteer work for local area teen mother mentor program The things I plan on doing soon to be more competitive: NRP basic EFM AWHONN membership??? Anyhow, what other suggestions would you make?

Genius me, I volunteered to work 5 of 6 (night before, night of) holidays if I could have Christmas Eve off. What did I get for a bonus? A bonus night of work that I don't want- thats right, working Christmas Eve, too. And I got to work short staffed on TD as they floated two of the nurses to floors that didn't bother to cover their holidays. We are free to have our own party, though. And to come in at noon on a random Tuesday for a buffet (I work night shift, so not really so great for me). Last year we got a card that said I was a valued member of the team and an orange.

I think that 12 hour shifts are manageable for me, but it depends how they are done. When I was orienting on my unit and worked 3 in a row and had 4 off, I loved it! I loved having time with my family and having the same assignment night after night. Since I am off orientation, it is a whole other ballgame. I work night shift and never even two in a row. Occasionally they throw me on a day shift, leaving me to get off at 7a, recover, adjust my schedule to be back at 7a for a day shift the next day. This every other day nonsense is killing me physically, emotionally and socially. Every single day of the week I am either recovering from or getting ready for work. Not to mention that 12s are never 12s. They are 13-15 depending on if my boss schedules a mandatory meeting before or after a shift. I am hoping my schedule will work out, but it is cruel to do this to staff. I am sure the every other day schedule is not so bad if you work days or if you are able to stay on a night schedule on your days off, but I want to see my son and my husband as well on my "days off." I am hoping that it will even out and I will love 12 hours a day again, but I would take an 8 hour, 5 day a week schedule in a second over this schedule.

I have tried talking to the NM. She "isn't involved in the scheduling." Hmmm... I thought you were the manager. My bad. I thought you had to approve what the scheduling committee does, but apparently you your staff do your job for you. I talked to the scheduling committee, and they don't care one bit. They just think the floor is full of whiners. I admit I feel whiny about the situation, but I approached it in the most professional way I could- even showing them research about self scheduling and morale and put it in terms of patient safety and preventing burn out. They just could not possibly care less. They sure get the shifts they want, though. The needs of the floor don't outweigh their needs. This includes another new grad who started at the same time as me, who needs to be focusing on her nursing skills and not scheduling. I will be transferring as soon as I am able. I am going to try to stick it out a while so that my resume doesn't show too much job hopping, and I will probably hold out until I can get into a unit that I might actually like. I might not mind the crap schedule so much if this wasn't the most boring med/surg floor in the world that might as well be a nursing home, but with only 5 pts per nurse. Anyhow, I am going to try not to think about it anymore and enjoy my day off today before I go back to that nightmare every other day for the next 2 weeks.

Every kind of computerized charting is different, so I can't comment on the ones you have had experience with, but ours is really quick and efficient. It takes me 3-7 minutes to chart a full and detailed assessment, depending on how complicated it is. We just implemented it last year and they are constantly working to improve it. It takes a fraction of the time of our old hand written documentation, which took me longer to do even when I was simply charting my CNA/Nurse intern things. We also have computer physician order entry, which is also very quick and efficient. From the moment it is entered, it takes probably less than 2 minutes for the meds to become available in the pyxis under the patient's name. There is no faxing, no checking off orders, no deciphering of handwriting and no searching through paper to find parameters or orders if there is not an updated Kardex. I love our computer programs and wouldn't go back to paper for anything. That being said, I can see the frustration with a lot of those programs. I encountered some of them in school at different facilities, and not all of them are easy or intuitive to navigate.

I graduated May 25th, 2010, was listed as licensed on the state website on June 17th, was hired on July 20th and Started on August 1st (due to the NEO schedule). I had started looking in March when new grad residency applications were due. I was hired on at the same hospital in which I worked as a Nurse intern. It took a lot of work to get an interview, even as an internal applicant. I had to call/email and drop in to several floors as well as go through the HR process. Luckily my previous boss let me keep working until it all worked out. I live in Denver, CO and (though I may complain about it) I am extremely fortunate to have a job so quickly in this town. Most of my graduating class (from a respected program) still haven't even had interviews.

I agree and I know that a majority of those nurses left partly because of scheduling, and more have put in applications on other units because of it. I would be completely willing (which I told them) to work every weekend night shift (supposedly the least desirable, but that is never where I get switched to) if I could have some sense of regularity. When I was a CNA and Nurse Intern on a different floor in the same hospital, people generally had set schedules. We didn't even have to do rotating weekends, because some people preferred the weekend schedule. I was in school and never had a problem with getting a schedule that worked around that. I just don't understand what the heck is going on with these people. I had told her, informally, that I would like to stay at least a year. But the hospital policy is 6 months before trying to transfer to another unit. If this keeps up I may have to just transfer then, even though I don't like what that will do to my resume. I can't sacrifice my sanity, my marriage, my time with my child and my health for the "good of the floor."

Haha, maybe if super nurse spends her only 5 minute break on the shift crying in the bathroom. We are supposed to have 5 pts mostly independently (with supervision) by week 8 of a 12 week orientation. So, I had been having 5 for a while, but they had been 2-3 placement patients.

By the way, I know a lot of you are looking for jobs and I am sorry if I sound ungrateful. I know many of you wish you had these problems, because I felt the same way a few months ago. I am happy to be employed, but I didn't count on these circumstances.

What a joke!!! When I was hired onto this floor, I was told I would be doing night shifts exclusively (very clearly stated in the conversation and on my paperwork). I was also told that we do self scheduling based on seniority. She said that I may end up with the more undesirable shifts, as the low person on the totem pole. I was and am fine with that. I am the newbie and I understand that as was one of the last people to sign up, that I would have to take the dregs. Fine, cool, I will work around it. Then I found out how it actually works... We are completely short staffed. We have lost 7 nurses since my first day on August 1, and we were already short staffed then. I am one week off of orientation and I am in the middle of the pack seniority wise already. We are especially short staffed on day shifts. There are holes on every single day and night. When I sign up, I follow the rules (2 full weekends (Fri/Sat for NOC) a month, no splitting weekends and at least 2 Sundays. I have even signed up for extra weekend shifts, figuring it was the best way to get my 3 in a row. I try to sign up for days that have the most holes. So, I follow the principles of self scheduling, I try to do the best thing for the floor. Then the finalized schedule comes out and I am not on a single shift that I signed up for. Every weekend I work is split (even thought the no split weekends rule is so strict when you sign up for shifts), meaning I work at least one day every weekend. I don't have a single 3 day in a row stretch for the next 2 months that is (tentatively) scheduled. I don't have more than 2 days in a row off. I am working every other day most weeks (which is CRAZY on a night shift schedule). I am working two nights and a day shift some weeks. I don't even get the courtesy of a phone call telling me I, a night shifter, have been changed to a day shift. I look at the schedule and want to cry! The rationale is that we "have to put the needs of the floor first" and "all staff is rotating, you are just PRIMARILY nights" (funny that is not what my paperwork says). Then there is the holiday schedule. We put in our preferences for holiday shifts. On the paper, we had the night before Thanksgiving, Thanksgiving, Christmas Eve, Christmas, New Years Eve and New Years Day. We had to rank them. The day most important to me to have off was Christmas Eve. I said I would work all of the other days if I had Christmas Eve off. The first holiday schedule came out and showed just that. Then the scheduling committee decided that only the day of the holiday would count for day shift and the night before a holiday would count for nights. We were expected to work 2 of the 3 shifts. But we didn't get to fill out a new preference sheet. They just completely made it up. I now work Thanksgiving Eve and Christmas Eve. No one will trade days yet because there is talk that they are redoing the schedule again! My family keeps pestering me about holiday plans, and I can't make them because I don't know what my schedule will be. Then there is the issue with night shift of what is going to happen on the night shift of each of these holidays? No one signed up for them, because they are trying to get at least one holiday shift off. So, they are going to have to just put people in. And that will probably be me. Another issue. We are not allowed to put in requests for days off other than the 2 weeks of vacation we sign up for for the next year (obviously I wasn't there to sign up for anything last year). So, is it your kid's birthday? Too bad. Do you have to go to a wedding? Too bad. You want to take a class? Too bad. You are expected to be available 24 hours a day, 7 days a week, 50 weeks a year. You absolutely can NOT put in unavailability at any time. Hired for nights? Too bad, I am putting you on random days. You can find someone to switch with you when the schedule is FINALLY finalized one week before it starts. You can't find someone to switch? Too bad. You can't have any life outside of work and we completely dictate your schedule, even though we completely misrepresented this to you upon hire. I understand that as nurses we have to work holidays, nights, weekends. I am FINE with that. But there are supposed to be upsides to this type of schedule. Flexibility, four days off a week, etc are all things that were touted as the benefits of nursing, and of this floor by the manager. It really sucks that half of my days "off" are spent switching my schedule to the opposite shift that I have to do the next day. Getting off from a 12 hour night shift at 730 on a Thursday and then being back for the day shift on Friday is insanity! I know this is probably not the only place that is like this, but other floors in this hospital do their schedule more efficiently. I also know that the scheduling issues were not always like this. Only since this particular scheduling committee came into being, according to people on the floor. I am trying to suck it up and get through this, but it is straining my marriage, my health, my relationship with my child. I just feel so completely powerless over my life. This is not what I signed up for. Thanks for letting me complain and whine a bit- I am done now and will work on making this better in any way I can.

I just finished my first week off of orientation and I am slightly frustrated with the way things are going (nothing new for a new grad, right?) I just wanted to vent some of my frustration to people who most likely understand. Because we are a hospital that is the "safety net" for our area and a lot of our patients are uninsured or underinsured, we have a lot of patients on the floor right now that are placement issues and need to find nursing homes that will accept them and get their Medicaid/Medicare applications finished before we can transfer them. These are a lot of people who have no real acute medical needs and just need supervision and assistance with ADLs. On our 20 bed floor, there are 7 patients who are placement issues. During orientation and my first two shifts as an RN, every day at least 2-3 of my 5 patient load were placement patients. I don't mind caring for them in the least, but I think it severely hindered my orientation. None of them have IVs, none of them need wound care, etc. I am also a night shifter and these patients tend to sleep all through the night. The only problem I had been having was boredom. Then, because we are short staffed on days, I got put on some random day shifts. Last Friday I went to work during the day, I had 5 patients who DID have acute medical needs. I was completely unprepared for this. I have to say I did pretty well considering, but I felt cheated by not being adequately prepared for this assignment. I discharged 3 patients and got 3 admits. They were all fairly complex d/cs and admits. I was running my tush off, had a disagreement with a PA that is fairly abusive to nurses (he is on probation for it) and he was a jerk. Not to mention that I had worked NOC on Wed and had to work a day on Fri. I was happy for the more intense pace, as I was starting to worry about how challenging this job would be. But I wish I had had a bit more training on the actually acutely ill patients, so that I was not completely thrown to the wolves. This is already a novel, so I will post my other issues in another thread. Thanks for listening! I know it will get better, and maybe I can talk to the educator about the deficits in my orientation and help make some changes for the next people.

I hardly ever feel safe at work. I work in an inner city hospital whose unofficial specialty is dealing with violent trauma. The ED has metal detectors, mom/baby/L&D/peds are all locked units, but the rest of the hospital is completely open. I was actually a bit worried about going back to work after the JH shootings, because just that day I had a very upset family that believed the imminent death of their family member was the fault of the nursing staff and being covered up in some hospital wide conspiracy. Anyhow, I was a bit afraid one of them would get ideas from that shooting. I have never been assaulted or threatened by a visitor, but have by A&Ox3 patients. I had a man actually throw the over-the-bed table at me and the MD when he found out he was getting discharged. I had another patient scratch the crap out of my arm (drew blood and left a nasty scar) because I wouldn't give her "just a little snack" when she was NPO. Neither of these people were withdrawing or had mental health issues. They have finally started buckling down on some of these behaviors in patients (and in visitors as well). We have a behavioral contract that a patient gets with the first instance of threatening behavior. If a (with it) patient or visitor has assaulted a staff member, they are no longer allowed to be treated at our hospital or our medical clinics unless it is a life threatening emergency. This threat has actually helped a lot because the population we serve (we are a safety net hospital) really have no other options. We also get training on de-escalation and escaping bad situations. It is really unfortunate that people believe that they can lash out like this and it will solve their problems. It also sucks that people like this get reinforcement for their behavior. If they curse the loudest, threaten, spit, punch they usually get what they want just because we don't want to have to deal with it.

Thankfully, I am off tomorrow. Thank you for that perspective.