nursecass

Thanks everyone! I decided to go conservative (which is my instinct anyway) and actually found a really cute pair of flats at Target that I can wear just randomly after the interview also. Thanks for the feedback though!

It's been a while since I've been on an interview and I have a few coming up and I was just wondering if open toe shoes are a bad idea to wear to the interview? I will be interviewing for ICU and ER positions. My instinct is close toe, but I have a really great pair of heels that gave a peep toe. If I don't wear those I will probably end up in my Dansko clogs because I'm having a hard time finding close toe dress shoes this time of year.

I just wanted to follow up and thank you for all of your responses. Unfortunately the surgery went as scheduled, and instead of being able to distance myself from the situation I was in fact the primary nurse for both before and after surgery (until I handed off to the ICU nurse) because I was the only one in the recovery area competent/capable/comfortable with the invasive monitoring that the pt came out of the OR with. The next day I told the manager that I would no longer be working in that unit because of the safety problems that I had identified and then witnessed and experienced (including being left completely alone with the pt in the PACU). No more PACU for me. Thank you all for the advice though-it was very appreciated! :)

Hi all, I'm going to keep this as brief as possible but I was hoping I could get some advice/feedback. I am an ER nurse that has cross trained to work in the pre-op/PACU in our little rural hospital. Tomorrow I am scheduled to be the first nurse (i.e. get there early and set up for the day and get the first pt ready for surgery) however the first surgery of the day is one that I am incredibly concerned about from a safety level. I verbalized my concerns to my manager several times about how this was a procedure should not be doing in our facility and that we do not have the training/staff to handle the pt afterwards and was told that "everyone is on board with this" and that it will be fine. I completely disagree and want my name and license no where near that chart, especially since I've already verbalized to both the manager and the CNO (and the head of anesthesia) my concerns for this pt's safety. At this point though I'm not sure how to handle tomorrow morning. Like I said, I'm expected to be the first nurse in and should be the one to get him ready for surgery. I've never refused an assignment before and I feel like that's essentially what I'm doing, but I'm not sure really how to handle that since the assignment has not technically been made. I do not want to be a part of this whole ordeal because I truly feel like we are placing this pt in harms way, but I'm not sure what I should say/do in the morning to ensure that I haven't "accepted care" of the pt. Any tips or advice would be greatly appreciated. TIA!

Thanks so much for the info TexeCuter! That's exactly what I was sort of hoping for-a bit of a run down on some of the hospitals. :) I'm definitely looking forward to getting into a higher acuity setting again with a bit of technology surrounding me. (the hospital I'm at just took narcotics from zip lock baggies and put them in an accudose in the last few months....) Fortunately the job DH is considering is in Fort Worth, so we are actually looking at Fort Worth and surrounding areas to live. The only bad part is that we'll most likely be moving this summer-right in the thick of the heat. :/ But even that doesn't deter how excited I am to have such a wide selection of places to work that really pride themselves in excellence! *fingers still crossed for his job offer to come!*

Thanks for these! I've listened to Dr. Guy's and am always looking for more. Thanks for sharing!

Thank you Commuter! It's actually a huge relief to hear that unions don't really exist there. I'm currently in a union hospital and it has been way more challenging than I could have imagined and I'm looking forward to getting out of that culture. I'm just so excited to have so many wonderful opportunities available. Several of the hospitals look amazing, and the thought of working at some of them is invigorating to me! :) Really hoping DH gets a job offer this week! Thanks again for your feedback Commuter!

Could any of you please recommend a book/source that is mainly CEN practice test questions? I found when I studied for NCLEX that reading out of the book did me absolutely no good, but doing repeated practice tests and then reviewing what I missed or had questions/hesitations about afterward was really beneficial for me and I'd like to do the same for the CEN. I really liked Saunders when studying for NCLEX-I just did hundreds of practice questions. Any ideas? TIA!

saving this thread-thanks! :)

Also if you know which (if any) are union I would appreciate that info as well. Thanks!

Hi all, My husband and I are looking at moving to DFW in the near future and I'm just starting the adventure of looking at hospitals in the area. I have about 5 years of ICU/ER experience but have been working in a state that has few choices for where to work so I'm a little overwhelmed at where to start in sorting out all of the facilities. So if you have any feedback/experiences-good, bad or ugly-about any of the hospitals in the area I would love to hear about it. Also on a totally unprofessional side of things-what fun stuff is there to do in DFW? I know it's a huge metro area so I'm going to be challenged keeping my shopping under control, but anything else that is fun and "DFW" unique that I should check out?

Oh, and this actually happened in a surgical area. The threat was against a hospitalist, and the way the family found out was the surgeon went and told them directly before the pt even went to surgery (because the threat delayed the surgery), which of course placed us in harms way as we recovered the patient. The whole thing was/is just a mess.

Thanks for all the responses-that was my initial thought but I wasn't sure I should proceed with the police report until I did something else. I'm going to go by work today and contact corporate to see what they told our QC person, but honestly I think she dropped the ball and did nothing with this. (Not the first problem we've had with her-she's pretty useless.) I think though no matter what corporate says I'll file a police report, just so that if something does happen it was well documented that there were problems. On a similar note though, when the threatened doctor asked for my written statement he was told he couldn't have it because it was a violation of HIPPA. Does this sound right? I used the pt and wife's name specifically in my report, but I don't think I put any medically relevant info in there (I will check it today). If I take out any references to why he was in the hospital it's not a HIPPA violation right? (I ask because I think if my QC person did drop the ball like I think and I escalate it, she will try to "get me" on HIPPA stuff.)

I will try to make this as brief as possible. Last week I helped take care of a patient that we have had behavior problems with in the past. He and his wife both have numerous incidents within both our facility and a neighboring facility-in fact they have been banned from the other facility. So before caring for this patient it was decided to do team nursing-no one enters the room alone so that there would be a witness in case anything occurred (most of the previous problems came with pt/wife accusing staff of things/comments). Another nurse and I went in to the room to complete care when very detailed and thorough death threats against a physician in our hospital were verbalized to us. I immediately went to my manager who took me to the quality control person (we don't have security at our hospital). QC person told me to fill out a report and she would call corporate to "see how they want to handle this". I asked if the doc would be notified and she told me she would notify him. I went and wrote up the report and when I turned it in to her she reassured me that the doc knew and when I told her about how this particular couple worried me more than others she proceeded to dismiss me because I'm "just an ER nurse and probably haven't had to deal with death threats before." I told her this wasn't my first time but that I just had a bad feeling about this couple and asked if police would be notified. She told me she would take care of all of it. Fast forward to today (my first day back) and I find out nothing has been done. No one has been talked to (myself, the other nurse, a CRNA that also felt threatened, the doc) and no one knows what's happening. The pt completed his stay and when the wife found out we had reported them they both started calling the other nurse and I **** and saying we would pay for that, etc to other nurses on the floor. I called the police department today and they have nothing on file about any of this-no report, no statement-nothing. At this point I'm not sure how to proceed. Should I try to call our corporate number to find out what's being done about this? Do I file a report with the police? (The other piece of this is that myself and a few other staff members are now concerned about running into this couple around town and aren't sure how to handle them if we see them in public.) Besides writing up/reporting the incident to my supervisor is there anything else I should be doing? Sorry this is so long, but I've never worked in a facility that doesn't know how to handle threats like this so I'm pretty lost. Any advice/feedback would be greatly appreciated.

A big part of nursing is education-a BIG part. I cannot think of one area of nursing that does not include teaching/educating patients and family members. It may not be the traditional standing in a classroom sense, but I can tell you I educate every patient that I come into contact with-sometimes I educate the same patients about the same things repeatedly. I say this because if you are not interested in continuing with teaching/educating then maybe nursing is not quite the direction you want to go. And if you decide to be a family NP (or PA) then it is even more teaching of the same people again and again. As for the rewarding career, I'm not sure nursing is much more rewarding than teaching from what you are saying. You have kids throwing spit balls at you, I have patients throwing full urinals at me because they are drunk/high and don't know what's going on. You have kids that give excuses for not doing homework, I have lab giving me excuses why a lab result that should take 5 minutes to turn around is taking over 30 minutes. People swearing at me because the doctor didn't give them a prescription for narcotics. Parents ticked off because their kid that has had a sore throat for a week has to wait to be seen because someone else is having difficulty breathing. Things like that are every day reality for nurses. I don't mean it to sound negative because I really do love my job, but ultimately you cannot allow someone else to determine how rewarding your career is for you. The holidays depend on your unit and how big it is. My experience is usually that you have to work 2 shifts of major holidays (for nights that includes Thanksgiving, Christmas eve, christmas day, new years eve, new years day). Plus other "lesser" holidays are dependent upon dynamics of your unit. I've worked some places where no one cared about 4th of July, the last place I worked EVERYONE wanted it off, so it was a battle to get it. Plus most places require you work at least X amount of weekend shifts as well. I don't mean this to come off as a debbie-downer sort of post, but I think before you invest your time/energy/money into nursing school I would take a closer look at the profession. See if you could job shadow someone that is doing what you would like to do (NP, PA, floor nurse-whatever) to see if that is something you would indeed like. Whatever path you choose, good luck and I hope you enjoy it!

First of all, congratulations! I worked in ER throughout the last 6 months of my pregnancy and really was able to do it without too much difficulty. I worked in a very "rough" ER with lots of very physically violent pts that were frequent fliers, so I tried to keep my pregnancy hidden as long as I could. I was worried that if some of our "regulars" knew I was pregnant they would aim for my belly while swinging/kicking (it has happened to a few nurses in that ER). I just tried to keep my pregnancy on the down low from my patients. That being said, I did try to be "superwoman" so to speak while I was pregnant. I was CONVINCED that pregnancy was not going to slow me down (both professionally and personally) and that nothing had changed. Looking back I really wish I would have cut myself some slack and allowed myself to be pregnant and just enjoy the experience a little more. I wish I would have napped more, rested more, and more than anything I wish I would have taken the last week before my due date off. I was due July 10th and my manager put me on a 4 day stretch over the 4th of July weekend. I told her that odds were if she kept me on that schedule that soon to my due date that I wouldn't be able to work the full 4 days, and sure enough on the 3rd night I went into labor. The problem with that was that I was SOOOO exhausted from working the holiday weekend that I wasn't able to really labor properly. Imagine working 3 night shifts in a row and then running a marathon-that's essentially what I tried to do, and it was really dumb. Not what you asked, but I actually found being a nursing mom and finding time/place to pump WAAAAAAY harder than being pg in the ER. I just don't think being pregnant was that big of a deal for me as a nurse. Ultimately just take care of yourself and your baby. If you are finding 3 12's are too hard, break up your days. Whenever you do get a break, put your feet up as high as you can get them. Eat and drink regularly, and just hang in there. Most of your co-workers will understand, and hopefully you will have some supportive ones if you have any problems (mine knew that I had hyperemesis so were really good about watching for me running to the bathroom to cover my patients-those coworkers made all the difference!) Good luck, and enjoy your pregnancy and the new baby!

I would love to do flight nursing, and there are some really great opportunities around me for that but I am worried I wouldn't be able to do it since I get motion sick occasionally. I used to be worse as a kid and have grown out of some, but when I am on a commercial airplane and we hit a lot of turbulence for more than a few moments I get queasy. I wish there were a way for me to "shadow" and fly with a crew for a day to see how I did but I know that's not possible. I just don't want to apply for a job, get the job and realize on my first day that I need as much treatment as the patient mid flight. I am just wondering if any of you have/had problems with motion sickness? How do you deal with it? Does it tend to go away or ease up a bit when you are "distracted" taking care of a pt? TIA!

I am having some issues with one of our doctors in the ER and I'm not quite sure how to handle it and was wondering if you all could give me some feedback. This doctor is not someone I trust AT ALL. He is a notorious gossip (we work in a small hospital), I have already witnessed him bad mouth nurses to other nurses behind their backs and back pedal when called out on it, and he is just overall someone I get a bad vibe from. I say this only because my first instinct when I have an issue with someone is to go talk to them and see where our communication issues are coming from and how we can fix them, but I am concerned that me going to talk to him will only get me gossiped about and maybe even complained to my manager about. I have had SEVERAL clinical problems with him the last few shifts I have worked-from him giving a verbal order then putting it in the computer differently and arguing that he would never state the verbal order (even though it was heard by another nurse), stating 2 meds that are clearly different are the same thing, he picks through the charts when we get backed up to see the "easiest" patients first (there is only 1 doc on, so that can become really problematic when he does this), inappropriately pulling the nurses out of pt rooms......the list goes on and on. For example yesterday he pulled me out of the middle of a triage to tell me that the pt I was triaging is a notorious drug seeker and is here all the time and to tell her that it would be at least a 3 hour wait and that she wouldn't get any narcotics anyway. (Of course I didn't tell her that-that's NOT part of my job.) The worst part was that he felt the need to do this while we had a pt sitting with a pneumothorax that had been in the ER for over an hour and had not been seen yet (because of the cherry-picking the patients). I am considering going to my manager about this, but I'm not sure what that will accomplish. Like I said, I usually just approach people about problems that I am having with them but I just am afraid that it will backfire on me-he is just a very weasel like person. He is the only doctor that I have had any issues with, and at least 2 other nurses have told me they have the same problems but I still feel like going to my manager is almost like "tattling." Am I wrong? How would you handle this situation? TIA for any feedback!

My husband has interviewed in Livermore, we are thinking of living somewhere around Pleasanton. Where we live will sort of depend on where I get a job, but ideally we would like to split the commute if possible. Livermore to Pleasanton is about a 25-30 minute commute from what we have been told from people in the area which seemed about right when we drove it on the weekend without traffic (it took us about 20 minutes). So somewhere about 30-40 minutes from either Pleasanton area or Livermore area would be ideal for us.

I started my career in a CVICU and because of location had to move to a hospital closer to home that does not offer ICU so now I do ER and I must say that I LOVE/LOVED being a CVICU nurse! It really is my passion, and I miss it every day. I loved the acuity of the patients, and how you can literally see them improve in front of your eyes. I used to work a lot of overtime (4 shifts a week regularly) and I was always amazed at the improvement just 4 days gives a person. I would take fresh open heart cases and (if able to) keep them all 4 of my shifts and it was amazing to take them from sedated/lined/tubed to walking around the unit interacting with their family members in just those 4 days. In addition to seeing how quickly the patients change (because it can also go the other way unfortunately) I also loved the technology that is associated with it. I loved tracking all the trends, catching just the slightest thing that is not right and trying to figure out what was going on-it was always such a mental challenge for me that it really made going to work fun. So for me, personally, it is the best job ever! :) Obviously everyone will be different and there are certainly some people that are not cut out for CVICU life, but I have found it to be where my heart is! (Sorry for the cheesy pun!)

The last hospital I worked at gave all the nurses a subscription to Pearls Review online and I found a lot of their information helpful when I was designing a class for intro to rhythms. I thought it did a really great job of explaining from the ground up so to speak, and the nice part is that since they are online learning modules you can go back again if needed like you said. I'm actually thinking of getting myself a personal subscription as I study for my CCRN I liked the program so much. HTH and GL!

My husband and I are looking at relocating to the east bay area (from out of state) and I am starting to do some research on local hospitals and was wondering what experiences you all have had with the different hospitals. Anything you can tell me would be appreciated-where you work, why you work there, what you like, what you dislike, etc. If you have done clinicals in any of the East Bay hospitals I'd like to hear your experience as well-were the staff helpful? Did they seem annoyed at having students around? How did general moral seem? Did people seem to be busy a lot, or was there a lot of sitting around happening? If it helps I have experience in ICU/CCU/ER and would be looking for similar work there. I have applied at El Camino hospital in Mountain View; Alta Bates Summit Campus; Valley Care in Pleasanton and am just looking for any other places I should check out. Based on some comments on here I looked at the John Muir hospitals, but they only have 5 openings right now, none of which I am interested in. TIA!

Does anyone know if/where I can get a replacement BLS card? I'm not sure where mine is. I carry my ACLS card with me, thinking it would be enough (since you can't get ACLS without BLS) but I start a new job soon and they want my actual BLS card-my ACLS is not enough. The instructor that I did it through has moved away and I don't have any contact info for her.

I am just wondering if I should list one of my previous co-workers as a reference, or if I should stick just to supervisors? Right now I have a house sup from the most recent hospital I worked at, a manager and nurse educator from the one before that but I'm just wondering if I should have a staff nurse as a reference or if that will look weird. TIA for any advice!

I actually think working nights works BETTER for my family, because I'm gone at night while they are sleeping like you said. The way we work it is I usually work Sunday and Monday nights (I'm only part time), so Sunday I nap with my 1 1/2 year old, get up, make and eat dinner with the family, go to work. I get home the next morning and hang out with her, make her lunch and send her of to daycare with my husband. He picks her up in the afternoon and brings her back home to me, so I've usually gotten about 6 hours of sleep. Then he goes back to work until 5:30 while I hang out with her and make dinner. He gets home, we eat and I'm out the door again. The next day she only goes to daycare for 4 hours, so I sleep 4 hours then try to nap with her that afternoon and then flip back to a day schedule. It leaves me a bit more sleep deprived than I would like, but it works really well for our family. If I worked days my daughter would have to be in daycare for 11 hrs at least 2 days a week since DH works 10 hour days, which I just think is too much at this age. The plan is to stick with nights for the foreseeable future for our family.