ghostchili

everything's been pretty much covered previously, but just wanted to throw in that at my facility, unless it's for two very specific populations, the ED is not required to call report on any patient it sends up to inpatient units... (not sure if this is true for ICU, but definitely true for med/surg & stepdown)

meds eventually time out in Epic...i'm not sure if it's 12 hours or 24. i usually chart against it somehow (missed, cancelled entry, &c...if it's a discontinued med i chart it as a cancelled entry and put "med d/c'd" in the comment box because the red overdue box is annoying). as far as BP meds, try to find out what time dialysis is coming. ask the cardiologist about giving them after dialysis if it's that late, and ask the nephrologist how far apart meds and dialysis have to be. what meds were they? depending on how late you gave them and the dosages, the drop in BP may have been related to something else.

i'm currently on night 8 of 8 (doing 12-hr shifts) and i don't even feel like i can do anything *but* work. i think i've had 4 nights off in the past month, and i never know what to do with myself if i'm off...i end up coming in to work for a couple hours in the middle of the night just to bring my working coworkers food and just hang out. :/

i would caution against calling a manager directly; managers are often really busy and it can make you appear aggressive and pushy instead of positively assertive. i still maintain that if you want to make direct contact, do it face-to-face so that a) the manager can associate a face to the name, and b) you aren't calling while they're in the middle of something on their unit. i've seen a manager remember the name of someone who called them directly a few times as someone that they would NOT hire.

always chart. in 7 years, the people involved won't remember specific conversations, so you have to cover yourself. it doesn't necessarily have to be detailed; you can just chart "d/w _________, supervisor/manager/whoever." in my hospital, we have to make a note when a patient falls, and part of that note is charting that you spoke with the doc, patient's family member, and that you notified the patient care supervisor, manager, and CNS, even if only by text-page. you are ultimately responsible for your own license.

@ 7 years as an RN I imagine you'll start somewhere around $24/hr? cath lab uses mostly techs; you'd work in the care unit (recovery, stuff like that) if you wanted to work around the cath lab.

Sentara has almost a monopoly in the area, and they are on electronic charting vs. the paper charting Bon Secours is on. I don't know what Chesapeake uses. The benefit to Sentara is that once you're hired onto a unit, it's very easy to transfer between hospitals. This means you can work in Norfolk General, Careplex, or even Williamsburg, and then if you decide to move around in the area, you can move hospitals as well. Sentara also has a hospital near DC if that becomes an option, and they recently chomped up (sorry, "partnered with") a hospital in North Carolina. I recommend Sentara pretty much because it seems you need to be more flexible, and Sentara also has a lot of physicans groups in the area if you want that.

i don't like you. i don't like anything about you. i don't like the way you constantly try to make everyone feel belittled, i don't like the way you treat everyone (especially new staff) like they're idiots--i'd rather work with some of these new nurses who've been off orientation for 2 months ANY DAY over working with you because i trust them to make much safer patient-care decisions than you would! i don't like your superior, holier-than-thou attitude and your snobby tone of voice. you started almost the same time i did; don't treat me like i'm a new grad. don't make the care partner feel badly because she failed her boards and can't work as a nurse until she passes them; YOU took two tries to pass them yourself. patients CANNOT PACE OUT OF V-FIB. STOP GIVING OUR PATIENTS WRONG INFORMATION ABOUT THEIR UPCOMING TRANSPLANT SURGERIES. we only do orthotopic transplants here and patients do NOT keep their old hearts when they put in the new one. no one wants to hear about your son trying to eat his own ****. fine, you never replete your electrolytes. fine, you never recheck them on the rare chance you DO replete them. this being said, stop aggressively micromanaging new grads who have patients with low lytes. after three years, you haven't figured out that the repletion protocol changes once creatinine rises above 2??? and YOU. you're a senior nurse, you've been a nurse forever, and you know your ****. you're a good resource, and you handle crises like a pro. this doesn't give you the right to bully around other nurses and leave the new ones at the mercy of your everchanging temper. backstabbing **** you say gets back to the people you talk about; you're one of the most two-faced people i have ever met. if i make a decision as charge, it goes. i have my reasons for doing the things i do, and none of them involve trying to screw you over. keep questioning me and ******** about me, though, and that might change. i hope you both realize that the only reason you have jobs is because we need warm bodies to fill this staffing shortage of ours. the nursing profession as a whole can do with fewer of you. ...dang, i actually feel better. :)

I honestly have no idea; I've only worked in one unit. I know we have people shadow, but I'm not sure if that's before or after they interview. It never hurts to ask, though, and I imagine it will set you apart as someone who's willing to go the extra mile to apply to that unit.

Ohhkay. So..I think I'll reiterate that this looks like something copy-pasted off a how-to-write-a-cover-letter site sample. You need to take this opportunity to show off what it is that makes you a stellar candidate vs. one of thousands of people graduating from school at the same time. The cover letter is especially important since it's very likely that your resume isn't strong, having little to no experience. So...here are my suggestions (at least the ones I can think of at the moment--coming off a 12-hr night shift and experiencing insomnia right now, haha)...things that are bolded are my suggestions and things that are underlined are things that should be omitted (I can't figure out how to strikethrough on this). Dear Hiring manager: I am a recent graduate from the Mohawk College Practical Nursing program. I have passed my CPNRE and expect to receive my registration any day. Also, my experiences gained through my clinical placements have given me the confidence to provide efficient patient care and the ability to collaborate effectively with other healthcare professionals. These skills, coupled with my compassion, patience, patient advocacy and on-going educational development are what I offer as an eager soon to be Registered Practical Nurse. I would be honoured ) implies that you are in an inferior position. Employment is a two-way street; employers may give you benefits and pay, but always remember that you are a person of value, and you are bringing intellect, skills, integrity, and work ethic to the table. Be proud of who you are and confident in what you can offer. and excited to be a part of your team and contribute my skills Sincerely, Sammy Fake I hope that helps a little....good luck! :)

i don't know how common it is anywhere else, but around where i am, a lot of the LTC positions open actually ask for at least a couple years' experience in an acute setting before they'll hire a person. that being said, LTC needs nurses, badly, but i think it's unfortunate that it has such a bad reputation among newer and graduating nurses. :/

oh, good to know! that just kind of solidifies the ICU direction more. thanks. :)

one thing i can think of is to physically go into the hospital and introduce yourself to the manager and see if you can set up a time to shadow one of the staff nurses after you've applied. this way, they'll put a face to the name and when they call you to interview, you can speak to specific things you liked about the unit and things you noticed that pique your interest. good luck!

So...I have a dilemma. I've been working on my unit for about 3 years now. I work in heart failure--we get LVADs, PAH, end-stage CHF, and heart transplants. We also care for the lung transplant patients in the community. It's really a great unit, but I don't want to be here forever. I'm looking to make a change, and I eventually want to do one of two things: 1. Work as a clinical educator for a major device company. 2. Work as a flight nurse, especially with prehospital trauma. I've always wanted to do ED and I have never had an inclination to do ICU, but ICU seems like the more marketable experience. Option 1 requires ICU experience (our ICU takes many more devices than we do--we are categorized between an ICU and a stepdown unit), but ED experience is better preparation for option 2. Is anyone here working in the VAD/transplant population? As a flight nurse? As an educator? How do I best prepare myself to be the most marketable no matter what I decide to do in 2-3 years? My biggest fear, I think, is that I'll choose a route and find that five years down the line, I have to kind of backtrack. Also, it seems like a lot of transplant centers are hiring MSN-prepared nurses for their coordinator positions. For those of you in transplant, does this seem like the case in your center? I guess I feel like there are too many choices sometimes...it can be a bit daunting. :/ Thanks for any thoughts.

i don't think that being pregnant is a "temporary medical condition" when she doesn't plan on returning to work. as far as the employer is concerned, that would be permanent.