hdhnurse

Thank you for your answer. I just wondered if a 20-year seasoned nurse would have a better chance of procuring an NP job compared to a nurse with just one or two years of experience. I would think that nursing experience would count for something. Do you find that the better NPs possess certain personality traits? Such as...being a self-starter, self-learner, type-A, leadership abilities, etc.

When you are looking for FNP employment is there any consideration given to prior nursing experience? I begin the FNP program this fall and I currently have 20 years nursing experience. Right now I am working as house supervisor at my local hospital. We are a rural critical access hospital with a very busy ER. I have been an ACLS instructor for over 10 years. I am certified in PALS and NRP. I am just a little worried that the market is getting saturated with NPs and when I graduate in a couple of years I will have trouble finding employment.

When you are looking for FNP employment is there any consideration given to prior nursing experience? I begin the FNP program this fall and I currently have 20 years nursing experience. Right now I am working as house supervisor at my local hospital. We are a rural critical access hospital with a very busy ER. I have been an ACLS instructor for over 10 years. I am certified in PALS and NRP. I am just a little worried that the market is getting saturated with NPs and when I graduate in a couple of years I will have trouble finding employment.

rural hospital ......medical surgical unit that has everything. (peds, geriatrics, tele, post-op, criticals, etc,) Our ratio on days is 1:6-9 nights 1:8-9 primary care...one aide at night for as many as 20 patients. The ratio for aides on days it about the same as the nurses. On a daily basis we will have cardiac drips that should be monitored closely, tele patients with active chest pains, occasionally ventilator patients. Its a total hodge-podge free for all when it comes to the acuity of the patients. Admin. recently took away our charge nurse and incorporated charge nurse duties into our daily assignment. One nurse may be assigned to relieve the HUC for lunch and breaks another is supposed to do assignments. We are still paper charting. Another bright money saving idea admin had was to close the outpatient clinic down a few days a week. Guess where all of the outpatients have to come to get their treatment? You guessed it....our med-surg floor. So it is common for me to have to drop everything I am doing for my patients and do an outpatient iv antibiotic or blood transfusion. Surgery is not allowed to have overtime so any surgeries that run over will be recovered on our floor also. Then they tell us we have a bad attitude!!!

I know how you feel....our security has just been downsized. They used to come on duty at 8 PM but now they don't have to report until 11 PM. The hospital is not secure at all....anyone can wander around the entire hospital all hours of the night with no one to stop them. We have a ton and I mean a ton of drug addicts in our area. Our hospital is also known for handing out Dilaudid like candy. All of us that work there can see the recipe for disaster that is about to happen.....drug addicts + Dilaudid + no security = someone getting hurt really bad! I am so mad and frustrated right now I can hardly see straight!!!!

Thanks for the replies....I talked with my nurse manager today. She took some notes and said she will bring it up at the next admin meeting. I asked her to keep me updated but I am not going to really hold my breath on that on. My nurse manager said that we should have called the police but I also told her that house supervisor are told not to call the police until situations gets so out of control that it can't be handled because it will look bad for the hospital. I also remember an incident where one of the nurses on my floor got shoved and threatened by a visitor. The nurse wanted to file a police report for assault but this same nurse manager would not let her. Here's the thing.....visiting hours have never been enforced in our hospital. Now admin is doing this big push with signs in the rooms and wanting the nurses to enforce the visiting policy. How many angry people do you think we are going to be dealing with now and sometimes it will be with no security back up. I am going to see if anything transpires from the admin meeting and if not I will have to check into other actions.

Rural comprehensive med-surg that treats everything from peds to vents, telemetry and geriatrics. In Ohio, days 5-7:1.

How does the hospital where you work handle security issues? Is the certain areas of the hospital locked down at off hours? Do you have security 24/7?

My husband suggested contacting the local news to have a reporter come in a do like an expose. He said that would be sure to get the attention of admin. Of course, if word gets out that I blew the whistle my job would be tanked. I am the sole support of my family and while I am pretty sure I could find another job I would lose my retirement benefits that I have acquired. I have been at his facility for over 12 years and have the shift that I want.

Does anyone know of any laws that are in place to protect nurses from the threat of violence? How would I go about finding any info on a hospital's responsibility to ensure a safe working environment for employees? I work in a rural hospital that has only part time security (security guard does not start his shift until 8 pm on weekends) the hospital is never locked down on weekends. Word is out in community that Diluadid is given freely and we are seeing an influx of drug seekers and unruly visitors. This is being perceived as a threat to the employees of the hospital but risk management and admin. literally laughs at us if we bring it up. (no Kidding laughs!!) This past weekend we had two incidents...one was a lab tech that was threatened by another employee's intoxicated husband that he was going to shoot him. Admin knows and would not allow the threatened lab tech to leave. Made him sleep in a bed on our med surg floor. (how safe is that.....come in to blow the lab tech away and take out all the nurses and some patients while you are at it...Duh) Second an intoxicated and drugged up visitor wondering all over the hospital even in areas that are not open, had to be restrained by nursing supervisor (who is female and 5'3") from entering patient's room. Luckily he did not become violent because we had no security guards on duty. Just us nurses. He was estranged BF of patient with hx of violent behavior. This is just two of many incidents that are taking place....only by the Grace of God has no one been hurt yet but we nurses all know that day is coming. So I don't know where to turn to have something done to keep us all safe. No one should have to work in conditions in which their physical safety could be threatened. Please help...

Let me make another point.....Every patient that I admit to my floor I have to ask them if they are a smoker. It they say yes I am required to give them a smoking cessation packet. Smoking is an addiction....smoking kills and it is hard to quit. So why am I trying to change a patients smoking behavior by addressing this addiction problem but when it comes to narcotic and prescription drug addiction no one wants to talk about it. It is not "politically correct" to inquire about a patient's drug use? Drug addiction causes tons of other medical conditions and affects not just the drug addict but everyone around the addict. We may not be able to change the behavior of the drug seeker but we can stop giving them the high that they want. In my research on Dilaudid I came across an article that said Dilaudid produced the same feelings as shooting up with heroin. Yeah.....that's what I went to nursing school for....I am now your legal drug pimp!!! Just call me Nurse FeelGood.

Dilaudid is highly over prescribed and it is a dangerous drug.....how many of you have had to narcan a pt. after dilaudid? In our facility we have done it several times.....for those of you who say not to question just give it. This is dangerous practice. Drug seekers will lie, manipulate, steal and even self-medicate in between their allowed doses of dilaudid. I for one do not want to a party to such behavior or an enabler. I will medicate for pain but if something else is ordered I will try that first before moving on to dilaudid. Every nurse should read up on dilaudid and the type of medication that it really is. The doses that are being given by the nurses on this forum are way above the recommended doses. Keep in mind that 1 mg of I.V. dilaudid is equal to 5 mg of I.V. morphine. Take some time and do some research on this drug. Here's a link to get you started http://http://www.merck.com/mmpe/print/lexicomp/hydromorphone.html

Our hospital is a critical access hospital and we only have three floors. The first floor is OB, the second is the Med-Surg and the third is geriatric psych. But on the med-surg floor we get everything as I have mentioned. We even have ventilators but no ICU. It is not uncommon to have gtts. ( cardizem, dopamine, levaphed, insulin,etc.) and still have a load of 5 or 6 other patients. I am curious to know how many other med-surg floors are like this and if there are a lot why do they not have a unique classification? We are treated like the red-headed step children of the hospital. Admin. thinks it just med-surg so how hard can it be? "You know it's not like ER where there are critical patients." Hellllllooooo! Most of my critical pts. come from ER with no BP, lungs full of fluid and about 15 minutes away from coding....then I get to discover that the ER nurse didn't start an IV because it "wasn't ordered":angryfire I guess I am looking for a way to get people to understand that not all med-surg's are the same. Therefore a different classification of the med-surg title would help. By the way, we found out the other day that Admin. ordered pizza and drinks for the OB dept. because they had a very "busy day" Let's see......the last time that we had a 9:1 ratio on our floor with several criticals and nurses working 16-18 hours to help out we didn't even get a thank you from admin. let alone pizza. The ED gets little "thank yous" from admin on occasion also.......med-surg gets grief because no one has any earthly concept of what we actually go through in a 12 hours shift on that floor.

Does anyone know if there is an official title for a medical surgical floor that houses everything?....What I mean is we have telemetry, cardiac drips, pediatrics, geriatrics, general illness, post-op, occasional psych and everything that no one else wants. How many of you work on this type of med-surg floor? Don't most typical med-surg floors just house medical and post-ops? What I am trying to find out is if a medical-surgical floor is so comprehensive that it houses everything that I have mentioned above shouldn't it be classified as something besides just med-surg? The acuity of the patients on a comprehensive floor are through the roof!!! What are your thoughts on this? Thanks

Just wanted to give an update on the situation at my hospital. I worked yesterday for twelve hours as a nursing assistant...I am an RN but they are constantly pulling us to work in NA capacity since they are short on NA's Horrible day. I had nine patients with two getting blood and one receiving platelets. We had a ventilator patient and another pt. that is on an amiodorone gtt. , cardizem gtt, TPN and numerous antibiotics. There were two other patients besides the ones that I had getting blood. One was a GI bleed that the house doc decided he wanted to bowel prep before he transferred her to the "city" for her scope the next day. Bowel prep + Lower GI bleed = increased risk for bleeding which then results in more blood being needed, falling BP, unstable patient then the need for immediate transfer. We had a floor census of 27 patients....three nurses coming in on nights with only two NAs scheduled....Now mind you this census includes the critical "ICU" patients. (we don't have an ICU, but the doc tries to act like we do). ER was trying to admit more patients and I blew my stack. I told the house super that she needed to call admin and let them know about the situation. WE could not safely take anymore patients. Heck, we weren't safe the way we were working now. Her solution to the problem was talking a 12 hour nurse into working 18 hours and calling everyone that was off to try to get help. They were pulling NA from OB and the geriatric psych dept. to try to cover. She would not call admin. for whatever reason (maybe afraid of them?) I am so frustrated I don't know what to do. I could file a complaint with JCHO but I know the hospital would find out and fire me. JCHO says that you can't be fired for filing a complaint but everyone knows they will find another reason to fire me. There is the only hospital in my immediate area. The others are over 50 miles away. I have been at this hospital for over 12 years and I don't really want to drive long distances and I don't want to work in a Nursing home. So short of packing up and moving (which I don't have the money to do because I am the sole supporter of my family) I feel that I am stuck. Is this really what healthcare has become? What can we as nurses do to make it better without fear of losing our jobs? I know for a fact that if the hospital gets sued they will point the finger at the nurses first. We have a doctor right now that has told the family of a recently deceased patient that it is the nurses fault. Sorry for the long post ......just trying to vent and ask if anyone else has the same insane working conditions and if there are any solutions to the problem without fear of being fired.