ANH_RN

thank you so much! To be honest I really do not know what the position is like. On the site it just says staff RN, nothing about CM. I was anticipating it to be more of an inpt unit, which is what I kind of had in mind. How do those positions usually work? I have been trying to do my research but there is a lot I still do not know about the field. I don't want to come off as if I don't have a clue either! thanks! (im typing this w one hand and ill have more questions later!)

hey all! haven't posted on here in a while. I have been doing some job searching and I came across a couple positions at a hospice facility. I have been doing med-surg for over 4.5 years and I feel like this is my calling. I don't really have any close friends in this field so I really have no idea what to expect. We frequently get hospice patients on our unit bc they have recently transitioned to hospice or they have been transferred from the ICU and recently admitted to hospice care and the family doesn't want to move them to an inpt unit for one reason or another. They called me the next day after putting in my application and I am truly excited for this opportunity.. the first time I have ever really been excited about a potential job interview (I've casually looked around at positions in the past). I am doing my research on interview tips but does anyone have any advice of what I could say in particular to a hospice interview? I am already anticipating a pay decrease but I do not even care. This is what I want to do. Thank you!

hey all! haven't posted on here in a while. I have been doing some job searching and I came across a couple positions at a hospice facility. I have been doing med-surg for over 4.5 years and I feel like this is my calling. I don't really have any close friends in this field so I really have no idea what to expect. We frequently get hospice patients on our unit bc they have recently transitioned to hospice or they have been transferred from the ICU and recently admitted to hospice care and the family doesn't want to move them to an inpt unit for one reason or another. They called me the next day after putting in my application and I am truly excited for this opportunity.. the first time I have ever really been excited about a potential job interview (I've casually looked around at positions in the past). I am doing my research on interview tips but does anyone have any advice of what I could say in particular to a hospice interview? I am already anticipating a pay decrease but I do not even care. This is what I want to do. Thank you!

Just press down on the arm a little harder next time. I normally have to put a lot of pressure on the arm above the catheter insertion site to keep it from gushing out. Usually it works long enough for me to wipe it with an alcohol pad or a gauze around the opening then I connect the ... connector thingy!

In our facility the standard is if the patient suddenly complains of chest pain we call a 'rapid response' and a couple ICU RN's come over and that automatically gives us the right to obtain an EKG. Then according to how the rapid action response goes we give Nitro, Morphine, whatever. Now if you suspect that the patient is developing an arrhythmia (the patient is not on tele and they have a heart rate of 120 and it's irregular) then for that scenario.. I would call a rapid action to have them sort of evaluated and get an EKG. I actually like our rapid action protocol because if you ever have any serious concern over anyone you can call them and they have their sort of order sheet... they can order labs, ekgs, stuff like that.... The other night I had a patient with a HR of 80 but it was irregular. The pt denied history of a fib or irregular heart beat and I didn't find anything in her chart about it. She had no idea what I was talking about. She did say that she went to a cardiologist and they did an EKG when she was at their office last. I did call the doctor and ask for an EKG .. you know, just beccauuseee ... and the doctor was NOT HAPPY with me (she was admitted with cellulitis).. "Now, do we do an EKG on every person that is admitted with cellulitis??"... "well it's just that... her heart rate IS irregular" ... "well, what would you do differently for her if it IS a fib???!1!" "Well she says she sees a cardiologist and I just thought that maybe I could just you know, check it!!!" Turns out she had a fib. He increased her fragmin, put her on tele, and ordered a cardio consult for the AM. Maybe that is something differently I would have done, for example. sorry for the rant..

I probably would have dropped the oxygen down just a touch but I wouldn't have worried too much if I hadn't, either. It's not like he was on 10 liters and was being blasted away with oxygen. Generally if he's not a chronic oxygen user they do like to titrate them down a little. Was he comfortable at the 4 liters or a little SOB? And 95% might seem more than adequate to people that are used to taking care of patients who runs in the low 90's... but 95% could be better? If it was say 99% or 100% sure I would decrease it but he was still only at 95% even with 4 liters. And you know, at night time you don't really breathe as deeply when your asleep and I bet you anything his sats probably dropped a little bit through the night. Just my input and judgement.

:rotfl: Sometimes I seriously wonder if people I work with have this same belief. It is so sad to see that there are actually nurses who are taking care of human beings and their lives that present themselves as being incompetent. Nursing really isn't the type of profession that you would want people thinking you're an idiot in.. for real.

presumably I would think this is how it works. the whole increase doesn't happen too often in my dept in my hospital though. We've gotten 2 raises and I've been there 3 years now. The second raise they gave us as a courtesy (I firmly believe for many reasons) b/c a lot of us were going to take paycuts with the decreased SD in the next month.

Before our hospital joined another company we were paid $4 7p-7am. Now that someone else has kind of taken over we get 15% of our base pay which I took a pay cut by now only receiving $3.30 an hour. If I only received 0.75 cents an hour more working nights I would have switched over to days a longggg time ago. The only reason I haven't switched over yet is because we still need the extra $$. DH had to get a job (he was a stay at home dad) a couple months ago becuase on top of the pay cut our insurance went up and we just can't keep up anymore. it stinks..

I had already planned on handling it just how you 'told me' to. Thanks.

I think of bullying as putting down a person on a personal level not just how they do their job. They also act out their aggression to their face and are not polite. I see that as being a bully. And it's not always just that one person, it's a lot of people. No one seems safe. Everyone talks crap about everyone.

I think that says it best.

I just have to get something off of my chest.. I have been guilty of talking about other people behind their back but I am downright shocked at the amount of bad mouthing that goes on in my hospital on my floor. Is it like this everywhere? Seems like certain few nurses just complain about everyone they come in contact with. If it isn't the aides, it's other nurses, or pharmacy... etc. Last night a few nurses (one of which I have a lot of respect for unfortuneately) were talking so bad about one of our aides. I just can't even believe how rude they are to this particular aide. Now she may not be my favorite person in the whole world but I could not bring myself to talk about her and her intelligence endlessly in public view for anyone to walk up on. These same people that are having their livelihood put down have children and husbands and wives. I am not the most positive person in the world and I am very guilty of complaining especially when times get hard but to put down others' as a person just seems so inappropriate. Sometimes it's so bad and towards just anyone that I often think to myself 'jeez what do other people say about me?' I hate working in this.. I hate having to listen to it. Is it really like this everywhere??? I just always attributed it to the high stress nature of the job but it just seems unacceptable. Now I admit there are people that make me mad and frustrated and I vent from time to time about them but this is downright bullying! We don't let our kids do it, we shouldn't either especially as professionals in a professional environment. And just listening to everyone else's rant and rave makes you more aware of yourself and how you sound when you complain. I have been making a more conscience effort to not complain a lot especially about other people.

Update: I had the interview and I think it went great but the person I spoke to said that they didn't know if they would want to put so much effort into hiring and orienting someone that is only going to work 2 days a month (what?!?!?).. I asked her what the minimum was and she said... 2 days a month... and I asked her what their prn's usually work... she said 4 or so days a month. I am open to working up to 4 days but I can't guarantee that I am going to work 4 days every single month because I DO work full time ... The pay is oh.. only about I dono, 7$ more than my base pay (but about $3 more than my actual pay if you take into consideration shift diff)... I am still hoping for the job. It has been 1 week and 2 days and she said if I don't hear anything in two weeks to call back, because I guess the person that normally does the hiring is on sick leave. They did a urine test on the spot. The only thing I'm worried about is the orientation.. two days a week for three weeks. I will just have to ask for a LOT of voluntary call days at my FT job:) So would you wait until the official two weeks has been up to call them back or is it too presumptuous to call back tomorrow? Wish me luck!

So apparently giving meds and monitoring the reactions of those meds and assessing the pts and how they are progressing and having the skill to know when the pt is not doing well is not considered 'care'??

Hah, I had never heard of charge nurses NOT having a full pt load until someone mentioned it a few months ago. At our hospital, on our floor, we each take 4-5 starting out. A bad night we'll end up with 6 pts. Charge nurse usually starts off with 4 sometimes 5 and will even get an admission. It's very taxing on them, especially day shift. Day shift nurses will end up with a full load AND they're in charge of doing tele checks, staffing, the crash cart, and (now for example) they are doing 'audits' as well. I would love it if the charge nurse did not take any pts because then they could actually help you if you were in need of some assistance (especially with codes, rapid actions, etc)...

Thanks GM, I can't imagine being hired to two jobs at the same time! I just hope they are flexible with the orientation because I believe I would be a great addition to their staff if they work with me.. and I assume that most prn people have other jobs so they are used to working with your schedule.. and my application does state that I have a full time job in a hospital so they know what they're getting themselves into.. I really hope I get this job! My only concern is keeping my job if I were to get pregnant and with maternity leave I know you have 12 weeks legally of leave before they give up your job but with prn and the 'no benefits' I don't know if it reigns the same...

I am just wondering for your PRN people with other jobs... how did you go about orienting to the facility?? Do they orient you once a week or part time like twice a week for so many weeks?

We have a float pool and I would say 2-3 people get VCD's every other day (voluntary call day for low census)... and they do NOT want us to stay later than 7:30 AM because they are crazy about money... I have actually picked up a 4 hour shift because they have been SHORT early in the week and I will have you know they have called me off of a 12 hour shift because I would be in overtime... NO JOKE.

haha if I could get just any PT job other than nursing then my husband would be working extra not me. The only reason we're resorting to PRN work is because he is having a hard time finding a little part time job that will work with my ever changing schedule. I've thought about even doing home health care visiting (not particularly nursing) but if I am going to work extra away from home I would like to make as much $ as I can in those hours and PRN nursing seems to be the best option so far....

Also how do they do orientation for just prn nurses?? Do you normally orient once a week for so many weeks or what? I'm assuming most people they hire prn have either part time or full time work already..

Thanks for the comments! so far I am feeling confident...

I haven't posted on here in a while! But I am currently a full time RN at a local hospital med/surg/tele unit. We were recently bought out/joined to a certain health network and I am now making .70 cents less an hour (because their shift differential is based on base pay and not the straight $4.00 like our previous employers were)... our insurance is more expensive, I'm now paying for student loans for my husband (who is proudly a stay at home dad) .. and needless to say.. we're broke!! No longer able to make it on just my base income alone... I am really wishing to supplement our income with some PRN shifts. I have an interview at a nursing home and I was just wondering what is everyone's thoughts on working PRN in a NH setting on top of working in a hospital??? I am hoping to work at least 2-3 days a month. I would be happy if I just even worked 1 day a month. I know it will be hard on me (I also have a 1 year old) but this is what we have to do right now to pay down some debt and save money. My husband has actually looked for and applied at several part time jobs but no one is willing to work with a rotating schedule (mine)... Do PRN nurses at NH'S typically make more money per hour?? I realize you do not receive benefits or anything. What if you went on maternity leave... do they keep your job for at least 12 weeks even though you don't get 'benefits'? Also what is your experience in general working in a NH as an RN?? What do you find yourself doing most on night shifts? Thanks for the information.

Baptized in fire... what a true yet wonderful choice of words! No one became a great nurse floating on clouds. It's hard to remember that sometimes, but we must keep reminding each other of it!

My first night out of orientation on my own was the worst night of my life. The family of a patient that I admitted even told my manager the next day that she didn't anymore new nurses. It was that bad. I am almost a year and a half in and I have people tell me all of the time I seem like I have it together. Like many of us on here, you will most definitely have more than your fair share of breakdowns and insecurities. This is a hard job. A lot of people do not realize how hard it really is. Believe me when they say it takes you a year to get your groove -- they are right. I feel like it took me exactly a year to the week. I still have my ba-aaaaddd nights but nurses who have been around for 50 years have the same exact days. You just get over them a lot easier with time. I still have my insecurities from time to time but I have gotten a lot better and trust me if I can do it YOU CAN TOO. Also my preceptor taught me something VERY important -- to hit the *delete* button when you go home. I used to go home thinking about every single patient I had and what all I did and what did I do wrong and blah blah blah. Nowadays if you ask me who I took care of the night before I couldn't even tell you half the time. In a good way -- it's REALLY nice and you will come to it. Keep up your chin!