Quaffetti

Keep trying. I had no experience either, and just recently got a job. I was able to get a job at the hospital where I already worked for 12 years, so they were willing to train, since by my track record it appears I will stick around. I would suggest researching case management thoroughly so you know what you're getting into, so the interviewers see that you're serious about it. I wanted to get into this field for a few years now, and kept applying when I saw job openings. Eventually either I wore them down, or they didn't have enough applicants. Actually, she told me she had many applicants for the job. One thing that helped is that I was willing to take an on call position to start and get my foot in the door, so to speak. You may have to do something like that, although if you're your family's primary wage earner, that can be scary. Good luck.

I just started in UR after being a telemetry nurse for 20 years. I never "hated" bedside nursing, but I felt I was becoming a bit jaded in bedside nursing. Plus, as I was getting older (I'm 50) I didn't want to risk a back injury or something like that that would make my elderly years miserable. Although I have only been in the position a month, so far the things I like about it are that it seems to fit the way my brain works. I am a very methodical, task oriented person (which was kind of a down side as a bedside nurse cause I always wanted to get all my "tasks" done and not sit and comfort the patients). So in UR, my very logical, right brained type thinking fits in perfectly. There are ordered steps we follow, tasks to be done, etc. Not that clinical judgement doesn't come into it; I am not explaining myself very well; it just seems orderly to me and works well with my personality. The downside to UR nursing is it's a very sedentary position. I sit in front of a computer all day. Although I will say that since the job is not as stressful as floor nursing, and there isn't the time crunch that exists in floor nursing, I can get up and walk around for a few minutes every hour. But still, it's VERY sedentary. That's really the only thing I've found that I don't like about it. And although there is a lot of work to be done, I don't feel the stress I did as a bedside nurse, cause I don't have to worry about making a mistake that leads to killing someone or getting my ass sued. In this position, if I make a mistake, I will be corrected and that's it. It's a learning experience. Perfection is not required in order to avoid being sued. I think to make your decision you just need to think about what type of person you are and if the position suits your personality. If you like action, activity and lots going on at once, you probably wouldn't like CM nursing.

Have you tried Prov Everett? I have seen a few new grad job postings on their site. Also, try the smaller hospitals like Cascade in Arlington and Valley General in Monroe.

Mama d must work in the same hospital as me. Our computers were put in as an afterthought, and sometimes you cannot even get around the end of a bed without gouging your back by one. Plus, we have one wing that was originally offices, but they decided to make them into pt rooms. Not single rooms, mind you, but double rooms. These are just tiny offices and now we have two pts in them. There was a time last week I literally had to crawl over the patient's bed to get to the other side to see his chest tube. Yeah, that looks professional.

There is no way I would dump that on an incoming nurse. I don't know legality, but it is definitely not morally right. Nurses coming on their shift are busy enough getting their patients assessed and all, they don't need that. How long can it take to give a report? 5 min max?

I love our RT's. They are always the first people we call when our pts get into trouble. I have nothing but respect for them. But I guess it's time for the RT/Rn "joke." When god was deciding who was going to be an RT and who was going to be an RN he put all the candidates in a room filled with waist deep poop. Then he hurled the most humongous lugie of sputum ever seen into the room. The people who ducked down into the poop became nurses, the people who stayed up to be showered in sputum became RT's.

You know what I think the problem is? I think it's that, no matter how hard you work as a nurse, no matter how good the care, you always go home feeling like you forgot something, or could have done something more, or whatever. There is never that feeling of self satisfaction that goes along with completing a job, because in nursing, no job is ever complete. For example, if you have a patient that crashes on you and you do everything right and get the patient stable and everything's good, they're still going to remind you in the next staff meeting that "patients are saying on their surveys that they didn't get their teeth brushed." You just can never do enough. I think that's the reason for burnout. You know, like if you were an architect, once your building was complete, you and your crew would all go out to a bar and celebrate a job well done. That never happens in nursing.

Mama-D... I empathize with you, but I will tell you, the only way to deal with people like that is to call security. The minute a pt starts swearing at me and pseudo threatening me, I'm out of there and security is called.

I would be asking to see the pay of the administrators, and what their raises were. Including bonuses, travel, etc. I'm thinking that could easily make up for a nursing raise. Our hospital just announced they are laying off 100 people. I would imagine they could lay off one CEO and spare the other 100 and be even at least.

If you mean would it be considered critical care experience, I would think no. At our hospital it is a procedural place. Pts are not held there, the procedure is done and then they are transferred immediately to the floor either to cardiac tele or icu, depending on how big their hit was. Our cath lab hires people without ICU experience and many of the procedures they do are on people not having MI's. They may have had a positive stress test, or the docs cannot figure out what's going on so they cath them. Although there are also a good number that come through the ED as STEMI's as well. So I think the experience is intense and all, and requires a high degree of specialty, I don't think you could go from working in the cath lab to working in ICU without a lot of additional training.

Our precepting is so disorganized it's a joke. The first time I precepted a new nurse I had no idea. I walked in for my shift and was told, "oh, by the way, you'll have a new resident with you." I had no idea what to tell them, what to have them do, etc. Now I've been around for awhile, and I have still received no formal training as to how to precept. Plus, half the preceptors on our floor have less than a year experience themselves, which to me is like the blind leading the blind.

I've worked cardiac tele for 8 years and I don't think I've ever given that drug. The only drug we commonly give where we watch the QT is sotalol.

I hope you don't think this "every man for himself" attitude is only present among nurses. People do things when they're scared that they would never do under normal circumstances. I mean, we accept that of patients all the time. How many times do you hear a nurse say, "Well Bob is really angry, but it's because he just got a diagnosis of cancer." The threat of being unemployed or not being able to support your family must be at least as scary as having cancer (and please don't think I'm making light of having cancer). The only person you can control is yourself. So keep a good attitute and continue to support your fellow nurses. I'm one who believes good karma comes to those who deserve it.

I live near Seattle, and our hospital is still hiring, although they are not renewing any traveler/agency contracts. Our CEO has been pretty up front with us about the economy. They plan to lay off 25-50 staff, none nurses. But things I never considered, the hospital system our hospital is a part of has money in the stock market just like I do and has lost a whopping large amount as the stock market has crashed, limiting thier ability to fund things. They are also really begging us to limit our overtime, saying if they could decrease the overtime in nursing from 8% where it currently is, to 4%, that would equal those 50 layoffs they have to make. So while I know sometimes overtime is unavoidable, I also know nurses who deliberately stay late for the extra money. I think we, as nurses, need to do our parts to help our hospitals out. I know I have, in the past, had a kind of bad attitude toward the hospital about things like working short, and too heavy of pt loads, and while I'm not excusing that, I think when I see people around me losing their jobs it makes me see that I am very fortunate to have a fairly secure job and I do understand the hospitals' financial position a little more so I'm a more willing to work a little harder and try to do my part to help the hospital weather this tough economic time. But right now, yeah, we get low census occassionally and there aren't many extra shifts. I think people are scared, and so people are conserving vacation time, putting off retirement, etc. Fortunately our hospital is so large that low census doesn't come around too often.

Well, sometimes things are accomplished without the patient realizing. As the above poster said, once I've helped someone get up and go to the bathroom, I have essentially checked their skin, as I've seen it all. If I tell them what their meds are for, that's education. Telling someone about a procedure they are about to have is education, telling someone to protect their groin after a heart cath is education. Hospitals encourage this. They always tell us, "you do education all the time; make sure you chart it." Also, you can tell a lot in a little bit of time spent with a patient. Obviously you know if they've listened to your lungs or felt for pulses, but many other things are observed just with nurse/patient interaction.