manager123

Speaking as a manager and seeing this happen to family members applying for positions. The "no call back" from employers and disconnect between HR and managers for open positions is all too common. Many hospital employers have outsourced recruiting. Unfortunately, these recruiters are generally clueless about nurse staffing needs. Resumes and applications need to have certain words in them (never mentioned) to get through the first pass to avoid living in resume 'jail' prior to screening. If the manager is even forwarded a resume, it goes to 5-6 other managers and the competition ensues even within the same system. Alternatively a manager is sent a resume with zero job skills relevant to a specialty unit. Just because 'neuro' is included in a job set of skills from the applicant, it does not mean that a rehab or SNF RN is a great fit for a neuro trauma ICU. Not uncommon for applicants to be told 3-4 months after submission that the recruiter would like to speak with them. Chances are high that the applicant has found a job or is put off by the late response. Cue the random emails from that point on to the applicant that they would be a "great fit"for PBX operator or MRI technician!

This is quite the 'all about me' pity party isn't it? Absolutely fascinating that you dare call yourself a leader. You and your attitude are why nurses are leaving the profession. Not only are they dealing with increasing loads of sicker patients but administration whines and hides. I am sure your colleague knew months in advance when planning a vacation or requesting time off that it would be busy (rolls eyes). I am sure you never take time off and had this happened to someone that needed to cover for you because you are more special than anyone else. Time to look for a new job and yesterday is not soon enough to protect the staff you oversee. Harsh words but I care more about your staff than your poor me attitude.

Reading through most pages of this post (I skipped a few), one area is not clear to me. Does the other area not have a shift charge nurse and reasonably competent staff? If so, they should only need you to check in a few times a shift as they are familiar with the patient loads, acuity and how to run the unit. Leave them your phone number for emergencies and respond(!) if they call you. Of course managers cover for each other. it is an expectation. In my experience, the charge nurses and staff nurses were excellent problem solvers and generally needed to go to a higher authority for the token odd things or staffing issues. A week is not huge. Try covering for a 6 week medical leave! If you call off, I can guarantee you will not earn points from the other manager OR from YOUR boss. If responsibility scares you or you are afraid of making a mistake, leadership is not for you at this point in your career. I hope your own staff respect you and your leadership style. If you are micromanaging them to the point where everything has to be confirmed and approved by you, it will take a toll on you them and you.

Do you know if references are collected by phone or by an anonymous survey with questions to mark and a box to complete if desired for "additional information"? In some states, if references are false the candidate can sue for slander. Many companies have imposed a 'no references rule' for managers and HR will provide hire date and job title only. I usually never provided a phone reference (who knows who is really on the phone) but if it was an excellent employer moving out of state etc I gave a generous review due to those circumstances. Definitely submit a copy of your last excellent evaluation (or at least have it ready). Some places will accept reviews from a shift manager instead of a unit manager. Especially true if working a night shift with limited unit manager contact. Worth a try to ask if that would be acceptable plus a copy of your last evaluation.

I have managed to stick out a horrid director in my lifetime. However, she was a temporary manager and I was hoping that she would not be the permanent one. Completely different personality than our former director. At some point she refused to be the director for the temporary units. We did the happy dance. However, I made sure my resume was updated and I was browsing/ looking. If you think you will need to find a new job, make sure your ducks are in a row. Resume updated, private phone numbers of staff and ideally shift leadership (other than the manager) who would vouch for you. In my state the only info we gave out was through HR and it was hire date and job role/title. Pros and cons to that. What you want to avoid doing is being the last person to leave and turn out the lights. If this policy is going through to all part time or casual staff, you will not be the only one leaving based on that. Something is "off" at much higher levels to enact this policy and taking federal money and then changing to for profit could have some investigations soon. Third manager in a relatively short time is a potential sign that a) your unit has issues perceived by others b) other managers with stronger ethics could not participate in changes they were told about or c) used their management experience for a better job elsewhere. Just don't be the last one out. . . jobs will be harder to find.

I am a bit confused. You were terminated because of ONE medication error and a negative drug screen? I think you said you took a drug test but did not see the results. BON will typically not care if you were terminated for 'diversion' with the lack of proof here to make that claim AND your screen was negative. If your screen was positive for the missing drugs category, even if you had a prescription, there is a potential for the employer to notify the BON that you were working "under the influence". If your screen was positive and / or you could have been considered to be working under the influence, the BON in my state prefers to hear from the RN as a self-report rather than from an employer. Yes, you will probably be on probation (lawyer up with a lawyer who has experience with the BON) if positive etc. I have been a manager under similar circumstances. It was always a positive drug screen (along with odd behavior that drove a drug screen) and have offered my office and the BRN phone number for the employee to immediately self report. On occasion, the employer [usually through HR] would make the call. In some places, no one called and the issue was never reported. Bottom line, if you were terminated, without explanation, and had a negative drug screen, then your employer has issues and it is good to move on. Until you are being investigated by the BRN and you have no drug use / diversion going on, I would not report it to my next employer. If you have issues with drug use/diversion, recurrent behaviors will probably kick in and they will figure it out and initiate disciplinary / termination actions.

Dear caring CNA who is going to be a wonderful nurse, document your request for common equipment in writing to the DON. Staff should not have to count on 'sharing' personal equipment. In that email (preferred for a paper trail), if staff are expected to bring their own BP cuff and thermometer etc does the facility reimburse staff for these items? DO keep looking for a different option. This is an unsafe facility for patients and staff. Yes, do report your concerns to the ombudsman and to the agency that inspects SNFs. In my state it is the department of public health that does these. Yes, the facility will connect the dots quickly for who made the notification and yes, you will need to have another job as a result. On the off chance that the 'administration' does care, you may get a very positive response for common equipment and other needs. "Administration" is always presumed to magically know that equipment is missing, lost, broken but it is amazing how often that knowledge is reported to one person who doesn't care [perhaps the one saying administration doesn't care] and it never gets reported up the chain. One of the most useful and eye-opening exercises I did was to post large poster size 'sticky posters' in a common private staff area labeled "broken/need more" and "wish list". I did it after finding out something was broken and no, I wasn't aware and staff assumed I was and "didn't care". As I was able to purchase new equipment, follow up on repairs or move items that made no sense for locations (time clock), I updated the notes with the progress. Some were fast, easy fixes, others took a bit of time but staff and patients reaped the benefit of being heard on many issues.

California is not a compact state. Since the DUI is recent, you might need to talk to a lawyer. It will be worth the expense but make sure you are talking to a lawyer with experience for CA BRN issues. . . not just a lawyer that specialized in DUI. There are lawyers that advertise they can get the DUI charges dropped based on issues with the testing. If that happens, the BRN might reconsider. Yes, it does sound like two different lawyers for different issues. If you had a license already, it is usually probation for the first DUI, potential random drug monitoring, mandatory board reporting for various required actions, meeting with a supervisor from the BON, taking additional CEs, meeting with a psychologist, etc etc. The best scenario is to try to get the DUI charge dropped, declared not guilty, etc and proceed from there. If the charges don't go away, then another type of lawyer (used to working with BRN in CA) is a definite must. As for other states being more lenient, not sure about those reports being true and probably depends on circumstances. Good luck as you process through this.

You are an amazing daughter who provided care that was above and beyond. Sadly, our moms don't live forever except in our hearts. Please reach out to talk to someone. Surprisingly even our funeral homes here have resources for grief counseling. Even for those of us who 'know' our moms (or dads or other loved ones) are going to pass because of the diagnosis, the actual death can be a surprise and bring emotions we thought we were immune from. You and others are daughter first and nurse second. Nurses can't prevent death even though, sometimes, we try really hard to avoid that happening. I am a believer in comfort over rules. My own mother, in her final week, could not tolerate a particular side lying position. She could not breath that way with comfort. It was obvious. The staff in her assisted living honored my request to not turn her to that particular side. Did she develop DTI pressure ulcers on her heels and butt? Yes. Her body was shutting down and her circulation was minimal. Did I feel guilty? Yes. Briefly. In my mind, breathing with comfort overrode the potential for DTI or other pressure ulcers. I was the one who found them and showed the staff. The administrator apparently had heart failure when they told her about the ulcers and insisted that a butt cream be ordered and applied. It came the afternoon before she died. The point of ordering it was beyond my fogged brain. I offered to write a letter to be placed on her file that the 'daughter refused turning protocols' if the were investigated (I believe that was her concern). I also told the aides and staff to document my refusal. Although it was tough to see those, I knew physiologically that the skin was the least of our priorities in her final obviously dying days/hours. Blessings on all nurses who are blessed to be able to provide or assist in the care of their loved ones. Remember to be allow yourself time to be a daughter or son or grandchild first. Feel your pain and your loss and I pray that happy memories will replace your sadness and loss.

There are a variety of preceptors out there. Some are nurturing and caring and others will do as little as possible for their preceptee. Having a preceptee can slow 'their' routine down. . . the preceptor has to be a role model for performance AND teach the nuances of their unit and try to have some sense of time management. May do it well. Others see the preceptor role as a way to earn prestige and more money if there is a differential for being one and orienting a newer nurse. Some, sadly, see it as a way to make themselves look good and awesome and fail to give positive feedback and encouragement . . . especially to the novice nurse. I hope in your next experience, you will have a more mentoring and positive relationship. The cliques and failure to truly fill out the expected role are an early warning of horizontal violence. You may have done yourself a favor by leaving that environment early in your career. There is valuable advice in the thread for courage to have needed conversations with manager and preceptor to ensure you get what you need and what was promised. It is scary to have those conversations and sometimes it needs to be done with great diplomacy. Learn also how to resign in good standing if it is necessary to leave any job in the future. Keep looking for positions. Even if your next position is not in an ED, you will learn valuable skills for the future and may find that the ED isn't where you really want to be or isn't really the best fit for you.

Do NOT leave it off your job experience or work history. All employers do background checks and this will show up. In some states, this is enough to terminate you or fail to hire you because you falsified your application. Depending on the laws in your state, your employer may only provide the hire date and date you left and nothing more. Other states may have different laws and provide more information. If your previous organization is part of a chain, you may find that the "do not hire" applies to ALL of their hospitals. You can try to avoid the discussion with the "do not contact" box but it often raises more flags by doing so if you are not currently working there. It is best to be forthright and honest. You can identify that you were not prepared for the complexity of the patients in that ED and that the orientation was not as you had expected. I respectfully disagree with some of the posters. If you gave an incorrect medication, dose, or performed a procedure that caused patient harm because you were not being appropriately mentored, if the error was significant enough, either the patient, family, or your own employer could report it to the BRN. I would also say that in the investigation, the facility might be hard pressed to explain how they called this orientation but that is a whole different can of worms.

Many posters seem to think this person will fail boards. What if he is a great test taker and passes? Review courses can be fabulous in helping students at all levels pass required boards. These clinical situations will not be tested. No one knows if their NP or Physician or other health care practitioner passes with flying colors or barely made the grade. Would posters feel differently if this person was caring for your family member? The student is exhibiting high risk behaviors that have the potential to seriously harm others before being 'caught' officially. At some level I also wonder if this student exhibits similar high risk behaviors in his current work situation and hasn't been caught? Or perhaps he is a fabulous bedside nurse and sees this as a next career step and is just not wanting to put in the work. It could go either way.

IF you were truly never charged or you were a juvenile and are able to seal your records, this does NOT need to be disclosed in applications or entrance issues. Once the record is sealed, the charge never existed. If you were truly never charged, then no record exists either (I think). Bottom line, move fast to figure it out. It is worth the $$ and time to figure it out sooner rather than later. I have seen several job applicants recently who are accepted into nursing programs, complete the program, take NCLEX and are immediately placed on suspension or probation (If they are allowed to test in the first place). It is when I start asking why there was a significant gap between completion of degree and licensure that the story is revealed. Remember that acceptance into nursing program does NOT guarantee eligibility for NCLEX and license. I know of very few places that will accept a new grad on probation as a new hire. Sometimes they will work with someone who is in a different position (i.e. Nurse Aid) and becomes an RN. Many will work with existing RNs who suddenly are on probation because they have a track record.

Yes, retain a lawyer or look for lower cost legal aid (perhaps with paralegals?) that can do the necessary research to see if you truly have a record of any type. If you were a minor (under 18) there is a process in California to seal the legal record. It is hard to tell your age from the narrative and that age difference truly does make a difference. Sealing the record of a minor is a paperwork process and does not require attending a court hearing. Did it with a kid who made a stupid mistake.

I agree with the neon colored tubing. Once I bought a bright neon pink stethoscope, I never had an issue. Even the doctors wouldn't borrow it! Bright yellow, green or whatever really did the trick. Engraving is impossible to see from far away and when everyone uses a black stethoscope it is tough to demand to see them to check engraving. I have also discovered that there are hidden places for lost supplies on every unit. I can't tell you the number of places people put 'found' items but never bother to post in the lounge or whatever that xyz was found. You could try guilting your co-workers by putting a note up in the lounge describing the birthday gift that walked away. Ditto for placement in a physician view area. One never knows.

Use it as an opportunity to grow. In the ideal world, you would get some time with the charge nurse (preferably on that same shift) to go over the extra duties expected. At a minimum, ask for a written list of the extra duties and time frames for when they need to be done. Some common examples include predictive staffing for the oncoming shift and how to request extra help if staffing is short or if census is down how to flex in the appropriate order, any bed or huddle meetings that need to be attended, when and where they occur and what information you need to have before going. In some places, you may need access to certain programs. My favorite is pyxis access to request a temporary password for an agency RN. Can't tell you how many times that gets forgotten in bringing on new relief charge nurses! Many places will offer a differential for relief charge and/or a lighter assignment. If you enjoy puzzles and ability adjust a game plan quickly, you may find that you actually enjoy the role! Good luck and let us know how it went!

I think the bigger question I would want to know is "Did your program become accredited?". There can be changes to meet accreditation standard changes. The online vs on ground controversy is an ongoing issue. There are great online programs and shoddy on ground programs (and vice versa). I have heard rumors of some hospitals not hiring online BSN degree RNs but most are so desperate to hire BSNs to meet IOM 2020 and Magnet expectations that they don't care where the BSN is from as long as you have it and the school was accredited. Previous posters have good suggestions for managing short term clinical times and you would do well to invest some time in looking at other options and what credit you might receive for your completed courses. . .that will vary considerably. If your program is NOT accredited and it seems to be struggling, I would strongly consider looking elsewhere asap. There is one accrediting body (CCNE?) that will not accredit until the first cohort graduates and then the accreditation will go retroactive. Others must review and recommend for accreditation before the first cohort graduates so be sure you understand what agency is or has done your school.

My experience is on two fronts. . . caregiver and family member/caregiver. Families struggle with the fear of the unknown. Concerns about the ability to provide the care needed (after all they are in a hospital now) and the lack of funding for private pay nursing or aid staff. Those seem to be the biggest issues I see from a caregiver perspective of families. For many, there are few additional family members to rotate care with and not working is truly not an option for many to provide in home care. SNF payments are poorly understood, especially in times of exhaustion and crisis. My father (many years ago) was in a SNF and had terminal cancer. The way the social worker there presented the hospice option was not good and seemed that he would not have care needed from the staff in the SNF. We turned it down. It was early in the understanding of the role of hospice and just poorly presented. My mother was moved to hospice care. It was a huge relief to know that she could return to her assisted living/dementia apartment. The burden of trying to find yet another place was overwhelming and I shed tears of joy when the staff said, "no problem, bring her home". She was expected to live a few weeks at most. She lived for 9 months and lived well. Returned to her normal functional state and enjoyed life. She did not know her diagnosis but enjoyed the music therapy, spiritual support and all of the other aspects of excellent hospice care. When it became apparent that the cancer was moving fast, we coordinated medication administration around the clock with me, another family member and hospice. The assisted living staff were not allowed to crush and administer meds sublingually as they were med techs and it was outside their scope. Hospice nurses came out rapidly for any concern and medications were adjusted for comfort. We were with her when she died. It was an excellent experience in caring from her staff in hospice and the assisted living staff. We do not have hospice only facilities in my area. That is not an option for our families. My editorial rant: I do wish that the commercials on TV about "we promised to keep mom/dad at home" didn't play. It brings tremendous guilt for those loving families that do not have the resources or ability to continue the level of care their loved one might need. Rather, the discussion should be "We will do our best to keep you home when it is safe and caring to do so, recognizing that there might be a time we can't provide the care to keep you comfortable or safe and we will need to look at other options". The guilt of family members who must place their loved one in a SNF for their final days/weeks is a burden they don't need at this time and they didn't "fail" as they often believe.

Just curious as this is a hot topic here as well. Why is it ok for the floor to leave to go to ED for transport (and probably leave the floor out of ratio) if the ED is concerned about out of ratio as well? Obviously the ideal state is to have a resource RN of some type stationed somewhere to pick up or deliver but floor staff question why ED is upset about transporting 'when no one seems to understand the same thing is happening on the inpatient unit and no one cares about them or their patients'? Part of the issue is probably the lack of ED support in times past when they had a quiet night and the floors couldn't even get them to come up and help with a difficult IV yet the floor staff are expected to float wherever and whenever. I fully understand ED dynamics of 'anything could happen at any minute', but there are times when help and support would have been greatly appreciated. Floor nurses have seen those "snapshots in time" moments when all of the ED staff are 'just sitting' and the floor came to get the patient and left a chaotic unit to do so. How are you addressing what seems like a disparity of collaboration? Or perhaps your areas are more collaborative than what I see?

I have a few thoughts: Whether assisted or not, if the butt hits the floor, it is considered a fall in my state. Did you give report on the patient to the other nurse? Did other nurse call for help because she saw patient standing unsafely? Any chance the other nurse was actually trying to get the patient into bed and patient was too weak or the night nurse somehow messed up the actual transfer "contributing to the fall". The lack of chair alarm is a non issue in this case since the other nurse was in the room and the chair alarm doesn't alarm until the pressure is off and patient already trying to stand. The only real good part is that you know when the fall occurred instead of finding them on the floor randomly. [minor editorial comment]. Now, the $64,000 question. . . did the charge nurse and others that you involved in asking for a chair alarm back you up and indicate you had tried? If not, the unit has a bigger issue than the fall. Fear from other leadership around manager or lying about your request are bigger concerns in my book.

I had a wise professor who may have summed up what graduation means. The actual ceremony is not just about "you". it is a way for your family and friends that supported you on the journey to see the successful conclusion (or at least this step) of your career journey. I think she was right in many ways. For me, the pinning is "nursing graduation". I could have cared less about the college / university ceremonies. I didn't attend the community college graduation after my ADN because the pinning ceremony was really my graduation in my mind. When I completed my BSN, I walked commencement for my parents and my husband to acknowledge the achievement and in my mind, I was "done". Twenty years later I completed an online MSN. Graduation ceremonies were held twice a year. I had no plans to attend until my professor posted those words. I had tremendous support from my husband, several special professors who indicated they were attending the ceremony, and from 4 or 5 peers that I met online but had never seen in person. The group of us committed to go and it was one of the best weekends of our lives. I would not have missed it for the world in retrospect. Although some of those online friends have dropped from my contacts, I still am truly connected with one and we chat via email at least weekly and stay connected. My daughter recently completed her BSN. I think the pinning ceremony was as emotionally moving for me as it may have been for her. I think she had some bittersweet moments of this chapter of her life ending and some anxiety about the future roles she would have. She made the decision to attend commencement (surprised me a bit, knowing her normal views of ceremony) and I think she felt she wanted one last time to connect with her peer support and to make nursing school 'complete' in her mind. My joy in watching her happiness overcame the hard seats, etc. Whatever anyone chooses to do, is their own choice. Just be sure that you don't have regrets later. Those that want to take offense at a perceived 'snub' to the class or professors by not attending pinning, make a choice to feel that way.

A new grad RN on probation may have a difficult time getting that first job. Many employers are not willing to start a new hire with "baggage". However, there are many out there that will. It might not be in an inpatient clinical area but outpatient and other areas may be a better first start if this job doesn't work out. I wish you success. It is nerve-wracking enough to be facing NCLEX and job hunts without this additional stress.

For many employers, they will work with their current staff on these issues. They have formed a relationship and know the staff will follow through. New hires are a roll of the dice and since the CNO is ultimately responsible, many will simply not take the chance. It also greatly depends on what the restrictions are. . . unable to give narcotics? No float? Level of supervision required? Unable to work night shift? All of these will play into hiring decisions. Depending on the restrictions, you may not qualify under their expectations to be able to work on the inpatient side. You may need to look for work in outpatient testing, Occupational health, or other similar areas until your license is cleared.

This is a difficult situation. Read the application carefully. There may be phrasing in there that indicates something along the lines of less than truthful could be grounds for immediate termination. My gut says to indicate your military service and be ready to provide an explanation if asked about the type of discharge. My other concern is the BON. Are you absolutely certain you are cleared to take your exam? Where I live, they are strict to the point of rigid for previous offenses for drugs or alcohol. They may stall your application, eventually allow you to take the exam but immediately revoke your license and put you on a probation status, regardless of how long ago the issue occurred.

Finally coming back after a few hectic weeks at work and home. I greatly appreciate the sharing of experiences and comments. I wish nursing schools would be more objective in how they portray residencies to their students and encourage them to really explore what is offered in a residency as opposed to how a hospital orients a new grad. It appears that often it is a matter of word semantics but not having "residency" in the job postings can be a deterrent for new grad applicants. Thank you for your input!