NJFek

I'm a new grad RN (May 2010) working in a prison on the 7a - 7 p shift. (For a little background, the oncoming day shift arrives before night shift finishes morning pill call, so we have to wait until it is over to do our turn over). The majority of the inmates speak little or no English, mainly Spanish (of which little of the staff speak). Today at evening pill call, two inmates who share the same last name approached the window and told me that one of them had received the other's medication at morning pill call. I got their ID cards from them and found their MARs in the book, one right in front of the other. Sure enough, exact same last name. The inmate who had received the wrong medication was supposed to get Naproxen, the other (who said he didn't even GO to morning pill call) was supposed to get INH and B6. When I checked the MARs, the INH and B6 had been signed off for the inmate who was supposed to have gotten it, and nothing had been signed off for the one who actually got it. The inmate who got the INH and B6 (having the other inmate translate) accurately described the four pills he took. There was not a doubt in my mind as to what had occured (wrong inmate got the wrong meds). I administered the INH and B6 to the inmate who was supposed to have gotten it, circled the initials of the person who had incorrectly administered them this morning, and put my initials on the MAR (this is the way I have been told to document a med error). The nurse who relieved me tonight is the same nurse who administered the meds this morning. I explained to her that the inmates came to the window and explained the situation. I told her what I did to try to correct the situation. She is a kind but brash person and immediately went into a tirade (sorry, but no other word) about how she didn't make a mistake and that the right person got the right meds, as proven by the MAR. She then told me that it was MY error for administering the dose, saying that I double dosed the inmate (I firmly disagree). She said that I should have withheld the medication and told the inmates to return to morning pill call to discuss the situation with her. In hindsight, that probably would have been the best course, but I know that patients with TB must stay on track with their medication and he was already going to be short one dose, I didn't want him to be short two. (BTW... neither inmates has any allergies, thank God... that was the first thing I checked when they told me what happened). The nurse also told me that the inmates were playing me because they wanted more medication. I completely disagree. If the meds in question had been narcs or NSAIDS or really any other med, I would have refused to administer more meds and sent them away more than likely. However, the inmates on TB therapy or prophylaxis KNOW that they MUST get their medications on schedule and all of the ones on it so far are really good about it. Not only that, they're not going to get a high or sleep better (a big goal of some of the inmates) from taking INH and B6. Why would someone lie about those particular meds?? What SHOULD I have done? Is this now my error because I documented?? At the time I felt I handled the situation correctly and didn't question it until the other nurse started her tirade. I'm concerned because if this does fall on me, that will make it appear as though I have two med errors (the other one was my fault: It was another case of nearly identical names, I handed some KOP/SAM meds to an inmate through the window and sent him on his way. Within seconds, I realized what had happened and had the CO call him back (he was only yards from the window). He came back to the window and I told him I needed the meds, he handed them back and I saw he had already taken one (again, thankfully no allergies!! I always check for allergies before I give ANY med and until recently I felt that I am very careful checking names and inmate numbers, but I've already learned to check and recheck those since this event)... anyway, I immediately called my supervisor and we are meeting next week to discuss the situation. Anyway, if the situation today comes back on me (which I'm sure on paper it appears to), it will look as though I have TWO in a week!! When in reality I "only" have one. In both cases, I made certain to put a name alert on the MARs involved. I feel I handled these situations ethically and honestly, but I would like to hear some opinions, please. Thanks!

Thank you all for your encouragement. One poster suggested that I speak to instructors. I have a letter of recommendation from one prof., but as far as speaking to them about calling managers, none of them that I had are employed at the hospitals... they are employed through the college. I can't really go to the prof that I had for clinicals at the unit where I sent the letter, because she was (trying to be nice here)... less than pleasant to everyone she came in contact with... the manager of that unit despised the instructor and gave all of us much kudos for tolerating the things she did to us (they were pretty bad!)... anyway, using a reference from that instructor of all people on that particular unit would be the kiss of death for any opportunity. As far as I know, none of the other instructors I had are affiliated with that hospital... I'll keep racking my brain to see if there are some instructors that would maybe put a word in for me at places I did not have clinicals, but right off the top of my head, I can't come up with names. Thank you all again. I kind of feel like we got the bait and switch as far as choosing nursing as a career... :0/

Hi all! I am a new grad and have had my license for a little over a month. I have applied to at least 100 (seriously) positions and haven't even gotten a call from one of them. I call the HR recruiters every couple weeks and am always told the same thing... "That position was filled" or occasionally "Your application was sent on for manager review". After I'm told the latter, I always get very hopeful, but then nothing comes of it at all. I went to one of the hospital HR departments and spoke directly to the nurse recruiter who said my resume looks good (I've had other people tell me that as well), but still nothing! I also sent a letter to the manager of one of the units that I was on in nursing school that I absolutely loved. Along with the letter, I sent my resume and a letter of recommendation... no response... not even a call or email to acknowledge receipt of the letter. I've also spent a great deal of time hand delivering resumes to urgent care centers, doctor's offices, etc., all to no avail. I've been trying to figure out why I haven't even gotten an interview, and the only thing I can think of is the sheer number of applicants and the fact that employers can be as choosy as they want to be right now. I realize there are a lot of people in my situation, but if anyone out there has recently overcome this economy and landed a job, I would be so thankful if you could share your tips for landing that position.

Thank you all of you for putting your two cents in! I considered every statement that was made. I called the DON and told her my concerns. She told me not to go in on Saturday or Sunday and to meet with her Monday (today) morning. I went in fully expecting a conversation. I was open-minded and ready to hear what she had to say... When I went in to her office, she handed me a job description and told me to take it home, read it and if I felt like I could "handle it" to call her. I told her I had some questions and she cut me off and repeated that I needed to take it home, read it and call her with my decision. I should have said no right then, but my DH just retired from the Navy and our income has been cut in half and our savings is nearly gone, so I felt that I needed to be as open-minded as possible. I agreed to take the PD home and read it. Half an hour after I left, I got a call from the ADON saying that I had caused an "inconvenience" over the weekend (which I had already apologized for) and that she didn't feel I was a good fit for the company. I told her I thought she was right. I was ELATED! ALL the stress of the past several days was completely lifted off of me! I have NO idea how we are going to do this with no money, but I know we will find a way... and one that is legit!!! I would have appreciated them being up front with me, but in the end, the fault is mine for not trusting my instincts to begin with. This will not go on my "record" because I never worked on the floor, so I kind of see this as a fresh start. There aren't many positions in my area that new grads/licensees are qualified for in my area, but I do have some apps out there and I am going to physically go to one of the hospitals I've applied to tomorrow and hope something comes of it. I never dreamed I would be so happy to be unemployed, but I am. I want to thank all of you again! Your unfortunate experiences were not wasted!!! They helped me AND you all DID learn from them... even if you simply learned that LTC isn't for you, it is STILL valuable!! Thank you again!!! :0)

Thank you for your reply. I am just exploring options to get my foot in the door of a hospital and am considering every option. Thank you again.

Hi all. I was wondering if anyone knows if a newly licensed RN is allowed (legally) to work as an Associate Care Provider in Florida. I'm not having much luck in the way of nursing jobs, and I know that working as an ACP would be a great way to get my foot in the door of a hospital. I know some states allow this, but I don't know about Florida. Any info from those "in the know" is greatly appreciated! Thanks!

Thank you very much for your input. I am taking everyone's comments very seriously and am weighing my options. The most difficult part of this entire situation is that my DH just retired from the military and we have lost half of our income. We really need the income right now, so I have a lot of things to consider. Thank you again!

I asked so many questions that I think people were getting irritated with me, but I felt as though they were trying to dodge my questions... I made it very clear that I am a newly licensed grad and never once was "charge nurse" mentioned when I spoke to these people. This is a position that I would really rather not take, but there really are no other options in my area for new nurses. People with experience would do very well finding a position down here though. Thanks everyone for your thoughts.

This is an accurate description of what is going on. There was a facility orientation that was 2 days long and consisted of me sitting in a room watching videos. As for unit orientation. I'm being told that I will have three days of mentoring and after that I'm flying solo. I had to ask the ADON five times before I got a straight answer out of her as far as liability issues with me being the only RN in the building. She told me that I won't be liable which helps a bit, nor is anyone on the floor at night "in charge". We all care for our own patients/residents. I am still not completely comfortable with this situation, but I am comfortable enough to give it a chance and see how it goes... Thank you for your response!

Forgot to add one critical piece of information... I am newly licensed and just graduated in May... and I'm NOT ACLS.

I was recently offered my first position as an RN in a LTC/SNF in northeast FL. I completed orientation and was scheduled for nights (7p-7a). The thing is, when I looked at the schedule, I noticed that I am the only RN with 3 LPNs and several CNAs. I tried to ask the ADON who would be in charge in that situation and all she told me is that the company expects all of their RNs to oversee everything and that if there were a code I would have to run it... I've never even been in one! I asked her a couple more times in different ways thinking maybe I wasn't very clear in what I was asking and she seemed to be dodging my question. My intuition is telling me this is a potentially unsafe situation (there are 100 residents and I would be the only RN in the building). I'm going to call again today and have a conversation with the ADON and try to get some straight answers. I'm scheduled for Saturday, but I really don't want to put myself in a situation that jeopardizes any residents/employees or my license. I just wanted to see what others thought about this situation. I tried to ask the ADON who would be liable if anything went wrong (legally, I am sure it would be me), but again, she dodged me (at least it seemed like it). The pay is great for starting, but when I was hired I honestly felt that the reason I got hired is b/c I have a pulse and a license. There was NO competition for the job at all (which is FAR from the norm in my area)... I'll update later after I've spoken to her again, but I would like to hear other people's thoughts on this.

Anyone know where (or even IF) I can find white women's scrub pants with a liner? I have to wear white pants to a new job... thought I was done with white pants w/ graduation, but I guess not. Would like to find some with a liner in the "seat" region to avoid the obvious problem. Found some thicker dickies that I liked in school, but the fit isn't the greatest for me.

Wow... I just put an application in at PSA in Jacksonville, FL. I would really not be thrilled to do housekeeping but as another poster said, I would keep the patient's area clean. My only other option is to work in a nursing home that wants new grads to have a three day orientation and go on the floor alone with 30 patients and 2 cnas to supervise. The PSA website says there are 24/7 support systems for the nurses, I can only hope that is true at this point. The way it stands now, I'd rather do laundry than have responsibility for 30 patients! Although that view might change if what everyone is saying here is true. No good options here it looks like.

I graduated in May, Miss Whitney... (I actually remember you responding to some of my posts when I came on here to ask questions when I was applying to FSCJ!). Where did you end up getting hired? I have heard of newbies getting on with peds home health. I haven't tried that yet or Integrity... I'll do some research into those! Thank you for your input! :0)

I have followed up with some of the places, but others that said they would hold on to my resume but were not hiring, I haven't called or followed up with them. One of the hospitals told me that I could check the status of my applications online. I told her that for three of the apps I had no status at all when I checked. All she would say is to keep checking, but that it probably means I didn't get the position. I called a recruiter that distributed my resume to local hospitals and all he said was that if the places wanted to hire me they would call... so he basically just did what I've been doing all along (and I drove an hour to meet with him for him to do what I've done...). I don't have any idea where to go from here...

I wish I could say yes, but I can't. I'm in Jax and in the exact same position. I've been offered ONE position at a nursing home in north Florida, and honestly it doesn't have a great reputation. They have three days of training on the floor even for new grads, after that you're on your own with 30 residents! They seriously hire anyone with a pulse. I really don't want to take it but I'm afraid I'm going to have to. The benefits suck and I'm so afraid that I'll have no support system at all there. I have put in a LOT of apps at SVMC and BMC Downtown... not one interview. Two of my apps were sent to managers at BMC but not even a call. I called HR today and they basically said that I need to limit my apps to med/surg or areas that require no experience... there aren't any out there! The thing that is making me so mad right now is that BMC also said they don't hire RNs w/o experience outside of med/surg... I PERSONALLY know two people I graduated with (and have heard of others) who were hired in ortho and at the heart hospital... neither of them worked in the medical field while in school (one had experience as a receptionist or something like that in a medical setting, but no RN experience... the other was a bartender during school... How on earth can they say they don't hire anyone w/o experience to one person, then hire another w/ no exp. in a highly specialize area? I'm so ready to just pack up and go to another state. How are we supposed to GET experience if no one will LET us do it??? GRRR

LMoon~ I've been reminding myself lately that I know God has a plan for me... I just wish He would let me in on it! LOL I feel as though I am forced to take it as well. I guess all we can do at this point is pray... best wishes!

Thank you, LMoon. I agree that starting out in ltc is far from ideal. I have many reservations myself. Three months ago, I was caring for four patients and staying busy for 12 hrs straight... I have no clue how it is going to work out with 30!! I realize these are not patients, but residents and they are not nearly as acute, however, 1:30 does not sound safe in any situation in my mind. I keep praying that something will come up before Tuesday (that is when my orientation starts) but we'll see what happens. I haven't read any postings about ltc but I have personal reasons why ltc is not where I want to be... I feel that in general (I realize there are exceptions) nursing homes are seen by our society as dumping grounds, they are grossly underfunded and understaffed and the residents are not well cared for. I am trying to not see myself as "joining" but trying to see each shift as an opportunity to make things better for these people who are seemingly ignored and neglected. Some people find that they are cut out for ltc, I don't see that happening for me, but it might... and it might for you as well. I would take the fact that they really interviewed you as a good sign. I honestly feel like the only requirements to work at this place I'm talking about are a valid license and a pulse. I'm going to be making some phone calls tomorrow about other positions and I'm honestly praying that something comes up... I just don't think I can be a part of that organization for long. Good luck!

I graduated in May and got my FL license, but I live in southern Georgia. I wanted to start the process of applying for my GA license by endorsement but when I went to the BON website, I saw that there is a 3 month or 500 hr work requirement, so I called the BON to ask some questions and they told me that the work requirement does not apply to new grads and all I needed to do was fill out the application and send it in. In the application, it specifically asks if you've met that requirement and if not, it warns you that you'll have to take a refresher course... there is no option to select stating that you are a new grad. Did you face this situation? I have no idea how to answer that question. In addition, there are so many hoops to jump through on that application that it gives me headaches to sit down and look at it! While I was in nursing school, one of our instructors told us that some nursing political action group is pushing congress to create one national license... I certainly hope that happens (although it probably won't). The NCLEX is standard, why shouldn't licenses be?? That way, you get licensed once and you don't have to worry about applying in multiple states and jumping through so many hoops. Anyway, if you could just detail your experience with the GA BON, I would really appreciate it. I'm going to call them today and have them hand walk me through that particular area, but hearing it from someone on this end of it would be helpful, I hope. :) Thanks!!

Just wanted to send an update here. I got a job. It is at a nursing home, but getting it feels very hollow. The DON told me that she "likes to give everyone a chance to get started"... which I appreciate, but there are two other new grads that I graduated with who have also gotten jobs there, and basically it felt like the only requirement was that we have a pulse. She didn't ask me anything about nursing at all. She said "So, tell me about yourself". I told her a little about me and she spent the rest of our entire interview doing all of the talking and me nodding and saying umm humm. I'm going to keep looking and pray that something else comes up, but this will have to do for now. Gotta feed the kiddos, right?

The hospitals were just the areas I focused on yesterday. I am exploring every opportunity I can think of. Part of the issue is that in our area many of the doctor's offices are affiliated with hospitals and do all of their hiring through hospital job boards. The few that don't either aren't hiring or are looking for NPs. Just did a search on a major national health system board in three different states... came back with 14 openings in total throughout all three states, and not all of them were RN positions. Some were LPN and even NP and physicians... whew... not sure where to go from here... play it by ear I guess...

Went and picked up the letter from my prof today and dropped it and a copy of my resume at a major local health system. I get the feeling that it probably won't help much because most of the positions are specialized, but we'll see. Will be dropping them off at another hospital this week.

You know, at this point, I would probably take the position. You do have to consider how bad traffic will be, hours that you will be working and how much time you are willing to spend on the road, but I would probably take it if there were no other prospects.

BKC, That is very discouraging, but I'm thankful that you were honest with me (and I'm happy for you that you finally landed that job! Congratulations!) I sent an email request to the children's hospital in my area requesting more information about volunteering there. I did see on their website that they have volunteers in their outpatient surgery area (and also an RN position!!). I told them that I'm interested in volunteering in the surgery center but I'm open to other areas. The hospital is a half hour drive from my house and with losing so much income, I have no clue how long I'll be able to do it, but hopefully I won't have to for too long. I realize I haven't been at this for that long, but already it is so frustrating. I just don't understand the hesitation to hire new nurses. Nurses already are overloaded, hospitals are understaffed... I get the liability thing and that certain areas require expertise that I just don't have right now, but just because we're graduates doesn't mean we are incompetent. Every nurse started where I am right now, even the managers... you'd think they would remember where they came from. I feel like I'm trying to break into a secret club and I'm starting to wonder if I really want to be a part of it... which is sad because nursing is the only career I have ever seriously considered... but I guess it doesn't matter anyway, with the amount of time and money I have invested in this, I'm locked. I know that right now the frustration is doing most of the talking and hopefully one day (soon) my outlook will change but... grr ;0).

Thanks, Carol... "Good"~ If you don't mind my asking, have you been working in the medical field at all? I'm seriously thinking I'm probably just going to have to take A job, any job to feed my kids. Have never been in this position before and will do everything in my power to ensure it never happens again. No matter what the cost to me.