ChangeAgent

Sounds like I would want a representative from HR. Clinical educator? The comments above dont speak to any competencies that werent met - and you havent stated a particular incident...it sounds like they got everyone involved so the accountability is spread out... So that only leaves one impression with my mind... Unfortunately cc units have their own dynamics and cultural fit. Why waste your talent here. When they interview people sometimes they dont take into account those already there. I have worked with a few whackos - LOL -another post another day. There are critical care units everywhere. I am shocked in this shortage that they can afford this. It bizarre that they didnt address this earlier. They have already $$$thousands - thousands$$$ of dollars by the time you are done cc course, tele course, and time paired with your preceptor. Perhaps an administrator out there knows the current cost - it was $90K for a new cc orientee when I researched in early 90's. Chin up - you sound smart with a great career ahead of you. If you decide to resign - exit gracefully - people show up in other facilities. The age comment I am not surprised about - many in ICU feel new nurses shouldnt be working there. I dont happen to agree - many fine nurses started new there. I have observed some preceptors and fellow nurses mark someone from the beginning of their orientation and excuse the same behavior in other new nurses. I wish you the best...dont doubt your decision to be a nurse

Perhaps your strength as a leader will develop the team??? Even though you are not in a formal managment position - your leadership will likely shine through. What you are describing is one of the wonderful things about nursing. best of luck to you in your new endeavor...

The uniforms are fairly straight forward - I saw white scrub pants and I dont think they have a uniform top. They have an official school lab coat - it has a patch on the sleeve, it is short and professional. It looks really sharp. They left their jackets on during the clinical time. Now that you mention this - I will delve deeper into the shirt situation. However, some students were wearing some that barely covered the abdomen. Some of it is instructor discretion regarding hair etc. - and that heavens common sense prevails most of the time with that. Just leave the giant earrings at home - and the tight low tee shirts (saw that too). Best of luck! Anxiously awaiting the semester start in a few weeks!

I beg to differ. Thank you every day for your hard work. CNA = MVP

Congratulations! Best of luck!!!!!!!!!!!!!!!!!! :roll

Everyone added great comments so I will try and not repeat. If the site was red etc. - then I wonder if the nruse filled out an incident report. Typically their is a section that states tx - it probably states the IV was removed. Your quote from the patient is interesting - and it would be something I would repeat in a deposition. It is not a normal comment to make - perhaps he was trying to intimidate. I probably would have written it in the chart. The plaintiff counsel will also ask if you discussed the situation with anyone. Email and list servs are discoverable. I heard before that Medicaid patients sue more frequently. I wish you the best...Good luck...hard lesson.

My favorite story... Relax though it was for a sales type position. I waited in the lobby of a hotel for about 20 minutes - because I was early. I then walked into the conference room and faced five interviewers. One of them happened to be a man I chatted with in the lobby to kill time. I was offered the job. I was friendly and polite - a good sales asset for the company. I have noted in the last two years a lot of places are shifting toward behavioral interviewing. They are hard to prepare for because you wont know where they will go - once you give them a scenario - they will keep asking probing questions. I would think with QI - cultural fit is important I would anticipate questions on: 1. what accomplishment are you most proud of 2. have you ever gotten into an argument at work - of course we all have. I shifted the tone and situation toward disagreement. 3. tell me about a time when you faced incredible odds - deadline - opposition to your idea Dont be afraid of the weird questions - they ask those to throw you off guard. "what would you do if a man didnt extend his hand to shake with you upon meeting?" My answer - "smile and move on. The customer is always right." This company was a small for protfit firm and the clientele included Hasidic Jewish men. "what would I be surprised to learn about you?" my answer was that I enjoy public speaking. LOL - not sure what he was getting at with that one?%$#@@%! Last note - if you want the job at the end of the interview... Tell them you are interested (fairly sure) or that you want it (if you feel strong). I have heard interviewers state that many candidates dont even let them know they want the job. Maybe someone has different experience - but it isnt wont do you any good to play hard to get. Companies want enthusiastic workers - excited to join their company. The job market is stiff for management positions. Good luck!!!!!!!

Just a thought - how about hiring a lawyer and pursuing expungement? I didnt know a history prevented you from attending classes - but it will come back to haunt you when you apply for a license with the BON and you will also need to declare this on applications. I think the applications state "were you ever charged..." this means even if you werent found guilty you would need to state this. All jobs do criminal record checks that I know of.

I dont have any clinical experience with burns. But a good fit seems like a wound care specialty IF there would be support from medical staff. NP's can write the orders etc. If you are not hospital employees - you can bill for services.

Orals are fine if you can coordinate - or IV in hospital setting. It is very difficult - I understnd where the RNs come from in the hospital...With coordinating pain meds to wound care. Sometimes you are doing a linen change - perineal clean up and it is works out well to do wound care then. In that situation you described - it does sound like pain. You are a good advocate.

You raised some really points. Many facilities do not want to pay for someone certified. By the way there are some nurses out there practicing wound care without any training. More alarming - there are NP's doing the same. I dont believe in week long crash courses - or similiar programs without a practicum. I attended a graduate level course (one semester of wound and one semester of ostomy and continence). While I realize this is not an option for everyone - it is the standard. Its interesting because I have seen the "dangerous" results of erroneous staging. When you Stage a wound - you are basically telling me (BTW an expert witness and LNC) that the wound is not infected - and also telling me that it is not a wound from a cutaneous manifestation of chronic disease. I have seen doctors mess that one up. Staging also gives clinicians a false sense of security - if I had a dollar for everytime I heard "its only a stage I or II" without takign into account the chronicity of the wound (Osteo) or colonization or infection. I feel that there is a component of diagnosis involved and therefore in the hospital within the role of an APN. Legally I see your responsibility as no different than a doctor practicing incompetent medicine. If the doctor prescribes the wrong treatment you are obligated legally and ethically to intervene. Remember patients families do not "see" the same thing we do when we examined the patient. In my practice I have doctors and staff nurses all the time not recognize the severity of a wound that gradually evolves. One successful approach is to make sure your facility documents a complete "naked" exam on any admissions. Some elder are incontinent and dont tell anyone and lie on admission assessments. This could be disastrous from a PR perspectice when in assisted living you are asking the family to bring in Depends two days after admission. I have witnessed some adult children do care - they stand in the door way of a bathroom, arm outstretched, with a wash cloth, and handing it to mom. I recognize sometimes a wound that is likely stage IV but has not opened up yet. This is the reason if I see purple or dark discoloration I document "...likely Stage IV - presentation heralds a much more serious lesion."

I haven't heard of it. It is not a bad idea though, student nurses are providing a service. The presence of nursing students on a floor is considered when staffing is done. Jennifer

I dont believe the starting salaries are bad when compared to graduates of similiar education. that being said... all the bonuses, and tricks dont seem to help the retention issues at hand. The vacancy rate is still high in most institutions. The nurses that elect to stay in our organizations are resentful at the bonus structure that favors newly hired staff. I have also noted that there are nurses that could be working fulltime but instead choose to work 2 part time or per diem jobs. There is also a hot market out there in non traditional areas (business, sales, research.....and so many other areas) that are eager to hire nurses. worried, Jennifer

The more I think about this... I question how someone in a masters program could have that much difficulty writing a paper. This person wanted to take short cuts. We need all APN's, but I recognize the life and death decisions that a CRNA's makes in seconds/minutes... There is no room for this person. There is no room for shortcuts in the OR. HATS OFF TO CRNA's. Consider submitting the article for publication next time, Concerned NP

Academic policies are clearly outlined in all student handbooks. This is academic dishonesty. I am not sure if you knew from the onset the level of help you were to going to give (editing - style). The student made a conscious decision to submit the paper. I would question this students integrity. ...unfair to you, maybe ...unfair to fellow classmates. probably ...unfair to the student, probably ...unfair to future patients????? What else has this person cheated on. Faculty, Philadelphia