sparta802

From what I've heard new grads are having a tough time in the Philly/South NJ area. Most hospitals are offering very few jobs and tend to hire experienced nurses or from within. I've heard other states are still having shortages though. In this economy, look at all nursing jobs- not just in hospitals. You can't be picky about nursing jobs anymore, unfortunately. So look at nursing homes, offices, psych facilities, etc. Any experience is better than no experience.

I work in Med-Surg and am jealous of the experience others have in tele/ICU! The main thing, as mentioned, is the # of patients. For example, dayshift here can get up to 6, nightshift up to 10 (no monitors). It's a lot but you don't have to do VS as often, they're on routine meds (po, IVF, IV Abx), they're *usually* stable and some are self-sufficient. The main thing is time management so you can do all you're supposed to but for a lot more pts. We sometimes get tele/ICU nurses pulled to Med/Surg and that's their issue. I think that will be the main adjustment for you.

We just started this and it's not a part of the pt's record. We just have to go into the pt's room and make sure they're ok, see if they need anything, etc. If they're sleeping, we let them sleep. We have to initial a paper hanging in the room each hour. I like the idea b/c (on night shift especially), pts might not be checked on for hours since the nurses/aides assume if they're quiet, they're asleep or content. There could be a pt on the floor, dead, anything and no one would know for hours! I think this also makes the pts happier since they know we're there more- to get water, empty urinals, get pain meds, etc and they don't have to ring the bell and "bother us."

Great thread! -Families who want to talk to the attending doctor at 8pm- sorry, but the doctor is long gone! Or the patient is fully capable of answering questions but the family wants me to give them info and they think I'm lying about HIPA laws. Or the families who write down everything anyone does like they're just looking for something to sue over. -Those patients who are very elderly with no quality of life and the family wants *everything* done to them. Why are we putting a Peg tube in a 105yr old practically unresponsive pt. and also giving her PRBCs, etc?? Such a sad waste of everything. Makes advanced directives appreciated! -Dayshift nurses who in report will say "The pt gets dressing changes daily" but doesn't actually say she did the dressing change. I used to assume it was done and when I check the pt it obviously wasn't done. So now I specifically ask if it was done. It's dayshifts job to do the dressing change since they have less pts so why can't they do it? If they were busy and said they just couldn't get to it, fine, but don't avoid the issue cause you're lazy. If the nurse is reading a magazine when I come in and stuff like that isn't done, it's plain laziness! -Nurses/aides who don't answer their call bells (and they're online, reading, etc). Just answer it! The pt will get more annoyed if you wait 10mins, the problem won't go away, there might be something really wrong, etc. And some aides are online yet aren't giving baths, feeding pts, etc. I shouldn't have to tell someone how to do basic functions of their job! -Nurses you're following who don't check/sign off their orders. Why am I having to clarify orders at 6pm that were written at noon?? Or they sign off an order for say a urine sample, they never get one, and never tell you to get one. -Nurses who can chart before even seeing a pt! Or who don't have a stethoscope but tell you how the lungs sound! -Some (not all!) of the new grads have such an attitude. They tell me what to do, tell me what they won't do, and are just plain lazy! They act like they're doing me a favor or something when really, it's 100times easier for me to do my job without them. So different from when I was a new grad. Geez, I could go on forever! haha. To sum it all up: annoying families and lazy workers!!

In this area (Southeast PA/South NJ) there's definately NOT a shortage. My small hospital usually hires a lot of new grads from a nearby nursing school but this year they said they were able to be "picky" since they only have a few openings (and we don't even really need those filled). Other hospitals have a hiring freeze or only hire from within. It stinks and obviously has to do with the economy so it won't be like this forever. Definately look in other states!! I know new grads don't want to start in nursing homes, but they always seem to be hiring so you can look there if need be. At least you'll be getting a paycheck/benefits and keeping up your basic nursing skills.

Our nurse manager also hired several new grads- and we don't really need more nurses right now since we don't usually have a full census, plus we have lots of pool nurses to fill in. The new grads unfortunately become resented since they're taking away shifts on our units and then the nurses who have been there for years (and who had to train these new grads) get pulled. Of course, it's not the new grads fault- it's managements. I agree with the other post about how we should get paid more if we're pulled to a different unit. Pool nurses make more, so should we. There should at least be some sort of bonus if we get pulled. If only managers would listen...