happycamper

New grads start out pretty decently in the midlands of SC, considering AM or 7A positions can be pretty hard to comeby. Here the start is generally $19-22 w/shift differential, weekend differential, holiday differential, on call pay, call back pay, permanent shift differential fo PMs and Ns, BSN bonus, certification bonus. It can really add up.

I wish I knew. Is it the nurse with a husband/wife and four children? Is it the single mom/dad? Is it the hospital who continually operates in the red? I have been in nursing for quite a while and did not see salaries significantly rise until men entered the profession in larger numbers. Not to reveal my age :rotfl: but I started many moons ago for $3.84/hr. I definitely think it should be a colaborative effort between hospital administration and nursing. With so many more nursing staffs become empowered because of the push for Magnet Hospital status, I envision a time in the near future for a Compensation/Benefit Committee to be a voice for nursing. I do think that if nursing saw and understood the revenue issues faced by each hospital and for administration to come down from the Ivory Tower and face the issues of nurses then we could begin a productive dialogue. I also think that it certainly isn't just salary but a combination of benefits to include adequate health insurance, long and short term disability, education reimbursements, promotion opportunities, retirement plans, and other issues specific to each facility. I notice some areas much more vocal and reactionary than others and, maybe, this frightens some institutions that do have employees interests at the forefront. The value of nursing in any institution is very hard to determine particularly when our services are lumped in with the "room charge." So unbundling our profession and services needs to be paramount in any negotiation. Sorry for being long-winded but I guess I am trying to think out loud to answer my own questions.

What is "fair"? Who decides? A union? Do you think they really have your best interest as their primary focus? Then, why do they push so hard for payroll deduction of union dues? Why are their executives paid such exorbitant salaries? And why did organized crime find them so lucrative? These are a lot of questions they skirt when asked? Much like a politician who is cornered. I am neither pro or anti union. I am pro Nursing! And finally do we expect non-profit county or charitable hospitals to be able to compete with the big for-profit entities? Someone, please help me with these issues.

I agree to a lot of what you say. However....the hospitals don't despise unions for the loss of total control over the nurses' lives but over the loss of control of what happens inside their walls. Nurses need to face a few hard facts also. If you're looking for money as a motivator, it never was and never will be according to all research. But we, as nurses, need to be very clear about what we want and be able to intelligently and rationally articulate our position. We, also, need to make the hard choices if a hospital is not able to meet our needs or demands. We can stay at the facility and complain we can constructively try to reach a compromise beneficial to both, or we can leave. It's what the "big boys" do in the corporate world. Or, there is another choice if we can't find satisfaction. We can pursue another career. I'm not going to tell you anything is "for the sake of the poor patients." But, if not for the poor patients, why are we here?

Who are we to blame if a student does not have a good clinical rotation or if the unit does not have a good experience with the student? Well....let's start with the nurse manager and the instructor. What kind of relationship do they have. My unit generally has groups of student nurses from two major universities as well as a technical school and job-shadowing high school students. The development of a productive relationship is ongoing but cannot be solved at the nurse-student level. The manager and instructor need to spearhead the experience. In our unit, the nurse manager and service line director met with the clinical instructors and their director to develop a plan for students, to formulate realistic expectations that the nurse can have of students and students can have of nurses, what time the student will report to the unit, and how involved she will be in the care of her patient(s). Since it would be foolish, self-defeating, and demoralizing to place a student with a nurse who is not willing to teach, our manager interviewed perspective student preceptors to get their opinions. Ongoing dialogue was begun with the nurses who agreed to precept and discussions were initiated to communicate both distinct expectations. Although this process sounds complicated, it has worked beautifully. The students feel comfortable with staff, know who they can readily go to, know that they are welcomed to seek out additional experiences, and readily take on all learning opportunities. In turn, considering future hires, the hospital gets new graduates who are a "step ahead" in hospital orientation. To foster good communication, the instructor, who has students in numerous areas in the service line, carries a beeper so she is available. She also empowers the staff to review a student's performance during the learning process. Works for us.

Try The Nursing Diagnoses Reference Manual by Sheila Sparks. Can be purchased online, new or used, from Amazon.com. Hope it helps.

#1 There are many books on the market that practically spoon feed you care plans for any diagnoses condition. #2 Haven't you heard of networking. A group begins doing drug cards and then supply each other with the drug card for their day. Pretty soon you have a library to choose from and so does your study group. #3 If you have had a similar patient before, don't reinvent the wheel, modify it. I have many students on my unit and having completed a masters within the last few years I am more than willing to share info, research material, and read their papers for content. All A's so far. Help is out there, use your nurse and let her expound on what she knows best. You never know until you ask. Everyone likes to show off sometime.

I don't know where your plans will take you or which hospitals you have investigated but things are pretty good here in South Carolina. Maybe the salaries may not be comparable but the cost of living may not be either. If you would like to hear more about "my" hospital system would love to help.

No wonder we cannot unite! No wonder we are viewed as "eating our young." If you cannot agree to disagree on some issues as responsible, intelligent professionals then we do not deserve to be treated differently than we are now. Maybe in some areas hospital systems view nurses as expendable, but those hospitals may be the ones who find it necessary to recruit "foreign" nurses. But foreign nurses are nurses also. Possibly some hospitals do not pay well or offer exceptional benefits or treat everyone fairly. So what. We are not married to our institutions and our patients are not our children. Change if you can. No institution is all bad or all good. If you think that the bad outweighs the good you have two choices. Do something about it or accept it. Arguing among ourselves does not accomplish anything. Personally, I recognize that everyone's perception of any situation is not the same as mine and, maybe, they have a different set of circumstances which requires different interventions to achieve different outcomes - sound familiar. Use the "old-fashioned" nursing process. Assess, plan, intervene and reassess. Sounds a little bit like JACHO's Performance Improvement? Maybe we not only need to assess our working environment but our attitude as well.

Thank you for your response and your independence. I dislike having an outside entity "calling the shots" for me, telling me I have to leave my patient's beside to go on strike, ridiculing my colleagues for having to cross picket lines to support their families, and demanding I pay union dues whenther or not I voted affimative for their organization. Perhaps nurses who work at a for-profit institution do have issues I am not experiencing, just like employees at any corporation. It delights me that my healthcare facility has ".org" instead of ".com" after its email. Enjoy your nursing career. I sure do mine. :)

Sounds like you are on the right track. OR can be exciting but dangerous as well, back injuries, blood/body fluid contact, accidents with equiment. The hours are good except when nurses call in and you can't leave your room, when your case goes on forever and you get out for one 15 min break, when you don't have lunch/break relief, when docs treat you not like second but third and fourth class citizens, when other staff treat you like "goffers." Just a little reality check. It's good and it's bad. For you I hope you experience the good more than the bad. Mine was but you have to make it that way. Lots of luck and thanks for choosing nursing.

At my hospital, we follow the national standards recommended by our organizations, i.e AWHONN for unit. Our hospital South Carolina didn't need a legislature or union to tell us that we get better patient outcomes by a 1:5-6 nurse patient ratio. Our Nursing V-P and CFO already determined the need and revised our FTE requirements without all the browbeating. We are formalizing a structure that nurses are involved in all aspect of hospital operations to improve patient care, research, education, and, yes, budget. Hope you will have the same input. :balloons:

What better way to ensure the success and love of future nursing than by nurturing, mentoring and teaching those bright smiling faces of the future. I think that if we as nurses foster self-confidence in students by teaching then the tasks we do every day, then they are one step ahead when graduating. We can teach them what we do but they have to see in us and in the care of our patients why we do it. Yes, nursing is an art and a science, but more the need and drive to be a nurse is in the heart. Our young adults come to us with that desire in their heart and it is up to us to treasure it and recognize it. They are truly our future and the furture of our profession.

Please let me clarify. I am not a physician, did not attend four years of medical school, did not spend 5 years residency, have student loans that are comparable to the national debt, and will never try to fathom why a physician becomes a physician. I am however very concerned about my profession and do not want it to descend to placing only a dollar value on what I do. I have always been employed in South Carolina, and as a nurse have always enjoyed excellent benefits and salaries without a union. My hospital alliance is non-profit which may make a difference and our administration beginning at the corporate level is very attuned to the needs, the accomplishments and the contributions of nurses. I would believe your statement about a union being "a group of people who stand up for one another" if the first issue they bargain wasn't payroll deduction for union dues and not my benefits. And to answer your first question, when I began my nursing career my salary was 1/20th of what it is now. And my benefits have continued their upward spiral without a union. Do I need a union? No. Do other nurses need a union? Maybe. I can only say that in my experience and on observation of conflicts between employee/employer relationships in other areas, it would appear that both may have their priorities confused. Perhaps all of us need to review why we went into nursing in the first place. How much "money" did we expect to make? And, more importantly, who did we think our target population was? Is our profession now relegated to defining what we do by the money we make? Can't we receive enourmous satisfication for helping deliver a healthy baby, watching a mother bond successfully with her infant, watching our patients return to their optimal level of function? How much more appreciated do we need to be? I have excellent insurance, tuition assistance and reimbursement, numerous education opportunities, involvement in the function and practice of my unit, service line, and my hospital, excellent retirement plans, outside benefits, overtime, call back pay, shift differential, permanent shift differential, bonuses for higher degrees, and much more. What could a union do for my coworker? When the CEO and President of my Alliance and CFO and Nursing V-P know my name, stop me and ask about my family, and how things are going, and are interested in my opinion for improvements, how could I not support my status quo? I think I have it great but am truly sorry for those nurses who are not as fortunate as I. Maybe a union is right for you, but for me at this time it is not necessary nor has ever been.

I worked the OR for ten years, trauma surgery, open heart team, intraop transfusionist, etc. If you are a new graduate take at least a year to operationalize you assessment skills and to learn the daily routines of patient care and the emergency routines for critical patients. The OR will always be there. I left not because of the OR but because my skills had greatly diminshed. While the OR can be exciting, in a lot of areas it has degressed from interactive patient care to technical skills with machinery. Just a thought