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Don't even put it on "inactive" status;" b/c you may want to use it in the future--and you can if your reactivate; but there is a record that you had it on inactive. That alone doesn't mean something terrible, but it hurts you in having a competitive advantage. What's more, you can continue to volunteer as a nurse, and keep some ground in terms of exposure to healthcare. Fortunately there are many different things today for which one can use a nursing degree. Explore them, but do not surrender or even place it on inactive. When you want to return, and you just may; future employers will wonder why it was on inactive status. Pay the money every two years. Keep up your CEUs, do some volunteering, and begin searching across all different nursing, healthcare, and business venues. And yes. You can work as an Uber driving too. :) I know nurses that work on Norwegian Cruise Line. Seriously, best wishes.

Or they quit b/c of a toxic work culture...

If you sense that the culture is not for you, it is totally OK. Go with that feeling. It happens. It's fine.

Unless we are talking about a small community ICU, I have to agree with the above comments.

I am glad I did Medsurg/tele before critical care. Mostly, I say, find a place that has excellence in nurse education and support. Find a thriving, healthy environment in which to grow and learn. Sadly, this can indeed be a challenge. Also, depending upon the ED, it is crazy enough (so can MS be crazy at times), so if you don't go to a place with a good and supportive education/mentoring/precepting system in place, you may well get burned in the fire of ED craziness. If you are in an inner city; it's just the nature of the ED beast. Personally, my new recommendation to nurses is to not only meet with the manager of a particular unit and shadow with nurses there--and for more than 2 hours; b/c that will not get you what you need to know. I encourage people to interview with the Nurse Educator of the unit. Get a feel for this person, how much they have on their plate, how organized is the system of didactic and clinical education, and try to find out what their systems of evaluation of progress are--how objectively they are structured and worded. Get a feel for the particular culture of the unit; which will probably take more than one or two exposures, if you can do so. Go in with your eyes wide open, and see if they are structured and have the integrity to set new nurse hires up for success or not--whether it is based on more objective measures or capricious measures that can be so loose that your evaluation could mean anything anyone wants it to mean. I have lived and worked in this field a very long time. Shop hard for these things--even if it means your better off working nightshift for a while. If you are competent, ethical, and motivated, your new position should be willing to invest as much into you and you are investing into it. Nurses have to get and stay smart and strong about this. When they do this more consistently, in mass, ours will be a healthier, happier profession. But go where you will be challenged but also wisely and supportively moved toward success. It is very discouraging to invest in a position, only to realize that they are not really able or don't really desire to also, in good faith, invest in you. It's your education, license, and livelihood. Don't let any system ruin what you have worked hard to obtain. At the same time, give your absolute best, listen well to your preceptors, and be a smart, ethical nurse. Good luck.

Just know that they are very nice to you while you shadow,but it's a different world when you come in there to persue [sic] the CRNA career. They eat you alive! The above comment was in reference to CRNA shadowing; but I find it applicable in nursing across the board. I read the above comment in another thread, and the truth is, yes. This is still going on in the field/profession. After being in nursing--very demanding critical nursing role--for decades, I am still so perplexed by this phenomenon in nursing. Yes. I understand that it just doesn't happen in nursing; but let's be honest. There is A LOT of it. What makes this happen? Is it simply part of the human condition? How do we progressively rise above this as professionals? I have said from many years back that a HUGE part of the problem is weak systems of evaluation--also weak communication skills in teaching and in leadership. I also believe we need to strive for more objective systems for clinical evaluation. It's impossible to eliminate all subjectivity in evaluation; but the main goal is to step back and strive hard for objectivity. Whether you think you like someone or their style is the same as yours has nothing to do with meeting sound prognostic indicators for clinical success. How do we move forward? How do we get to a place where bias, personal or otherwise takes a backseat to balanced and objective systems of evaluation? When this is held as the standard, there will be much more unity, respect, and professionalism in nursing. Without it, nursing will remain stuck as some glorified tech position. (Please don't misunderstand me. I love techs, so no disrespect to them; it's just that we have a whole philosophy and pedagogy for nursing education, practice, and professionalism, which goes far beyond technical skills. You don't know how many times I have cringed when I have heard techs in ED or some other place say, "We do everything the nurses do.!" No. You are skewed in your perception of the role of the nurse and the profession. I don't argue with these people, b/c I doubt I will change their perspective in a number of cases. They are blind to what nursing really is and what it is supposed to be.) Trust me on this as well. Regardless of current economic swings and political issues with healthcare and insurance, the demand for truly professional nursing is going to greatly increase--and yes. I am saying this in 2017! It's time to take the silly, capriciousness out of nursing and get down to more objective systems of teaching and evaluating. Further, if someone doesn't want to precept, they definitely should not be doing so. It takes a lot of patience and insight. Also, just b/c people have taken preceptor courses DOES NOT MEAN THEY SHOULD BE PRECEPTING. Excellence in communication, empathy, and teaching the adult learning is key. Taking a mere preceptor course alone will not make you a good teach or mentor.

Yes, like at least a good three years or more of FT+ residency, among other graduate education/licensure requirements and supervision--and they can push those weekly hours up to 80/wk, and some specialties opt to do more, b/c they want to be sure they get as many opportunities to be up-to-speed and competent as possible. Just saying. Don't hate on me now.

Holy crap!

True, but will that ACTUALLY happen? There is a lot of looking the other way when you are in the right "crowd," and I have seen a fair share of NM's complicit with this sort of thing. Very few strong ones that function out of principle and don't ride off of the "special" inner-crowd's micromanaging and being their set of eyes. Do do otherwise can get in the way of their next move up the ladder; so they keep their inner circle, and it's amazing how exceptions are made of the inner circle and their allies. So, I'd like to know that if the nurse gets fired, will the other people involved get fired also? I'd be very surprised if that is how things went down. And if they really want to cover the inner-crowd people with screwed up ethics, they may slap her on the wrist, so to not bring the others to a disciplinary hearing if the original nurses protested about it. I love hospital/unit politics.

Is this a serious post? Most people sign online and/or on paper saying that they will not use someone else's PW/UN, etc. It's all in the info given at the beginning. The reply is absolutely "No." After that you document it the request somewhere, in case the person that asked you to do the wrong thing has clout and tries to get you in trouble over something stupid or misrepresented later on--which happens a lot more in nursing than I would want to admit in a court of law. It's embarrassing really. Unless you can prove (very difficult if not impossible) that she was made to do this under duress, she doesn't really stand a chance. She should begin looking for another position ASAP.

Houtx, I know this thread is old, and I don't know if you still come here, but this is one of the most awesome, all-time truths. This is precisely what happens to many on orientation. It's reflects poorly on the institution/unit, but MANY so MANY get away w/o having these things. Dear Lord, if I could just put you in a 3-D printer or clone you! :) Now how do we get hospitals and units to start being better about this kind of thing?????

People in general chew on others too much. It is nothing short of tragic that healthcare is like this. I have taught too, and the scathing or harsh approach is generally nonproductive. I submit that the politics and money that go along with it are the reason that other states aren't united in this. Interestingly enough, if you work for the Veteran's Administration, your license will confer to any relocation in which they (VA) place you. So beyond the idiotic politics/money, I submit that people really can't give you a logical answer, b/c it's political, and mostly, politics are NOT logical. You can get tough in healthcare, externally, but once you become hard and unbendable, the value of your true efficacy begins to drop. Sensitivity and empathy are Key in healthcare. The gunner mentality is a toxicity everyone can live without.

PS. Sadly you will usually find some people that don't really work and focus enough on their patients and job that fly under the radar. You can see them in any field. It's just extra annoying in healthcare; b/c people are, well people, and not widgets. Some number of them schmooze w/ docs and stand around talking about other people or something stupid. And some people are just downright unethical w/ their horizontal violence and sabotage of other nurses. I have actually seen where nurses have changed ordered heparin rates on pumps or other meds--unethical, but I swear to you this kind of thing can happen. You learn to make sure you are really checking everything every hour or more frequently--depending. You make sure that you take the time to document that carefully. I have seen some weirdo stuff--some of it mean sick and mean-spirited. Thank God in heaven this is not most nurses or docs. Thank God most of them have scruples. I have seen lazy nurses in recovery areas or ICU that just don't document vitals at anywhere near the appropriate times--some people just think they will always get away with that and the patient will never have a problem in the next hour, where you now have to explain why the post-op admission assessment and VSS and gtts, etc were not recorded. They fire some nurses for being busy and missing a few things here and there, yet other people that are blessed with being in the posse have their poor practice ignored over ad over again. It's great when the NM are in on this too. Lack of scruples in leadership. And again you want to say, "But hey; we are dealing w/ people not widgets!" But then it still falls on deaf ears; and you just learn to be ultra careful over every little thing--especially in the ICUs. There are a lot of games. You have to find ways to rise above them that won't get you singled out regularly--or you have to smile, do your job, cover your orifice, and go home and send out feelers or responses to other jobs on the down low. Sometimes unions help, and other times they don't--especially when they are just as corrupt and in bed with the hospital as all heck. And then you learn that the cliche' "Money talks, BS walks is this tragic reality."

Listen, I am not trying to make excuses for you or to have you step away from whatever your part/responsibility/accountability is in this thing. Nonetheless, we have to be realistic and include vital information, which is quite relevant if Risk Mgt is going to do a true Root Cause Analysis. 7 patients in an ICU, which are left in your care/charge, is outrageous, period. I've worked it for many years. I have worked pediatric ICUs and such as well. 3 can be incredibly dangerous; depending on acuity, which often is ever-changing and considering a host of other factors. Bottom line to me is this. Sure, you have to take what is yours, but under the circumstances, I'd say that you are damn lucky you didn't make a worse mistake. Please write this up carefully on your computer, including all the relevant, factual information and circumstances. Step back and present it as objectively as possible. If you don't know, look up what is or should be involved in a RCA. Look up your institution's policies re: RM. Contact the RM person and ask to speak with him/her. Document as thoroughly as you can--again, presenting, as objectively as possible. Do NOT beat the crap up out of yourself over this. Again, I truly feel like under those circumstances, it very well could have been worse. Just a very unsafe situation/environment--at least during the time you described. You may also want to evaluate how administration assesses and works this up w/ RM, and then you need to see if this is an environment you really want to stay in. You worked hard for your license, and I am sure you don't want to be on the giving end of less than stellar practices--and the consequences of regularly functioning under them. You can learn for this mistake, but if the situation was, in the critical care setting, as bad as you presented, well, even the most careful of nurses and docs can easily make mistakes. Sad thing is when people then run around looking for scapegoats. Don't be the scapegoat. Yes, we need to be careful in labeling labs, but I am an expert practitioner, and honestly, I have made a few mistakes over 20 some years than could have killed a couple of patients. Thankfully I caught them before any crap really hit the fan. Sometimes, even as bright and diligent as one can be, well, at least for me, I've just had to thank God for looking out for me when things got crazy or stupid for one reason or another. There is also this little alarm that goes off inside of me, and that has helped me in avoiding bad consequences with the situations I refer to, as well as with catching things that had nothing to do with me--just stuff that people missed or docs missed b/c of utter craziness. We are there as a team, and we have to look out for each other. It's never one of those weird superior nurse things that some nurses do; like "Ah ha! I got you!" It's just more of being a reader and analyzer and then this intuitive thing--I guess mixed with experience. But my first priority is to the patient--and peds, that includes the family as well. Still, we just have to be a team, or life sucks for everyone. I would like to tell you that you will never make another mistake, but that would be a total untruth. If you work long and hard enough, in enough wild environments, yes, human error will be a factor. But this particular situation set you up for the error--again, if what you shared is true. After you have documented well and as thoroughly and objectively as possible, look, carefully communicate with manager, RM person, etc, and see if they are going to be looking to scapegoat you, or to truly do a fair analysis and correct the factors that led up to the error. They may say one thing, and then do another, so you may want to check your HR file and the NM's "secret" or open file, and whatever RM has written. People just have this whole, pass the buck kind of thing. The loss of that integrity in the workplace happens, sadly, more than enough. Your shop may not be that way, but on the other hand, eh. If they do not strive to be truly objective and work on correcting the "set-up" that was in place ASAP, well, then you need to start looking elsewhere for another position. Seriously. You don't have to tell them. Just start doing what you have to do. If they are that short, and if you have been a bright, conscientious nurse, they aren't going to fire you--unless someone is demanding a head to roll or a scapegoat. They might try to slap you on the wrist with something too; but just make sure on whatever form/s they give you, you put your addendum in of what transpired, and that it's noted that your addendum is added w/ your initials. Administrative records sometimes have a way of being there one minute, then being gone the next, and then returning. Oh I could tell you some stories I have seen over the years. Hang in there and protect your license and livelihood and professional reputation.

THANK YOU FOR HELPING PROTECT OUR NATION'S HEALTHCARE WORKERS AGAINST EBOLA AND OTHER INFECTIOUS DISEASES Please forward this petition to friends, family, and others who can help healthcare workers Link to this petition: http://www.nationalnursesunited.org/page/s/national-nurses-united-urges-you-to-take-action-now Everything in the petition is quite reasonable. Nurses should be at the forefront of effecting change when it comes to this and other infectious disease issues. I have been, sadly, not surprised by the lack of hospital and CDC control and competence re: safe standards of practice for Ebola and really all infectious diseases. Contact Precautions must also include Droplet Precautions when the patient is coughing or is with artificial ventilation, with a coagulopathy that causes bleeding, or has diarrhea, etc. In such infectious disease cases, nurses and those directly involved in care need to be properly protected. It's 2014. Such standards should have been in place all along, and all hospitals should subscribe to and follow proper-SAFE protocol/s. Please go to the website, read through, and sign the petition. Also, here is the most current CDC Guidelines for donning and doffing PPE. Warmly, SamAdams8, RN, BSN