exit96

I tend to agree. I've been at this awhile myself, and the world has changed a lot. Good to be a Nurse, and the current demand has made at least that part of the scene advantageous for Nurses. What I don't like is that I have to scheme on how to get my last few days of PTO from these jerks. They would likely try to withhold it. I don't want to screw over my co workers, but may have to call in for my last few shifts just to get the PTO I am due.

I have a new job offer, much better pay Current employer has been messing with me recently, unnecessarily, I don't trust them, I don't see myself ever going back there. It's not like me to NOT give 2 weeks notice, but the world has changed, and if these *** wanted me gone it would be immediate. Where do you stand on the 2 weeks notice protocol?

Wow, hot crowd

I work in LTC, on the rehab/covid unit. We've been getting over loaded, is how I would say it. Recently the floor had 19 skilled residents, and 4 LTC residents. 1 Nurse, 2 aides. You all know the charting responsibilities this demands, on top of the resident care, running off the floor to the Pixis for meds because we admit 2-3 residents at a time. Recently got mandated for 16, one of those shifts where you are doing everything right and no matter how fast you run you are always 3 steps behind. Well it ended with my getting a disciplinary for soem allegedly "undone" tx's, although the Nurse who I handed off to marked them completed and got them done. The lecture I received was basically a "you need to ask for help, otherwise we don't know you need help." This has me pretty ticked. If you are a Nurse manager and you don't know what you are doing to the unit then perhaps it's you who needs to look at your practice. The whole discussion really amounted to how it is a risk to my license for a couple reasons. I think this is a good indication to get out as fast as I can. What do you think? What are your floors looking like? Thanks E96

I've been part of bigger, strong Unions, and these I would support 100%. Currently I was in a small, amalgamated union, which is basically worthless. I am currently wondering how to expose the corruption I see. The Union rep is besties with the DON, receives special treatment, and so does her "little boy" who she is mentoring. It's pathetic. They don't represent anyone, they turn people in and tattle to the DON over trivial stuff. They receive bonuses that no one else receives.

CNA before being an RN: First place for a year in LTC Second place hospital CNA 3 years LPN at facility for 1 year per diem while finishing my RN (I think I had like 2 others jobs along with this one at the time) as RN: 1 + years med/surg 4 years in ER 2+ years in management (never again)- severance pay, they don’t like people who don’t play the political game, it’s all a game next place, Dialysis company for 2 years. Like dialysis, hated the facility, region, most toxic environment imaginable, from the management right through the floor staff it was a sh*thole- let go for 1, yes 1 missed medication. They also don’t like people who call them out on their sh*t currently; back in LTC for 1 year- I’ve learned a few things, hope to stay and retire in 5ish years

I did a search to see if this topic is on here, didn’t find it. If you know of a link so we don’t recreate the wheel please feel free to direct me. 1- My inquiry: my facility offers a bonus for SOME shifts when they are in dire need of coverage. $150 for a 12 hour shift, and then accordingly for less hours picked up. What type of bonus do you see at your place? 2- when Mandated, do you receive a stipend/bonus? At my facility we do not, we just get forced to worked.

I think you are reading way too much into what I'm saying. A "team" first and foremost? Absolutely! But let's not mix licensure and roles, it's best for the patients. As far as the machines, it shouldn't take 12 weeks of 4 shifts per week. It needs to be thorough intense training, but there's an awful lot of wasted time in those 12 weeks that could be utilized elsewhere.

Accurate observations, I agree. One other, BIG Item...the insurance sucks bad. United Health Care, Express Scripts, Accredo, hell you don’t even know how to get something accomplished. United Health Care doesn’t want to pay anything. $6500 out of pocket!?$13500 out of pocket for a couple!?! Then they don’t want to pay anything!? Worst insurance I’ve had in my entire life. HR- you can’t get ahold of them. Remember the days of being able to speak to an HR rep?

Michigan 1:16 4 techs when fully staffed

Nice job writing this, very accurate. I've been a Dialysis RN now for 1&1/2 years, 16 chair clinic, 1 Nurse, 4 techs. It has been a difficult, interesting time, I do enjoy it, but some things should not be the way they are. The training “seems” to be very thorough, 12 weeks in class/machine training, then I had like 5 days with another Nurse on the floor. IMO, if you are going to be a tech then this is good, but a lot of wasted time for an RN. There should be a separate machine set up in the back where one can just set up the machine over and over, that’s really just task oriented, non critical thinking stuff, but needs repetition to get it down. There is really no benefit to setting up 4 machines, then standing around watching techs do tasks. Much of the classroom training is also something that could be condensed into maybe 3 comprehensive classes for an RN. Not everyone can teach. As mentioned here, techs do tasks, they can say “do this, do that, push this button,” but that teaches nothing. I too think like an RN, I want to know context, conceptual understanding, why I am doing a specific thing, and I have not had a tech yet that can answer these types of questions. It is maddening to be trained by someone who cannot teach. And, it should not be happening in this way. One more though on that- techs in this setting can get pretty cocky and lose track of their scope of practice. Having a subordinate “train” an RN can lead to a perception that they are on equal ground. Let’s not pretend that this is true. You know what I’m talking about. For me personally, much more value would have been found in spending time with the precepting Nurse, working with, and thinking through patient scenarios. I had like 5 shifts to shadow, in which I really learned nothing. So, 1 RN, 16 patients with no on site support or RN to do the “real” precepting. I can find the break room, bathroom, supplies by myself, let’s focus on the important stuff, you know, the patients. The company I work for is so over focused on the techs that it is detrimental, and rather depressing. Keep an eye on the techs. As mentioned they have zero medical knowledge. I don’t care if you’ve been doing the tech thing for 10 years, you are a task doer, period. It may sound like I dislike my RN position, but that’s not the case. Just pointing out some stuff that took me well over a year to sort out, as everything comes at you at a very fast pace.

After putting my thoughts, and reality down here, I guess I know what the right response to this is...?

I’m in month 8 of a new position, it’s in a dialysis unit, but this isn’t specific to dialysis. Last week a new, or newly reinforced policy for the techs to weigh the patients on the way out was reinforced. Seems like an easy enough task to complete without fanfare. Well, on Friday evening, a couple hours into the shift, the 4 techs who were on shift all went straight to the Manager with the story of “ Joe (the RN) wont help us. So, the manager came out to the floor and told Joe RN that “the techs all said that you won’t help.” Joe RN was completely blind sided as he was busy preparing meds, checking patients in and assessing them, and so forth. Joe RN has had zero complaints by staff and patients, and the Manager “knows” that this cannot be true. So everyone went on with their business and completed the shift. However, there was no more communicating between the techs and Joe, the normal, appropriate communication ended. Joe has had a great report with the techs he was working with, no issues whatsoever, until now. All the techs involved have always been great at communicating and asking “can I get some help,” and Joe has always been the type to say “I’m glad to help.” The techs are not happy with the reinforcement of having to accept their responsibility of weighing the patients out, and for some strange reason, this shift not one of them asked for help, but all went to the Manager with complaint (lie) that “Joe won’t help us.” Joe requested a huddle with the staff before the Manager left for the evening. And the techs all complained and nothing was accomplished. The Manager told Joe that he doesn’t believe the techs story, yet does nothing about it... The main concern: Joe RN doesn’t feel that the patients are safe, nor is he safe with behavior such as this being allowed. Joe works with this same crew on the evening shift twice per week. Joe has never seen or experienced anything like this before. It appears that the Manager has no control over the techs behavior, and their ganging up on the RN and all sticking together with the same lie is very, very concerning. So, yeah, I am Joe (not my real name), and this has me so stressed that I haven’t been able to get it out of my mind all weekend, nor can I get rid of this headache all the stress has caused. I don’t know what the hell to do about this, seems like the staff is out of control and I am concerned about my upcoming shifts, patient safety, and my own future. This is truly a messed up situation...

I understand the physical differences, but I don't think that is a good excuse. I was a tech before a nurse, and I don't have a problem helping. But I have experienced, numerous times, at different facilities, men being the first call for lifting people. I have a herniated L5 S1, and now a likely torn cartilage in my knee. I want to maintain as much quality of life as any of my lady counterparts, so yeah, don't call me first. I could say I'm not built to move people anymore too, maybe moreso, because I have the injuries to prove I have not bailed on my duties. When we hired on, being able to do all of the job was in the description, so do all of your job.

Sorry if I sound angry, I think sick of the gender bias would be more accurate.

It's sexist and it's wrong...but don't look for it to ever change...

SICK!! Unethical...

Of course, but they ARE NOT the same. Come on...

Race differences are not the same as gender differences...so let's stick to comparing "apples to apples."

I think it is time to hire RN's based on gender so that patients can be accommodated.

Thanks for sharing. I'm not surprised at the lack of sensitivity, but the behavior after your requests are seriously worthy of legal action!!

I believe in the Charge Nurse role. I work a small rural ED, and we have at least 1 real good Triage Nurse. But even that individual can get caught up in emotions, and a level headed, QUALIFIED, charge Nurse would be a good balance....

Actually, I believe that we should be able to earmark our tax dollars for what we believe to be correct. If someone believes in this foolishness, then they can pay. My tax dollars should not go to arbitrary crap.

I here you...but that doesn't make it "society's problem." I've seen the huddle masses, that "don't have money for co pay," with their cell phone in hand, cigarettes in hand...fine. I don't begrudge anyone having that stuff, it's their life. But knock off the stupidity. And like you said, they likely DO know better, so why do we play along? Why do we insist on raising ANOTHER class of those who are entitled? So many of these "poor souls" don't even try to get a job...at least those in the demographic that I see on a daily basis...

In my ED, we get our rooms, and then treat whatever we are given. Each of us has 1 trauma room and then general rooms. The triage nurse basically fills the rooms on an as needed basis according to how they arrive. No bias in my ED. It is a crap shoot. But on days when I have been blessed with lower acuity patients I am willingly, without being asked, to assist my coworkers with their patient load....as it should be.