lazz1

Thank you for your reply! That's encouraging to hear. I'm from Vancouver, BC but now live in South FL. I have one year to leave this place and we might be moving to WA where my husband is from. If you can take a travel job to Florida do so, but DO NOT willingly move here because this place will make you want to leave nursing all together.

How much do RNs in Seattle, WA make?

Though the person who wrote the original post had a misunderstanding of what DNR means in terms of patient care, I think she or he now knows the different perspectives that experience RNs hold when they care for DNR patients and hopefully has come up with the right understanding now. I find it more alarming, however, and frankly no one has commented on, is that how a new nurse with only 3 months of experience could possibly feel this burned out. This saddens me, because if her heavy work load of 5-6 patient could be reduced just to four, she or he will have more time to spend with her patients, making him/her feel like they are actually doing their job well. I have been a RN for four years, and I'll admit, I have had thoughts similar to her, where I for a moment think, "Why bother?" I don't let these thoughts change how I treat these patients in any way, but I think many new and old RNs are burned out and this is a result of horrible, stressful working environments. RNs have no control anymore of their workplace environment and are at the mercy of cripsy, old hospital administrators that are absolutely clueless what being a bedside nurse is like today. I feel for you and I encourage you to stay positive and know that you can and do make a difference in those patients who are approaching the end of their lives. We are privileged to help them and provide them relief of their symptoms so that they may live the remaining days or weeks with dignity. Take care!

South Florida, 3 years experience WITH BSN and high acuity training 25/hr (includes benefits ect), night 6/hr, weekend 3/hr, 1/hr if floated Stepdown Was not enough money, so I went per diem and now I get 38/hr with the same diffs.

I think it is quite alright to withhold a medication such as a beta blocker if the heart rate is in the fifty's because I would be cautious in not wanting to cause this patient to brady down further (since this patient already did that before to the 30s). This patient needs a pacemaker. She has tachy/brady syndrome. I would hold the med if her heart rate was that low and get parameters. A good cardiologist would write parameters down at the time of ordering the medication. Most do not, so I would use good judgement and not give the med until I know what parameters the doctor wants.

You speak the truth!!

I'm shocked you are earning 30 dollars an hour down here in Ft. Lauderdale. I'm an RN from canada, with three years of cardiac care and they best two hospitals offered me was 25.00 as a staff RN. I have two degrees, including a BSN. I am now per diem because the pay is 38/hr, and based on how poorly they treat RNs down here in FL, I might as well get paid well for the hard work I do and crap I put up with. I hope things will be better for you. ED/ICU RNs are in demand so you should be able to find a job, but lower your pay expectations, unless you work per diem, because you might be disappointed. It is expensive to live down here. Maybe not as bad as NY, but living on 25/hr and supporting a husband in dental school is just not enough.

Florida is the worst state to work in for LPN's and RN's. Experienced, smart and well trained LPN's are treated like PCTs. They are not even allowed to check blood sugar at my hospital in Fort Lauderdale. I'm an RN, and we too are treated poorly. Exploited by being over worked and frequently under staffed because my hospital is too damn cheap to hire nurses. Believe me, it is not worth moving here for a job. Move here when you retire. I still see nurses who are in the late 50's working their asses off to save for retirement because the only make 35 dollars an hour with 20+ years of experience. I went per diem and make 38$, otherwise, they made it sound like paying me 25$ and hour was doing a favor for me. I have 4 years of training experience. Don't even get me started on the manners of the physicians. There are none.

I'm happy you were able to go back! That is my hope when my hubby finishes dental school here.

Good luck! I wish you the best!

Wow, thats awesome! Your weekly paycheck is 980-1000? What company do you work for if you dont mind me asking? I'm thinking of home health.

Florida is the worst paying state for staff RNs. I have three years of experience and I get 25 dollars an hour. It is an absolute joke how poorly they treat nurses down here! I work in Fort Lauderdale. I have no idea if the gulf coast is better. For your sake I hope it is. I've only worked in FL for 6 months, and I'm done with being a hospital nurse. Doctors are rude, patients think they are in a hotel, administration has their heads up their butts and are clueless to what is actually needed on the floors, which is more staff. I'm from Canada, and we are protected there by a union, while here you are **** upon and expected to hold the hands of incompetent doctors. I'm being blunt because no one was with me and it was a rude awakening. I really hope for your sake it is better on the gulf side, but Florida does have the reputation to treat highly trained RNs, who are smart, intelligent and skilled, as if they are nothing more than grunt workers. The minute I find another job, I am leaving nursing all together.

Thank you so much for replying. I will look into AWHONN. Never heard of it!

Hi everyone, I've been a Cardiac RN for three years now. All of my nursing education and specialty training has been in Canada, and I've worked in the states for 6 months now as med-surg. I do not like it. The unit I was working in Canada was highly specialized in receiving patients POD 1 from OHS, while down here I get the pt POD 4 or 5. We use to get our patients home after valve/CABG sx on pod 4-5!! It drives me nuts to get POD5 CABG patients now and they are only walking for the first time!! I find my job boring and mundane now. I still like caring for my patients, but I am DONE with med-surg. Before I decided what specialty I wanted, many RNs told me "get the med surg experience" first. Well I did that, I got my experience, and though not all of it was bad, I'm ready for a big change. I want to be a maternity/L&D Rn. I always wanted to and I'm ready to do this. I know what I would have to do in Canada to become a Materity/L&D RN in terms of the training and courses, but I'm not so sure how to go about this in the states. If there are L&D RNs, can you tell me what certifications you have, or what education is typically required of RNs in the states to work as maternity RNs. Thank you for reading. Christina

Yes, that is very unsafe. Mostly for you!! The patient won't be harmed laying in bed with all rails up. And as for your "co-worker", if anyone expects you to be able to push a 400 lb man on a stretcher with no help, they need to stop being a nurse because they lost their mind. Next time say no you won't do it without help. Protect your back and shoulders. I injured my shoulder in my first year of nursing, and I should have said no, I need help. Never do anything you are uncomfortable with and seek out those co-workers who will help you and forget those who don't. That is not teamwork.

Hmm, perhaps there is a union, but they must keep very quiet. I don't see or hear about a union advocating for patient safety and safe RN to patient ratios like I did in Canada. I'm only here for two years, and then i am headed back to the north to work.

Hi, it's a culture shock down here. I came from working in Canada where nurses are well protected and governed by a huge union, to working in south FL where there is no union and nurses are not as well respected. I left one hospital and now I work at Holy Cross (magnet) where it is wayyy better. I heard that CC is obsessed with their doctors and forget about their wonderful nurses. My gut said to work at holy cross so I am now. Good luck. You make the most out of your work place! Stay positive and do not tolerate crappy working conditions.

Incentive Spirometry is so important. If you don't have one, get him to do deep breathing exercises 10 per hour, or when he remembers. Gotta keep those lungs working well to prevent atelectasis.

Interview went well. They offered me a position right away after showing me around. I ended up turning it down because I got hired at Westside and Westside offered more $. However, I will be quitting Westside because I do not like the nursing standards there and refuse to work where patients are neglected. I just got hired at Holy Cross, they offer a little less than Cleveland Clinic, but it's a good hospital to be working at. I was impressed with Cleveland clinic. That was a super clean hospital, in a very nice community. Good luck :)

Hello, I just had an interview at Cleveland Clinic, FL for an RN position. Is there anyone out there that remembers their hiring process? The nurse manager mentioned it could take 2 weeks for HR to get back to me. I'm just wondering if anyone has insight into the hiring process at Cleveland clinic? Thanks.

I'm not disagreeing with you. Medications to improve BP and CO are much better and more effective than just NS boluses, I was only stating that boluses have their place in codes and to not be afraid to run the line open during a code until proper help has arrived. I am not a critical care nurse, I worked on a cardiac stepdown unit, so when one of our patients coded or were crashing, we immediately called the code for the code team to arrive and the second thing we did was run fluids until the doctor and ICU nurses were present to give the meds. That is the perspective I am coming from.

Hi, I still think fluid boluses can be one of many interventions that are applicable in a crashing/code situation. Have you been a code? All the ones I have been in, nurses are running NS fast to at least keep the BP up while meds are being administered. When the meds are working, then the boluses slow down, but fluids can be giving in a code situation.

I would be most concerned with the NS continuous infusion order. There should also be a daily weights order too. The patient should be on strict in/outs and sodium restriction. If a patient is overloaded with fluid, you do not want to be giving more fluid IV. The patient is not dehydrated. The patient is overloaded, meaning has too much fluid volume in the blood which over stretches the heart and causes the pump failure. This extra fluid also tries to infiltrate the interstitial spaces of the lungs and other body tissues causing edema. Also, in heart failure, the kidneys are actually hypo-perfused, because of the pump failure, so the kidneys act as if the body is dehydrated and retains fluid (worsening the heart failure). Therefore, the diuretic is necessary to get the kidneys making a lot of urine to pull off that extra fluid volume. Now if the patient was crashing, a fluid bolus would be necessary of course, but a continuous one at 250 cc and hour would warrent some serious questioning.

Yes, please tell us what cleveland clinic is like. I have an interview there next week :)

It's at Westside Hospital. I didn't hear favorable things about Plantation General either. Not sure if Westside if the same. I did accept the job, so we'll see what comes from it. I was quite offended when they said I would earn 26/hr, when I am use to 33 with only two years experience and extra training. This of course is up in canada, British Columbia where it is expensive to live. I do feel, coming from Canada where nurses are well protected and advocated for by the union, we are a powerful body up there, i do feel nurses here in Florida get shafted HUGE! I'm here because my husband is at Nova in professional school there, so once he is done, we are outta Florida and probably back to North West somewhere. I'll miss the sunshine though! Thanks for posting.