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My sense has been that hospital administration does not view academic management experience the same as hospital management. At least as far as nursing is concerned. In some ways, even though it doesn’t always seem like it, they are two different worlds. Healthcare is a business, and nursing education is in a small corner of that business. Managing a facility day in and day out and being responsible for it 24/7 is hospital management. Academic management of clinical groups is not dissimilar, but is looked at as a micro sphere of hospital management and definitely not the same. It seems to be an unspoken “rule” that working only in academia is viewed by some administrators as a good retirement gig after earning your stripes in the career ( at least as viewed by the hospital). I’m not saying I agree with these perspectives per se, but it is the reality of the current landscape that I can see. That is why there are in some hospital contexts overqualified nurses from an academic perspective doing certain roles that they might feel they are under qualified for… The academic possibilities and the workforce realities do not always meet for nurses. All that to say, if you really want a hospital upper management job, I think you would have to follow the recruiters suggestions and go back to square one. If you don’t want to do that, you should stay in academia where the bulk of your experience seems to be. All the best!

Sounds like you need clarification as to company’s expectation of the role of manager. It is appropriate to want to make sure the patient gets the best care and is safe. However, if as a manager, emergent situations cannot be handled without your involvement on a routine basis, something is wrong. Maybe you need more qualified staff. Maybe the staff you have need more training. You will run yourself exhausted if you have a system where every emergent situation has to run by you. And the staff will allow you to handle as much as you want. But you also have your own administrative work to do that they can’t help you with. You need to be able to have staff below you on your team that you can trust, so that you can spend your time directing the choir, so to speak. I hope that you can find the middle ground. I wish you all the best, these situations aren’t easy!

A few ideas: Make sure you have a hobby or two outside of work so you can recharge. Walking, visiting a park, biking, painting. Something that gives you enjoyment. Know why you went into nursing in the first place. When you are at work, when you start to feel frustrated, take a step back in your mind and notice the “thousand foot view” such as: The patient is sick and not me. The patient needs my help. At least I’m not the one in the bed today. And remind yourself that nothing is perfect even if you do feel ready to scream because someone didn’t stock a supply cabinet again or something. ? Make sure you take your breaks. If you can go off the unit for your break, do that. Try to have a time during the day where you shut your brain off, even for a few minutes. This does not mean spending the whole break on your phone. Stay hydrated and don’t eat all the junk food that is all over on a unit☺️ And you might consider getting involved in some hospital or unit committees. Sometimes it helps with the frustration if you can at least feel like you are playing a role in helping to change things... and taking back some control. I hope some of this is helpful.

Never an easy situation. Is 5 months time a normal probationary period for your clinic? That seems extensive. If you haven’t already you should be speaking with HR about how to best proceed. Ideally you should have met with the new employee and discussed expectations and why perhaps these errors are occurring. If there is a fixable underlying cause, then that needs to be addressed and worked on. You may need to give a written warning asking that improvement starts to happen or termination will take place. I would not suggest having these conversations alone. The situation might take care of itself after a few well thought out conversations. Discussing how these documentation errors impact patient safety is generally an appropriate route. There are three options generally: 1. They will improve 2. They will not improve and realize they need to resign. Or 3. They will not improve and you will need to ask them to resign/ terminate their employment. Best wishes for the conversations!

Excessive debt ( and frankly, the $$ you are describing seems excessive ) will trap you for years. Less debt = more freedom in the future to do what you want. There are plenty of affordable programs like community colleges out there. Everyone takes the same NCLEX in the end. Unless you have a sure plan to be able to pay that debt off ASAP after graduation, with the interest that will accrue, you will be setting yourself up for a lot more stress and bondage in the future if you go this expensive route.

Never burn bridges. Give two weeks and you won’t regret it. Quit on the spot, and you might regret it. Healthcare can be a small, small world.

Have you considered working in a specialty or primary care office? Sometimes you make less $$, but depending on the specialty you will see less sorrow. Can be very beneficial in the long run!

Yes, in my opinion I would hire you. No need to make it overly complicated. You became sick with COVID and due to extended recovery needs you had to leave your position. Put in the appropriate notice and work with HR and don’t burn your bridges if you truly feel you need to leave. You need to give yourself oxygen first. Then, when you are all recovered and able to get back into the swing of things, reapply. And just tell the truth if you are ever asked about it. You can’t help that you got sick, and you need to take care of yourself. And the truth is, this pandemic could last a long time. There will be a lot of job changes in many industries in the upcoming months. Best wishes.

If you are someone who loves to have friends at work among your co-workers...and you have good solid friendships and a team with the people that you currently work with...then I would say seriously consider not taking the management job. I only say this because-in order to be an effective manager I feel that it involves a different skill set...one in which you need to enjoy the people that you work with certainly...and develop your team of people and allow them to grow and develop...but the bottom line is-when you are their manager, you cannot be their friend. I mean this in the nicest way possible. What I am basically trying to say is: when you are the manager, you cannot be the friend. You can be friendly, and caring and supportive...but if you are the 'friend' in the same way you are currently with your co-workers-you will lose the ability to be an effective manager. And if having many work friendships are important to you-you are best remaining where you are. That being said- if it works better for you pay wise and distance wise-and you are up for a new challenge....go for it! Either way, all the best on whatever you decide. ?

A few tips that I have...have been doing clinicals for a couple of years now. (of RN students but I feel that some of this will translate). 1. If you are not also employed at the facility I would not do a 'nursing task' that would not fall under the student heading. Therefore, no, don't do a PICC line dressing. Allow the students to watch the nurses-but don't do this yourself. You have to remember that you are employed by the school and not the facility. 2. I have a strict "No meds are passed except with me" policy. Procedures...are ok for the student to watch the nurse do. However, anything invasive like a foley, I would rather be there. The last thing you as an instructor wants is something to be given/done to a patient incorrectly and you had no idea it was happening. I just decide at the beginning of the day what meds we are passing and then let the nurse know. 3. If the school you are working for has guidelines for what the students can be doing along the timeline of where they are in their studies, look for that. 4. Check your state board of nurses for the scope of LPNs. Keep in mind that students of course are not LPNs...at the very least they should have been checked off in the lab on a skill before doing it in a facility. 5. Stop into the facility on an off day and meet with the DON or whoever and ask for their policy book and review it. Hopefully something here can help you...all the best!

You've received some good advice already. I have a few ideas: 1. Work with management to get the time to take the classes. 2. Jump in and learn from the other nurses how to do what you don't know what to do 3. Don't feel embarrassed asking for help. In order to succeed you need to ask questions and jump in there...doing IV's etc. don't come from a class or watching, they come from jumping in and trying again and again even when flubbing up a few times. 4. Don't listen to the negative ones who say that certain classes etc. were useless, etc. make your own judgement on that. You will do fine. You have a skill set already, and sometimes, the best training comes when you least expect it. Just speak up for yourself in the middle of a situation if you don't know what to do, and jump in when you can to do something you are not familiar with. It's basically having to work out of your comfort zone...but you will get through it and be fine I am sure! Best wishes. :)

My two cents: Talk to each of them privately (preferably right before the shift begins) and ask them not to do it-explain to them that even if they find it funny it makes you uncomfortable. Ask them to talk to you privately if they have any actual concerns about how you do your nursing care. You could even make it about the patient...we need our patients to have confidence in their caregiving team....etc. and talking about me or anyone else like that in front of them does not help the look of the overall team... If it continues, take it up your chain of command. Hopefully you have a manager that is respectful and professional enough to deal with the issue appropriately if you don't feel strong enough to do so. But whatever you do-don't let their "sense of humor" or whatever it is.... get into your head and make you doubt yourself or lose confidence. They should not be doing what they are doing. They are responsible for their own actions and words. Their actions reflect poorly on them and what they are focused on while they are at work, rather than professional and appropriate patient care. Focus on the patient-don't lose sight of that. :) All the best!

The interesting piece here is the wondering "where the disconnect is." I can offer a perspective from my time spent orienting nurses with varying levels of experience/credentialing....take it for what it is worth. What I have seen with errors is often the person is doing the 'task' of medication administration without realizing the disconnect is with the 'thought' of medication administration. It gets tricky and seemingly hard to 'nail down' when the person is used to speed and efficiency and the muscle memory of the task (and is good at it!), but not necessarily the 'thought' piece. I don't know what your errors were/are, but one example to demonstrate what I am saying is: being in a rush, pulling medications from the Pixis or whatever for patient A, and walking over and giving it to patient B because 1. It is emergent so you were focused (even if you didn't realize it) more on task of pulling it quickly and giving it quickly rather than the thought of does this make sense...also # 2. there is not built into your thoughts and tasks an ingrained, same way every time method of administration where the name and date of birth are checked EVERY time, before giving someone anything that they will swallow and maybe even 3. it was not scanned specific to the patient (bedside verification) because the seemingly urgent task of giving this is overriding the more appropriate thoughtthat this needs to be scanned, urgent or not. I have seen this often in folks who were trained in acting in emergent situations before they had a base built in their muscle memory of giving medications slowly and thoughtfully, with the mental checks needed built in about the 5 rights happening the same way every time. I don't know if any of this applies to you but I am just trying to assist with some observations. In other words, if you don't train your brain to slow down and say to you while you are in the middle of the task of medication administration: to think is this for the right patient and does this make sense, and is this the right drug in my hand and is this the appropriate dose based on what is happening with the patient in front of me? each and every time you give meds, errors will happen. If someone says "Please give this med" and you just do the task of giving it, mistakes will happen. I am confident that if this is anything like what is going on with you, you can fix it. But you have to train your brain to think differently and override inbuilt incorrect medication administration habits that you have that are causing errors. I should also note that in my experience, taking more courses, for example in pharmacology do not often help this. You can always look up a medication that you don't know. Rather you need to create a checklist in your brain that you follow the same way every single time you administer a medication-regardless of the situation. If you have mental safety checks (or even a paper checklist) built in that matches with your muscle memory of the "task" of medication administration, you will be safer. Basically you will need to go back to medication administration 101 and retrain how you think about administering all medications. I wish you all the best!

Caregiving is exhausting hard work. Everyone who is a nurse has the potential to burn out. Everyone has given good advice. I think if you have another non-nursing job option you should do it. And just keep per-diem status for the sake of the resume. :) Why limit yourself with phlebotomy? That might not be far enough away from healthcare to help you get some motivation back. Maybe there is a coffee shop that could use a new employee!? Or anything really...there are many options out there in life. Just have to be brave enough to try something new!! :)

When you look up your patients, look at the same thing the same way every time. For example, here is how I do it: 1. Why are they admitted and who is the admitting doc? 2.When were they admitted? 3.What are their recent orders? 4. What is their dietary status (NPO etc.) 5.What is their ambulatory status? 6.What recent labs were done? Write down ones that deviate from normal. Even if you don't know what they all mean...write down ones that are flagged as abnormal. 7.Check the meds and see what is due and write them down. Check allergies 8. See if they are on any IV medication and or need glucometer checks. 9. Look up any imaging that was done. 10. Read the last dictated provider note. At the very least if you look in the chart the same way every time, before long it will become second nature. You can give report in that way as well. "80 y/o patient admitted with pneumonia under Dr. so and so, recent orders include...diet status is...recent labs are...etc. If you know what you are starting with, you know what will have changed before you leave. And even if someone "already knows the patient" I think they should listen to you give a full report anyway. The most dangerous thing anyone can do is think that just because the patient was one way on their last shift they will remain the same on the new shift. :)