AC439

Thanks. I just resigned and I turly believe I made the right decision.

Thanks for reply but I really want to hear from Vitas people. Currently there is no EHR, everything is paper. Have I talked to my educator and manager ? You bet - many times! They keep telling me I have been doing a wonderful job. I know the system fails me and I am frustrated everyday. I'm actively thinking about quitting, same reason as you stated - it is absolutely nothing close to what I hoped for ! I started around 8am today, saw my pts with some unscheduled visits. Tons of phone calls, messages, emails. Almost 5pm now and have not charted a thing.

Hi there ! I'm new to hospice and have been with Vitas for only 6-7 weeks. I am sure there are many of you also working for Vitas. It doesn't take long for me to realize the system within Vitas is broken (I used to work in hospitals). Biggest frustration is my pt's med list never get corrected regardless of what I do. My understanding is we are switching back to Enclara but I was also told they will not maintain the med list any more. So then, what do you do to make sure meds corrections are reflected under the pt's profile ? Also, I found myself on lots of phone calls. A call here and a call there. You are only supposed to use 047 group activity for 30 mins but certainly I spent way more than 30 mins. How do you account for those lost time ? Thanks. AC

I have just switched from hospital nursing to hospice nursing for about a month, thinking I would give it a try. Although the OP typed in all caps, I interpret it as a big crying out for help (cause I feel the same now !). When I read the OP's posting, I felt like someone can completely read my mind! I have been off the so call *orientation* and on my own for 2 weeks. But I already feeling burn out. Most of time I feel alone in the field without resources and also not knowing what to do (in the hospice system). Our company still charts on all paper and the med list is a mess. In the past few days, I have doubts if I made a wrong choice. I got burn out in the hospitals and thinking hospice will let me stick to the purest form (or close to) of nursing. But in a new case I'm handling past 2 days, nobody cares except me and the SW. I'm giving some it some thinking over the weekend and then decide if this is the right place for me.

I apologize if this has discussed before but I don't see a thread recently regarding this subject. I wonder if the agency pay rate has dropped in response to the bad economy. I have friends that did agency before and referred me to their favorate agencies. They told me how much they were making. But when I called their recommended agencies, I was quote a much lower rate. I'm wondering if you guys see the agency pay dropped across the board, or it is just me not knowing the hiring manager in person within the agency? Can anybody shed some lights ? (I'm in the central florida area) -AC

Really all your worries are valid. With a year of experience, you should be able to handle that although it can be difficult at the beginning. But if you stick it out, you will feel better and better with the facility as you are more familiar with them. Also, you are making more money than everyone else on the floor so be prepare to be cancelled first when the census drops.

I rarely check allnurses.com anymore but just happen to read this thread by accident. I went through similar career change 3.5 years ago from I.T./Electrical engineering. I went through some layoffs in my previous career. My wife is an RN and, of course, told me what kind of work it is. I did admire people with scrubs and stethroscopes around their neck. I then went through the same path as most of you do - talked to schools only to find out there is a long waiting list. I was lucky enough to get into an LPN school and finished in about a year then went on to finish RN. I jumped rather quickly and now being an ICU and ER nurse. I can only speak for myself and don't mean to discourage anyone -- I am leaving nursing. My wife warned me before I decided to pursue nursing that this is not a professional environment and I did not understand. I thought everyone goes thought school, earn a degree, pass the board and be a caring person to work on the floor. The real environment is far from ideal although I do see some excellent nurses sometimes but not very often. Instead, horizontal violence is what I see most of the time. Hospital policy is another issue (which you should find many threads here about it). In general, nurses do not get much respect from pt or the family (you do once in a while). However, I have to say being a male nurse myself, I have the most respect from doctors and rarely get into conflicts with them. I still remember the cultural shock my first day in nursing school. If you are from an engineering background, you will be shocked by the nursing education - how they put simple common sense into those 2" thick books. Again, I can only speak for myself. Maybe it's just my environment or region. Maybe some other places are better. Now, I don't blindly admire people in scrubs. I only admire and respect those who really care about people. -AC

I usually do not response to debate threads but since this thread seems already got nasty, so what I'm gonna to say shouldn't make the matter worse. First, I totally agree with Timothy. When I first heard about "nursing dx" in school, I was laughing. I thought the school was joking but unfortunately this was part of the nursing education. IMHO, the so called nursing theories are nothing but trying to make a big deal out of common sense (or even nothing). They are written in a way that "sounds" professional but when you read it, you've got no real meat from it. In real world, nobody cares about the care plan, nursing notes or admission paper. What important is to carry out the MD's order correctly, know how to read labs and when to call the doc. The docs only care about labs, diagnostics reports and the pt is still breathing. Due to the knowledge gap, many docs don't want to talk to nurses. This is not to say all nurses are incompetent but unfortunately many of us don't meet the MD's expection. If we are at the MD's level, we will be doctors. I have also seen some MDs respect nurses, but seems to be limited to those top of the line nurses that knows how doctors thinks and what they want. Nursing is not a science. That's what I was told by my nursing school director. Most nursing instructors don't know science. I wish my nursing education were science based. I personally think the nursing education is a dianosaur. IMHO, to train better nurses, they should drop the nursing theories and spend more time teaching scientific materials. Teach the nurses to apply basic science/physics/chemistry/maths to their everyday work. I don't think things will change. I believe those people that designed nursing education are trying to spin off from medical and build their own empire. Students are therefore required to follow their "thoughts". Does it work in real world? I'll let you figure out the answer. No, I have not used any nursing theory at work. I only use them on paper (charting) to fulfill institional requirement. I know how to take care of my patients (and MDs), properly.

I also see this issue everyday and I don't think there is a solution to this. I'm in the same boat and from a different career where hardwork pays off and any non-production or non-professional behaviors (such as the bullies and horizontal violence) are strightly prohibited. Before, I consider nursing a profession. But, now, being a nurse and have to face this kind of working environment everyday, I can no longer consider nursing a profession. In fact, I started to see this bully problem from day one I was in nursing school. I listened to a radio program couple of months ago and they talked about bully at work. The mentioned a survey on nurses has identified this true problem at the working environment. The survey says that nurses reported the highest percentage of workplace bullying. I see this as nurses' way out of being stuck in the health care ladder. To make oneself feels better, has to beaten up some weaker folks. Afterall, we can't write orders, Dx (except those so called nursing Dx, which nobody cares), have no autonomy and being supressed. We can't beat up the managers, MDs or administration and we are so insecure so we turn to the weak and beat them up. There are some really good nurses out there willing to mentor and help the newer nurses succeed, but you don't see them often.

I also just came into ER from med/surg. Just finished my 5 weeks orientation. I'm getting comfortable in most areas except fast track, especially one nurse for 6 fast track beds without tech/CNA. Actually, I like ER in a way that the documentation is lesser and MDs works with nurses. You also have a bit more autonomy and being less bounded by policies. Most ER people works together as a team although some are not team players. But I'd never go back to med/surg.

I just left a CHS owned hospital. My new job pays less but money is not everything. CHS tends to pay a little more but they run their staffs level very thin so it can be a bad environment. CHS lies on newspaper that their staff satisfaction level is all time high. But when you are on the floor, most nurses are slammed really bad that you'll hear really bad languages all the time.

Congrats !!! Thanks for sharing the experience !!!:balloons:

Thanks and good luck !!!!! Looking forward to your goodnews !

Hi...I'm planning to take CEN exam and have started using the Lippincott's Q&A in Emergency Nursing book. I'm wondering if anyone has used this book recently and taken the exam. I'd like to know if the questions in the LWW book resembles the level of difficulities in the actual exam. If the LWW book is not enough, what other books should I use? Thanks - AC

Don't be disppointed ! The NCLEX is basically the last torture in the entire nursing education before you're allowed to practice. It is not designed to tell if you are a good nurse nor designed to see how competent you are at work. It is designed to see if you can read their mind (those who set unreal questions). There are some questions that you will never answer right, such as those ask for drugs that we have never heard of. So, you ask, what's the point? Exactly ! When I studied and took the test, I tuned my thoughts to the NCLEX way and used the rationales I read from the study materials. When I'm at work, I have to use a complete different mind set to get things done. You will soon find out that a lot of smart nurses are not textbook bound. You can pass NCLEX !