lylenrn

Congratulations on your acceptance to the program. I agree with the previous poster. I would suggest that you request to be PT or PRN. Fortunately, since you mentioned to your manager that your goal was to become an RN working in L&D, she/he is not unaware of the possibility that you might have to adjust your schedule. The good news is that when you finish with the program you will also have L&D experience (that looks good on a resume). Also since the census in L&D is not constant you might still end up with time off when the census is low. The first to be cancelled is agency staff, then PRN....then PT. Wishing u the best of luck in whatever u decide>

As an older nurse i want to have a simple answer for why it takes so long to chart,but its not always short and simple so perhaps i can take you through an example: A few years back i was involved in a lawsuit against the hospital by a patients family. This patient had a poor outcome, and the family was very angry (understandably). I will say that i consider the click/point three minute charting to be reserved for pts that are stable walky/talky progressing as expected in other words probable discharges. When i have patients that have change in condition usually a lot of narrative charting is included (aside from the drop/point/click). I will chart when the patients condition changed who i called, what they said, whether orders were given, what the outcome was of those interventions. Whether i needed to go up the chain of command (nursing supervisor/medical director) based on the md response. All of this is timed. As you can imagine its also time consuming. In this particular example my charting was extensive. I cannot tell you how uncomfortable it is to sit at a conference table full of attorneys (only one of them being yours) and answer for the care you gave a patient years before. It was the thorough narrative charting on this particular patient, my interventions, reassessments,etc that got me dismissed from the lawsuit early (after the deposition). I think it was the time consuming charting that made it evident that the problem was recognized, steps were taken as ordered and still there was a poor outcome. Unfortunately, some of the people that subscribed to "speed charting" saw that lawsuit out to the end (a couple are no longer practicing nurses). Based on this experience in my career my motto is "either spend the extra time as care is given, or spend it with a familys attorneys later".

working 7p-7a... hurray for OT

It's an awful feeling when the count is wrong. I have had it happen a couple of times, sometimes because the sheets have been adjusted or because a dose is more than one pill and requires two pills/signatures. The keys should never be turned over until after the count is done/other nurse is endorsed responsibility. If this nurse insists on "starting early" how about counting out early? I love our pyxis.....but every now and again i work at a snf and it is a pain to count all those pills. God forbid the count is incorrect,....they start to eye you suspciously. I know the feeling. Best of luck in your new position. Make the count a priority so that you are not the one under suspicion.

Glad to hear you re-thought the California idea. There are more unemployed new grads here than you can shake a stick at. Its very hard to find a job here without experience, and sometimes challenging for the experienced to get to the areas they prefer. I cant say that Texas is any better, but i have heard of a couple of new grads from here finding jobs there. One even got a relocation allowance in these times. Glad to hear you plan to have the job before relocating. Good luck

Unfortunately, the bottom line is always about money. I have noticed mostly in nursing homes here they have posted the patient staff ratio. Usually will say something like 40 pt....4 cnas...2 lvn....4 rns. The problem with this is that probably 3 of those rns are not directly involved in patient care. 2 lvns have 20 pts a piece or 1 does tx and the other does meds....and the lone rn...is charge for all. During the admissions process they are very proud to show these staffing sheets to prospective families and the families expect all these people available for the family member (if they only knew). Usually later after admission they find there really arent as many people available to attend to every need immediately. I have found that the general public often thinks nurses have 1:1 care and are there to attend to their family member only.

Look at the bright side. Now that you have someone on "the inside" perhaps they can keep you posted about upcoming open positions. It never hurts to have a friend put in a good word or two to a manager. Especially if they are doing well on the unit. This could still work out to be a positive for you. Its true, "sometimes its not what you know but who you know". Keep positive.

This reminds me of a school nurse we had in high school (ms K). The only thing that students got sent home for was if they had a high fever. Any other ailment got the same treatment. The student was sent down to cafeteria for oatmeal, given tylenol and instructed to lie down. Maybe this had something to do with the fact Ms k was an old army nurse and figured tx for anything else was "walk it off". In most cases, since students knew they werent going to go home early and didnt want to spend the day laying-in with Ms K, we either carried our own med supplies or stayed home from school.

It is unfortunate that this behavior continues to be tolerated,but i dont think much will ever be done in these situations because docs generate income and nurses are an expense for the hospital. I worked at a community hospital over a decade ago with a very emotionally labile surgeon. He would do surgeries late into the night (mn/2am) and get very angry if a nurse called about a change of condition. He would make a point of coming in the early am to complain to the manager about these nurses/calls and got more than a few fired. Once he had a sixteen year old die less than twelve hours after surgery, nurses had called at least three times during the shift without orders, nothing happened. You know the reason that a complaint was filed against him with the medical board finally?? He made the error of trying to bully another surgeon (like the nurses) over a surgical suite. He went so far as to intentionally contaminate the sterile field to keep this surgeon from using the suite that he thought he was entitled to. Ever wonder if being mentally unstable is a prerequisite to being a surgeon?? Or is it their brilliance that drives them mad?

I too would vote for staying on the crazy med surg floor. The only reason i make this vote is because i know it is possible. Your description of your unit sounds exactly like my unit (although not med surg). It is not the ideal working condition but it pays the bills and provides the opportunity to improve nursing skills. Good luck to you.

Here's an incident that happened at a snf near me recently.....CNA caught having sex with demented pt. Pt was so confused she couldnt have possibly reported it and even after proper authorities alerted pt was no help in giving information about incident. My point? while this population may have issues with confusion and report incidents that never occured. What about the rare occassion when sexual assault actually does occur. These reports all have to be taken seriously. There are some sick people in the world, unfortunately, some of them are in healthcare too.

wow 120.....amazing. My state also requires an RN in building for 100 pts. But i recently had a friend who is new grad RN accepted a job at SNF with 80 pts. A large portion of those had am meds, drsg changes and blood sugars. She found she couldnt handle it and quit. Guess what they hired two LVNs to replace her. That is an unreasonable workload, but employers know its a buyers market at this time. People are desperate and they are banking on our need to pay bills and keep a roof over our heads. Good luck to you in your search.

As a previous poster stated i dont think you have much to worry about from the board of nursing if its not in their practice act. However, many employers are doing internet searches and you would be surprised at the things they find. I recently saw a new poster at work. ( I work for a company with 13 hospitals and growing) This poster states that one should be careful about what is posted on the internet facebook,etc., because you dont know who can view these items and can be grounds for termination. They didnt specifically say r/t hipaa. Right now in nursing its a buyers market. They can get rid of you for almost anything as there are plenty of unemployed nurses (some cheaper) waiting to fill those vacancies and employers are taking full advantage.

Amen!

You are correct Esme. The MD got involved. I think 1 person got fired over this. But even if i had gone back 48 hrs it wouldnt have helped. The order was further back than that.