jorjaRN

Another vote for at least 3 in a row here. I actually do 6 in a row...and I love it that way-sure, I'm exhausted by the end, but having 8 days off in a row, and not having to "flip-flop" is great. Ultimately, however, I think you have to do some experimenting and figure out what works best for you. Some of my co-workers hate doing even 3 in a row-most of them think I'm crazy. If you decide you want to try doing a long stretch, I would recommend starting with three, working your way up to four, and seeing how it goes from there. The key is getting good sleep during the day-I'm home by 8 most mornings, eat some cereal, read a little bit, and usually turn off the light by 9:30, and I sleep until 5:30. It helps to live really close to work. As far as the PP who asked about noise reduction-a fan is your best friend. And turn your phone OFF (or on silent)-not on vibrate. I also have a dark colored blanket hung over my window to keep light out. I never have trouble sleeping-I actually sleep better during the day than I do at night. Hope that helps, and good luck with the beginning of your career in nursing!

Hello Everyone, I'm hoping for some input regarding looking for jobs and how to handle notifying current coworkers/management. A little background: I went to college about 3.5 hours away from my home town, met my boyfriend there, and planned on remaining in that area when I graduated. Unfortunately, after searching for over eight months, I couldn't find any employment in the area. I moved back home, got a job at the hospital here, and have been working here for a year on a telemetry/PCU floor. I actually LOVE my job, my coworkers, and really respect my manager. If this place was 3.5 hours north, I'd be happy to stay there indefinitly. I've been working six twelve hour shifts in a row, so I have eight days off in a row-which I use to drive up to my boyfriend's house (so right now, I'm driving 3.5 hours every week-either there or back). Just FYI-he has a great job and owns a house, so he won't be relocating. Now that I have a year of experience, I'm hoping to find a job in the area I went to college/where my boyfriend currently lives. I'm aware even with experience, it might take a while, and I'm fine with continuing my current routine for as long as it takes-just want to get things rolling now. So my questions are: 1. I had been planning to wait until I had some definite interviews/things were a little further along in the process to let my manager know that I was looking. She's been supportive in the past for employees leaving due to relocation (telling them they should contact her if they ever come back to the area and are looking for a job, etc) as well as employees who accepted positions at local hospitals. I know the prevailing wisdom here is to wait until you have a definite offer to let your boss know, but I feel like I owe it to her to give as much notice as possible. Also, several applications have asked for contact info for my current supervisor, and I'd like her to be aware that she may be getting phone calls/e-mails. So do I tell her now that I've filled out applications, or wait? 2. Several applications have asked for professional/peer references. I've tried to keep in quiet that I'm looking, but several of the co-workers who I'm closer to know that at some point, I would be planning on trying to find a job closer to my boyfriend. Who would be the best people to ask to serve as references? Right now, I'm thinking two of the charge nurses I work with, as well as a girl that I'm close to/was hired with. Sorry this is so long...but felt like the background was relevent. Thanks so much in advance for your input!

I'm pretty much the same as others here. I usually eat something light when I wake up around 5pm, sometimes it's part of a full meal if my family is around and cooking. I never have had a big appetite right after waking up, so I'm usually not too hungry before work. I keep some granola bars, crackers, stuff like that in my locker, in case I get hungry before my "lunch" break. I usually eat between 1am and 2am if I can, simply because that's halfway through the shift. When I get home in the morning, sometimes I eat a bowl of cereal, sometimes I'm too tired to do anything other than crawl into bed.

I agree with PP. You need to write them up, especially if this is something that is happening repeatedly. I know it feel like "tattling", but this is a patient safety issue, and there could be factors influencing this pattern other than the nurse herself that need to be addressed, and there's no way that's going to happen unless you go through the proper channels to report the issues. I know it's hard, but try to remember, you're reporting the incident, not the person.

I feel your pain...it took me months to find a job after graduating in May 2009, and I had to relocate even then. There are many, many threads already started on this site with a lot of great information and tips. I suggest doing a search and using them as a resource. Good luck!

First of all, no, it's not wrong at all for you to be afraid of those who are dead or dying. Yes, death is a part of every person's life, but it is not something that people normally have to deal with on a regular basis, so it's completely understandable to be intimidated/afraid of being so intimately involved in the process. As far as the details concerning a death go, it largely depends on what setting you are practicing in. For exaple, working in acute care, you may be experiencing more unexpected deaths than in long term care. Where you practice also probably dictates what your role in post-mortum care will be. I think this also varies alot depending on the facility. Where I work (in acute care) the nurse and PCT take care of cleaning up the patient, family is given however much time they want with the body, and then the funeral home comes up with thier stretcher to take the body (if they are a non-autopsy case...if they are, we take them to the morgue after the family has had their time). For me, the most important thing I can tell you is this; the majority of people who have passed away while I was involved in thier care are at the point where thier life has reached an end. This includes many elderly people who have lived full, happy lives, but also younger people who have had horrible accidents which essentially ended thier lives the moment they happened. Many of these individuals have DNR orders, but even those who don't, at least I personally have felt thier lives have reached an end, and that death was the natural outcome. Many times, thankfully, the family has realized that this is the inevitable outcome. As a new nurse, I have been involved in very few code situations-none of which were completely unexpected. Taking care of these bodies is really not much different than taking care of a totally comatomse patient, to be honest. In general, they are not cold or stiff, and you're perfoming the last act of care that you can, and bringing a great deal of comfort to the family.

I appreciate what you're saying, and agreee that people who whine because they can't get a job in L&D or ICU right out of school are ridiculous, but the reality is, many new grads have been unable to find work of ANY kind. Personally, I applied to multiple positions at the VA hospital, and never received a call back for any of them. Camp nursing, prison nursing, clinic nursing all want nurses with experience. Many of these positions require a nurse to be the sole medical professional on site, so it's not a great place for a nurse with no expereince, regardless. The current economic climate has placed many nurses with years of experience either out of a job and looking, or back in the job market after retirement, most places will hire those nurses over a new grad any day. New grads of the past several years are up against a lot of obstacles that the classes of new grads before us did not have to face. My roomate in college graduated one year before me, and she was upset that it took her until the following September to get a job (in NICU, her preferred specialty). The class before her all had jobs lined up, most in specialty areas, before they graduated. That was the reality when we started nursing school-that's why people had the idea that when they graduated they would be able to quickly find a job in a specialty area. I think we've all had a rude awakening. Trust me though, most people who don't have jobs after 15 months of looking ARE looking everywhere possible, they're just not getting called back, much less hired.

Two things come to mind for me; the air at my hospital is so dry, that by the end of 12 hours my lips are chapped, and the inside of my nose is incredibly dried out, and I bet that could cause headaches. Also, I notice when I'm stressed at work I clench my jaw, which could definitely cause a headache if you're doing something like that for 12 hours...or even only 6. Good luck...hope you figure it out!

It's absolutely about location...I spent about six months looking for a job in the mid-atlantic (and I mean, pretty much the entire region...applied everywhere from DC to New York). I finally realized that I wasn't going to find anything, and even though my goal for all of college was to get a job/live in a city right out of school, I moved home to my small town in southwest Virginia and got a job that I really enjoy in a mid sized community hospital. I know relocation is NOT realistic for some, but if it's at all plausible, my advice would be to look in more rural areas, and at community hospitals that may not be quite as saturated with new grad applications. You might be surprised by the oppurtunites if you look 30-45 min. outside a metropolitan area. Good luck, I know it's tough, but hang in there!!

We had the same policy at a hospital where I worked as a PCT while I was in nursing school, at the hospital I work now as an RN, we have the RRT system, but to my knowledge, patients/family aren't able to activate it. I thought the exact same things you are thinking when I realized the fact that patients or family could activate the RRT at my old hospital, and I even asked some of the RNs if it was a huge issue, and surprisingly, no one had any problems with patients using it inappropriately. I think the key was explaining that it is only to be used for life threatening emergencies/changes in condition that they feel are not being adressed, and that it will be taken very seriously if that system is used for something that could have been adressed by the nurses on the floor, or a non emergent situation.

I work on a telemetry/PCU combined floor, and we do staffing together. Usually at night, we have 5 RNs on tele, 2-3 for PCU, no aides, one clerk for both sides. During the day, I think they have 6 RNs on tele, 3 on PCU, 3 aides and a clerk for both sides. Of course, this all depends on the census, but they wouldn't ever leave an RN alone on the floor-if for no other reason because we have too many drips and stuff that need to be double checked/co-signed.

I actually laughed out loud when I read the subject of this thread. Why don't you try getting some finance majors on board, maybe you could get a class action suit going.

I can't be 100% sure, because it's been a while since I had one leave AMA, but I think the paperwork we (attempt to) have them sign says something about "the possibility that insurance will not cover the cost of this hospitalization, or subsequent hospitilizations resulting from refusing care" or something like that. Of course, most of the time they "threaten" to leave, once you set the paper in front of them, they decide the warm bed and free food aren't so bad after all, even if it doesn't come with all you can eat narcs.

I've also never worked ICU, but I work telemetry/PCU in a medium sized community hospital. I've never worked as an RN anywhere else, so I can't really offer a comparison, but overall, I've had a great experience at the hospital where I work. I actually thought I was going to hate it when I started there, as I only had experience in clinicals and working as a PCT in larger teaching hospital. I thought the physicians were going to be difficult to work with, and practices were going to be out of date. I wasn't completely wrong about that, but for the most part, our hospitalists are great to work with, and although there are some things I find a little "backwards" there have been so many great things as well. The people I work with are great, and it really does feel like a family, since it's so small, you get to know the people on your unit, as well as elsewhere quickly, and everyone has been so friendly and welcoming (granted, it is the south, too :) Also, especially at night, we have very little that we delegate. We don't have an IV therapy team, we do our own EKGs and lab draws, just to name a few. I don't know if it's true in every larger hospital, but where I worked as a PCT, there was support staff who usually did most of that. There also obviously aren't any residents, so RNs assist physicians with alot of procedures, and I've gotten the oppurtunity to learn alot from our physicians who enjoy teaching. As far as ICU, I know my hospital doesn't keep the most critical of patients, so that would be one thing to consider, but we do only have one ICU, so I'm guessing you would see a wider variety of conditions than in a specialized ICU. Also, I'm guessing there would be even more oppurtunity in the ICU for procedures and such that might be taken care of by support staff in a larger ICU. Anyway, to make a long story long, I'm really glad that I was "forced" to take the job I have now, because it's been great, and I think community hospitals are definitely worth considering. Good luck with your decision!

If the patient had a PCA, then they had to be pretty alert and oriented, because PCAs aren't prescribed for people who aren't aware enough to use them properly. In my opinion, in this particular situation, the nurse did the right thing by staying with the patient and offering some amount of comfort and worrying about going up the chain or command (which definitely should happen) later. It doesn't sound like this doc was going to wait around for the nurse to be there to do the procedure, and probably would have kept going even IF concerns had been voiced at the bedside. The last thing this patient needed at this point was a nurse and doctor arguing, or getting physically confrontational while the doc (most likely) proceded to do said procedure anyway. I also agree that patient's can usually be thier own best advocates, and the best thing we can do is educate them about how to advocate for themselves. After all, we can't refuse treatment for our patients or request a new doctor for them, they CAN do that for themselves though, and we need to make sure they know that. This post actually made me think of a very similar situation when I first started working. A doc did a debridement, or something similar (wasn't my patient) at the bedside. Apparently, this doc was "old school" and notorious for this type of thing, and nursing staff had been complaining for years about him, to no avail. Someone mentioned to this particulat patient, after this incident, that they needed to make it known how unhappy they were with his care. The patinet refused to see him again, went to the hospitals customer service department, etc. I'm not sure what the outcome was, exactly, but I know there were ramnifications for the doc. In today's customer service obsessed healthcare industry, the patients have far more pull then we do in a lot of situations.