vanlo001

I absolutely never meant to take away from the fact that there are hard working RNs in every state and find that response odd. I've worked in many states and each group of nurses stood out in a special way. Nurses are incredibly gifted people who touch the lives of many and every nurse should be compensated appropriately for the intensive work they do. Kudos to you for pointing out that fact.

There's an LVN on my unit who graduated, found no jobs, and now works as a CNA. New grad RNs are also having an incredibly hard time. Maybe applying for CNA position will get you in the door. Yeah, it's not about the grades. It's not fair, but it is the reality. Perhaps calling staff that Precepted you and asking if they'd recommend you or if there's openings. I do believe this trend will turn around but who knows when.

19 years, no one that was named in a suit or called to court, once I received a letter from a hospital where I worked that said my accurate and complete documentation of an event that led to restraining an alcoholic man led to the case being dismissed but I wasn't named in the suit and I think it is rare that individuals are named in suits. I do know one nurse who gave a bag of insulin like an antibiotic. The patient didn't die or have immediate injury. The nurse transferred off the unit to a less acute area. No action was taken against her license. I know three nurses who collaborated in a cover up of a narcotic mistake, two of whom falsified documentation of the narcotic record were reported to the board of nursing. There was no accusation that they took the drugs but they admitted falsifying the record to cover up for the mistake. I'm not sure if they lost their license for good or were reprimanded.

Thanks Caliotter- but once you work here it is hard to walk away from the dedicated and hardworking nurses.

Top 10 reasons CRONA nurses must reject the hospitals "last, best, final offer". 10. The sign on bonus was specifically included to blind members to the hospitals ultimate agenda. It is a smooth move that plays on everyone's fears in hopes of dividing CRONA members. Even if we reject the proposal the sign on bonus rema...ins in play. April 1st is not the date we strike- it is the date our contract expires, but only CRONA members can decide to strike. 9. The PNDP remains unattainable for the majority of nurses. The application process is time consuming. Put aside the flaws of the point system, to prepare the documents for your application and to submit it to the manager then come in for an interview before the board and to have to do this each year is unrealistic. Once you earn you CN III or CN IV the duration of your status should be 2 years. 8. The point system is undervalued still. We must see some movement on the point values. We no doubt need a more effective PNDP but there is still much room to make this an attainable and realistic point system for the highly skilled nurses at LPCH. For example, 500 hours as resource RN should be worth more than 2 points. 7. The application for Clinical nurse III should be automatic if all the points are met, and approval dome by the unit manager. The sheer numbers of RNs who meet qualifications for clinical nurse IIIs and IVs would make it impossible for the committee to approve applications in the timeframes they have alotted. If we aren't able to meet with the committee than we can not be promoted. 6. The corrective action portion of the PNDP must be removed. Anyone of us at any given time could be given a corrective action. Under their last, best, offer that would mean you would be demoted to clinical nurse II, and ineligible to move up for 2 years. If you have never had a corrective action you haven't been a nurse long enough. It can and will happen at the discretion of those in management. 5. The PTO/ATO take-aways and the establishment of the extended sick leave "bank" is a way to "say" they are giving us leave hours knowing that it's almost impossible for most nurses to use their extended sick leave bank. You must first be absent so many days before you can touch this ESL "bank". Just because SEIU and other hospital employees have settled for this does not justify us having to step into this model, which is less than our current system. 4. We are the backbone of the hospital. We assist doctors in residency and in varying levels of schooling in the care of our complex patients. Our professional knowledge and care needs to be acknowledge. We already make less than other hospitals and our dedication to this hospital shows we are not just in it for the money. But we are professionals. The wage proposals are the minimum we should expect especially in light of the proposed PNDP. 3. Retirement. The retirement plan is far behind most other hospitals plans. We in the medical profession should have some assurance that if we commit ourselves to the care of others than we will be taken care of when we retire. If they are going to stick with the matching program they could fo better. 2. We should receive a bonus because the hospital has failed to offer us a fair contract despite the diligent efforts of our CRONA team. We should unite and show support for our union that stands by us and defends us in corrective actions. Ask why the hospital is talking directly to members yet failing to negotiate at the table. It is because they hope to divide the union We deserved to be presented with an equitable contract and their attempts at a last, best, final offer should be met with a resounding NO. 1. THIS IS ONLY THEIR BEST AND FINAL OFFER IF WE LET IT BE. They can and will return to the bargaining table if we as a union reject their proposal. They are counting on the ratification bonus dividing us. Do not let that happen. A united vote is a powerful vote. Vote no to their proposal, force them back to the table, and walk away with that bonus when we have a contract that fairly awards the bedside nurse for their skill and expertise.

I struggled with this question too. I'm in school now for my MSN/MBA. My advisor told me I could do the same thing with a BSN/MBA that I woulddo withMSN/MBA andit would take half the time (and half the cost). He explained his sister was doing IT implementation in the hospital with a BSN/MBA and had no trouble finding work. However for me I wanted to leave the door open for executive management in hospitals which requires the MSN and I wanted to have the option to teach which also usually requires the MSN. Ultimately it's all about options to me. I have theclinical background but I want choices for career advancement and I felt like the MSN/MBA offered me the most flexibility. In addition to other options already mentioned you could Own your own business offering a product or service, start a travel nurse company, work in many different types of med supplycompanies or work your way up the corporate ladder in the hospital.

Where do u work sunny Calif? U can just say the state and what part or the hospital name if your comfortable. That seems a very strict ladder. Are the roles for RN 4s different than the RN 2 or 3?

Is there a preferred experience requirement? At least one year of experience on hospital in the specialty area they are looking for. I'd recommend at least 2 years of experience because travel nursing is not easy. You need to quickly assimilate to a new facility with minimal orientation. Which nursing specialties traveling nurses needed for? All specialties. Med surg is a strong base. But virtually every specialty is needed at different times. How do you go about picking an agency that is right for you? I would apply to several companies and go with the company that offers the contract where you want to go or with the terms you find attractive. Different companies offer different packages but basically thet are all very similar. Travel companies are paid to provide experienced qualified nurses out of this money a certain amount goes to the traveler as salary. One big question to ask is are your shifts guarenteed. Sometimes in low census the traveler is first cancelled and if shifts aren't guarenteed they may be without pay. You want guarenteed shifts- this means your paid regardless of census. How long are typical contracts with travel agencies? 13 weeks. They can be anywhere from 8 weeks to 26 weeks and you may extend if they ask you to extend. How long are typical travel assignments? Your contract is only as long as your travel assignment. Once you complete your contract you may go with another agency, sign on for a permanent staff And any other information you have to offer....

How does your hospital recognize nurses. Most places I have start new nurses at RN I, advance nurses to RN IIs automatically then you must perform some leadership or committee roles to earn the RN III and IV. How does your institution do it? Do any institutions require a bachelors degee to advance past RN II?

I have oriented to countless jobs in countless states so I speak from experience: bite your tongue. Observe how they do it and even if you feel you know a better way now us not the time to bring it up. Orientation is the time for you to learn how they do it. After orientation you can do it the way you feel best as long as it doesn't interfere with safe patient care. Orienting to a new job is hard. One of my favorite sayings is "Where others see obstacles, I choose to see opportunities". You can't create change if you are viewed as a know it all who is not receptive to the accepted way of doing things. You can try changing things after you have been there awhile but for now pick your battles get your job done and put a smile on your face even when you don't want to. IMHO.

I have always hated the term Strong vs. Weak. However as a charge RN it is essential when planning staffing to consider skill mixes in order to even things out. You may not hear the term weak because we do not use that term to people directly. However it would be a sign of potential if you helped out with the personthat has the sickest patient. And maybe you do. Certainly there are areas where there are cliques and the sickest patients go to the "strong" nurses and the annoying patients go to "weak" nurses. This of course is a set up for failure because if all you ever have is stable patients and then all the sudden there is sick calls and you end up with the sickest patient of course you will have questions and need reinforcements. We all have strengths and weakness. Getting your certification will definitely help. Mirroring behaviors you see in charge nurses you admire will also help. At our facility the charge nurses are developing a Clark-Sweeney Clinical Performance Tool. We will be evaluating staff nurses based on Patient assessment, clinical judgement, patient teaching, teamwork, etc. There are levels from novice-0 to expert- 5. Each spot has a measurable goal and based on this you get a total score that rates you. The purpose is not punitive but to get an accurate reflection of where nurses are based on measurable criteria. U can then schedule people accurately and those nurses that are novices will need to advance (or not) and those that perform above par will need to maintain that level by measurable outcomes and not who is friends with who.

It sounds like you have all the steps down. Perhaps someone else has advice but rest assured you more you do your job the easier and less stressful it becomes and these calcs will become second nature as well. Best of luck.

Are you talking about figuring mg/kg/minute or something like that or how figure out 50mg/kg when you have a patient who is 10kg and the vial is 100mg/ml. I'm just not sure what types of tips you are looking for. I'd be glad to help I've done nicu PICU peds for a long time so it's something I do routinely.

I think it is great that you want to recognize your preceptor. The foundation you receive from a preceptor is irreplaceable. I would go with a small gift- a nice dr grip pen, a gift card for a scrubs store, a card with a handwritten message. The letter of acknowledgement is one of the best gifts for the preceptor. Recognizing those nurses that stand out is key. We have rose awards and annual nursing awards. Consider one of these modes of recognition if your facility gas them.

Your nursing license is on the line here. Think of it that way. When a patients discharged the meds need to go. Either with the patient or back to pharmacy. If it's still hanging out when the patient is readmitted I would send those narcs back to the pharmacy and have new ones reissued or save that script and give them to the patient on discharge with this next discharge. This is a serious infraction (having narcotics laying around for discharged patients). There should be a policy fir the handling of narcotics fir residents and what to do on discharge. If there is not encourage your facility to create one.