Nire83

You need to get a new job! This literally blows me away that professionals adults are acting like this! Just for an example - We have 6 assignments, each nurse has 5 patients MAX (usually only 4). We try to keep 2 trauma rooms open for traumas, but everyone helps out each other if someone has a heavy load. Our charge nurse, an extra triage nurse or a float nurse will cover breaks. When i have a room open up I will either chose a patient to pull from triage, or while one of the triage nurses is floating around checking out the floor they will ask me to hold a room if i have a patient leaving. If we have an ambulance coming in its the same thing, if there are no open rooms and i have a patient leaving i will be asked to hold the room. No favoritism or cliques. You deserve better than to work in the place you are describing!

The worst is when you have a pt with great veins....and TELL THEM THAT....and then miss!

Oh - i forgot to add some stuff! Do you have order sets that you can order? If an abd pain is coming in i will order a bunch of things to get the pt going so during the first quick hello i'll get a line put in and labs done, ask the pt to give a urine sample and then ask the tech to pick it up and dip it when the pt is done. I'll draw several tubes to be spun so unless something special needs to be ordered i will basically have all the blood for any add on tests the doctor orders.

1) Speed: Go in and say hi to your pt, QUICK focused assessment. Wait for the orders then go back in and do EVERYTHING. IV, meds, fluids...etc at the same time. 2) Delegating: Just speak up and when you know something is coming in tell the techs what you need. Our techs do a lot of blood draws (if im not starting an IV, or couldnt get labs), EKGs, urines, ambulating, meal ordering, paging for xray etc... When an ambulance is coming in i will say "We have a chest pain coming in, can you please grab the EKG machine, get vitals and hook the pt up to the monitor." Again, get EVERYTHING done in one trip to the room. Its a pain but i will often grab another nurse too if i know i have a very sick patient coming in and i need to get a line (or 2) in, labs done, an EKG, foley placed..etc..etc. If you are drowning tell your charge nurse, thats what they are there for. 3) This may be a facility issue - our codes (and yours) should be very organized. Someone on meds/tasks, someone on monitor, someone documenting. If we know a trauma/arrest is coming its important for someone to speak up and say "Who is doing what?" If my patient in a room codes i will scream "I NEED HELP IN HERE" and just start with the ABC's - just get chest compressions going ASAP. BLS first. Good luck - it takes time but just lean on your other co-workers and be sure to be there for them when they are having a heavy pt load day too!

Thanks guys - def not looking for medical advice =) I agree its a fine line between momma and nurse!

Just wondering what you guys would have done, and if you think i overreacted?! He is 2 years old and pretty verbal. Has a ? allergy to Tuna so we have an Epi Pen jr for this. Yesterday he jumped on a bee hive that was under the ground and started screaming. I grabbed him and ribbed his clothes off and saw a sting on his leg and ear. I asked him where his boo-boo was and he kept pointing to his ear. Listened to his lungs and they were perfectly clear, no hives....but then after about 5 minutes his lips started to swell. I grabbed the Epi, gave it to him and called 911. They were great, O2 was perfect and it was nice to have a 2nd set of ears tell me that he had no wheezing. We figured that he must have been stung in the lip too. Am i crazy?! lol, sometimes i think that too much information/knowledge may sometimes be a bad thing, but you know what...i would have done it again given the same situation. Oral swelling = not something to mess with!

I'm starting in the ER in a few weeks and was told that i would need to be there a year to get my TNCC. I guess every place is different. I would think it would be worth it to just hang out and soak in as much as possible for the next 6 months and then persue some certifications.

Starting in the ED in a few weeks, and i was wondering what supplies you carry on you daily. I have a pen light and a stethescope, what else do i need! =)

No she hasnt, i asked. She told me that i legally didnt have to tell them. grrr. No one wants a lawsuit! haha. I just dont want to **** anyone off and address it the best way possible.

I just accepted a new position within my company, a transfer. I interviewed when i was 14 weeks, so i was just entering my 2nd trimester and really was JUST telling people. I also was told by several people not to mention it at the interview. I got the job, and now i am 16 weeks. My manager wants me to stay for a few extra weeks to help train my replacement....and i wont be starting at the new position until i am 21 WEEKS!!! eeeks! I'm gonna walk in on my first day with this big belly that i didnt have in the interview. Should i call my new manager and tell her over the phone, or should i just wait until the first day? I know that legally i am not required to tell them...but i want to. Any advice on the best way to handle this? eeeks! I feel so guilty!

Yes - but after 2 years out of school i finally feel like I have my opportunity! Worked outpatient for 2 years doing no clinical skills at all. Phone traige. It SUCKED. I have applied for thousands for positions and have only had a few interviews. Finally i took another out patient position within a hospital system hoping to be able to transfer. Was then told by HR that they werent hiring inpatient nurses that didnt have inpatient experince as a nurse.....BUTTTT...I made some connections FINALLY and got a position to start in the ED next week!!!!!! I seriously was bawling my eyes out because this is what I've been waiting for! Just find a job where you may be able to make some connections and hope for the best! There was seriously some pretty bad times where i thought it was a stupid move to become a nurse, and that i should have just stayed a medical assistant.

Great advice backpacking! Thank you for the tips! so......I GOT THE JOB!!!! I CANNOT believe it! I have been waiting 2 years for this; to feel like an actual nurse and to use clinical skills! I have a 12-20 week (depending on what i need) orientation with 2 preceptors and they said i wont have an acuity 1 patient for A YEAR! I am thrilled that not only is this an amazing experience, but that they actually arent throwing me in with no resources...and that i'll get the support and training that i need. PHEW! I think that was my biggest fear. Good luck backpacking - you'll do great!

Her choice, her life. I know a woman who was 41 at the time who reduced from 3 to 1...and that baby was then born at 27 weeks. If she had 3 she would have lost them all weeks earlier no doubt.

Thanks guys! Keeping my fingers crossed and hoping for an amazing preceptor!

I have a girlfriend who graduated with my 12/09 who still doesnt have a job either. She is planning on doing some flu clinics this year to try and at least keep up with some clinical skills. She's still working at a sub shop. =(

I'm kinda scared! I've been out of school 2 years and have only been able to get jobs in the outpatient setting doing phone triage...and it kills me! I've continued to apply to everything inpatient and have never (before now) even been called in for an interview. =( I keep being told that they arent hiring nurses without any inpatient experince as an inpatient nurse. Makes sense huh?! Anyway, on Friday I'm going in for my 2nd ED interview and to shadow another nurse for the day. I am FREAKING OUT!!! I reallly love the ED, and was an EMT in highschool and a float aid in college, but i feel like i should have had some much other RN experince before ending up there. I dont really even know cardiac rhythyms well. But i wont pass it up if they offer me the job because literally i think this may be my only way in...or i'll be stuck outpatient forever. Any words of wisdom?

Totally doomed. I've been out 18 months and am still in an outpatient office setting doing NOTHING clinical. My office is affiliated with a hospital and when i tried to transfer to a floor i was told that they do not hire nurses to inpatient floors who have not had inpatient experince as a nurse. AWESOME. Talk about a dead end job from the start.

oooh ooohh!!! I know i KNOW!!!

i'm having a really really bad day and feeling like i will never be able to break in to nursing and find a job i will enjoy. i am 18 months out of school, with my bsn, and took a job at the pediatrics office i had worked at during school. i wanted a hospital position, but am in an extremely saturated part of the country and there is just nothing. i have literally applied to thousands of jobs. i was at the peds office for a year and then switched to a specialty pediatric office which is part of a large hospital. i did this thinking i could suck it up for a year, make some connections, and then transfer in patient. i have 2 kids and am pregnant, we recently moved to a new home and i am working 40 hours a week....and i hate my job! the doctors don't get along, there are no other nurses here, i have no clinical support and one of the doctors is completely negligent. i had no formal training and do absolutely no clinical skills at all. i finally broke down the other day when one of the doctors screamed at me and told my manager that i couldn't do this anymore. i literally feel like i am wasting my life, and it kills me to leave my babies every day to come to a job that i hate. my manager is very understanding and said that she would allow me to transfer before my 1 year contract is up. however, i just met with hr and because i have no hospital experience as an rn (i do as a nursing aid and emt) that i am unable to transfer to inpatient. i have already pigeon-holed my career and am stuck. i make less than 20 dollars an hour, and i am absolutely miserable. i should have just stayed part time as a freakin medical assistant and never have gone to nursing school to begin with.

New grad - 20/hr in Mass (the pay scale was 20-24/hr) and i know nurses with 20+ years of experince were only making 24. 1 year of experince 19/hr in NH. Just waiting for that one year mark to get into the hospital.

Exactly - A girlfriend of mine basically lost her ER CNA job because they couldnt hire a new grad, had no open RN positions, and couldnt keep her on once she had her license because it would be a conflict of interest. She found another RN job, worked for a year, and then was hired back to the ER as a nurse.

haha no! I applied to every facility in a 50 mile radius!

just a word of warning - ob office is not the same as ob in-patient (obviously). if you really want to go into l&d, then look for a med/surg lpn position. it is so much easier to go from one hospital floor to another, than it is from an outpatient specialty to an inpatient specialty (even if they are the same specialty).

i'm 18 months out of school and i just feel so darn disheartened. first, i couldn't find a hospital job so i just stayed at the pediatrics office i had been working at as an ma. the whole time i was there i was looking for something *better*. more clinical, to get me onto a hospital floor...etc. the first interview i had "with" a hospital was an outpatient pediatric neurology department, so basically the same thing i was doing in the pediatrics office, only it was affiliated with a hospital. i took a pay cut, moved my whole family, pulled my 5 year old out of a kindergarten she loved and took the job. and i hate it!!! i have no clinical support, and i'm basically a medical secretary. the doctors don't get along at all and i have already gone through 3 managers. i'm the only nurse in the small practice so i'm not learning anything. my hours are worse than they were at the other job and i am just so unhappy. i *have* to stay in this position for a year before transferring to another position in the hospital, but i honestly don't know if i can last another 6 months. i have two jobs offers right now and i just need some guidance. 1) i could stay at my current job for another 6 months and then hopefully transfer onto the pedi floor. even though the office where i am working is awful, the hospital and inpatient staff are great. i really love the director of pediatrics and the pedi nurse manager, and they both know me really well. also, my kids go to the daycare here so i am hesitant to move them yet again to another daycare center, which is something i would have to do if i left. 2) is a per diem position on a psych floor. it would be per diem evenings and nights. the nurse manager is wonderful and the support is basically a 180 of what i have now. when i shadowed the charge nurse the other night she basically said "pick my brain, ask me anything, we are here to help and guide you and we know you don't know everything and we would never thrust you into a situation without proper training and support." also with this job i would be cross trained on med/surg so i would actually get my foot onto the inpatient world. i would obviously have a lot of learning to do, which i am excited about, but it does scare me a bit to be starting totally from scratch. also it's per diem so i would have no set schedule, no 401k, no option of benefits. i would need to figure out what the heck i could do for childcare with the kids, but because it is inpatient i would be making a little more money and the evening/night rotation would give me more time with my husband and the kids. 3) is a 20 hour position in a busy pediatrics practice. basically the same thing i was doing at the first job. i feel comfortable with it, i'm good at it, the hours are great for having young kids, i would have a set schedule, a 401k, but i also feel like its a dead end (why do i feel that way?!) once i just stick to pedi outpatient what is the possibility i would ever get in the hospital?! i dont know what i wanttttt!!! ahhhhh does anyone have any thoughts or been/there done/that advice?! thanks in advance!