CharmantUn

Has anyone successfully pushed back against hourly rounding against management? I've been through mandatory "sim labs" on hourly rounding that take 20 minutes per nurse to hit management's entire script, managers checking that our whiteboards are updated and the patients are happy during every shift, and frequent reminders about hourly rounding during daily safety huddles. It's too much. Management seems to believe this is the magic fix for our poor HCAHPS scores--I believe the numbers never going to improve so long as we are understaffed, only have semi-private rooms, and really inflexible food service. How have you pushed back?

I went to nursing school in CA, but before I graduated my husband took a job on the East Coast. I've seen it both ways. In the community hospital in the SF Bay Area I trained at it was 4:1 for the tele floor, and only 1 CNA to cover 30+ patients. Where I work in Virginia, it's 5:1 in an Intermediate Care unit, with one tech covering 8-14 patients. It definitely feels unsafe when I'm running high risk drips (Cardizem, Heparin), pushing a lot of IV pain meds, etc....but it is sooo nice being able to rely on the techs for all the lab draws and assistance in turning/cleaning patients.

As a new nurse, working in a step-down unit, can I tell you how relieved I am when the peds nurse from my son's pediatrician's office calls me back? I am so grateful for her wealth of knowledge and willingness to work for less money in an out-patient setting. She's gotten me to come in to the office when I didn't realize he needed it (impetigo) and called in Rx to keep him out of the office for other stuff (conjunctivitis). It certainly helps relieve the worry I occasionally experience as a working mom sending my toddler to daycare.

Thank you all for your posts! I've been orienting the past two weeks; most shifts have been in dedicated classrooms to teach us Epic, ECGs, etc. I was pleasantly surprised to find a dedicated lactation room near the bathrooms at the training center. I'll second the comments made about having a hospital grade pump making a difference. I was an exclusive pumper and rented a Medela Symphony for seven months--I loved that it was so quiet and automatically shut off after 30 min (sometimes I would fall asleep while pumping). I also have a Medela Pump In Style (that's what insurance would cover). Although it was a dual pump like the Symphony, it was much louder and made it harder to forget I was pumping. However, the PISA did make pumping in the car and even on a plane possible. Agreed, pumping bras are awesome! I also learned from a RN/IBCLC that you can rinse your pumping parts, put them in a ziploc bag and store them in the fridge and reuse them a couple of times before washing. That was a HUGE time saver. After all this, I've decided it's time to stop pumping. Baby is 10 months old, I'll be working 12 hour DAYS on a busy step down unit where patients have your phone #, I'll be commuting 45 minutes each way to/from work, and I was only getting 5 ounces a day at best. It just seems like the right time to stop. However, I feel much more empowered to pump at work when we have another baby. I'll take your advice to heart and consider switching to nights and see if 8 hour shifts are available.

I'm a new grad, but took a year and a half off for pregnancy/raising a baby. I'm starting a new job in a step down unit and have been exclusively pumping for the past 8 months (baby is 9.5 months old). My supply magically tanked when I got the job, I went from 24 oz to 10 oz...if I'm lucky. I'm now at the point where I'm OK if I only do 2 pumps a day and I don't resent formula like I once did. But I still feel incredibly sad that I might not make it to my one year goal. I don't feel comfortable asking for time to pump at a new job at a busy unit with high acuity patients (vents, central lines, etc). My commute is far enough that pumping in the car to and from work seems reasonable. Anyone have any experiences with pumping or weaning with a hospital job? Most RNs I know have no idea that the ACA now requires employers (with 50+ employees) to provide a pumping room and adequate time to pump. The nurse managers I interviewed with know I have a baby (and great daycare) but I didn't dare bring up pumping during the interview. Thanks!

Jessica-- Normally I'd say you have the right idea to get the books now! BUT SFSU is actually changing their whole academic program starting with your cohort (example: Med Surg will be in the final two semesters instead of just the second semester). It is very up in the air right now what your books will be as well as how many units you will have your first semester to calculate the total cost of your tuition per semester. Hang tight for now. If it really bugs you that you're not doing anything, start reading Nursing Interventions & Clinical Skills by Perry/Potter. No guarantee that you'll be using that book in the first semester like we did, or that you'll even have Skills Lab during the first semester, but it was always referred to as "the bible." We also used Calculate with Confidence--we were expected to do that book on our own to be prepared for a math test every semester. Don't know if that will change. Other than that--congratulations on getting in and starting your new adventure! I recommend starting a new thread on allnurses.com for your Cohort....

A new battery for your laptop--in case you're to far away from a plug during class. Plus, you don't have to kill a tree if your prof posts their power points online. An iPhone--great for recording lectures, looking up lab values on the fly, setting reminders, and keeping track of your schedule.

I had a 2.5 GPA with my first degree, too. Pulling mostly As in my pre-reqs, becoming a CNA, and volunteering over 400 hrs at two different hospitals (and getting great letters of recommendation) made a strong statement that I was now a serious student, and I was admitted into a BSN program. I continued to prove myself by getting a 3.8 my first year of nursing school; hopefully this will help me get into grad school one day. Seek out programs that calculate your GPA based on your last 60 units, not your total college GPA. Associate Degree programs in my area (California) have significantly lower overall GPA requirements, too.

Will you have to work more than one shift per week? How heavy is your load? My nursing school requires us to take classes in a specific pattern--all students are taking the exact same 15 units the first semester. It was on par with taking anatomy, physiology, and microbio all in the same semester. You may want to hold off accepting that job until you're aware just how intense school is going to be.

Here are the "stories" I made up for my med-surg exam: CA is the abbreviation for California. How would you rate the weather in Calif., out of ten? 8.5-10.5. Ca++ 8.5-10.5 There is an inverse relationship between Calcium (Ca) & Phosphorus (P). How to remember it's these two: CaP Na: 136-145. I just think of hypertension and the relationship to salt. 136-145 (systolic) is prehypertension & stage 1 HTN. K+: 3.5-5.0. No easy way to remember this one, but it's the most important electrolyte to know. Potassium is mostly inside the cell, and sodium is mostly outside the cell, which is why the numbers are so different for serum values. Hope this helped!

It had some good ideas, but was a little older. My instructors are able to post all powerpoints and docs online for us. A 3 hour Med Surg lecture can easily have 120 slides-- I'm not about to print that out and put it in a binder. Instead, I bring my laptop to class to take notes. I use my iPhone to record the lectures, then play them back when I'm driving. I also use quizlet.com to make flash cards (you can share them with classmates, too!)Try to embrace technology now...you'll be using it frequently in the hospital.

Don't believe everything you hear from an employee at a very expensive private school...they have other motivation$. I'm in the SFSU program. Degrees outside of nursing are taking a long time to obtain because everything is impacted. Nursing is different. Your spot is reserved for all nursing classes. If you have all of your G.E. done prior to starting nursing school at SFSU, there is absolutely no reason you can't finish in 5 semesters. There is a Segment III Upper division requirement you must do in order to graduate...it's 9 units you must take after you've completed your first 60 units. Most SFSU nursing students opt to take them in the summer time when they don't have nursing classes. It could be fair to call that a "6th" semester, or you can take those courses when you have a lighter load, say level 4 or 5 (4th or 5th semester).

"Commit to the stick" is still stuck in my head. We practiced on oranges, hot dogs, and then finally in check offs did saline into our partner's abdomen. So only one person got to stick you--not bad. A few weeks later we gave each other flu shots at clinical (supervised).Shots aren't that bad compared to a fellow student attempting to start an IV or do a blood draw (final skill we did first semester). When your partner is digging around to find your vein--that hurts!

Yes. Main campus does require white scrubs at clinical. Main campus also requires scrubs during lab time, but allows any color/print. The Canada/Sequoia instructor does not require scrubs during lab. After completing the second semester everyone gets to wear colored or print scrubs.

Hi Nugget, The first semester is insane! I was in class or at the hospital four days a week...the other half of our cohort opted for six day a week schedule. Typical schedule: Tuesday: 8-11 Pharmacology lecture 12-2 Health assessment lecture Wednesday: 8-11? (maybe 12) Skills lab Thursday: 12-4 (maybe 5?) Skills lab & Health assessment lab followed by a loooong evening at the hospital writing a care plan (I feel like I'm forgetting something on Thursday) Friday: 6:45 AM - 3 pm ish Clinical (at the hospital) You will enter a lottery at during the Canada/Sequoia orientation. Based on your lottery number you can pick your clinical instructor, which will dictate if you have Monday clinicals (and are at the hospital on Sunday doing care plans), or Friday clinicals (my schedule above). Your lab time is also based on when your clinicals are. Keep in mind you won't be starting clinicals until mid semester, your first semester. The sooner you prepare your family for the fact that you won't be around a whole lot and might be a bit of a zombie at times, the better. Some of my classmates have young kids and have proven it can be done, but it is HARD. Thankfully you will have the entire week of Thanksgiving off. There is also a 5 week winter break, so you can truly unwind. It does get better, too. The second semester is just 2 days of classes and one clinical day. Best wishes!