MntnGirl

We have a PsychNP at our hospital, she is not a FNP, she is licensed as a Mental Health Nurse Practitioner. She practices alongside the psychiatrists in the clinic and hospital setting; she has prescriptive authority, and from the experiences I've had when working with her she is very knowledgeable, thorough, and provides her patients with excellent mental health care in the acute setting. There are specific Mental Health Nurse Practitioner Nursing Programs that provide this Masters Nursing Degree. I suppose a FNP could exclusively work in the Mental/Behavorial Health area, I'd hope that these FNP's would have nursing experience in this field. In rural areas of the country FNP's probably have to take on varying roles such as Mental Health providers due to the limited amount of providers in general.

It is not uncommon for employers (especially large organizations) to have computer people working for them whose job is to look through the employees web pages such as Facebook, MySpace, etc. No joke, people are paid to 'surf the web' for employee information. Assume nothing is private and assume that your facility is spying on you via the internet.

This Just In Time Gig is being done to cut costs but I'm very interested to know how much this hospital paid to get this program implemented. Just like the Studor Propaganda, I love that Studor has all these "studies" to pass around but when you look at the fine print all the research has been paid for by, who else, but the Studor Group. Fortunately at my hospital patient acquity is taken into consideration and we're all about customer satisfaction, patients aren't smiling and giving us all our "stars" on our surveys if they have to wait for ANYTHING so we seem to be staffed pretty nicely, all to make our 'customers' smile and tell their buddies to come to our hospital.

Chronic tardiness comes across as "my time is more important than your time", the tardy person needs to start seeing the situation from anothers' perspective (very unlikely though). I've dealt with a chronic tardy person (married into family)for years and it is frustrating and un-excusable. I see it as a very selfish act and I avoid interactions with my tardy acquitance because of the feelings evoked when I'm left waiting. I have a hard time understanding why the "always late" people are late, can't you just get going on your preparation earlier? I don't have an opinion on this person being fired for tardiness (and additional issues) because I don't know how often they were late, how late they were coming onto shift, etc. I just wanted to vent about how I feel regarding chronic tardiness. Thanks for listening.

I suggest the 3 in a row, when shifts start getting spaced out like 1 here then 2 a few days later, it feels like you're always at work. Working 12 hours shifts can be exhausting so for me that 1st day off (when you get off at 7am and then sleep and don't have to return to work) is pretty much a useless day for me, my body and mind are usually burnt - it's my "Recovery" day. So the more days I can have off in a row the better for me. But there are times when I will schedule myself only 2 in a row with a day break before returning for the last shift of the week, and this is usually when our floor is rocking full and or we have patients that are lots of work. Some of my coworkers do 4 in a row to maximize their time off but I only do 4 if forced to because by Day 4 I am exhausted - you certainly know your crew of patients by Day 3 and 4 which is helpful but in general 12 hour shifts are long and draining.

3 days of orientation is barely enough time for you to get familiar with the layout of the floor neverless learning how to manage your time so that you can care for 30 elderly patients. All I can say is "WOW" and Good Luck.

You should get your facilities Policy regarding this and have a paper copy to present to your Nurse Manager. At my workplace we do have low census times - we are not required to use PTO with low census shifts, and we do acquire PTO for low census oncall shifts (cuz we are still 'oncall' - we could be called in at any time). We also acquire about 7 hours of PTO every 2 weeks and I work 12 hours shifts, I save my PTO for my actual vacation, it certainly isn't a vacation waiting around at my house to be called into work. I find that because of my 12 hours shifts, taking 1 shift off of work (be it for sick day, vacation, or oncall low census) requires about 1 month of PTO - it takes awhile to get those hours accummulated to a nice amount. I'm curious to why your nurse manager is 'requiring' your unit to use PTO for low census? Please fill us in on your thoughts. Good luck and I hope this is able to get figured out so that you aren't losing all your PTO and you don't even get to go on vacation.

My first job at a hospital was 16 week orientation and I had a 1:1 mentor that whole period - I'm sure it cost the facility a pretty penny to pay my wage and not have me taking my own patients for 4 months. I got my first RN hospital job in January 2010 (graduated Dec. 2009). Along with me there were 4 other New Grad RN's - I don't know the exact dolllar amount but I imagine it was definately "an investment" for the hospital to train us new grads.

One doesn't have to "be psychic" to figure out whom you're referring to. All it takes is for one of your co-workers to read this post to figure out who your referring to. If I worked for this organization and I saw a post titled like this I would read it - anyone that was involved in this specific situation, or heard about it through the grapevine, is going to know the who, what, where, and how's regarding what you're posting here. I think too much information was revealed in the original post, and it's very possible that someone will be able to figure out who the person is that you're referring to and even figure out who posted this question.

Look at the facility you're interested in website; I've also found that your states 'department of labor' website can be a good site to look for available jobs.

On my floor, med/surg, all new nurses hired (experienced RN's) are given at least a month of mentoring with an experienced RN on the floor. Then if the mentor and new hire agree that the new hire RN is ready to be on own ,so be it, but there is always the option to extend orientation. As for new grad RN's, they are hired into a 'new grad program' and are given 18 weeks of mentoring/orientation to floor and classroom time also.

I frequently am giving Lovenox several times on each shift, never held the injection site and am not aware of anyone else that does (coworker). As for bruising, it happens, especially if the patient is on additional thinners; I try to administer the Lovenox into the 'love handle' portion of the abdomen, more lateral than medial, this area has more fatty tissue.

If you're really concerned about getting meds administered within that 1/2 hour window maybe you could administer meds to each of your patients and after administration go back and begin your assessments. This way your introducing yourself right away and getting meds passed and basically starting all over with the patients. Patients (most) seem to like this because they get to see you 2 times within the first hour/hour and half of the start of your shift. I imagine you will be getting bigger patient assignments as your training progresses? With more patients (a typical pt load on my floor is on days 4-5 and nights 5-7) comes more meds and more assessments and more orders, so time management becomes extremely important. What can really throw me through a loop is change of shift admits - I still have a hard time juggling the admit and passing meds, assessing, and managing my patient load. It will take time and experience to develop your own routine, I've been on a surgical floor for 15 months (started as a new grad) and I can say that it took me a good 9 months to recognize that I wasn't as rushed as when I first began, and I was doing more 'looking at the big picture' versus just checking off tasks on my daily checklist. At 15 months experience, I'm comfortable with managing my 5-7 pts at night (minus that dreaded admit right at the start of my shift), I have developed my own routine and have my own brainsheet which is my organizational lifeline during my shifts. Good Luck!!!

I use to be in the same position you are (schedule wise), I recently told my manager that this was not working for me, I only want graveyard shifts and nothing else. Manager was okay with this and I am now 100% graveyard - the flip flopping was hell on my body, physically and emotionally, and by the time I had adjusted on my days off I had to turn around and go right back to work. I find that if you don't speak up and let the powers that make the schedule know what you want you'll continue to be prone to these chaotic schedules. Now on my floor it was no problem for me to say I want 100% nights but there is no way I would be able to do 100% days (never want to work days on my floor anyways), there is a waiting list for RN's to get day shifts. You need to speak up or forever hold your peace!

There are jobs out there for new grads but it does require lots of searching around for these jobs. I think you'll have a better chance of getting a new grad job in the more rural areas of the country, look in smaller communities and in more isolated areas/states. As for sign on bonuses, I started with a hospital as a new grad in January 2010 and there was NO sign on bonus (the year before there was sign on bonuses). I was able to get moving costs reimbursed but this was not profitable for me, it covered my moving expenses and I had not a penny left over. Good luck with your new career.