Trece

I do have some favorites that have served me well in the past. Our organization sent all management to the "hire for fit" course offered throught the Health Care Advisory Board. Hire for fit is an awesome strategy to find the right person - not only for your unit but for the organization as a whole. Here's a few of my favorites: "tell me about a time when you felt like you made a difference in someone's life and what that did for you". "give me an example of when you've had to deal with a difficult patient, family, or co-worker". 'tell me about a time when you had to confront someone you worked with. How did you handle it? What was the outcome"? "What inspires you/ignites your spirit" "tell me about a time when you worked on a team that didn't function well. What do you think was the cause of that disfunction"? "if I were to call your current supervisor, what do you think he/she would say about you". "tell me what you know about our organization? Why do you want to work here"? "describe to me your perfect work day. what would you do to achieve that perfect work day"? I'm often amazed at what people will reveal with the simple question "tell me about yourself". Always a good one. And a little extra advice - always listen to your "gut reaction". If you don't, you'll be sorry. NEVER hire someone just to fill a hole in your staffing. "Warm body" hiring will come back to bite you in the end :trout:

Dear new grad: Some welcome to the profession!!! :welcome: If I were you, I'd talk to your manager (or whoever hired you) and explain what's going on and ask for more orientation. If the answer is "no", then I'd resign on the spot and start looking for work elsewhere. In my state we don't give "temporary licenses", but I would assume you are to be working under direct RN supervision - not all on your own. Your future license is on the line here and you are responsible to ensure you are providing safe care to your patients within your scope of practice. Here at my hospital our new grads are assigned hand-picked and trained RN preceptors for a minimum of 8 weeks, usually 12 weeks. Our new grad program includes both floor work and new grad didactic course work. Our new grads have weekly meeting with their unit's nurse educator, manager, and preceptor to discuss orientation progress, identify learning needs, and set goals for the next week. We also have nurse mentors that offer emotional support and help integrate the new grads into the "culture" of the unit (potlucks, secret pal, etc). The feedback we get from our new grads is that our process is very positive and really helps integrate them into the profession and our organization. This is a far cry from my experience 12 years ago - 3 days of orientation and then I was responsible for 7-8 patients on an evening shift! My advice: there are a lot of opportunities out there - look for an organization that cares for and values their RNs or you'll never be happy. Good Luck

Heather A. I've experienced both sides of this situation: as a staff nurse that made a mistake and a nurse manager having to deal with the doc, nurse, and patient when a mistake was made. You did absolutely the right thing (even if it did take you a bit of time). It takes a lot of courage to admit a mistake. I accidently gave 10 times the dose of a med (no sleep, 12 hour night shift, saw what my brain told me to see). As soon as I realized what I did I did report it to my charge nurse, called the doc, etc. My pt ended up going into renal failure and needing temporary dialysis as a result of my error. So yes, I feel your pain. I felt like I must be the worst nurse ever. I went home and sobbed and sobbed, I feared for my job and my license and even getting sued by the family. None of this happened. I didn't even receive any disciplinary action, just coaching from my manager. She and most of the nurses I worked with were very understanding, after all - they've made mistakes too. Unfortunately there are always those nurses that try and pretend they've never messed up and will talk about you behind your back and give you funny looks. It's hard to take, but try not to let it get to you. Don't give up on your job or your profession. I'm sorry you're manager is not more supportive. As a manager, I've stood behind nurses that have fessed up to errors and helped them grow and learn from their errors and become much better nurses for it. I'm much more frightened of the nurse that won't "own" her errors, blames others, makes mistakes and lies about them, and makes the same errors over and over again. I'd take someone like you over someone like that in a heart beat - and that's the message you should be getting from your manager. Good Luck, Sweetie

Do any of you have a "bed control officer" or "bed control coordinator" or "nursing supervisor" who handles all admissions? At our hospital all admissions, whether through ED or direct from clinics, must first go through bed control. This person is an RN with supervisory and care managment experience. The bed control coordinator takes the admission information and places the patient in an appropriate bed and notifies the ED or clinic with a bed number when the floor is ready. This person also acts as an "intermediary" between the ED and the floors when things get tight and sometimes must push the floors to take the admit or push back on ED to hold the patient so the floors don't get slammed. This certainly isn't a perfect process and we still have many of the same issues with ED trying to push 6 patients to one floor in an hour (usually our telemetry floor), docs waiting to write admit orders on all his/her patients at the same time, and those "shift change" issues. One process we put in place after an RCA on an adverse patient outcome was no admissions at shift changes (we work 8 hour shifts, so this would be from 0700-0730, 1500-1530, and 2300-2330). This gives the floor nurses time to give/take verbal report on their patients and be available to admit the patient when he/she arrives from the ED. We're still struggling getting ED to comply with this and they push it, but the floors push the time too (say they're still getting report at 0740 and refuse to let ED bring the patient up). We're also forming a mini task force of ED nurses, floor nurses, an ED doc, and a PCP doc to try and open dialogue and increase understanding between everyone involved and problem solve some of these issues to at least try and create a better atmosphere of cooperation. After all, safe patient care is really the issue here and safe handoff is a huge part of this equation.