chebre62

Oh, and I found this http://www.medicare.gov/Dialysis/Static/Contacts.asp?dest=NAV|Home|Resources|Contacts#TabTop

Perhaps one of the agencies that govern your type of facility might be useful. https://www.cms.gov/GuidanceforLawsandRegulations/05_Dialysis.asp Remember any place that accepts payment from medicare has to be licensed and have to follow certain rules. It's worth a call.

another word for where the astericks are would be "angry"

I started working as a nurse a little over 10 years ago when my hospital was always critically short staffed. Every night they asked us to stay over and many times had mandatory overtime. I was in my thirty's and was used to standing up for myself. One night, they asked me to "volunteer for mandatory overtime". I said that "volunteer" and "mandatory" can't be used in the same sentence. I would not "volunteer" and asked if I would be required to work 'mandatory" overtime as I was tired and would like to go home. If you mention to management that you are tired, any errors that you make can be attributed to the fact that the knowingly required you to work beyond your ability. They decided that I could go home. The senior staff were ****** initially, until they figured out that our union contract required that any time a nurse was forced to work mandatory overtime, they couldn't asked that particular nurse again until ALL staff had been required to work mandatory overtime. Then senior staff loved it. You should be filling out incident reports and unsafe staffing reports for each time you are forced to work beyond your ability. Calmly go up the change of command. Good luck

This is a great line -Learn to prioritize and learn to say "I will take care of it as soon as I can, but I have a critical situation right now." My version is "The good news is that you are stable. The bad news is that you are stable and that means that you will have to wait while I (or MD) work with those that are unstable."

Everyone is overwhelmed in the beginning. Take a deep breath. It's nice that you have a long orientation (at my hospital it's two weeks, even for new grads). During your orientation, find out who else is a good resource. Knowing who your resources are is the best advice I can give. Forgive yourself for not knowing everything, but continue to study. I used to jot down notes at the end of the shift of the things that I needed to look up and would before going in the next shift. Ask the docs questions when the MD's look like they have the time. Good luck!

Typically 1:4 on my PCU, occassionally 1:5. After reading most of these posts, my head hurts! We all must be crazy!

I live in Oregon and we have 8 hour shifts for floor nurses, 12's for ICU and 10's for ER. And we have a good union:yeah:

Thanks everyone, I sent the info to her. She has an appt set up with a cardiologist now at least.

NRSKaren- Thanks for your response. I have explained in great detail why she needs to go, but so far she hasn't gone.

OK, let me rephrase the question. In the state of Oregon our hospital has a link which shows were the hospital ranks on core measures. For example http://www.peacehealth.org/apps/quality/QReport.asp In Indiana where does one find that info? And how does a pt. find out information about financial assistance? Thanks

Hi everyone. I have a friend that is having cardiac problems and she lives in Fort Wayne, IN. Between Lutheran and Dupont hospitals, which is has the better outcomes and has the better MD's/nurses? This friend has no insurance and is waiting for a referral to a cardiologist. Despite my best efforts, isn't willing to go yet to the hospital and has symptoms of an MI and CHF because of the costs. Do either of these hospitals offer financial assistance? Thanks in advance. Cheryl

I recently got a gift certificate to a bookstore.

Take a deep breath. Study cardiac and respitory. Breath again and take the test. You'll do fine.

The wages are thanks largely to strong union. I'm represented by ONA (Oregon Nurses Assoc.) Love them. Not only have I seen my pay increase over the 10 years I've been a nurse, but they are adamant about safety. Most of the rooms in our hospital have ceiling lifts, needleless access for IV's, etc. If you don't have a strong union, check out the ona's website and contact them. Maybe they can help you.

The books you bought are good. I took a two day class and studied quite a bit and passed the test about 4 years ago. If you work on a cardiac floor most of cardiac should make sense, so concentrate on your weak areas. Good luck.........you can do it!

OMG, 41 patients that you're responsible for! I don't get how that works. Do you have any MA's or CNA's that you delegate to? If so, why aren't they getting the vital signs with that many people? You have my sympathy, I couldn't do it.

Agree with JoyfulRn- I love etsy and not just because I sell retractable ID badge holders there! It makes shopping easy. I had my daughter look and told me her favorites. I ordered on line and she got the coolest earings ever. So, go check out esty.com. And then, if you had a hard shift and need to laugh check out Regretsy.com from those people that really shouldn't be making things!

Agree with blondy..........depends on symptoms. SOB, chest pain, syncope means get to the ER now.

Eugene is south of Portland with two hospitals, both with very few openings at the moment and 60 new grads from the local college competing for a dozen jobs. I love Oregon and if couldn't live in Eugene, I'd be in Portland. Lots to do and see. Beautiful country, mountains, lakes, great bike paths. The advise given previously is sound. No matter what you decide, find the work first and then move.

Sounds like you are in need of taking a vacation. Take at least a week.......it helps alot. While I am currently a little burnt out from my own doing since I work full time (32 hour/week) at a hospital and then have part time jobs in the cath lab and doing research, I wouldn't stop nursing. At what other job will someone tell you that the time that you spent taking care of them has helped them at the worst time of their life? And we really do see people at the worst times in the lives, so some really don't cope well. You can't take it personally. Much better is to remember to laugh. Recently, I took care of a pt. with dementia that came from a nursing home with a uti and frequent falls. I was precepting a 2nd year nursing student and had him get vitals while I used old records to do the admission history in the room. The student was attempting to figure out if the pt. was alert and oriented and asked "Do you know where you're at?" The pt. responded "Of course, I'm above the fruit!" And he was right, he wasn't a vegetable. lol Chin up, next week a pt. will either make you laugh or tell you that you made their hospitalization better. Of course, the week after that will be hell.

lol, I remember working with Rick (an excellent RN) and he had a cheap $10 stethoscope. When asked about it, he said "if I can hear it with this, it's clinically significant! Along those lines, if you can hear something like wheezes or crackles without a scope it's clinically significant. Personally, though, I have a master littman.

This is a great pocket book http://www.amazon.com/Tarascon-Internal-Medicine-Critical-Pocketbook/dp/1882742508 and I would buy it used.

Your off to a good start, as many labs require ED or ICU experience. Start reading http://www.cathlabdigest.com and http://www.sicp.com Both are great reading for cath lab staff.