VANurse2010

ER nurses have never transported any but vented patients anywhere I"ve worked. Nice try.

The best person to answer these questions is your unit director, but in general... Telemetry and step-down are the same thing in some hospitals, and in others step-down is higher acuity with lower patient:nurse ratios. Step-down may take more and different drips than telemetry and have the ability to titrate, depending on the unit. Some step-downs also take arterial lines and chronic or newly-chronic ventilators. Telemetry typically does not take patients with anything more invasive than IV access and often any cardiac drips are non-titratable in telemetry units. Ratios can go as high as 6:1, maybe more in a really bad hospital. Either will be a crap storm of admissions and discharges. From my perspective as a critical care nurse (and former telemetry and step-down nurse), those two are the worst! Sometimes very high acuity with lots of admits/discharges and turnover. It's my hell on Earth.

Your opinion that you're qualified for this job is objectively false.

Are you people serious? The floor nurse is supposed to leave her other 4-6 patients to go transport a patient from the ED? Does your director have a picture of the CNO with a goat? Utter BS.

Really? You triple the travelers and floats first - the ones who bail you out of staffing clusters? What a s show of a unit.

None of those are legitimate reason except perhaps the orientee. I am an experienced ICU nurse.

Inform them that an order to use equipment against safety guidelines is not a valid order and you won't be doing it. Document the date and time of the conversation. You'll get nailed if you lie in your charting just as quick as if a patient gets hurt from a tipped Hoyer (which could obviously be serious). I hate using the cliche "find another job" because that's casually thrown around this forum like it's nothing, but if your story is accurate then your management clearly has zero regard for your license.

You are throwing out the "insulting" and "rude" bits to distract from the substance of what's actually being said. Frankly, the "tone" is irrelevant, and you're still not qualified.

Don't confuse your getting an interview or even getting hired with actually being qualified for the job. They aren't indicators for that and you're not qualified.

You are not qualified for that job, irrespective of your masters and administrative positions. You have to have some clinical expertise or at least a lot of clinical exposure. You don't have it. The other comment may have bene overbearing, but I find your indignation over it a little misplaced. It should be obvious, even to you, that you don't have adequate experience for that job.

I hope you enjoy your moral superiority on the unemployment line.

That's all well and good but it's not a "medication error" if the doctor's order doesn't match what they take at home.

Why did you write it up if the doctor changed the order? Why do people insist on hanging themselves?

I get that, but this is supposedly a professional job and management should be a bit more collaborative with solutions. I would expect this type of condescension from a retail or hospitality outfit, not from a so-called professional environment. ETA: There's nothing wrong with leaving a job if it doesn't meet your scheduling needs.

This is far enough in advance that you should just find a new job and quit. I'm a little put off by all the advocates for putting the unit before your life, but that's the lay of (some people's) land I guess.

This is all valid and I get the frustration. However, legally the med. rec. is ultimately the physician's responsibility. It is his/her job to ensure the right meds are ordered. Community hospitals especially like to dump this on the RN because there is no intern to dump it on.

Your manager is full of s. This isn't some interpersonal conflict over a minor policy. This is a major health and safety issue that involves documentation and BON issues - not something you "work out" with the coworker. Manager needs to do her damn job.

I sort of agree, but to me a unit where the director is taking patients on the floor is not a functional unit. *that* is a big red flag to me.

In the event that you're actually serious and not a troll - you're not actually qualified as a new grad to really know what is a dangerous, busy, or inappropriate environment. So there.

Neither of those two require 12 narrative notes. Most EMRs have checkbox functions for this BS.

Tell us your thoughts first and then we can provide more insight. What have you seen thus far?

It's not rude, at all. Not even remotely.

You are not experienced enough in acute care nursing to travel. You have to have good patient care and assessment skills to deal with all the BS that's thrown at you traveling. You need AT LEAST a year, more like at least two. It's to your recruiters financial advantage to place you - don't think they have your best interests at heart. Why are you so desperate to travel? The money's nice, but the facilities have problems (usually major, though not always obvious) otherwise they wouldn't be hiring travelers. It's not the exotic experience that some like to pretend - by a long shot.

Most of us have worked in specialities long enough to know. I would suggest making a list of the most common medications on your unit and memorizing the purpose/dosages/precautions of them. Keep in mind that truly inappropriate dosages (a) are not common, and (b) the pharmacy does verify meds before they are available for you to give. this is not a justification for not knowing what you're giving, but don't think you're the only thing between a bad order and a patient, either.