guinans

Sorry it took me so long to get back to you. My first forray out of bedside nursing was as a clinical practice nurse at a major teaching hospital. I floated around the different practices - endocrine, GI, General Med, Heme/Onc for awhile as a temp until I finally found a home in cardiology. I just loved it - alot of phone triage, monitoring lab results, coumadin managment. I learned so much I felt like I' did a fellowship in cardiology. But it was not a happy ending here. The docs were fighting between themselves over who we staff belonged to, and I had to go. I temped again at another big teaching hospital, and landed a full time job as a research nurse coordinator. Also just loved it. I left here to raise a family and started doing home care nursing when the kids were young. I find home care a lot more tolerable than hospital nursing, though I wouldn't be doing it if it weren't for my kids. I've also just started with a new company doing medical record review, chart audits, HEDIS and the like. I really like this sort of work.

PS It would not have made one iota of difference to me WHAT anyone put after my name. My perception of being in hell had nothing to do with whether or not anyone addressed me as R.N.

When I worked as a hospital nurse, I "booked off" work all the time, only I called it "calling out sick". I've maintained jobs (this was back in the 90's) when I only made it to work about 1/2 the time. I could give a hundred or more reasons I didn't want to be there. Bottom line was when I was going into work I felt like I was going into hell. Some days I just couldn't force myself anymore. I didn't care if I ended up jobless and homeless, I didn't care about burning bridges, I didn't care about getting a bad reference. Anything was better than working as a hospital bedside nurse. Since I left hospital bedside nursing for good in 1999, I don't think I've ever called out sick.

We all know as nurses we cannot simply "follow doctor's orders" if we know harm will or may come to a patient if we follow the order. Because you hold a license and are responsible for your own actions, I think you have a right to have it explained to you the rationale for administering IV potassium to a patient with a high potassium level. I think you were right. If your charge nurse was not able to investigate the situation, and the physician was unwilling to explain, maybe your nurse manager, a nurse educator, or a supervisor could investigate prior to administering the med. I don't see how anyone could fault you if you took steps to clarify an order that made you uncomfortable.

I graduated in the late 1980's. Even then, in a good job market, employers liked to see hands on experience in a hospital, nursing home, ambulance crew as an aide, tech, EMT ect. before hiring. Diploma school nurses got great bedside experience back then, but if you were in a baccalaureate program, you had to go find that real world experience on your own. Anyway, I know there are hospitals hiring in Philadelphia. Look on www.nurse.com and select PA, then Philadelphia. There are tons of jobs. There are several health systems in the area, so if one job doesn't work out, there are others. The Hospital of the University of Pennsylvania is open to hiring from out of State, I know that. But I also know that new grads in the Philadelphia area are having a hard time landing that first job. There are so many nursing schools in the area. But you may stand out at places like HUP specifically because you are out-of-state. Never know till you try.

Yeah, I wasn't trying to be sarcastic either. I'm just telling you what I know from experience. I graduated nursing school 25 years ago, and it was easy to get a job back then. However, I'd spent my senior year of high school plus my four years of nursing school working as an aide at nursing homes and hospitals, and I know how a foot in the door can swing the door open. But that does not seem to be an option for you. How about a medical assistant job in a physician office, if none are hiring RNs in your area? Did you get any experience at all while you were in nursing school, besides your clinicals? I'm surprised how many nursing students don't do this these days. I'm also telling you from hard earned experience that packing up and moving to a new State can turn into quite a nightmare if you're banking on a brand new, untested employer for your sustenence. I'd stay put unless you have substantial savings or a trust fund.

Actually, I've been a practicing RN for 25 years now. I was a nurse's aide for 4 years prior to this while a student nurse, and prior to that an aide for 1 year while still a senior in high school. I think I've got the bedside thing covered. I can't imagine how I might fall into informatics!

Jeez. This is tough. I would recommend a travel nurse assignment but it sounds like you don't have any experience yet. The difficulty with moving to a new State is, what if things don't work out at your new place of employment? As they so often don't. It seems to me that, if you can afford it, finding work as a CNA, unit clerk, monitor tech, ect. might at least get you a foot in the door at a local hospital, and get a particular hospital familiar with you and you familiar with them. Just a thought.

Has anyone studied nursing informatics and/or worked in this specialty? It seems interesting but I'm not sure of all thats involved in this sort of work. Where specifically does a nurse with this type of training work? Is it hard to get a job once trained? Can anyone recommend a good online program? Do you need a Masters to be successful?

Yes! And their old and everything in between. This can be an obsolutely vicious profession.

I hope I didn't come across as discouraging anyone from hiring an attorney. I think an attorney would be an assest in a situation like this. However, if you want to sue anyone, and have an attorney work on a contingency basis (no fee unless you collect a settlement), you most likely wont be able to do that in this situation, IF you are in an "at will" employment State. I'm not sure how things work in a non-at will employment State, since I don't live in one. But there is certainly nothing stopping you from hiring an attorney, except cost. I've found paying an attorney to be undoable after I've just lost my job. Once, when I was fired for refusing to go along with a physician's blatent discrimination against members of a particular religious group, I was easily able to obtain an attorney on contingency, and got a very big settlemet. This physician was so arrogant he didn't bother to hide his attitudes, so me winning that one was a nobrainer. Sometimes it boggles my mind I've survived in this profession as long as I have.

Ugh! The embarrassment. I know all about it. Look, did you steal from your employer? Did you cheat your employer? Did you lie or misrepresent yourself in any way to your employer? Did you willfully and knowingly and with bad intent harm a patient? Were you uncaring and neglectful of those is your care because you just don't give a **** anymore? Did you deliberately harm a coworker's reputaion or well being? No, it doesn't sound like you did any of those things, so what have you got to be embarrassed about? Crazy thing is the people who really do these things rarely seem embarrassed about it. When the time does come for you to move on just keep in mind that you are NOT a liar or a cheat or a thief. You are NOT a person who goes about harming your employer, your coworkers or your patients. I think some of the embarrassment comes from being singled out, and from the realization we are as vulnerable as we are. Yup, we're vulnerable, all of us. This sort of thing can and does happen to lots of good people.

Hi Nocturne. Hope you're feeling a little better today. I had posted yesterday about how this same thing has happened to me, and more than once in my 25 year career. Its happened 3 times. I can tell you from my own experience that I always qualified for unemployment compensation when this happened. I can also tell you that I never needed it for more than 2 weeks. Thats all it ever took me to find another job. I live in a large city with lots of health care providers, so that might have helped my situation. Reference checks and interviews with potential employers can be tricky. I can tell you that I have always used the employer who bamboozled me as a reference. I knew they couldn't say squat against me because I hadn't really done anything wrong, and I knew that THEY knew I'd be setting them up for a damages claim if they DID say anything against me. Another option might be to be honest with a potential employer, but you really have to feel that one out. I can't say I have ever used that tactic. One of the best options I've found is to go with a temp agency. I've been able to be pretty honest with a temp agency about what happened at my previous, problem job and they are usually pretty understanding. I think they hear this sort of thing all the time. This gives you a chance to feel out different job situations, maybe even different specialties. It was through a temp agency after a firing that I found a position as a Research Nurse Coordinator at a major, world renowned teaching institution. It was HIV research back in the 1990's when HIV was still a big threat and the work was fascinating, and felt important and noble, which appealed to me. I just loved it. This position lead to even better things and now I never let myself stay stuck in bad situations. The creeps did me a huge favor. Just don't let embarrassment or shame rule the decisions you make over the next few weeks. Keep in mind that the creeps likely did you a favor, and you may have been stuck in that awful, hostile situation forever otherwise.

This has happened to me, and more than once in my 25 years as a practicing nurse. Its really painful, I know. Usually its because you've ruffled someone's feathers somewhere, usually a person in a position of power. Had you noticed anything unethical going on at your place of employement and spoken up about it to someone? It could be anyone really, who might have ratted you out. Once I agreed with an upset family member that the care her father had been receiving at our hospital was substandard. The family member used my words to complain to a manager "see, even his NURSE agrees this is wrong!". All the sudden administration found all sorts of things wrong with my work. I was gone the next day. What are you going to do. The family member was right and I was right and I hope patient was OK in the end because I'd called it like I saw it. Other times I've openly taken a stand and boy they'll rip you to shreds for that. You can try lawyering up. However, if your State is an "at will" employment State your employer doesn't need any reason at all to fire you. You'll need to prove damages beyong the firing, like if you use them as a reference and they start spouting this stuff without proof to a prospective employer. Also, if you file for unemployment compensation you'll likely get it. You're employer has to give warnings and work on a documented plan of improvement with you before firing -at least as far as the unemployment office is concerned