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I agree with Snowshoe RN. The best option is for her to call her manager or HR and ask where they are with this. Being a manager myself, I can tell you that they will NEVER take this lightly and will look at all angles before making a decision. Most likely, this far out, I would think it was probably not going to be termination. Your friend should have access to the HR policy manual and the facility will most likely address this in the book. Most facilities I've seen say something like final written warning with actions up to and including termination. It is always difficult to wait for the results. Good luck.

Take a look at the new report from the Institute of Medicine which talks about the future of nursing. The impetus is to have 80% of nurses at the BSN level. The report goes on to say there is certainly a place for ADN nurses. However, this should not be viewed as the stopping point of education. With the advent of quality online courses and many flexible choices out there, moving to the BSN level is easier now more than ever. I also beg to differ with the assertion that we BSN nurses received less clinical. That is certainly not the fact. Some may never choose to get the BSN. However, with the push on the national level for the entry level to be a BSN, it's time to face facts and look at options. Having just completed my master's at age 42, I can tell you, it's not easy but well worth it any time you choose to enhance your education. Facts are facts. BSNs are looked at first. I (as a manager) will look at ADNs if they are a great fit for my department but I want to know that ANY employee I have is looking at life long learning in some fashion or another. Good luck with your search and I hope you will take a moment and reflect on what's been said to you in this blog.

May not be HIPPA due to her getting information from outside source but certainly sounds slanderous.

Let me come at this from the ED side of things. What you are describing is not a unique situation. Many of the issues result from a misunderstanding of what each other does and the type of nursing required for each area. Any ED nurse would take offense at being referred to as "functional". Any ED nurse would tell you we can't stop the ambulances from coming during our shift changes. Any ED nurse would tell you we'd love to have a stable 3:1 ratio but can not turn patients away. Therefore we must make room for them and that means getting admitted patients upstairs to admitted rooms. We just got a group together to discuss this very issue and improve our report process. ED nurses should be reporting on those they are assigned to care for. What you describe is unacceptable. However, the "no fly zone" between shift change presents a problem. ED nurses change shifts at the same time as well. If you hold admitted patients in the ED, you are forced to have the off going nurse stay over or the oncoming nurse give report and they don't know the patient. Determining how to handle this requires a concerted effort by all involved. Until we all view this as a system problem and not an ED problem or a floor problem, we won't be successful. When we begin to think outside the box, we'll all come up with some really good ideas and solve this situation. One more thing... always think about this from the aspect of what's best for the patient and let that be your guiding principle. Good luck to us all!

Look into East Carolina University. I graduated in 2010, May with my MSN with concentration in leadership. They are ranked as one of the best online programs in the US. The first day I set foot on campus was the day I graduated. My diploma is the same as anyone who went to class every day. My professors were wonderful. I still stay in touch with them and confer with them. The price was not nearly as high either. I guess you can tell I'm a HUGE fan.

As a manager, I'd ten times rather know you were unhappy early in the game than invest any more resources in a situation that is not going to be long term. You deserve to work where you are happy and the hospice company deserves a nurse that is happy in their job. Make sense?

Preprinted t Sheets work well for a paper system. Docs seem to like them pretty well. The nurses sheets are good as well. They'll do the ticket for you until you are forced to go to electronic documentation. As far as the ESI system. I've implemented it twice in two different systems. (I am a manager). Both went well. Go to the AHRQ website and you will find FREE DVDs and booklets and everything you need to implement this, teach this and create competencies. Kudos to you for being a leader in the absence of a manager. Leaders are what's needed everyday and rarely carry the "manager" title.

Speak with an advisor at the school you choose. I graduated in May with MSN concentrating in Leadership. Many of the base courses are similar and will be required no matter what tract you choose (i.e. research, theory, issues in nursing, research application). Perhaps begin with these and your path might be enlightened by these courses...... good luck.

Nurses and physicians are like apples and oranges. It's impossible to compare the two. I have never wished to be a physician. Nor, do I envy them because I simply do not think about the patient in the same way as they physician. Nursing should be looking at the entire patient including support systems, environment, knowledge deficit. Nursing is about educating the patient, determining their ability to cope with the situation at hand. It is not about prescribing, diagnosing or determining tests. We are simply different creatures. All important and all vital to the process. None more than the other. I love my job and love the career I chose over 20 years ago. I think it's sad when nurses regret their choice. It's indicative of some sort of disappointment or disenchantment based on a misperception of what this career entails... just my thoughts.

The comment to "reapply after your pregnancy" is very suspicious. Get a lawyer and review this with them STAT!

Is there any talk of hourly rounding at your facility? Not necessarily by you always but SOMEONE making a pass on your patients to check for these things? There has been a lot of research that patients hit the call lights less and even nurses take less steps if hourly rounding is in place. Also, sounds like your safety team needs to take a serious look at the layout of your medication administration and preparation areas. You should have an interruption free zone or someway to denote you shouldn't be interrupted when passing meds. Everyone deserves your full attention when you are getting their meds!

I would agree with the others. This organization doesn't seem like the place to be. I am a manager and there are so many "etiquette" rules broken by that manager, I wouldn't waste my time worrying about it. I do want to clarify that she doesn't "owe" you a response to your thank you note. She, or the organization, do owe you a response that the position has been filled. Some organizations have very strict policies about any dialogue with a potential candidate going through HR. The reason for this is highlighted by the fact that your perception was that she gave you "false hope". Anything can be misconstrued that she tells you outside of the interview process. For that reason, follow up with the HR departments in the future. That's what they are there for. Good luck with your search.