DawnJ

I work in ER and see all these patients with Medicaid from ACA. I don't think they are going to stop coming in using the ER like a walk-in clinic because their ACA goes away. Which makes me frightened about the financial future of the department. We have to treat them, won't get paid. What's different from before ACA? Treatment costs are even higher than before and we will run deeper in the red.

New Mexico. Although you have to pick your public schools carefully

Sounds like a homework question

E: Look up nursing info on internet

I felt really bad about my needle skills too. I started in an ER and let me tell you, the techs were NOT subtle or gentle in letting me know that my skills were sub-par. At first I got maybe 20% of my attempts. Now, 8 weeks of practice later, I notice I can get all the easy ones and a surprise moderate one now and again. Eventually I hope to be able to get 75% of my attempts. It is just getting the feel of it and building the muscle memory. One of my first mistakes was not laying out all my supplies in the order I'd need them, all ready to go: INT flushed and ready, tegaderm peeled and waiting, blood tubes standing by, gauze and tape ready. Once I knew exactly where to reach for my supplies once I got that flash, I was better able to concentrate on getting that vein

What do you have to lose? Try it and if it doesn't work out you have a wealth of experience that will get you back into a hospital.

Well, for some reason, they must feel that they are "not enough" and need to inflate themselves to others.

RN transports on monitor if patient is going to ICU or stepdown. Otherwise, we call transport. BH is escorted by Security

Take one day at a time, one step at a time. You will learn tricks, learn your time management. Nothing is easy when you first start it. I remember thinking that if I just didn't have to put so much thought into EVERY little task, I wouldn't be so overwhelmed. And as time goes on, some things become automatic. I don't have to think about priming an IV line, I just do it and while I do, I have some brain power freed up to plan my next tasks, or process data on that patient, or whatever I need to do.

I started in Corrections and love it. I'm in a big jail with a couple-three thousand inmates. I've moved to a hospital now but keep my part time at the jail. The only regrets I have is that as a new nurse, I didn't use the more invasive skills like NG tube, urinary caths, PICC line changes, drips. But the jail was exciting enough that I was bored in the hospital except in the ED.

I'm sorry to hear what you have been through--you are a true survivor! I'd look into a refresher course so you can show employers that you are ready to hit the floor. Also, leverage your nursing contacts, the people who know you. They will have insight as to openings that may work for you and be able to recommend you. You may also look into a staffing agency and get your feet wet with flu shot clinics, wellness fairs, clinic work, etc.

Depending on the facility: blood draws, IV's and lots of wound care.

In two years, I witnessed one bad situation, which I reported. An officer lost their job because of it. I had some blowback from Security for a month or so, but the majority of the officers were as appalled as I was. My company (a contractor) stood by me the entire way and did everything they could to support me.

I can hear the response...."No, you need to learn how to do it"

The evidence is going to be eaten, so she should followup with an email to HR :)

You'd get more response in the Corrections forum. I have worked for CCS and in corrections. I went in as a new RN and loved it. A lot of people do it for a year of experience and then move on to a hospital or other type of nursing. I LOVE corrections, you often get to do things that are not commonly done by nurses because many corrections areas are essentially run by nurses with MD/providers on call. I've seen a lot of things that I don't imagine I'd see in other places, except maybe the ER. Correct Care is a company that has expanded rapidly in the past couple years, buying up other companies and signing contract after contract. There have been growing pains--scalabilty issues with the EMR and training are huge ones. There hasn't been much support from corporate, at least until my facility reached critical mass, unable to keep nursing management or nurses period. They do have someone who's job it is to troll the internet and "deal with" any negative press, though. I don't work for the company anymore, so threaten away CCS! The computer system they use is what I'd expect a high school senior's final project would look like. It is not intuitive, is unreliable and I think was designed with the theory of "why do it with one click when you can make them do it with five?" I know people always complain about the EMR, but truly....I've worked with several now and NONE is as bad as ERMA. But overall, unless you are in TN, the tone of the site is driven by local management, not corporate. Which in this case, is a good thing, I think. Eventually, CCS will figure out how to be big instead of small, they are learning. But overall, you can't judge the site by if CCS manages them because the local management is more impactful than the corporation

So, the outcome at my facility is: they recognized that it is impossible to always adhere to the rule. Night and weekends don't have coverage. As long as we fill out a shift exception report (every shift with no lunch--HA. A lunch would BE the exception) then they consider us in compliance

Heroin, meth, ETOH

HAH! What's lunch? I grab what I can at the desk during lulls. All of a sudden, we are getting instructions from up on high that we must clock out for a 30 minute, uninterrupted meal break away from the unit. If we don't, they threaten to not pay us for the whole shift (which they would never get away with). Also, we are not allowed to leave the perimeter during our shift at all. The issue is that as the senior position, I'm responsible for charge duties and all emergency response in the facility. Often, I'm the only RN there and there is never another RN who is trained for this position. So, regardless of if I'm on "lunch", I still need to monitor the radio and deal with emergencies and urgencies brought to me. That doesn't sound like being "away from the unit". Worst case scenario I think of is running to an emergency off the clock and then getting sued and having the company throw me under the bus saying I wasn't really working because I was clocked out. This kind of thing is exactly why the officers sued and got paid breaks. How does your facility handle this for the nurses?

I started in corrections out of school and loved it. Just try to go into the water slowly. Start in sick call, pill line, clinic before letting them give you responsibility for emergency response

For opiates, mostly it is symptom management and VS monitoring. If needed, IV fluids. But it is the ETOH and benzo addicts we worry about dying.

In my world it would be Tweaker Tuesday, Seizure Saturday and Scabies Sunday

I've never had anything like this happen in my long career until recently. Job offer made, resignation given, and a week before my start date, the manager calls to tell me that they can't pay me the salary we agreed on. I ended up taking the job for a significantly lower salary. No job vs. a lower paying job with a (now) questionable facility. Is this kind of renigging/renegotiation following an employment agreement something common in healthcare? This is only my 2nd job as a nurse

Pink and frothy sputum = PE Wash anything "cleanest to dirtiest" Never round med calcs for pediatrics If you push Zofran IV too fast, the patients will feel genital burning. Never saw this one, I always push it slow. If you push an IV H2 acid blocker too fast, the patient will get hiccups. Again, never happened to me.

I was once asked "You aren't very smart, are you?" My response "You aren't very nice, are you?"