AlisRN

http://www.nursingsociety.org/sttievents/leadershipsummit/documents/the%20high%20cost%20of%20lateral%20violence%20in%20nursing_stanley_4-24-2010.pdf statistics show that lateral violence in nursing causes most new grads to quit their 1st nursing position wsithin 6 months to a year. sorry to say but, if you believe you are not part of the bullying / lateral violence problem, your post calling another nurse ignorant is considered lateral violence. so, you, my friend, are definitely part of the problem - that's why you don't see it. so you see, i am not the ignorant one.

Ashley, I'm going to assume from your profile that you are very new to the nursing profession. Someday you will see what people put their "loved ones" through just to gain financially. Trust me, someday your naivety will be replaced. As a nurse, we must always advocate for the patient whenever possible but it seems our hands are tied in situations like these. Have you ever seen someone who's been in a coma for 9 years and hasn't responded to anything but PAIN since they were admitted to the hospital? I'm guessing the answer to that would be a "no". All their muscles have contracted (even with daily passive ROM exercises). They cannot even wake up and tell you to stop the nonsense and take them off the vent & feeding tube. After 1 year, you have a better chance of winning the big lottery drawing than to see a comatose patient awaken and even less of a chance of that patient waking up and actually having ANY quality of life whatsoever. Someday you will see what suffering some are put through just so families either "feel better" about themseon the lookout lves or "collect a check as long as mom/dad's alive". Since we are supposed to be advocates for our patients and 'mandatory reporters', you cannot always assume the best in people - you should always be suspicious of the other side to protect your patients! Also, since you work in a PICU, you really are working in an entirely different situation and really have zero cases that would even resemble the comatose patients for which I care 40 hours per week. Investigations were done by the social workers on these long-term comatose patients' families and family "let it slip" about the checks being deposited into the account of their loved one where they promptly remove it as soon as the government deposits it. These family members NEVER visit unless called in by the doctor. They PRETEND to really care while their "loved" one's pension and/or social security is paying for that new car s/he's driving as well as anything else they can obtain with their loved one's money. Since Medicare / the government take so long to even INITIATE their own investigation into this kind of situation, there is absolutely NOBODY to truthfully act as a healthcare proxy in the best interest of the PATIENT, instead of the financial well-being of the family. So, these patients are allowed to suffer unnecessarily while their family are out having a grand ol' time. And thank you to everyone who understands exactly about which I'm speaking. Alissa, RN in MA

I am not making assumptions - This has already been proven.

right, I've seen so MUCH lateral violence in the workplace during my clinical rotations (NOT where I currently work), that new grads actually RUN away from the job. And they WERE great nurses with a solid foundation upon which to be built a really awesome seasoned nurse - but were constantly belittled and whispered about because apparently should have known every single hospital policy 1 month into their jobs, among other things, NicuGirl. And as far as the response stating what I said was bullpuckey (whatever that may be - not in my vocabulary). If a graduate is precepted and orientated WELL by a preceptor, then there shouldn't be any problems. Perhaps the preceptors don't know how to teach and that's why their preceptees are incompetent? That's what my boss says anyway (nursing director). You have to have a certain personality to be a good preceptor and perhaps you two should not ever be placed with a new grad. IMO, if a strong preceptorship program is instated in a hospital, then there is a net GAIN in training a new graduate nurse. The hospital where I work has a great preceptor protocol and I've never been in a hospital full of mainly female employees (the hospital is roughly 85% female, including the president and VP's) where there is almost zero GOSSIP or whispering and secrets and everyone works TOGETHER and actually WANTS the others to be GOOD at their job. And I know I'm correct about new grads leaving after 6 months to 1 year - it's usually due to the "seasoned" nurses trying to eat them alive. I've heard stories time and time again. Remember that new graduates can sometimes teach the seasoned nurses something new. Open your ears and your hearts and lift up the nurses around you rather than try and beat them down. Nursing is a difficult job and having a bad attitude only makes it that much more difficult. SMILE Love to all the hard-working nurses (RN's, LPN's/LVN's, CNA's, Nurse Tech's, etc) and remember it's a TEAM effort, not an "I can do it better than you" effort.

I currently work in a LTACH. One side of my floor has an average of 18 patients at any given time - 17 of whom have tracheostomies and 100% of the trached patients are on ventilators for at least part of the day (usually nighttime, roughly 75% of the ventilated patients require 24/7 ventilation). There are 4 who are in a chronic vegetative state and typically have been that way for years. I believe all of these 4 have their years-long hospital stays paid for by the government (Medicare/Medicaid) while their 'loved ones' are at home banking Social Security checks and/or pension checks. All of these 4 DO react to pain, but that's about it. If you've ever seen a comatose patient with a look of horror on their face while you're working on them / suctioning them, you know what I mean. These are the saddest cases I've ever seen - WHO is looking out for their best interest? Shouldn't SOMEONE? I mean, I probably have a better chance of winning millions in a lottery than to see any of these patients wake up and have ANY quality of life. Since family has no intent of allowing their family member's suffering to end, shouldn't someone investigate the fact that the person's social security checks are being used for themselves and government money is being thrown away for keeping these poor souls "living" with feeding tubes and ventilators? If these patients could wake up for 10 seconds just to say one thing, I almost guarantee it would be "Please, let me go in peace!" I know I shouldn't get so involved in certain patients but it just seems like someone should take responsibility for them since their family members are using them as a paycheck. Can't the hospital social workers perform investigations and go to court to gain guardianship / become healthcare proxy? It just seems like more should be done to stop these patients from undergoing unnecessary suffering. What is your opinion / advice here? Ali, RN in MA

Well - this quote absolutely depends on where you live! Acute hospitals here in Massachusetts are phasing out hiring of LPN's AND ADN's. They allow current LPN's or ADN's to stay but are pushing them to also try and get a BSN in the future. I actually got a job as a new graduate at a Long-Term Acute Care Hospital (LTACH). The average stay of our patients is about 30 days and is primarily a respiratory hospital. Lots of very sick, medically complex patients - lots of trachs, vents, etc... As an ADN I was very surprised to even get an interview and then even more surprised to get a job offer. I found out a bit later that they ONLY hire ADN's IF they graduated with honors. Thank you Lord for that "Cum Laude" on my diploma! lol I absolutely plan on going for my BSN after I work for a year. I just needed a little bit of a break from going to school! And,I was even more pleasantly surprised that I would be making $30/hour for the night shift after a 2 week orientation and another 4 weeks of preceptorship. So, my point is, TRY to get the BSN if at all humanly possible. It will save you a lot of trouble in the long-term (took me 6 months to find a job after graduation). However, if you're willing to look "outside the box" and not just apply for the local acute-care short-term stay type hospital, you might just get an awesome experience. Once I get my BSN, because of all my trach & ventilator & tube feeding experience, many of the nurses who start where I work wind up in an ICU setting - which is where I really want to be in the long run. Good luck in your Nursing education! Hope you love it as much as I do P.S. Nursing is my 2nd career and am loving every fast-paced second of it! -Alissa:heartbeat

Take ANY job you can get. If you become licensed after graduation and then don't get a job for a year because you're waiting for the "right" opportunity, then you'll be overlooked and perpetuate your joblessness. Alissa

Jules is right. MS is unpredictable. It's also a subject that is close to my heart - my only sister has it. She was diagnosed almost 15 years ago and still works 30 hours/week as a veterinary technician - pretty much a nurse for animals. Get a good neurologist who specializes in MS and get on a treatment ASAP to prevent progression. Women who get MS tend to have a much slower progressing disability while men are usually not so lucky. And, if you want to go on to be an RN, do it! Do it NOW! Don't wait! The higher your education, the more job opportunities you will have. You can always teach if you get your masters and cannot work the floor anymore! Take care, Alissa, RN in MA

I work night shift as well - but our nurse to patient ratio is 4:1. On one side of the floor it is usually 3:1 and the other side is usually 5:1 but that side also has 2-3 CNA's. I keep a piece of paper sectioned off with 1 section for each pt & write down in abbreviations (of my own choosing) everything I need to chart so it's sort of a short-hand. Then, when all assessments are done, I go back and put it all in the computer chart. You can make up your own "sheet" on Excel or Word as well so you can just fill in the blanks as you go - if you know everything you need to chart. Alissa, RN in MA

when renewing for your CPR, go for the ACLS instead of BLS. And I'm also in MA - so try here... http://www.ehow.com/list_6643901_new-nursing-continuing-education-requirements.html

If it's not something you wish to pursue, and it sounds like you're not confident in your abilities to do the job - then you should tell them that's not the line of work you had hoped in which to specialize. But, the more specialized training you get, makes you more marketable in the long run, you know? IV access is IV access - and PICC lines are really not all that complicated. It's a skill - if you're good at IV's, you'll probably be good at inserting PICC's. Be confident that you can learn the skill - nurses in my facility insert PICC's all the time :) Or politely turn down the job, it's entirely up to you. Alissa, RN in MA

Actually, if you drink Visine, it will give you diarrhea (as seen in the movie, The Wedding Crashers lol) Alissa, RN LOL

I have 22K in student loans from my RN schooling - it's about $220/month. I have another 8K from a previous bachelor's degree left, cost is about $62/month, so just under $300/month for 30K in student loans. Alissa

So, NicuGal, were you never a new graduate nurse? lol I believe, in the long run, if a new graduate is trained and is treated like a NURSE by the other nurses and not like a lower life form on the floor, that nurse would be more inclined to feel included in the TEAM on the floor and, therefore, the new nurse would be more inclined to stay on after orientation and beyond. It's the nurses who forget that they were once new graduates that create the problem of losing money on hiring new graduates. I think if lateral violence and bullying among nurses is addressed in a hospital and protocol was in place to prevent it, many new grads would stay on, making it worthwhile for hospitals to precept new grads. Alissa, RN in MA

there's no PAY difference, no. But it's a LOT more difficult to FIND a job with an ADN than a BSN.