EDNurse74

I recently transitioned into a Management role at my facility. I would like to start a Masters program this year and have been doing my research. I really like the curriculum of the Masters in Healthcare Administration programs. I have found one online dual MSN/MHA program that is doable, but I am not crazy about the MSN curriculum. I currently work at a Magnet facility and they have announced several promotions of current staff that have BSN, but their advanced degrees have been MBA and MHA, with no associated MSN as I have asked them. It seems in my facility the MSN is not required to advance, although I was under the impression Magnet facilities required MSN for advancement. As long as we have our BSN, my facility seems to be OK with whatever advanced degree we choose. In my 5 year plan I will probably be leaving the area I live in and will move to another state. I also do not have my heart set on working in Magnet facilites, but I do not want to rule myself out for a decision I am making today. For other Magnet facilities do they hold applicants to having that MSN in addition to any other advanced degrees for management (more in admin side) positions?

I am new into management and have decided to go for a MHA in the fall rather than MSN. I did my BSN online and honestly felt like I did not learn anything that helped me become a better nurse, I was just jumping through the hoop of getting my BSN because I worked at a magnet facility. I am in a different magnet facility and after looking at the courses I feel like the MHA would help me more in my current position. I also feel like with the MHA, I have the option to leave a hospital and go to a management position in another sector of healthcare.

All the travelers here get paid less than staff, but they have housing provided. Hawaii has the luxury of lots of people wanting to do assignments here so travelers do not get paid that well. Hospitals do offer travelers positions tho, so it may help to take an assignment and hope there is an open position when the contract is done.

I managed to get a job in Hawaii after getting 5 years experience working in the mainland. I originally applied as a new grad and got nothing from Hawaii, then I tried again after one year and still no bites, then again after two years. Not to bust your bubble, but a lot of people that graduated from nursing school in Hawaii and moved to the mainland for jobs came back to work at Queens or Queens West and they all had several years experience. Good luck whatever you decide

Being a psych nurse most of your options would probably be on Oahu...not sure if you have your heart set of Maui.

Had a guy come in several times ℅ pain and saying that he has taken so much Tylenol and it is not relieving his pain. So when we check his acetaminophen level they are thru the roof. Doc wants to give him Mucoyst to save the ole liver. The patient refuses the mucomyst until he gets a 2mg dose of Dilaudid for his pain. I mean its like the guy is holding his liver hostage for pain meds. Saw him a month later and same deal, with how much a tool he was with yelling and cussing us out I say let the Tylenol work and put him on a liver transplant list so he finally has some legit problems...i know its mean but he was exhausting

Reread your post, multiple times and post #5 was not rude either.

We used to get the influx of Suicidal Ideation pts when the weather got crappy. After a few days of rain the homeless pts that did not want to necessarily go thru CT scans, lab draws, etc would claim SI instead of vague abdominal complaints. Then they at least could boss the psych tech around, get a few warm meals and maybe even and shower if they proved that they could walk with a steady gait and not acting like a total A hole. One guy used to come in monthly claiming SI and got to the point that if we told him to wait in the waiting room because it really was busy he would run out to the street and lay down in the street which would send security out there dragging him into the ED and a bed in the hall for his suicide attempt which I personally saw as him having a control issue, lack of patience, and chronic abuser of the system. I honestly doubt he would have flung himself in the street if he actually saw the bus coming down the street.

I don't think the OP's messages were rude, they were correct and to the point. The majority of pts I see with that list of allergies as well as Toradol usually have the suspicions confirmed when the MD checks their name in the DEA database to see how many hits the person has had for narcotics. Then comes the excuse of I dropped the bottle of 120 vicodin in the toilet on accident....yesterday. But no mention of the three other 30 day prescriptions from the other 3 docs.....just sayin.

You've got the experience that it should not be a problem, but I would for sure touch on the fact that you will be currently pursuing your BSN since up here it seems like everyone either has their BSN or is planning on starting it soon. Pay is different between the Bay Area and Sacramento, so it depends on what you are looking for as where to move. Living in the Bay Area all the extra money goes towards housing/rent.

I just interviewed for a large hospital in Miami and base was $28.45 with 4 yrs exp and BSN. More than likely going to pass on the offer cause I doubt they will come up to a point where I can actually afford live in the area and not have to commute in. I agree its depressing/sad/travesty knowing the nurses in Florida work just as hard as we do, or even twice as hard with no pt ratios for half the pay. Maybe gulf side is a little more realistic since houses are cheaper??

I spent months looking for just that type of job because I wanted to get out of the bedside and into case management. Everything I saw required a case management certificate or several years of case management experience. All I have is several years of ED experience and my BSN. I would have jumped at the chance, but instead I am now in Northern California, still at the bedside and still looking for case management jobs that don't require case management experience.

The good: We have this homeless learning disabled lady who comes in all the time and she does not know how to speak in an inside voice. So she usually yells "I want a pregnancy test" for the first 10 visits, Then it became "I want a chlamydia test", now it is any sexually transmitted disease she can think of The Bad: Drunk guy who calls 911 from the bar to bring him to the hospital so we can discharge him home with a cab voucher just so he can get home from the bar. I had a real yelling match with him in regards to this one night and the local PD came and picked him up and drove him to the edge of the city so he could walk home the few blocks in the neighboring city. Instead the drunk guy calls 911 again and ends up in our ED. I knew from the call that it was him again so PD took him to jail the second time around. The Ugly: The 500 pound guy who has not left his house in 3 years comes in today because he is afraid he has HTN. I mean wouldn't you have been concerned about this ummmm 200 pounds ago?!?! And why does every FB stuck up someones rectum always happen in the shower? I mean who keeps cucumbers, light bulbs, flash lights, and soda bottles in the shower and how do you always manage "to fall" right on them without them breaking first?

Hello, I currently have 4 years nursing experience all of which has been in the Emergency Department. I also have my BSN. Recently have been looking at transferring into Quality or Case Management but I am running into the problem of lack of experience in those specific areas. All the jobs I am seeing require several years experience in Case Management or Quality Coordinator. I am fine starting from the bottom and working my way up but how do I find that job that is willing to hire me, or is it luck to find the person that is willing to give me the chance. My question is how does anyone break out of bedside nursing and into management or case management or Quality compliance?? Aside from getting my Masters degree and educationally being qualified for the job how to I break into this field?

I just registered for my last semester at Chamberlain for the RN-BSN program, and have two friends already graduate that program. No clinicals, just a lot of papers.

Ok two questions, two scenarios, two answers, one of which I hope is what you were asking for. A: If you have two fluids and you decide to Y site them at the most distal port from the bag of fluids (or the port closest to the pt) you would need two channels attached to the pump with each pump set at their med and infusion rate. B: If it is a medication that is piggybacked into the mainline (such as the line attached to the fluids) and it is Y-sited above the channel you basically need to have the primary (or fluids you want infused first) to be hanging higher than the other infusion. So set the pump primary and secondary as appropriate Or just go with good old gravity and hang the bag you want infused first higher. If you want them to go in at the same time (such as when MD orders 2L bolus and I just piggyback them) then hang them level.

I applied at over 200 places (I quit counting at 200) and spent six months looking for work when I was a new grad 2 years ago. It literally was a full time job looking for a full time job. I got lucky and finally landed a gig. The stars just aligned right, it was the right application at the right time. I took the job, didn't care what dept or what hospital. Just keep looking and keep applying your number will come up. Good Luck

I am doing Chamberlain right now even though my job has a contract with Western Governors. I had two friends do Chamberlain and they had no complaints and so far I have none either and have been happy with my experiences during admission and financial aid.

Not sure how different North Carolina is from California in regard to license but here is what happened with me and my story: I got my license at the end of June 2009 and had to renew it Aug 2010. I was told by the BON that they go by you get 2 birthdays before renewal. So basically I just got my license and had a birthday, then next summer 13 months later I had another birthday so I had to renew my license after only 14 months of having it. A buddy of mine had her birthday just before she got her card so her first renewal was this year. For the first renewal they don't expect us to have all those shiny CEU's. From what I recall there was some box on the form to check that says something to the effect of it being the first renewal. Had I known that I would have waited the extra few weeks before taking my NCLEX since I didn't have a job at the time anyway.

When I first started at my current facility I would try and get taxi vouchers and soon discovered we had a 5 page list of pts that have abused the system so much they were not allowed to be given taxi vouchers. I don't have time to spend 10 mins scanning to see if your name is on the list. So now I just give some lame excuse about getting management authorization (which we technically need) and a bag of food to tide then over. If that does not work, we have security "motivationally" discharge the patient. Some times they just come right back into triage claiming suicidal ideation and we get to start all over again.

I would so spend that last shift sharing my opinions freely, esp with the frequent fliers that always start off super nice but you know they are gonna go postal when they don't get enough dilaudid. I will just roll their gurney to the waiting room if they give me lip. Then I have this one night shift charge who is just MEAN, MEAN, MEAN. She dislikes physical contact, so I would give her the biggest bear hug and not let go until she becomes a psych patient herself and I would say "XXX are you happy?? Cause you need to tell your face if you are." She NEVER smiles. Oh and I would park in the MD parking spot too.

Practice, practice, practice. I swear some nurses have magic fingers where they can find veins and put an 18g while I would have used a 24. Now I have my hit and miss weeks. I also have my bloody weeks, which I am going thru now. Every stick I do is messy for some reason. It is the same moon that makes the pts weirder that controls this, I swear!

Yes be nice to the ancillary staff, I appreciate all of them. This way when I need something from the STAT they will usually be there to help me. Also figure out what docs are just plain mean and which ones are the nice teachers. I have a few meanies where hald my charting is covering my ass cause the doc does his cookbook medicine and sometimes just orders completely unnecessary stuff. Other docs will take a few minutes to explain what they are looking at or why they picked one medication over another. Help your other nurses when you can, even if it is just starting a line on a STEMI patient. Hopefully they will jump in and help you when you have that crashing pt. Eat fast and pee fast too :)

Most Ridiculous: Pt was about 600 lbs and hadn't left his house in about 3 years. Well that day he decided he might have HTN. He had no c/o symptoms. But why after not leaving your house for 3 years and you are 600 lbs, why today do you decide to go to the ED to check your blood pressure, why today?? Cutest Story: 5 year old male had an undescended testicle. He just knew it was not where it was supposed to he. So he gets a lump in his neck and presents to the ED saying "My ball is coming out of my neck." Mom and I had a good laugh on that one. Funniest Story: Grandma comes in stating "I just feel weird." VSS, A/Ox4, looked great. Ate dinner, was normal, and ate a brownie that grandson had made for desert. An hour later she is "feeling weird." Well grandson comes in and tells up the brownies had weed in them. Granny was high, grandpa was ******, and grandson was grounded.

I've been an RN for two years now and its all been in the ED, just by chance. I'm also the nurse that fell through any and all cracks available: The Director that hired me quit before I started (and she had a plan for me to take classes and attend a few local conferences) so all I got was 16 week preceptor, then drop kicked on my own. I've learned to be loud and ask for questions/help/etc and who cares if everyone thinks I'm brain damaged. After a year, got another job in an even bigger Trauma I ED. One again classes promised, blah, blah, blah. The ED internship program this place has is for RN's with at least 2 years exp that want to transfer into the ED. So they have a preceptor for 16 weeks as well as classes. So here I am with less exp than theses nurses and not taking the classes (officially) I just sit in them on my own time when I have the time. I figure screw it, its my job, I'm taking the bumpier road. But when I meet up with my old nursing school buddies that are on the floor (and did have classes) I feel like I can run circles around most of them cause I still need to remember everything from nursing school AND I'm a whiz at starting IV's. My advice: don't be afraid to ask questions. I just had an experienced nurse come up to me asking about how to set up syringes on the Alaris pumps, none of them could figure it out. I have been lucky enough to get lots of sick kids so I knew how to set it up and it's because the pharmacist on the floor took the time to show it to me once.....so also ask the ancillary staff questions too!