travkitty

I guess I forgot to add that this bullying is making my physically ill from the anxiety & stress. I get nauseated on my way to work. I can't do this for 3 more years. Sad that the climate with dealing with bullying in nursing seems to be just to take it rather than have someone fix the problem. My husband is encouraging me to go to HR, as he had a problem manager, went to HR & it fixed things. That manager is no longer a problem. Obviously, I'm skittish of doing so in my case because there are so many horror stories of retribution....even though legally there's supposed to not be any. My husband also said to look for a different job with another hospital if need be. It would hurt, but paying back the tuition isn't the end of the world....as well as paying most of the upcoming tuition. He said it's only money & he hates seeing me coming home a basket case & in tears.

I have a manager who is the textbook of psychological bullying. She constantly creates drama by telling me & others things about others, spreading gossip about people having nonexistent affairs with each other, admonishing you for doing exactly what she told you to do that morning & denying she even said it (even sometimes with witnesses). I was bullied by a unit secretary as a new grad & feel the same type of anxiety as I did then, except I could go to my manager (a different job & company) about it, which I did. Someone else went to my manager's manager with our concerns (it's not just me, though I'm the only one saying it's bullying). That manager basically said she didn't want to hear what our concerns are & that she would back the manager no matter what. I love my job except for my manager. It has the location, hours & co-workers that I get along with & we've gotten very close. I'm in graduate school, so my schedule & hours is very important to try to keep consistent. The rub is that there are years between openings in my position, so a complementary transfer is almost impossible. I'd likely lose my great hours for school & perfect commute if I transferred within my current company. However, I have gotten tuition reimbursement from this smaller hospital & if I left before my obligation, I'd have to pay back 10K+ that they have paid already. I'm stuck in a toxic environment, it seems. My husband wondered if I'd even have to pay back the tuition if they can't accommodate a complementary position given that I am in a hostile work environment. Has anyone encountered this? I know I should probably go to HR with this question, but if the boss's boss doesn't care about me, should I even expect to not see brushback if I pursue this?

I'm currently in the USI ACNP program, but I'm hearing from people who just graduated with FNP & ACNP who are having trouble finding jobs. I've always had an interest in psychiatry, & would likely be a psychiatrist if I had gone to medical school. I'm just wondering what a day in the life of a PMHNP might be like. I hear they are in mega demand in many parts of the US (esp Florida, where I wish to relocate down the line).

We've had people check in for "cramping" after drinking mag citrate. *facepalm*

1600 in a frequent flier in our ED & ICU. Type 1 Diabetic who just insists on not using his pump. Every other week he comes in at death's door, we get him stable, ship him to ICU for a week with his sugars looking awesome, then he's back over 1000 a week later. Idiot. When EMS calls with a 20-something, male diabetic, we're all like, "I bet it's Fred (name changed)." I feel like smacking my head against the wall each time. So many resources for someone who really doesn't give a crap. I posed the question of ordering an inpatient psych consult for him next time because he seems passively suicidal if you ask me.

I applied for the Acute Care NP program for Fall. Does anyone have an inea of how long it takes for the application to be reviewed & to be accepted/denied?

Ah. That option wasn't there when I went through the accelerated program in 2009-2010. So, can't offer you any advice as I don't know how it is.

sbain51, are you traditional track or accelerated?

I just started the certificate program with UC-Riverside. So far, so good!

*standing ovation*

OMG, Christy1019, this is a fantastic idea! My ED needs this badly.

From what I understand, though I wasn't there, she did rouse with sternal at med time & the nurse called a raid response. The MD ordered an ABG. During the ABG, the pt must have responded good enough, & the ABG indicated, that she was okay to just sleep it off with q15 checks. I'm off today & I haven't gotten any calls from work, so I'm assuming all is well at this point. When I sent her, she would rouse to less than sternal, satting fine on RA, which is absolutely what I see on patients who get the same meds. All the same, looking back, I probably should have given her half of the amount, with the rest ready just in case. I admit, when I was a floor nurse, I would have freaked more easily than I do now in the ED, just because there is sick & then there is SICK. Sometimes I forget that psych or floor nurses haven't dealt with possibly unstable or out of norm patients as much, therefore they are likely more apt to pull the trigger on a rapid response.

So, today in my ED I was in charge of our psych holds. One female, who I've had before, & is normally a smidge anxious but always able to be talked down, was quite over-the-top on the manic spectrum today. She was unable to stay in her room & would not stop talking, not to mention not listening. She did take 1mg Xanax PO willingly, but it seemed to have no effect. At one point, she was almost uncontrollable, almost hyperventilating, & the MD ordered 10mg Zyprexa IM & 2mg Ativan IM. I have given this mix before with no issues. They go into deep sleep for almost the whole day. She got the shots, then did fall asleep. Rise/fall of chest was fine, RR was 14, BP of 98/54 which can be normal for her. 97% on RA. Lo & behold, her psych room became available & report was called. They were told that she was sedated because she was agitated & could not be de-escalated or redirected. When we went to place her in the chair, she was obviously REALLY sleeping, but did rouse with verbal stimulus & squeeze my hand when asked. She was a bit mumbly & fell back asleep quickly. Again, this is what I usually see in the first hour of getting this mix. She was sent to psych with a PCT & security. From the report I got, she roused with sternal rub & mumbled when they arrived to psych. Again, this is pretty typical. They almost wouldn't take her in, but they did. I found out that they rapid responsed her about 3 hours later when she only stirred with sternal rub for her evening meds. They did an ABG, which apparently got a much better response from her, but again, she went right back to sleep. ABG was nothing remarkable for someone in a deep sleep on those meds. The only thing atypical is that I've never sent a patient over to psych so soon after sedation. In fact, our psych beds were coming open about 15 hours sooner than they normally do, so I've never had this issue. Do patients not get sedated for agitation on psych floors or something? It just seems like someone freaked out there, so now I'm wondering if they will attempt to write me up. They did accept the patient & the rapid response was 3 hours later. I just have never sent a sedated psych patient to psych before (& maybe that psych nurse never received one before...don't know). Just picking some brains.

I had a critically ill patient in the ER, intubated, extremely hypotensive, even after 10 bags of fluid & 4 units of blood. It was about 6:45 pm, shift change at 7pm. I was basically stuck in this room with the patient until he was ready for a head CT & then went up to ICU. An RN needed to stay with him, but he was my patient & I was with him at the time. I asked my PCT to grab me something like a flush or something innocuous & simple that would take 5 minutes. Her reply, "I can't help you...I get off in 15 minutes" & scampered away. I imagine my jaw may have literally hit the floor. Basically, I ran to grab what I needed & hurried back, infuriated. Of course, I was so busy in the meantime that when the patient was finally upstairs & I spent my 2 hours catching up on the charting AND taking care of my other 3 patients who had been waiting patiently while I semi-stabilized my critical, I was too exhausted to say anything to anyone about it...& it was like 11pm, so there wasn't anyone around to tell of any consequence. This tech is known for being lazy...& a know-it-all. It makes me appreciate the vast majority of good ones. I wonder if she would have given the same excuse had my patient needed CPR at that moment, "I can't help. I get off in 15 minutes."

You could always meet in the middle & find a job that offers a mid-shift. I am a night owl, but 7p-7a messed with my real life too much. I can't function at 7a, so that shift was out. So, I found my perfect 3p-3a ER gig. Problems solved!

I got the HRSA in 2009 & didn't have ANY volunteer experience. Things may have changed since then, but it was based on your EFC & then a lottery. I don't even recall ANY essays. However, that was several years ago, so I may have just forgotten. Sounds like the process has changed since I did it. I do know their criteria for what constitutes an "underserved" job has gotten tighter. When I graduated, just being in about ANY hospital would satisfy the requirement. Now it's only hospitals in certain geographics OR non-profits. Never could have gotten through school without it, but I'll be glad to be released from my "repayment" come September.

I just wonder if it's even worth getting the Master's if the certificate is enough.

I'm fairly certain I want to become a Forensic Nurse. However, I'm torn about whether to go about it through a certification program or go the Master's degree route. Obviously, the certification would likely take less time & less money, not to mention no GRE. However, the MS degree would offer more prestige & maybe more income, but not sure. Can anyone offer some input on this? Either path is going to be via online learning (except for clinical learning) & will be done part-time while I continue to work full-time in the ER. Thoughts?

No, I can't give you anything for pain until the Doctor sees you! Actually, I did say that, but outside the room I said to myself, "Why the frack do people think I, a nurse, can give them a narcotic before any tests & any doctor sets eyes on them? *****

I'm an atheist RN in an ER at a Catholic hospital in a VERY Catholic city. I get letters all the time, with compliments, telling me I'm the best nurse ever (I'm not, but I think I'm above average) & they have NO clue that I don't believe. The key is being respectful & compassionate of all faiths, even if you don't share them. That can be difficult, but can be done. We have a Jewish MD on staff...wears his yamaka every shift, & no one ever complains about his faith, to my knowledge. He's very good with respect toward other beliefs, too & a fine doctor in most regards. Not the best communicator with nurses, in my opinion (can come off as an ass to us) but I cannot complain about his care for patients. That's another thread, though. :)

I had a year of med-surg & had 8 weeks of orientation at my ER job. My preceptor says new grads need at least 12 weeks or more, depending on the nurse, of course. Many new grads are only given 4-6 weeks, though, simply because we are short staffed & need them out on their own. They didn't have preceptors with as much seniority & experience lobbying to get proper prep, though. Mine was AWESOME. I didn't know everything, but I was ready enough & my preceptor knew I'd be smart enough to ask questions & ask for help when I needed it. My ER no longer hires new grads, though, unless they have ER tech or paramedic experience prior to nursing. Are any of them "set up to fail?" Not in my ER. Sometimes our staffing is crappy & it's just not a fun night, but 90% of the time, if you ask for help, people willingly come to help, or instinctively know to help. We all know each EMS patient that comes in, via Charge nurse, so we can help if our patients are stable. Perhaps not all ERs are like this, but mine is, which is nice. I know, if a patient crumps, I'll have plenty of hands & brains on hand.

Why won't BJC hire you? As of August 2010, they were hiring new grads like crazy. I know everyone in my class at UMSL had jobs waiting for them at places around St. Louis.

As a former med/surg floor nurse, I used to get mad when an ER admit would arrive during change of shift. Yes, it can be dangerous. However, now that I'm in the ER, & work 3p-3a, I sent the patient up when they & the room is ready. My CSN is on my butt to get the room clear for the next patient. 90% of the time, I don't even notice what time it is. Then, after I give report & send the patient up, I look at the clock to see it's right in the middle of shift change on the floor. Woops. I've worked on both sides. I wish I had the time to sit on a patient until after shift change.

I have a couple of classmates who work there now & they say it's unsafe now. They are looking for a job somewhere else.

It's nurses talking about how dangerous it was when they worked there, like they felt their licenses were forced to be put on the line every day.