Clovery

Callbell goes off for the umpteenth time... "Yes, Can I help you?" "Why don't you have bendy straws?" "We do have bendy straws" Points at bent straw in cup. "Well they don't bend enough. Do you have straws that bend beyond a 90 degree angle? It's hard to drink laying in a bed." I just laughed and got a handful of straws. This was an observation chest pain patient, not even admitted, who was independent at home just hours ago. We were just going to put him on a treadmill stress test and send him home in the AM.

Of the 5 different places I have worked, all have had a minimum requirement for per diems which generally includes two weekend days per month (not necessarily on the same weekend) and one winter and one summer holiday. Some facilities extend the holidays to "special days" that aren't official holidays like easter, mother's day, halloween, etc.

Which FAQ? Here on the site or HIPAA's FAQ? Do you have a link? It's more than out of curiosity, it's clinical learning experience to follow up your assessment of the patient and the final outcome.

Is it a HIPAA violation to look up the outcomes of patients you cared for? For example, you had a patient on a med-surg unit who you transferred to ICU. You come into work the next day wondering about what they did for him and what was the outcome (out of concern for the patient and for your own knowledge). Is it a violation to continue to access this medical record if you previously cared for this patient but transferred them to another unit? Thanks for any answers and I apologize if this has been discussed before, I searched but didn't find anything.

I have worked on units where bedside report turns into "let me give you a long list of things to do before you can leave". I work nights and I understand day shift has the pressure of administration on their backs about every little thing (I've worked days, too). But sometimes it just gets ridiculous. Once I was giving bedside report and the patient decided at that moment to finally cough up their sputum sample into the container on their table. The incoming nurse said to me "You're going to send that to the lab, right?" I didn't want to argue in front of the patient so I just did it but I couldn't believe she asked me to take care of it. Other things like I didn't put a chair alarm on the bedside chair for the fall precautions patient who came in at 2 am and has been sleeping in bed all night. Although I have to admit getting bedside report "right" for the most anal nurses has become somewhat of a personal challenge. I prefer to give "real" report at the desk, then make rounds together, the incoming nurse updates the white board, checks the IV, asks about pain, and mentions the patient's upcoming procedures and treatments. I think this is good customer service, gives the patient the security that their needs have been communicated without wasting too much time in the room.

$19/hr? Is this a decent rate for your area? I assume you are an RN? I would worry about the drive home after working nights. I have never minded driving to work. I work 10 minutes from home now and I miss the drive time of previous jobs. Driving into work gave me time to drink my iced coffee, listen to some good music, be alone, and mentally prepare for my shift. One hour would be my limit, though. 30 minutes is just right. Now I spend just as much time walking from my car to my unit as I do driving into work. I can never complain about the short commute home, though. Especially when I have to work another 12 the next day. A two year contract is a long commitment if you find that you can't stand the drive.

I worked in LTAC for over a year. Whenever someone asks me what it's like I have to mention the poop. It's all total care patients, mostly vents. Many of them have c. diff. So basically we run feeding into their tubes and then it just streams out their butts and all over the bed. I always warn CNAs especially.... "you don't want to work at an LTAC".

My husband isn't a cop, but my mom is a nurse and my dad was a police officer.

A quad patient with a chronic infected sacral wound became infuriated with me for waking him up at 0900 to take his meds and encouraging him to eat his breakfast. He didn't want to eat so I tried to get him to take his marinol to stimulate his appetite. He only wanted his IV dilaudid of course. After I gave him that, hung an IV antibiotic, and again talked about the importance of nutrition for wound healing, he accused me of being racist. He then asked to talk to my supervisor, who I brought into the room. He told her that I was extremely rude and said "maybe I'm the wrong color for her" (he was African-American). Management assigned an African American nurse to him and I didn't have to take care of him for the rest of his stay. Fine by me.

I interviewed for a position recently, was told they'd be making decisions in a week or so. Three weeks later I got an official offer letter. Since you are past the recruiter interview stage, you don't have to worry so much about annoying the recruiter. The decision is no longer in his/her hands. I would call the recruiter, tell them you interviewed for the position and you would like to know if you're still being considered. If you get a voicemail, hang up and try again at another time. The problem with email is that it can easily be ignored. If you send the email, the recruiter might read it but not respond and then you'll be left wondering. It's best to catch them on the phone if you can. At my hospital system, it's against policy (or at least frowned upon) for the nurse manager to have any contact with applicants in the post-interview/ pre-offer stage. So you may not get a reply from the nurse manager. However it could prompt her to contact HR to send you the offer or "not selected" letter. The four hour shadowing experience sounds promising. I have never heard of anyone doing this, although it could be a form of a peer interview. Did you send thank you emails to the nurse you followed and the manager after that?

Coming from an area with a similar nursing job economy, it has been my experience that hospitals aren't hiring per diem employees who have no experience in acute care. For a new-to-acute care nurse, the orientation is generally at least 8 weeks on a full time schedule. Think about how long it would take just to orient you if you are only available one day per week. I agree with the previous poster.... look for a full or part time hospital position and leave your current job when you find one. You could easily pick up a per diem position in LTC/rehab to supplement this once you are off orientation.

One of my family members was in a medium-sized community hospital (admitted from ER with SVT). She was in the ICU on a cardizem drip and once the drip was d/c'd they transferred her to the tele unit. I have worked on a tele floor in an LTAC and vasoactive drips were also limited to the ICU.

As someone who has had numerous headaches with trying to get insurance from the marketplace outside of the enrollment period, I sympathize. Have you tried looking for a plan on https://www.ehealthinsurance.com/ ? I have purchased plans there in the past and it was easier than going through the marketplace. To enroll outside of the open enrollment period you need a legit reason. In my situation I selected a plan, and it was pending until I provided proof that I lost coverage within the last 60 days. I had HR at my job write a letter that I was no longer eligible for benefits. My insurance was activated after they received the letter. It might get a little more complicated if you apply for a subsidy, because I believe then it will still have to go through healthcare.gov. Like other posters have mentioned, it shouldn't be too difficult to find a clinic to do the necessary exam and labs for roughly around $200 for everything. Going to the department of health and family services would also work. Plan to spend the better part of your day there and show up early. They can help you get insurance through the marketplace. Don't leave until it's sorted out.

Congrats!

This is pure awesome!

I lived in Sarasota for a couple of years and I didn't like it much either. Unless you live out on one of the islands, it kinda feels like a New Jersey suburb (strip malls, traffic, and crowds) and not much like a beach town. The population is very transient with lots of older people who go there for the winter. They have a major problem with fire ants. Like... don't stand outside in the grass in one spot without constantly checking to make sure you are not being swarmed by vicious ants. There was a lot to do with Tampa being just an hour's drive and lots of state parks, museums, and nature. It was a pain to go to the beach because it's a long winding drive out and around to the barrier islands. I believe you have to be rather rich to live anywhere close to the beach. I wasn't a nurse when I lived there so I can't speak for the hospitals or the job market. I just had to check out of curiosity... Lower Keys Medical Center (Key West, FL) has some ICU positions posted. There is also Fisherman's Hospital in Marathon (half way down the keys). I used to live in the keys and would go back there in a heartbeat if I didn't have family obligations up north. Especially if you are just looking to be in FL for a few years and rent a home, the keys are awesome. And medically you'd probably see some pretty interesting things like marine life and scuba diving injuries. Although I imagine they have problems with drug seekers and psych patients because there is a large homeless/drifter population there.

I suppose I'm sensitive to criticism... I prefer to hear criticism coupled with something positive. Like "It was great how you did C but next time remember you need to do A before you do B". Or "you have amazing customer service skills and rapport with the patients, but you need to balance this better with time management." I'm definitely a hands on learner. I could watch someone do something 10 times but I don't really get it until I do it myself. If I'm being walked through a new procedure I like to verbalize what I'm going to do then get a quick approving nod or "okay" then do it. If a preceptor needs to take over because I'm doing something wrong, realize that I'm going to feel like a complete failure and be really nervous about doing this again in the future. It would be best to talk about what went wrong right away, practice or verbally walk through the procedure again, then make me do it again as soon as possible before I develop a phobia about doing that task.

You're welcome! I have been a nurse for two years now, and am finishing my BSN this month. I finally just landed a full time med-surg night shift position, which was what I wanted from the start as well. Depending on where you live, the hospital position may not happen until you get closer to finishing your BSN. I'm in New Jersey, and all of the hospitals here pretty much aren't considering ADN new grads anymore. I think that started the year I graduated with my ADN, go figure. I worked in LTC/subacute and long term acute care (LTAC) for two years. If you have an LTAC in your area, try there. It is great experience and you will learn tons. I worked LTAC for over a year am now experienced with telemetry and vents, and they usually don't care about a BSN. Good luck in your search!

Have you graduated with a BSN? It will look bad if you quit your first nursing job after only a month or two. That will be a red flag to recruiters and nurse managers that you have little loyalty to an organization. If you are a new BSN grad, it might be worth it to hold out for a hospital position, especially since you haven't even taken the NCLEX yet. LTC/subacute positions aren't too hard to come by. I have worked 11-7 on a subacute unit as a per diem. They offered me the full time position I was covering but I had to decline. There was very little actual nursing and I felt like I was more of a nocturnal secretary. That shift you will spend the majority of your time doing chart checks. There may be a few 12 am meds and then there is lots of omeprazole and synthroid to hand out in the morning. My advice would be to take the NCLEX and keep applying at the hospitals. Be flexible about the hospital shift... Some nurse managers prefer to start new grads on days vs nights because there are more resources available to you. If you are applying at subacute then look for 3-11 positions. This shift gets the majority of the admissions, so you will get to practice head to toe assessments and admission processes, doing med recs, skin/wound treatments, and setting up CPAPs and BiPAPs.

My best guess is $26-28/hr. Plus a shift differential for evenings or nights. Since this is your first RN job, take the job offer with the best experience you can get and don't focus so much on the pay. The rate won't be negotiable anyway because they can easily find another new grad willing to work for what they've offered.

It's just filling in for one shift? It will likely be just passing meds and doing treatments but the number of patients will be high. Did you get experience with documenting on a MAR in school? It will be a challenge because of the high patient ratio, but the process is relatively simple. If you take it be sure to get a good report including how patients take their meds, who sundowns, and any known issues (like a demented resident who always complains about something that has already been addressed). Patient identification can be tricky especially if they are all hanging out in the dining room/activity area and may not have name bands. Ask your CNAs to identify the residents for you. Be very careful with your narc counts because agency nurses are the first to get blamed (or set up if a regular is diverting). I've been an RN for 2 years and work per diem at a LTC/rehab. It's usually challenging to go into a LTC unit that I'm unfamiliar with for just a shift. Sometimes I have trouble finding the meds and the residents get upset because I don't know their usual routines. It would be a good experience for you. Just carry out the prescribed interventions and report any issues to the supervisor. Hopefully the people there are nice and willing to help you. Let us know what happens and good luck!

Since no one replied to this, I'll answer my own question in case anyone else searches here: All of the lectures/sessions were held in rooms that had tables, so it would have been easy to type on a laptop. There were some non-table seats towards the back of the room so if you are planning to type on a laptop, get there early to get a table seat. Maybe 1 in 5 people had a laptop. All of the tables also had a complimentary pad and paper from the hotel and pitchers of water with glasses (no need to lug around a water bottle all day). They also provided a shoulder bag for folders/literature/info that was given at registration, so carrying your own messenger bag is unnecessary. A small purse will do. Some people at the conference were dressed very casually, in jeans. Most were in the business casual realm. The conference was awesome and totally confirmed my desire to pursue nursing informatics!

I got a call for a second interview today, so I guess it went okay!

Emse you are one of my favorite posters on allnurses. Your comments helped me through my first nursing job in LTAC. Keeping you in my thoughts and wishing you a full recovery.

Nursing school (in NJ) had a policy that only 1 pair of stud earrings was allowed and all tattoos had to be covered. The hospital we did our clinicals at has a policy that all tattoos must be covered. Covering a tattoo on your finger can be difficult... can't really put a bandaid there since you constantly need to wash your hands. I have a friend with a tat on the inside of her finger and it hasn't stopped her from getting a job in the area. I don't think hospitals care so much about multiple ear piercings, maybe more so with the hole stretching. In any case, having lots of piercings and visible tattoos certainly won't help you get a job. And job seeking is rough in the NJ/PA region.