ChicRN

In my current job I have worked as an inpatient nurse case manager (midshift) for the past 5yrs. My schedule has always been harsh working by myself for the entire hospital and scheduled every single Friday to work. I have voiced frustration for a fair shift in the past multiple times, but management never helped at all. I obtained my graduate few yrs ago & I’m at the point where I feel like I’m ready to look for a new challenge. Honestly, like everyone else the pandemic just completely paused any plans I had these few yrs ?. Few weeks ago, my boss asked me something unexpected. She proposed an idea of fixing my schedule that would better fit my needs since my opposite shift is leaving. I’ve waited so long for management to help me that I’m not sure how I feel about a schedule change. I kinda want them to leave my schedule as is at this point since changing my schedule will take away my already approved annual PTOs LOL. I have this poll up to see how others feel about Monday vs Fridays since I’m deciding whether to entertain a schedule change idea.

SF Bay area nurse. I am currently working in a MCO hospital in acute care and also have years of experience working for the state hospital. I am at a crossroads on which healthcare organization for my long term. I have some family friends retired from Kaiser that had very poor pensions and fortunately worked for county hospitals (2nd jobs) that funded greater reward in the end. For example, Kaiser 401k employer match is 1.25%! For those working at Kaiser, VA, UC healthcare etc. I appreciate your feedback.

I’ve been a nurse for over 10 years.

Currently, I am an RN acute care inpatient case manager. I have been in this role for the past 3 years and have prided myself on being efficient & effective; however, this job has become extremely draining in a shift role where I’m the only one responsible for all patients for multiple units on my own. I feel that I am getting burned out, bouts of depression and anxiety nowadays. With Covid, management has increased my workload to become even more overwhelming proportions. Honestly, I always go the extra mile everyday for my patients and our care teams w/out appreciation from my dept LOL. For nurse case managers who left acute case management - what was your next job? I think its time for me to consider a different job role because this is not a healthy position in the long run. My experience includes 3 additional years as an outside facility (acute inpatient, ED, long term) and internal nurse case manager, Public health nurse, care management ambulatory care and direct patient care in community care facility setting. I also have a BSN and MHA. Thank you in advance.

Does anyone know of any good & affordable PALS, NRP, & EKG courses? I've heard of combo classes where a few are provided at a discount rate, but have been unable to find one. Even an all online simulation course with inperson skills tests would be okay. Thank you in advance for your responses.

A Gay or straight coworker really doesn't make a difference to me. What's important to me is the worth ethic & ability to get along with coworkers lol. I respect a good nurse, an efficient nurse, a team player! I enjoy hearing about my coworkers lives/activities (i.e. their kids bday, how's judo class, new recipe, new movies, how has their vaca/moving, etc..nothing too personal or long though). It just shows caring & creates stronger team bonds.

I did try to call a few times, for a few days after that rejection email. I ended up emailing her about it & she never replied back. She cut all connection after the survey i guess? Lol..oh man.

I feel your frustration! I was doing pretty well during my hiring process for a recent application, phone interviews with the director, etc..she actually told me"i would love to have you work in our hospital" & she said the next step was just my results on a survey that she emailed after our convo. I got on my computer right after & filled out the online survey, the next morning a generic rejection letter! They loved me, but reject me because of a personality test?..oh man lol. i was thinking...should i have selected "i am not a passionate nurse" & "i prefer being alone, than teamwork"?! Lol.

Does anyone know any Nurse recruiters willing to hire a new graduate nurse in the SF Bay Area? I'm an RN with a BSN, ACLS, BLS, PHN, & other certifications. I have been on the job hunt since last year with no avail (I graduated Aug 11' and passed Nov 11'..). I apply from NorCali to SoCal, follow-up by phone call & email with no luck. Often times when I call, HR they will say "don't call, check online. If we want you, we'll email you or not. check your spam mail" or my email to the director is forwarded to their assistant & they tell me to "apply online", even though my email starts off with "I submitted my application for XXX on XXX". *sigh* It hurts every time after taking my time to research the company and position, putting all that effort to email or call... The major hospitals like Kaiser, Sutter, etc. wont even let you get close to talking to a director to make an impression; LTC, home health, & hospice agencies here want 1 year experience. I'm currently loading up on Mollen clinics and trying to not give up hope? I'm sorry if I sound so discouraged, I'm a very positive person..its this job hunt that is frustrating and I'm not sure whether to cry or laugh on most days lol. Any advice/tips are welcome, but please no negative talk. Let's keep it positive.

I am RN in that position right now! We don't have a med aide or a shift supervisor or desk nurse! It's the most stressful thing i have ever tried to overcome..i'm great at multitasking, but i have 25patients..not sure how to even handle that much!..i want to quit so bad, but i'm a new grad w/no experience elsewhere..i dont know what to do. Theres a few other new grads in my position & we all feel stuck..not to mention tricked by what this place "pretended" to offer & treat their staff! It was just all pretty & smiles at the front door, but on the floor is a different story w/the nurses. LTC/SNF need tougher regulations to protect staff members! At our place, the cna have union but the licensed nurses do not! Weird how the facility has it that way.

I'm an RN who just started working at a SNF and I feel all your pain! I didn't know so many places operate in the same way. I love nursing, but everyday since I started working I feel anxiety ridden & unhappy to go to work. In our short stay one nurse gets 4/5 patients & the other 1/5 plus desk nurse role. It's unfair since the one w/the patient workload still has to do all the paperwork desk work for all 4/5 of the patients. In a regular day I have 25 patients, passing meds, assessing, calling MD, admits, discharges, charting on all 25 pts, talking to fam/other HC providers regarding patients, faxing, putting in orders, doing treatments, coc, etc etc. (some places have a med pass nurse who also just charts- i would be soo happy to be in that position, i do that plus EVERYTHING else as an RN!! We don't even have a desk nurse..so imagine it all..). Weird since we have echart/emar/etar, but they're that tight w/saving $ to help staff. We don't take breaks, lunch is not lunch..it's clocking out & in 30 mins later while working like a dog to attend to 25patients in 8hrs..I can barely eat my power bar! A good day is staying extra 2hrs & a bad day 4-5hrs (w/no pay!! Just to finish work! And no, its not just the new grads! Its everyone!). The administration discourages overtime, so you work like a dog for free..& not approved unless your doing back to back shifts even under many circumstances. All the nurses call in sick or are just so stressed you can feel it throughout the stations. I was a new grad trying to get a job somewhere, but now I wish I didn't look the SNF route. The staff is treated so poorly. Everyday I'm forgetting the reason why I went into nursing, it's impossible to give all 25 patients the care they deserve. I was recommended to this place by a fam friend & now i wish i never even applied. Currently, i'm still on my 90 day probation period. I have 2months left. What would be appropriate steps to resign? I already feel myself getting burned out and I feel this place is very unhealthy for me...it's so hard because you don't want to burn any bridges, but at the same time your license has to be protected. And its even more difficult because new grads need to have experience to get hired anywhere. I found out us new grads at the facility are getting paid way below the minimum around the area compared to other smaller places too. I wish there were more laws governing LTC/SNF. All my patients are basically medsurg, but X5 the ratio...i'm usually a very upbeat, positive individual but these days not sure how I get by each day being here..

I just started working at a SNF and I feel your pain! I love nursing, but everyday since I started working I feel anxiety ridden & unhappy to go to work. In our short stay one nurse gets 4/5 patients & the other 1/5 plus desk nurse role. It's unfair since the one w/the patient workload still has to do all the paperwork desk work for all 4/5 of the patients. In a regular day I have 25 patients, giving meds, assessing, calling MD, charting on all 25 pts, talking to fam/other HC providers regarding patients, faxing, putting in orders, doing treatments, etc etc. We don't take breaks, lunch is not lunch..it's clocking out & in 30 mins later while working like a dog to attend to 25patients in 8hrs..I can barely eat my power bar! The administration discourage overtime, so you work like a dog for free. All the nurses call in sick or are just so stressed you can feel it throughout the room. I was a new grad trying to a job somewhere, but now I wish I didn't look the SNF route. The staff is treated so poorly. Everyday I'm forgetting the reason why I went into nursing, it's impossible to give all 25 patients the care they deserve. I was recommended to this place by a fam friend & now i wish i never even applied. Currently, i'm still on my 90 day probation period. I have 2months left. What would be appropriate steps to resign? I already feel myself getting burned out and I feel this place is very unhealthy for me...

I feel your pain! i just started at a SNF & we have to be the nurse who: assesses, passes meds, charts, makes appointments, follows up, calls the other members of the HC team who work w/ the patient, etc. The amount of stress is incredible!!

At the place i'm orienting at we dont have a desk nurse like your ADON. The licensed nurses manage all the patient care, charting, inputting orders, appointments, labs, desk work, med pass, etc. I think if we at least had that the nurse(s) would be a little less stressed w/the patient workload. There needs to be some change in the way LTC/SNF are run. Some patients are at a med/surg level nowadays, not traditional/stereotypical nursing home.

Omg after reading this I have realized this is me! I started orientation at a "fancy looking" snf & the office staff directors were soo warm, etc. I never really paid attention to the staff on the floor until orientation, but now yes..i notice they just run around the best they can to finish their work, they're burnt out, they do try to smile...but who can w/soo much to do! They don't even have a desk nurse or secretary on their stations and do all of that too. Not sure how to get out myself since its been so hard to find a job as a new grad, but this place seems unhealthy for my well being. The directors don't listen to staff & worry about how to make they're facility look better! I obviously got tricked from the appearance of the place! The comp charting, cna smart charts, & updated facility. i'm hoping everyday i find a job asap because i am getting depressed and this much anxiety is overwhelming..

I find it interesting how SNf can get away with this! I personally think of it as unsafe since nursing homes aren't what they used to be. Some are basically medsurg acute care! I have a mix of geri & some adult on our floor. It's unsafe for the nurse & patient. This amount of stress is how nurses get burnt out licensed or not! I'm a new grad whos only been in acute care and find these places extremely worrisome for all. The nurses don't take breaks or eat lunch during charting or not at all. Heck, drink water is a luxury w/their time constraints! And overtime to catch up on their work everyday, now that is just too overwhelming. It's ridiculous how there are no strict rules w/nursing ratios to protect nurses in these type of settings & that due to our economic times they suffer. It's awful..

I find research nursing interesting and discovered myself to be not so much of a bedside nurse. Thanks for the tip! Not sure where to start looking here in the San Francisco bay area though..but i'll try! Thank you!!

I am currently in the same conflict that you were in with wanting to quit during orientation. I've been on the job search since passing my nclex in november and i desperately took a position at a SNF. The place is more of a med/surg for the geriatric, no respirator patients, etc. So far during my orientation I've been thrown to preceptor all over the place; thrown to work w/an RN in one side for 2hours, back w/another, then another nurse the next & i'm left helping them w/med pass, the pressure of computer charting for them &other documentation(when they didnt even give me a report on the patients!), & since theres no secretaries on the nursing stations the nurses are required to handle all the appointments, fax, paperwork, all the clerical stuff! The sad part is their the nurse to patient ratio. They have 3 stations: short stay(geriatric medsurg), long term residence, & hospice side. They started a new policy where during the day each station: Day one nurse is charge nurse (mans the nurse desk) plus one side of pts(usually just 3 or 4), while the second nurse gets 18 to 26 patients (doing their med pass, charting, assessing on own, documenting, tx, input orders, admit, discharge,etc AND trying to care for patients & meet their needs is somewhat more than impossuble which is upsetting). The nurse ends up staying on a good day 2hours overtime to just finish all the work & on a bad day up to 5hours! It's sad since even when the charge nurse helps w/med pass the second nurse is still everyday having to overtime quite a few hours to catch up). The DON actually repremanded some of the nurses for helping by splitting the workload!! AND the directors meet everyday to make a list to critic the nurses & a list of things they need to do from the previous shifts which is plenty! Imagine that criticism to start your day lol. Their pm & noc are worse w/just one nurse on each station doung everything w/no desk staff. I feel so stressed coming home everyday preceptoring w/burnt out nurses & seeing how much management doesn't care about staff..and more about their ratings. Surprisingly, the CNAs have union & the licensed nurses do not (not surprised so they can load us on workload lol) I am hardly learning being thrown in to help random nurses where i still need orienting. I feel this as an unhealthy environment & that i could be risking my own license working in these poor conditions. I was referred by a family friend & i feel awful about wanting to resign already, but i dont see myself growing as a new nurse here. I see myself being burnt out & unhappy...and this is the complete opposite reason I wanted to be a nurse! I'm on my 2nd week starting this Sunday (4days a week) of orientation which is also my lastweek . (we had a 1week 4day orientation going over policy/procedure & 3hr charting crash course lol). Any advice in appropriate steps to resign? I am so stressed as I write this that its difficult to function..

Hi everyone I am a new grad who just started orientation at a SNF and I'm on my 1 of 2weeks orienting on the floor. At first I thought this would be a nice place to start my nursing career, but now I am quickly realizing how management works!! They really take advantage of how the nurse to patios work!!! On one station, short stay they have 2 nurses and 29 patients (btw none on respiratory); one nurse gets 6 patients and it charge of the nursing station, while the other nurse gets the 28 patients!! This place expects a lot & does not allow nurses to share the workload (some nurses actually got in trouble for helping each other..). Imagine there is no secretary on the station, & the one w/28 patients has to do meds, tx, charting, other charting, call MDs, appointments. The nurses have let administration know, but they just don't care to listen. And have very bad work conditions. They want the stars & good reputation (but in reality their staff is overworked). My orienter doesnt help me at all, gossips(i heard her!), & is basically making me take her patients instead of teaching me! Also, admin said they just throw us on the floor after 2weeks to be in charge on our own..I'm debating whether or not to leave & if so, how if i'm on orientation? I was hoping this was my opportunity to gain experience, yet i come home stressed to the point where i get neck pain. Please help. I really need it!!!

Hi Penny, i am also a new grad RN who is too nice! I feel your pain! Patients can complain so much or families try to argue nonstop. It's definitely stressful. I think, well..I hope w/experience we do gain a tougher back bone dealing w/more difficult people. I guess it will just come w/practice lol. We can do it! We just need to believe it (= goodluck to you! I only have orientation on the floor for only 2weeks at a snf and your thrown on the floor as a nurse supervisor on your own lol..family is even more difficult!

Same Here. Got a rejection letter for Peds today..Guess I'm meant to work elsewhere. Goodluck to all. We are all good nurses!!..just in a horrible economy lol.

Hi everyone! I'm a RN located in the San Francisco Bay Area and looking for an affordable wound care certification course. The one I have found is through WCEI and it costs $2,800+, not including the expenses to stay at the hotel where they are conducting the course. I'm a new grad RN and I can't afford the price tag for this certification at the moment. Please let me know of any places these courses are conducted, including the exam. I also want to take on other certifications, any suggestions are welcome; I already have BLS & ACLS, just in case it's an offered suggestion. Thank you all in advance for any responses.

I agree with the videos. I watched one and I felt it was too much lol. I just invested more time practicing questions and briefly looking up something I really felt I should go over. I practiced some SATA on the Saunders cd.

Hi there, no I didn't watch the Kaplan videos or read the book. I did practice some q&a on the blue Kaplan strageties, practice book when I just wasn't up for practicing on the computer. I felt like I've already read too much during my exit exams in nursing school. I felt that practicing q&a was more effective for me. All my fellow classmates passed doing the Kaplan qbanks& trainers, since we all study similarly I followed lol.

I just wanted to leave a post to let you NCLEX takers know that this test is definitely doable. I graduated at the end of August 2011, moved back home from going to school in So cali back to No Cali in mid Sept and just went out and spent time with fam and friends for about well over a month & took Nclex November 1st 2011. My mindset was to get out all the distractions out of my system 1st before I started reviewing. I reviewed for about 2 weeks, except weekends. My plan was to do all of Kaplan-focused reviews, qbanks, & trainers. The trainers get pretty long towards the end being at 200+ q&a. I did 3important things:1-i reviewed only rationales of questions I got wrong(because there's no point of going over your right answers-you got it right for a reason!!); 2-wrote very brief notes on items I kept getting wrong(not a paragraph, but a few words or a sentence); 3- I took breaks (when I got too many wrong in a row I took breaks to clear my mind & focus--which my bro taught me). I made a goal for myself, at least 100 q&a a day, but on my focused days I just kept going lol. After doing so many questions you realize that interventions are very similar and it became easier. My scores ranged from 50s-80%. I went out on some days after finishing my goal of questions, spent time w/ fam & friends. I realized that nclex isn't made to have us fail & it is minimum competency; we are all competent! You passed nursing school! The day before nclex I just reviewed some notes, made a snack for the test & made sure I had my att with me. I hardly got sleep thinking about the exam (which was weird since I was pretty calm lol), I ate breakfast and left early to avoid any traffic & make room for any possible problems. While taking the test I stayed calm & broke things down-used my critical thinking, sometimes I didn't even have to lol. I felt like I was taking a more simply worded kaplan exam to be honest. I took a break after question 60 something-drank some water, ate a snack& used the restroom. I came back w/ a clear mind lol. When the questions hit 75 & the computer didn't shut down I thought "I guess I have to be ready for 265 & kept going"...but then my comp shuts down to a blue screen before I even get to 80! I'm thinking..great I might of failed, some questions were too easy, I might of failed? I got so many SATA questions & decent amount of pharm..so I wasn't sure what to think. I drove home happy that it was over, but also unsure with that unsettling feeling if I passed-which is normal!! Heck, I even thought some questions seemed to easy, should I have remained on it longer? Lol. I did the pearson view trick & it said I passed etc etc & I couldn't register. I was in shock & in disbelief!! I came in before the test thinking if I don't pass, then I don't pass..I would just keep reviewing. I think many of us are just plain anxiety ridden--belief in yourself & what you know!! When my friends tell me they aren't ready yet, I tell them that you can't know everything. It's true, I had topics I wasn't sure of, but I knew how to connect it w/what I already know. I hope thing helps somebod. Good luck to you all!! Btw: please avoid social networking when reviewing! I would see updates from my flow classmates & it would give me palpitations-I took my social work app (facebook) off my laptop & my phone. Nothings worse than feeling rushed. Remember, they're not taking it for you..so minimize distractions!