coolnurse42

Hello everyone, I have worked for the past 2 and half years in Case Management for both home health agencies and managed care provider. I plan to sit for the CCM exam in August '15. My career goal is to work in Public Health for local or state government. I am assuming a dual MSN/MPH can assist in accomplishing my career goals. I would like some career advice regarding Public Health jobs. What types of jobs are available in Public Health with a MSN/MPH degree? What jobs should I look for now in Public Health? I would appreciate any advice you may have...

Thanks all for your replies. @Grntea, is it too soon for me to complete the CM certification. I have read other sources that suggest having 2+ years of CM experience. And I would assume CSM certification should come before the MSN??

Hey all, I just accepted a position as an In-house RN Case Manager for a MLTC agency. Very very excited!! For the past year, I have worked in home health as Case Manager in the field and I love it. I love the autonomy and being in the community. However, I am ready for a change. I work in the Northeast in a major metropolitan area. Majority of my patients physical conditions are complications of their psycho-social circumstances. The CHHA I work for is notorious for overworking their nurses. I am exhausted. This is a welcomed break. Nursing is a second career for me; my previous career was in Logistics, so transitioning back to an office setting won't be difficult. I do plan to keep working part-time for my current agency (CHHA) on the weekends. Long-term goal is to become an agency Director for either a CHHA or MLTC. I would like some career advice about the Case Management path. i.e. Case Management certification vs MSN (or both) and the other skills necessary to becoming a qualified agency director. Thanks in advance.

Well, I did receive a reply from HR. He only confirmed that I am released from the ED and that he didn't have any open positions at this time. He also said if I saw any positions to let him know and he can try and get me an interview. Go figure! There are other facilities within their system. At this point, I am reluctant to work with these people. But I need a job and the job market is insanely competitive for new grads! My unemployment claim went thru with no problem. I went to the unemployment office with my paystubs. I will begin receiving benefits next week. Still waiting for legal advice. I had an interview this week for an RN position at an agency for developmentally disabled adults. Basically, I'm just trying to stay positive.

Netglow, I guess this question is really something for a lawyer to answer but I will ask anyway. Is their intention to delay this decision so that I will request to be released? If I were to ask for the release papers or termination papers, are they no longer considered liable for wrongful termination? From my perspective, the facts remain the same. My request for release papers are only for financial reasons.

Thanks everyone for the all the GREAT advice. 1. Last week, I did initiate contact with employment lawyers that will give free phone consultations, since this is what I can afford right now. They guarantee a week turnaround for consultations. That's my follow-up for this week. 2. Yesterday, I sent another email to HR recapping the timeline of my last day of work in the department, the meeting with the educator department, the med-surg interview, and the date I was notified I did not get the position. The message concluded with a request to meet HR re: my employment status. 3. In the meantime, I am looking for a JOB elsewhere. I received another piece of advice on allnurses from a clinical educator who told me to negotiate for a positive or neutral reference from HR.

I was employed somewhere else before this job. In my state as long as you have been employed for the past 18 months, then you should be eligible. I've never been in a situation where HR is reluctant to give release papers. That was my concern....

Hello Everyone, Here's my story...I am a new grad and was released from orientation after 10 weeks on my first job. I was told that they didn't think I was a good fit. However, I was experiencing a hell-on-wheels preceptor who made my learning experience very tense. At week 8, I was given a unsatisfactory progress report (to my surprise) and told I had until the 10th week to turn it around. The progress report was in writing, however, there was no action plan. From the beginning of orientation, I met weekly with the department educators. I discussed with them my experiences. They never expressed to me that there was concern from the preceptor about my performance. She complimented my performance early on, but progressively she became more and more impatient and interfered with my work, doing a lot of things that I could do for me. I asked for a new preceptor at the time of the progress report because of the way that I was being treated. I was told they would take that into consideration. They never did. So, my last two weeks were more intense with this preceptor. It seemed like a sabotage. She was just incorrigible. We get to week 10 and of course, they tell me to come in for a meeting with the Nursing Dept. administrator. My department educators recommend me for a Med-Surg position. The administrator says they have coordinated with HR and there was an opening in a Med-Surg unit. I go to the interview and was told by that manager another more experienced RN was being considered (which I didn't believe). This week I was informed they chose someone else. Its been two weeks since I last worked. I asked my HR representative (via email) what is my employment status? He says that he can get me another interview when a position becomes available. I continued to ask him what my employment status is and he responds the system is down, so he can't verify. That was his last reply on Friday. In my state, you can apply for unemployment online. I submitted my claim. My question is, has anyone ever received this kind of treatment from HR? It seems to me they are protecting themselves from a lawsuit. I am concerned that they will also return the claim to unemployment stating I am still employed. On the claim I listed my status as Lay-off, because I was never given a termination letter and have signed no termination papers. I also have money in my 401K that I need to withdraw pending my employment status reflects ended. I need to pay my bills. This has been the most unprofessional experience I have ever had in my life (I am second-career nurse)!!! Thoroughly frustrated.

HouTx, Thanks for the reply. This will have a positive effect on my interactions with new staff when it's my turn to be a preceptor. I would never treat anyone in this manner. Another question for you....you stated I received a reply from HR and they are saying they can get me an interview when a position becomes available. How long is a reasonable time? I'm assuming I need to seek legal advice about my state's employment laws and the statute of limitations.

The latest update in this saga.... The Med-Surg position was offered to someone else. Now, I am confused. What is my employment status? Doesn't the hospital now have to deem me LAID OFF, since I have no department? I have sent a message to my HR representative. Can anyone please advise what to do? Has anyone been through a situation like this? I have to take care of my life and its been two weeks without working. During this time, I started looking for work elsewhere.

Let me say I have no sense of entitlement or specialness issues!!! I specifically said that I was taking the progress report as an opportunity to improve. But what I will never do, is dismiss unprofessional behavior. At any rate, the meeting went well. I thought long and hard about what had been said and how frustrated I was feeling. I discussed my options to transfer to another floor. As of today, I have a meeting scheduled with the nurse manager on a Med-Surg floor. The ED educators and the hospital nursing department were in agreement and helpful with finding the MED-Surg position. We are parting ways in a professional manner and my creditability intact. I thanked the ED educators for the opportunity. As for the last two weeks, I was only given a different preceptor for one day. She was excellent. Very patient and allowed me to do my job with little interference. There was no tension whatsoever. The last few nights I have had the primary preceptor. And it was business as usual. She was impatient and condescending. I ignored it and tried to kill her with kindness. I picked up the pace in handling my patients. In last meeting, she cited an intubation patient in the Resus room has not neat. I was the transcriber and I ran into the room as the pt was coming in from EMT. I used the piece of paper in my pocket, a half-sheet, and just worked it out as best I could. So, it was a lesson learned. But the way she talked about my notes you would have thought I killed a patient. This experience has been a learning lesson. ED is a challenging environment. But I still say my preceptor did not do much to instill confidence or encourage a learning environment. That is what I feel could have made a significant difference, there was alot of unnecessary tension.

Thanks so much for the encouragement! I really need it! Just to keep you up-to-date! Last night was my first do-it-myself shift! Well, she interfered a little bit, however, we met at the end of the shift in the conference room outside the educator's office. Of course, the educator was in the office with his door open. She proceeded to tell me that although I had 5 pts last night, I STILL did not manage my time well. My preceptor proceeded to sight situations with patients that were out of chronological order! She deliberately left out facts about where she interfered and decided to have teaching moments and add tasks that slowed down my process. I really feel sabotaged. So, I listened and interjected when appropriate, but it is clear she is doing this on purpose. I decided to tolerate the rest of the meeting. She ended the meeting by saying, 'I feel like with you, we take two steps forward and then we go two steps backwards'. Ugh! As I left the conference room, she immediately went into the educators office. I arrived back home about 30 minutes ago and I called the Nurse educator and asked to meet with him before the end-of-the-week, as originally scheduled. He agreed to meet with me tomorrow morning. I will give my side of this madness and hopefully, get assigned a new preceptor. I feel as though I have been schooled big time! Nurses do eat their young and I've been my preceptor's meal!

That's one person's opinion; a very bad one at that. You didn't accomplish all that you have if you weren't meant to be a good nurse. There would be clear signs to YOU that you weren't cut out for this profession. Unfortunately, there are some very unhappy people with a little bit of power, who like to see people squirm. Keep your head up!

Hello Everyone, I am new grad and I am 8 weeks into my 12 week orientation in the ED. I received a progress report from the Nursing Education department yesterday that stated my preceptor does not feel I am making any progress. I was sited as "lacking initiative in Learning" and "Ineffective Time Management". In the meeting, I felt the educators were biased. Of course, they have the preceptors words against mine. But the discrepancy lies in reality of what happens on the floor. In the first two weeks of the orientation, my preceptor told me I was doing very well and that she could see my confidence. And at the end of each week, I would meet with the educators to review and discuss the weeks events. At no time until now, was I made aware of such extreme disappointment in my work. My preceptor is very hands on in her mentoring. She shadows me as I am handling my patients. Many times she takes initiative to do certain tasks and then to remind me of things to do. It seemed to me that this is how 'preceptorship' works. I have been assigned about 3 to 4 patients. The goal is to handle 5-7 depending on the patients acuity. My preceptor is quick. She's been doing this job for several years. I feel that she doesn't give me an opportunity to do the work when she jumps in to assist. Now, if its an emergency situation then I get it, but mundane tasks of transferring pt to the floor; giving report to the floor; other desk procedures etc I feel she could step back. This progress report and meeting felt like a slap in the face. To say I lack initiative in my learning is like saying I am sitting there filing my nails and doing the least possible work. However, I decided to take the meeting as opportunity to improve. So, last night was my first shift since the meeting. Her behavior was the same; she's hovering and jumping in and giving me assignments with my patients; reviewing my charting. How can she judge my time management this way? Then there is the matter of bias. We were working on Hep drip calculation. It was a simple calculation of 5840 units, how many mL do you give? One vial is 5000 units/ml, so you calculate the difference (840 / 5000 = 0.168). I said this to her she ignored me. She leaves the med room to ask another nurse, her friend, who says the same thing. She tells her friend, you're so smart! I was like okay, that was biased. Then we had a patient brought to our zone who was unresponsive from alcohol consumption, according to her friends that brought her to the ED. Of course, this is treated like a code situation because the patient is unresponsive. My preceptor is yelling for me to get the Narcan. I get the Narcan quickly, from the Pyxis and return ready to administer the push. The docs, the charge, another RN (who is starting a line are at the bedside). My preceptor says get the nebulizer mask because we are going to give the Narcan via nebulizer. I go get the nebulizer, my preceptor comes running after me to move fast. One of Dr. tells her Narcan is not given by nebulizer, which I questioned myself but wouldn't dare bring that up in front of these doctors. Then my preceptor tells me to do a fingerstick. I get the machine and then the other Dr. takes it from me. My preceptor then says get the portable cardiac monitor and a urine cup and pregnancy test. I go to get them. She runs after me and gets the cardiac monitor. The charge returns with a foley kit and then my preceptor says help with holding the patients legs in position for the foley insertion. I could have easily inserted the foley, but she didn't give me the opportunity. I feel as though she is trying to make herself look good at my expense. This progress report proved it and last night sealed it. Needless to say, my blood was boiling by the end of the shift and I told her going forward I would like for her to allow me to handle everything with my patients. My question is has anyone had a similar experience and if so, how did you handle it? Am I correct in my approaching her? I feel like I'm being sabotaged. Thanks for the replies.