RCBR

My guess is that the bonus will be paid in bi-weekly installments over the two year period. They will divide the bonus over the number of pay periods and credit the amount on each of your paycheck over 24 months. That is what my hospital system does. Say you leave after 1 year they would only have paid you half of it.

All you fellow RNs there belittling, trashing medical-surging nursing, encouraging people to leave, praising nursing specialties with minimal patient/family interaction... so sad. How about when YOU or one of your DEAR ONES need to be admitted to a med surge unit? Who is gonna take care you?

Not St Louis or anywhere in MO. New grad pay here starts @ 19.50 with the best hospitals (Washington University's Barnes Jewish) paying $20.80. Very, very depressing, even though cost of living in Missouri is allegedly low.

Don't get too hung up on the "I" thing. There are much worse charting sins you can commit. Take your cue from physician notes; they use "I" all the time, as pointed by another poster here. The issue of objectivity is non-sense. Using the passive voice (dressing was changed) instead of the active voice (I changed the dressing) changes nothing substantively, only stylistically. You can only chart what you did, not someone else's work, so saying "dressing was changed" means exactly "I changed the dressing". The greatest sin in narrative charting is double charting, repeating what is already recorded in the flowsheets, such as A&Ox4, SR 70s, 4L O2 NC, VSS, etc. You should also avoid the "will continue to monitor" at the end. Of course you will continue to monitor, that is the core of your job! Writing a shift summary note does not mean you are abandoning your patient.

I am RN now but I could go back a couple of months to my nursing school days and start a thread in the same vein about the view point from the other side: nursing students losing respect for licensed RNs. The great majority of the RNs during my clinicals (except my preceptor - what a wonderful mentor) wanted NOTHING TO DO with us students. They had no time or interest or disposition to teach us or let us do anything (but had ample time to gossip at the nurse's station). They completely ignored us. Even worse, they made us feel like a burden to them and the unit, constantly complaining that we were taking the computer stations, on their way etc. While I agree with most that have been posted here so far, this thread is very much one-sided.

"It is rough out there right now and most units who are hiring now and especially who are hiring new grads are less than stellar themselves." So very true. The good units have low or no tunover, thus offering few and far in between hiring opportunies, and when they hire they will pick from an extensive list of experienced nurses who who have asked to work there (word gets around abou the good units). It is usually the crappy units that take new grads. That is the case in my hospital, and from talking to other peoople who graduated with me, elsewhere too. If you jump ship now you might be exchanging 6 for a half a dozen, or landing in an even worse unit. No point asking about patient/nurse ratio or turnover during interviews; they will never be truthfull to you about it. I am going to be the odd man out here and tell you to ride this storm out. But with a different attitude. First, never cry in front of anyone, especially your preceptor or management; you will not elicit pity or compassion but derision for you will look weak and emotionally unstable. Cry only where no one will see you. Second, show confidence in your clinical skills. When you are going to perform a nursing skill, act and pretend like you have done it a thousand times. Do not show insecurity, do not let others think you don't know what your are doing (but never do something you don't know how to do). Third, try to find an informal, unofficial preceptor amongst your fellow RNs. Not all nurses eat their young, you will find that some are actually willing and able to help you. You obvsioulsy need help and coaching and your preceptor is not giving it to you but maybe some of your colleagues will. Fourth, you will be a stronger and better nurse after you pass this transition. It is the strongest fire that forge the strongest bonds and you will emerge a much stronger person and nurse after this ordeal is over. You you feel proud of it and will have grown a thick skin which will help you through the rest of your career. But if you make it through it, don't ever inflict the same treatment you received onto the new grads who will come after you. It is only by refusing to treat other new nurses like we were treated that we will stop this sick cycle of older nurses bullying and eating the young nurses.

The ones who turn off the TV, the cell phone, the laptop, put down the book and magazine and suspend the third party conversation when I walk into the room. In summary, those patients who respect my time and professional expertise by giving me their undivided attention whenever I am providing nursing care.

Are you for real??? Universities award bachelor degrees. Community colleges award associate degrees. They are not the same degree. Please approach reality. I cannot believe you think that 2 and 4 year educational institutions award the same degree. Are you even a nurse? Yes I can. The content is not the same. BSN graduates have 120-130 credit hours of education versus 60-70. Sorry, but twice the credit hours IS A BETTER EDUCATION. Now, if you think all that extra education makes no practical difference, look at the research done by Aiken et al. showing that the higher the education of nurses the lower the mortality of patients. The NCLEX is a joke, sorry. Do you really think a 75 question multiple choice exam evaluates your skill and ability as nurse? At its best the NCLEX tests the bare minimum knowledge you need not to kill your patients the first week of work. True, I accept responsibility for my choices, but I don't regret them. The Saint Louis Community College had a 2 year waiting list when I applied to nursing school where the University I attended had no waiting list, which means I graduated two years earlier. Those two extra years of RN income (80K) more than pays for the student loans. I think this is the same situation (long waiting lists at community colleges) in most markets. I trust scientific research more than anedoctal evidence. The Aiken research clearly correlates better clinical outcomes with more extensive formal nursing education. QUOTE=Surgery182@RCBR Go to any nursing manager and ask who their best/hardest working nurses are and I bet the answer will be a mix of BSN and ADN nurses (along with diploma grads). All anedoctal evidence. Again, please read the scientific reasearch on the link between ASN/ADN and BSN nursing education and patient mortality. QUOTE=Surgery182@RCBR Some ADN nurses may not be able to write an excellent paper on the microbial skin count near an incision on postop day two, but they will run circles around a BSN nurse who got an 'A' on said paper. How do you know they run circles on BSN nurses? Sorry, you have no evidence for what you are saying.

They are not equivalent, but more education means more qualification and more qualification should mean more pay, in my books at least. Now, even though that is what I think is fair, I do not think that we will see a significant BSN differential anytime soon. The way the health care market seems to be rewarding the extra education of BSN graduates is by hiring BSN graduates in the first place instead of ASN/ADN/Diploma graduates, as evidenced by the "BSN preferred" or "BSN required" new grad positions positions posted. That is how I think the market will deal with this issue.

My point is that your point that exact same job should equal exact same pay ("Why should you get paid more if you're doing the exact same job?") doesn't hold water, as even you acknowleged that more experienced nurses deserve (and get) higher pay for performing the exact same job. By the way, after you get more experience and think of negotiating a higher pay, please remember what you told me: "If you think you deserve more, then go find a management position..." If the health care market financially rewards nurses who bring more experience to the job, I think it should also reward nurses who bring more education to the job. Sounds logical to me.

"Why should you get paid more if you're doing the exact same job?" Good point, if it was true. Pick any 10 staff nurses in any single hospital floor. They are all doing the exact same job but they are all the different pay rates.

I am in St Louis, MO and will start as a new grad next month @ $21.00/hr working full time in acute care for the largest health system in the region. I also got an offer from the number 2 hospital system @ 20.80/hr. I am super excited to have a job (many of my classmates have not) but the pay is depressing. Listen, $21.00/hr is good money if you went to a community college and your whole nursing education cost you $5,000.00. But people like me who went to 4 year schools had to borrow 30-40K to pay for school tuition alone. Once those student loans payment start to kick in, plus rent, car payment and other expenses, $21.00/hr is going to be barely enough. The RN pay structure needs to be changed to reflect the reality of the BSN educated RN who enters the profession with tens of thousands in students loans versus the ADN nurse who starts almost debt free.

Your story is so sad. I really feel for you because I was in the exact same boat. Full-time dedicated BSN student in a top NS with good grades = guaranteed GN offer from major teaching hospital upon graduation, right? Thankfully for me I saw the light and got a PCT job a year before graduation which became the major reason why I got a GN job after graduation. I really don't know what to tell you except to thank you for posting the painful lesson that you learned, which I think it is that direct patient care experience is key to landing a job after graduation. I hope all the nursing students out there will pay heed.

When you mention hourly pay you have to specify if you are getting benefits otherwise the comparisons are meaningless. Remove health benefits, pension deductions, disability insurance, paid vacations, sick days and all the other goodies and your hourly pay jumps at least 50%.

it seems that the point of the original post was simply to demonstrate that the role of the cna is more physically demanding than that of the rn. having worked on both roles, i think that is entirely correct. generally, there is a lot more lifting, pushing and pulling in an 8 hour cna shift than a 12 hour rn shift. but there is nothing wrong with that; it is the way it is supposed to be! the main role of the rn is critical thinking, not manual labor. cnas often don't understand the much higher intellectual demands of the rn job. for instance, the cna might see medication administration as nothing more than dispensing pills but behind that mundane acitivity there is a ton critical thinking working on the background such as: a) are these meds appropriate for this patient? b) which side effects do i need to monitor for? 3) are there dangerous interactions between these 15 drugs i a giving this patient? 4) are there prior assessments before these drugs are given? it may look as you are just standing there passing pills but your brain is hard at work. and that is why rns go to school for much longer and get paid much more than cnas.

IMC is critical care. Are you sure your contract specifically says you will work in an ICU instead of critical care? Have you worked in an IMC/step down unit? Honestly, those two units are not THAT different to warrant a concern for losing any nursing critical care skills, especially for such a short period.

Do you tuck in your scrubs? Would you? Should you? Can you?

Do the same thing you did on your first year. If it worked then it should work now for your second year. Although, things get a bit harder on the second year (more content), so you may have to add some extra hours to your study routine. OB is a pain for male students, I mean we have to learn stuff that we could not care less about and will never apply such as what are the hormonal differences between the follicular and ischemic stages of the menstrual cycle. Peds, on the other hand, I found very useful because many of the disease processes are the same you studied in adult health, so you come to class already with a background on the subject and it works also as a review of the adult health content. With the OB and Peds rotation you have to be a bit more careful. Both are specialized and sought after nursing fields so expect the staff nurses and techs to be arrogant and display an inflated sense of self-importance; they really think they are the eighth wonder of the world for having landed a position at a Children's hospital or Labor and Delivery. At the L&D unit expect to be looked at and treated as if you were an alien from outer space. You don't belong there and the nurses and techs will make that clear to you from day one. Hang in there and complete your OB rotation dutifully. Afterwards, wear it as a badge of honour.

"I finished CNA clinicals". I didn't even know there was such a thing as a CNA clinical. "There is absolutely no reason for hiring managers to choose new grads who never worked in healthcare over those who have." This is a rather radical statement. Imagine a nursing grad with a BSN from a reputable university with a 3.8 GPA, extensive clinical rotations and superb faculty recommendations and another nursing grad from an obscure community college with a 2.2. GPA who failed several semesters and is on her 3rd attempt at the NCLEX but has 3 years of hospital experience as a tech. Who would you hire if you were the nursing manager? While one learns valuable skills as a tech, many of which such as prioritization and communication are transferable to the RN position, the role of tech and RN are fundamentally different. Most of the knowledge, skill set and critical thinking required of the RN are not learned working as a tech but in the classroom, during clinical experiences and later during orientation on your first RN job. Disclosure: I am a tech at a large acute care hospital, soon graduating with a BSN.

It all depends where you live. I work for the biggest hospital nerwork in St Louis, MO. When I got hired earlier this earlier I asked HR if having a BSN instead of an ADN conferred any advantage to RN applicants. They categorically said no, that they cannot afford to discriminate on that basis; that they have enough trouble hiring enough RNs as it is. There just isn't such a surplus of RNs in St Louis to be that selective. They would not be able to fill all RN positions if they only hired BSNs. But that is St Louis; I don't know how is the RN demand/supply equation in your neck of the woods.

I hear you libran1984. You have my sympathy. I am an SN, graduating with a BSN in few months. I work as a tech at an acute care unit. We have 24 RNs and 2 LPNs on our floor. I have worked with them all and I will tell you: if I were admitted to my unit as a patient, I would INSIST on the LPNs being assigned to my care. They have a wealth of experience and knowledge; they are caring, humble, competent and the safest and hardest working nurses I have ever seen. On the other hand, I see these newly minted RNs showing off their BSN titles on their badges who are absolutely useless on a hospital floor. They don't know how to turn a patient, have no clue how to safely transfer them and think that cleaning patients is beneath them. All I have to do is look at my university colleagues. I see how they work during clinicals and I AM SCARED TO DEATH TO THINK THAT IN A FEW MONTHS THEY WILL HAVE A BSN AND BE TAKING CARE OF PATIENTS. It is really unfortunate that these people get rewarded with much higher pay to the detriment of people like you. But the reality that the USA is a very degree/education conscious country. At the end of the day, is the RN and BSN designation that counts. You can vent and get exasperated about it and hope it will change but it will not. It will only get worse. Look at all the nursing schools opening left and right in the country, most of them offering BSNs. With only an LPN degree, you are going to be way behind. The future, it appears, will be a BSN to get an RN license. For LPNs, the best is to accept this reality and get on with that LPN-RN bridge program and then an RN-BSN program. Getting that ADN or BSN is not that difficult, but requires discipline and sacrifice. Good luck to you libran1984.

Let's compare hourly pay. Please state you city: St. Louis, MO: $12.75 (plus differential for weekend/might)

Here in St Louis tuition for the cheapest BSN program (the one I am doing, at a state university) cost 32K, and that is just for the nursing courses; it assumes you have all your prereqs. Tuition for the ADN program at the St Louis Community College is just over 6K, total. At the hospital where I work as a tech 80% of the new GNs have ADNs. They told me they had no problems finding jobs in acute care at all, and none of them excelled in school or had prior health care experience. Bottom line: I FEEL LIKE A TOTAL FOOL SPENDING 32K FOR A NURSING LICENSE THAT I COULD HAVE OBTAINED FOR 6K!

My instructors/references are all on spring break. This is the worst possible time to have to track 5 of them down.

woahmelly: from somebody who, in a previous life, was involved in corporate hiring: 1) i agree that it is far better to address the hr manager by name. but what are the chances you will get a name from them? you have better odds winning the state lottery. so don't fret about it. hr managers understand that. dear sir or madam will do just fine. 2) drop all bls, acls, ekg, clinical, education and related references. this information is already on your resume and/or online application right? no need to repeat it here. cover letters are not supposed to be a summary of your resume. why would you submitt two documents with essentially the same information? there is a reason why hr wants a cover letter in addition to resume, and that is to give you a chance to convey information not on your resume. don't waste this opportunity. talk about your career objectives, your passions, why you chose to be a nurse, and, most important of all, why you are interested in that particular hospital and in that position. incorporate the hospital's mission statement here. state that you believe and identify yourself with their mission statement. go further and state what their mission statement means to you and how would you apply it in your day to day work if you were selected. give specific examples. but keep in mind that this is a much harder cover letter to write. the temptation is just to summarize your resume, make your cover letter a mini-resume, and this is what 95% of the applicants will do. but once hr managers start reading about bls, acls, ekg on your cover letter, they will put it aside and go directly to your resume. they are ultra busy and will resent you making them read twice the same information. don't miss the chance to make your application stand out from the majority of other applicants. good luck!