BGgirl

I'm relocating from Ohio to the Detroit area and am wondering if anyone can give some insight into the hospitals around Detroit. I'm leaning towards Henry Ford but I don't know anyone that currently works there. I've been at the same level 1 trauma center for the past 14 years as a SD/progressive care nurse, so the move is daunting to me. Anything good or bad would be helpful to know. Who are the best employers and would you recommend working there?

We are ALWAYS putting nurses on call now. I'm a charge nurse and even after a call in and taking our float to another floor I had to put one nurse off and 3 on call. It's not fun but they have an hour to come into work and then get time and a half. PLus if you're just on call you get $2/hr. Nothing more you can do when census is so low. They either have to take on call or get forced off.

I know ours cost a few thousand dollars. We had a pt leave AMA with one of our tele boxes and didn't seem inclined to return it. We told out security dept about it and they have a unit that will actually go out to people's houses or wherever to get our tele boxes. I was told if the tele box wasn't found, the pt would be charged with theft.

I think with experience comes assertiveness and confidence. At least with me that's how it is. I was very timid in nursing school but I really can't say that about me anymore in regards to nursing.

1. What kind of floor? tele step-down and m/s pulmonary 2. Ratio patient:nurse?4:1 on nights on tele and 5:1 on m/s 3. Is it functional? depends on what day you're talking about. Both floors can be super busy. 4. Have you worked in an environment that had aides/techs before? How did it compare? When we did have aides we were teamed and the aide was assigned to us. We then took 8 patients and an aide and it could be bad or good depending on your patients and the aide you're with 5. What other support staff do you have, that those of us with techs/aides might not?none

We call ours bedside handoff and we basically still do a written/verbal report at the nurses station and then both the oncoming and outgoing nurse go to the pts room and introduce the new nurse, and make sure the room isn't a wreck or your pt isn't. It doesn't take that long to do but we've only been doing it about a month.

We can be held for a max of 45 days which is usually how long everyone is held for. My manager takes every transfer personally so she likes to keep holding onto you as long as she can.

We have visiting hours that usually end at 8p and they are announced overhead. I normally let people stay a little longer if they are not in my way and are not being overbearing. Otherwise I tend to mention that visiting hours are over. Some visitors do get to stay the night but that's on a case by case situation. We frequently have people head over to the hospital at 2-3am wanting to visit their family memeber. That's when we normally put our foot down and don't let them upstairs to see the pt. (security stops them at the front desk) I just don't like the though of random people wandering around the hospital at night when we're not a locked unit.

We usually encourage pts to either have their families take home their meds or we lock them up with security if they're controlled.

I agree. I'm a union nurse and I feel at least some security with my job having a union in place. Some of the bad things include union dues every pay and it is MUCH harder to fire bad nurses. They are protected and you have to document, document, document their bad behavior in order to do anything about it. And even then it can take many months for anything to do done ie firing. We learned that the hard way and now we cut our losses during the probationary period.

We work either the holiday or the eve. I worked Christmas Day and had the eve off. I work New Year's eve but get New Years Day off. I also had to work the day after Christmas. My night at work was so horrible though, that I took on call. Also, if we call in the scheduled day before our holiday or after, we don't get holiday pay. You really can't go anywhere around the Christmas holidays.

Do we work at the same place? We have this same exact problem. In fact, it has come down to people on days assigning baths to the night shift. It's rediculous. I'm a nurse, I can tell when someone need to be bathed and when they don't. Some people during report only ask if the pt was bathed. That's all the care about. Our policy on nights is to bathe confused pts and those going for tests early in the am. I've had dayshifters though say we should bathe people that need to be fed because they're just so busy on days. I'm sorry but they get one less pt and sometimes we're staffed with 8 pts and 2 nurses. Plus I agree we get a lot of admissions. I find this subject is just a never ending battle between the shifts.

I would apply early because by the time I started applying, the only jobs left were med-surg jobs. If you want a specific area, do it before everyone else. I was hired before I graduated. Of course our manager has gotten burned a few times by people who haven't taken boards, so she no longer hires new grads that aren't licensed.

I practice what I preach so yes I always wear a seatbelt. I've neve been on a motorcycle but I would absolutely wear a helmet if I was one one. I see a of traumas just working on the floor and some are lucky, some not so much.

If you're ever in London, there actually is a Florence Nightingale Museum. I was too late getting there and it had already closed. I really wanted to see what it was all about. In DC there is a Red Cross Museum and it does have an exhibit on Clara Barton. I also never got to see that one because I was only there a few days and it was closed. I walked past it though. Might have been interesting.

Wow, my hospital doesn't even employ sitters. The only time we can get someone to sit in a room and watch a pt is when their suicidal. And of course half the time, you find the person who is supposed to be watching them sleeping. All our beds have bed alarms on them but once they go off people forget to turn them back on or when they're going off, no one is around to respond to them. Or even worse, they go off and people just sit at the nurses station like they can't hear them.

I find that while we use wound vacs when possible, we also do a lot of wet to dry dressings on my unit.

I do agree that a lot of our pts should be in ICU. I feel like we are the ICU half the time. It is a very stressful environment. I'm lucky enough (if I can say that) to really have a pt ratio of 1:4 on nights and sometimes 1:3. Dayshift is 1:3. Even with ratios like that, you can be running your butt off all night long. YOu can't beat the experience though. LIke I said, I feel pretty confident in most of my skills.

I've only worked on a tele unit and I've learned so much! We take everything from surgical pts to your simple chest painers. We take a ton of gtts so you can learn a lot about those too. I feel very confident in my abilities as a nurse from the experience learned on a cardiac unit and I can say that in my 4 years of working there, have only coded a handful of pts on my shift. Now as for 4 nurses just leaving. On my unit we have a high turnover rate. Now this is due to certain factors but it also is due to the fact that many nurses start out in tele to gain their experience and then go to other units that they are interestd in such as OB, ER, ICU which is where many of the nurses have gone recently. We even have a nurse that wants to be in peds but there were no jobs when she applied. You will take some telemetry classes before starting and you'll probably get a good orientation before being on your own. Good luck.

I can't remember what drug this pt claimed to be allergic to but when we asked her what it did to her she said it made her curl up into the fetal position. :chuckle

I usually end up cleaning things like blood, poop, etc up myself because if we don't get the majority of it up, our housekeeping staff won't mop it up. Housekeeping has refused in the past to clean up stuff that we haven't already attempted to get up. Plus they take so long to come, it's faster to do it myself.

I took the class several years ago and it was painful to say the least. It goes above and beyond what you need to actually know. My hospital used to have a class on it before they did it only online which I think might be a little more helpful. I took notes for the whole thing and then when I was all done found out the nurse educator had printed off notes for us to follow along with. That was very helpful but too late for me to use. I think it does provide good information and teach you important things, but I'm unsure of how it's really helped my practice any. Good luck. If you need CE's though, make sure you send in for them. You can get a bunch by taking this class which I neglected to do. One audit later, I'm kicking myself.

wow, and I thought only our interns were scared to death to order any pain meds. I've encountered this many times before. They must drill into their head that any pain meds cause resp. depression because they refuse to order anything for pain or even ativan when pts are agitated and crawling out of bed. We even had a pt on bipap once and they didn't even want to give them anything because it might depress their respirations. They're on a bipap for goodness sakes. I remember once I had a pt with a chest tube and they refused to give the pt anything for pain even though he was having a lot of it. WE finally just ended up calling the attending and told him the whole story and said your interns are too afraid to order anything. The attending was the one who finally gave us an order for something.

I had a pt once who kept asking for delilah. Come to find out, he just didn't know how to pronounce dilaudid. Another pt was proud to tell me his mother worked as a CNA but pronounced it seena. He was the same pt who told me his temp dropped to 50 the night before. My favorite was a quote we got from an ER report. Apparently this pts family member was at the bedside and was trying to sound important when the pt was getting an iv. He apperently didn't like the way they were doing it and told the staff they were doing it wrong. His reasoning. "I should know, I'm a blebotomist"