JetBlitz

Hey, so I work night-shifts, 12-hr shifts (7p-7a), 36-hrs/wk. I work in ICU/SICU/IMCU. Before that, I worked the same schedule for a med-surge unit. I recently took this new position in June. I am still learning a lot. And in the past few months I have had the worst sleep schedule ever. I tried chamomile tea and blocking out the light with heavy drapery, but for some reason they are not working well anymore. My team told me, "oh you're young, you'll be able to handle [iCU position]," but lately I have been losing motivation to learn anything since I'm too tired to look at text books, etc. So this happens when I get back from work: I keep getting a "second wind" when I get home. I can't sleep and my mind is moving a billion times an hour when I'm in bed. And if I do sleep, I end up waking up 2 or 4 hours later, and have trouble getting back to sleep. It's affecting my mood and I find myself getting depressed when I'm too tired to do anything on my off day. I know when I don't feel like myself so I make it my goal to just get out and be with other people, but I'm too tired to even enjoy other's company. I am also very active and love going to the gym or just exploring or playing sports, but when I'm tired because of lack of a proper sleep schedule --- it really takes a toll. I once overslept and was late for work because I didn't sleep until 1pm (I usually wake up at 5pm to get ready for shift-change at 6:45pm). Do you guys have any suggestions what's going on? ICU is stressful enough but the team is very helpful so I'm not that stressed out about it. What's stressing me is the lack of sleep or outlets for me to enjoy the things I do. I don't really want to take sleep meds because I get scared of "not waking up," if you know what I mean. I wanted to exhaust all options before talking to my doctor. I'm also aware it's against AN's terms to ask/provide health recommendations/diagnoses so if you recommend I should go talk to my primary doctor then let me know please. Thanks for your help!

Hi, I'm new to critical care (to be exact, about 3 months). I was wondering if it is worth joining the AACN; what are the benefits? (Background: I have 2 years of Cardiac-Telemetry/Medical-Surgical experience, I also did some school nursing to be more comfortable around treating some kids). I'm still learning A LOT of new things in my ICU/CVICU (Swanz, balloon pumps, DRIPS!) so I was wondering if I should wait it out before joining the AACN. Also, when would be a good time for me to take my CCRN exam? After a year of ICU/SICU experience? I think for my hospital, they reimburse us for the exam fee if we pass it on the first try, and I believe we get an extra $1/hr. Thanks.

Hey MissKait, I didn't do part-time studies in seminary after all. It's still a possibility in the future if the Lord wishes for me to go that route, but currently He's keeping me where I'm at. I'm sorry; I wish I could have been more of a help! However, when I was visiting Dallas Theological Seminary, I spoke with the admissions office and they said they have a few students who do part-time school/work. It works out very well but they needed to be very strict with their time-management so they can study well. God Bless! Sincerely, JetBlitz

Ok so I'm a nurse with 2.5 years of experience. I've worked in Cardiac Tele with 9 patients on drips (in a 36-bed floor), and currently I'm working in a Med-Surge unit with up to 6 patients (in a 28-bed floor). I work nights. Lately, I've been getting burned out on the med-surge units because 1) We just had 2 experienced nurses on my shift move to SICU (for various reasons) in January. 2) We have 2 more nurses moving to day shift by the end of April because (one is getting sick from the stress of school and working nights, and the other is having trouble balancing school and working nights in general) 3) I am having trouble managing my time since our documenting process involves meticulous "clicking" in our new documentation system (we transferred from MediTECH to a new system that does not have the "F5" function). 4) I can't educate and teach my patients and their families as effectively as I can. 5) I can't get to my patients when they call me (my rule of thumb is to get to their room in 6) We are short-staffed, and as of 2013 our unit is no longer hiring Agency or Travel nurses since it's too expensive to pay for them. (We had a net loss last year because of hiring out-of-hospital nurses to try and meet the demands of the floor) Here are traits on what I'm really good at from what my patients and co-workers, and even educators and Managers of other units, say about me: 1) I am very compassionate. 2) Very good at teaching about pathology and explaining why the MD chose this type of treatment. 3) I am a team-player. 4) The educators are impressed of my eagerness to learn (I am PALS, ACLS, BLS certified, and I recently got my 12-lead EKG certification --- I'm not that good yet at 12-lead since I don't get the opportunity to practice it on a med-surge floor; I also don't have anyone to critique my assessment of a 12-lead strip since no one on the med-surge floor knows it besides me) 5) My manager has given me assignments here and there to educate my co-workers on various new policies or Evidenced Based Practices. Biggest pitfall: 1) Time management - for some reason, documentation is always my downfall. I have clocked myself that it takes at least 25 min, to do 1 patient's start-of-shift assessment; 15 minutes if the patient is a walkie-talkie, independent patient who does not call for anything (this is rare). That's because our new Electronic Health Record (EHR) documentation does not have the ability to "pull up" information that has not changed from the last assessment. At the end of shift, we "close" our Notes with the Education we gave to our patients, which takes about 2 min. to "click" and type in what we did during the shift. I usually have 6 patients: so that's 2.5 hours on documentation itself, which includes the Education part. Remember, there's NO way we can "pull up" or copy the information from that last assessment; we have to "click" our way through. I've been thinking since January that if I just skip most of my documentation except for the start-of-shift documentation (eg: head-to-toe assessment) and just place Nurse's Notes on things that are not normal, I should be able to cut down on my documentation. I don't have to open my Notes and chart q2 hours if my patient had nothing happening. I spoke with my Manager who spoke with Administration, and they said there is no consensus that charting ONCE for the entire shift is no different that charting q2 hours with no changes to the patient's condition. In other words, if I only chart ONCE (mystart-of-shift documentation) I "should" be legally covered if I am audited in the future... right? When I look at my co-workers' documentation, there's a handful of errors, some RN's skip all-together the Education piece and some RN's don't document that an MD was called, for example, chest pain. They clock-out on time, but it's not best practice. So Management has already warned me twice for the Overtime I'm doing (that was within 6 months). And the third one will cause Administrative discipline (whatever that means). I am burnt out. And since January, I've been getting sick and not sleeping well (I usually work out 4-5 days a week and play sports; now I just sit at home sleeping most of the day). I still give my patients the best care I can do while trying to keep up with what is expected of the RNs when we document interventions, or input what the MD's ordered, etc. But I am extremely unhappy since I get reprimanded for doing: a) What my patients expect of me. b) What the State expects of me with my documentation. Our HCAHPS have plummeted to 79 (we average 88) this past first quarter. And the surveys have said that the RNs on my floor have not met their needs in Education nor controlled their pain nor have made their stay comfortable. I am striving to turn this around, but it's impossible to meet the demands of the new documentation system and still be expected to be a "nurse" to my patients. My coworkers sometimes ask me, "Why in the world did you want to work as a nurse? You know too much! (They say this colloquially as friends, not as a derision) " Some of the MD's who know how I treat my patients and are pleased with my work ask me: "So tell me again, why are you working as a nurse?" My patients who approve of my care to them even ask me, "So are you going to be a doctor some day? Are you still in school?" I answer all of them the same: "I love what I do, I love being at bedside, I love being a nurse." So my dilemma: I don't want to leave our unit because I'll get reprimanded/fired for putting in too much Overtime. I also don't want to make our unit more under-staffed than it already is. But I am increasingly unhappy because: 1) I can't take care of my patients the way I want to if I'm too worried sick of clocking-out on time. 2) I can't put to use the critical thinking I have in my brain to good use. 3) I find myself hating that the nursing profession has turned more into a money-making field (no matter how you slice the cake, nursing is different from 30 years ago). Our ICU RN's usually have a 2:1, max 3:1, nurse to patient ratio. I like a moderate dose of adrenaline --- I want to know how to do Open Heart patients on drips. I want to get better at doing Codes. I don't care about giving blood products as long as I don't have to juggle 6 patients with it (who call for pain meds, going to the bathroom, feeding them, turning them, suctioning, cleaning, calling MD's for events, etc). I don't mind doing Total Care patients (turning, cleaning, fixing vents, etc) since I "enjoy" getting to know my patients inside and out. I know floor nursing is different from ICU, so I'm willing to take a chance so I can be enjoy nursing and still not be bogged down by time-management constraints. So should I stay on the Med-Surge unit until we get more staff to cover? Or is it ok for me to switch to ICU?

Yes! Go for it. From my experience, sending a thank you card is and has been extremely helpful. Even if after the HR interview I do not get a position, I STILL send a thank you card so that there is a positive rapport left just in case a new position is available in the future. Again, always follow etiquette: after a face to face interview, give 48 hours before emailing or hand-writing a thank you note. Reiterate your interest, remind them of your name and when you met, and share something positive about your meeting together and something positive about the company. Lastly, make it clear what positive things YOU can offer to the company; avoid the usual "hard worker," "energetic," and "motivated" words --- these are a given. Lastly, it doesn't hurt to be polite at all with thank you cards (I prefer hand written notes since that shows attention to detail). If HR sends a thank you email/card back, that means they really appreciated your efforts, and hopefully, they'll give you a time frame as to when they will get back to you with a 2nd interview. This will give you an opportunity to ask if it is ok to call them back if after 2 weeks you do not hear from them to call HR back if they have any further questions you can answer or if you can assist them with anything. Best of luck!

i once worked directly with a hospital administrator who audited my work (lucky me!) --- it was one of those random things for quality control. since day one of nursing school, i've always been told to always be precise with my documentation no matter how busy i get in order to protect my license. so when i was audited, the administrator was surprised that someone so young was doing way better than the "experienced" nurses; mind you, i've always debated with myself if i was doing way too much since my senior nurses would tell me that i was too "precise." after being audited --- i was scared out of my mind --- and the administrator being happy with my work, i felt more confident that i was doing the right thing to represent my company if jcaho (the joint commission) happened to stumble across my work. the administrator then had me make a booklet to help refresh my colleagues on how to document properly. i was also given expressed directions that if anyone tried to give me lip to contact the administrator's direct line so s/he can come down and teach the unit personally. *ouch justbeachynurse - i don't think you're making yourself work hard. you're doing the right thing. as for the other nurse, i think she just needs a friendly re-education; just let her know that in order to protect her license she ought to use her own findings (if there is definitely a change in the patient's status). also, it would help a lot to see if there were improvements to the patient's condition (eg: in regards to the petechiae improving).

Loneliness is definitely something you have to deal with primarily. Humans are social creatures and we need to physically interact with others or else we'll feel boxed-in. Definitely find friends outside of the hospital setting, quick! Not necessarily to spill your feelings with them, but to connect with them, build relationships and bonds, so you have something to look forward to after your shift is done. If you are church hopping, make sure it's a solid church that has gatherings on other days of the week so you and your new friends can hang out. Get to know the pastors and let them know your struggles; they are there to console and guide you. Also, I don't believe you hate nursing - why would you put up with 4 years of stress and cleaning up gross things? For the money? I don't believe nurses get paid well enough to put up with the financial constraints that hospitals are imposing. The floor does seem toxic. A mixed race unit is definitely sought after nowadays. Don't let your race be an issue; let your skills stand out!!! If they gossip, let them gossip but do not let their negative comments affect your care to your patients. Your patients need YOU to help them; they did not ask to be there and most likely they are scared, too. But if their comments start affecting your work, definitely ask Human Resources for help/look for that Employee Assistance Program that Been there,done that has mentioned. Do your work well, and help your colleagues, too, EVEN if they do not help you. Don't gossip back or try to buy their friendship by acting like them --- you gave up your friends and family to work in a place you are not familiar with, you should feel accomplished! Remember: to take care of your patients well, you have to know if you are not felling well, either.

Whoa thank you for the heads up! And boy that IS a lot of applicants!

I spoke with a Paramedic who was my instructor for PALS. He was the coolest and friendliest teacher I knew; he had full sleeves on both arms and he had gauges that were more than 2 in. on both lobes. He was very intelligent and knew a lot which was even more impressive. We got talking and I told him I liked his ink and gauges and asked if he wore the gauges anymore. He replied, "No, I outgrew them and it's easier to not have them." I then asked him if other people looked at you different for having ink and gauges as a medical professional, and he said, "Yes, and I had to work extra hard and watch myself carefully so no one will doubt that I was competent at what I did; because of the variety of cultures in the US, having ink and gauges is usually not a good thing in the medical field. Also, I didn't want to scare the kids, parents, or the elderly so I have to make sure my skills stand out -continually- or risk being looked down upon or have someone question my professionalism and my abilities to treat people." I think you should do your best to be aware of your appearance and use flesh colored gauges to hide them. Hospitals want employees who are able to represent them to the public. If you're an independent practitioner/doctor, then the situation changes because your patients will know you better as you build a long-term relationship with them, lets say, if you are their primary MD. Again, judge well for yourself on what you want to do with the gauges, but just realize the job market is hard right now and you want to get as many positive references as possible. PS: My favourite band is Wolves At the Gate. lol who says that nurses can't like country (rascal flatts) and post-harcore? haha

Same here. I applied at around January/February to all of the GN programs and then when I checked at the end of March the applications were closed. No word yet. Maybe they're sifting through all of the applications and will figure out which ones to call? I doubt they'll do a first come, first serve basis unless someone has exceptional credentials.

Hmm.. I'm glad you're practicing your interviews; have you tried practicing in front of the mirror? Body language and eye contact plays a big role with recruiters when you're trying to answer their questions. If your body language doesn't match your response, they have reason to doubt your confidence on your answer. If you're thinking of a response that's hard to answer, don't use "um" or "uhhh"... use silence and think about what words you'll use. Also, make a list of your strengths and weaknesses. Be prepared to have an answer for your weaknesses. With your strengths, make sure you sell it but don't be pompous about it; add a dash of humility and give examples on how you were an effective employee. Use positive language when speaking to the interviewer and don't use passive words like "would". EG: Instead of, "I would be an excellent employee at your facility," say "I can add onto your facility a caring worker that thrives on team work and empathy to make the patient's stay memorable." Lastly, don't and NEVER set yourself up for failure! That kind of mindset is self-sabotage. If you feel nervous before an interview, go to the bathroom and splash water on your face (if you are wearing make-up, run cold water on your hands), and TALK yourself in front of the mirror to compose yourself. I play lots of sports and my coach used to say that even if you're playing with a team that you know is way better and stronger than you, you play the game you know how with your own style --- don't feed into your enemy's mind games but play the game to WIN. I also learned this trick that works very well for me, when you feel scared, force yourself to smile and think of a happy thought (it's best to know what makes you happy beforehand). For some reason, looking at myself in the mirror while forcing myself to smile is a silly thing and gives me a chuckle to help me recompose myself. I hope this helps on your interviews! Best of luck!

wow gitanorn, that's definitely awesome you've planned so well! if i ever rise to your level someday, i would love to do the same for my team. i've seen that if upper management is able to take care of their team, then the team will know how much they are valued and thus will be more loyal to the hospital and work their best for their patients. i know for sure that you're definitely an inspiration to young nurses like me and how to be a leader, so thank you so much for what you do. and what takes the cake is taking care of 3 children! children are important in my life and someday when i'm a father i wish to balance work and family well, too.

Hmm.. it sounds like a system I've heard of called ASPIRE, is that the one? Those time goals are hard to achieve when patient care is of utmost priority and charting is second, especially when you are understaffed. To make it work, you will definitely need 1) a proper training to the time model you are using. 2) a dedicated IT service person to help you with problems with the program. 3) even though you are a small hospital, for the time being, you will need extra staff on board to help lighten the load while getting used to the new system. My colleagues and I had trouble with our time-tracking system since we would more often than not be in the "red" and trying to clear those --- we are a medium hospital --- but we are understaffed as well. It becomes frustrating when we're trying to beat the "clock" and we can't do proper nursing care... but when there was a meeting with the DON who walked us through, it was to help us provide faster and better services to our clients. Bad news, in the real world, when we can't meet the demands of the time-goals the staff get in trouble by upper management; however, inversely related is that by meeting the time-goals, our patient care suffers and our patient experience scores drop. But right now, we're leveling off the more we get used to the system and staffing levels are adjusted to help us. My advice would be to continue an open communication with your management in regards to the patient care being delivered and the time goals you have to meet. It is very difficult to adjust to, but never allow a new system to jeopardize the quality of care given.

Hi, I know this might be a very small population I'm targeting but I was just curious as to if anyone here is a student at Dallas Theological Seminary (DTS) and working literally across the street at Baylor University Medical Center. I was visiting DTS recently and spoke with the admissions staff and they mentioned that they have a handful of students who are studying full-time to get their degrees whilst working at Baylor across the street. "Yeah we have a handful that just walk across the street for work after class! And some come to class in their scrubs!" (I cringed at the last part because of infection control but I'll stay on the optimistic side and think that their clothes were not soiled in any way) My question: How are you able to balance seminary and work at Baylor? What schedule are you working? What classes can work around your work schedule? Any difficulties with balancing graduate school and work? I spent the day as a student during Chapel and went to two classes (Historical Theology with Dr. Bingham and NT 102 Honors with Dr. Daniel Wallace). Those two classes were hard! Background info: I do not have any biblical studies background but I am interested in getting my Masters in Theology - Youth Education or New Testament Studies. I love learning languages (eg: greek) and I do enjoy syntax studies and exposition. I know I will need to take the basic classes first so it's ok with me. Also, I intend to study to get my DNP someday too. Call me crazy but I figured since I'm young and single, I wish to use my abilities in nursing and in ministry to the fullest to help serve those in need. Any insight would be wonderful! Having Baylor right next to DTS is like a dream come true to me!

Thank you so much for clarifying that. The notice did not mention about quality posts as part of the accepted requirements. If I may make a kind suggestion, are you able to add the quote above to the notice so new members will also understand that they do not have to start new topics per se? You saved me much time from trying to think up of new topics lol. Thank you! On a side note, I was in TX recently and the temp was around the 99-100˚ but the great thing was that it wasn't humid! I liked the heat you guys have, but the bad part was that since it wasn't humid, I didn't notice I was getting sunburnt! I was in so much pain when I was taking a shower, especially my face/cheeks! O_O

@CrunchRN - Do you have any theories/guesses as to why they might be desperate? I mean, if the hospital is 'unstable' should I have reason to worry? In other words, when I fly down there for my interview, do you have any questions I should pose to them? I wish to ask them legitimate questions but also to keep it professional so as to keep our dialogue friendly (I've been told to never burn bridges even if I don't want to accept the position). Also, does anyone else have any experiences with 'desperate' hospitals? I've never heard of such a term and any insight on their methodology in recruitment and their treatment of those from out of state would help me prepare my material for the interview. Thanks everyone!

@SandraCVRN - Hey, I got your PM, thank you! However, whilst I was writing my response I couldn't press the "Submit" button lol. The same notice came up to stop me. But there's good news! The moderator that replied on this thread clarified that the "topics" I have to add up include "posts" such as these. He said I have currently 4 posts, and I just need approximately 11 more.. 10 more after this one is placed. I'll save the response I wrote for the PM and submit that to you whence the limitations for my account has been lifted. I'll be around the allnurses site replying to some posts and I have to make sure they are the quality ones to have them count.

@SandraCVRN - I'll PM you once I get the chance but it will take me a while. When I looked at my PM option, I received a notice that says the ability to send a PM has been disabled because of the prevalence of PM solicitors who abuse accounts. The only way this option of using PM can return is if I create/start 15 quality topics (I guess it's one way allnurses.com can verify if the account is real). If my memory serves me right, I've only started 1 topic (this thread). Haha! Give me about 2-3 days to PM you. Thinking up 14 more quality topics will be a challenge haha.

Thank you all for your quick reply! I called TX back and they confirmed that the all-expense paid trip was NOT contingent of getting a job offer. So I'm in the clear *phew! I then told them that I wanted to go down for the interview! The ball's finally rolling :yelclap: All I gotta do is pay for my own car rental and food, and submit those receipts for reimbursement. Again, I'm making sure everything is in writing so I definitely saved all of the emails just to make sure; though I have no doubt that they are very genuine in their interest with me and are eagerly trying to fly me down and have me enjoy the local area. I must say, this is the first time anyone has went out of the way for me to have me interview with them across the country. I'm quite humbled actually. But interviewing is a two-way street so I'm definitely preparing a whole list of questions for them, too. :-) @not.done.yet - I actually understand what you mean of dying to get out of Texas lol. I spoke with the locals at two different towns in TX (a man in his 30's working as a salesman for Hertz; a college student working in a museum; two guys 23/31 who love adventures/to travel) and if you're unable to make your own fun like the two guys (who love to hunt and fish; 'clean' an axis/ or whitetail deer, freeze a fish) you may get bored easily. Thank you all for your help!

Hello everyone, I applied to Methodist and will be doing an interview with them. If you haven't received a response yet, make sure you give them a friendly (but professional) call-back to see if they received your résumé and if they have any questions in regards to your credentials in your application. Also, if you met with them in any career fair at all, or in any setting, make sure you send them an email within 48 hours to say "thank you" for the chance to speak with them and to know more about the facility; add your strengths and highlight the hospital so they know you took time to research the facility. From what I have been told, and my own experience in job searching, it also doesn't hurt to send them a written, thoughtful letter of thanks. A touch of kindness goes a long way. (I know it's a lot of work, but you've gotta pull out all the stops!) Best of luck and never give up! Sincerely, JetBlitz

hello all! i believe this is the first time i've written a topic so i'll be brief. i have been unemployed for the past 7 months and have been aggressively looking for jobs even before i resigned from my previous employment (long story but trust me i was in a toxic work environment and even my own colleagues would not speak up for me when they were there witnessing all of this). i was at a career fair that nurse.com had sponsored in which i pulled all the stops and did phenomenally well! the recruiters who i felt were doing well in asking questions asked me "so what made you leave your last place of employment? what have you been doing since then?" i had responses i practiced and with all of my preparation and practice, a couple out of the 15 recruiters had set-up an interview! one of which will require me to travel to tx. now, with the recruiter in tx, they mentioned that it is an all-expense paid trip (food, lodging, rental car, etc). my dilemma: since they are paying for everything, am i [color=#00cc33]obligated to accept the offer (if they are willing to go all out and pay for my travels)? i don't even know if they will pay for my relocation, and i'm really short in finances right now to do it alone... i wish to see if the offer here in nj will actually work out. i spoke with the recruiter in tx and i told him i would call him back tomorrow [after my interview with another hospital, which is tomorrow; an information which i did not want to disclose for fear that tx might rescind their offer]. what should i do? when i travel to tx for an in-person interview, am i obligated to work for them because they paid for my trip?? i want to hear back from my interviewer in nj first. but i only have until 4pm on may 3rd to reply to tx on my decision to fly down. if i take the tx interview but if nj gives me an offer and i accept, am i obligated to pay them back? i'm the type of guy that does not like receiving free things especially if they are going on a limb to provide for my travel needs. background info: i researched the hospital in tx and although they are medium sized they are top notch comparatively to the hospitals here in nj; employee benefits also meet my needs. the only thing lacking is my exploration of that area in tx and to find out if they have a solid church community which makes the transition easier and allow me to live in comfortably. i am very loyal to my employers and intend to stay in tx greater than 5 years (permanently if i find a wife there haha) so i can help build up the hospital and train new nurses as well. i have traveled to tx recently (first time!) and enjoyed the place very well! the congeniality of the people are phenomenal compared to the tri-state area here. i was actually a little torn up with flying back to nj because there is definitely nothing like tx here at all; i will sorely miss the friendliness of the people, being able to randomly start a conversation, and building a bond with them. i also spoke to my loved ones here and although i hate to leave them, i have a higher obligation to continue serving wherever i may be going. please reply with any wisdom at all! in the end, i will be the one deciding so any further input is greatly appreciated. thank you :-d