Barley

My nightmares include warehouse-like units (complete with improvised and dirty furniture and linens), multi-floor or multi-building patient assignments (patient 1 in building 1, patient 2 in building 2 down the street, etc), unit rearranged and no one will tell me where things/rooms/patients are, not being able to find the assignment sheet and no one willing to help me, forgetting about patients, missing med passes, not having done anything all day long and realizing only 1hr left...

While not really related to the shared "project", one thing that really irritates me is the docs who walk down the hallway, and completely ignore me when I say a friendly hello (no hello, no smile, no nod, no eye contact, nothing). I don't know of any other type of workplace where this rudeness would be the norm or OK. Luckily the docs doing this are not typically docs for patients on our floor.

Why not the executives themselves? Make them earn their big bucks. And if they think it's such a trifling job that won't take away from patient care, then it shouldn't interfere with their executing (executiving?) either.

"...Assistant Vice Chancellor John Howser, said: "All decisions... are being made in a patient-centric manner ..."" If this is what "patient-centric" means (to give nurses extra work without extra time or extra staff), I hope any hospital I ever go to isn't "patient-centric".

I don't mind if they call to ask during my waking hours - sometimes I'll answer and say "no I have plans/appointments/etc", other times I don't answer. I DO mind when they call in the middle of my sleeping time to see if I'll come in, especially if it's to come in for a shift when I've already been working several shifts in a row. Ringers can be turned off, but I don't really want to shut off possible communication with my out of state family, thinking about possible emergencies I'd like to be made aware of, if they were to occur.

This is what I was going to recommend.

I became a second career nurse in my late 30s after being in science research. I was able to quit my old job to work on pre-req's exclusively (I had to take five 3-ish-credit courses) - prereqs took me about 8 months (local community college (highly recommended if you can get a slot - may vary with location) and univ of phoenix (the only good thing I have to say about them is they're convenient)). I got my BSN from an accelerated program that took 4 semesters (17months). I had two job offers within a few weeks of graduating (both through connections I'd made in school). With part of the year doing weekend option, my gross pay last year was just a couple K shy of my starting salary as a researcher at a nonprofit research company, so not too bad.I'm still pretty new. My take on the nursing shortage is that it really depends on location. And your ability to find a job will likely depend on where you go to school and where your clinicals are located (and thus what kind of connections you can make). I'd recommend nursing assistant experience to potential second career nurses, and especially to those who would go through an accelerated program - you can get a first hand look at the work involved (so you can bail earlier in the process if you decide it doesn't appeal to you), and develop resume building skills that will serve you well when you start your first job. If I had to do it over again, I would've done NA work during prereq's and possibly during nursing school too (though time was tight in the accelerated program). I agree with others who have posted that respect is often lacking - I sometimes feel like management treats the staff nurses like we're all delinquents. Very different feeling from when I was research project manager (and from how I and other managers treated those under us). I would say that some of our staff do not behave in ways that demand respect, so I try to tell myself that that is where some of the disrespect from management is directed. One on one with management, I feel respected for the most part. Collectively, I feel like management tries to squeeze every last bit out of us they can in the name of the bottom line. They add new responsibilities and expectations while neglecting to account for the additional time required to comply. A friend has described the hospital as a factory, and staff nurses are just part of the assembly line. We're also expected to provide excellent customer service, but are lacking in time to do the kind of relationship building and patient education that was the ideal we learned in school. All that said, I'm glad I made the switch, love my coworkers, and really like working with (most of) the patients.

How are demented and/or delirious people strangling others comparable to patients with long toenails, possible buns in the oven, or mild fevers? Should the LTC staff just let this resident rampage until the MD shows up the next morning, or until the resident can see the MD at the next available appointment time? If only delirium were curable with clippers or dip stick, or as benign as long toenails... If there's a chance that someone's indigestion might be a heart attack, the patient ought to be worked up to rule that out. Likewise, if there's a chance that a LTC resident's violent behavior might be the first sign of UTI or some other medical problem, that too needs to be worked up to rule it out. It's not dumping, it's addressing the needs of patients who might be in acute medical danger. An untreated MI is dangerous for the person having the MI. An untreated infection with delirium is dangerous for the patient as well as those around him/her.

When I corrected some nutritional deficiencies I was having, my energy increased and brain fogginess decreased. Might be worth looking into some physical as well as mental health causes.

Unfortunately I don't know the answer to your question, but in thinking about my own negative experiences with the bureaucracies of UofP, I would encourage you to get something in writing, directly from UoP about something as important as whether you'd be able to take the NCLEX-RN after making such a huge investment.

Seems like pt care and safety would improve if the resources put into committees were instead put into an extra nurse each shift. Most of the RNs I know and work with would love to be able to be able to improve patient care and safety, but are just stretched too thin and so are forced to deprioritize some items to the bottom of the to do list.

As an introverted nurse who's career counselor told her not to go into such a public career as nursing, I can relate to many of the comments here. One thing I tell myself when sometimes wishing I had a more outgoing personality is that not all patients have the same personality type, and there are plenty of patients out there who prefer a nurse who is not the bubbly outgoing type. I'd be one of those patients if I were ever in the hospital - I'd be ready to pull my hair out if I had some of my "friendlier" coworkers as my own nurse. To the OP, I'd say from your post that your interpersonal skills are intact - it appears that you just don't enjoy doing them. That's a different problem from truly not having interpersonal skills.

Makes as much sense as the current situation: some health insurance bureaucrat making my health care decisions.

This diagram seems like a good draft, but I'm supsicious of anything that uses wikipedia as a reference. Also, I dislike the use of a christian symbol for hospice nurse, since we're nurses for all patients, not just christian patients.

We have 6 patients days and nights, but I think it should be 4-5 max on days and 5-6max on nights. For us, there are things day shift has to deal with that night shift does not typically deal with: discharges, patients going off/coming back on floor for testing/procedures, phone ringing off the hook, new orders, having our work flow interrupted by discovering PT/OT/Speech/SW/dietician/MD/etc is in room working with patient, multidisciplinary rounds. I was told at the interview for my job that day shift is typically 5 patients per nurse and will occasionally go to 6, but since last spring, we've been running consistently at 6 for all nurses on day shift.