Amnesty

You really come across as stuck up and confrontational. We don't need to know the capabilities of your special brain nor do we care how many algorithms you've memorized. What we know is that in nursing practice, things get messy and you need to know how to prioritize. With all the things you could be dedicating time to memorizing as a nursing student, this is like six feet underground it's so low on the totem pole of importance. You can look this up in less than a minute in just about any hospital you'll ever work in. I've got it bookmarked; click, type in drugs, give if green light, rework the plan if a no-go. An eager nursing student is good. One coming in, asking nurses for advice, bucking all advice they get and lecturing us on their special brain capabilities, and being really insulting and rude to people YOU asked for help looks like a real brown-noser who can't take social cues and will one day be the super annoying unit snitch. However, I will point out that this: is one of the most uppity self-important quotes I've ever seen on this website and there have been some real doozies. I legit cringed.

Hi all! Doing some research into moving to ABQ in the next year and just wondering what I can expect as far as finding employment there (looking at UNM and Presbyterian specifically -- cannot work at Lovelace as I need a not-for-profit hospital). I have 2.5 years of experience, 1.5 years in med-surg/ortho/neuro, and the remaining year in ICU/SDU. I'm wondering mostly about things like base pay, shift diffs (I like to work nights and weekends), paid time off accrual, whether separate sick leave is available, how being called off or in works, how much a decent health/dental/vision insurance plan costs, etc. Any information about these things in regards to UNM or Presb would be helpful. Thanks :).

I've had this situation come up at work several times before. The answer is a bit complex. If I've discussed it with the patient and he is well-informed about his health and says his heart rate is usually in that range and his primary doctor has okayed the use of those meds, I'll usually give them after running it by my charge nurse. He'll check over the other meds being given and tell me if there are any red flags. If the patient doesn't know but both are home meds, hold Coreg (or whatever other BP med it is) and give Cardizem, then call the doc to see if they want any kind of coverage on it like hydralazine. On the couple of occasions where I'd ask my charge nurses's advice on this, he told me that cardizem is one that we try to always give because it controls how the heart beats and keeps patients out of afib or unstable angina, as mentioned in different posts above. If the Cardizem is newly prescribed, I'll look up what's happened with it and why it was prescribed and call whichever hospitalist is on for us that night to get their take on it. In my experience, they usually say to give it anyway. It's 50/50 on whether they want hydralazine administered with it. Almost always, they'll say to hold the Coreg if it's a new med and the HR is in the 50's.

Tenebrae, my original assertion was that most people would not want to work 3 hours a day every day. I didn't say that no one would do it. I said no one would choose it if better scheduling was available. I've just about explained myself to death in this thread. You're either satisfied with what I've said or you're not. It's pretty clearly the latter. I thank you for the advice regardless. Every single little thing will be communicated crystal clear in writing going forward, and it will be documented as such. I will see a lawyer this week. As such, I'm going to lay this thread to rest. Thank you all for the advice, criticism, encouragement, and well-wishes. I appreciate it :).

I'm so sorry about your injury . I hope mine doesn't end up debilitating me. I've clung to the optimism that if it doesn't affect the actual spinal column, just the ligaments, it's probably not nearly as bad as it could have been, and I can hopefully expect a full recovery. I've read a lot of stories of other nurses who have not made full recoveries and still deal with back pain to this day. I've worked with a lot of patients who have similar stories. I know how low the success rate of back surgeries is. I'm desperately hoping I haven't started myself down that path so early in life. I'm keeping my eyes peeled for new opportunities, and learning a lot from this thread on how to lie low while I do so.

Yeah, I don't think I'm going to push it by asking to do ACLS while still injured. I've definitely gained some perspective on how that could seem self-motivated in a bad way. I'll wait and go with the flow. No more wave-making for me.

Yeah I saw that. Manipulation also means "handle or control, typically in a skillful manner". Both have bad connotations though, which is why I'm going with poor phrasing. Another communication problem! I'm definitely going to see an attorney. I didn't think I could afford to, and I might not be able to, but something tells me in the long run I can't afford not to. Thank you for your advice :).

This is the major difference. Some of the people in the thread assumed I was doing this. One even blatantly stated I was faking the injury/the severity of the injury because I worked through a weekend after sustaining the injury. When I clarify my points, I'm accused of embellishing. When I show that I was trying to advocate for myself in a bad situation, I'm a manipulator trying to take advantage of my hospital. There is great advice to be gleaned, and I'm definitely taking it. I've looked up a lawyer and will be making an appointment this week. I have plans to talk with my managers. I'm starting now with documenting everything, printing out all the emails, etc. It's valuable to see yourself through the eyes of others, but only if those others are open to changing information and perspectives. Having to pick through a minefield of people who probably aren't going to believe me even when I do respond doesn't seem like a particularly useful exercise for either party involved.

Perhaps the phrasing isn't the best. Apparently manipulation implies dishonesty/unfairness. Maneuvering is a better word.

Taken out of context, a quote can look like a lot of things it was never meant to. The context for this one was that I was being accused of manipulating it because I just didn't want to do the med surg work. There is a big difference between taking 5-7 med surg patients on my own on a floor that's already understaffed and sometimes doesn't even have a CNA to help, vs. doing orientation for a new floor for six weeks minimum, where I'm not going to be left to my own devices to sink or swim. I am 100% sure I would have sunk being put back on med surg. I was just as sure that I would have swum if I'd been able to start the new position. I likely would have been wrong about that, which I've admitted to. Manipulation in and of itself isn't a horrible thing. It's the fact that people use it to take advantage of others to their benefit that makes it awful. I'm being accused of doing that. I'm pointing out I wasn't doing that. It was my idea to resource so I could still work and help on my med surg floor. That ended up straining me after a couple of shifts. It's demoralizing. It doesn't make me a crook.

That's something I've had to seriously consider. I do know it's not any less physical on a critical care floor even if the patients you have are fewer. The only real benefit might be that at least most of the total cares have foleys, but even then, it's not as easy to turn and bathe and manage them while they're hooked up to a million drips and potentially on a breathing machine. One actual benefit though, and it's a big one for me, is that the critical care floors in my hospital are staffed much better than the med surg floors are. The manager has been there for 10 years. The employees are generally happy and supported. That could change. It changed on my floor. My own NM had been there over a decade, and I loved her. It was the whole reason why I chose that floor to start on. If she'd stayed, I probably wouldn't have left for a loooong time. That saying "People don't quit jobs, they quit managers" is just about 100% true IMO. I was leaving my floor because for the past 9 months, it's been hell. Ratios went from 4-5 to 5-7. We were asked to do more and more and given less and less staff. The result: massive turnover, and then even worse conditions. I've decided not to rule out critical care yet, and to stay optimistic about my ability to heal from this. If I end up needing to go a different direction, I'll take it in stride. For now, I'm keeping my eyes set on the goal.

@Dances with Wool I'll address a few things: ACLS and PALS are probably 2 day classes anywhere, but that's still 2/3 of a week where I'm not expected to do anything outside my restrictions. My hospital is particular about the meds. I might be allowed to give meds I was able to give on the floor, but from talking with current workers on that floor, it's generally not done. New orientees just watch for a couple of weeks. They get the med education about drips and differences in floor med uses vs critical care uses, then at the 2 week point they take a med test to ensure they've grasped the education, and then they're allowed to start giving meds. It was the same way when I started on the floor; technically I was only restricted (by hospital policy) in giving IV medicines. In reality, my preceptors did not allow me to give any meds at all until I passed the basic med exam. I asked in the interview about the code stuff because I've never even seen a code on my med-surg floor (lucky me!). They basically told me that until I have ACLS under my belt, I will not be participating in a code. Even after that, they'd prefer I be there observing but let the experienced nurses handle the codes until I get a familiarity with them, and then get into helping with the codes as I felt comfortable. They have a code team and a rapid response team, and they're very good. They're not understaffed the way that my med-surg floor constantly is, and the manager is very supportive of her staff. I am familiar with what orienting is like. I did a lot of research before ever applying for the critical care position, especially regarding orientation. It's a huge part of having a successful move to a new floor, especially one at a higher acuity level. That's why I know that the first half of the orientation contains a lot of classroom education. It just so happens that ACLS and PALS were being taught toward the beginning of my orientation.. That would've been fortuitous had I been allowed to start. With all of that in mind, I didn't think it would be perfect, but I did think I could be accommodated without too much trouble. And I've already said I understand fully why the CC NM didn't want to take the risk with that. It turns out she was right not to. I don't like the replies accusing me of lying to manipulate others and cheat my workplace, because they aren't true. Even in your post, you accuse me of embellishing. Embellishment is defined as, "making (a statement or story) more interesting or entertaining by adding extra details, especially ones that are not true." I'm not adding details that aren't true. I'm clarifying. I have reasons for the thoughts I've expressed here, and I'm giving them. Helpful is, "I know you're trying to do x but it's coming across as y for z reasons", not "You're lying about things and making excuses and your employer is right to fire you". I was given the opportunity to do desk work and then took it upon myself not to show up one day because I was told I could pick whatever schedule I wanted. It was a situation where I could've done better, and I have acknowledged that. It is not a situation where I blatantly skipped work as a no-call no-show when I had been told to be there, which is what so many here are making it out to be. I'm not concerned about the critical care manager rescinding the job offer. Even if that were to happen, I have numerous contacts throughout the hospital and could find a department to join once I'm healed, and I'm confident I could once again get on the path to becoming a critical care nurse. I am concerned that I'm now on administration's cost-cutting radar because injuries cost a hospital money and mine is being slow to heal, and like others said, there is a possibility that I could be reinjured more easily. I don't think anyone is out to get me, but I also don't think everyone believes what I'm saying, and if that's the case, it's fine. I don't believe everything I read on the internet. I took the insinuations and accusations with a grain of salt at first. I've seen what you guys do to people who get emotional and upset when they get bad responses to their threads. Truthfully though, I don't need people in my thread accusing me of manipulating my workplace to get out of things or into things or whatever. It's not helpful. If users really believe I'm not being honest, the interaction is probably not going to be beneficial for either of us. As said above, I did not think I'd have 6 weeks of lighter duty. I thought I'd have at least two, maybe three, and potentially even four, and there was a good chance they could be grouped. It's not so far-fetched if you read what I've written about the orientation for a new critical care nurse. In fact, I got the idea when I read a post online about a nurse who managed to do exactly what I tried to do. I'm absolutely going to contact the CC NM and talk with her about the plan going forward. I think it'll be a salvage-able situation, and I'm pretty sure she'll accept my apology and understand.

Because that hospital doesn't know you. No hospital you go to does. Drug testing makes sense for new empoyees. That's the standard for I think all but one of the numerous places I've worked at. I was drug tested in retail, drug tested in fast food. The only place that didn't drug test me was a college, and I don't think they'd have liked to find out how many of their student employees used drugs recreationally xD. However, there is merit to the fact that if my hospital has no reason to suspect I'm using drugs, they shouldn't have any reason to randomly test me. I don't like medicines, so I don't even use the narcotics I get scripts for most of the time. They're not going to bother me by doing a random drug screen because they're not going to find anything. The issue comes when I don't do drugs and they do find something. Maybe they do another test that's more sensitive, but maybe they don't. I've seen cases where they just used it as grounds to fire someone without ever taking that step. And if they're reporting it to a BON, you'd better believe it's going to create a massive legal mess, because BONs are even more unwilling to listen to people when they say this was just a mess up.

dishes, it is possible. It's not something my former med-surg manager would ever have thought. But the fact is, I'm dealing with 4 managers who don't know me at all. One liked me enough to hire me, but possibly now views me as broken goods. One already disliked me for wanting to leave my already-short-staffed floor. One said one thing and did another. And the fourth, the risk manager, seems just as overwhelmed by having such complications to deal with as I am, but she's been nothing but kind and I feel like despite any deficiencies, she's tried her best the entire time. She's the one I'm concerned with in the present, and she hasn't expressed having any sort of issue with me. I'm pretty sure I'm okay on that front. I'm not worried about being fired because of the nurse managers complaining about me. I'm worried about being fired because my hospital's administration has a long record of treating nurses poorly and saving money any way they can no matter whom it screws over. With that said, though I wish more of it was on the constructive side, I do appreciate the criticism I'm receiving here. I need to be as close to perfect as I can be in my dealings with this, and I need insight from other nurses to help me navigate it, because it's clear I don't know how best to do it on my own.

That is literally what I feel like I'm doing, and that's what I'm being thrown under the bus here for. If anything, I should have been even more proactive in my advocacy and gone straight to the critical care nurse manager once I knew the injury was likely to affect my start date. I could've advocated for her letting me use the first few weeks to get all the additional education out of the way so I could hit the floor running. Knowing what I know now, it seems unlikely she would have accepted, and it may not have been enough time for me to heal either. But at least I'd have tried, and the communication would've been better. I'm learning a lot more about workers comp and on-the-job injuries than I ever thought I would at just over a year into a profession .