trueblue2000

Please help me choose the best answer for this questions. Thanks. 1 When a patient complains, what should you do? [TABLE=width: 90%] [TR] [TD] Find out what is going wrong and what you can do about it. [/TD] [/TR] [TR] [TD] Ask a supervisor to get involved. [/TD] [/TR] [TR] [TD] Do what you can to make the patient feel happy and satisfied. [/TD] [/TR] [TR] [TD] Listen and apologize. [/TD] [/TR] [TR] [TD] If it is a valid complaint, address the problem right away. [/TD] [/TR] [TR] [TD] Apologize and assure them it will not happen again. [/TD] [/TR] [/TABLE] 2 - In your immediate work area, you are at capacity. You have two additional patients who need attention. What would you do? [TABLE=width: 90%] [TR] [TD] Let them know they will have to wait their turn [/TD] [/TR] [TR] [TD] Make them comfortable while they are waiting [/TD] [/TR] [TR] [TD] Talk to my supervisor [/TD] [/TR] [TR] [TD] Rearrange the circumstances and try to accommodate them [/TD] [/TR] [TR] [TD] Find another place for them to receive care [/TD] [/TR] [TR] [TD] Wait for an open spot [/TD] [/TR] [/TABLE] 3 - How should a patient be treated? [TABLE=width: 90%] [TR] [TD] Individually [/TD] [/TR] [TR] [TD] Like you want to be treated [/TD] [/TR] [TR] [TD] Fairly [/TD] [/TR] [TR] [TD] According to the hospital's policies [/TD] [/TR] [TR] [TD] The patient is always right [/TD] [/TR] [TR] [TD] Like a guest in my own home [/TD] [/TR] [TR] [TD] As their condition requires [/TD] [/TR] [/TABLE] 4 - What is more important? [TABLE=width: 90%] [TR] [TD] To respond to the situation [/TD] [/TR] [TR] [TD] To respond to the people [/TD] [/TR] [TR] [TD] Be consistent with who you are [/TD] [/TR] [TR] [TD] Respond first to the needs of others [/TD] [/TR] [TR] [TD] It is important to take everything into account [/TD] [/TR] [TR] [TD] To respond quickly [/TD] [/TR] [/TABLE] 5 - What if what your patient wants and what is medically best are in conflict? What would you do in this circumstance? [TABLE=width: 90%] [TR] [TD] Do what the patient wants [/TD] [/TR] [TR] [TD] Change the patient's mind [/TD] [/TR] [TR] [TD] Do what is medically right [/TD] [/TR] [TR] [TD] Try to do both [/TD] [/TR] [TR] [TD] Re-evaluate what is really best for the patient [/TD] [/TR] [TR] [TD] Depends on the severity of the circumstances [/TD] [/TR] [/TABLE] 6 - What do you do if different symptoms suggest different diagnosis? [TABLE=width: 90%] [TR] [TD] Rerun the tests [/TD] [/TR] [TR] [TD] Consider multiple ailments [/TD] [/TR] [TR] [TD] Identify the ailment that includes all of the symptoms [/TD] [/TR] [TR] [TD] Search for other symptoms [/TD] [/TR] [TR] [TD] Treat the most likely ailment [/TD] [/TR] [/TABLE] 7 - Who should be in charge? [TABLE=width: 90%] [TR] [TD] Me [/TD] [/TR] [TR] [TD] The person who has the most experience [/TD] [/TR] [TR] [TD] The person with the most formal training [/TD] [/TR] [TR] [TD] The person who has been in charge before [/TD] [/TR] [TR] [TD] Whoever is assigned to be in charge [/TD] [/TR] [TR] [TD] The person who can do it best [/TD] [/TR] [/TABLE]

This will be for sure a setback on your nursing career. It is not over, but, absent powerful family/friend connections in the desired hospital, expect future employment to be at much less prestigious facilities, locations, units, and shifts. Prove you are a safe nurse there and in a couple years you will be rehabilitated and eligible for the kind of job you just lost. In your position, I would take it as a good thing that you were terminated. Seriously, by what you wrote, I have no doubt that your cockiness was driving you down the road to do serious harm to a patient and consequently your license. You were a very unsafe nurse. The hospital did you a favor by stopping you before you got your license revoked. Better lose a job than your license right? This is how I would view the situation: a blessing in disguise. Now get your head up, change your moniker to humblenurse1, and start applying for jobs!

Just be careful for your creativity not to fall outside the nursing scope of practice. Some nurses get carried away. Remember that for some things THERE IS a strict protocol that needs to be followed to a T. Always remember that you need a physician order even for the most mundane medications, like Tylenol and Colace. Nurses start to get comfortable in their practice and start giving OTC meds without calling the MDs. That is practicing medicine without a license, a criminal offense in my state.

Nursing employment has been cyclical, you are right. But what is different this time is the number of nursing school graduates. Look it up, twice as many people graduate from nursing schools today than 10 years ago. 5,178 people graduated from nursing school in California in 2000-2001. In 2008-2009, that number was 10,570 (The BRN school report shows more nurses graduating from California nursing programs. | Samuel Merritt University). That is 100% increase! In the same period, the population in California increased by only 10% (California's Population (PPIC Publication)). You have a tenfold increase in nursing graduates versus population growth. This is unsustainable. I bet this is the picture elsewhere in the country, with the exception maybe of North Dakota. Yes, the economy is in the tanks and older nurses won't retire, but is is this unchecked growth in nursing school graduates without regard for demand and population growth that has led to the sorry state of nursing we have today, with low wages, low moral and poor working conditions. It is destroying nursing.

I am not going to sugarcoat this issue. Shyness will be a major handicap in your nursing career. Once you start your nursing courses, you will learn that being a patient advocate is at the core of nursing. This means speaking up for your patient, representing the patient's concerns, issues and interests before doctors, hospital administrators and other members of the health care team. It may require you to stop a physician from performing a procedure that you believe will harm your patient. The good news is that shyness can be overcome! It takes practice and time, and since you are just starting your courses, you can have both. Good luck in your nursing career!

It is theft, plain and simple. Narcotic or nonnarcotic, prescription or OTC, patient or hospital supply; does not make an iota of difference. You are stealing. Can't believe some nurses think it is OK! Say you had contractors working at your home and they started helping themselves to your medicine cabinet, would you think that would be OK? This is a police matter more than a BON issue. A nurse in my facility was stopped by security at the parking lot (they were tipped) and found her scrub pockets lined with syringes and small medical supplies. Did they report her to the BON? They called the cops! Handcuffed and taken to jail for stealing hospital property.

I hear your call to unite and fight for nursing. In this respect, I find a pity that only about 5% of nurses are ANA members. After I passed the NCLEX, it was the first thing I did. And I consider my ANA membership my most important contribution to nursing. ANA is not a perfect entity, but it is our only credible national organization. If all 3.5 million nurses in this country were members, we would be unstoppable. With such a membership, ANA could lobby and push for federal legislation on staff ratios and better working conditions. No representative or senator would dare stand in the way of 3.5 million nurses. As it is now, we have no strong voice in Washington or at the state levels. The membership at the state nurses association is also pitiful. We have no one to blame but ourselves and out lack of unity for failing to advance our interests. There is strength in numbers!

The OP is (was) definitely mistaken in believing that being a male RN guarantees a job. But so are those who believe that gender has no effect in nursing employment whatsoever. The truth, I believe, lies in between the above extreme propositions. I, for one, have seen several RN job postings with the following statement at the end: "Male candidates are particularly encouraged to apply". In our very diversity conscious society, being a minority is an advantage in almost anything you seek you accomplish.

You are forgetting workforce diversity. Employers value it. Since males are underrepresented in nursing, as are African Americans, Asians and Hispanics, it may give men an advantage in the hiring process. Not that it guarantees employment, but if there is a tie between two equally qualified candidates, a male may have an edge over the female applicant. This has nothing to do with men being better nurses than females, but with employers wanting their workforce to be representative of the population they serve.

The fair thing to do would be to apply this policy across the board with all hospital execs and managers cleaning their offices and restrooms and all physicians responsible for cleaning their areas too. Selectively applying this cost cutting measures to nursing is wrong.

They are not thinking this trough. Was HR ever consulted on this? This is going to affect their RN recruitment and retention big time. Vandy is not going to attract the best and the brightest nurses with a job description that includes heavy lifting janitorial services. And it will be a big incentive for the ones already working there to look elsewhere for employment. In the end, the nurse turnover and costs associated with training new RNs will far exceed whatever this new policy will be saving them. And I am not even go into the subject of infection control (you think we nurses, already behind on everything we need to do will disinfect and clean as well as the environmental services staff?). This policy will be immediately reversed when their hospital acquired infections increase (for which they will have to eat the cost of treatment) and their HR budget skyrockets. Short-sighted and dumb-headed. Penny-wise but pound foolish Vandy.

If you are researching hospital benefits, it is crucial you get the terminology right, lest you get turned down when you apply for your perceived benefits. "Tuition reimbursement" is the term used by hospitals to describe reimbursement for eligible educational expenses incurred while employed. "Loan repayment" is the payment of student loans incurred prior to employment. The first is very common; the latter is becoming quite rare, close to extinction.

SSM offers tuition reimbursement but as with BJC has discontinued its loan repayment benefit to RNs. In the STL region I think that only Mercy and St. Lukes still help you with educational loans prior to employment.

SSM will reimburse tuition up to $4,200 per year for full time employees. This is NOT a loan repayment program (SSM dropped that benefit a few years ago). People get confused about this. Tuition reimbursement is for school fees you incur and paid WHILE you are working. Any tuition you paid or school loans incurred BEFORE your employment start does not qualify. You have to pass the course(s) and submit your transcripts along with your receipt of payment for reimbursement.

Your sources are right. At SSM, for instance, new grads start @ $21.00/hr for days; $24.00 if you work nights (15% differential for taking on the graveyard shift!). And that is one of the best paying hospital systems in the state. Disappointing, I know. Contrary to popular opinion, there is no money in nursing. I work full time as an RN in an acute care facility and will make 39K gross this year! And I have a four year BSN. A waiter with a GED at Red Lobster makes more than that. One of the reasons for the low pay is that this is largely a non-profit industry (SSM, BJC). Dentistry, because is dominated by for profit interests, pays much better, hence the fact you make the same as a nurse but with much less education. Reconsider your career choice if your primary motivation is monetary. Nursing is hard work, physically, mentally and emotionally demanding; if your heart is not into it (at least partially) you will not last long in the profession, because there are so many easier jobs out there that pay more.

I disagree the new grad market is a game chance. To say that you mean employers randomly pick a resume and hire that person, and nothing a candidate can do will improve their chances. I do not think that is the case. Cynical people say it is a game of connections. To a large extent, based on my experience, I agree. One of my classmates was a very charismatic tech at a local large hospital which had no posted openings for new grads, yet she and all her three BFFs (all mediocre students with zero health care experience) were hired there, while no one else in our 50+ class got jobs at that facility. Coincidence? But making connections is not that hard. The easiest way to do is work as a tech. I doubt (and have never seen) a competent, hard working and resourceful tech NOT get offered a job at the hospital they work. A nurse manager rolling the dice on an unknown candidate instead of hiring the tried and true? VERY RARE! Sure, if you have a tendency to disappear from the floor when nurses and patients need you, you are lazy and ***** about everything, do not expect them to keep you on board. But that is you sabotaging your career.

Fully expecting and prepared to be flamed for this post, I will say the following: You walked in the interview thinking you were the big shot - CCRN, major teaching hospital experience - and they sort of put you in your place. The big casualty of this encounter seems to have been your ego, bruised by the fact that the interviewers did not bow down to you but instead did what they were supposed to do, which is to grill candidates with pertinent questions. Maybe this was a needed humbling experience for you. Such is my reading of what transpired.

Two facts here. One, there is really no time to learn everything about a patient. You would have to arrive to work hours before your shift to go through and memorize the entire medical records of each of your patients. So do not beat yourself about it and be patient when the reporting nurse does not know the answer to question you have. Focus on learning what is important. Two, nurses regard different things as important and thus focus report and questions on those things, which will differ from what you regard as important. Some nurses LOVE to ask me the gauge of the the patient's IV whereas for me all I need to know is that the patient has a working IV. So I say I don't know. Other nurses get really interested in peripheral pulses: is the left lower limb pulse weak, moderate, strong or bounding? All I need to know is that the patient has a palpable pulse on all four limbs. Do not feel bad about saying you don't know and do not get upset and others cannot answer your questions because each nurse focuses her/his care on different aspects of the patient's condition.

I think I will never understand why being care for by a person of the opposite sex means trowing one's modesty, comfort and dignity out of the window. If you think it is OK to discriminate someone solely on the basis of their gender, what is so wrong about discriminating on other basis, such as race, age and religion? My comfort, modesty and dignity requires nursing care by white, male Baptists ages 18-25. This is a very dangerous road to travel. Our laws prohibit discrimination on the basis of gender, age, color and religion and we should abide by them.

The answer to your question is found in Patricia Benner's seminal book "From novice to expert", where she explains the process of becoming an expert nurse starting out of school. I read this book after nursing school and really wished I had read it earlier on. The biggest myth that she dispels is equating experience with expertise. All expert nurses are experienced she states, but not all experienced nurses are experts. She says, and has the research to prove it, that you can have 20 years of bedside nursing experience and still be a novice nurse as far as your nursing competence, skills and judgement are concerned. What creates an expert nurse is not the passage of time but really a deliberate and purposeful attitude of learning and reflecting on your work, knowing why you are doing something, the rationale for your interventions, the scientific principles behind it, and evaluating what works and what doesn't. It is very different from the almost mechanical way in which most nurses operate, mindlessly performing actions they don't understand the basis of and never reflecting what they are doing, if it works or not. Benner thinks it takes about 5 years of working in such a way to become an expert nurse. Another point that she makes is that nursing expertise is specialty specific. Say you are an expert med surge nurse and decides to transfer to the ER, you will revert back to novice status, almost to the level of expertise of a new grad, with the 5 year period resetting. She makes a very compelling case to sticking to specialty if your objective is to become an expert nurse.

Yes and no. It is not unethical or unfair to kick you out of the CVICU, even after only a month, even without screw-ups, if, in their subjective judgement, they deem you unprepared for the position. It is all about patient safety, as mentioned before. But it is highly unethical, in my opinion, to leave you hanging high and dry without another staff RN opportunity in the hospital, if, as you mentioned in your post, there were never any gross negative issues with your performance in the ICU (such as lying, stealing, abusing patients etc). If that is how the hospital treats its nurses, I would be glad to have gotten out of it, this is not really a place where you want to work.

You are the exception.

Secure a new position first then give your notice. You are much more employable while being employed.

With some additional training yes. Drawing ABGs, for instance, that is not something part of the nursing school curriculum or new grad orientation. Same with nebulizers. Also extubation; RTs do it and ICU RNs aren't trained on it. So there would be additional training involved but nothing too extensive I think. On between choosing RN v RT: many RTs I have spoken to find their work rather boring and repetitive; they really envy how diverse nursing is and the multiple career paths available to nurses.

Good post Larry, but how about unprepared interviewers? People who ask silly and contrived questions like "what are your weaknesses?" without having a clue about what is the relevance if any of such questions and and as a consequence have no idea how to judge the candidates's answers. You mentioned that half of candidates are unprepared for the interview; I will say 50% of interviewers also come unprepared to the interview. They do not understand the rationale for questions they ask and either ask questions that they were asked when they were getting hired or that they googled the night before "questions to ask candidates". These canned, contrived questions deserved canned, contrived answers. Don't expect candidates to prepare for interviews when the hiring panel is a bunch of clueless HR amateurs repeating scripted questions they have no idea why they are asking it.