purplegal

Hope all goes well for you. Both of you have no idea how lucky you are. Might go without saying, but don't take these great opportunities for granted.

If you are already being offered a job on a unit that you want to end up on, go for that. Day shifts will likely eventually open up.

Could be a difficult one, but I'm going to aim for no more job applications. See if I can go an entire year without pestering other employers (especially one) with my applications and try to just focus on the job I have right now. I'll also try to focus on no comparison to others so my "need" for a new job decreases.

We have a report sheet that we take notes on that we carry around. On there, I like to write major medications I don't want to miss, who needs vitals, blood sugars, who needs a skin check, certain procedures like wound care and bladder scanning, etc. I leave room so I can add the results of these items plus make note of anything unexpected that happened throughout the day (such as episode of chest pain, patient sent to hospital, etc). As far as procedures go, I work during shifts that another nurse is around. I wait to perform the procedure until someone's available. Very rarely will I attempt a procedure after looking it up alone. Most procedures can wait until someone more knowledgeable is available.

Hmm, with LTC it's pretty hard to find a lengthy orientation period. I had 3 days of in class orientation which basically discussed charting. I was supposed to have 5 days of on the floor orientation but on day 3, I was the only nurse on an entire wing (although there was a supervisor in the building if I needed assistance). 19 months later, I am precepting new nurses, even though I am still learning new skills myself. The other day, my orientee and I both learned how to remove staples from surgical incisions. I think, if you pursue LTC, your success will depend on how receptive your coworkers are to teaching and answering questions. My coworkers are approachable and always willing to teach and brainstorm solutions to situations that come up. But it may not be that way everywhere.

I haven't heard any feedback from the jobs I recently applied to, but am almost tempted to withdraw from all of them. At this point, more applications probably show a lack in judgment and not a sincere interest in any position. It does make sense to not hire someone who repeatedly applies to job after job, with no regards as to whether or not they are qualified or a good fit for a position. If someone cannot critically think about what jobs may be a good fit, or lacks the judgment to stop applying once they are told the answer is "no," it may be a sign they would not be able to critically think in order to provide good, competent patient care. I'm just wondering if withdrawing from these jobs would be a good or bad sign.

My thought is, since you only have a couple more shifts with this preceptor, to not mention it to the manager unless the situation gets brought up. When you are new, you want as little negativity expressed about you as possible; if your preceptor doesn't mention it, I would keep quiet about it. Seems likely she wouldn't, as you would both be at fault. Yes, you missed a critical change in a patient, but you're right that she should have been supervising you and your patient. If not right with you, at least where she could see what was happening. She would likely get dinged for this herself, so she will probably be quiet, if only to keep negative attention off of herself. As for your next preceptor, that is great that you want to jump out of your comfort zone. I think a lot of preceptors appreciate that. However, make sure you have a good discussion with him or her as to what you feel comfortable with and what you do not. These patients are critical so it's important to keep patient safety in mind and not take on too much before you are ready in the midst of gaining learning experience. State exactly what skills/procedures you are comfortable doing and how you feel your assessment skills are, but also request that your preceptor be nearby in case your patients start declining.

The job that pays the most and is the most advanced, requiring you to use the most knowledge possible.

I do not often speak positively about my current position as a nurse in a skilled nursing facility that cares for rehab, long term care and hospice patients. However, although it has been a disappointing alternative to other nursing positions, it appears to be the position where I will be working for an indefinite amount of time, so it's not going to hurt me to say something good about the position every once in awhile. 1. It's hard to get people to come and stay in our facility, so the workers who have been there a significant amount of time do their best to help you out and teach you, probably in hopes that they can get at least some people to stay. They're willing to help you out when you need it, they'll answer your questions without constantly criticizing you, and they're more than willing to help you learn new skills. 2. Despite it being a "nursing home," there are a lot of skills that you would see on a med-surge floor. In fact, there are some skills you acquire that your colleagues at local hospitals do not since they have specialized teams for about everything, and we do not. However, even though there is a variety of patients, and a variety of skills, they do not come in overwhelming amounts. 3. The continuity of patients is generally helpful. It means you'll get some of the skills everyday so you get time to get better at them, you can figure out how to better plan and manage your schedule because you have an idea of what each patient is going to require/want, and it's easier to detect deviations in health condition because you have a visual baseline to compare it to. 4. Most of the time everyone is more appreciate of you than they are at the hospital, both patients and coworkers alike. Lots of criticism at the hospital with little to no feedback on what you're doing well. 5. Your schedule is more consistent. You are either scheduled days, evenings, or nights. You can choose to work other shifts if you like, but you're not required. The only time is maybe when the next person does not come in and you have to work a few hours of the next shift. 6. It's five minutes away from my house, and parking isn't nearly as restricted as it is at our hospital/clinic. I am not going to even start writing about the negative aspects of the job. I am already negative enough about the position, that I do not believe discussing the negative aspects of the position will be beneficial.

Landing a new job was part of the plan for 2017. Getting a full time position at a place I'd already worked part time doesn't count. I'm already far behind in my nursing career. Working a long time at a SNF is not going to help me achieve my goals, I need to get back into the hospital as soon as I can. Otherwise I may always work in nursing facilities and never achieve my by-age-30 goals. There are 23 and 24 year old nurses already doing what I hope to be doing before my 30th birthday. What a disappointment it will be to have never achieved what I set out to do.

3 months is better than 0 months like myself.

I have not yet been one yet, but it is my goal to be one by 2019. It would be a great achievement to work with the sickest of the sick and be good at it.

Never heard of this before, but it doesn't sound like a good unit. More than likely, the two or so ICU patients you are assigned will need all of your attention because of how critically unstable they are. I would not think you would have time to care for other patients, even if they are "just" general med-surg patients. I probably wouldn't take the job for that reason alone.

Not sure there's much you can do. You brought evidence forth, and now it's their decision whether or not to keep the student. It's not fair, for sure, and the fact that there were a lot of other students involved is not a good excuse (every single one of them should receive disciplinary action), but it's probably out of your hands now. Focus on passing nursing school and forget about this student. Eventually, things will catch up with her. She may end up failing the NCLEX or being fired as a nurse, because, obviously if she's cheating, she's not learning the material. She will not get away with it forever.

My plan is to have a new job by 2018. Maybe I'll get back into cardiac nursing, I've applied to a couple of PCUs. I will work there for a year and then move onto ICU by 2019. I will be an ICU nurse before I turn 30 years old.

There's a good chance that someone else gave that patient coffee eventually and he doesn't even remember that you were supposed to get it to him.

I would think destroying them as soon as the patient's body has left the facility or within a few hours would be the best way.

I would say it's probably okay as long as "nurse" is always preceded by "veterinary." I can see your role as being similar to that of a nurse, just for animals. But it's important that people recognize that you work with animals and not people.

I am sorry to hear this was the outcome. However, this situation was so similar to mine, it doesn't surprise me. That's great that you made the decision to resign instead of being terminated, as it gave you some control over the situation. I'm glad that you're eligible for rehire, but realistically it may not happen within this organization. Technically, I'm also eligible for rehire in the organization I left, but after over 50 rejections, it hasn't happened. Yes, you're eligible for rehire, but there's a good chance they won't actually do so. But, good luck on your job search. You have 4 years of successful ICU experience, so there will be something out there for you. Best wishes!

Sounds like my workday everyday, although with 20 patients versus 8 (at one time I had that number though). I've been at it for 19 months. Sorry to say, but none of the issues you talked about really ever get better. It does sound like you handled the situations well, especially when the patients were unstable and that's the most important part; recognizing who needs attention the most, and that may not be the person who is constantly on the call light (in fact, it rarely is). I agree that in rehab we get a lot of patients who really are not stable enough to be there. Unfortunately this means quite frequently we have to take the time to send them back to a more appropriate level of care. As for forgetting a blood sugar, it happens. It's not really acceptable but I've done it and I think others have done it as well. Sometimes more critical patients demand our attention and the time to get the blood sugar flies by before we get it. Really try to make it a rare occurrence though because you never know when the stable diabetic will become unstable. As for staying hours late for charting, that happens all the time. Sometimes you have to decide which really needs to be charted today and which can be completed on another day. Otherwise you'll never get out of there. I feel like I also get behind for many of the same reasons. I also like to please my patients but some people are not going to be happy no matter what you do, so you just have to leave the room once you realize they don't really have an immediate medical need. I also have to ask for help with skills that I am not proficient in. As a new nurse, it's going to happen so not really a big deal. Better to ask for help and do it properly than assume you know what you're doing and possibly causing patient harm or not doing the task at all. I also feel the need to answer call lights, although a lot of it has to do with the stares visitors and other non-staff members will give you when they perceive you to be ignoring a call light. However I think it's a good idea to keep continuing to answer call lights since it is part of our duties, not just the CNAs. Most documentation can wait. At the same time, if there is a CNA doing nothing and you're charting, they should be answering the lights. Also, it is actually a good thing to do some of the cna work if you're available and they're busy. It's also part of our jobs and the CNAs will appreciate it as well as the patients. Sometimes nurses simply cannot avoid doing CNA work. The amount of charting is daunting but remember that caring for the patient comes first. From what it sounds like, you're doing great. There's not much I would change since yours sounds like a pretty typical day in this type of setting. Good work!

My thought is, if you really don't want or think you need the BSN, don't waste your money. I have a BSN, but it's gotten me nowhere. The position I work I would have only needed an RN license or even an LPN license.

I can relate to every word completely. I'm 19 months into my job, and unless I've had like 8 patients, nothing ever gets done on time. I'm on 12 hour shifts on days, and basically if no one dies, you can consider it a "good shift." By the time I get done with my 7-11 am medication pass, it's almost time to start the 2 pm med pass because there are so many distractions in the morning; with therapy, patients are never in their rooms when you need them to be. By the time my 2 pm med pass is done, it's basically time for 4pm meds and supper. Theoretically, I like to get my charting done while patients are eating so I don't have to stay so late, but it almost never works because someone is always needing something and the fall risk patients get up from the lunch table without waiting, so you have to catch them as quick as you can. And 6-7 pm never seems to work for charting because some patients are already wanting their bedtime meds (sure wish I could go to bed at 6 pm!). Basically, what I'm saying is...it's not you. It's the job. These types of positions are basically impossible to do everything exactly right. I can relate to calling off because I didn't want to be at my workplace either. I was always a little sick, but there were probably times I could have worked if I'd pushed myself. I agree to start looking for another job. That's what I'm going to do. I may end up leaving the nursing profession if nothing else comes up, because these types of jobs aren't worth it (especially considering how underpaid we are to do all this work!).

Already sick of this position, but I got yet another rejection today (from three months ago). I cannot work my current position much longer but I don't have much of a choice if no one else will hire me. Unfortunately, leaving nursing altogether may be the ultimate answer.

Hmm, I've never heard of someone being suspended for an unwitnessed fall. Mostly, because, it's impossible to be everywhere at one time, and some people are not going to call for help, no matter how many reminders you give them. Since there is no NEW injury according to family, suspension also seems a little harsh. What might get you is that you left the room knowing that the resident is a fall risk and had an immediate need, even though technically an aide could have met that need. Once you realized that all your aides were already busy, you probably should have just gone back to help the resident right away. Issues regarding food could have waited. Not trying to criticize you, as you yourself know that maybe you didn't prioritize tasks as best as possible. I also try and delegate tasks such as changing a resident...IF an a aide is available. However what I like to do is put on the call light, stay with the resident and start the task. If they come to take over, that's great. But sometimes it's easier to just do the task myself. However since there were no new injuries, I don't know that you necessarily have to worry about losing your license, although I would be nervous too. As far as your job, maybe reach out and explain what you would do to prevent this in the future. If this is your first time, hopefully they will take that into account. Sorry that you are going through this, as you were actively trying to get help for your resident.

There are so many meds it's not possible to always know every single one of them right away. But you do need to know which ones to hold for low blood pressure, recognize that you don't need a pain level for atorvastatin even though the MAR requires you chart one upon administration, know which ones are better given with food and which ones to give on an empty stomach, etc. As for illnesses, you don't always need to know exactly what is wrong but you do need to recognize that something is wrong and know who to contact and whether or not the person may require a higher level of care, etc.