caringchic

thanks so much, had my first interview to day second interview on Wednesday, I think it would be so fun and give me a break from the bedside.

I am interviewing for a Precert job today w/ a big insurance company, I am excited but nervous, I really want to get away from the bedside. I too think it would take awhile to get used to the slower pace, inpatient is just dang crazy any more!!!

You go girls it is so inspiring to hear other nurses more seasoned than I who appear to be able to critically think be devalued by their employer!! It has been my experience that most employers really only want followers, willing to follow the script and be overjoyed while doing it!!! Canadians health system has it's weak points, but is such a far cry better than the arrogant egotistical system we have in the States. I would like to ask some one who was at a 6+ figure income and now after this "economic downturn" is on state assistance aka (welfare) if they would value a system like Canada's??!!!! In my life time I have been both on the top and on the bottom, health care for all needs to be every ones responsibility!!! Thank you for sharing your experience w/ us!

I absolutely loved the OP! That nurse had it all figured out and it was awesome, so refreshing to see that other nurses experience similar events!

Sorry, I clicked on reply in this OP but somehow got out of sequence, sorry for the confusion.. OP Re: "And it's all going to be your fault" You do sound a bit jaded, that is coming from a new graduate. However, maybe you are taking it as a personal thing when people are just not always nice. I'm sure dr's are asked for medical advice a lot too, and often it is their fault! But thanks for the uplifting post!

I recently had this happen to me, pt drug seeker, known to the unit, kept insisting I give meds for which there was no orders, she told me she was going to report me for unethical nursing, I informed her I had spoken to the doc, no orders rec'd charted it all, and she did in fact report me to the BON, which did open an investigation and I get to wait for 3 months until the next board meeting. Completely ruined my career at this point, more than likely the BON will close it b/c there is nothing there, but the stress and uncertainity of it has completely embittered me to nsg, healthcare, admin, I hate it. I have gotten beautiful performance evals, amazing raises, opportunites b/c of my knowledge and clinical skill but the minute customer service rating was bad w/ this crap pt, admin didnt give a damn about my 93- 98 % scores for performance, 10 years down the drain,.. run fast and far from nsg

try re-posting when you have somewhere between 3+ yrs under your belt your perspective may be significantly different.

Do a search on this site under the word burnout and you can read and make an informed decision based on serveral different perspectives w/in this given curse uhh, I mean profession called nursing. From my experience NO, hell no, it is in the end the bottom dollar every time, in every way, didnt used to be that way. So very sad, and frustrating

MSN SUXXXXXX, Intelli Staff SUX, fellow nurses really need to be cautious when interacting w/ this company.

MSN is the worst, I repeat worst travel agency and their partners Inteli Staff are unsafe and unreliable. I have worked for them in various locations and make it my perogative to expose their risky business. Be extremly cautious when interacting w/ them.

YEP to all four, especially on those days from hell. Wouldnt it be nice if all systems could talk to one another especially nurses!

I have been denied promotions, tx, and other career growth steps b/c of my absolute determination to pt advocacy ahead of company propaganda. However the reputation of "trouble making" has been less than ideal. One think I remind myself of is that I have a stack of thank you cards from prior pts and families for being a pt's nurse first. But as I have said in other posts, that doesnt pay my mortgage!

to the original poster, in the start of your career there will always be times when pressure is great, patients to many or to demanding and the shortcuts seems like the best way. I think every nurse takes shortcuts at times, the ones who say they dont may not be completely honest. It has been my experience to ask myself some questions in that pressured moment: #1 is this short cut capable of harming the pt, in the short term or the long term? #2 is this something my management would like me to do but bears no potential danger? and #3, is this action something that can has a narrow margin of error or is there several ways to accomplish the same goal? Nursing is sometimes so very frustrating b/c much of our prioritazation and approach is very individualized. If you can ask 20 nurses the same question and get 20 different responses you are probably ok. However if it is someting critical you will usually get the same response from all 20. Nurses are way to back biting, and not near enough mentoring of one another. Has anyone asked you what you learned from this experience? What you would do differently the next time? How would you could change the outcome given the opportunity? We all know when we have screwed up, what we need to know is how to do it better the next time! Good Lord nothing in your post is worth the cruifiction you have gotten. Was it best practice ....um.... I think you know that ! :) Take a deep breath, and move forward hindsight is always 20/20, move confidently forward b/c of your mistakes that is how we learn! From someone who has been there...

to babybug, when you are a licensed RN then feel free to write a post beratting another nurse about their nursing practice. Until then why dont you learn from someone else's mistakes b/c lord knows you dont have time to make them all yourself.

thanks, my old hospital is on a hiring freeze right now, so I am currently looking. I just dont have it in me, I am so burned out right now. The only way to get support is as a staff nurse and even at that I am begining to think at a facility backed by a union. Some way healthcare standards have got to be brought to a balance in this country for the pts, the providers/healthcare professionals and the people footing the bill. I think I'll take up truck driving LOL

Did you get in writing? If not you may be screwed, if you did, ask about their employee grievance policy or speak to their General Manager.

OMG I could tell you some stories to make your hair stand on end.. I worked at two different facilities, one as a staff RN and one as a traveler.. both places are not facilities that I would recommend to a new nurse or probably not even my worst enemy. The companies running both were ok, good benefits and the management not terrible. It is the concept that I was uncomfortable with. Just the name "acute long term care" hospitals aka LTAC.... means sick people w/ no where to go but hopefully to rehab enough to go to rehab or to get poor enough to be eligible for other insurance options. My experience was because they have hospital in the name JCAHO rules apply, so we were expected to run our own codes. That was fun I have ACLS, done codes previously, except.. this certain place had no docs except by phone, no lab, no RX, no x-ray, no RT who could intubate and I was prohibited from doing so per facility protocol... and 911 was a no go d/t us being a "hospital" we were expected to run our own stuff. Did I mention that I was the charge, w/ one LPN, one RT, one CNA and a tele monitor for my staff.. ICU pts, and M/S pts anywhere from 8-16 on any given shift. My experience taught me alot...run, Forrest, RUN!!!! :) For me it was not something I felt comfortable in, I need to know that I have the tools to do my job and do it well. I dont like feeling helpless especially under pressure, so I ran fast. Maybe others find it very rewarding.

they terminated my contract immediatelly sighting "interspersonal difficulty". One RN who is a new nurse makes for such statement. I was amazed that this could not be used as a learning situation for both of us. I was especially frustrated given my evaluation! Especially when it was not a lack of clinical skill, med errors do happen, thank god it wasnt something more serious. My attitude is nursing sucks, it isnt the pts though. One day last week I got two cards sent to the hospital from prior pts and a plate of goodies delivered from a previous pt...but that doesnt help w/ this. My mortgage is still unpaid! I have never been good at getting along w/ catty women, I just dont play games well. I am so depressed I cant make myself apply for another nsg job. I have got to get an attitude adjustment. I had been calling my recruiter weekly just to make sure all was well, cont to reinforce that I believe in direct communication, she kept assuring me all was well. Then after the fact she tells me she is not clinical at all! Further frustration..

This spring I will have been licensed for 8yrs. Worked in a huge variety of settings, however I am so burned out on nsg, healthcare and anything that has to do w/ organized health systems. Nsg is great b/c there is a million different avenues to persue and ever changing methods/tx/ and ways to reinvent your practice. This is a good site to read regularly then you may not be as disillusioned as some when its your turn!

I feel your pain! I worked in an LTAC for about two weeks and that was enough fear factor for me! I was the charge RN, sometimes the only RN, w/ an LPN, CNA and an RT. Who informed me after the fact that she was not able to intubate and we were not to call 911 should a pt code. I was confused so I asked the manager who clarified that I was to run the code but we had no lab, no pharmacy, no radiology and no doc in house. None of the RT's were certified to intubate. I gave my immediate resignation the next day, this was 2yrs ago and so the economy was better there were more options. However wont do much good to have your license under investigation by the BON and be suspended until they review the complaint. Remember also if you do something negligent you are liable, it is the facilities job to provide safe staffing, you can always refuse the assingment document it then should something happen the burden of proof lies on the facility as I understand it. Doesnt help in the day to day stress though! Best of luck to you.

I have experienced some of those things which were exactly the reasons I got burned out and quit for a time. In my original response I wrote that prison culture is very different from life on the outside. you dont get to be overtly helpful and caring d/t the different perspective from security. I was never accused of anything from the staff but the inmates talk, a bunch of men testorone floating around w/ no "appropriate" release seems to me like a expected outcome! LOL BUT the difference is being a RN on the inside is I didnt have to have the same perogative as the C/O. I worked only in mens prisons, I have previously worked w/ all women inpatient psych locked units and they are some crazy hunnies in their! Women are all catty makes balanced girls crazy! Being on the inside I found it best to take it all w/ a grain of salt, the inmates, the security staff and the expectations of the joint. Lets face it is one of the fastest growing industries in our country...what can we say to that?!

the benefits are great i worked for the state at one prison and yes the PTO and health isnurance is great plus you could contribute to state retirement plan. private institutions have OK benefits. Just make sure you have good boundaries and are not easily manipulated, I had a pt once realistically perform psuedo seizures so realistically we sent him to the ER and myself and my co-RN both used to work on an epilpsy unit! LOL It was amazing!

Lock downs can last for awhile, the longest one I was in was about 5hrs. Depends why the facility is locked down; riots, fights, escapes, seg problems anything that requires alot of security staff will lock down the joint. Can you go to sleep depends on who is in or out of the medical. Once I was on pill call, and the LPN was in the unit, the relieving nurses were at the front lobby but had to be frisked prior to entering the facility. It was a long wait! :) Just a reflection of my experience that I can pass on would be CCA prisons are not my first choice for employment. They are very safe but they are contracted to states- TX, OK AL, and a few others so dollars are watched closely sometimes not providing good care. No fed prisons where I am from so dont know anything about that! Stay safe!

OK I want the dirt from other nurses who have traveled.. I have been traveling locally and contracted for the last 11/2. Been an RN for 7 yrs, never had problems until I started traveling. I recently took a day shift job on a busy PCU. High acuity pts typically 4 rarely three w/ one CNA for 15-18 rooms. Ward rooms are still there w/ 3-4 pts to a room. Got my 30 day eval and got 97% great comments and great feedback from assistant nurse manager and unit director. Last week got my assignment and report. Report on pt #1 - cant tolerate dopamine gtt titration. pt #2- new onset CHF given 60meq KCL no replacement protocol ordered. plz f/u. pt #3- cant thermoregulate, cooling blanket/warming pad at bedside, tube feeds ordered pls f/u pt 4- d/c when CE are negative this afternoon. 1445 my pt codes call team, by the time code crap was completed and ready to catch up on my other 3 pts it was 1630. During report in the am nurse told me pt one who coded had not been able to tolerate titiration of dopamine gtt d/t hemodyamic instability. Doc rounds and writes to d/t gtt. Call doc update on BP's w/ titirations. Call doc and get new orders to d/c gtt regardless of pt's BP or response to titration. Again made sure MD was aware of current BP. I literally was at pt's bedside almost all day until code, between quickly running across curtain to check on CHFer and across hall to see vent pt. No charge RN around, CNA unavailable no other nurses around, so I admit my attitude is getting a little grumpy. Catch up on meds that are now late for 1500-1700, d/c pt who has now waited all day and it is time for report. Night nurse comes on and wants to know why a 1800 IVPB wasnt hung on my shift, and if I was going to sign off orders. I said I had some charting to catch up on and I was sorry that was going to have be taken care of on her shift. NOC RN is visibly upset, yells at me about leaving her a mess. I apologized b/c it was a mess, however the entire day had been a mess. I am only one person. Next day come back and RN wants to know about 60meq of KCL that "werent given" I stated what I had been told in report given at night. WEll KCL wass now 2.3 and it was my fault. I reviewed that hyperK was much more difficult to treat thhan hypoK and had I given it 120meq within 4 hrs could be much worse. Have same pts that day except at 1700 direct admit arrives w/ 10/10 CP. Needs SL nito, line started for Nitro gtt and BP is 220/118 w/ N/V/E, LOC and increasing SOB. Who the hell direct admits that to a floor? anyways.. d/t guy isnt finished up until 1835, lines in meds given, CP resolving, CBG stable, again no CNA, no Charge RN, and my other pts. Give report to same NOC RN who is now mad that none of this guys admit stuff is charted. I explained that I had some of it done but the U.C had not put the chart together yet, no labels, or anything else. Next day I get call from my agency that the contract has been terminated b/c I am difficult to work with. I feel horrible. I feel like I was trying to take care of my pts. I dont just want to leave the guy w/ 10/10 CP, to go sign off his admit orders that arent even input in the computer yet. What is more important the pt or the paperwork? I know 12hr chart checks are the norm, but sometimes it isnt possible, or should I have thought it was my responsibility? I am so burned out on nsg always trying to do more w/ less and travellers seem to get screwed w/ no recourse. I am up for any feedback. Good, bad or ugly, what are other experiences?

OK I want the dirt from other nurses who have traveled.. I have been traveling locally and contracted for the last 11/2. I recently took a day shift job on a busy PCU. High acuity pts typically 4 rarely three w/ one CNA for 15-18 rooms. Ward rooms are still there w/ 3-4 pts to a room. Got my 30 day eval and got 97% great comments and great feedback from assistant nurse manager and unit director. Last week got my assignment and report. Report on pt #1 - cant tolerate dopamine gtt titration. pt #2- new onset CHF given 60meq KCL no replacement protocol ordered. plz f/u. pt #3- cant thermoregulate, cooling blanket/warming pad at bedside, tube feeds ordered pls f/u pt 4- d/c when CE are negative this afternoon. 1445 my pt codes call team, by the time code crap was completed and ready to catch up on my other 3 pts it was 1630. During report in the am nurse told me pt one who coded had not been able to tolerate titiration of dopamine gtt d/t hemodyamic instability. Doc rounds and writes to d/t gtt. Call doc update on BP's w/ titirations. Call doc and get new orders to d/c gtt regardless of pt's BP or response to titration. Again made sure MD was aware of current BP. I literally was at pt's bedside almost all day until code, between quickly running across curtain to check on CHFer and across hall to see vent pt. No charge RN around, CNA unavailable no other nurses around, so I admit my attitude is getting a little grumpy. Catch up on meds that are now late for 1500-1700, d/c pt who has now waited all day and it is time for report. Night nurse comes on and wants to know why a 1800 IVPB wasnt hung on my shift, and if I was going to sign off orders. I said I had some charting to catch up on and I was sorry that was going to have be taken care of on her shift. NOC RN is visibly upset, yells at me about leaving her a mess. I apologized b/c it was a mess, however the entire day had been a mess. I am only one person. Next day come back and RN wants to know about 60meq of KCL that "werent given" I stated what I had been told in report given at night. WEll KCL wass now 2.3 and it was my fault. I reviewed that hyperK was much more difficult to treat thhan hypoK and had I given it 120meq within 4 hrs could be much worse. Have same pts that day except at 1700 direct admit arrives w/ 10/10 CP. Needs SL nito, line started for Nitro gtt and BP is 220/118 w/ N/V/E, LOC and increasing SOB. Who the hell direct admits that to a floor? anyways.. d/t guy isnt finished up until 1835, lines in meds given, CP resolving, CBG stable, again no CNA, no Charge RN, and my other pts. Give report to same NOC RN who is now mad that none of this guys admit stuff is charted. I explained that I had some of it done but the U.C had not put the chart together yet, no labels, or anything else. Next day I get call from my agency that the contract has been terminated b/c I am difficult to work with. I feel horrible. I feel like I was trying to take care of my pts. I dont just want to leave the guy w/ 10/10 CP, to go sign off his admit orders that arent even input in the computer yet. What is more important the pt or the paperwork? I know 12hr chart checks are the norm, but sometimes it isnt possible, or should I have thought it was my responsibility? I am so burned out on nsg always trying to do more w/ less and travellers seem to get screwed w/ no recourse. I am up for any feedback. Good, bad or ugly, what are other experiences?