ann915

Hi everyone! It's been a while since I've been on here. A lot has changed since then, and I've been working as a nurse for almost 3 years now. But to make things short, I am now currently working in postpartum/nursery; and have been working there for about a year now. Anyways, so here is the story. I apologize if this is long and redundent. I'll try to keep it simple and discreet, so I won't expose any potentially easily identifiable information. I am a nurse in California working in the maternity department of a hospital that gets many high-risk maternity patients. Our hospital has gone through some changes that has led to a significant increase in census in certain departments; OB being one of them. Since then, we've been very hectic and chaotic. They're currently working on making new floors for our department to keep up with the increasing census, but I don't think it will be complete for a while (about a year is what we've been told). As of now, whenever our beds fill up in our department, we open up a postpartum overflow unit (which is a floor on another side of the hospital), which is neighbored to an acute pediatric unit. The original rules were that there would need to be at least 2 maternity RNs in the overflow unit, and that the patients sent there would be transfers of stable moms and babies who were going to be discharged the next day. We would also supposedly take turns on who would go to the unit next whenever it opened up. A few weeks pass, and then all of a sudden they are only sending 1 maternity RN to open up the overflow floor with 3-4 couplets. The director feels that it is okay because the peds next door has at least 2 nurses to aid the nurse regardless of the issues with patients going on their floor: such as covering her breaks, answering her call lights, medicating her patients if she is too caught up with another patient, etc. She also says there was nothing to worry about because the couplets transferred to this floor were stable patients who were going home the next day, and that the lone nurse there would not get more than 4 couplets (as that is our ratio in California). If somehow the pediatric department were to close because there were no patients for them and if the overflow unit needed to be opened up, then she would allow sending 2 maternity RNs there. Another few weeks pass, and now admits (fresh deliveries) from L&D are being brought to postpartum overflow. When confronting management that this was not supposed to happen, because the patients were supposed to be stable transfers, they say the rules have changed. So now new admits will go to that unit now - so no more transferring old OB patients that were going to be discharged next day. They tell us these admits were only "stable" lady partsl deliveries and that they would never send us c-section patients, or patients with maternal and/or newborn complications. Well, few weeks pass again and now they send whatever couplet from L&D is ready to go to postpartum overflow, just as long as they weren't on magnesium or were "too sick". Many times when I was the nurse on postpartum overflow, they would give me moms on iv antibiotics; babies with temp, blood sugar, and feeding issues; moms with blood pressure issues who supposedly became stable in recovery; preterm newborns; newborns born from moms who were ruptured more than 20hrs or from moms with chorio; newborns who ended up being transferred to NICU later in my shift because they became too sick, etc. This is also along with rushing me to discharge patients before midnight (I work night shift), working on an admit I got an hour ago, having to weigh babies at nighttime, do hearing screens, teaching, etc. "Why are you making it a big deal? It's not that difficult. You have help from peds. So there is nothing to worry about." They'd say when we bring up our concerns. "Call OB if it's really urgent. Or call RRT." They'd also say. And yes. They've ALMOST sent c-section patients there with only one OB RN present on the unit a few times (at least from what I've heard from my other coworkers). Luckily, it hasn't happened yet. But the fact they've considered it several times is scary to me. Is this really legal? I thought by law, a unit/floor needs to have at least 2 RNs to open it up. Or maybe it differs per state? Or maybe I'm wrong? Regardless, I really don't feel this is very safe practice for a hospital to do. While the peds nurses I work with whenever I'm assigned to overflow are super great and helpful, especially when it comes to helping me with sick or potentially sick newborns (as they do encounter newborns in their pediatric population), I don't think it's really fair that they are expected to help us along with whatever issues and tasks they have going on in their unit. Not only that, if an OB emergency were to occur, they really wouldn't know what to do to help me stabilize the patient, as OB is not their specialty. Yes, they float to our department sometimes when needed; but they do not go to postpartum on daily basis and are usually not given very complicated postpartum patients. To me, and many others, this is just bad news waiting to happen. And it keeps getting worse with them constantly changing the rules. It's a huge safety issue for the patients and our licenses. It just doesn't sound right to me. It's beyond frustrating. We've expressed concerns to management of this issue multiple times and they just keep brushing it off. We've also brought this issue to our union many times, who just tells us to keep filling out our ADOs and that they're working on it with management. This has been going on for almost a year and nothing has changed. Has anyone here ever been in this kind of experience with the facility they work or worked at? Anyone's input and advice would be greatly appreciated. Thank you very much.

I want to say thank you to everyone for sharing your experiences, advice, and opinions on this post. I'm learning so much these past few months; and this was quite the learning experience. It has been very challenging - but little by little I'm getting the hang of things and learning the ropes. All your replies were very helpful and has helped me how to deal with such situations like this. Next time, I'll be much more firm and say "Stop" when things start to become way too inappropriate. Everything is intimidating as a new grad, especially when standing up to others who are degrading. But eventually, I'll grow out of that. My main focus is to learn as much as I can and maintain patient safety. As long as my patients are safe and are getting the care they need, then that's what matters most. Everyone's been really supportive here and at work - and I'm truly grateful to have this. Thank you so much! :)

Thank you for the encouraging words :) Yeah. I felt the comment where he threatened to "beat my head" was a bit uncalled for - totally didn't see that coming :/. There were a few cranky doctors I've called - but never went to the extent that this one did. But, from what I hear from my coworkers, this isn't exactly new. He's yelled at many of the staff on the unit I work on. I don't know if anyone has brought it up to management yet. Maybe, maybe not. Calling doctors is very nerve wrecking - especially at night - but it's necessary for patient care; that, and most of them I called and talked to were nice, patient, and helpful. But yeah. No matter where you go, there's always going to be jerks. Just keep on swimming. Keep on swimming. As long as I can keep my patients safe and help them get better - those are the most important tasks to do :]

Thank you guys for your replies :) This incident has kinda struck me for a bit. I just wish I could've stand up for myself and handled it better, but I was just taken back. It was just one of those instances where you kinda freeze and don't know how to respond, since it just came out of nowhere and wasn't expected, and then think about it later and finally come up with things you should've said or done to handle the situation better. One of my downfalls is that I'm just way too soft and too passive and tend to not say anything to rude remarks. But I hear that as time continues though, that'll change. I'm working on it, it's coming along slowly - just gotta learn to say stop when things are unnecessary. :) I'm glad to know that I'm not alone here. Thank you all for sharing your thoughts and advice - it's really helpful. I truly appreciate it :) An1991

Hi. I'm a brand new RN working nights on a telemetry med-surg unit. Just started off on my own. I know there are a handful of topics on this particular subject. But I just wanted to share a particular experience I had last night calling a doctor regarding a patient, and wanted to hear how some of you would've handled this. If there is anything I need to work on, it is my assertive skills. So I called the doctor. And it went like this... Me: Hi Dr _____. This is ____ from _____. I'm calling in regards to a patient, _____ from room ______ who came in w/ _______. Are you familiar with him?? Dr: If you ask me that question again, I will beat your head!!! Are you stupid? Didn't you see my name on the board!? Don't you dare ask me that. Just get straight to the #^#/ point. Of course, I apologized. Then continued and so forth, just trying to get to the point while he still rambled on. I suppose it was a dumb question. I mean, I'm still figuring all the things in the hospital and Doctor names, who is on call/who covers who, who is private - just still figuring how everything works and so forth. But still, I felt that was just a bit overboard. Yes he is a private doctor; and maybe it was a dumb thing I asked (I always ask "are you familiar with this patient" with every greeting to determine the familiarity and how much background history to provide - maybe I shouldn't ask that). Well, at least I got orders... and I got to finally make the patient comfortable (he was ETOH withdrawal) I know that some angry or irritated doctors will just hang up or say whatever and leave you like "Huh?" I don't know. Afterward, and even still now, I feel kind of bad. Even feel intimidated if I have to to speak to him again. I asked some of my coworkers their opinion, and apparently they weren't too surprised and told me he usually bickers about petty things such as so. What do you guys think? How do you handle angry or rude doctors or coworkers? Any advice to someone too soft like me. Thanks :) An1991

Yeah. I agree. It's really nerve-wrecking - I'm here with you and many new graduates out there. But, when in doubt, we just got to hang in there and maintain a positive attitude - and tell ourselves we can do it! :] I was told by one of the nurses at my orientation that one of the most important things for us new nurses to do is to be kind to ourselves and maintain good self-care. Learn, learn, and learn. Ask a lot of questions, even when they seem silly. And most importantly, ask for help if you don't feel comfortable with a task. :)

Ah, I see! I'll be reviewing and brushing up on those then. I know that the hospital I'll be working at has an Electrocardiography class that goes into detail with cardiac physiology and anatomy, as well as arrhythmias that occur, coming up soon. So I'll definitely be looking into that class as well - and other cardiac and critical care classes that is offered there. Thanks for your input! I really appreciate it :)

Thanks greyL for the advice and help! I really appreciate it :] And I do believe that the floor I'll be working on does the drips of the medications you mentioned above (I remember my manager talking about that during our interview when I asked what the acuity of the floor was). So, I'll definitely be looking and brushing up on those meds :) Thanks again! I'll keep everything you mentioned in mind.

Thank you so much for sharing your experience and input! This was very helpful indeed :) Despite hearing how challenging and hectic the Telemetry Unit can be, I also hear it is a great place to learn as a new nurse because there is so much going on with the patients there and that there are many skills to learn that you can also apply to other hospital floors. And although excited and grateful for this wonderful opportunity, I'm still nervous, since this will be my very first RN job and I'm fresh out of school - it's the whole, "I'm not a student anymore, now an RN..." and the "What if I hurt someone..." nervous feelings. But, I also hear the real learning begins once your nursing career begins. So, I want to do and learn all I can to become a competent and reliable nurse. Gotta remain positive and very determined :) And thanks for clarifying what category Telemetry falls under. I was a bit confused, some say it's Critical Care, and others say it isn't - and then I went and looked on the AACN website and noticed that Telemetry was a selection on the "Which Unit do you work in" section. So it just really depends on the unit and the kind of patients that come in. I see, I see... Anyways, thanks again! I really appreciate it [: an1991

Hi! It's been a while since I've been on here. After about 9 months of job hunting with no luck, I finally got an offer for a Nights position on the Telemetry floor - which I'm really excited for, but super nervous. I've heard many mixed feelings about New RNs starting on Telemetry (I hear it's a very busy and difficult floor, yet can be a really great place to start depending on the hospital and the unit). So I just had some questions. I know there have been some topics regarding New Grads starting on the Telemetry Floor around this site (forgive me if any of these were already answered in other forums). I was just wondering if anyone could recommend or share any good resources (books, links, drug books, etc) that I could use to better prepare for the floor. I also just got my ACLS and took a Basic Rhythm Interpretation course through AHA - which was recommended to have before starting. What other classes would also be good for me to take? Another question that might seem really silly. Forgive me if it sounds so. But, is Telemetry considered Critical Care or Acute Care Nursing? Or does it depend on the facility? I was just wondering since I know that some Tele floors are considered Cardiac Step-Down Units, while some Tele floors are mixed with Med/Surg (or Med-Surg/Tele Units). Any tips or shared links would be greatly appreciated. Thank you very much! an1991

I haven't heard anything back yet for a second interview either. I remember them saying that if we were selected for the second one, we'd hear back in a week or two. That was a week ago during my first interview when they told me. I hope to hear back. But I don't know. I got pretty nervous on that first interview.. Eep! ...."OTL

Thanks so much for the tips! It's very helpful and I really appreciate it! :)

Is this the e-mail message asking for supplemental information to mail to them: transcripts, the 2 essays, letters of recommendation, copy of RN license, etc? I just got one from them too, and am in kinda disbelief that I heard back from them (it's been a while since I submitted an application to them). I hear it's a really nice hospital to work for... but that's all I have heard so far. I have heard that they do hold high expectations (as most hospitals do), but they are very supportive of their new grads and want them to feel supported. But yeah, I'm also interested in what experiences previous new grads there have been.

Hi. I was hoping if there is anyone who would be willing to critique my resume and cover letter. It would be very much appreciated. Thank you! Also, regarding the cover letter. If you don't know the person or the address of the facility, how would that be written? Can someone share some good sites that has information on that kind of situation? Thanks again :) ~an1991 _________________________________________ Resume [Full name], BSN, RN [**** Street Address] [City], [state], [Zip Code] Phone: (***) ***-**** --- OBJECTIVE --- Seeking RN position that will further develop expertise as a Registered Nurse. Special interest areas include Labor & Delivery and Neonatal Intensive Care Unit, but will accept any position to enhance experience. Brings unique skills in electronic health records, simulation, an extensive preceptorship in Medical-Surgical area, and Nursing Research and Development of a teaching project regarding the prevalence of eating disorders in the Type I Diabetes population. --- EDUCATION --- [Educational Institution], [City], [state]; May, 2013 Bachelor of Science in Nursing * Dean's List * Sigma Theta Tau International Honor Society of Nursing --- EXPERIENCE --- [Name of Educational Institution], [City], [state]; Oct, 2012 to Jan, 2013 Skills Lab Assistant * Helping and assisting students in learning their nursing skills along with being present for questions and practicing skills during open lab hours. [Name of Company], [City], [state]; Jul, 2012 to Oct, 2013 Caregiver * Providing home care to seniors with tasks including light housekeeping, meal preparation, errands, and much needed companionship. --- PRECEPTORSHIP --- [Name of Hospital], [City], [state]; Feb 2013 to April, 2013 Med-Surg (MS1), 186 hours * Acute patient care in Medical-Surgical unit, adeptly handling all aspects of treatment from medication to wound care to monitoring for 3 to 5 patients per shift. * Closely monitored acute conditions. * Performed basic physical assessments of adults. * Developed patient care plans, including assessments, evaluations and nursing diagnoses. * Monitored fluid intake and output levels. * Followed infection control procedures. * Experience with various medical conditions including Parkinson's, Dementia, Diabetes, Cancer, and Alzheimer's disease. * Assisted patients with bathing, dressing, feeding, lifting and transferring. --- CLINICAL EXPERIENCE & TRAINING --- * Advanced Med-Surg: [Name of Hospital] - [City], [state], Telemetry/ICU, 120 hours * Community Health: [Name of Clinic(s)/Site(s)--I used my school] - [City], [state], Community Health, 112 hours * Pediatrics: [Name of Hospital] - [City], [state], Pediatric Acute Care/PICU, 112 hours * OB/Maternity: [Name of Hospital] - [City], [state], L&D/Postpartum/NICU, 112 hours * Mental health: [Name of Hospital] - [City], [state], Psych Emergency, 112 hours * Med-Surg II: [Name of Hospital] - [City], [state], Acute Care/OR, 112 hours * Med-Surg I: [Name of Hospital] - [City], [state], Acute Care, 112 hours * Gerontology: [Name of Hospital] - [City], [state], Skilled Nursing, 90 hours * Simulation, skills lab training and competency testing: [Name of School] - [City], [state], 200 hours --- OTHER RELATED EXPERIENCES --- [Name of School] - [City], [state]; Aug, 2011 to May, 2012 Living Health Community Member * Planning, educating, and promoting health and ways of healthy living among the campus and surrounding communities. [Name of Institution/School] - [City], [state], CA; Jun, 2007 National Youth Leadership Forum of Medicine (NYLF/MED) * Pre-medical education program involving hands-on, interactive curriculum--including shadowing practicing physicians, clinical site visits at various medical centers, and meeting and interacting with faculty from various medical institutions. --- CERTIFICATIONS --- * California RN license, expires [date] * Basic Life Support for Healthcare Providers, expires [date] --- REFERENCES --- Available Upon Request ________________________________________ Cover Letter [Full Name], BSN, RN 1230 [street Address] [City], [state], [Zip Code] Phone: (***) ***-**** Date: August 14, 2013 [Human Resources/ Nurse Recruitment] [Name of Hospital/Institution] 321 [street Address] [City], [state], [Zip Code] Dear Sir or Madam: I am writing to state my interest in the [insert Name of position/program] at the [insert Name of Hospital/Institution] in [City], [state]. I graduated with my BSN from [insert name of educational institution] on May 2013. My education and past experiences have helped me develop valuable skills that I believe will help me become an asset to your health care facility. As a student nurse, I have experience in electronic health care records, simulation, and care of multicultural patients. I had an extensive preceptorship in the Medical-Surgical unit, and with 1286 clinical hours as a student, I feel I have the confidence to provide excellent nursing care to patients and to be a solid member of your team. I am enthusiastic regarding this position and believe that my values of care matches your institution's core values of care--[insert Institution's values/philosophy of care]. My special interest areas include Labor & Delivery (L&D) and the Neonatal Intensive Care Unit (NICU). However, I am open to any entry-level RN position that will enhance my experience, knowledge, and skills that will allow me to grow to be the RN I aspire to be. My enclosed resume will give you additional information about my work experiences. My application can only tell you a little regarding my inspiration and qualifications for a position as a new graduate RN. I would be grateful for the chance to meet you so that I can further discuss my background, qualifications, and interest in this position with you. I can be reached at my phone (***) ***-**** or at my email . Thank you for your consideration in this exciting opportunity. Sincerely, [Full Name], BSN, RN

Thank you, autonome for your input! :)