teriadn2004

How do you get started on Case Mngt? All the posted jobs want you to have experience or certification? Any ideas? I am particularly interested in Workers Comp.

We have a CNM who delivers at our hosptial who graduated from Frontier - she is WONDERFUL!

We are a 4 bed LDRP with total 44 bed hospital - as above, us LDRP nurses are the "rescue squad" for the rest of the hopsital since we sometimes have no patients. Problem is, last week the nurses had both been pulled to Med-Surg where sometimes we are even asked to take a patient - well, women comes in ED c/o stomach ache - LD nurses are called to meet ED on LD floor - barely got her off the stretcher into the bed before the baby came.....if the LD nurses would have had actual patient assignments, there would have been no time to report off - isn't that patient abandanment? Still, they ask us to "come up and help - but no more patient assignements. And as stated before - NO ONE comes to help us?????:banghead

I say get your BSN - I had similar plans to yours when I started - work now in LDRP in a hospital for the past 3.5 yrs and thought that was the only thing I ever wanted to do. However, in my previous career, I only had an AAS degree and found that even though I could do management jobs while my employer looked for a replacement, I could not be awarded the position because of lack of that degree. So, I got my BSN "just in case". I'm not sorry either........I stumbled on to a partime opening for a Newborn Home Visit Nurse with the state DHEC - guess what - I woudn't have gotten the job if I didn't have the BSN, and who knew that I would love doing this kind of nursing as much as L&D.

We are currently struggling with this same issue and are no longer giving bags to our BF moms, but still giving to our FF moms. We are a very small unit - avg 10-15 deliveries per month, really have NO budget for gifts, but a volunteer makes knitted caps for all babies and last year (and this year) after Christmas, I went shopping and found some cute Christmas onsies/sleepers for really cheap - we dressed the babies in them after their bath who were born after 12/10 - Mom's were thrilled. This year I found cute caps and bibs for next year. I spent maybe $10 out of my own pocket, but it was worth it just to see the Mom's reaction.

I think you will find that there are a lot of "non-traditional" students in nursing programs these days. I graduated in 2004 with ADN and in 2006 with BSN and am now soon to be 54.....and I was not the oldest one in my class either. Hang in there, as a rule, we do better too because we really want to be there and in most cases, are paying for it ourselves. Good luck.

Thanks everyone, I appreciate all the help

Thanks for your comments - we are opening a brand new unit in a brand new hospital and my NM just wanted to know what others are doing. Our understanding is that medical records will be scanning our strips into the record in addition to the recorded EFM. Seems like duplication to me too.....?

Does anyone know of any law or official documentation that addresses writing on the fetal monitor strip? Are people still documenting on the strip if they are doing elelctronic record? If anyone knows of any references, could you please list them? Thanks ahead of time. I am starting in a brand new unit in a brand new hospital - so we are writing the policies ourselves. :typing

We are a 32 bed LDRP and we have mandatory call of 12 hrs per 4 week schedule. Sign up is for 4 hr increments - dates and shift needs are posted when the completed schedule comes out and all are expected to sign up, and if have not signed up by second week into the schedule, will be ASSIGNED. On-call pay is measly 1.25/hr - if called in, 1hr travel pay, + 1 1/2 - however, our on-call satff are really just reg staff - because in 20 months that I have been there, I have NOT been called in ONLY 3 times. Even with the on-call staff, we are still often desparatly going thru the roll-a-dex calling every name - needless to say, with all the call we already do + our 36 hrs/wk - not many takers. Now we have 14 travelors in addition to our own staff - they say this is temporary and the call time will be "going away" soon - but I will believe this when I see it! :rolleyes:Flip side - I love the extra money -but hate all the time away from my family.

Wow! If I didn't know better, I would think that you got inside my head and wrote this post for me. I too am in my last week of orientation (14 weeks - although I lost time when pulled to do PP on three different days) - my preceptor kept telling me the same mantra of "you need to pick up the pace" or I'm concerned about your ability to multi-task", to the point where 3 weeks ago I was ready to resign in anticipation that they were going to fire me anyway.......I am a night shift nurse, but was being trained on day shift - I went back to night shift, and low and behold, my precetor on nights thinks I am doing GREAT! So......hang in there and do your best - I agree, I'm slower than my precetor, but that doesn't mean I don't get the job done. My night presceptor told me that she still has to stay over sometimes to catch up on charting, particularly if baby comes quickly after picking up patient or ir things change (i.e., your C-sect case). All the comments posted really helped me feel better too. Good Luck........:smilecoffeecup:

This is a wonderful post - I just accepted a position in NICU and I'm a little scared - I have 19mo experience as a nurse, but with adult primary care outpatient (basically, doctors office). I thought I always wanted to do L/D - but have never been able to get a slot - so when NICU came along, and they WANTED me, lack of experience and all - I thought, well maybe this is REALLY mycalling ....so thanks to all who have shared and have me now thinking that NICU just may be the perfect nursing role for me - thanks:nurse:

I just graduated ADN 2004 and will complete BSN next month.....I have a 4.0 GPA.....however, I am the sole support for my family, provide the health insurance etc.....I had to work while in school and it has taken me 6 yrs to do this with taking classes at night, weekend, etc. In SC, there was NO help for me beacuse I have a documented income of $32,000 for a family of 2.....my husband was injured in a accident and diagnosed with a brain tumor while in the hospital for the injury.......that was in 2002 and he still hasn't gotten disabilty......meanwhile, we lived on credit cards as I struggled to NOT lose our house, etc and to NOT give up on my dream to get by RN. I applied EVERY term for financial aid & too many scholarship apps to list......all I ever qualified for was "UNSUBSIDIZED" student loans........note, we live in a double-wide trailer, so we are not "rich". I will begin paying my loans back in the FALL......there are lots of roadblocks to getting aid, especially if you are an responsible adult who is not a minority. P.S. I am ADN, soon to be BSN Exp: 1yr, 5mo Work: Primary Care Outpatient Clinic - Fed Agency Location, SC Salary: 40,000 Work: 40hrs/wk Good luck to all who want to be a nurse.......I wanted it badly enough to not let all of the above stop me and I am 50 yrs old....it may take until I retire to pay back my loans, but it was worth it!:monkeydance: :monkeydance: :monkeydance:

I don't know about ADN and BA in something else, but in other healthcare areas there is a difference in 2yr vs. 4yr. For example, in the laboratory there are medical lab techNICIANS (MLT) who went to school for 2 yrs at a community college and have a AS degree and medical techNOLOGISTS (MT) who went college and have BS degree - they both do EXACTLY the same jobs in the lab but the pay is not usually significantly different at entry level, but climbs rapidly as experience level increases - they both studied the same things, very similar to the differences in ADN vs. BSN programs. (I know this because I have a AS-MLT degree and now an ADN degree). As you can see, they have DIFFERENT names and they take DIFFERENT exams for certification. The MT exam presumes that the person taking it will have a better understanding of the theory and tests more heavily in theory and management issues. I worked as an MLT for 25 yrs - and yes, I was a much better tech than a lot of MT-BS people who were hired in the later years of my career, BUT, the bottom line was, the BS-MT's got the pay and they were chosen for the supervisor and management jobs. No matter how good I was nor how often I proved myself by DOING the job in the interim of a vacancy opened up - I never got the promotion. So, when I reached my "ceiling" on the wage scale, I had 2 options, be happy with just COLA or go back to school. I chose back to school, but for Nursing - now I will continue on to get my BSN because I've seen what a difference it can make down the line.

I too am a "second degree" RN. I chose the ADN at my local technical college only because the waiting list for BSN prgrams was rediculous and I need to BSN to get paid better because I work for the government. In the area where I live, local hospitals have little if any differential for ADN vs. BSN in pay or responsibility, so I've been told. I work for the Federal government where the pay difference is significant enough to drive me to get my BSN, i.e., $37,000 per year for ADN w/2yrs experience vs. $49,000 for BSN with same experience. My point here is, I don't believe that one program better prepares the new graduate than the other one does. Case in point - a new grad from BSN program was hired for the same job as me a couple of years ago - she quit after about 4 months because she was not getting the proper precepting that ALL new grads need - the story told was that new grads don't belong in primary care outpatient setting - then along comes me, ADN new grad, they have to give me a shot at it because the govt paid for my school. I got 2 weeks with one of the supervisors, then was assigned to a physician and told to "ask if you need help". Who is watching over me to catch me "when the pieces of my puzzle are missing and I don't know it"? NO ONE. When I'm on the phone with a patient trying to sort out if he needs to be brought in to see the doctor or when my doctor is not here and I have to decide if a patient phone request can wait until he returns or if I need to get another doctor to review it - no one reviews these behind me? In my experience, the idea that new grads get OJT is a JOKE! Unless you are hired for an ICU, most of us are getting the minimum that they can give us - no wonder we aren't staying. Was it the BSN new grads fault that she didn't get a "proper preceptorship"? Was I, the ADN new grad any better prepared? NO to both...but in an earlier post, someone mentioned that Canada has it's nurse do year long internship - I would love that - I go home everyday, worried that I may have hurt someone by what "I don't know that I don't know". In the ADN program that I just finished, they had to cut some of the clinical hours because the state added another course to the mandatory Gen Ed classes for AS. When we, the students, asked for more lab and clinical time, we were told that they couldn't give us more because the program would exceed the max no of hours for AS degree. Hum! What does that say......we got a grand total of 80 hours with a preceptor at the end of our program - ours just happened to be in December - my assigned preceptor was off or called off EVERY day that I was scheduled, so I was put with "who ever was available" - what a joke......I vote for the return to hospital based nursing programs with a minimum no of gen ed courses PRIOR to admission - I'm old enough to have friends who went that route - they came out MUCH more ready to be nurses. In my opinion, college based programs assume that the employer will spend the needed time to FINISH the training - but it's just not happening unless you are lucky enough to get hired by a hospital that is tied to a university - the others are just wanting a "warm body". I question my decesion everyday, unfortunately, I didn't have a choice as to where I would work after I graduated........I'm counting the days until my obligation is paid back and hoping that a university based hospital will be willing to hire me and invest some training in me. Too bad I didn't get that in school.....

Greenville Memorial Hospital in Greenville has a Peds ER. Don't know much about it though.

As a matter of fact, I did on another area - that was about 6 weeks ago when I found this wonderful website - I too had a "top of the pole" position and was always the one that everyone came to when they didn't know who else to ask - worse yet, it was at the same facility I'm at now - I think this what makes it so hard for Hang in there, I can honestly say that I feel better about myself JUST about every day. I think "this too shall pass" for us both. Good-luck .

I know that going to MORE classes sounds like that LAST thing you want to do, but take it from a DEC04 grad - the alternative could be like what happened to me...... NO orientation - 2 weeks with a supervisor and, HELLO new RN - "page me or ask one of your co-workers if you have a question" - IF I HAVE A question - get real - I have a question about every 3 minutes, or so it seemed - than there's the "battle of the staff nurses vs. superviors" - supv think that staff should precept new nurse and staff nurses think that supvs should do it - end result, a very frustrated, stressed, scared new grad nurse who WISHES she was in a class------so, enjoy it while it lasts - you will be in the "trenches" soon enough! Conrats on the new job though :)

At the time that I wrote the original post, I had been searching for financial aid. What I found when I searched was MANY, MANY scholarships and grants for nurses, IN OTHER STATES, but NOT SC. Many states have loan forgiveness for nurses who agree to work in their state - Florida has special mortgages with lower interest for nurses, just like for teachers. Second, my husband was military, so I have lived any five different states - the cost of living in SC is higher than ANY place else when you add in taxes on vehicles, insurance rates and cost for property here - including Florida, which has NO state income tax - interesting since the pay here is lower than any place that I have lived. It seems to me that the only chance of getting any help from the state is if you graduated high school here and go right on to college - that Hope Scholarship or Promise, whatever it's called. I have lived here 12 years and paid taxes all that time but because I didn't graduate high school here, I'm not eligible for ANYTHING. I guess what I'm saying is, it was very frustrating to search for help and discover that I couldn't have picked a worse state to have moved to and had I picked just about ANY other state, there would have been help. Just seems like the powers that be are counting on nurses who grew up here, to want to stay here, because they aren't doing ANYTHING to recruit people from other states nor to keep them here. Sorry if I hurt anyone's feeling who grew up here, but these are the FACTS.

:) Thanks again Darla - I think most of the nurses that I work with probably would like to share their experience with me too, but they are all so rushed just to get their own work done - I know it's hard for them. I'll keep you posted...

This is EXACTLY what I am afraid of - I became an RN at 49 (hence, my screen name) because I want to work in hospital - preferably in L&D or maybe ICU. I'm terrified that I will never be able to do this because it will be expected that I should have gotten my experience my first year out of school. I sure hope that I can get a hospital job as soon as I get through with my obligation. Thanks for sharing. I needed to know this.

It's so nice to read that someone feels sorry for me - most of the staff that I work with just tells me that I am having "reality shock" - just like any other new grad - as for a mentor, unfortunately, I have a mentor - she was a staff nurse when I started nursing school, but by the time I finished, she had been promoted to nurse manager -now, I feel like I would be "laying myself out for the slaughter " if I tell her much. Most recently, when I tried to tell her how I was feeling, she told me, "I told you that you needed hospital experieince, but we had no choice but to keep you here". So - I just do my best, watch my back and drive all the other nurses batty with all my questions. I will keep coming back to this post - I need to know what others are feeling -you know, "misery loves company". By the way, this week has been a little better - I just made up my mind that I was not going to hide the fact that I need help. I take my time and if the providers complain, maybe it will get someone's attention.

I am a new grad and I started 2/21 in a primary care outpatient clinic - basically a doctors office. I had no choice but to be in this position as I went to school with a scholarship and I was assigned to pay back my time here. From the first day, I have been miserable. In this setting, I am expected to assess patients and decide if they need to see the doctor, triage them over the phone, do lots of patient teaching concening medications, new diagnoses, pre-procedures and basically, "catch any mistakes or missed f/u" made by the doc. I must act on my own, as it is impossible to stop and ask another nurse what to do in every instance - and EVERY instance is different. After 3 and 1/2 months, I still feel VERY insecure and I haven't made it thru a week yet that I haven't been in tears at least once. And I am not "inexperienced" - I was the Lab Supervisor in the clinic where I work and I have worked in more than 10 other doctors offices in the lab as a relief, as well as hospitals. I am "mature" nurse, so I have "life" experience to draw from as well. As soon as I can, I plan to get out of here so I can get some "real" experience. I'm concerned that even after I have been a nurse for over a year, I will not know how to do anything besides take VS, do EKG's and give injections - not what I went to school to be! Get that good basic foundation before you imprison yourself in a doctors office - I don't think you will regret it! :uhoh21:

I just graduated in December - of a class of 40, at least 10 that I know of had 75 questions and passed. I did however know one person who also had 75 and did not. So....you have at least a 90% chance based on our experience. Hope this helps