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Just and R.N

Just and R.N

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  1. Just and R.N

    A Newly Defined Type of Constipation: Opioid Induced Constipation

    A timely article for me. I recently took care of a patient with metastatic gastric cancer, on opiods for pain control. He had difficulty with maintaing an adequate bowel regimen due to large amounts of IV narcotics, difficulty tolerating senna and miralax, (or any PO for that matter) and possibly the physiologic effects of his disease. The only thing that worked was relistor, so yes the med does have a place. His (and my) relief when he finally had a BM was worth whatever the drug costs. Big pharma or not this was about a young dying man getting some much needed relief.
  2. Just and R.N

    Nursing Jobs in NYC

    The OP makes an excellent point, one which had I been aware of I may have chosen another career. Unfortunately I only discovered AN after graduation while spending endless hours searching for jobs. It's hard for me to wrap my mind around the fact that the U.S Bureau of Labor Statistics, the CCNE, STT, etc. are propagating the concept of a nursing shortage, while a nursing blog, albeit a respected and wonderful forum is more on top of the reality. As a data driven person I can say; lesson learned - data, numbers, impressive quotes and statistics are NOT always the most accurate source of information. (expensive lesson learned at that) It's not about the money and expense though. Nursing school has changed me as a person and given me tools I may not have otherwise acquired. While I certainly did not realize how difficult it would be to find a job I still love nursing. I have tremendous respect for the strength of the role models I have met along the way, both in the clinical setting and online. I hope to be as good a nurse one day given the opportunity. As a born and bred NYCer I do feel a little disappointed, both in myself and the current job market. Some days are downright depressing. But NYCers are tough! No matter what the climate, economy, situation I will pay back my loans and strive to become the nurse and professional I desire to be.
  3. Before I begin, I would like to ask that any misconceptions/assumptions/ presumptions be excused as the wondering of an ignorant new grad. This article is not meant to disparage, just to gain a clearer perspective on some of the more perplexing aspects of job searching. There is a certain dark mystery to some of us as to the secrets of the HR hiring process. Countless threads have been dedicated to unraveling (excuse the pun) the intricately spun web of online applications, resumes, cover letters and interviews that go into that first job. That being said, this is a compilation of questions from some of my colleagues that we hope will garner some advice from those in the know Are you for real? Is it true that often online postings are for made up positions? It's hard to believe that the jobs actually exist when you call up the hospital to be told they are in a hiring freeze right now. Even if they mean a hiring freeze for new grads why post positions that seem available to them? Do grades matter? Some of us have been told by nursing instructors that in today's competitive market grades can make all the difference. This seems to be a stretch as the students who have gotten jobs after graduation are not necessarily the ones who were at the top of the class. Is G.P.A even a consideration when the NCLEX is the national standard of competency? How pushy is too pushy? When the online application site explicitly states NOT to call about the status of an application why do some people seem to think that means that if you don't call you are not being persistent (aggressive?) enough. Doesn't that mean that you are simply following directions? Does the squeaky wheel indeed get the grease, or is this a myth propagated by people who obtained jobs by other means and post their successes under the guise of persistence? Spending money to make money? Is it worth it for nursing students to spend extra money to get certifications like ACLS/PALS/EKG/IV? Does this indicate commitment or a desperate attempt to gain attention? Are there certain certifications that put a resume on the radar? Are they perceived as a sign that someone is active in pursuing education or as a jump on the alphabet cart bandwagon to try to get me noticed? Take a walk......(or a hike) This is a sensitive one with two major camps who seem to be certain about their side. Is walking in a resume a way to ensure that it gets there, or are people who attempt this told to "take a hike?" How about cold calling and asking about positions? (uhhh look on our website we don't have time for this) So does someone actually go through all the resumes or what? Is every resume submitted into cyberspace picked up, or do some unfortunate ones end up in the intergalactic black hole of the wastebasket? Are there any "code words" in a resume that send it straight to a shredder (ie: new grad) What's the magic word? There are so many ways to format a resume. Some people say to add generic skills like time management, customer service and quality and safe care to make up for a lack of technical experience, while others call that filler that's likely to send your resume into the abyss. Is there something(s) in particular that recruiters LOVE to see? Or is the magic formula for new grad resumes akin to the fountain of youth and other such myths. Sometimes those who have jobs claim that it's because of XYZ on their resume. Is it a "total picture" or a specific detail? The ideal candidate? So let's say someone graduated summa cum laude, was president of their school's SNA, as well as the national chapter, worked as a nursing tech throughout school, volunteered for several organizations, did an externship, and belongs to several professional organizations. Does this make them an ideal candidate? These are things that nursing instructors stressed as being of particular importance during school, yet in the real world don't seem to matter at all. What makes an ideal candidate on a resume, BEFORE an interview is even attained? So it's all about who you know? What percentage of new grads are hired due to connections? Are there times that more qualified applicants are passed up in favor of those who somehow have an inside advantage? Or is it an "all things being equal" we are going to hire the one who has some sort of" pull." What's the real reason new grads are not being hired now and is there REALLY a nursing shortage? The economy? Budget Cuts? Uncertainty about the Affordable Care Act? The cost of training new grads who are likely to move on? The lack of retiring nurses? Surplus VS. shortage. Propaganda by nursing schools to churn out more grads? All of the above? None of the above. Select all that apply!
  4. Just and R.N

    Interesting or Different Anatomy:What have you encountered?

    In clinical had a patient who was carrying to babies that were NOT twins. One was conceived about 2 months after the other. The OB/GYN said it was his first experience with this in his 25 years of practice.
  5. Just and R.N

    Suggestions please, New grad asking for help

    Thank you all for your suggestions. When I started my job search I was a bit naive and was reluctant to "use connections". I stupidly believed that as far as new grads go I had done all the "right things" to make myself marketable and would get a job without calling in favors. So much for that reality... Now I knew that as a new graduate I am missing the only thing that hiring managers are interested in, EXPERIENCE, but new grads do get hired SOMEWHERE. I knew that being picky or choosy is not an option, and that I would take any offers that came my way, and work hard at whatever job I would get. So no entitlement to get into the specialties of my dreams (peds onc, adult ICU, dialysis) just the feeling that with all my hard work I should be able to pick up a job somewhere. Then came phase two. Swallowing that I obviously was not good enough on my own and would have to beg someone to let me in was a bitter pill to swallow. But hey, as a nurse bitter pills are part and parcel of what we do and if I can dispense I should be able to take some myself. Well, that didn't go too well either. When I exhausted (and I mean exhausted) the list of former professors, preceptors, unit managers, close relatives, distant relatives, friend's relatives etc. etc. I realized that despite the fact that I always had a solid reputation as a hard-working and bright individual it really made no difference. Sure I can apply for forbearance and deferment, I can take a low paying non-nursing job so that I can send my check directly to the loan companies while I wait in the social services office for government assistance. I know that these aren't necessarily bad things and that it's temporary and as soon as I get a better job I'll give back double!! The thing that bothers me the most is that I have one desire, to be a PRODUCTIVE MEMBER OF SOCIETY. To be able to pay my bills and dues on time, and give back to the world more than I take. It's incredibly frustrating to see this fall away. I have always been self supportive, fiercely independent, and strong willed. I am naturally shy and quiet but I have always given the impression of being smart, capable and hard-working. I became a nurse because I truly believed that it was the right choice for me. The combination of art and science, humanity and technology, physical and emotional, passion and compassion is something that I view as an honor and privilege to be a part of. I'm not going to give up because that's not in my nature AT ALL. I will take a job temporarily (already lined up) and continue to search. I hope that someone, somewhere, someday soon allows me the privilege of working for them so that I can really use those letters after my name.
  6. Just and R.N

    Suggestions please, New grad asking for help

    I have tried every connection POSSIBLE. I have made hundreds of follow up phone calls. I have hand walked my resumes (most HR don't appreciate I just wanted to attempt and see if it would make a difference) I have tried numerous non-hospital settings. HELP!
  7. Just and R.N

    Suggestions please, New grad asking for help

    Thanks everyone. I'm licensed in NY and NJ - I realize it's competitive but moving is really not an option right now for numerous reasons. I have followed up and tried to use all the connections I have. The hospital I interned in is not hiring now, which would have probably been my best shot under normal circumstances. Like I said, I am not applying only to hospitals. (I tried HH agencies, LTACs, SNFs, clinics, Dr.'s offices, etc) Guess it's time to look for non-nursing. Sigh.... I really really thought I was doing the right thing. It's really devastating to be turned down time and time again.
  8. Another desperate new grad post. Perhaps a seasoned nurse out there could give some advice? I'm a new grad who has not scored a single interview after three months of intense searching and licensure in two states. I have had my resume and cover letter reviewed several times and tailor my cover letters to the institution. I have applied to hospitals, SNFs, LTACs, home care agencies, staffing networks, flu clinics, Dr.'s offices, community health clinics, etc. NOT A SINGLE RESPONSE. I know there are new grads out there with more experience, however I do feel like I tried my hardest to make myself marketable. (4.0 G.P.A, ICU externship, nursing tutor while in school, medical office secretary work) Loan deadlines are approaching. Any ideas for a dejected and rejected new grad? Please no comments about making my bed and sleeping in it or not doing enough research, all my fault etc. I became a nurse because I felt it was the right thing for me and my future. Not for the money, not for the glory, but because I feel I am a solid candidate, who is willing to work hard and try to make a difference. No I don't think I'm entitled to get into a hospital/ICU/ED/ or my specialty of choice oncology right away. Yes I'm prepared to take anything and work my way up. I just haven't been given a chance. Positive and proactive advice only please.
  9. Just and R.N


    Thank you for your help. When in doubt leave out.
  10. Just and R.N


    Is it acceptable to include a short personal reason for interest in a position in a cover letter. (especially a position that wants you to demonstrate specific interst) For example when applying for a position as an oncology nurse can one briefly state that as a cancer survivor you have a particular interest in the matter. Or is that too personal. Or when applying for a position as a member of a transplant team can you include that you have a close relative who underwent a transplant or that you are a transplant donor? Thanks