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egg122 NP

egg122 NP MSN, APRN

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  1. egg122 NP

    Feedback appreciated

    You did the right thing. It's unfortunate that many times the person who does the right thing isn't treated well in health care and I'm sorry you were put in this position by others. Be proud though- you showed integrity in this situation! My opinion, from a root cause perspective, is that the order should have been either discontinued or put officially on hold in the EMR so there should be some provider education/ practice change there in addition to counseling the RN who gave the drug on the 5 rights. Is it common in your ER for people to give meds while walking by? If so, that practice may need to be changed as well because it is not reasonable to expect you speak to every nurse in the ER every time you get a new med order so that it is communicated.
  2. egg122 NP

    Are we not asked to give to much?

    Kalipsored21- There was recently a good article in the NYTimes about the same topic that you might like: https://www.google.com/amp/s/www.nytimes.com/2019/06/08/opinion/sunday/hospitals-doctors-nurses-burnout.amp.html
  3. Jedrnurse, BSN, RN is right. LTC and Sub-acute are now similar to many med-surg floors since they offer acute care services with IVF and IV medications. SNF nurses tend to also develop excellent assessment skills. On top of this, nurses have 15-40 patients in the SNFs! I have a lot of respect for LTC/sub-acute care nurses. I think you won't have trouble on the inpatient side at all with time management, assessment and treatment. The hardest part may be adjusting to the EMR/documentation but this is also facility specific. Best of luck to you!
  4. egg122 NP

    Nurse Practitioner Union in WA

    I agree with you. Plus you'd loose income on union dues. One other thing to think about is negotiating future raises/ bonuses. If you are union, would you be locked into a bargaining unit that limits your ability to individually negotiate this?
  5. egg122 NP

    Rude nurses

    OP, it is likely the hospital or unit your are in and not personal to you given how little time you have been on the unit and that you have significant nursing/ hospital experience. There are some hospitals that are incredibly toxic and the culture is to be rude to newcomers due to frustrations in the work environment, "it was done to me", or just the personalities on the unit leave a lot of be desired. The last hospital I worked in was like this (and I could not believe a place like this existed until I saw it myself). If your hospital has a significant amount of derm on the inpatient side and engaging with staff still proves to be difficult over time, you may be able to connect with the WOCNs (if your hospital has them) on certain cases to help ensure the care plan is carried out if needed. The good part is that you are out of there in 4 years and I imagine a significant portion of your rotations are outpatient in derm. Just remain professional, do not engage, and focus on learning and patient care on the in patient side. You have shown yourself to be respectful and professional in your posts here and I have no doubt you will be successful. Best of luck in your future endeavors and congratulations on starting this great new chapter!
  6. egg122 NP

    Nurse Practitioner Union in WA

    Does the union offer any additional benefits (pension, cheaper or better health plan etc)? Also why did the NPs feel the needs to form an join a union (ie does this employer have a history of being toxic or unfair)?
  7. egg122 NP

    "Not sure what unit you will be hired into..."

    Generally when trying to get people to see your point, how you say it can have more influence than what you say. People tend to shut down when they perceive communication to be belittling, angry or negative. Just some food for thought. 15 hours ago, TitaniumPlates said: Sigh. I will explain this one more time. The posting was for ICU NURSE. PERIOD. The interviewer asked her why she wanted to relocate to the east coast from the west coast. ERGO---the interviewer knew that she wanted to move closer to her family. This is not an "illegal question" which is truly ignorant of you to state. Any job I've ever been up for that would have me move cross country (i've done this 4 times) or even across states---THEY ASK YOU WHY YOU WOULD WANT TO MOVE THAT FAR. It's because they want to know how serious you are about moving.. Do you have ties? Are you just looking and wasting their time? does this clear things up for you? THE JOB WAS POSTED AS AN ICU NURSE POSITION. THE JOB WAS POSTED AS AN ICU NURSE POSITION. SHE WAS INTERVIEWED UNDER THE PRETENSE THAT THIS WAS AN ICU NURSE POSITION. Any further clarification needed? Good lord almighty. THE. JOB. WAS. POSTED. AS. AN. ICU. POSITION. THEN the RN Mgr, once she had interviewed with my friend---and asked for references---and had her sign forms to get her background check---the Manager dropped it on her that it was "UNKNOWN" what unit my friend would orient into. Do you get it? She wanted my friend to RELOCATE 3000 miles for a job that was POSTED as ICU, only to be told that it was "actually unknown" and that "a dozen others" were also "orienting into the unknown" and they would choose after an educator decided in 3 months---what unit she would be assigned to.
  8. egg122 NP

    Am I experiencing signs of burnout in ICU?

    I'm sorry you and your partner are going through this. I have gone through the same feelings at work and for me it was generally a combination of burn out from work along with a propensity towards depression/anxiety. I am not saying in your case you have depression or anxiety though- just sharing my background. It does seem like you are going through an emotionally trying time. Do you see a counselor? It may help to talk to someone sooner rather than later, even for a short period. Make self care activities a priority (exercise, eating healthy, regular sleep). Also, can you transfer back to the CCU? Good work cultures make a world of difference, particularly in high stress jobs. I wish you the best of luck.
  9. egg122 NP

    Some advice on "Orientation"

    I wish I could tell you that this is not typical, but that is what every orientation I've had since starting in healthcare has been like. I had more training on the job (and the computer system) when I was working in a pizzeria. I'd advise reviewing videos online for any procedures you may feel you need to improve or learn. Youtube has a lot of videos produced by medical and nursing schools that are pretty good. If your hospital has a subscription to UptoDate.com, it is worth looking up the most common disease states on your floor to familiarize yourself with them and the possible treatment plan. It is a learning curve but you can do it.
  10. egg122 NP

    Night shift mentality: keep them alive until day team comes on

    This is a great point. Many times the covering night providers are advised that they should really be handling emergent/urgent cases and outside of that the care plan should be differed to the primary attending or team. This is to allow for care continuity and so that there aren't "too many hands in the pot". Also, many time major changes require extensive discussion and if it not urgent it is important to let the patient, and/or, family sleep rather than wake them up late night to discuss something that can wait until 7 or 8 am. I'd say don't hesitate to call with any concerns at any time, since that is what the covering provider is there for. If a provider is not addressing a urgent situation (change in condition), that should definitely be elevated.
  11. egg122 NP

    156 Applications and 0 Interviews

    I think Nurse Beth is on to something with the resume. However, have you reached out the companies to discuss your situation? For example, UHG has set times for clinicians to chat with recruiter about positions: https://careers.unitedhealthgroup.com/getting-hired/recruiter-chat It may or may not help. Sometimes just getting in front of a human face can push your resume through. Also, a lot of the corporate entities are really into values and try to hire based on if they think a candidate is a fit with those values (which is difficult to determine and can be hit or miss). It would be worth taking a look at each individual company and try to incorporate buzz words/ corporate values into your cover letter and resume when possible. It will also help on the interview if your are familiar with them as well.
  12. egg122 NP

    Exhausted; I want a way out.

    I'm sorry for your struggles. It is a lot to go through. In terms of the work aspect, have you thought about looking at working at insurance companies as a nurse case manager or other nursing position? A lot of the positions are work from home and the insurance benefits tend to be a little better (including IVF). Not all of the insurance jobs are utilization review. Some have a lot of patient contact and some have none.
  13. egg122 NP

    PMHNP prescribing questions

    If that is the argument- why is there a line drawn at insulin in your prior post? Wouldn't prescribing insulin be prescribing to mitigate the effects of anti-psychotic therapy? Why not also prescribe an ACEI for renal protection since the patient is having sequelae related to the antipsychotic therapy? Are you going to refer them to an ophthalmologist and do the recommended foot exams? What if the patient develops a sequelae of diabetes and you were the only one managing it? People can, and do, get reported to their respective licensing boards for mismanagement of diabetes or face lawsuits. Starting down that path can distract from their psych management. Also, coordination of care is truly an expectation.
  14. egg122 NP

    Why are so many nurses against unions?

    I was expecting to really support unions when I started my last position. As a non-union, but non-management, member of nursing staff I have to say it was a rude awakening. It was the most hostile and worst patient care environment I have ever seen. The union employees weren't even getting decent pay and benefits relative to the area. Staffing ratios were 1:10 at times. The delegates seemed more concerned with getting their own and would even bully other union members. Patient care and outcomes was what you would expect in this type of an environment. There was no sense of nursing professionalism or pride in work. I could not get out of there fast enough and plan to avoid working in any union environment in the future.
  15. egg122 NP

    PMHNP prescribing questions

    100% agree with OldMaHubbard. I am an adult NP and would be fairly annoyed, to the point of not referring patients anymore, if I found they are being started on medications for diabetes and antibiotics in a psych office without calling me. Why not just call and coordinate with the PCP?