MIA-RN1

I have the standard find-outabout-pt-at-end-of-shift dream a lot but recently, I've had a real run of dreams where I have twin boys and one I can care for and one I can't. Mostly the babies are born where I work and the one stays with me and the other goes to the special care nursery where he is cared for. Usually I am worried sick about both babies and torn between which one I should spend my time with.. I realized recently that it symbolizes my desire to leave my current job, and how torn I feel. As soon as I accepted a new job, the dream stopped.

both!

I agree with you but when is management really going to take responsibility? Lets face it, a bad outcome is going to first be attributed to the bedside nurse, even if its a staffing issue. ("The nurse should have refused the assignment." "The nurse should have asked for help from her coworkers.")Management will not end up accountable because they will fall into the us and them mentality. Bedside nurse vs management is a common theme in nursing I think. I would love management and nursing to work together--maybe these new 'unit council' ideas will help. But the reality I have seen is that if you call management because of a staffing issue on the off hours, you are told to figure something out. And I have yet to see a charge nurse who does not dread making the call to the one who is on 'administrative on call' at 11pm because there are too few nurses to cover the census. So yes, management should be forced to take responsibility but the reality is that the burden will continue to fall on the bedside nurse. I wish there were a good and simple answer. This is a great topic for discussion!

Oh yeah I agree and I have made issue of assignments before. Just also felt the powers that be kind of trying to make me feel guilty. Management had decreed that our ratio would be 1:5 couplets. And charges had to work within that, flexing us down to that level. (It is about 10 patients/nurse, sometimes more, sometimes less). And that is where the greatest level of stress came in, I believe. They changed it now to 1:4 couplets (strangely at about the same time the new safety nurse came on board) We are not allowed to work overtime unless its call time that we are coming in for. Period. Staying late gets you 'counseled'. I don't know what its like anywhere else. Hopefully though its better where I am going. I don't htink that there is any easy answer for these types of staffing issues. It boils down to what the other poster said about nursing not being billable. Imagine if we were---people wouldnt be able to afford us nor would patients afford their hospital stays! People don't come into the hospital for care from a doctor; they come to receive nursing care. Its a nurse they shout for when there is a problem. I wish that mangement could see that. Not just for me but for all nurses everywhere.

If I refused my assignment because it is too heavy, another nurse would have to absorb them and then it would be worse for her. Plus I would worry about abandonment issues. If management will only staff so many FTE's, then thats what we have to work with. We are taking 12 - 16 hours of call time per month as well as working full time or part time. Its the way it works. I agree that a nurse-run hospital would rock but I don't anticipate seeing it happen. Bottom line is it wouldn't be cost effective because of the piddly payments from insurance companies etc wouldn't support the staffing that nursing knows is vital to patient well being and satisfaction. Meaning we'd be right back where we started from. I am deciding what to do about the issue with my feet--changing to a floor with lower ratios and hopefully fewer staffing issues (AND NO CALL TIME YIPPEE!)

start looking now, beat the rush to find the hours you want. I had my job lined up in November, didn't graduate til may> I am just about the only person I know of who didn't have to work a job with overnights, because I looked early and got one of the primo shifts.

you are only a new grad until someone is hired toyour floor that graduated after you! :) Seriously, if you have recently passed your NCLEX, then you are not a new grad. You are a new nurse. Even after my first year which just ended, I consider myself a relatively new nurse.

you have to follow your heart; you are working hard to become a nurse and you deserve to do what you want to do. There are no 'shoulds' because there are two sides to everything. I graduated and went right to postpartum (mother/baby) Its been just over a year now and I will be moving on shortly to a surgical floor. I was too scared to start my career on that floor, and used mother/baby as a jumping off point. Yes I will have to 'relearn' some technical skills (IV starts anyone? lol) but I did what I had to do to feel comfortable in my new role. It was perfect for me. Others I know started right off in med surge. Some are happy, some aren't. It all depends on your own feelings. Just go with your gut and do what you feel pulled towards.

I am soooo in the minority but I like the white scrubs. Perhaps its because I've been forced to wear lavender for the past year, but whites to me are so symbolic of nursing and I feel better in them. That might change of course after I am wearing them for a while. I expect to have to replace them more often but a stain on lavender shows as much as a stain on white will, so no big deal to me.

I am moving out of mother/baby and onto women's surgery which also includes some oncology, hospice and bit of dialysis just for grins and giggles lol.

coleen, I empathize. I am leaving my first nursing job next month to switch to a different unit all together but within the same hospital. What I did was I waited til the last moment before mentioning to anyone that I was even thinking of leaving. I was afraid of the proverbial wrench as well, like meownsmile mentioned. HOwever d/t mine being an internal transfer, the cat had to get out of the bag much earlier than I wanted. Look around and make inquiries as to your options first and get something lined up before you tell anyone at all that you are thinking of leaving. Its possible that even just the looking and inquiring will help you get thru the rough days at your current job. And you want to keep your bridges intact, especially if you want to remain there per diem. Good luck! And congratulations on getting married! :balloons::balloons::balloons:

we have self-scheduling w/ the rules (e/o weekend, e/o holiday) and it works okay but the bottom line is what is good for the unit. The perdiems and the full time and part times all put their requests in at the same time and the scheduler does what she does. It works about 85% of the time. Lots of times the ft staff get a day or two changed from what they put down to work. And even tho I repeatedly request not to work more than 2 12h shifts in a row it still happens that I have got scheduled for 3 (for the best of the unit). And last year I had to work labor day, thanksgiving day, christmas day, new year's eve and was scheduled this past memorial day but switched w/ someone. I would be a better fan of self-scheduling if I saw it used appropriately: I think that the ft and pt should get first 'dibs' and the perdiems should be used to fill in the gaps. Likely we would then have less on-call time. (12 - 16 hours mandatory a month) because there would be fewer holes.

I love being a nurse. Maybe I don't love my work situation right now, but the basic, fundamental fact of becoming a nurse is the best thing I've ever done for myself.

hmm when i first started in 1989 I went for two years...one year of prereqs and sciences and then another semester of clinical and then half a semester and withdrew for health. Started back in 97 or 98 to just finish up liberal arts degree since I had enough to almost do it and finished that in 99. Then went back to nursing program in 2004, and graduated in 2006. Seventeen years if you keep a running tab......with a long break in the middle lol

I use it when patients are painful or stressed or worried or basically whenever it seems right. I use a really simple one: Feet on floor or if not sitting then feel them rest against the bottom of the bed. Feel the earth between your toes, feel the grass around your toes and over your feet to your ankles. Feel yourself connecting to the earth. Now feel the sun on your head, feel the gold soothing light as it warms your head and travels thru your body. Feel the strength of the earth hold ing you firm and safel and the gold sunlight as it warms and sooths you... Thats the abbreviated version. Its more of a grounding technique I learned when I first delved into psychic stuff but it really really calms people down and helps them focus. I had one patient using the images as she was working on weaning from the vent and she said it helped. edit: and I also never use it in place of medical treatments or interventions. Just as an adjunct.