supakimchee

Yeah, we all passed. Just be patient. Nothing is going to make it go faster.

I was accepted into the BSN bridge with CSULA, but I chose not to go. If your goal is to work for a County (DHS) hospital, I would wait to get your BSN. CSULA is expensive to complete the bridge option and it is based mostly on grades you received in semesters 1 and 2. DHS hospitals don't require BSNs and only offer a 2% bonus for completing them. Some programs cost anywhere from 20-30k, so it's really not worth it. If you're planning to work at a private facility, that's a whole another story, as some hospitals require RNs to carry a BSN or the pay increases might be significant enough to warrant going back to school to obtain it. Just be aware that the bridge program with CSULA for County is during the summers meaning you will have zero time off in between terms. If you already have children, that might be a tough pill to swallow. Also the tuition deferment is not 1 year after graduation. It's around 6 or 7 months.

Paramedics do not act independently without orders, neither do nurses. If you are carrying out ANY ALS interventions in the field it is under the direction of a licensed physician/MICN or it is part of your Standing Field Treatment Protocols which are orders created by your Medical Director of your EMS agency. As for the surgical/needle crics - this is NOT allowed per LA County EMS protocols, so that's just a jurisdictional thing. I will agree with you that medics and nurses are complementary. There are things medics can do WITH orders that nurses cannot do and vice versa. I really don't see a point in bickering amongst ourselves when we're all part of the same team.

Skip the LVN, get your RN if at all possible.

Since I haven't worked in an ICU, I'll just fill you in on some pros and cons of working in the ED (level 1 Trauma, level 2 Ped)! Remember guys, this is my list. Some of my pros might be cons for others and vice versa. Pros: -Fast-paced -Less documentation -You will become an IV padawan (vascular access nurses are the Jedis) -You become a more well-rounded nurse (you can take care of any patient - not like you got a choice!) -Job satisfaction -Exhausting - You sleep like a baby -Exciting - TFAs, TTAs, TCs -Assessment skills become lightning quick -Patients that are thankful for you -Scumbag patients that warm up to you because you're actually nice (actually my favorite patients as you build better rapport) -If you empty your pockets when you get home after a shift, you can probably open your own hospital. Cons: -Fast-paced - Make sure you take your breaks -Resident physicians that think orders should mimic a leaky faucet -Homeless drunks who want to take a bed all night -Not-homeless drunks who want to take a bed all night (worse than the homeless) -Interchange drunks with IV drug users above -Patients who claim to be allergic to every pain med except dilaudid -Exhausting - you can literally sleep for 2 days after 4 straight shifts -The month of July -You're literally overflow for every damn area of the hospital -Scumbag patients that treat you like crap no matter how nice you are. -Patients that show up to the ED because they have "too many boogers" (I'm dead serious) -If you didn't test positive on a PPD you probably will working in the ED The Worst Part of ED: Watching family react to a family member's unexpected/tragic death. Oh, also...you're going to get a lot of psych patients. I would also list management as a con, but I cleverly work the night shift so I should diplomatically disclose that management is not a con.

When it comes to ABCs, always err on the side of caution. No one is going to get their license revoked by acting in good faith for the patient. But they will yank it if you start practicing medicine and dismiss it as a panic attack :) I remember during my EMS years, I had a nurse ask us why we had the pt. on a NRB when he was sating @ 98% on RA. Because he was breathing 38 times a minute? I'd be a fool not to!

Yeah, it's called saliva kid. Not the sharpest tool in the shed, is he/she?

Well, that's why I work at a County hospital. We don't make money, we bleed it. We're still understaffed as hell though, HA!

I'm confused. Can you clarify how your relationship is with your ex-husband? I would personally never put myself on the line to get someone an interview unless I was willing to completely vouch for the other person, meaning that I'm comfortable and know the person well enough (and consider them worthy of sticking my neck out for). If you and your ex-husband are not on great terms, you need to run...run screaming from this situation.

Well, I'm not going to quote the guy that gave us the Great Wall of Confabulation, because I'm pretty sure you all know who I'm talking about (plus I got really tired of scrolling). But this is squarely directed at him: Sir, there's a reason you have 10 posts and zero likes. Please stop trying.

Hey guys, just send me a private message if you have any more specific questions. I'd rather not post publicly about where I work :)

I think we'd just end up with adults getting poked by Narcan pens that are trying to sleep. Honestly, how would a child have the assessment skills to know whether their parents are OD'ing or asleep? I know it should be a simple task for adults to grasp, but that is a crap-ton of responsibility we'd be expecting from just mere children. Whatever happened to the times when kids could be kids? SO sad nowadays.

Sorry to say but it varies quite a bit. I've had friends that took over 2 months to get results and I got mine in 1 week. It's just the way the BRN works I'm afraid Just keep checking your BRN account for your license number!!

I dunno, anyone over 300lbs? *Rimshot*

You should come to our hospital. Some of our CNAs don't actually do anything. They can't even do 1:1 sitting without somehow walking out of the room and magically socializing with the unit secretary. I worked in LTC and those CNAs bust their butts compared to acute care CNAs. Most of the time in our hospital, they usually disappear or argue with one another about who needs to do work. They actually started giving our CNAs phones because of the disappearing Houdini acts.

I've had over a decade of EMS experience working 911 side by side with our local fire department. I've seen everything there was to see in the EMS point of view. TFAs, decapitations, eviscerations, STEMIs, CVAs, major crush injuries, amputations, GSWs/stabbings, 100+ foot falls, blah blah, typical trauma/medical stuff. Before I started nursing school, one of the fire department medics pulled me aside and gave me the best advice that I still follow to this day. He was a trauma nurse before joining the department, and he said the WORST thing I could do walking into nursing school was to act like an insufferable know-it-all because I have a ton of experience. I'm going to ask that you heed this same advice OP. Take it from someone who has been in your shoes before, except someone was nice and caring enough to explain to me the pitfalls of previous medical field experience. Start as a blank slate, because that's what you are. You don't know what it is to be a nurse, so to be critical even during the "boring" theory stuff reeks of a lack of humility and frankly a lack of patience (I think someone pointed that out too). To discount a basic fundamentals course before you even have an inkling of what nurses do, shows how little insight you actually possess. If you wanted the "blood and guts" you should have went into prehospital EMS. Nursing school was the biggest challenge of my academic life. Sounds like I scraped by with Cs? I graduated with a 3.9 cumulative, valedictorian of my class, and won every academic/clinical award from my program (high 90s NCLEX pass rates). I would NEVER tell anyone considering nursing school that it's easy or boring, because any program that's worth its salt is going to chew you up and spit you out. I seriously hope you change your attitude in general, because at best it's going to make you a horrible bedside nurse, and at worst your arrogance is seriously going to harm a patient. P.S. Even to this day I still constantly brush up on my pathophysiology/pharmacology, ask my attendings/nurse educators all sorts of random and annoying questions, because I know that I always have room for improvement. There's always new treatments and medications coming out too, so it is our professional duty to keep up with them as well. "I don't know that medication or treatment" because it is new is NOT an excuse.

Any monitored pt. gets a nurse for transport (ICU, PCU/SDU), ward transfers are handled by our NAs. We do not have a transport team or transport RN (I wish LOL). However, we have a huge shortage of NAs because they also have to sit as well as run blood, take bodies to the morgue, so nurses also commonly have to transport our ward pts. We used to have unit support assistants, but we don't anymore as well. Oh, we also have zero ER techs. I know what I'm asking Santa for this Christmas.

You sound exactly like my preceptor. Although, she did give me a choice on my first day if I wanted to shadow or jump in. Wasn't even a question for me. Took the full patient load on day one and never looked back. Of course I asked hundreds of questions throughout because I knew better than to play chicken with a patient's life, and I always reached out to her when I needed help. Unless I was drowning, I always wanted the first crack at every procedure. Later on towards the end of my orientation, my preceptor basically said she was relieved because she couldn't stand new grads that wanted to stand around and watch. I'm sure I got lucky because I got paired up with someone with similar personalities and styles, but I'm told that ED is a place for certain personalities. It's not for everyone, but boy is it rewarding for those of us that thrive in this environment.

Double post

Absolutely loved your post. I would definitely agree that's how I would personally handle that type of situation as a new grad. What those nurses did on your OB floor was cruel and I think it is the biggest problem in nursing, and something that desperately needs to be addressed. However, I have to disagree with you that we as nurses need to "buck up and be strong". The reason I say that because it only works for certain individuals. Again, to be clear, I know you made it clear that lateral violence and bullying should not exist, but what is more benevolent here: asking nurses to be more supportive of each other or telling new grads to suck it up? I know for a fact SmilingBluEyes that you're not the type of person to tolerate that behavior. We know if we're not getting respect (because we're new, we need something explained, etc), we are busting our behinds to gain that experience and knowledge so those bullies have no choice but to respect us. However, I also realize that there are those nurses that wither and shrivel when faced with those challenges. And therein lies the problem. The only way we can solve the problem is the root cause, the behavior among nurses. Also, I agree with you that there is no trend until there is concrete statistical data to back up the OP's claims. I think what we can all agree is that lateral violence and bullying is a huge problem in nursing, but it would be false and irresponsible to claim that suicide is often the aftermath. I think the case OP was referring to was isolated.

Here's my biggest pet peeve as an ER nurse at my facility. But first of all, I'd just like to give props to all my floor nurses (as well as the ICU, PCU, tele, insert any area here nurse) here on AN and everywhere else! Much respect to you guys and the great work you guys do...HAVING said that. There's been a few...annoying interactions with some select nurses upstairs at my facility (but most are professional and they go with the flow...I mean, what else are we going to do). So a little background, I work in a large level 1 trauma center, on the 1900-0730 shift. Usually the WR is about 70-100 deep when we start our shift, so needless to say, we rarely ever clear the waiting room by 0730. We have 80 beds in the ED, including 7 trauma bay rooms. So yeah, we're overwhelmed, it's a county hospital, and we're up to our necks. I realize that translates to never...ever having an open bed upstairs, so I realize that our floor nurses are feeling the pressure too. Most of the times, it takes a while to get a bed upstairs regardless of which area they're getting transferred to, but generally ICU and PCU/SDU beds are the longest waits. So this means I end up having to do admission orders for the majority of my patients - especially the sick ones. But once in a while, I get a ward patient that gets a bed the same time their admission orders drop. I've had some floor nurses grill me over admission orders I have not completed, and they were ordered less than 15 minutes ago! Our hospital policy only mandates us to carry out admission orders as long as no bed is available. I'm sorry, but as soon as bed control/pt. flow tells me the bed is clean and ready, I'm calling report and shipping the pt. upstairs. What rankles me even more about these complaints is that our inpatient areas have dedicated IV access nurses and phlebotomists. So when I hear,"oh, why didn't you draw that routine CBC/BMP?" all I hear is:"I'm too lazy to pick up the phone to call someone to butterfly my patient." Our ER used to have a phlebotomist, but we don't anymore, because she has to cover the floor areas now. Forget about IV access nurses, I asked once on a particularly hard stick and they basically said we don't cover ER. So basically when we get an impossible stick, we have to go to our residents for US guided PIVs , EJs, fem sticks, or the dreaded venous cutdowns! I actually have a friend who works on the ward. She basically says that no one on her floor actually starts IVs or does butterflies. They just make a phone call. So please, berate me more for not starting a 2nd line, or not drawing some ridiculous routine labs (I'm sure you're really curious about that protein level, I just don't care). (run-on sentence warning) Never mind that I have an ICU overflow ARDS patient with a brainstem astrocytoma that's completely unstable with a diprivan drip + pressors which is infusing through a PIV b/c wbc/anc complete garbage which according to neurosurg means no central/picc line and also on bag 4 of 8 of k-riders because holy hell K+ of 1.8 but somehow still alive and I'm actually running out of lines (even with 5 PIVs) to infuse all the damn boluses and the 10 ABXs for the massive septic shock for a pt that's been here for over 36 hours in the ED. WHEEEEW. Anyways, can you guys tell I'm just venting? Not meant to offend anyone. Just don't get why a very select few floor nurses think that ER should carry out all their orders. Just boggles the mind.

God, I hope schools are covering SCD. My most recent SCD pt was a 55 year old female in vaso-occlusive crisis. Very scary condition, pushed 10mg of dilaudid IV, yikes!

Hey! Hey! My Monday night tango classes shouldn't take a backseat because you have children! All kidding aside, learn to take a stand, and live with the consequences. You're being awfully passive-aggressive in this situation with your manager.

Hey fellow applicants! As a fellow LA County alum I'll give you guys a quick run down. The point system is pretty straight forward (it's literally the only thing they consider). Low 90s to high 80s scores are pretty much guaranteed acceptance. The cut off is a bit trickier, as it is highly dependent on the applicant pool for that incoming semester. It seems to float anywhere from the high 70s to the low 80s. Lower than the high 70s, and your chances are not that good (but I won't say no one ever got in with mid 70s). As far as clinical sites, it's generally based on where you live. Most students will be at LAC+USC (not USC University, Keck, or Norris as those are non-county hospitals), with usually 1 clinical group at Olive View for all 4 semesters. Harbor UCLA currently only has 1 clinical group each for 3rd and 4th semester students. Please keep in mind that they do ask where you would like to attend clinicals, but their decisions I'm told are largely based off your mailing address. However, there are many cases where I've seen students have to commute to Olive View or Harbor even though they are much closer to LAC+USC. This is because they HAVE to balance clinical group sizes. The cap for students per instructor is usually 10 (I think 11-12 is possible, but they try to avoid that). So if you live in Alhambra but they assign you to Olive View or Harbor UCLA, you can raise your objections, but they may fall on deaf ears. Also, please keep in mind that if you go to Harbor UCLA for semester 3, you WILL be attending Harbor UCLA for semester 4. Also, it is possible to get moved around sites from semester to semester (I was at LAC+USC for 1 year, then Harbor UCLA for my last year). This is largely due to the fact that not everyone makes it through. If this does happen to you, take it in stride! I was not happy initially, but seeing a different county facility was an eye-opening experience for me, and in the end it had a heavy influence on which county hospital I ended up at. Good luck everyone!

You are sorely mistaken if you think LTC has nothing useful to teach you. Take it from someone who went to a LTC for a few months as a new graduate, then was hired into a level one trauma ED, I would not trade those months of LTC for anything else. LTC will hone your time management and prioritization skills like no other. You think you're going to have 47 patients with 20 blood sugar checks on a Med Surg unit? You're going to get into it with some CNA that's going to test you, they smell weakness. It might rattle you at first, but you get a hold of yourself and damnit, you delegate just like they taught you in nursing school. You gain confidence as your coworkers gain a new respect for you. You might not know how to paper chart like me out of nursing school. My entire nursing education had been with EHRs. Oh so convenient, no need to even call a provider, I'll just alpha page them, and they'll just enter the orders remotely. Transcribing? The hell is that? Welcome to LTC, where many of these facilities don't have the money or the motivation to switch to EHRs. Yeah, paper charting is tedious, yeah calling providers for something trivial sucks (and those ridiculous paper SBARs they made me do), but learning something they never really taught me in nursing school is valuable in my book. You're probably wondering why we need to know how to paper chart, well, some times EHRs go down, sometimes for an entire shift. But I'm not that nurse that crawls into a corner to cry about it, because LTCs taught me that lesson a long time ago. So I highly recommend you keep an open mind when it comes to LTC facilities. You don't have to make a career out of it, but I think it is the ideal area for a new graduate to pass through.