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Hello, I was wondering what everyones opinions are on feeling micromanaged by nurse managers, nurse educators, infection preventionist, etc. I'll start with saying I tend to be a little of a perfectionist in the ICU that I work in (what ICU nurse isn't..lol) so I try to ensure I do all the little extra things perfectly that management likes such as: filling out white boards appropriately even though my patient is intubated and sedated, labeling IV lines with date stickers, ensuring all caps are on central line ports, dates on all lines/tubes, no loops in foleys, making sure theres an actual order in the chart for a central line a foley, charting perfectly on absolutely everything because it gets audited, and never bypassing a scan of the patient, even if its lab work because that gets audited as well, etc. So anyone who works in the ICU knows that sometimes things get a little crazy and your patient tries to die on you every now and then or all shift ha! So it's very often that you just don't have time to make sure absolutely everything is perfect for when managers come around because your patient is having 15 beat runs of v tach and their BP is 70/30 and your assisting the docs at bedside putting in a quinton for emergent dialysis etc. So sometimes I feel like I am being (or more every nurse on the unit) is being micromanaged by management, nurse educators etc. Like the other day, my nurse educator was auditing what we set our alarm limits at to ensure we're "setting them appropriately" (according to who??) and she comes up to me and tells me my parameters for my heart rate are inappropriate because my patients baseline HR is 86 my alarm limits are 50 for low and 125 for high. I tell her my patients HR gets up into the 120's and when he falls asleep in the 60s and this is where I like my alarm limits set for a patient like this. Another one she said is that the limit for systolic BP alarm at 90 low and 180 high was inappropriate because it is what was preset in the monitor and I did not adjust it. So we proceed to argue for about 5 minutes with me ending up giving in telling her okay Ill fix them to her liking. I was extremely frustrated and upset. I feel as if I get offended that she feels the need to come around and check what I set my alarm limits at, I mean after all don't I have a nursing degree? Don't I know a little bit about nursing? Don't you think that I know what limits are best for my patient? Most of the nurses that have been on my unit for 10 years plus tell me when management comes around to check all that stuff just say "uh huh I'll fix it" and walk away and don't think twice about it. Just want to get some opinions on what everyones experiences are with this and how you deal with feeling like your being micromanaged. Thanks.

I live in Amarillo, TX. Moved here about 3.5 years ago. Be prepared for friendly people who say hello in the grocery store and gentlemen who hold doors open for you and take their hats off when they meet you! Everyone is alllll about their guns, so after living here a few years you'll become a Red oooh the weather... not so great. It's very windy in the spring/summer and cold as hell in the winter with 2-4 blizzards that come through that can shut the whole town down. Not much big city life here in Amarillo, but the city is expanding massively and new stores, restaurants, activities are popping up everywhere. It's a great place to raise a family, real sense of community here, lots of churches etc. As for the hospitals, the major ones are BSA and NWTH. Pay is about the same at both hospitals. Expect over worked nurses with little pay, but thats anywhere in Amarillo. Cost of living is decent, lots of new neighborhoods to live in on the south side of town. Small houses though, 1700-1800 feet for maybe 170-180k.

Thank you all for your responses! Staying per diem at the hospital is a good idea, however the clinic is hiring a full time employee, so the only available days to work at the hospital would be saturday or sunday. Which is doable, if there aren't any requirements as to how many per diem shifts I would have to work in a month. Working at the hospital I get paid about 42,000 per year when it all comes down to it. Which is the same as any of the hospitals in the area. I was talking to some of the other clinic nurses and they say the same thing, the office pays more. About 54,000/year. However, this is all heresy of course until I talk to the HR department of the cardiac group. The cardiologist is very persistent about me working for them and continues to ask me if I've applied for the position yet and keeps telling me to go into the office and talk to the HR lady about it. I was thinking about going in the office this week and speaking with them about the pay, benefits etc. and maybe submitting a resume. Do you guys think if I left the hospital job and ever wanted to go back later, or even moved to a different city that it would be hard for me to get hired into a hospital only have the 6 months experience as a new grad? Thank you all so much you are very helpful!

I've been a nurse for 6 months now and landed an amazing job right out of school in the Cardiac ICU at a local hospital. During my orientation my preceptors and managers said I was exceeding expectation left and right and couldn't believe how well I was doing. They asked me if I would be interested in working day shift and of course I jumped right on it! (new grad nurses automatically get sent to night shift to get their experience and "feet wet", there hasn't been a new graduate nurse sent directly to days in over 10 years from what my managers say) So needless to say, I lucked out and got the day shift job, a great schedule and everything. My managers are great, the nurses around me are extremely supportive and helped, I love every single one of them. I am happy with where I am at. Some days are extremely stressful but others aren't and I really enjoy my work. I do dislike working 12 hour shifts though. However...I am a little disappointed with the hospital itself. They have went back on their word twice now concerning raises. When I was first hired and at 6 months. I was "promised" a $1 raise and now they have cut it to .50 now so thats been sitting in the back of my mind for some time. It was kind of like, they told me all the things I wanted to hear in order to get us nurses to work there, and now its like they are going back on their word because I already work for them. The hospital is all about saving money and won't hire more nurses even though we are all short staffed. I was recently approached by one of the top cardiologists and asked to be his personal nurse (they have their own nurses that work with them in the clinic and rounding with them in the hospital). The job would be Mon-Fri 8 hour days, no weekends, no on call, paid holidays off and paying $12,000 more/year that what I am at now. At first, in my head I was like "oh of course not, no way I would ever leave my job, I love what I do" However... the idea keeps lurking in the back of my mind and I cannot seem to shake it. In the long run, it would be optimal for me. I knew I wasn't going to be at the bedside forever when I started nursing but I figured I would get 5 years or so. My husband and I are newlyweds and we plan on having kids here within the next 2 years, so an office job would be the best in that situation, plus that is the schedule he works now as well. The job pays more money, a better schedule, and in the long run would be something I've always wanted. The opportunities to work for a good doctor like this are hard to come by and I don't want to be passing up an opportunity that may not come along again. However, I only have 6 months experience and I'm still extensively learning every single day and do not want to hinder my future opportunities by quitting so soon after graduation. I feel as if it would look unprofessional and if I ever wanted to go back to the hospital I may not be able too. If anyone has any advice about this, please! I'm all ears :)

Hi everyone, Last week, I performed my very first round chest compressions during a code. (had practiced on mannequins, but never an actual person) There was a team of nurses, docs, pharmacists, there to guide me and ensure I was doing adequate compressions. It was the longest two minutes of my life. All I kept thinking was "please live, please live". I kept trying not to look into the eyes of the patient because I was so terrified that I would burst into tears. It was scariest moment of my life, and I will never forget it. I ended up getting a pulse back after my round of compressions, but the patient ended up dying. As I left work, I couldn't help but cry while driving home. That night, I had nightmares about people I know and love, all collapsing and dying. I was trying to do CPR on one person, when others needed it as well. There wasn't enough of me to save everyone. I know I will probably do this many more times in my career.. But I hope to never get comfortable with it, never become the nurse that thinks a code isn't a big deal, never be the nurse who isn't impacted in some way by a code, never become the nurse who doesn't get nervous or scared when their patient crashes. I hope to never be that nurse. To never lose my ability to realize that it's okay to be scared, it's okay to cry, it's okay to feel as if your best isn't enough...because in all reality, sometimes it just isn't. And that's okay.

Hello, I come from a school with a 98% pass rate for several years in a row now. I was top of my class and graduated Magna Cum Laude with a 3.873 GPA (so close to summa gaaah! :/) anyways.. I recently took my NCLEX and passed in 75 questions. We had to take HESI's throughout school, including the Exit and to me the Hesi Exit exam was much harder than the NCLEX. I still studied for the NCLEX, mostly notes from nursing school, red alerts in Saunders Comprehensive and did about 60-80 questions per day on my NCLEX 10,000 for a week. (granted, we took the Exit 2 days before graduation, and I took the NCLEX 10 days after graduation so all info was still fresh in my head) To me, you have to know yourself. You have to know how you test. Personally, I am a slow test taker, I take my time and read the question 2x, think of the answer, then look at the answers last. There was 1 time I screwed up, it was on my first exit. I rushed through it, didn't take my usual amount of time and got a 902, which is still above passing but way below my personal standards. After that incident, I vowed to never rush through a test again, the second exit I took my time and scored a 1062. For the NCLEX I took my time, about 1hr and 40min to finish 75 questions. KNOW yourself. KNOW how you test. You know the information, you got this!

Hey guys, I just found out that I passed my NCLEX! I took it, the computer shut off at 75, did the Pearson Vue trick, got the good pop up, then 48 hours later found out I passed! I took Hesi's all throughout school, including the exit which we had to get a 900 to graduate. To me, the Exit Hesi seemed very different from the NCLEX, granted the NCLEX was still difficult but it seemed easier than the Exit Hesi to me. NCLEX was very straightforward and Hesi just seemed to have more "tricky" kind of questions. Just some things on how I studied.. I know a lot of people do the Hurst & Kaplan and all those, but I didn't. I had 1 Saunders Comprehensive book that I skimmed through, reading only the red alerts. I bought the NCLEX 10,000 when first in nursing school, and did some questions before the NCLEX. Probably about 60 questions a day for a week. But! I did something that I don't see people often doing to prepare for the NCLEX...I studied what we learned in school! To me, wasn't the whole point of nursing school to prepare you to be a nurse? And the NCLEX is what determines if you get to be a nurse or not... Granted, throughout nursing school I took VERY good notes in every class. I would sit close to the front (mostly because I'm blind as a bat ha!) and listen very intently and try to understand everything the professors said, asking questions anytime I did not understand. These NOTES are what I used to pass my NCLEX as well as my Exit (got a 1062). Like I said before, I had the Saunders book and I also had the green Hesi book (skimmed through as well, mostly for the Hesi Hints) that I briefly went over, but to me knowing the content of my notes was what really helped me. Yes, I also did some NCLEX questions, but to me, if you don't know the content.. you can't answer the question. Of course throughout the progress of nursing school, you're going to forget things you learned in Pedi/OB or Med/Surg but if you have those notes from your classes...Study them! Just another option to think about when studying for the NCLEX, for the people who don't necessarily "learn" from doing thousands of NCLEX questions (such as myself.) :)

I have not received any rejection emails. I am not sure they are sending them out this year? I haven't heard of anyone receiving any.

Well I guess we'll keep our fingers crossed!

Has anyone heard anything from Critical Care or ER?

Hello, BSA used to be a non-profit hospital and is now for-profit. They weigh very heavily on patient satisfaction scores and it is very apparent for nurses who work there. They are also hurting for nurses very badly. Many nurses that used to work there have quit their jobs, they are calling people that used to work there years ago to see if they will come work for them again, offering 5 year sign on bonuses etc. The other major hospital in Amarillo, Northwest Texas Hospital is the same as far as they are hurting for nurses in their Med/Surg units. They cannot seem to keep a nurse in those units. Northwest is also trying to achieve Magnet status so they are very interested in hiring BSN over ADN hence the $2/hr pay difference. New grad pay in Amarillo is pretty poor. BSA offers around $21/hr base. Northwest offers $20.81/hr for ADN new grad and $22.81 for BSN new grad not including differentials. I am not sure about experienced nursing, however I do know that Northwest is offering 10k sign on bonus for 5-year contract for experienced nurses who will work in med/surg.

From my personal experience, While I was in nursing school, the majority of our exams contained CRITICAL THINKING questions, not memorization questions that you can answer from simply reading a book. In my experience, the nurses that excelled in school also excelled in the profession. Answering these critical thinking questions correctly on the exams directly correlates for how you practice nursing in real life. For example: You must know that before you give Lasix you should check the patients potassium, sodium, & blood pressure because all of these factor in to whether you will be administering the drug or not. You also must know to check you pediatric patients (& adults) urine output before administering Potassium to prevent hyperkalemia. You must also know that it is priority to listen to your CHF patients lungs throughly to detect crackles etc. & intervene appropriately not only informing the doctor, but raising the HOB, O2 available, fluid restrictions, etc. to prevent respiratory complications. If a student misses these type of questions on an exam, how can they properly ensure the safety of their patients at all times? Nursing is much, much more than just following orders and giving medications. Sure nursing is part skills as well, such as IV's. foleys, dressing changes & these can be taught to someone fairly easily. The critical thinking aspect of nursing is much more difficult to obtain. And from my experience, students who excel in nursing school tend to be proficient in critical thinking type of situations. So get those good grades, prove your professor wrong, & be proud of your ability to excel in through a very challenging journey!

Hi, join our on-going conversation about the internships. Search "Baylor June 2015" and it should come up as the first one! That thread has helped me quite a bit!

My classmates have had their OR & Med/Surg phone interviews already. Apparently the only place that is left open for those positions is in Garland. The interviewers said Baylor University Medical Center and Plano are full for those internships. Still no word about Critical Care, Progressive Care, or ER. Oh and base pay is $24.25/hour.

My classmates have had their OR & Med/Surg phone interviews already. Apparently the only place that is left open for those positions is in Garland. The interviewers said Baylor University Medical Center and Plano are full for those internships. Still no word about Critical Care, Progressive Care, or ER.