Clever_Alias

I work in a facility that has just decided to merge with Piedmont. We are all a bit nervous about what to expect and have some questions. 1. Is the company good to work for overall? Or, is the pay fair, supplies and equipment available and in working order, and...well. We won't touch staffing right now. 2. Does The Piedmont system require or encourage nurses to take call? Some of us like the chance to earn extra cash, others would be happy to never work a call shift again. 3. Has anyone been through these sort of mergers before and have some ideas to get through any rough spots? 4. Is the EMR Epic, and is it difficult to learn? We are just finally getting comfortable with the EMR that rolled out last year. 5. We have a lot of ADN nurses. Will we get a chance to show we are enrolled in a BSN program or just shown the door? Any input welcome. Thanks in advance.

Stop right here. If you as a student don't get that yes, it DOES take a lot of effort to teach you why we are doing something, how we do it, the risks and benefits, and then evaluate your understanding of the lesson, you are delusional. And I'm a toddler RN with 18 months of practice, so don't yell NETY at me. I love having students, but rushing through a brief description of a task, procedure, or medication does you a disservice. We cannot teach you anything complex without a lot of effort. You don't get how much work it is to teach someone properly. Would you tell one of your nursing instructors it doesn't take much effort to teach your Med-Surg or Mother-Baby classes? If so, heaven help you, because you have some very skewed notions. And no, I don't see so much as one extra cent for taking a student. You want a good experience but refuse to listen when we tell you that actually requires work on our part. Most of us want you to get a lot out of your clinical days, but some students, in particular you, will not acknowlege that it does take work, and a lot of it, to give you that. Do you really think bedside nursing is that easy?

Yikes, you caught us. That's exactly what I'm thinking as I run down the hall and check the break room, looking my student so I can teach them to do an EKG. That's why I'm on the phone 10 minutes at the start of my shift trying to get said student into the cath lab. As long as I can get them off the floor with the patient, they won't see me munching trail mix. My hesitancy has nothing to do with the fact your instructor can't be found. I'm sorry, but this topic has really touched a nerve, and I far more of a lurker than a poster. We had so many students this summer with a sub-par experience because their instructor ditched them. It wasn't fair to either the students or the nurses. For example, they couldn't give meds, because the instructor was not with them. So we found a way to compromise so the student learned the 5 rights and how to do patient teaching at med pass. Did i let those students help to the degree they wanted? You bet your sweet bippity I didn't. Did I go out of my way to find them something? I did, but the vanishing instructor tied my hands.

There's a theme here. The students who have good experiences in clinicals have instructors who are present on the floor to do the actual teaching. Students need realize the responsibility for education lies with the clinical instructor, not the RN. Why is this a difficult concept to grasp?

This is truly an issue with the instructor, not the floor nurses. We are providing an opportunity for you to learn, a setting, NOT your actual education. That is the responsibility of your instructor. It's not right your education is being neglected, but be angry at the proper person. And I say this as a nurse with only one year under her belt. Abandoning students under the guise of "you will be with Clever today" is irresponsible on their part. For all the instructor knows, I'm an idiot will teach you bad practice.

Hi, I am a relatively new nurse on a busy unit that is facing a staffing crisis. So far, I able to keep my patients cared for, medicated, clean and fed, and have reached out to my coworkers to find better ways to stay caught up with my charting and get out in a somewhat timely manner. However, I find that I'm often dehydrated and hungry because I can't find the time to get a drink or grab a snack. I leave my water bottle at the nurses station, but often can't get to it because someone else is in my seat-we have a limited number of computers, so social work, PT, or a physician hops on if I'm away for a few minutes. Any tips for managing better? All input appreciated.

Thanks to all for the input. I'm going to try to get traction for the team nursing approach. We are supposedly hiring a new tech for days and a couple of RNs, but that doesn't solve what is now a staffing crisis. In an effort to save money, each day doesn't have enough slots when we sign up to allow to the unit to be staffed if our census is full. So we then send out the SOS begging people to come in at call rates, which makes no sense to me. If you want to save money, why pay people time and a half? But I'm new and perhaps there's a logic I don't see. I'd rather not think it's just epidemic of stupidity, but that is my first impression. I would like to just meet with the CEO and say "Seriously? I've seen junior high concession stands that were better run." He reportedly said he would look into maybe staffing us more as a step-down type unit, but would have to look at the numbers. Under this system, step-down units get more bodies. At least my first year is almost up and I too can start filling out applications. Thanks again.

Long-time lurker, first time reader. I have worked almost a year on a busy cardiology unit., and am still unfamiliar with many things that don't involve bedside nursing. A consulting company was brought in last fall and implemented a new master staffing plan. The said plan has been a disaster, and patient safety is severely compromised. We have a unit-based council that has tried every approach we can think of, the most obvious being combining our two 15 beds units into a single 30 bed unit, and cross-training our unit secretaries as techs. Frankly,everything we have tried to do to improve patient care has just made matters worse. Physicians are angry because because the nurses station is empty when they round, nurses are fried and getting sick. Many are leaving in droves and physicians openly say they would not want to be treated here. Two of our nurses met with our CEO last week to discuss the issue, and he asked why they thought the model was not working for us when it has worked for other facilities. We believe the high acuity of our patients is a contributing factor: it is not uncommon to have an assignment of 4 patients, two on cardiac drips, one post cath, and one who is a confused patient who is on Lasix and also a fall risk. And some days we will take a fifth patient as well. Our CEO noted we seem more like a step-down type unit than a med-surg unit, and the model is based on typical med-surg patients. Several of us are wondering what places who successfully use this model are doing we aren't. The problem becomes finding information on this, a report, essay, journal article, anything to find out how floors similar to ours are run safely. Can anyone give me guidance on where to start looking? Or how units with similarly complex patients are staffed? We feel an assignment like the one described above is overwhelming especially as we also now function as unit secretaries, squeezing in faxes, answering to phone, putting toner in the copy machine while trying to assess, medicate, educate, and chart on our patients. Are we unreasonable in feeling that way? Is this the norm? Any suggestions would be welcome. We are planning to brainstorm more ideas, but would like to avoid re-inventing the wheel if possible. Any cluelessness is merely a by-product of being a new grad, and I have plenty of ketchup of anyone feels like taking a taste of a tender young RN. Please leave the fingers, I need them them to chart. (A joke actually, never been so much as nibbled by my co-workers. Or maybe I just was too busy trying to do my job to notice.) Thanks again.