Grumpygs

We have one or two nurses who are chronically late. Not 5 or 10 minutes late, but coming in at 0725 or LATER when the shift starts at 0700. I detest having to wait for them so that I can report off and head for home. Often if they are not on the unit by 0725, I report off to the charge nurse just so that I can avoid overtime (which 'we' get in trouble for from management - though the late comers never seem to be talked to or reprimanded for arriving late...). THEN they expect to be walked through all of their patients from top to bottom (4 or 5 total - sometimes with 4 or 5 different outgoing nurses) WITH bedside endorsement and confirmation that all the patients are clean, dry and that IV's are infusing and patent OF COURSE!!! I've even refused to come in for extra shifts if I know that I'll be reporting off to one of the late comers - I feel really disrespected; my time does not appear to be as valuable as theirs, etc. It's ridiculous - really. I also don't care about whatever their reason is for being late - children, traffic, overwhelmed or depressed - not my problem. I can get myself to work on time (EVERYTIME!!!) I expect my co-workers to be professional and do the same! I don't think that is an unreasonable expectation. End of rant... :argue: :thankya:

I'm only answering this because you are young and appear to need some information. That being said - you should NEVER attempt a career 'just for the money' - especially NOT nursing. You may want to consider starting off as a nurse assistant and see how that goes for you before you spend a lot (and I mean A LOT!!!) of time and money taking courses only to find out that nursing isn't for you. As a nurse assistant, you will help people that need your help more than you will believe. It appears from your post that you have a compassionate streak and the people that you will be working with as a nurse assistant will benefit greatly from your compassion. I didn't decide to get into nursing until I was almost 40 - you have your whole life ahead of you - don't be in such a rush to decide on a concrete career. Try a few different things out - see how things feel and work for you. Good luck with your future.

The hospital I work for also started 'primary' nursing with a similar patient population. Also a small community hospital (our floor has between 28 and 32 beds) but almost all of the patients have a psychiatric co-morbidity and we often have up to 10 vent dependent patients and up to 15 or so telemetry patients. Fresh abdominal surgical patients, hip ORIFs, lots of CHF and COPD, some with tube feedings etc with NO flexi - seals (though I keep asking them to order them...). Seems like we get a little bit of everything. Prior to the 'primary' nursing scheduling, we had 1 CNA for up to 32 patients and we usually assigned them approx. half of the total care patients and the nurses did the remainder of the patient care for their patients. The CNA took vitals twice during the 12 hour shift with the nurses taking the noon/midnight vitals. However, with so much psych - we often had to have sitters and the CNAs were taken for sitters more often than not - they could always staff for sitters but not for patient care... (but that's another rant!) We have always been assigned up to 5 patients without or without a CNA and often have 2 - 3 total care patients each to care for and clean along with all the rest of the work that nurses do. We have experienced an increase in skin break down because few of the nurses seem to be able to keep up with cleaning and turning patients while assessing, passing meds, cleaning up other patients, talking to doctors/family, documenting, new admissions, discharging patients, I could go on and on... So, I'm NOT a fan of primary nursing with the acuity/patient load that we currently have. Though I am able to better assess my patients skin conditions than when the CNAs do most of the patient care. I suppose there are pros and cons to every matrix of care. I wish you luck with the new matrix!

First off, I just typed a great response and lost it when I tried to add a smiley... Anyway - Shifts range from 8 hours a shift to 12 - depending on the hospital/facility. I 'think' most nurses work 3 12 hours shifts a week. I work 3 12s one week and then 4 12s the next week (7 12 hour shifts in a 2 week period). I know of one hospital in my area that has 8 hour shifts but I'm not sure if they then work 5 days/nights a week... A typical night is hard to describe - some are smooth and some are nightmares... I work night shift by choice; less doctors (though you still have to deal with them...) less family to deal with, less patient procedures, etc. Most nights I start by getting my assignment, checking to make sure the patient is still 'alive' and in their room and has a good IV (not infiltrated and that will flush without difficulty), then I get report from the nurse that had them last. I do a quick review of the doctors orders, then a quick assessment and see if they need anything immediately - to be cleaned, taken to the toilet, are they in pain? etc... Then start taking vitals on the patient that I think needs it most- we don't often have a CNA/PCA to help with vitals or cleaning patients so it falls on the nurses. We get 4 - 5 patients (in California, so there are 'laws'... but that's another post... ) After vitals, I start my med pass after making sure that some doctor didn't sneak in while I was taking vitals and change the orders... then chart my assessments, make sure that any doctors orders have been noted and carried out - could be labs, could be a request for a test/procedure, could be a change/addition to medications. Clean anyone who needs cleaning, more meds, more charting, new admissions, discharges, talk to doctors, talk to the family member calling at 3 am to check on their family members, more charting, more meds, more cleaning, more charting etc... then get ready to turn the patient over to the next shift. Money can be researched online or on this site - under Region - pick your state, there are tons of posts on wages for nurses... As far as Specialties - you may want to wait until you get through nursing school to pick. I can't tell you the number of nursing students I know who were SURE - ABSOLUTELY CERTAIN that they had to be X specialty who RAN the other way once they went through that part of nursing school - so you may be 'sure' you want to be X specialty now - but you may change your mind - so please don't get stuck on one area... I am a single mother who also worked full time during nursing school - it can be done - there are tons of stories on this site that tell you that it can be done. HOWEVER, it is HARD, HARD, HARD. I waited until my daughter was in 10th grade before going back to school and it was still HARD. Nursing school was like NOTHING I've ever experienced. You TRULY need to have a SUPER SUPER SUPPORT System - I'm talking about someone to cook meals, clean, do laundry, pick the kids up from school/day care, drop them off at school/daycare/sports/activities, etc, take them to doctors/dentists appointments, keep them out of your hair so you can study - basically, to replace you until you are done... You'll spend more time studying, preparing for clinicals, going to clinicals, STRESSING over EVERYTHING - grades, skills, clinical instructors, the kids, tests, getting through nursing school, passing nursing school, studying for the NCLEX, taking the NCLEX, passing the NCLEX, applying for that first job, interviewing for the job, getting the job, etc and you will (probably...) feel terribly guilty because you'll feel like you are abandoning your kids... but you will be so busy, nursing school kind of takes over your whole life! It is true that 'real' nursing is very different from nursing school - but you will use everything you learn and MORE... In nursing school you have an instructor that will stop you from making a critical error - in real life, you have to stop yourself. You will have co-workers (more experienced nurses) that will help you, but you may also have co-workers who will stab you in the back... After my soap box rant - IF you really want to become a nurse, nothing will stand in your way. But, please seriously consider WHY you want to become a nurse... If it's 'just for the money' or for 'job security' this is not the career for you... There are tons of posts on this website where new grad nurses are unable to find jobs - It took me 9 LONG, Depressing, stressful, maddening, frustrating, painful months to find the job I have now. it's not the hospital of my choice, but I'm learning so much and some nights are wonderful and some are horrible nightmares... I wish you the best of luck with your decision! :heartbeat

This sounds like you work at my hospital... all the way down to the circus!

I do like diva rn & stick to the 'modified' night routine - but have no kids at home to worry about keeping me up. I've found lots of things to keep me occupied during my nights off - clean house, do grocery shopping (local 24 hours super market...) do laundry, catch up on movies, troll all nurses!

Sorry, but I'm a bit offended by the "We all do on nights" part. Not feeling well is one thing but I ( my 2 cents) don't think it's right. While I've only worked nights for 6 months I'd never sleep at work. Though we do have several LVNs & CNA (sitters especially) that sleep FREQUENTLY during the shift. Of course all the call bells going off belong to the 'sleepers' which is annoying; and no one seems to say anything to them though I do. We don't get paid to sleep! I just couldn't ever nap with patients that may need me. One even had a patient elope while he took his 'break' napping.

I agree that it would be unethical and on many levels wrong. I actually did have a patient ask me if I'd marry him... My response was that I was already involved though I wasn't. What I really wanted to say was NO WAY!!!! We see patients at their worst; in pain, with multiple disease processes going on, totally vulnerable and dependent. While outside of a medical setting, these aspects are something that you may not see in a relationship for months. People are (usually ) on their best behavior when in new relationships...

When in doubt - call the doctor to clarify the order.

I've actually had the dialysis nurse (small community hospital - dialysis done at bedside) tell me after dialysis was completed that the patient had thrown up during dialysis. I found the patient soaked in her own vomit - and the clean linen cart was LITERALLY right outside the patient room. I understand that the dialysis nurse may not be able to leave the patient during the procedure, but to simply leave them 'dirty' seems so wrong...

Our hospital (small community hospital in an 'under-served' area) has some agreement with some transportation service - we call them and a mini van arrives - they take the patients home - not sure how this service is paid for, we get lots of people (frequent flyers) who have run their Medicare into dust and crumbs - but we still take them as patients...

to OP - I totally agree with Five&Two Will Do...Please, please, please - seriously consider taking a nurse assistant course BEFORE you decide to dedicate all the time and long hours it will take you to become a nurse. You'll learn so much more about what it takes to care for your patients than you will in posting questions like this on AN. Not that I'm telling you not to post, but the job that a nurse assistant does is most definitely part of what most nurses do on a daily/hourly basis. It will give you a much clearer view of a small portion of what nurses do. I've learned that a good nurse assistant can make your shift - and a poor one can make your shifts torture... Treasure the good ones!

Okay, I'll jump in with something that I didn't see in the previous posts - This is from personal observation... Some people get into nursing because they think they can make a great deal of money, but are poorly prepared for the work needed to actually 'CARE' for another person... "you mean I have to clean up their 'dirt'?!??!?!!?!" or "I'm going to be an RN so I don't have to wipe butts" I've HEARD this... Some cultures seem to 'push' their children/relatives into nursing (expecting them to pursue the career) when these children/relatives have little or NO interest in becoming a nurse. They are simply doing it because the 'family' expects it... We had a young man in our nursing class (his 2nd attempt) who admitted that he had NO interest in nursing but that his family expected him to become a nurse... He didn't make it the 2nd time either... I also am a new 'older' nurse, 2nd career and I thought long and hard before deciding to enter nursing - I took an 18 week course and received my certification as a CNA before even considering nursing because I wanted to make sure I could 'stomach' the job... At my school, the Nurse Assistant class was NOT a requirement for Registered Nurses, but SHOULD have been... I learned A LOT from that class that I didn't get from the quick 6 weeks in first semester on how to take care of a patient - which was taught with all the 'other' pressures of being in nursing school. From personal experience at my current/first job - I'll jump on the lack of support bandwagon. I work in a small community hospital that serves an 'under-served' population. On my unit, we have 32 available beds that are almost always full with everything from vent/tele tube feeding patients from local nursing homes to drug abusers who have 'skin popped' and ended up with a nasty abscess - craving their next hit and mad that the methadone isn't given on demand..., to the older person with generalized weakness or SOB, or a young person with uncontrolled HTN or ESRD and on dialysis. I received a total of 12 shifts of orientation with 2 very different nurses - neither of whom wanted to precept, one who admitted she got into nursing because her sister told her she could make a lot of money... My first night was a nightmare that I'll never forget. Our assigned 1 or 2 nurse assistants (for up to 32 patients, which I've always thought was crazy, but they think nothing of it...) often are used as 'sitters' for confused/combative/psych patients or taken from us to work on a different unit. Which causes the nurses to need to do all the normal work in addition to cleaning patients (often with the vent patients needing 2 people just to manage the tubing or girth of the patient). The patient load is most often 4 - 5 patients (in California, though I've heard nurses here say that they have had to take 6 patients due to short staffing) with discharges and admits along with patient care and paper charting. So, my opinion, some people that enter nursing don't really consider nor are they really prepared for the WORK that goes into staying in nursing.

I'm just curious - did your father expect to be placed in a bathtub? I ask this because we bathe/'wash up' patients every night (I work night shift on med-surg/tele floor with many vent dependent patients...) but the occasional non-vent patient who I personally have cleaned/bathed will be overheard telling their family members that they have not had a 'bath' in DAYS... I simply wonder if it's the terminology used- maybe he expected to go to a room with a tub??? If he hadn't even been bathed in bed - then shame on the staff!

Are benefits an option that you can choose not to take? Maybe you can keep the permanent position just without the benefits? I've worked for places where benefits were an option and that may boost your paycheck a bit - some companies may even pay you to waive the benefits... I'd ask HR if you can waive the benefits - I would assume that you may have that option instead of giving up the position for per diem. Good luck!