Tisme

Dear New Job, I do believe that one of the greatest aspects of being in the Nursing field is the ability to choose from so many different nursing roles in the medical field. There are so many roles that there is a lot to choose from including, hospital nursing, home health, school nursing, private duty nursing, travel nursing, Community-based nursing, research, Day Stay Surgery Centers, Hospice, Occupational Health, Operating Room, Trauma based nursing, Teaching, Intensive Care, Pediatrics, Labor and Delivery, Psych Nursing, Case Management, Cardiac, Organ Transplants, Gynecology, Oncology, etc.... I could mention more but I think most of us have been exposed to or have friends in different fields of Nursing. This is a bonus for Nurses because there are so many interesting options. To answer your question regarding applying for one job or all three options at once, may I state that if you are definitively moving to a new role, which it sounds like you are as you find the need "to get out of your current job." If this is the case, then applying for all three positions would be a smart tactic. I state this because you will hopefully apply before someone else is hired into each of the roles that currently hold interest to you. It would be awful if the 'one that got away' was a perfect match for you. Please know that applying for three positions at once in the same organization in which you now work may come to the attention of your current supervisor. I don't know if this is okay or not for you. Only you can decide this. During the the initial interview is a fantastic time to ask questions about the expectations the position holds for nurses working there. Any and all reasonable questions, except pay, about the job are fair game. Remember, they are interviewing you but you are also seeking information and performing your own interview. Actually, asking questions shows that you hold an interest in the position and will work in your favor. Usually, if you are asked back for a second interview, this can be taken as the interviewer holding an interest in you. Because they are showing that you have impressed them, the second interview would be a better time to bring up the subject of compensation as opposed to asking this right off the bat. Mailing the interviewer a "Thank you for your time" card is both classy and has the interviewer thinking about again! Please know that questions regarding the expected days of the week to work, how long each shift is such as eight, ten, or twelve hours a day, and if any weekend work is required are all great questions for the initial interview. As as far as declining an offered job, never burn bridges so be as polite as possible. Since most job offerings and job declinations are now provided through the organization's Human Resources Department, something along the lines of, "I really am thankful for the time made to interview me and I enjoyed meeting Mrs. Smith very much but would you please be kind enough to let her know that I accepted another offer?" I wish you only the best. Good Luck!!! Tisme

In post-surgical patients admitted into the hospital, do non-pharmalogical methods of preventing venous thromboembolisms, compared to current prophylactic DVT treatments, reduce the incidence rate? Examples: walking, turning, small excercises in bed, etc... Good Luck, Tis me

The nurses are unionized where I work. We have to be careful in ensuring that all are treated the same for the same infractions, scheduled time off, overtime, canceling of shifts, policy issues, etc.... Treat one, treat all. In this case, if it was me, and I did not write up the offender for breaking policy, I would have a hard time writing up the next person who did the same thing because the Union member could say, you didn't write up Mr. Well Liked in August 2015, why are you writing me up now for the exact same thing? In effect, I would be endorsing this behavior if not addressed. I know it seems harsh but the policy was written for patient safety AND a family member saw it and complained. If this is his first offense, you could give a verbal warning and put this in his file and there is proof that you addressed the issue. He has apologized so there is proof that he knows his actions were wrong. My hands would be tied and I would be compelled to take action. Besides, 'treat one, treat all' saves a manager from being jammed up in the future. Tis Me

Wade, You do not need to worry about Walden degrees being accepted. I work at a large Teaching Hospital and my boss, one of the AVP's of Nursing (associate vice-president) along with two Nurse Managers of nursing units received these very degrees last year. We are a Magnet Hospital and all three people took the classes together to increase their education experience. Be well, Tis me

Dear New Grad, You have been offered excellent advice as the starting pay for a new graduate is a fairly fixed number. As Nurse Beth advised, the place for a little bit of negotiation is when you have experience or hold special skills like caring for Berlin heart patients, patients on CVVH, or perhaps a wound care specialist. Unfortunately, new grads though are pretty much offered the same rate. This is true at my organization and I'm fairly certain it holds true at other places of work as well. The main reason I wanted to reply is that you should keep in mind that all furture raises at your six month evaluation and then yearly evaluations are very negotiable. This is the time to write well and offer a lot of self-praise on your self evaluation. Raises are usually offered in a range like 0% to 5% as an example. So please keep this in mind as it can make quite a difference throughout a thirty year career. You most certainly can max out on your salary and you want to get there as quickly as possible. Compounding interest is helpful over a long career. By the way, the organization where I work offers lump sum incentives at your yearly evaluation if you have reached the maximum. This is in addition to extra hourly pay if you hold a Nursing Certificate. Best of Luck and congrats on completing school, Tis me

tsm007, I'm sorry that you are in this position. Obviously, when applying, nobody expects to be assigned this many patients to care for. That is just plain insanity on the hospital's part. Adele is absolutely correct in that the chances of this hospital filing a grievance against you are slim to none. If they did choose this path, their incompetence would be be in the spot-light for all to see and then it would go on their record for the unsafe practices they utilize. First, five days of orientation? That's plain awful and shows their desperation to staff the place. Then, they assigned you to a Unit that you had zero orientation and to add to this same day, they went way outside the prudent guidelines and assigned you twenty four patients. They really expect one person to care for twenty four patients in a Unit where zero orientation has occurred. How would you know the population, expectations, where the supplies are kept, the acuity of the patients, and exactly what your specific role is without ever being exposed to this Unit previously? Wow!! On top of that, tsm, when the ADON came in, you told him/her that you were having difficulties and were behind in your work. Why, exactly, didn't the ADON jump in to assist you? Was this ADON not patient-centric? I would be pretty angry at this person for not pitching in to help. Personally, I don't think you have anything to worry about. This organization is probably more concerned about you bringing their unsafe practices to light! Lastly, when a new employer would call them for a reference, because of the ligitigous nature of our society, ex-employers do not go into a litany of examples about previous employees as some workers have won lawsuits over what was said about them. The new employer would simply ask if they would re-hire you. They would probably say "no" but you would have addressed this on your resume by stating stating you left the job because xxxxxxxxxx. Examples could be: you didn't feel safe practicing there or you didn't feel safe caring for an assignment of twenty four patients. Then, handle your responses in an interview professionally. I would recommend keeping it simple, not denigrating the previous employer, and just stating a couple of facts, like: the last day that I worked there, they assigned me to a Unit I had not received any orientation to and on top of that, I was assigned twenty four patients to care for. I am a really good nurse but could not work under these circumstances because my patients deserve better. If I were interviewing you, I would put this in the 'plus column' for utilizing critical thinking and realizing prudent, safe care wasn't being delivered because of the staffing model at the old organization. You made the right decision. Something better will will come along and you will have this story to tell for the rest of your life!! Regards, Tis me

Hello Krissy, I can tell by your long post that this is both important topic to you and you hold a fair amount of anxiety about the situation you have put yourself in. I have to say that I feel you are doing the 'right thing' by going back, retaking some of the classes you did poorly in, and are earning a better grade at this point. Also, Kudos to you!! Microbiology is a no joke class and you received an 'A'. I respect that. Also, please know that nurses do not know what the GPA their colleagues held. Therefore, focus on getting into a program, work hard at it, and you will get noticed. I had one of my Professor's write a letter of recommendation for me when job searching for the first time. This went very far in helping me out. The Professor noticed that I was passionate about Nursing and tried even harder in the parts of school that I had weaknesses in. Lastly, when you apply to another school to earn your Bachelor's degree, the new school will look at your transcripts to see if you meet the specifications for entrance into their program. If you do, they will accept the classes for transfer that have the right grades and not accept the transfer credits if the grades are not high enough. As a starting point but certainly not utilized in every school, usually one needs a 'C' or higher for transfer of the class to the BSN program. You are in a position that you are already repairing the damage done when you were younger and did not hold the wisdom you do now. From your post, it sounds like you are making pretty good grades in the Nursing classes now. You should take this to heart and continue on your current track. If you have been accepted into an LPN program, you could prove your worthiness right now. I would feel remiss without mentioning that all of nursing is headed towards bedside nurses holding a BSN degree. You should know this when making any decisions as entering an LPN program would mean more schooling for you in the future. Truly, I wish you well, Tisme