WIBound

I work as a hospitalist and we have the option to wear business attire or scrubs. I prefer scrubs as I tend to find different ways of getting dirty. I usually spill food on myself twice a day. forget to cap pens and all my pockets get ink stains and I spill coffee quit a bit too. Maybe I should wear a bib with my scrubs..

Recently I applied for a position closer to home and a week ago I received an email thanking me for applying. The email went on to question my salary request and asked if I would be flexible in what I was asking for. I responded that yes there is room for negotiation but I am not interested in working far below my salary requirements. I then received a nicely worded response about how the company could not afford to match hospital salaries as they were a value base organization and it was all about making healthcare affordable for the patients. Value based? Well that sounds nice. I then Googled the salaries of the CEO and other executives that are posted online. The value based salary of the CEO is a whopping 73 million dollars and the other executives are barely scraping by with meager salaries ranging from 5 to 7 million. So how could this noble company even consider paying staff a competitive wage. Because you know it is all about the patients and their vision of cost cutting everywhere but the executive salaries.

If your patient is alert it will make your neuro assessment much quicker. I have worked a Neuro ICU and sometimes they would keep QH near assessments as the residents were reluctant to step them down without the attending approval. At the minimum I am checking orientation, memory, having them move all arms and legs checking the face for any deviations...it can be completed is just a few minutes and if you do it often enough the patient will go thru the whole exam from memory. Better do it then miss something..

per the ANA

I started as an ADN and never thought I would spend another day in school, but over time I had the desire to lead instead of follow and even teach. Twenty years later and many years in school I can say I will be a lifelong learner and hopefully there will always be something new to learn and someone new to teach

Actually, facilities are moving toward nursing being a BSN only club. The NP programs are also moving towards a DNP without MS option. Still, you will see MS NPs for years to come but the eventual plan is to have DNP only nurse practitioners. You can't fight gravity or progress.

I disagree... even rung up the ladder you go demonstrates an investment you have made in both your career and education. An RN with BSN should be paid more than an ADN. An RN with MSN again should make more than a BSN. A DNP holds a higher level of education than an MSN and has a right to expect to be paid in accordance. I am not talking large amounts here, but there is a difference.

You teem 'em "slam that sh@t in!" LOL

On a resume list every dang certification and education you have or could think of. It is when you sign your name keep it simple. A. Nurse, RN or A. Nurse, APRN..... However to sign A. Nurse, RN, BSN is silly as as and RN you should be expected to hold a BSN at the minimum. Sort of like A. Worker, High School Graduate - that would be silly.

I would always laugh when nurses put BSN in charting or when signing their name when RN will be just fine. I think it is expected that the nurse should have the BSN and the ANA made the statement ages ago that the entry level for professional nursing starts at the BS level. I get that they want to be separate from the ADN nurses, but it is still funny. I had an educator years ago that would sign her name B. Nurse, RN, ADN, BSN, MSN, ARNP, CCRN, CEN, BC I think she had a few more even and I cannot remember the exact order she wrote them in. She would sign this way and every presentation she would devote a single slide to her title and credentials - there was much laughing at her pretentious nature. I myself only signed RN unlit I was responding to an email and I wanted to be a smart ass then they got the entire alphabet soup. Bottom line is that until you get at least an MS the BSN seems a bit silly.

We are taught not to prescribe abx for colds and viral infections, but in the clinical setting time and time again it is done. I had one provider tell me that if they do not provide the abx the patient will just go next door where someone will and the practice loses the business. Plus with these urgent care clinics every 10 feet the competition is getting much tougher for providers - I man not saying that makes the practice right, but I can understand the reasoning for handing out Zpac like candy. Also, when you talk about people coming to a provider for everything. Those on medicaid and medicare come much more often for the silliest things. I guess if you don't have a job and don't have to pay there is no incentive to stay home and wait it out. People with jobs and insurance only seek treatment if really necessary. I remember doing triage in the ED and would ask so many times, "you came to the ED for that?" It always amazed me what some people considered an emergency. A split toenail, a runny nose, hangover or whatever stupid reason they have to waste our time.

Most places I have seen FNP

I agree with prior comments that if you work for the clinic (in whatever entity) you are staff. And as an NP you are a provider and often referred to as a mid-level provider. Sounds to me you have an office manager problem and those can be sticky - for some reason people who answer the phones or make appointments often act as though they have earned a medical degree.

Why does your employer need to know your plans? Sure tell them you are in school and maybe they can work around your hours. You graduate in May, but what happens if an emergency comes along and you need to withdraw - or god forbid you fail. Until all the grades and hours are in the book nothing is guaranteed. It is a company or facility and not a mom and pop store. The will cut hours, benefits or toss you out in a skinny second to save them pennies. I never understood the whole idea you must give them two weeks or more but they can give you minutes to eliminate a position. Seen it over and over again. You share too much and you may not get a job and frankly you are not required to make full disclosures. You are providing a service and they are paying you for it.

I have a preceptor who is mega fast and she can see the patients in 15 minutes - most patients but what slows her down are the billion calls from pharmacies, labs, patients and calls she has to make to insurance companies. there is way more than just seeing the patient and writing scripts.. Plus when she gets in there are piles of charts with labs etc.. she has to review and sign off or follow up on. 15 min a patient - good luck..