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Content by TitaniumPlates

  1. Thank you for the clarification. It hit home because I am leaving nursing because of moral injury---and it seemed almost like someone is minimizing this because it sounds like the profession is harming us---which it is. It's not the patients, it's the profession. It's the requirements of corporate bean counters believing that this is a big chessboard or a robot factory--that no one has needs or feelings. I see this a lot with my family of Veterans. I also worked at a VA. These men and women are treated as robots. Told what to do--"OWNED" by the US government. You can't even get a sunburn without fear of repercussions (that is considered damaging US Gov't property). These people are damaged beyond belief. There is such a parallel between how soldiers are used and how Nurses and to a high degree---doctors, CNAs, technicians and other "front line" personnel are being used. The results are the same. Inability to cope even with "lavender oil" sachets and "mindfulness training". Tell that to a soldier who watches children die whether it's by his own hand or someone else's. This is the same thing we go through as nurses every single day. Bad decisions made by rushed and overworked/overwhelmed physicians--poorly trained, some of them--horrible policies set in place by out of touch or inexperienced "upper management"--all for the same goal--- PROFIT. Thank you for the clarification. This hits very very close to home for me and my family.
  2. Question: Why are you changing the verbiage from "Moral Injury" to the more sanitized and therefore less meaningful "moral residue"? "residue" doesn't really even make sense in the context of what the definition you are using This is the definition of injury. Residue means: noun: residue; plural noun: residues a small amount of something that remains after the main part has gone or been taken or used. Where does this verbiage sanitation come into being?
  3. TitaniumPlates

    Angry and need to vent

    {{{{{Hoosier_RN}}}}}} I have no answers just empathy. The various people that come to the ER as a result of their addictions is heart wrenching. Some are so angry and others are just so despondent that nothing reaches them--but they're there, getting some help to get through another day. I bold people because they are someone's daughter, son, mom, aunt or even grandmother. I always whisper under my breath when I get exhasperated with them, "There but for the grace of God go I". I'm sorry this happened and it takes a lot of inner strength to cope, as if life itself isn't hard enough. I'm always in awe of the families that pull together and provide support.
  4. TitaniumPlates

    Why wouldn't this cost of living hack work for California?

    I think that he is also credited with another saying that comes to mind with the serial contrarianism that is coming from this discussion. "The definition of insanity is doing the same thing over and over, expecting a different outcome." All I hear is "but but but but but"---no resolutions are acceptable---because Myoglobin, you want what you want and I'm not sure why you're asking anyone else's opinion if you aren't going to take any advice. I lived in Hawaii for awhile. Kauai is not someplace that one just goes and moves to. Do a little research before you insist that this is the be all and end all of your life. You say you "have no intentions of retiring". Yet Kauai has only three very very tiny hospitals---one is a teeeeeeeensy VA. Do you plan on getting a job that is all telecommute? I know a physician there on Oahu that does all telecommute and his salary is crap because of it. He lives in a tiny 400 sq ft apartment and can't really do much because the time difference prevents him from actually having a life. I'm not trying to be harsh. Hawaii---particularly the smaller outlying islands that mean you have to fly to other islands in order to get pretty much anything that isn't jacked into the stratosphere on prices---eating yet more of your income....the housing is usually lease hold in case you don't know the term---look it up. It's not all sunshine and skittles in Hawaii. The thing about "hoping she'll change her mind". This is a bad foundation for a relationship---"hoping someone will change into what I want them to be". People here are trying to help you and you're shooting down every single idea or suggestion. Then why ask. You need to get your financial house in order---because you clearly cannot do it by yourself, you need help with it--you admit that you historically are very poor with money---yet you don't want anybody's help you want the quick fix. I really wish you luck. I used to see people like you all the time when I lived in Hawaii and they lasted about six months before the reality of that place kicked their arse and they had to leave. Water the grass under your feet before you start wondering if it's greener somewhere else.
  5. TitaniumPlates

    Why wouldn't this cost of living hack work for California?

    My thoughts exactly--a 6 bedroom house with a pool is pretty extravagant especially if there is substantial debt to income ratio. The gyst of your comments is that your wife pays her half and you pay yours---n'er the two shall meet. Therefore, she's not going to assist in your debt paydown of your own educational expenses? There was a conversation with my nephew about a Z280 or 300 or some stupid flashy car like that some years ago in my family. He dug his heels in hard, that he was NOT going to sell that car. Insurance through the roof. Couldn't put more than an overnight bag in the trunk. Useless in the Ohio snow. No money for a decent place to live, so he mooched off of family members. No money for groceries so he mooched off of family members. He was fresh out of the service and "poor with money" as well (clearly)---but the key here was that he felt entitled to all of the high end things without the high end income. No one could reason with him. He had to have these things. He wasn't sacrificing anything because he felt he should have to. He lost the car to repo, so no getting around at all. Everybody was sick of hearing about his money problems and started closing the doors. The only time he got his situation under control was when he hit rock bottom and had nothing and a car debt that was ~$40K and no car. It takes time to learn how to manage money which is what I'm trying to say. You have to want to do whatever it takes to get out of debt. He did end up getting himself into a vocational program for electrical technician. Landed a decent enough paying job, moved to a medium sized town with good public transportation, sucked it up on the "high end lux apartment" he felt he needed---rented a studio---and he paid off that car debt. After that he moved back to my hometown and got a job with a local business, and purchased a small but cute little house. His budget is tight, but he owns a used car and he's now engaged. It takes time and sacrifice. The quick fixes aren't there anymore. I think being realistic about the situation and asking for a financial advisor to help you would be the first step in getting a good plan together.
  6. TitaniumPlates

    Nurses secretive about getting another job

    I agree. All I asked was a simple question--why does it matter what she does in her off time? then this: "Karen is actually quite gossipy herself, LOL. She constantly complains about people and management at Hospital A. She is highly critical of patients from the lower socioeconomic strata. She's openly expressed her jealousy that some newer Per Diems are getting the day shifts that she feels entitled to. " That's not a work friend type of comment. Emergent isn't friends with this woman---and yet she feels that "Karen" needs to give her personal information. Emergent is talking smack about her behind her back on a forum---which equates to "not friends" in my book. These may be facts as Emergent sees them--about "Karen"---which leads me to wonder---perhaps "Karen" feels the same way about Emergent. Ergo--information is not going to flow to someone who is so willing to disparage someone else behind their back, no matter the "intent". That's all I was pointing out.
  7. TitaniumPlates

    Nurses secretive about getting another job

    Nope. We deal with nosy nellies very effectively in my department. we tell them complete confabulations and watch them run with it so that they look foolish. after a few of those little juicy tidbits that aren't true--the noser usually gets the hint that if the information isn't being freely given---it's not your business to know.
  8. TitaniumPlates

    Nurses secretive about getting another job

    It doesn't bother me. At all. Discussing "ordinary human activity" isn't what you're doing. You said so yourself..."this forum has been a bit dull lately". This is pot stirring. What happened to going to your job and just doing that---and letting other people run their private lives how they see fit? If she doesn't want to confide her personal business...then it's not up to you to dictate that she does.
  9. TitaniumPlates

    Nurses secretive about getting another job

    Not an excuse to be in her business.
  10. TitaniumPlates

    Nurses secretive about getting another job

    "I guess I have always seen no reason to hide a second job. Lots of nurses have them, it's no big deal." Then why does it bother you so much that you're rubbing your hands together that she "underestimated the nurse grapevine". She's shown you that it's none of your business. I'm not sure why this is an issue for you.
  11. TitaniumPlates

    Wastefulness in healthcare

    Date stickers for IV tubing. I've worked at a place where the sticker is placed for 3-4 days (depending on your facility's IC policy) in the future--and as long as you're using the tubing for the same drug--you reuse it for 3-4 days. Room set up bags. Get a list of all of the things actually needed for an admit--ekg pads, rainbow tubes, 2 primary setups, suction cannister, 6 alcohol wipes...you get my drift---premake them and keep them in the supply room in their own reusable baggies. Nobody brings into the room what isn't in that bag. Empty the bedside carts of all items. If someone needs something extra--you go get it. boxes for specific procedures. Chest tube box, a line box...etc. only what is needed for that particular procedure---zip tie the box closed (like a tupperware bin) and use when that procedure is done. Restock items when they are used, don't bring the whole kit into the room---get what the doc asks for out of the box when he/she needs it. re-usable slings for overhead lifts--wash when dirty or between patients. use backboards for transfers and not these disposable things we do now. restart the autoclave biz. no more "one use" scissors or pushers. I get it that these tidy little "suture kits" are all so cute---but all you need to suture a damn lac is a pusher, a scissor and some prolene. FFS. even the wrapping is a waste on those stupid things. no more "pre packaged IV kits". if you don't know what to bring to an IV start...make laminated cards for each nurse to have on their person--or have them in the omnicell room for someone to refer to. the wrapping---again---is ridiculous. this is all about pharma companies like BD making money. like those stupid "expiration dates". someone here takes expired meds and supplies to another country and donates them. An expired GAUZE works just the same as an unexpired gauze. this is about a revenue stream for the hospital too. they can bill for these things if you let them.
  12. TitaniumPlates

    Is it like this everywhere now?

  13. TitaniumPlates

    What You Don't Know About Nursing Boards

    Thank you, Ms. Brown! I have commented many times on this very thing. Boards are for the PUBLIC's protection, not ours. The word you use, "draconian" is an understatement, in my opinion. I don't know who drafts this legislation, but it certainly cannot be RNs, I refuse to believe that even though we do eat our young, any RN would write such egregious laws. If RNs are actually putting forth this type of legislation, then I am embarrassed to claim membership as an RN. I, for one, am leaving bedside nursing because of the Boards of Nursing. I'm just one of many. My best and most heartfelt advice to all incoming RNs and present bedside RNs.....if you're not in it, don't do it. If you are, find some non-patient care position to transfer into, whether you love bedside or not. The states use RN licensing as a consistent revenue stream, exacting ever higher and higher fees for the privilege of practicing in an atmosphere that literally says..."we will ruin you at the slightest provocation, whether real or perceived." Why would anyone in their right mind go to a job where the threat of complete devastation at the hands of a vindictive ex-spouse or be publicly humiliated by an accusation that is "basically" untrue but the Board saw fit to find some thread to keep a reprimand on your license? Your essay clearly shows that it's a "Tails I win, Heads you Lose" arrangement for the states and the Boards. You pay these entities in order to live in fear of them. This makes no sense, for a profession that prides itself on critical thinking skills.
  14. Is Nurse Recruitment and HR contributing to the Nursing shortage as well as destroying careers? I've been hearing a lot of rumbling in the past few years, regarding the practices of HR/Recruitment and VMS using some pretty inventive, and quite frankly, disturbing tactics to "hire only the best"...while paying the least, and expecting the most and more. First off, this question is directed at Nurse Managers. It's you who has relinquished control of hiring the best or brightest or hardest working (whatever it is you are seeking) to some faceless algo or non-nurse and expect to get great resumes on your desk for interviews. Why would you expect that the outcome would not be "someone who looked great on paper" but can't actually do the job or is a horrible fit personality wise? I've been hearing about black listing RNs because a recruiter "just didn't like" the nurse. This can effect that nurse's ability to get a job in an entire market. Blackballing is illegal, yet it happens. Every.Single.Day. Recruiters all go to , "workshops" and "conferences" and network around their areas. They exchange information and gossip. "Hey, Joe from Hospital Across Town...did you see this RN's resume come across your desk? She was just nasty to me on the phone when I called her for an interview. I think she has an attitude problem. Might want to keep an eye out for that one." And that's innocuous. The smart HR recruiter will say...I'll be the judge of that. I have critical thinking skills and can figure that maybe...just maybe...RN was having a bad day. Or recruiter A called RN at 0800 when RN just got to sleep after her night shift, maybe she was groggy, not nasty. But there are recruiters and HR Managers, just like in any other profession, who shouldn't be in their position. They're qualified on paper, but in practice...look out. Gossipy, hateful, spiteful and maybe sometimes, not very good at the job they are doing. They are human, after all. Flawlessness isn't reserved for just us "worthy candidates". That's when the blackballing is just under the radar and might be combated by a persistent and qualified RN. In comes VMS. Vendor Management Systems. One red (or black? which is it, recruiters? do tell!) flag, because some recruiter somewhere in that system just didn't like this guy or maybe heard something once or called a problem manager without permission or did a Google search...seeing someone with the same name and RN after their name--but got the wrong person...and there goes the RN's chances at employment within that VMS's reach. There's just a tad bit too much reliance on the internet and electronic correspondence. The internet is the biggest and most comprehensive repository of information....accurate and inaccurate. It takes critical thinking skills to sift through the detritus to the truth, even when you have a face to face interview. I understand that. It's when VMSs flag a nurse without proof and valid, solid evidence as to why this RN is being flagged. Yet, these same facilities who use VMS or recruiters that have no workable knowledge of the units/nursing in general are on facebook and LinkedIn and Twitter..begging for RNs. Career Fairs and Open Houses...begging for RNs. Using travelers. Using PRNs. Multiple listings for multiple openings in all units. But they only want the best! Read: Someone who has never left a job unexpectedly for any reason. Someone who has never made a mistake, ever. Someone who has all RN Managers as references and is adored and loved and supremely cherished by everyone at their former facility. Someone with credentials that would make a CNO blush. Someone who will work garbage shifts, for little compensation...and not give a whiff of an expectation or an attitude. Let me be the first to say...if I worked at a facility where all of this was true about them an about me...I wouldn't be seeking employment elsewhere. On to the deceptive job board strategy. I am referring to Posting a Job that Doesn't Exist or leaving a job on the board that had been filled years ago. The elusive high paying PRN position that "just got filled"...but we have this nights and all weekends position in a unit you'd never work for in a million years available! Yes, it's 40% less than you are making now and half of what was advertised in the job posting, but there is potential here to transfer into something you want later! Transfer? Transfer? Do HR people actually understand how units work or do they honestly believe that RNs don't? Transferring between units takes an Act of God at times. Needs of the department, and all that. I've personally had a Recruiter from a well known hospital system call me, I interview well, we agree on a pay package...only to receive the offer letter....and it's wrong.The pay is $12 less than what we agreed!! I call. I now get the voicemail treatment, but I keep getting "reminder" emails to sign the contract! I finally get frustrated enough to leave a very direct message for HR person to call me, or I won't show at orientation. I get a call saying she "made a mistake" on the payrate....oh!!!....and the shift as well. Turns out, it's not a dayshift position after all. The Nurse Manager's fault, you understand. They changed things last minute. I declined the offer. Now, even if I wanted to go to that facility as a traveler, I cannot. Because I dared turn down the offer, and that RN had an attitude. My questions are simple. What is it that recruiters hope to gain by this behavior? The Nurses are suffering with understaffing and burnout. Hospital systems are being avoided because of horrible recruitment practices like these openly deceptive or overbearing recruiters. There was an article recently about the "10 reasons why you didn't get the job", which stated, as one of the 10 reasons..."Well, the recruiter just didn't ...um...like you" for some reason. Nothing concrete. Maybe it was your hair. Perhaps you had a jacket on with those 80's shoulder pads. Perhaps she didn't have her latte this morning and your appointment was preventing her morning Starbuck's run. Who knows? Now you get to suffer the consequences of some recruiter who may and may not even be a Nurse, who probably doesn't have a clue as to what the unit/team actually needs, deciding whether your resume gets to a hiring manager. You can have stellar references, Level 1 experience and credentials, and the completely-pointless-in-a-code BSN degree---but your hair! And those shoulder pads! How dare you. Then there is the Calling Former Nurse Managers Without Permission. Another tactic that I personally detest. It's underhanded and is representative of the facility that allows their recruiters to practice this particularly distasteful thing. Who here hasn't had the Nurse Manager from Hell? Anyone who says otherwise, I call liar liar pants on fire! You didn't ask that manager for a reference for a reason. Yes, maybe you're hiding something. Ok. I get it. But the remainder of your resume would suss the problem being you. What about the RN Manager being the problem? The malcontent who just clings to the job despite write ups and complaints and having a grudge against anyone younger/smarter/prettier/more handsome/slimmer/fatter/wealthier....and they exist. All over the place. Union protected or seniority or longtime pals with the director. I've seen them, and so have many of us. What about the RN Manager who is just so darned busy in a huge teaching hospital and can't call back? Or is perturbed because RN didn't tell RN Mgr they were a reference...because they're not. That recruiter who picks up the phone and calls anyone not on the list of permissible references is one that is contributing to the problems of the facility. Many of my colleagues are leaving Nursing for just this nonsense. One mistake, whether real or perceived, gets you kicked to the curb. The RN Managers ask...WHY??? Why can't we attract good people? Have any of you RN Mangers actually looked at the resumes coming in, instead of only the ones deemed "worthy" by a faceless, sometimes clueless recruiter? Unless a facility has a recruiter for each and every unit, there is absolutely no possible way that they could evaluate the "worthiness" of a resume with the exception of hard licensing credentials. Candidates have ridiculous standards to meet just to be eligible to apply for a nursing job. They've passed the NCLEX. Some states require such egregious background checks that it takes months to get licensed. I've had to show proof of a birth certificate, passport, driver's license, social security card, fingerprint card, DOJ and FBI search, state criminal search, all past employers, gaps of more than 30 days in employment, expired licenses (some which take months to verify)....pay $$$ to the state, NURSYS, and employers for verification, and on top of all of that..paid extortion amounts for a state license that has to be renewed every year..... all for one, single, non-compact state license and the honor of working for less than the median national average pay as a Nurse at a facility in said state. Then I have to deal with deceptive or issue-laden recruiters? I don't even get to speak to the Nurse Manager? Because I've been told...don't circumvent HR. Don't do it. If you do...they will flag you and you won't get hired at that facility....ever. Want to know why I'm a traveler and would never, ever return to staff nursing? Want to know why great nurses are leaving the profession in droves? Burnout and understaffing is huge, yes...but this issue is on the front end, not the back end. This issue is preventing good nurses from working. Yes. There are problem nurses. The states and the licensing boards filter many of those out. Then background checks do a great deal. Employment references take care of the rest. What is it that recruiters think they are accomplishing? Burnout is real. Understaffing is real. The nursing shortage is real and it's only getting worse. Patient care is suffering. Communities are suffering. The deceptive and damaging practices of HR and Recruitment is a large part of the nursing shortage. Collecting resumes on fictitious jobs, creating resentment and alienating good candidates. Blackballing without doing a microsecond of research as to what might have happened with a nurse who is qualified. Not leaving their biases and personal issues at the door when they look through candidate files. I appreciate the work and effort that goes into credentialing a Nurse. I really do. It's tedious and there are risks that just one that a recruiter lets through might be The Diverter or the Unsafe. In reality, those RNs are shaken out fairly quickly, either by credentialing bodies, background checks or simple job references. An RN that has a bad experience in a unit with the RN manager is normal, it doesn't make that RN a hiring risk. An RN that has made a med error once in a 15 year career, is not a hiring risk. An RN that followed their husband/wife/SO all over the country for their career, ergo five RN jobs in three years, is not a hiring risk. I encourage any HR/Nurse Recruiter to respond and give some insight regarding these practices, and how we might start to work together to stem this shortage, instead of throwing more fuel on the fire.
  15. TitaniumPlates

    RN needs work in VA w/ disciplinary action

    OK, so I was perusing this comment section because a good friend was just nailed for "possible diversion". I am terrified for her, because I know without a doubt, that she didn't do this. I could elaborate, but it would identify her and the facility if I did. Suffice it to say, she was a traveler at a facility and did something on the job that embarrassed the NM (in the NM's mind. I heard the story and it wasn't anything horrible. I think the NM was simply hair triggered bc her facility SUCKS and is mostly travelers. she takes it very personally it seems. and some lowly peasant traveler dared to talk back to her on something stupid.) I digress. She received a letter from the BON of her state, saying that after she had left the assignment, with no word from the NM, that the facility is now accusing her of diversion. During her THIRD WEEK of the assignment. I don't know, OP, if you understand this. BONs are NOT mandated to protect NURSES. They are mandated to protect the PUBLIC FROM THE NURSES. Period. End of statement. Remember it. Because when you deal with ANY BON, you have to get that. It's not something you will change, debate, negotiate or cirumvent. Period. They don't have to "give you" anything. Ever. They are there for the public's protection. Not yours. Feeling entitled to what you had before, because you are sorry and did your time....is a moot point. I see this attitude all over this board. It seems people don't get it, that they are lucky that the boards even give them ONE chance, let alone two or three. They have ZERO obligation to you or your problems. I know this because i went to them myself for a personal issue of a stalker who threatened my life. I wanted protection and I had legal backing to get it. The BON said...."nopity nope nope. you are who we say you are, it is public and too damn bad. we don't have to help you. you could be lying about this and just trying to cover up some criminal activity of YOUR OWN and we aren't going to take your legal documents as proof" This is how it is. I didn't say you had to like it or agree with it or that it's fair. They have something you want----your license to practice. It's their game. You are just a player. It's a revenue stream for them as well as a political tool. You and others, including myself as well as my friend....need to just deal with it. Your license will ALWAYS and FOREVER have a reprimand on it. Convictions? I dunno. My friend hasn't been convicted of anything. But a different friend had a reprimand against her TWENTY YEARS AGO....for defending herself against a patient who attacked her. The letter is still there. I can pull it up anytime. It has effected everything in her life. She's gone to the master's level of education....and it is a factor in every.single.thing.she.does. Every job. When I read the letter? It sounds like....crap....I woulda done the exact same thing, and the reprimand reads that the BON actually agrees that she was in a threatening situation.....BUT.....she should never, EVER (according to them) have defended herself. No matter what. She's not even accused of diversion, she was accused of being human. So. All that being said. I am mortified for my friend, and I know she will never get away from this if there is a reprimand letter. She can be "completely cleared" as you were....and what the BON does is find something else that you did within that particular problem you had....and reprimand you. It stays. I have been seriously considering just leaving nursing altogether because of this issue alone. That someone, somewhere---can accuse you of something, whether there is evidence or not---and the BON jumps on that like wolves on a rabbit, tearing your life to shreds. My friend is devastated...she can't go anywhere, do anything....and the board says "6 months" to "investigate" because they are short staffed. No recourse for her. I am not bringing up your past transgression. I don't care one way or another what you did or why. I am telling you that once you get caught doing something that is against the Nursing bylaws....you are forever tainted. Period. I personally am terrified of even holding an ampule of fentanyl now, for fear that someone might claim that they saw me put it in my pocket (I work at a place where you have to waste at the pyxis, but you have to scan the med at bedside. ergo, you are carrying around an empty vial of a narcotic that has been properly wasted, but........???). I used to tape partially used ampules to my badge during traumas, and then wasted when i got the chance. Do that now?? Oh hell no. After having a justified, in the right, legally backed tangle with the BON over something like my life being threatened, and they told me to pound sand? I hate to say it, but you might want to just take whatever job, wherever you can, and be okay with that. The BONs are NOT YOUR FRIEND. Luck to you.
  16. HaveNurse, honestly...this first part is what is basically an expectation of fast response travel nurses. The first responsibility is on YOU to make sure you can take a job 7 states away in the dead of winter with a crap car, not the travel agency. They asked, and you said okie dokie. I empathize with your winter driving. Grew up not far from northern Ohio. So I have very little patience for anyone who uses that as an excuse, particularly someone who LIVES THERE. If you were from Florida or California and had never experienced that kind of driving before, I would say...lesson learned, I am glad you're okay. But you are from WISCONSIN. You knew better than to try speeding to a job that far away in that kind of weather. If the remainder is like this, I really am wondering what Ned said..."what is your point?" What is the "dark side" of traveling? This IS traveling. It's flying by the seat of your pants and being organized and with enough common sense to be able to add, read a weather report and know your limits. If you don't have these, travel nursing is NOT FOR YOU. Cancelled when you drove 3000 miles? Gonna sit and cry? Uh...then travel is not for you. It's in the contract. Facilities can cancel at any time. Get your feet under you and compensate. I can name a thousand things that have happened to me over the years traveling, not all of them even in the realm of reality...but you sign up for a large amount of UNCERTAINTY. That IS the job. Anybody who tells you otherwise, is lying. Period. This isn't dark so far. I'm not sure why you'd find it acceptable to drive that vehicle to a regular job 25 miles away, let alone 2500 miles in the northern tier winter. Kinda flies in the face of the commentary on the thread about the kid who got fired for calling off a day before a snowstorm because she had a crap car. I know I am being harsh. But read the thread about this kid and how this forum came down on her for even complaining about her situation. What I think you should be hearing from this same group is.... GROW UP AND GET A GOOD CAR! Adulting is HARD! Suck it up! YOU made this commitment, you stick to it even if you DIED TRYING! What is wrong with you that you have a crap car??? Don't you have common sense??? I think travel is not for you, because if this is how you approached it and are now saying it's the "travel job" and not your lack of prep and common sense coming into it....you really need to stay at a local perm job where breaking down between point A and B is nothing more than a mile walk home.
  17. TitaniumPlates

    Sacramento Area Nurses

    No. Mercy San Juan, Kaiser South sac and Sutter are not just busier but also see the "actual" traumas. I don't think you understand the conditions of UC Davis if you are interested in doing trauma. Please read about it again. You won't see trauma for a minimum of a year by policy and if you happen to be one of the many that seem to challenge the trauma cn3 in any way (apparently you have to be an utter sycophant and know nothing so he looks good)....you will never, ever be trained and if you manage it after a few years, you would still have to get assigned. There are no rotations thru the resus room. It's charge discretion. You seem desperate for trauma experience. Not sure why. But if you are that desperate that you would allow yourself to be turned into med surg nurse for tow or three years while genuflecting at the feet of someone who may never ever allow you to learn trauma....then why not just go be a med surg nurse and be done with it. There are actual trauma units that don't have level 1 designation. I am thinking this is what you are after. Learn what the difference between level 1 and 2 actually is and then decide whether you want an actual trauma experience or you just want to pad your resume with a level 1 designation. Because trauma nurses know well trained when they see it. If you just want to fake it so you can get into CRNA or NP ....then I think you might possibly fit in well at Davis.
  18. TitaniumPlates

    Paramedic Vs. Nurse

    Everything Annie and Akulah said. Plus one thing. As a medic, we wear bullet proof vests in some markets. There's a reason for that. You go in with PD and FD. Scene safety is priority for yourself and your crew, and there is always the stupid with the gun. In the ED, I really never came up against a banger who wanted to finish the job. Especially with the tight security we had at my prior facility. Metal detectors and police, not security guards. It's fun on the truck, but we also see the scene "as it is". Upside down in a ditch, extended extrications in subzero weather or driving rain...you're in there intubating and securing for transport. Lots of help. Lots and lots and lots. A real brotherhood. In the ED, I get "cleaned up" versions. Packaged, sometimes intubated already, IVs started and there goes my ego...the medics got to do it all. I sent him to CT and surgery. Yay. Ups and downs to both. I hated the feud between the two specialities, because it's undeserved on both ends. RNs work like dogs and never sit, sick as crap patients at a 5:1 ratio. Medics for the most part are 1:1. MCIs...you get craptons of help, multiple buses and lots of direction from command. I do like my vest though. I feel like I should wear it in the ED for all those daggers in my back for not coming in during a snowstorm......
  19. TitaniumPlates

    Fired Due to Not Being Able to Get to Work

    Wow this really chapped my butt. ooooOOOooohhhHHH....the martyrdom here give me shivers. Really. It does. Please. This schtick about being proud of no bathroom breaks, standing for 12 hours and then working another 4-6 while Charge finds a float or PRN to come in, getting UTIs because really your patient's life is just way more valuable than your health.... Is exactly, precisely, 100% spot on----why we RNs receive zero respect from administration as well as patients. Why the working conditions suck. Why we will never, ever have nursing ratios or enforced breaks anywhere but in California. Being a martyr doesn't make anything right. Ever. Balanced approach to everything, and if I have to pee...you'd better believe I will find a way to get someone over there to push on that chest...no really, never happened, but you get my drift. Someone here said it...boy, you sure as **** find a way to get HOME when your shift is over, but watch the call outs when the game is on or the weather gets crappy or someone wanted a vacay and it wasn't approved. Don't ** anybody with this "I would walk 500 miles in the dark, during a blizzard, with my camping gear strapped to my back, throughout the night in order to get to my shift 24 hours early!" rubbish. I got fired from a "non essential" hospital job, because I lived 45 miles from the facility, my roads never, ever get plowed, let alone brined. I HAVE A PATHFINDER and I was a PRN lab tech. AS NEEDED. I committed yeah, to the shift---but that morning, a freak ice storm was predicted (in a southern town, that's the death toll for anybody coming in to work)...and I live alone. They had already sent all the kids home from school and closed businesses. I had a geriatric dog, no family in the area and nobody who could most likely take care of said dog for what was looking like at least 72 hours at the facility... and a nursing exam in the morning. You bet your sweet life I called out. I didn't tell them it was because I actually valued my life, my nursing career and the lives of everybody on the road---because just like most of the posters here, that facility's policy was....you give your life for the facility. Period. Until, of course, one snowy night, a nursing student got killed because she was going in to her CNA position at this very facility....because some ******* Charge RN threatened her with being fired. Feel all better now? Oh but now they're sorry. Really really really sorry. Gee....she should have blown off ALL of her nursing classes that day, with her attendance requirement, probably failing because of that very thing....because some ******* RN wanted her tech to flip rooms for her and just couldn't do without. Yeah, i got fired. And it was on a conference call with another supervisor and this woman gleefully stated that "your services are no longer needed". Whaddya know....two months later, that very same gleeful manager got fired for flogging her "Beach Body" ** to her employees, pressuring them to buy her and her husband's products. Where was concern for patient care during all of her hours on the computer selling her shakes and videos on company time? Yeah...I'm all for patient care, and I'm all for adulting....but guess what. This kid thought he was doing this ******* a favor by giving them a head's up and a chance to find a replacement or brace for impact. But no. That's never okay. Because it's inconveniencing someone who wants to go home and who the hell cares what happens to your relief, because hey, you are the center of the universe. I will never, EVER go in to work if it means I risk my life. EVER. I like living. No job is worth it. And I am all okie dokie with being the unpopular kid on the unit. When I am there, I give 100% at all times. When I am off the clock, I am not Nurse Titanium Plates. I am Private Citizen Titanium Plates with Responsibilities to Herself and Her Family. I am no good to MY FAMILY and MYSELF if I am dead in a ditch. But I'm sure my employer will send flowers along with that sympathy card. Maybe. The car advice..."go get a Surbaru!" Yeah. My Pathfinder can eat your Subaru, and I still wouldn't have come in to relieve you. Because you think your life is more important than mine. I recently was asked to return to that same facility, btw. Where I was unceremoniously told that since I wouldn't risk my life, my services were no longer required....and I kindly told them that would have to decline. Mentally, it was because I know that they don't give a rat's rump about my safety, it's all about their bottom line. A friend who worked for Vassar Bros some years ago, related a story where she and her colleagues were going off shift during a snow storm---and their CEO called each and every single one of them when they got home, to make sure they traveled safely. It's unreasonable to expect that kind of concern from an 850 bed Level 1....but I sure as **** will go and work for that tiny hospital and give it my 110% to get in there, when they at least ACT like they care. OP....move on. And if you want a great piece of advice? Always remember from whom you are asking guidance. We're a bunch of people who can't (or won't) stand up for themselves and fight for basic things like the privilege to eat or pee. But they'll gladly risk their lives to get to a job who denies them those basic rights. And think this is normal or "badge of courage" worthy. It's not.
  20. TitaniumPlates

    Sacramento Area Nurses

    No. It's only gotten worse. Someone who works there presently said, "Oh, we changed the culture that was bad. We hired a new director." In other words, and this is from others who have been there recently as travelers and as staff who ran screaming from them...this new director is very "data driven" and a micromanager. She dictated that "things will change" and she actually expects that since she said so, the "culture" will change. The core staff have all been elevated to positions off the floor, aka bedside. There are people in internal triage who are no higher than CNII yet will not be forced to do bedside. The night shift is routinely understaffed to the point (even with mucho traveler help) that state and union mandated lunches/breaks are in danger at all times. "Strong personalities". that's an understatement from what I've heard. Dayshift = high school and Nightshift = shark tank. Gossip, back biting, deliberate sabotage and bullying abound. The safety issue. I tried to follow the "flow" of this place when listening to several people describe it. The hallways are actual "pods". Non monitored, one RN per 4 beds, no privacy...pts have been lying in these hall beds for 3-4 days at a time. Not some drunk or homeless person either. One girl told me that her GI bleeder was set out in the hallway, no monitor, one IV pulled out of this guy's arm which dangled on the floor dripping an infusion, nobody stopped to even notice...and the next day when she showed up, the guy was still there. Same IV dangling from his arm, infusion dry and empty bag still hanging there with a beeping pump. I was told that this is routine, every day stuff. The hallways are lined with people at all times. They lie there for days and days. The "flow" is that they play musical chairs with pts/gurneys. One RN told me that she just had everyone assessed and stable....when internal triage decided, without so much as a word to her, that they were pulling every single pt out, separating them to other "pods" and she was landing 4 new pts all at once, two EMS critically unstable. Someone here described it as hellish. I said that to my traveler pal, who is finishing her 13 there and has vowed she'd rather live unemployed under a bridge rather than work one shift past her contract at UCD...and she said that is putting it nicely. The "core" staff are babied and elevated to positions of low-no stress and authority, while newbies and travelers and less well liked staff are shat upon and driven into the ground. Management only cares about numbers there. That's it. It's a big joke that UCD is a Level 1 trauma center when everyone in NorCal knows that Mercy San Juan and Kaiser South Sac are the places to go, and the trauma team at UCD can barely function bc of the micromanaging of some of the CNIIIs. There is some rule that you can't even "qualify" for a resus assignment until you've been hazed for 9 months and even then you have to apply for permission to take a course and do modules and then if the CNIII in charge doesnt like you, you will wait years to get into their "resus" assignments. What decent trauma RN would go there with that kind of crap going on. Then I heard about how it's all med surg nurses and ICU nurses in the general pods. Nobody is a real life ER trained RN. THey hire med surg or pull med surg from the units because they hold so many med surg pts. the icu RNs get anything "complicated" with more than a drip or two or maybe an art line. this is from four or five travelers, two of whom spent a year there, and two staffers who left within the past six months. not one malcontent, but a whole slew of people with the same story. personally i have seen places like this and during one guy's orientation with their educator, this woman actually said, "We used to have a reputation for hiring anyone with a pulse. It's kinda different now, because we have a new director" Does that clear things up? And yes. they have the lowest pay. add in the mandatory 10% forced retirement "contribution" that you can't opt out of, the $120/mo union dues, the $50/mo forced parking fee...and you're not taking home a few bucks less, you're taking home 50% less than anyone else in Norcal. And don't even go into the idea that you might get overtime. I heard that they will let the shift go 3-4 RNs short (and no ancillary staff, if you are curious. so you do your own stocking, EKGs, transporting, fingersticks, casting, etc) before they'll call anyone in that might be in danger of working >40. i wouldnt work there if my life depended on it, from what I'm hearing. Level 1 doesn't mean crap. it's an academic bunch of paperwork and translates to exactly nothing, especially in this case. go to San Juan or Kaiser South if you want trauma. If you want great working conditions and free benefits, Sutter is the way to go. If you're really smart, you will be a traveler and tell the HR dept of these places to stuff it.
  21. TitaniumPlates

    Many nurses do not chart?

    . Then rock that boat when you see it happening if it bothers you that badly. That charting is done under someone else's license, not yours. If your assessment disagrees with theirs then that will come to light and you have your opportunity to sink that nurse. This isn't about charting assessments that we're never done , however. OP is stressing because she is always late going home from catching up on what she seems important. There are basic audit rules and policies per facility. Usually they are common to each. Somway differ with q2 vs q4 or what have you, but basic charting per audit rules is a documented policy somewhere. They don't just expect you to know it by osmosis. If OP overcharts, that can get her into as much if not more trouble than undercharting. We all have been there too. I chatted a free note that said right foot by accident I meant left bc I was rushed. Just an example that is egregious but you get my drift. I then went on to continue charting on that properly noted left foot and that one incident of a free note that wasn't even necessary and said right? Gets me in hot water. Do the audit rules charting and add to it if it is something out of the ordinary. Blathering on in free notes doesn't impress anybody. In fact it ticks a lot if us off because we send our time slogging thru redundant crap. Learn the basics if your unit per policy. If you feel like staying an hour afterwards to chart that patient had a really nice personality and you brought them candy from the gift shop, go ahead. See how well it goes over when you make a mistake because you just can't keep it simple.
  22. 1. You control you. You don't control anybody else. 2. Nobody owes you a thing. If you hate where you are, grow a pair and change it. Nobody's going to do it for you. 3. Get a dog. The best people you'll ever know. 4. Don't tell anyone a thing. EVER. I like to change it up a few times, wait for it to come back and then smile mysteriously when it dawns on people that they've been outed as a big mouthed gossip. Keeps interactions with the Nosy Nellies to a minimum after they look stupid enough times. 5. You'll get played. Whether it's by an obvious addict or a cool sweet grandma, someone will make you feel like a dumba** for trusting them. Don't be hard on yourself, it happens. Just learn from it. And yeah. No employer is out for your best interests. Not ever. This is about money, and that's sad, and you might not like it, but it's the truth. Fortunately, the truth doesn't give a s***. Move on and protect yourself.
  23. TitaniumPlates

    What Else Can I Do For A Living?

    THIS. This is a very thoughtful, coherent response. She's frustrated, the OP. We all have those days. But she's coming to a point where she's questioning her decision to go into nursing, which means something. That's huge, considering what we all went through to get here. She asked a serious question and got what....kicked in the teeth for it? Yeah, she could have been a little less....um....nebulous...about WHY she doesn't like nursing and didn't mention what her strengths are... But seriously. Conflicts like this are common and if we all just turn on the person experiencing this and say..."GTFO" this isn't for you if you dare to complain or question...you're not reallly looking for a team or a full staff, are ya. Nursing offers a lot of doors, OP. Education. Teach staff nurses (um, how to act like civilized humans in some units, it seems, needs refreshing) CPR/ACLS/PALS. Consult with attorneys. Be a public health RN. A school RN. Work LTC or another unit in your facility may be a better fit. You can also use your BSN to launch into another career altogether and use nursing to pay for it. Law. Medicine (but if you hate backstabby whiners, that isn't the way to go). Engineering. Abstract and critical thinking is essential for these types of jobs. What about administration at the VA? A BSN goes far, as does an MSN. Give back to veterans. Be a diabetes educator or a lactation consultant. There's lots to do. If handling people isn't your thing, then you do need to reconsider medicine. However, on a side note--nursing has a reputation for eating it's young for a reason. It's not an unwarranted label. It's an accurate cross section of high school, only higher pressure. But then...so are MANY other professions. This is life. Taking offense to everything and everybody, all the time isn't a good strategy for getting thru it. If the problems are real, then you need to confront what they are and make changes.You control you.
  24. TitaniumPlates

    What do you think of 12 hour shifts

    Yep yep. Just an excuse for schedulers/management to use you as they see fit. If we had unions and set schedules, swapping when we wanted, we probably wouldn't have this issue at all.At my former (thankyoulordbabyjesus) employer, the scheduler had his faves. He'd put the cool kids on the shifts they wanted, together...and the rest of us could just twist in the wind. There was a girl who routinely got skipped for changing from nights to mids....for several years....even with new people coming in and they'd get the mids that would open first. It was bogus bs. And yeah. I agree completely that 12's suck. It's even been shown in studies recently that hospitals that offer 8s, 10s AND 12s have happier employees. I did 8s for years and wish to heaven I could get that back. I am considering Kaiser Perm because they have set schedules and 8s. It's complete rubbish that this has to do with "continuum of care". I worked 12 hr mids...and I could rarely ever find a person to hand off to. Thin staffing and people are just so exhausted, they can't take another bit of information. 8s gives you 4 more hours a day to do what you need to get done. Sleep. Take the kids to practice. Snuggle with the SO. BLOCK scheduling is even more wonderful. But tell that to a passive aggressive manager who uses it to make sure staff doesn't have enough time to go on an out of town interview or even have 4 days off to recharge. It's a rare place that allows consistent block scheduling. 12s made sense when that was a possibility. Now it's just a weapon that units use to be able to use staff as they see fit. No life balance comes into their equation.
  25. TitaniumPlates

    Many nurses do not chart?

    Sorry, but why is there such angst about this? Get a copy of the "chart audit" example, what NEEDS to be charted and when....and start from there. Geez. If you can see what you are REQUIRED by your unit to do, then you can see if it's YOU or it's THEM.