karmyk

I was making 41/hr with 6 years experience, but we'd rather move north and kill our student loans (in order to live coastal) than live in East County (and the heat).. But to each their own-- I can see why people would live there, so it's all good. With 3 dogs and one child, I think it's perfectly doable, and you can live comfortably and still be coastal. We did fine with two kids and were able to afford being 5 minutes away from the beach, and we were at the beach practically everyday. The paycut is the price we paid to be able to bring the kids to nice family beaches like fletcher's cove, Cardiff state beach, etc. I'm willing to take the paycut again once the loans are more bearable. I cant stand being away from the surf this long. Lesson learned: nursing degrees from private universities suck.

Ahhhh I stand corrected then.. I think most of the nurses I know who have wanted a position with either the VA, Balboa, Pendleton, or UCSD have primarily been concerned with retirement/pension on their minds.

Scripps La Jolla just built that huge, new cardiac center. Scripps is generally a great system. I've only worked at Encinitas and Green, and the people, including the doctors, are all really nice and awesome to work with. If you're going for scenery, I think Scripps Green wins (nothing like looking out one of the ocean view rooms in the ICU-- it overlooks the Torrey pines golf course, and on clear days, you can sea hang gliders in the sky).. Though I've never seen the new Camp Pendleton hospital's view, which is probably also ocean view. For cardiac, there's also UCSD med center (I believe they even do the heart transplants for the area.. Not sure if its the la jolla or the hillcrest location). The big hurdle is getting into a new grad program. Scripps has a very informative webpage for interested recruits. I'm on my phone so its difficult for me to post the link, but it's easy to find on their site. It's a great all-around program. They don't hire new grads directly into ICU right now, but you can easily apply for their ICU internship program after you finish the year-long new grad program.. And their in-house ICU internship program is EXCELLENT.

It's true at just about any hospital, but positions at ucsd are pretty coveted amongst rns in the area due to the benefits (mainly pension/retirement)... So I know quite a few who have accepted per diem positions in anticipation of being able to pounce on the very rare full time openings once they open up.

It's called the sunshine tax. If it weren't for student loans and the insane cost of daycare, we'd still be in San Diego, even with the paycut. I miss living 5 minutes away from the beach (and surfing warmer water... Especially since you can trunk it in the summers).

Correct me if I'm wrong... But I always thought the rumor was that you usually needed to start out per diem to get into UCSD, and from there you find a way to slip into a full time position once one of them came up... ...at least that's what I've heard from other nurses who I worked with when we lived in San Diego...

Sac isn't bad. It's more of a family town-- lots of family-friendly stuff here. Most people who think it's boring either equate "fun" to a crazy nightlife scene or have never lived in the middle of nowhere before (being military, I've been stationed in places that have helped me appreciate what Sac has to offer). You'll have to be patient with the job search-- it's pretty slow here right now... Though some of that is related to union contract negotiations. I've heard that a lot of nurses in the Kaiser system retired recently, and they haven't been "replaced" yet. Once Kaiser gets back to hiring again, it may move more quickly on their end. I have a little more than 6 years experience, and with Sutter, my pay is around the ballpark Nicki is listing. For California, you probably get the most bang for your buck with Sacramento. Cost of living is EXTREMELY reasonable here when you compare it to the rest of the state (especially the coastal areas).

I didn't start out in dialysis, but several of the dialysis nurses who work with patients in the acute settings at the hospitals I have worked at started out as new grads working in the clinic/outpatient setting. They later transitioned into the acute setting. Many of them are excellent nurses who have had the opportunity to get to know different floors at different hospitals and could most likely easily be hired and trained into those settings, especially since they also have gotten to know many of the floor supervisors and managers. Many of them end up being very satisfied with their jobs as dialysis nurses as well.

Hi! Have you tried going through the Kaplan review book for ESL (English as a Second Language) NCLEX test takers? I think it does a pretty good job of explaining why certain answers are correct in the practice tests. The NCLEX can be pretty tricky, but one thing I've found as I went through a lot of review questions is there is a big emphasis on safety, prioritization, ABC's, and Maslow's hierarchy of needs. If you can look at the questions with those things mind, it might help make the "most correct" answer stand out more clearly. I actually just sat in the bookstore and read this book from beginning to end, so it didn't really cost me anything other than a coffee and time.

UCLA pay is not representative of California as a whole. Pay rate drops the further away from San Francisco that you go. Starting pay is actually lower in San Diego. I started as a new grad in San Diego at $29/hr about 5 years ago. I live/work coastal, so cost of living is quite high. My cousin works heme-onc in Oakland and is making much more than $50/hr... But the cost of living in the bay area is high as well (I went to nursing school in the Bay Area). The reason why pay is so low here is the "sunshine tax"... Weather is lovely, we're close to the beach, we have all the benefits of being on the mainland, so people are willing to give up a lot of pay and deal with a high cost of living to be here. Orange County/Los Angeles pays slightly higher, but you really have to want to be in the thick of the LA culture and lifestyle to want to be there long term.

I've seen nurses use the plunger to administer the meds... they always tell me they feel like they have more control over the medication and can stop it if they want to.. ..I've always done it by gravity because it will go down fast enough anyways (as long as you don't have a humongous amount of residual backing out... but you always check that first). I figure if I want to stop it, I just pinch/clamp the tube. Also, flush thoroughly after administering the meds!!!! It's already torturous having an NGT be forced down your nose/throat once... the last thing I'd want to do is have to extract and reinsert (a new) one because I let the meds clog it. >

Has the head nurse discussed this with the doctor at all? IMHO if a patient is refusing to take any critical medication, it's the nurse's responsibility to inform the doctor to see if the doctor can write an order for an alternative method of giving the medication or an alternative medication/approach altogether.. I'd discuss it with the doctor if it feels like you're getting nowhere with the nursing staff.

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One of the two diabetes educators at our hospital is a BSN... that seems to be a bit different from doing floor nursing. Have you considered working outpatient? Med surg is tough, and it can easily burn a person out.. I've seen quite a few nurses-- new and experienced-- burn out on my floor. Maybe you just need a break or a change in what kind of nursing you're doing. Infectious Disease in our hospital system also uses RN's, and I'm sure being a BSN would help... that also looks like a different way to use your nursing degree. When I was a CNA, the guy who taught the CNA course I took was a BSN. I believe one of the PT's at work is married to a BSN who does the same thing... if you're willing to stay on the floor but in a teaching role, that's worth a try... A lot of SNF, hospice, home care reps that come and go in our hospital are RN's... not sure if they're BSN or MSN, but that's something you can also look into. They do a lot of the administrative stuff and don't look like they do any floor work at all (especially if they show up at the hospital in miniskirts and three inch stiletto heels). I know of a few nurses who also work as consultants (medical/healthcare-related) on the side as well...

How are you studying for this? Any sites/books you can recommend with advice?

Size/gerth won't scare them away. We had a male nurse who was bullied by the older female nurses and nurse managers at work because he didn't fit their perspective of what a good (male) floor nurse should look/act like. He was a bigger guy, lots of tattoos... In my humble opinion, a good nurse. They simply gave him heavy patient loads with minimal support... and wrote him up behind his back for the silliest things (such as talking to other willing listeners about his other part time job... something that other nurses on our floor do very often). He eventually had to take a leave of absence and then decided to turn in his two weeks notice. In response to people saying they drove him out, they just said, "He was a good a nurse, but he wasn't perfect." In all honesty, there's no such thing as a PERFECT nurse. We all have our flaws. It's a shame it had to happen that way. One of the day shift charge nurses with tons of years in was also deathly jealous of another younger, pretty nurse who worked nights and was married to a doctor (had nice clothes, drove a nice car, etc.). She would give the poor nurse the heaviest, most impossible patient assignments if she was charge the day shift before... You couldn't help but feel sorry for the poor girl. Luckily the young nurse has moved onto other nursing jobs at other hospitals, but it was a shame to see her have to deal with that sort of treatment. Yes, bullying happens on the floor, particularly to people who they don't think "fit in." The other bullying I see is from the RN staff to the LVN's/CNA's/techs. It's too bad. Everything would run so much more smoothly if people cooperated with one another and learned to maximize the differences/diversity of the floor staff.

Someone needs to explain this "nursing informatics" stuff to me because the more I'm exposed to it in the workplace, the more silly it seems... I heard, as far as IT at my hospital goes, a lot of the shots are being called by nurses who specialize in this "nursing informatics" stuff... what in the world are they teaching those people?! It almost seems like they have no idea what they're doing. This is coming from someone who used to manage/run (and do the systems design for) a network that supported 800+ users in her previous life. There are too many redundancies and too many complicated pieces to our charting software at work... and on top of that, the network is so inefficiently run that staff wastes too much precious time (because time is very, very, VERY precious in nursing) troubleshooting slow computers or trying to figure out how to navigate their way through the system (or help registry/travelers/float staff navigate their way through it).

Out of curiousity, in the "not-for" case, are hospital administrators (like CEO's) allowed to reinvest it into their own raises/bonuses?

We get that quite a bit (physical attacks on RN's, LVN's, CNA's) on my floor, and we're med-surg. We get a lot of ETOH, dementia, etc... and on top of that, a handful of wealthy customers used to get their own way. Unfortunately, we don't get a whole lot of support from management when it happens... a recent registry/traveler got burned out and ended her contract with our hospital because of it (and it happened multiple times to her). It's too bad-- she was a great nurse, and it was sad seeing her leave. Regarding the other service professions, at least they don't have to give bed baths, peri care, etc. to their perverted clients. I mean... it's one thing when a perverted guy continuously hits on you and you can walk away afterwards... but another if a perverted guy continuously hits on you, and you have to continually clean and elevate his swollen, infected scrotum because he moves it on purpose when you walk out of the room (and we have to round at least once an hour for a twelve hour shift). I think medical floor staff have to take it all above and beyond, and they have to do it with a smile... but I guess that's why we get to enjoy "job security" in our field.

Unfortunately, there are RN's who are like that... it makes it rough when I have to share partners (CNA's, LVN's) with them because they always seem to run my CNA's to the ground, and I end up picking up the pieces from my end. It's always the same repeat offenders, so I always check to see who my aides are working with when the assignment is out so I can plan out my day with them. It's too bad: we're supposed to be a team on the floor, and when you work people hard like that, it isn't right, regardless of what profession you're in. Cleaning poop, feeding patients, bathing them, etc. should never, ever stop when you're an RN. I get my best skin assessments from doing bed baths on my bedbound patients (especially the ones coming in from SNFs), and I always ask to, at the very least, look at my patient's poop (which means I end up cleaning it, too) because the poop says a lot about how a patient is doing... and if you think that's bad, wait until you have to disimpact someone.

Many staff RN's don't work 40hr work weeks... I work 3 12hr shifts/week, so at $37/hr, that's more like $63k/yr... wish I were making that much more.. i'd put it all into my massive student loan bill. We call the lower pay in San Diego the "Sunshine Tax." Warm weather, great beaches, etc... People down here are willing to be paid much less despite the high cost of living-- you see it across practically every other hospital job you can think of (other than, I could probably assume, CEO's, hospital administration, and physicians). Many nurses also attribute it to less/weaker unionization... and I'll just keep it simple and stop there.

New Grad hiring comes and goes in waves... I know that it was frustrating for me at first... and even more frustratingly so, most of the offers came AFTER I already accepted my current job (which I truly am thankful for; I've been learning a lot, and everyone has been extremely helpful where I work). Keep on trying... and don't wait to be called: call recruitment, try to call the nurse manager, etc. The jobs will come in time. I know we just hired a group of new grads where I work, so it might be awhile before another new grad group starts (maybe spring of next year).' Good luck!

edit: never mind. I'd say go with the ADN or the cheaper program. You'll probably get more of your money's worth, with the added bonus of semi-competent administration.

Not quite sure where you're going with that statement... but I read that article, too. I thought it was a lame attempt by Time magazine to promote its ideal presidential candidate. The responsibility of being the President (and Commander-in-Chief) of a major western power is a very different situation from working as an ICU nurse... and while they're both important jobs, it's ridiculous and irresponsible to make that sort of comparison between the two.

I relocated from Northern California... no connections to the hospital systems here at all. It took me about two months before I started working... but I also hadn't taken the NCLEX yet. If you didn't go to a local school or don't know people in the area, it's difficult to get an interview if you haven't taken and passed the NCLEX yet. Some managers will tell you to call them back after you've passed. I know of people whose instructors or clinical instructors knew nurse managers and were willing to hand resumes/cover letters to the managers, so they didn't have to go through the same process that you'll have to go through... it's a bummer when you see that happen, especially when you've been trying forever to contact nurse managers from those hospitals but have to call half a dozen times before you get called back. I might have been applying at a bad time (late January seemed like a bad time to start applying for jobs... March seemed to be better). I lucked out because I realized I hadn't applied for a job with Scripps... and within less than a week or so of applying with them, I got in contact with a really great recruiter at Scripps who knew that the managers at her hospital weren't hiring new grads, but she still helped me find new grad positions at other hospitals and apply for them... and she even followed up with me to make sure I got in contact with some of the nurse managers. That was probably the nicest thing any of the recruiters had done for me-- it definitely made a good impression of Scripps for me. The process with Scripps took maybe 2-3 weeks... I'm not sure what it would have been like, though, if I had applied in January (as opposed to early February). It was only after I finally started the new grad program there that I received calls from the other hospitals I applied to about potential openings for new grads. Nurse-to-patient ratios go by California laws... on my floor (med surg) it's 4 or 5 patients per nurse... lately you're more likely to get 4 (I think they're shooting for that as a goal), but there are some nights that you still get 5. The best advice I can give for anyone who's applying from out-of-area is to be proactive... realize that you don't have the resources that the local new grads have, so you're going to have to work two or three times harder (if not more) to get your foot in the door.