VTsquach

My advise to students is to take it as soon as possible after graduation. I hear many say that they take a month or two to study or take a Kaplan's review course and my response is "Why?". You just spent years learning what you need to know, take the test as soon as possible while that stuff is still fresh.

Just call the board of nursing and ask or call human resources as your facility likely has a policy in place. I have never worked anywhere where a CNA was allowed o continue in that roll after passing NCLEX. I am licensed in 27 states and know of multiple occasions where CNAs had to leave their job because they achieved their RN, but did not have employment as an RN. My gut says it isn't legal, but I don't know for sure.

If that is too stressful you don't want to go anywhere near a hospital/acute care setting where you can add TPN, Peritoneal dialysis, lab draws, PCAs, Epidurals, pain assessments, narc wastes when you can't find a second nurse, no break for a 12 hrs shift which ends up being a 15 hr shift by the time you get your charting caught up. Plus MDs calling you , family members wanting you to call the MD....... Discharges, admissions etc...

I have found that as you develop a relationship with the ordering physician you get used to their orders and know what they want without having to ask. Also your facility should have policies in place so if you have a question and can't get a hold of the physician, defer to the policy. For example BP and heart rate control is usually guided by facility policy and can differ for cardiac patients and A-fib/stroke patients.

At a year in I think you are way overthinking this. Work at this position until you feel like you have nothing more to learn from it, then move on to something else that interests you.

I have worked in both Union and non-Union facilities. I have found that benefits are about the same cost wise, pay is higher in bargaining hospitals. (in my experience, a lot higher) Nurses in Union facilities often have a nursing vs hospital attitude which gets old after awhile. Unions protect really lousy nurses who should have been fired years ago. On the flip side Unions insure you as a nurse against malpractice and represent you when there is an issue. When it comes down to finding a place to work I rank Unionized ahead of non-unionized. Union dues are tax deductable and usually under 1000 per year while pay can be 20 K higher in some situations over other area hospitals.