Code Caffeine

Thank you Nurse Beth!

I was invited to interview a week ago, sent references as requested and I am waiting to hear back for an interview date. Anyone else starting in October?

Hi all, I have been thinking about how to answer the What is your biggest weakness question in case I am asked. My thought is as a new graduate nurse, I have a ton of clinical weaknesses with time management being the biggest. If frame the answer as "As a new graduate nurse, my biggest weakness is time management, but I am actively working on ways to improve my time management skills by researching the best ways to get organized and other nursing strategies to improve time management." Is this a good answer OR do I stay away from Time management as an answer all together and focus on a personality flaw? What are some examples of this? This is a tough question and I really want to get it right. Thank you!

Hi everyone, I was invited to interview for the Progressive Care Cardiac Unit (PCCU) at Johns Hopkins. I am looking for information about the interview process, the PCCU team, the type of shifts offered to new graduates (e.g. 3-12hrs, 10hrs or 5-8hrs), any insight into the orientation and general advice about interviewing at Hopkins. I'm very excited to receive this opportunity but I'm more nervous because I'm a non-traditional student. I think my past work history helps establish me as a reliable, hard-working professional with excellent references. My experience and skills translate well into the Nursing field, but my GPA isn't as competitive as I hoped for. How much emphasis does Hopkins put on grades/transcripts? I was a good student but just missed the mark for honors and the Sigma Theta Tau honor society. Any thoughts on this? Anyone else out there interviewing in the next two weeks?

Hello, I have to work for a facility in an underserved area because I'm a Nurse Corps recipient. I am looking for input from anyone with knowledge about working for the NYC Health + Hospitals system, particularly the Manhattan locations Bellevue Hospital's ER or Medical ICU or the Metropolitan location ER. I'm a new grad and I'm looking for insight, advice, etc. I am putting in a call to the recruiter but would love to hear from you all!

Hello, I graduate with a BSN this week. I am starting to apply for jobs, I have to work for an underserved facility because I am Nurse Corps scholar. Bellevue Hospital in NYC qualifies and I wanted to find out more about it. I'm researching their website right now and will be trying to contact a recruiter but I would love some insight from a nurse who works there. In your opinion is this a good place for a new grad to receive a thorough orientation? What is med-surg like? Also what is the ER like? Are there any other units that would be a good fit for a new grad in your opinion? Thank you!

I am graduating in May, I am struggling to figure out what is the best place for me to learn and develop skills. I am not the most confident and I feel that I will probably need at least a year before I get to where I need to be. I have a lot of anxiety (but I don't have panic attacks or anything like that.) I'm beginning to think that I should start on Med-Surg to begin with and get more comfortable with my skills before pursuing someplace like the ER. The thing is I have a clinical in the ER now and I really like it but it is the most intimidating and scary placement I have had thus far. Part of me thinks I should push myself to get over the fear of the ER and try to get in a Residency program. I also have a strong interest in psych but I know it would be best to develop my skills first before looking into that. I hear good things about Floating, I have no idea if that is a good or bad idea for a new grad. I don't understand all of these roles enough to make informed decisions. I would appreciate all of the insight I can get. Thank you!

Thank you! Everyone is very nice so far! Day one I did more new skills than I have in the last 2 years! That alone blows my mind. I am also facisnated with psych which they say they get a lot of in the ER. I feel like it will be the most well rounded experience I can get. And those 12 hour shifts are NO JOKE! I have a brand new appreciation for what it's really like to be nurse!

Hello, I'm excited (and kinda terrified) to start a special one-on-one nursing preceptor program in the ER tomorrow as my final clinical! There were limited spots for these clinical oppertunites and I'm lucky to be there. I want to suceed and do well, any tips on what skills I can look over besides Catheter or ECG? Any tips on how I can stand out or go above and beyond? Thanks!

They do not teach ABG's that in depth in most nursing schools, they say that if you go into Critical Care you will be trained based off of your facilities policy. ICU nurses and ER nurses may know how to draw ABG's but that doesn't mean they all know how to interpret them. Many Med-Surg floor nurses do not draw ABG's, nor do school nurses, LTC nurses. So no the average nurse and especially a new grad nurse would not have the experience to interpret them unless they were trained on the job. Many facilites use RT for that. You are probably in the minority if you know how to interpret them.

Hi all, I'm doing a short EBP practice powerpoint presentation on Mandatory Overtime as a patient safety issue. Right now I am looking at: 1." What can we do as Nurses to help stop MOT?" 2. "How do we Implement and assess our plan?" 3. "What outcome do we hope to see with our implementation of this plan? After reading this article from the American Nurse Today, I came up with this list of things I thought that Nurses can do to stop MOT. Stopping the vicious cycle of mandatory overtime - American Nurse Today Push for Magnet status because nurse retention rates are linked to less staffing issues. Join your state nurse association, get informed on your state law, work with them for change. Raise awareness: With other nurses, nursing students, state reps, family, friends, and communities. Make sure to decline working if you know you are too fatigued. Fight to have proper staffing ratios so OT isn't relied upon so heavily. Implement voluntary OT with some guidelines to prevent working when fatigued. Longterm solutions like proper recruiting, implementing new graduate nursing programs or residency programs, investing in new nurses leads to long-term retention rates. Implement Direct Education Unit programs with nursing schools to have nurses work one-on-one with a student for their entire shift and entire patient load, have that same nurse assigned to one student longterm like a preceptorship. This allows the nurse to train the student to be more efficient and the student will learn the nurse's style, needs and be able to better anticipate what the nurse and her patient's needs. This leads to student nurses being a more effective low-cost resource for direct nursing care and gets rid of the problems associated with the disjointed Clinical group approach. The IOM recommends public reporting of Nurse-patient ratios and turnover rates, nurses should get behind this and help make this the new normal. What are your thoughts, do you have anything to add?

In my original post, I wrote that the OP probably considers her situation to be a family emergency. I don't necessarily think it is, nor do I think she should get the extension. Let me make that part clear, what I do think is the clinical instructor's response was strange and unprofessional. She antagonized a very stressed and overwhelmed student who could have probably used some support, and then the truth that if it's late it will be marked late, no exceptions. These schools take tens of thousands of dollars of people's money, offer very little support and then shoot themselves in the foot because once these students become alumni they aren't going to donate money, or contribute at the level they would if they were treated better, the way students in other majors are treated. There is a mentorship, a supportiveness that people in other fields receive that is non-existent in healthcare training, it's a shame and everyone knows it.

"Get the giant chip off you shoulder". Well aren't you very presumptuious? This isn't about me, I have never asked to turn in anything late, but I have witnessed innapropriate behavior plenty of times. If the original poster only had the one encounter with that instructor it was unnessasary for her make the statements reported above. No other college professor or instructor speaks to students or colleagues that way, if you would like I can go ask my Economics professor how he would respond, I could ask my Chemistry professor, my Ethics and religion professor, I could ask all the pharmacists I work with and they will all tell you the same thing, their answer would be "Unless there was a death in the family, or you were hospitalized this will be graded as late, no exeptions." I couldn't imagine my Chem profesor saying "Don't mistake my kindness for weakness." who says that? It's a strange response. As far as the foul language, I was speaking to experiences I've personally witnessed, preceptors/ instructors cursing, preceptors publicy humiliating ELS students and students with diabilites because they are not as tech savvy or as privilaged as others or don't have access to color printers so their paperwork isn't "As pretty" as wealthier privlaged students. Telling them in post confrence in front of everyone that their paperwork sucks never speaking to them in private, is uneccesary, why only berate them in public? Never using assessment skills to check if there was a language barrier with some of the terminoligy used (there was). It's not about the OP, it's about a culture of tradition in healthcare that perpetuates innapropriate behavior and language, I'm glad that there is a national movement happening to change that.

I also said "condesending and innapropriate language", which I think fits the language the OP's instructor used. I added cursing and yelling because I was explaining that it my experience in witnessing it happening in clinicals to other students. For example: Many ESL students or students with disabilites are told they have the ability for accomodations by school polocyy and the LAW, but clinical instructors on the floor don't care, don't ask, don't apply cultural sensitivity etc. My point there is a dissconnect between college policy and what happens on the floor during some of these clinicals. I am seeing more and more offical complaints filed by students (Many ESL and disabled) and an increase in clinical instructors being fired. Sorry to say that accomidations is a part of the professional work world. Many companies accomodate people with disabilites and treat them with respect. Obviously we are not taling about a disability with the OP, we are talking about a family emergency. If I had to guess based off my own experience, this was there first time she had a problem with instructor, OTHER students may have asked for an extenstion and the instructor is annoyed but the statment "Don't mistake my kindness for weakness." seems innapropriate. I have worked for large companies, this isn't how they talk to people who come to them with "family problems". There is a culture of verbal abuse and mental abuse in Healthcare as whole and the next generation is going to make that a thing of the past. We need healthy, safe work enviorments, not cesspools of agression, anger and dysfunction. The instructor has every right to say NO, she has every righto run her clinical how she wants, but she doesn't have the right to express that in a way that is unproffesional.

I'm just curious if everyone here is so desensitized to innaproriate language being used in this feild that they dont even deem certain agressive, cursing, yelling or condesending tones as unprofessional and iapropriate. I read the OP as saying the response she got was unprofessional and unessasary when a simple "Sorry, it's late no exceptions" would have sufficed. It seems like she was trying to convery that she is typically a responsible student and wanted her instructor to know that she had what she considered a family emergency and requested an extension. There shouldnt be harm in asking the question. It seems like a bit of an agressive response, but obviously we dont have all the details. I have witnessed culturally insensitive behavior and innapropriate cursing when it just wasnt necessary. Do you agree that the tone and language used in a response should be professional and appropriate? I would never get away with yelling at people in the pharmacy industry like that.

Yes exactly! I just don't understand the argument that the elderly, those with breast cancer who are out of work, disabled. etc can't afford property tax..so their idea is "OK, let's just make them pay a higher sales tax instead!" What the heck is going on my state!?

You do realize that everyone goes to school at some point in their life right? You do realize that we as society have become so self centered that we continue to fail to see that the greater good for our country and society as a whole rests on the foundation of education. If we defund schools we will have a nation full of incompetent people who will be even more reliant on government. Yes, if you read what I said before, I fully realize that we need to reform school property tax in PA, plenty of other states allow seniors to be exempt...all we need to do is update the property tax law to give veterans, the disabled and the elderly a tax break or exemption. It's not hard to figure out that you are going to hurt these same seniors you are talking about if we raise the Sales tax. How is that helping them? NO sales tax increase, NO elimination of school property tax, Yes to giving seniors who truly can't afford it a School property tax EXEMPTION! Save the schools! Save the Elderly (and everyone else) from paying higher sales tax!

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Yes, and to be honest, I don't own a home, or have children (yet) so now I am going to pay higher taxes for everything to send everyone else's children to school. That means tourists coming to Philadelphia are paying for everyone's children to go to school, people who work in PA but live in NJ are going to be paying for everyone else's children to go to school, and who decides how much goes to which schools? They haven't provided enough information to the public, and I'm confused because conservatives have been pushing very hard for Charter schools and vouchers, etc. All of the sudden they sneak this in and no one seems to know about it. I think it's unreasonable, and I'm not even sure if these people are conservative, I think it's a group that is very good at organizing for their agenda. A lot of these people are retired with a lot of time on their hands, they put together a nice plan of action and seem to be getting their way. I sympathize with these people who are retired, paid off their home but still need to pay property tax that they can no longer afford with their fixed income, but this is not right and not the answer.

Please spread the word, it seems like no one is aware that this is happening or they don't understand that it is happening and it will effect the children in this state. They have a huge campaign to get people to vote yes, so we need to explain and spread the word why they MUST vote NO.

I'm not an expert on this stuff but my understanding is because we have R Senate Majority, this is allowed to happen. There are extensive R grassroots efforts that lead to this, I believe they are called PTCA- Pennsylvania Coalition of Taxpayers Association. David Baldinger is their spokes person and has been creating lengthy You-Tube Videos for their argument for elimination of property tax. They want a Sales Tax increase to make it 7% and a Income Tax increase which will be 5% and that is how they want public schools to be paid for now. (Part of their argument is that the elderly can't afford to pay property tax, therefore we should just abolish it.) I mean SERIOUSLY? How about we reform it, offer some solutions to adjust it, but to just make it not exist, is very extreme!)

I want to know what school nurses think about this. I want to know if anyone knows how this could impact school nursing. It may not be happening in your state, but what if it does in the future? On November 7, Pennsylvanians will have their (local) municipal elections, that includes our school boards, state house and local judges. This is one that we MUST pay attention to because they are having a special question at the ballot that's asking you if you want to vote to have PROPERTY TAX eliminated, therefore eliminating the way we currently fund ALL public schools. It's important that we vote NO to this question because their flawed plan to fund every school in our state with sales tax will not work. If they don't fund schools properly you will see things get much worse for the future of children in PA, and our society's future as a whole. This has never been done before and there is a reason for that. It doesn't fix the problem, it creates new ones. Don't gamble with the education of our state, please. #VoteNO#BallotQuestion #DoNOTLetThemDefundPASchools State House ✓ State Judges ✓ Local Judges ✓ School Boards ✓ Municipal Government ✓ November 7th Ballot Question: VOTE NO - Action Network

Or you could work for Allnurses, haha! That would be a really nice online job. :)

Teaching! We need more nursing faculty, lots of people are retiring ! In the next 5 years

I have to give a group presentation on "Whistle-blowing". We did our research, put together our slides and met our professor to get her approval before presenting next week. She said that we focused too much on corporate or administrative whistle-blowing concepts. She says there is a range of types of whistle-blowing that can be anything from a nurse witnessing improper sterile technique by another nurse, then saying something to him/her; all the way to Medicare fraud and diverting drugs that require more formal protocols to follow for whistle-blowing. That is fine, we will make her suggested changes, I just didn't find anything in my research that specifies Nurses blowing the whistle on other nurses, and the proper way to handle it (confronting them and educating them.) I am re-doing my slides, so I thought I would come here to see if there is anything else you think I should include about this topic. What are your thoughts on talking to another nurse about safe techniques, how would you like a new grad to approach someone, or how would the experienced nurse approach a new grad? Do your facilities have any specific protocols, and/or protections for nurses who blow the whistle (for any reason legal or illegal). Thanks!