Recently interviewed: I said: "No, no, no, no...."

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I recently interviewed with a Nurse Manager of a medical-surgical floor combined with Telemetry. From what I gathered, these patients would be admitted with an acute/chronic condition related to the heart, in addition to another medical/surgical issue. I am fairly new nurse with one year's experience, and I am eventually wanting to work in one of the critical care areas (ICU, CCU.) I was willing to give this job two years, to gain telemetry experience with less critical patients.

A) Job description presented" "No experience is required, but 2 years is preferred."

B) What are you looking for in a candidate? "Someone who has integrity/honesty, Someone who will be here everyday, on time. Someone who wants 'to do' the job."

(Code: Warm-body) These are nice traits of a hard worker, but will this ensure someone's success?

C) NM: "You will be given a 8 to 12 weeks orientation. You will work with the same preceptor throughout your orientation, unless they are absent. Then, you will be placed with another Nurse for that day." (Why would they not show up for work?)

D) NM: "During your 8 to 12 weeks, you will complete the telemetry class. Upon completion of the class, you will have an examination. If you do not pass the telemetry examination the first time, We will help you to pass it the second time." (a...a.. do what?):nono:

E) NM: "I will not lie to you, this is a fast-paced floor." (what medical floors are not fast-paced.) Majority of the "day-shift" Nurses are having difficulty getting their medications passed on time." (Oh, that's bad!) :uhoh3:

F) NM: "Nursing culture around here can present one with a challenge." "Night-shift nurses seem to assist each other, and support each other." "Day-shift nurses seem to not help each other out, and stick to completing their own work." (Great, new guy on the floor with no co-worker support.)

G) For an entry-level person what acuity level should I expect, less critical?.

NM: "Oh no, you would have the same patient acuity level as the experienced nurses." "And, we get several admits during the day." 4 to 5 patient ratio. Total of 3 nurses on the floor. (Nice!) :uhoh3:

H) What is the Nurse retention rate for this floor?

NM: "Actually, it is low. Approximately, 26%. :eek:

I) What heart dysrhythmias are Nurses presented with on this floor?

(Are we talking afib?) NM: Oh, no... V-tach, heart blocks, anything, and we run "Codes" too! (Three Nurses on the floor, and 'we' run codes, with the combined Nursing year's experience around 10 fingers.) :eek:

J) NM: The Nurses do narrative charting at the present, but a computer system is on

the way..to do Electronic Charting- Maybe by June." (Critical patients, and the Nurses are still doing narrative charting...no wonder the Nurses are unable to complete their Med- pass on time.)

K) The unit also has 16 rooms with double beds. Total census is kept around 16. This enables the patients to have a "private" room. That is nice, but the work ergonomics is destroyed. The nurse is forced to walk a great distance between the 4-5 assigned patients, not congruent with time management. Then, if another patient is admitted to an occupied room, the nurse has to deal with the fall out of a disgruntled patient ." I WANT A PRIVATE ROOM!"

NM: "Would you be interested in this position?" ME: I think I will pass... where is the elevator, I am really distraught right now. Where is my truck, I got to get out of here!

Specializes in LTC, Psych, M/S.

I'd be interested to know if this was in a rural area? You say they have narrative charting - just wondering. what part of the u.s.? At least you got an interview - more than what some new grads get. Good luck in finding something better.

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Sounds like you made your decision already. The floor you were looking at sounds just like my old med/tele floor. Though, my peers did pitch in when you needed it. Teamwork is especially helpful when there's a code or crisis going on. I was impressed by the training & precepting you were offered, and that the nurse manager was upfront with you. I was impressed that she was even aware of the staff dynamics. I think I had 2 weeks maybe 3 of orientation to med/tele as a new grad. It is a stressful work environment due to the fast pace, the critical thinking skills required, and acuity of patients. But you do learn and grow a lot! I think you need to trust your instincts here. However, most acute care jobs are like this, so if you don't like this kind of work environment, maybe acute care isn't for you. It sounds like a standard med/surg acute type job. Good luck in your job search.Hope you find something that you enjoy.

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Again, I ask, have you worked on a hospital floor? You can monitor these things and still have a pt go bad. I work post surgical, almost without exception our pts have low RBCs. That just goes with surgery. If everyone with a low count went to ICU/CCU, every floor would critical care.

It is obvious you do not know, therefore appreciate what I am conveying.

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What are you talking about? It is so obvious that you have never worked in a hospital because nothing you have said comes close to being considered a rational train of thought . People code on med surg floors all the time, and for RBC's yes if there low you intervine but your gonna hang the blood rite there in med surg. what do you want to do send them to ICU for a couple units? You sound like a student that has been brain washed by instructors about the utopian dream hospital where you answer every patient question with another BS question like "how does that make you feel?" When in the real world the patient calls you an ***** and says "how in the ******* do you think it makes me feel ".

"People code on med-surg. floors all the time. I would hate to see the Heathgrades report for your hospital. And, patients have called me worse than "*****", and it does not faze me one bit--Sister.

And, you believe you know more than your instructors, which makes me question what education you really received. LOL HA!

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Yeah, a male at a boob center... I don't believe that would go over very well.:smokin:

We are just going to have to agree to disagree, getting off topic.

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What are you talking about you it would go over great.....and thank you for the fun :) I love arguing with people on here...people get so bent it makes me laugh...

I know...and then I think I am going to far sometimes, and become paranoid, and next thing a "guide" or "staff" agent of this site will pull my registration. I am sorry! oops!

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
It makes perfect sense if you think. It comes down to monitoring your telemetry strips, vital signs, and those lab values. If you are not doing these, your patient is a risk of coding. The patient should not even get that far on a "Medical-surgical" floor. One example, RBCs: If they are low, they are at risk.

*** First of all people code on tele floors period. They can code even with the very best nursing care. There are many reason for this. Those of us who have been at this for many years have seen them. I have been to quite a few med-surg codes and the person in arrest isn't even a hospital patient but a visitor or employee. Then you have the case where the nurse knows perfectly well the patient's condition is delining and had made the physicians aware but the physician refuses to transfer to ICU. In my hospital I (as rapid response nurse) can transfer to ICU without orders (can get transfer orders from the EICU physician when we get there), but that is not the case in many hospitals.

I don't mean to be offensive but in the OP you presented yourself and an RN with some experience. Since then your posts have sounds much more like they were written by a nursing student without a clear idea of what real world nursing is like.

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Specializes in nursing education.

A bit off topic but...our hosp. got rapid response teams after I left. You could call them before an actual CPR code- just if your patient is kinda going south, unstable. What a great idea. That's a good definition of "support." Rather than depending on other RN's on your floor who are just as busy as you are...

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There should be no "codes" on a Medical-Surgical floor. If these patients are that critical, they deserve to be on an ICU or Cardiac floor. Gees!

REALLY?!?!?!

Because you have a crystal ball to tell which pts are going to take a bad turn on the floor and place them on the cardiac floor or ICU? Because I have yet to meet anyone with THAT skill.

The "code" I ran on with a nurse from the Cardiac floor was to OUTPATIENT LAB. Was just in for blood draw.

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*** First of all people code on tele floors period. They can code even with the very best nursing care. There are many reason for this. Those of us who have been at this for many years have seen them. I have been to quite a few med-surg codes and the person in arrest isn't even a hospital patient but a visitor or employee. Then you have the case where the nurse knows perfectly well the patient's condition is delining and had made the physicians aware but the physician refuses to transfer to ICU. In my hospital I (as rapid response nurse) can transfer to ICU without orders (can get transfer orders from the EICU physician when we get there), but that is not the case in many hospitals.

I don't mean to be offensive but in the OP you presented yourself and an RN with some experience. Since then your posts have sounds much more like they were written by a nursing student without a clear idea of what real world nursing is like.

The two example in which you chosen to present, back-up my point very well. The patient was shown to be going south, but no interventions were instituted. The other example didn't have anything to do with the original patient. And, anytime someone begins their statement "I don't mean to be offensive", what follows is usually offensive. No offense taken by the way!

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A bit off topic but...our hosp. got rapid response teams after I left. You could call them before an actual CPR code- just if your patient is kinda going south, unstable. What a great idea. That's a good definition of "support." Rather than depending on other RN's on your floor who are just as busy as you are...

This is the idea I am attempting to get across. Thank you!

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T These patients are being monitored for a reason, and they deserve the proper care, which includes monitoring. There should be no "codes" on a Medical-Surgical floor. If these patients are that critical, they deserve to be on an ICU or Cardiac floor. Gees!

I'm not sure I understand this point. I work in a nursing home and we have codes. Some patients want the whole nine yards, it doesn't matter what environment they're in.

It's the nature of the job. I think you are passing up a good opportunity but at this point I can see that the job should go to someone with a better attitude and outlook.

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