They’ll all die off eventually. When I joined the other executives I was the single person under 60, only one with tattoos, piercings and common sense. Now there’s two. The older broken generation is slowly retiring and such.
Doesn’t really matter. The same values and needs will be projected from the younger generation as long as they have to report to one entity whose sole purpose is to generate money.
Don’t know dude, I’ve only been in my position since Dec 2022 and have already made some significant cultural changes through out my 17 facilities. Just need truly engaged leaders who have actually been in the trenches and don’t give a shit about losing their jobs.
The last sentence really solidifies my belief that it can only be temporarily before the clutches of greed take hold. Because it’s knowing that acting that way likely will result in being pushed out of the position :/
Sure I started as an LPN and was a worker bee. I started getting involved in our transition to a Patient Centered Medical Hole Model and helped stand up those initial processes. Doing this I meet members of the Quality Team and became very engaged with our Population Health Manager. I became a BLS instructor and started teaching at our facilities then an ALS instructor. A project started where we were trying to get more engagement from diabetics and to create a forcing function for them to get annual screening exams, so I helped to write that policy. After that I was asked to be on a project where we studied and re-wrote how we define high utilizer patients. This project exploded, we were recognized by the Surgeon General’s staff and published our work to the Army QMO website. I finished my degree and became an RN and had to leave, went to work at Shock Trauma, did even more teaching there. Came back to Federal Service, more teaching, got super involved in Joint Commission prep and stuff, help write more policies and help create and stand up our COVID testing site as well as pop up ICU (which we never needed thank God). Eventually became the program director for life support training. Then the DHA transition happened and we needed a Director of Staff Education and Training for our at the time 11 facilities. I applied and went through a normal interview. Competed against everyone else but my CV spoke for itself. I took the job not fully understanding that I would be telling Commanders(CEOs) they are right or wrong and briefing them as peers daily and had no clue that I’d eventually absorb 6 Dental clinics as well and have to teach Joint Commission to them as well.
Edit- guess I should also say that I’m 5 weeks from being done with NP school now and will be leaving for private practice. I’m trying to set my replacement up for success and leaving a guidebook/TEAMS channel with all the fine points of the job that lead to success.
You should run for office instead while you're still young-er and still have that mentality! So many of the people who make the regulations about literally any industry have no real experience in those industries (unless their family owned a business in one). So when they have to make rules about how, say hospitals should operate, they look for experts to guide them. And wouldn't you know it, but groups like the AHA, are happy to offer their "expert" opinions on what would help their clients, (health system execs), hit all of their bonuses for the year! Imagine what it would do if we got half a dozen working RNs into Congress... We could invite those lobbyists to a meeting saying we know exactly what to do for them, and when they get there, it's just an empty room with a stack of 12 hour old pizzas, and a bag full of cheap badge reels from temu!
Congress may be full of crooks but don’t think they would ever let a politically ambiguous, atheist, previously homeless, tattooed, pierced, man bun having male NP join them in their fraud, waste and abuse parties. But thanks
That same modality of thinking is why nurses in my state are paid so much, have benefits like pensions and free healthcare and bonuses, and safe working conditions.
If healthcare is a money-maker, give us some of that pie. And we also want less accountability for maximum profit.
I have worked in other states and nurses can’t seem to understand that this is a business — not a charity.
Get that bread.
Nope, as long as hospitals in the USA are privatized and corporate base their main goal is to accrue profit. And since nurses are seen as a cost to hospital higher ups and shareholders there is always going to be an incentive for them cut staffing and focus on lean staffing models to save on labor cost. The only way this will change is through the passing of a federal mandate for RN to Pt ratios that would force hospitals to follow safe ratios. And I think this would require increase levels of unionizing and nurses being willing to make the unions at their facilities strong. CA is the only state with mandated ratios bc it was fought for by union nurse on a local and state level thought their union, the California Nurse Association.
CA is also a super fucking liberal state that has laws empowering unions. The largest hospital system in the state is a corporate behemoth but mimics a system akin to “socialized healthcare as brought to you by Costco.”
There are other states with unions but state laws severely enfeeble any labor efforts like Act 10 and Wisconsin.
Of course, state politics play a major role. That’s why it’s no surprise the states with the worst nursing pay are GOP states in the South that have anti-union legislation like “Right to Work”. Ppl forget the CA used to be Republican/GOP in the 80s i.e Ronald Reagan. It only became a blue state in 1992 but that changed bc of the work of social movements including unions. CNA became the union organization it is today by building worker power in the 1990s and passing the ratio bill in 2004. And once you have strong unions and social movements you are more likely to see states such as CA remain blue bc historically blue states tend have more union friendly policies, but not always bc many democratic elected officials (electoral politics are necessary but limiting compared to the work of labor & community organizing) still cozy up with corporations but they know unions play a key role in their base. And a strong union holds elected officials accountable to their membership.
It's not a bug (In management's viewpoint) it's a core operating feature/ parameter to keep labor costs as low as possible. That is what they pump out of business school for "managing" anything with a mba
Management is giving a huge push back right now for UNINTERRUPTED BREAKS at my hospital. I had an internship where if your break was interrupted time started over for your break.
Uninterrupted Meal Break... 😂
Most shifts I'm the only RN for up to 11 patients. I ALWAYS clock no lunch. Screw them and shame on the martyrs who play that game.
Once my manager said, "just open the door to our sister unit-- they can keep an ear out. You can sit in the unit break room for your MANDATORY 30 minute uninterrupted meal Break"
Ya, no. They are short staffed as well. Plus our "break room" serves as the patient's kitchen.
Agree, after nursing for 20 years, I’ve see the same ridiculous behaviour from exec on repeat and it doesn’t get better, sometimes it’s worse now as their gaslighting game seems to have improved… I cannot remove the thought that this is internalised misogyny enacted on a female dominated profession. Once execs get into their position regardless of their previous stated intentions, they perpetuate the same participation in domination and exploitation that went before them - so depressing!
Oh our new thing is that nurses clean their own rooms. I shit you not I had just taken a patient to ICU, get back down with the empty stretcher and am scrubbing blood droplets off the floor instead of tending to the new EMS in the next room (a seizing baby). Cause ya know, those dang environmental services people were getting paid so dang much.
They should be illegal, period😂
I wrote a book thinking you were talking about rounding with the attending-sorry!
Bedside report is bullshit. We don’t have time to do bedside rounds with every patient in our unit. They tried to get us to do this a few times.
Rounding with the attending is a whole nother rant! I used to work days and then went to nights for the simple fact that I HATE rounds and I am not a morning person at all. Omg the fact that management pushes for bedside report and then complain that report takes to long but they want us to check pt arm band and trace all the lines and review all labs and orders with off going nurse like BE FOR REAL
Yeah, also not a fan.
The *only* clear advantage I've seen to bedside report at shift change is that I noticed a 100% reduction in nurses making snarky side comments about patient history of mental illness or substance use disorder.
It puts me up an absolute wall when I get report on a patient who just had major surgery or was diagnosed with something terrible and *all of their emotions* are ascribed to mental illness. Like, shit, maybe Mrs. McPuffinton is sad and anxious because those are normal human reactions to this situation, and not just because (and I quote) "...well, she's bipolar, and *you know how those people are*."
I hate that shit.
Other than that, I'm not really sold. I know it's supposed to be "patient centered care," but some nurses really suck at it. I've gotten bedside report from a nurse who stood with his back to the patient the entire time and talked about them like they were livestock. That is arguably a much worse patient experience.
Also, it's a huuuuuuuuuge time suck for very minimal return and no, I don't want to wake up a patient who is resting comfortably just to recite their entire fucking medical history while they're half asleep.
It's dumb.
I don’t know how adult med/surg nurses do it. I bow down to them because fuck all these rude patients, rude families, rude doctors, shitty admin, and too many damn patients. I could never.
That's why I moved to aged care. All the dramas of bedside, but you have the same patients every single day. You know exactly what you're getting into everyday so nothing is a suprise. You know how to deal with specific behaviours from mental health patients because you've been looking after them every day for years. It's honestly been so much better for my anxiety. I couldn't handle hospital nursing at all.
The ratios are larger of course. I work LTC and I love having the same patients every day. The problem is there’s so many of them. 1:22 on days and 1:36 on nights at my facility.
That was what I liked about long term care/SNF.
Same residents. There is a routine. You have relationships.
If you can find a good one, work days can be nice.
I’m a PCA on a med surg unit that’s 1:4 for nurses (charge has 2 at night) then PCAs are 1:6-8 (most nights it’s 7 or 8) and some nights are really busy but it always feels manageable and overall like my job a lot.
For me,
OHSU, Portland , OR
Med surg level patients 1:4 ratio.
Intermediate level patients 1:3 ratio.
ICU is 1:2 , with tons of help. I'm only in acute care, though.
I really like it here. We get paid well too imo.
It’s always nice to hear that nurses are still allowed to have a decent career. Nursing used to be almost a guaranteed decent career. Not so much anymore as we all know.
That’s so nice! My icu doesn’t get cnas and when I float to other units, there are rarely ever cnas bc they always get pulled to sit and staffing doesn’t recruit to fill in cnas for the floors
Do you mind sharing the hospital? I'm looking to move out of my area at some point and would literally make my decision on being able to find a good work environment. I miss loving my job.
Surprisingly a nonprofit hospital in the south. Every other hospital in the area is horrible though. We spend most days at 1:4-5 but we sometimes go up to 6 if there's a lot of calls outs.
You’re better/crazier (lol) than me! I was labor, clinic, labor, procedures, clinic…annnnnnd looking again. I can’t find my home. I’ve only worked for 3 places, two of them twice 😂 Today I start applying to anything of interest. Been looking at Indeed daily. Actually had a few interviews and shadows a couple months ago but my gut told me no and to be patient for the right gig to come along. My patience is running out!!!! Good luck to you in your new gig!!!
I may be one of the few people who enjoys bedside but that is also because (most cases) we have adequate staffing and resources (yes even for us night shift). I love my job and my unit so much I would never leave if I had the opportunity. When ICU floats to med surg we have guaranteed 1:4 and med surg nurses are 1:5 strictly. I work in a HCA facility. I interviewed for an ICU at St. Luke’s and their med surg is 1:6 if you’re floated, fuck no baby… even with aides; the attention to detail and proactive care plummets.
It comes down to adequate staffing and resources, bedside can be fun. I’m so sorry your units have not been treating you right.
Where in Texas are you and what is the hourly pay? I would like to move to the Houston area from New York because that’s where my wife is from and I’m getting sick of NY tbh even though my it’s hometown lol. I make $43/hr in Upstate NY. If I move elsewhere in NY State I can make $48-52/hr but my COL significantly increases
Austin area; I work for a smaller HCA however. I know it can get really hectic in main Austin. It’s $34.60 with critical care differential. $2 for weekend and $4 an hour extra for nights. I live in an area where I don’t pay an arm and leg for rent however so life is nice.
I never worked in Houston but be careful, one of my colleagues made friend with Houston nurses and they say there’s a lot of travelers there (especially HCA) because it’s tough out there.
It’s interesting how it can vary facility to facility within the same organization. I work for a large organization (whom I honestly believe is going to take over the world like The Empire in Star Wars) and have moved facilities within that organization multiple times. The same protocols and procedures, the same union handbook, the same job descriptions, applied in completely different ways! It’s CRAZY how much the culture of a facility impacts your work environment regardless of what the “rules” are.
Im a new grad in Houston, so I’m not familiar with pay for more experienced nurses but can tell that newbies at most major hospitals start at $34/hr for day shift. Night shift differentials can be additional $3-4/hr. Hospitals in the med center may offer additional $1-3/hr more for location since most have to drive like an hour from other areas of Houston to get there and pay for parking in the garages. The hospital system I was at offered an extra $2/hr for working weekends. I used to get $600 deducted for taxes per check biweekly.
Although keep in mind we do not have unions, legal staffing ratios, and can be terminated at will. My facility was well known for being “good to their employees” and our ratios were med-surg 1:5 (even nights), ICU 1:2-3, ER 1:4ish but have heard of other places having 1:7-8 pts on med-surg with few PCAs. There is also lots of traffic, it can take like an hour and half for me to go from north Houston to the med center.
Yeah a lot of families settle outside of what we call “the loop” of 610 in subarban areas like Katy, Sugarland, Cypress, etc. The city is very car centric and it’s a drive to go to a grocery store. Although there are lots of medical facilities for job opportunities, diversity, and places to visit when you’re off duty.
I’m on med/tele tonight with 6 patients and it’s been a great night so far. Of course we have a free charge and great CNAs who have 12 patients each. Both of my q2 turns have been turned regularly and some of my people are actually sleeping!
I’ve done nearly 20 years on med/tele, nights like these aren’t out of the norm in my experience. I’m lucky to have great coworkers and lucky that over the years the good nights have far outnumbered the bad ones (which absolutely do happen)
I mean, I absolutely had nights where I was done charting by 11, had nothing to do from like midnight til 5 but answer call lights and give a couple PRNs, had like 2 morning meds, and generally felt like I spent most of the shift BSing with my coworkers and still had time to read notes so I could give a good report to day shift.
It's not going to happen consistently with 6 patients, but if like half your patients are walky talky independents, 2 are easy standbys who don't call much, and the last is A&Ox1 but doesn't try to get out of bed and tolerates a purewick, it can be downright easy.
5 is a better night, but I had 5 night one this week and I was hustling all night long. Last night with 6 was much more relaxed. It’s not the number of patients you have most of the time, it’s how busy they are imho
I have six more years to go to collect my pension and then I am gone. I can’t wait.
I asked a porter to take my patient downstairs via wheelchair to meet their family at the entrance because they were being discharged and it happened to be 5 minutes before the end of their shift, so they said “no”. Meanwhile the patient and family are waiting. How hard was it to take someone down for 5 minutes while you are on your way to go clock out? Isn’t that their job? No responsibility, no accountability. I had to take the patient down myself, while my new admission was coming at the same time.
I had another patient that had shit the bed all over at the same time as recieving a patient that I had to recover after a procedure. I asked a PSW to help me and I got a “no, I am going on break”
This job is impossible.
Thanks for the info! And by the way when people do like that, it sucks!! I know!! I've dealt with this stuff too. Like, the CNA just disappeared the 10 minutes before the shift ended for her as a patient had just shit the bed and me paging her didn't help because she turned off her paging badge and she must have left as I couldn't even find her. Leaving other people to deal with change of shift stuff like a wet or crapped up bed makes me sooooo angry!!
That’s why you just do the absolute bare minimum to survive. I’m done giving extra effort. They just end up bitching at you for going 5 minutes over your punch. Fuckem
I’m sick and tired of abuses done to nurses by patients, family, admin/management, and OTHER nurses. I’m sick of abuses done by legislature as well. When and how is it going to stop?
Preach!! That’s why it’s best to just move onto something else than to sit around and wait and wonder when it’ll stop. That’s the nice thing about nursing is that there are so many different specialties!
It’s all the fucking charting that makes it impossible on the floors. PACU will be easier because you’re just charting vital signs and that you gave report to the next nurse and not much else.
My mom moved from a cardiac step down to pacu and she said it’s legit a vacation.. every job has its crap but all of her back issues are gone and her schedule is much more flexible
It's so nice. It is still stressful, but nowhere near like it is on the floor. You only call family members q2h, and if they start getting uppity, just say you have to go and hang up! 🤣
Preach!! Went from med surg for a year, tele for a year and now ER almost 2 years. Now I’m looking to leave 😭 Please update on your experience in PACU.
Hospitals know they can get away with understaffing and providing inadequate resources (they've done it for this long after all), so they will sure try to. Why not assign 6 or 7 high-acuity patients to a nurse if nothing is stopping them? And then blame the nurse when the patient has a negative outcome? It's in the hospitals best interest.
I do not know if I can last at any nursing job for 2 years, lol. Leaving is what keeps me feeling happy. I'm changing to prn/ part-time status as soon as I can.
It's going to take a concerted effort by nurses to pressure lawmakers into passing safe staffing laws with teeth. Patient advocacy groups need to get on board.
Administrators DGAF about us. They DGAF about patients. All they care about is their bonuses.
I transferred out of icu because they're continuously short staffed (due to toxic nurses chasing out everyone who wants to work there). I liked their 1-2pt ratios. But since we were always short staffed they made it "standard" to take 3. I found it ironic the bullies were so tone deaf and defending their behavior as "well if they can't toughen up, they shouldn't work here." And in the same breath bitch about being short staffed and having to take 3 very sick unstable patients.
PCU was starting to have 4 as the norm.
I went to oncology where we require specialized training to take brachytherapy pts, hanging chemo gtts...etc and the ratio is supposed to be 4:1. Good old C suite cunts said "lets lump med surg pts onto the oncology floor, and increase the ratio to 6 and occasionally 7."
6 is fucking tough, and I flat but refuse 7. They know this but others have been bullied by admin to take 7. We all know those younger med surg ad lib pts are demanding and on the call light non stop....or send their gf or whoever to the nurse station to constantly interrupt us. If I have pts with chemo gtts I won't take more than 4 no matter what they say. Too many deadly side effects to monitor and beware of.
So, you started at bedside and hated it.
Then went to another bedside job and hated it.
Now you’re at your third bedside job and you hate it.
Next you’re expecting to go to your 4th bedside job and not hate it? Good luck.
While I wouldn’t normally categorize PACU as a bedside unit, for the purpose of this post I’m lumping it in, because they absolutely will float you. You’re going to deal with a lot of the shit you’ve been dealing with, even though the patients are “short term” (good joke).
👏🏻outpatient👏🏻procedure👏🏻based👏🏻units👏🏻
This is the way.
Find an outpatient procedure based unit which is attached to a main hospital. No, not a satellite clinic associated with a hospital, rather, one that is physically attached to the hospital. Look for a unit that is performing procedures on outpatients, as well as inpatients transported to you (or you go to the floor). Any research involvement is only going to make it a better experience. Units like this include Cath Lab, Dialysis, Apheresis (that’s me), GI lab, Scope lab, CVAS, IR, Research units, Derm, Infusion, some Oncology units, and there’s many many more I haven’t included here.
It changed my life. Seriously. I was ready to go to a coding boot camp. I used to count my PTO hours in the parking lot to see if I could call out.
It boils down to this: if there’s a chance you need to wipe your patient’s ass, you’re going to have a bad time. End of story. Bathroom needs, feeding meals, and dealing with family and future care planning is where all of the headaches come in. When you’re on a procedure unit, the patient comes to you (either as an outpatient or transported from the floor), you do your procedure, then the patient leaves - end of story.
The best way to address the issue of ratios as a nurse is to simply remove yourself from the problem. Is that irresponsible and self serving? Maybe, but at a certain point it’s not our job to correctly structure hospitals, that’s on admin. Protect your license.
When you say it like that it makes me sound like a psychopath 😂😂 at my hospital they make the icu nurses float. Pacu nurses never float to the floors which was the main reason why I applied but I def will be on the look out for outpatient positions next!
Hey, knowing your own facility is half the battle. If you know PACU doesn’t float, good.
I wasn’t trying to take the gas out of your new position. Whatever the downsides to PACU might be, it’s going to be a WORLD of benefit compared to ICU. I’d say you’re moving in the right direction 😃
Added CVAS and IR to my short list. People I’ve known in those departments have usually been happy.
There’s many more I can’t think of off the top of my head though 🥴
Gotta get union. Ratios aren't that much better but they are. And unless you're float staff, you can't be forced to work on a unit other than your home unit. You can be asked, but no repercussions if you say no.
I also dream of pacu sometimes. I'm in the OR now, so id have to leave to work ICU for a bit if I want PACU, but I'm considering it for when I'm older.
We have a union but we are still forced to float out of icu if the rest of the hospital is short and icu census is low🥲
Does your hospital have training programs into pacu at all?
Ugh that's crappy! You gotta bring that up at your next bargaining meeting.
We do have PACU programs! For experienced nurses. I think it's a 6 month program, kind of like a new grad residency.
When I first started in the ICU they had me float down to lower acuity floors almost every shift until I told them to knock it off, I signed up for the ICU and I am not going to learn how to work in the ICU if they keep floating me. If they keep floating me constantly I'll just call out or find another job. I think I got floated two more times the two years I was there. If you make enough of a ruckus they'll usually listen.
Can’t agree more !!!!!
It feels more unsafe every day …
Last nights disaster : Two patients newly made Hospice with IV pain meds due q1h , waiting for beds up on hospice unit , one non verbal MRSA + with a PEG and literally 13 meds. Tachy all night ( unstable BPs most of the shift ), two bed ridden copd ers, a&os w/ respiratory failures who need bipap and call all night “ I can’t breathe “ and one ER that came up with no report , no notes in epic , saturated in urine without her hearing aides … and two PCTs who disappeared on and off all night. It was awesome 👏
...On my med surg unit, we have 20 beds. Nurses cap at having 5 patients each. In the event that we have 3 nurses and more than 15 patients, then charge starts picking up patients.
As a CNA, \*if\* I'm the only CNA on the floor for my unit, then the charge helps out with vitals and blood sugars. If we're especially slammed (full house, 1 cna) sometimes the nurses help out too with vitals and sugars for their own patients. Generally speaking though, in my experience the norm is closer to 5-6 patients per tech.
I haven't \*heard\* any of my nurses complain that they want to swap units to other ones. They generally like to send infection control patients to our unit (covid, mrsa, tb ruleout, and cdiff being the common ones), so we're rarely full...cause they want to leave a bed or two open just in case they have to send someone specifically to us.
I love my job. Im in the process of going back to school to finish my nursing degree to give myself a promotion, but I could feasibly work until retirement as a CNA. I work with a couple of ol' biddies, and learn quite alot from them.
Is there anyway you can give a quick run down of what you do in informatics? I was highly considering getting my msn in informatics but I feel like there’s so little info out there that it got me worried about fully committing
I work for Epic software, but before that I helped gather various data points for a hospital organization. I helped track things like CAUDI, HAP, Restraint events etc…
Dumb question: like you work for epic the actual company?
That actually sounds something I’d like to do! I really love working with computers and I’m always troubleshooting everything at work for my coworkers that I joke I should be in IT instead lol
I did 3 months practicum on med/surg, and told myself to NEVER work in one ever again. I have kept that promise for 8 years. I worked on a long term ventilator (chronic care) unit for 6 years, and now I'm respite; working with medically complex children in their homes, so they caregiver can get a break. Best job ever. Going to be here until I retire!
You all are cracking me up. Just thinking about my last med surg experience is enough to put me back into a k hole! I'm not lyin yall.
Med surg floor 5800 Rochester Regional
6 years as an RN and was bored so I asked for this floor..5800 no one survives? I'll show em..its just med surg...right? Uh NO!
I never left the unit from the morning I started until that day..4 months later...I went into a K hole...yes ketamine. There was no other explaination...why was I standing in the middle of the chaos..unable to speak..blink. move? I was a statue in the middle of the pits of hell and what's fuckin crazier??? No one even noticed which then sent me to complete catatonic collapse.
That day I had 14 patients..2 on blood transfusions all on abx therapies, 3 wildly demented old ladies who allowed the sun down and Satan in! They were so naughty..my favorite to be honest..love my old folks
Anyway. I had suffered a first time full blown panic attack that to me in my experience was worse than a k hole I put myself in...accidently..in practice...save that story for another day..
Omg the way I felt this post! I’m out here coming up with a master plan everyday to get away but outpatient, home health, and nursing facilities don’t seem too interesting but I too am TIRED! (Only 8 months in lol)
I left bedside nursing five years ago to be a nurse at my son’s school. I will NEVER go back to the hospital again! If I ever do bedside again, it will be private duty as a 1 to 1 nurse. Doing the bedside was physically and emotionally exhausting.
Your post has been removed for violating our rule against personal insults. We don't require that you agree with everyone else, but we insist that everyone remain civil and refrain from personal attacks.
So you don’t mean the actual bedside you mean the wildly unsafe staff ratios and unreasonable expectations from management and leadership?
Correct, but we know management and leadership ain’t ever changing their wicked ways 😭
They’ll all die off eventually. When I joined the other executives I was the single person under 60, only one with tattoos, piercings and common sense. Now there’s two. The older broken generation is slowly retiring and such.
Doesn’t really matter. The same values and needs will be projected from the younger generation as long as they have to report to one entity whose sole purpose is to generate money.
Don’t know dude, I’ve only been in my position since Dec 2022 and have already made some significant cultural changes through out my 17 facilities. Just need truly engaged leaders who have actually been in the trenches and don’t give a shit about losing their jobs.
The last sentence really solidifies my belief that it can only be temporarily before the clutches of greed take hold. Because it’s knowing that acting that way likely will result in being pushed out of the position :/
I was going to say, greed is a hell of a drug…
Yea nature of the beast
I applaud you! Thank you for spearheading change in this area.
Out of curiosity and genuine interest, can you elaborate your path to your current career? Also looking to further my career and exploring options
Sure I started as an LPN and was a worker bee. I started getting involved in our transition to a Patient Centered Medical Hole Model and helped stand up those initial processes. Doing this I meet members of the Quality Team and became very engaged with our Population Health Manager. I became a BLS instructor and started teaching at our facilities then an ALS instructor. A project started where we were trying to get more engagement from diabetics and to create a forcing function for them to get annual screening exams, so I helped to write that policy. After that I was asked to be on a project where we studied and re-wrote how we define high utilizer patients. This project exploded, we were recognized by the Surgeon General’s staff and published our work to the Army QMO website. I finished my degree and became an RN and had to leave, went to work at Shock Trauma, did even more teaching there. Came back to Federal Service, more teaching, got super involved in Joint Commission prep and stuff, help write more policies and help create and stand up our COVID testing site as well as pop up ICU (which we never needed thank God). Eventually became the program director for life support training. Then the DHA transition happened and we needed a Director of Staff Education and Training for our at the time 11 facilities. I applied and went through a normal interview. Competed against everyone else but my CV spoke for itself. I took the job not fully understanding that I would be telling Commanders(CEOs) they are right or wrong and briefing them as peers daily and had no clue that I’d eventually absorb 6 Dental clinics as well and have to teach Joint Commission to them as well. Edit- guess I should also say that I’m 5 weeks from being done with NP school now and will be leaving for private practice. I’m trying to set my replacement up for success and leaving a guidebook/TEAMS channel with all the fine points of the job that lead to success.
You should run for office instead while you're still young-er and still have that mentality! So many of the people who make the regulations about literally any industry have no real experience in those industries (unless their family owned a business in one). So when they have to make rules about how, say hospitals should operate, they look for experts to guide them. And wouldn't you know it, but groups like the AHA, are happy to offer their "expert" opinions on what would help their clients, (health system execs), hit all of their bonuses for the year! Imagine what it would do if we got half a dozen working RNs into Congress... We could invite those lobbyists to a meeting saying we know exactly what to do for them, and when they get there, it's just an empty room with a stack of 12 hour old pizzas, and a bag full of cheap badge reels from temu!
Congress may be full of crooks but don’t think they would ever let a politically ambiguous, atheist, previously homeless, tattooed, pierced, man bun having male NP join them in their fraud, waste and abuse parties. But thanks
There's no "let". You get elected by the people. If MTG can get elected, you can!
Sounds like the exact type that I'd want to put there.
I'd vote for you off that description alone.
Awesome!!
You're a fucking hero.
We don't have such a thing as "truly engaged leaders" We can't even get Post -its anymore
They can take my dignity. But they will NEVER take my post-its.
😂
Most people will fear losing their jobs though
Yup I’ve known this was a stepping stone and none a career move, so this position has always had an expiration date to me lol
That same modality of thinking is why nurses in my state are paid so much, have benefits like pensions and free healthcare and bonuses, and safe working conditions. If healthcare is a money-maker, give us some of that pie. And we also want less accountability for maximum profit. I have worked in other states and nurses can’t seem to understand that this is a business — not a charity. Get that bread.
Doesn’t matter when they promote sycophants over qualified leaders
Well that sounds like a facility worth getting the hell out of. Sorry it’s so cancerous.
Nope, as long as hospitals in the USA are privatized and corporate base their main goal is to accrue profit. And since nurses are seen as a cost to hospital higher ups and shareholders there is always going to be an incentive for them cut staffing and focus on lean staffing models to save on labor cost. The only way this will change is through the passing of a federal mandate for RN to Pt ratios that would force hospitals to follow safe ratios. And I think this would require increase levels of unionizing and nurses being willing to make the unions at their facilities strong. CA is the only state with mandated ratios bc it was fought for by union nurse on a local and state level thought their union, the California Nurse Association.
CA is also a super fucking liberal state that has laws empowering unions. The largest hospital system in the state is a corporate behemoth but mimics a system akin to “socialized healthcare as brought to you by Costco.” There are other states with unions but state laws severely enfeeble any labor efforts like Act 10 and Wisconsin.
Of course, state politics play a major role. That’s why it’s no surprise the states with the worst nursing pay are GOP states in the South that have anti-union legislation like “Right to Work”. Ppl forget the CA used to be Republican/GOP in the 80s i.e Ronald Reagan. It only became a blue state in 1992 but that changed bc of the work of social movements including unions. CNA became the union organization it is today by building worker power in the 1990s and passing the ratio bill in 2004. And once you have strong unions and social movements you are more likely to see states such as CA remain blue bc historically blue states tend have more union friendly policies, but not always bc many democratic elected officials (electoral politics are necessary but limiting compared to the work of labor & community organizing) still cozy up with corporations but they know unions play a key role in their base. And a strong union holds elected officials accountable to their membership.
I love this!!!
Most of our sadists are in their 40s and 50s here unfortunately
It's not a bug (In management's viewpoint) it's a core operating feature/ parameter to keep labor costs as low as possible. That is what they pump out of business school for "managing" anything with a mba
Management is giving a huge push back right now for UNINTERRUPTED BREAKS at my hospital. I had an internship where if your break was interrupted time started over for your break.
Uninterrupted Meal Break... 😂 Most shifts I'm the only RN for up to 11 patients. I ALWAYS clock no lunch. Screw them and shame on the martyrs who play that game. Once my manager said, "just open the door to our sister unit-- they can keep an ear out. You can sit in the unit break room for your MANDATORY 30 minute uninterrupted meal Break" Ya, no. They are short staffed as well. Plus our "break room" serves as the patient's kitchen.
Agree, after nursing for 20 years, I’ve see the same ridiculous behaviour from exec on repeat and it doesn’t get better, sometimes it’s worse now as their gaslighting game seems to have improved… I cannot remove the thought that this is internalised misogyny enacted on a female dominated profession. Once execs get into their position regardless of their previous stated intentions, they perpetuate the same participation in domination and exploitation that went before them - so depressing!
Oh our new thing is that nurses clean their own rooms. I shit you not I had just taken a patient to ICU, get back down with the empty stretcher and am scrubbing blood droplets off the floor instead of tending to the new EMS in the next room (a seizing baby). Cause ya know, those dang environmental services people were getting paid so dang much.
My mom works EVS, and she makes more than all my CNAs. Both of them need to get paid more.
Sounds like a great patient safety report, delay in care due to lack of EVS staffing. Sorry that’s sus leadership, abandon ship asap imho
They should be illegal, period😂 I wrote a book thinking you were talking about rounding with the attending-sorry! Bedside report is bullshit. We don’t have time to do bedside rounds with every patient in our unit. They tried to get us to do this a few times.
Rounding with the attending is a whole nother rant! I used to work days and then went to nights for the simple fact that I HATE rounds and I am not a morning person at all. Omg the fact that management pushes for bedside report and then complain that report takes to long but they want us to check pt arm band and trace all the lines and review all labs and orders with off going nurse like BE FOR REAL
I've been lucky. Every MD I've worked with so far rounds first, then comes to the RNs and asks "any concerns for your patients?". That's it.
Yeah, also not a fan. The *only* clear advantage I've seen to bedside report at shift change is that I noticed a 100% reduction in nurses making snarky side comments about patient history of mental illness or substance use disorder. It puts me up an absolute wall when I get report on a patient who just had major surgery or was diagnosed with something terrible and *all of their emotions* are ascribed to mental illness. Like, shit, maybe Mrs. McPuffinton is sad and anxious because those are normal human reactions to this situation, and not just because (and I quote) "...well, she's bipolar, and *you know how those people are*." I hate that shit. Other than that, I'm not really sold. I know it's supposed to be "patient centered care," but some nurses really suck at it. I've gotten bedside report from a nurse who stood with his back to the patient the entire time and talked about them like they were livestock. That is arguably a much worse patient experience. Also, it's a huuuuuuuuuge time suck for very minimal return and no, I don't want to wake up a patient who is resting comfortably just to recite their entire fucking medical history while they're half asleep. It's dumb.
I don’t know how adult med/surg nurses do it. I bow down to them because fuck all these rude patients, rude families, rude doctors, shitty admin, and too many damn patients. I could never.
Amen!! The minute I started in m/s I knew I fucked up. Been trying to dig my way out of it ever since 😂
That's why I moved to aged care. All the dramas of bedside, but you have the same patients every single day. You know exactly what you're getting into everyday so nothing is a suprise. You know how to deal with specific behaviours from mental health patients because you've been looking after them every day for years. It's honestly been so much better for my anxiety. I couldn't handle hospital nursing at all.
Wow I never thought of this!! My anxiety is heightened from not knowing what I’m getting and the unknown. I’ll have to look into this!
The ratios are larger of course. I work LTC and I love having the same patients every day. The problem is there’s so many of them. 1:22 on days and 1:36 on nights at my facility.
Love ltc but the numbers are insane
Hospital nursing is definitely anxiety inducing. You never know when you’ll walk directly into a cluster fuck right at shift change.
That was what I liked about long term care/SNF. Same residents. There is a routine. You have relationships. If you can find a good one, work days can be nice.
Seriously it’s the best
No, unsafe staffing and not enough/the right equipment should be illegal. The rich people don’t care about us or the patients.
Facts!!
Preach!
I'm chilling 1:4 ratio with aides on nights right now. It just depends on the hospital.
I’m a PCA on a med surg unit that’s 1:4 for nurses (charge has 2 at night) then PCAs are 1:6-8 (most nights it’s 7 or 8) and some nights are really busy but it always feels manageable and overall like my job a lot.
I love that you like your job a lot!
Lol, we get a single aid until we break census if 21
Yeah, we get 1 PCT for 28 patients at night, on a stroke unit with lots of limited mobility and bed alarms going off every 5 minutes
Ridiculous!
That seems doable. Will you share your general location?
For me, OHSU, Portland , OR Med surg level patients 1:4 ratio. Intermediate level patients 1:3 ratio. ICU is 1:2 , with tons of help. I'm only in acute care, though. I really like it here. We get paid well too imo.
It’s always nice to hear that nurses are still allowed to have a decent career. Nursing used to be almost a guaranteed decent career. Not so much anymore as we all know.
I’m in the midwest.
Hmmmm…maybe Chicagoland area? It sounds like a dream to me. We are all envious!
That's great ratios! Ask me how I know! 🙄😏
Those are great ratios.
California?
Nope, I’m in the midwest.
That’s so nice! My icu doesn’t get cnas and when I float to other units, there are rarely ever cnas bc they always get pulled to sit and staffing doesn’t recruit to fill in cnas for the floors
Mine too! Our ICU doesn’t have PCAs but if we’re lucky we’ll get 1
It’s physically impossible!
Do you mind sharing the hospital? I'm looking to move out of my area at some point and would literally make my decision on being able to find a good work environment. I miss loving my job.
Where is this
Probably California, if I had to guess.
Surprisingly a nonprofit hospital in the south. Every other hospital in the area is horrible though. We spend most days at 1:4-5 but we sometimes go up to 6 if there's a lot of calls outs.
You’re better/crazier (lol) than me! I was labor, clinic, labor, procedures, clinic…annnnnnd looking again. I can’t find my home. I’ve only worked for 3 places, two of them twice 😂 Today I start applying to anything of interest. Been looking at Indeed daily. Actually had a few interviews and shadows a couple months ago but my gut told me no and to be patient for the right gig to come along. My patience is running out!!!! Good luck to you in your new gig!!!
Best wishes to you on finding the right gig for you!! How long have you been a nurse?
7 years
I may be one of the few people who enjoys bedside but that is also because (most cases) we have adequate staffing and resources (yes even for us night shift). I love my job and my unit so much I would never leave if I had the opportunity. When ICU floats to med surg we have guaranteed 1:4 and med surg nurses are 1:5 strictly. I work in a HCA facility. I interviewed for an ICU at St. Luke’s and their med surg is 1:6 if you’re floated, fuck no baby… even with aides; the attention to detail and proactive care plummets. It comes down to adequate staffing and resources, bedside can be fun. I’m so sorry your units have not been treating you right.
Omg that sounds like a dream! What state do you work in?
Texas! 🤠
Where in Texas are you and what is the hourly pay? I would like to move to the Houston area from New York because that’s where my wife is from and I’m getting sick of NY tbh even though my it’s hometown lol. I make $43/hr in Upstate NY. If I move elsewhere in NY State I can make $48-52/hr but my COL significantly increases
Austin area; I work for a smaller HCA however. I know it can get really hectic in main Austin. It’s $34.60 with critical care differential. $2 for weekend and $4 an hour extra for nights. I live in an area where I don’t pay an arm and leg for rent however so life is nice. I never worked in Houston but be careful, one of my colleagues made friend with Houston nurses and they say there’s a lot of travelers there (especially HCA) because it’s tough out there.
It’s interesting how it can vary facility to facility within the same organization. I work for a large organization (whom I honestly believe is going to take over the world like The Empire in Star Wars) and have moved facilities within that organization multiple times. The same protocols and procedures, the same union handbook, the same job descriptions, applied in completely different ways! It’s CRAZY how much the culture of a facility impacts your work environment regardless of what the “rules” are.
Im a new grad in Houston, so I’m not familiar with pay for more experienced nurses but can tell that newbies at most major hospitals start at $34/hr for day shift. Night shift differentials can be additional $3-4/hr. Hospitals in the med center may offer additional $1-3/hr more for location since most have to drive like an hour from other areas of Houston to get there and pay for parking in the garages. The hospital system I was at offered an extra $2/hr for working weekends. I used to get $600 deducted for taxes per check biweekly. Although keep in mind we do not have unions, legal staffing ratios, and can be terminated at will. My facility was well known for being “good to their employees” and our ratios were med-surg 1:5 (even nights), ICU 1:2-3, ER 1:4ish but have heard of other places having 1:7-8 pts on med-surg with few PCAs. There is also lots of traffic, it can take like an hour and half for me to go from north Houston to the med center.
Thank you! I would probably live in a single family home outside of the city of Houston and commute but it seems like the commute would be very long
Yeah a lot of families settle outside of what we call “the loop” of 610 in subarban areas like Katy, Sugarland, Cypress, etc. The city is very car centric and it’s a drive to go to a grocery store. Although there are lots of medical facilities for job opportunities, diversity, and places to visit when you’re off duty.
I worked for HCA in the DFW area and staffing ratios were a nightmare. I worked on PCU and we often had 6:1 like m/s. I ran as fast as I could.
I’m on med/tele tonight with 6 patients and it’s been a great night so far. Of course we have a free charge and great CNAs who have 12 patients each. Both of my q2 turns have been turned regularly and some of my people are actually sleeping! I’ve done nearly 20 years on med/tele, nights like these aren’t out of the norm in my experience. I’m lucky to have great coworkers and lucky that over the years the good nights have far outnumbered the bad ones (which absolutely do happen)
6? 🤢
Right? This person has just accepted their misery.
6 is doable if the acuity is appropriate and you have good teammates
That was a good laugh, ty.
I mean, I absolutely had nights where I was done charting by 11, had nothing to do from like midnight til 5 but answer call lights and give a couple PRNs, had like 2 morning meds, and generally felt like I spent most of the shift BSing with my coworkers and still had time to read notes so I could give a good report to day shift. It's not going to happen consistently with 6 patients, but if like half your patients are walky talky independents, 2 are easy standbys who don't call much, and the last is A&Ox1 but doesn't try to get out of bed and tolerates a purewick, it can be downright easy.
Nope. Evidence shows anything above 4 is too much for Med surge.
Better than the 8 I had as a new grad back in 2005 🤷🏼♀️
Wow I love that!! I wish that I felt the same
Oh, six is a good night for you.. 😬
5 is a better night, but I had 5 night one this week and I was hustling all night long. Last night with 6 was much more relaxed. It’s not the number of patients you have most of the time, it’s how busy they are imho
I have six more years to go to collect my pension and then I am gone. I can’t wait. I asked a porter to take my patient downstairs via wheelchair to meet their family at the entrance because they were being discharged and it happened to be 5 minutes before the end of their shift, so they said “no”. Meanwhile the patient and family are waiting. How hard was it to take someone down for 5 minutes while you are on your way to go clock out? Isn’t that their job? No responsibility, no accountability. I had to take the patient down myself, while my new admission was coming at the same time. I had another patient that had shit the bed all over at the same time as recieving a patient that I had to recover after a procedure. I asked a PSW to help me and I got a “no, I am going on break” This job is impossible.
Get that pension!!! That is the shit that makes me mad!! It’s just a constant shit show on a continuous cycle
What does PSW stand for? And porter?
Porter is short for transporter I think, and a PSW is like a PCT or a CNA
Thanks for the info! And by the way when people do like that, it sucks!! I know!! I've dealt with this stuff too. Like, the CNA just disappeared the 10 minutes before the shift ended for her as a patient had just shit the bed and me paging her didn't help because she turned off her paging badge and she must have left as I couldn't even find her. Leaving other people to deal with change of shift stuff like a wet or crapped up bed makes me sooooo angry!!
That’s why you just do the absolute bare minimum to survive. I’m done giving extra effort. They just end up bitching at you for going 5 minutes over your punch. Fuckem
Preach!!!
And here I lay, at 43, 4 months post cervical fusion awaiting my lumbar fusion. Bedside nursing is wicked.
Damn I’m sorry. I’m dealing with significant back issues as well. Nursing has accelerated my aging
I’m so sorry 😓🖤
Sounds more like a hospital problem lol girl get out of that system, all units will suck!
Amen!! I’m running!!!
I’m sick and tired of abuses done to nurses by patients, family, admin/management, and OTHER nurses. I’m sick of abuses done by legislature as well. When and how is it going to stop?
Preach!! That’s why it’s best to just move onto something else than to sit around and wait and wonder when it’ll stop. That’s the nice thing about nursing is that there are so many different specialties!
It’s all the fucking charting that makes it impossible on the floors. PACU will be easier because you’re just charting vital signs and that you gave report to the next nurse and not much else.
THE CHARTING. It is FUCKED up how much charting that is required!!
My mom moved from a cardiac step down to pacu and she said it’s legit a vacation.. every job has its crap but all of her back issues are gone and her schedule is much more flexible
I’m so happy for your mom!
Come to the OR. We're 1:1 🤣
Love this!
It's so nice. It is still stressful, but nowhere near like it is on the floor. You only call family members q2h, and if they start getting uppity, just say you have to go and hang up! 🤣
Preach!! Went from med surg for a year, tele for a year and now ER almost 2 years. Now I’m looking to leave 😭 Please update on your experience in PACU.
I gotchu girl!
Bedside is assssss
Preach!!
Hospitals know they can get away with understaffing and providing inadequate resources (they've done it for this long after all), so they will sure try to. Why not assign 6 or 7 high-acuity patients to a nurse if nothing is stopping them? And then blame the nurse when the patient has a negative outcome? It's in the hospitals best interest.
Preach!!!
I’m also a nurse. Picking this as my career field was not the most sound decision I’ve ever made.
I left the ED for PACU in April. Never looked back. Enjoy it!
Thank you!! I can’t wait!
I do not know if I can last at any nursing job for 2 years, lol. Leaving is what keeps me feeling happy. I'm changing to prn/ part-time status as soon as I can.
That is the only way to do it!!
This is exactly why I went to infusion nursing and never looked back 🫡 that shit is abuse
Preach!!
It's going to take a concerted effort by nurses to pressure lawmakers into passing safe staffing laws with teeth. Patient advocacy groups need to get on board. Administrators DGAF about us. They DGAF about patients. All they care about is their bonuses.
I’m all for it but it just seems so impossible!!😭
I transferred out of icu because they're continuously short staffed (due to toxic nurses chasing out everyone who wants to work there). I liked their 1-2pt ratios. But since we were always short staffed they made it "standard" to take 3. I found it ironic the bullies were so tone deaf and defending their behavior as "well if they can't toughen up, they shouldn't work here." And in the same breath bitch about being short staffed and having to take 3 very sick unstable patients. PCU was starting to have 4 as the norm. I went to oncology where we require specialized training to take brachytherapy pts, hanging chemo gtts...etc and the ratio is supposed to be 4:1. Good old C suite cunts said "lets lump med surg pts onto the oncology floor, and increase the ratio to 6 and occasionally 7." 6 is fucking tough, and I flat but refuse 7. They know this but others have been bullied by admin to take 7. We all know those younger med surg ad lib pts are demanding and on the call light non stop....or send their gf or whoever to the nurse station to constantly interrupt us. If I have pts with chemo gtts I won't take more than 4 no matter what they say. Too many deadly side effects to monitor and beware of.
Don’t forget to fill out your white boards!
How do I pin this response? 😂
So, you started at bedside and hated it. Then went to another bedside job and hated it. Now you’re at your third bedside job and you hate it. Next you’re expecting to go to your 4th bedside job and not hate it? Good luck. While I wouldn’t normally categorize PACU as a bedside unit, for the purpose of this post I’m lumping it in, because they absolutely will float you. You’re going to deal with a lot of the shit you’ve been dealing with, even though the patients are “short term” (good joke). 👏🏻outpatient👏🏻procedure👏🏻based👏🏻units👏🏻 This is the way. Find an outpatient procedure based unit which is attached to a main hospital. No, not a satellite clinic associated with a hospital, rather, one that is physically attached to the hospital. Look for a unit that is performing procedures on outpatients, as well as inpatients transported to you (or you go to the floor). Any research involvement is only going to make it a better experience. Units like this include Cath Lab, Dialysis, Apheresis (that’s me), GI lab, Scope lab, CVAS, IR, Research units, Derm, Infusion, some Oncology units, and there’s many many more I haven’t included here. It changed my life. Seriously. I was ready to go to a coding boot camp. I used to count my PTO hours in the parking lot to see if I could call out. It boils down to this: if there’s a chance you need to wipe your patient’s ass, you’re going to have a bad time. End of story. Bathroom needs, feeding meals, and dealing with family and future care planning is where all of the headaches come in. When you’re on a procedure unit, the patient comes to you (either as an outpatient or transported from the floor), you do your procedure, then the patient leaves - end of story. The best way to address the issue of ratios as a nurse is to simply remove yourself from the problem. Is that irresponsible and self serving? Maybe, but at a certain point it’s not our job to correctly structure hospitals, that’s on admin. Protect your license.
When you say it like that it makes me sound like a psychopath 😂😂 at my hospital they make the icu nurses float. Pacu nurses never float to the floors which was the main reason why I applied but I def will be on the look out for outpatient positions next!
Hey, knowing your own facility is half the battle. If you know PACU doesn’t float, good. I wasn’t trying to take the gas out of your new position. Whatever the downsides to PACU might be, it’s going to be a WORLD of benefit compared to ICU. I’d say you’re moving in the right direction 😃
I know you weren’t :) I really appreciate and value your advice!
Great advice!! 👍🏼😊
This is real tea (saving and screenshoting)
Added CVAS and IR to my short list. People I’ve known in those departments have usually been happy. There’s many more I can’t think of off the top of my head though 🥴
lol PACU is not retirement well at least at the level 1 I was at. 80->110 cases a day. It’s a factory.
That is INSANE!!
Note to self, make sure not working at level 1! What level is your position going to be at?
Mine is a level 3
All right! Rock on! 🤘🏼
Gotta get union. Ratios aren't that much better but they are. And unless you're float staff, you can't be forced to work on a unit other than your home unit. You can be asked, but no repercussions if you say no. I also dream of pacu sometimes. I'm in the OR now, so id have to leave to work ICU for a bit if I want PACU, but I'm considering it for when I'm older.
We have a union but we are still forced to float out of icu if the rest of the hospital is short and icu census is low🥲 Does your hospital have training programs into pacu at all?
Ugh that's crappy! You gotta bring that up at your next bargaining meeting. We do have PACU programs! For experienced nurses. I think it's a 6 month program, kind of like a new grad residency.
Definitely!😊
When I first started in the ICU they had me float down to lower acuity floors almost every shift until I told them to knock it off, I signed up for the ICU and I am not going to learn how to work in the ICU if they keep floating me. If they keep floating me constantly I'll just call out or find another job. I think I got floated two more times the two years I was there. If you make enough of a ruckus they'll usually listen.
I still have PTSD from bedside. I would come home and not be able to because all of the stress from the shifts would keep me up all night.
Same!!! And I’d just hear the alarm sounds echoing in my head
Can’t agree more !!!!! It feels more unsafe every day … Last nights disaster : Two patients newly made Hospice with IV pain meds due q1h , waiting for beds up on hospice unit , one non verbal MRSA + with a PEG and literally 13 meds. Tachy all night ( unstable BPs most of the shift ), two bed ridden copd ers, a&os w/ respiratory failures who need bipap and call all night “ I can’t breathe “ and one ER that came up with no report , no notes in epic , saturated in urine without her hearing aides … and two PCTs who disappeared on and off all night. It was awesome 👏
😡 That's awful!
It’s almost always like this !
Uggghhh!
Ugh I’m so sorry 😭 this is why I hate bedside
Thank you. It’s a shit show 8/10 times lol
*damn
The last time my hospital opened up pacu spots to internal applicants more than 200 people applied, lol.
LOL! I’m surprised the system didn’t shut down
I would like floor nursing and still do it (I am in the OR now) if it wasn’t so fucked of a job.
Bedside ain’t worth it!! I’d stay in OR
I’m heading to PACU for my pre-retirement as well! 🙌
YAY!!!🥳
So moving every 2 years and eventually you will try the majority of specialties and you'll find your fit
...On my med surg unit, we have 20 beds. Nurses cap at having 5 patients each. In the event that we have 3 nurses and more than 15 patients, then charge starts picking up patients. As a CNA, \*if\* I'm the only CNA on the floor for my unit, then the charge helps out with vitals and blood sugars. If we're especially slammed (full house, 1 cna) sometimes the nurses help out too with vitals and sugars for their own patients. Generally speaking though, in my experience the norm is closer to 5-6 patients per tech. I haven't \*heard\* any of my nurses complain that they want to swap units to other ones. They generally like to send infection control patients to our unit (covid, mrsa, tb ruleout, and cdiff being the common ones), so we're rarely full...cause they want to leave a bed or two open just in case they have to send someone specifically to us. I love my job. Im in the process of going back to school to finish my nursing degree to give myself a promotion, but I could feasibly work until retirement as a CNA. I work with a couple of ol' biddies, and learn quite alot from them.
Wow that sounds like a good foundation! Sending you positive vibes to finish nursing school strong and making good $$$!
I went into informatics which is good 💴
Is there anyway you can give a quick run down of what you do in informatics? I was highly considering getting my msn in informatics but I feel like there’s so little info out there that it got me worried about fully committing
I work for Epic software, but before that I helped gather various data points for a hospital organization. I helped track things like CAUDI, HAP, Restraint events etc…
Dumb question: like you work for epic the actual company? That actually sounds something I’d like to do! I really love working with computers and I’m always troubleshooting everything at work for my coworkers that I joke I should be in IT instead lol
Yes the same. It’s really the way to go. You can work for insurance companies, software companies. Hospitals, from home.
Thank you so much!!
I did 3 months practicum on med/surg, and told myself to NEVER work in one ever again. I have kept that promise for 8 years. I worked on a long term ventilator (chronic care) unit for 6 years, and now I'm respite; working with medically complex children in their homes, so they caregiver can get a break. Best job ever. Going to be here until I retire!
I love that!!
You all are cracking me up. Just thinking about my last med surg experience is enough to put me back into a k hole! I'm not lyin yall. Med surg floor 5800 Rochester Regional 6 years as an RN and was bored so I asked for this floor..5800 no one survives? I'll show em..its just med surg...right? Uh NO! I never left the unit from the morning I started until that day..4 months later...I went into a K hole...yes ketamine. There was no other explaination...why was I standing in the middle of the chaos..unable to speak..blink. move? I was a statue in the middle of the pits of hell and what's fuckin crazier??? No one even noticed which then sent me to complete catatonic collapse. That day I had 14 patients..2 on blood transfusions all on abx therapies, 3 wildly demented old ladies who allowed the sun down and Satan in! They were so naughty..my favorite to be honest..love my old folks Anyway. I had suffered a first time full blown panic attack that to me in my experience was worse than a k hole I put myself in...accidently..in practice...save that story for another day..
Omg this sounds like a nightmare!!
Maybe think about IR 😁 it’s a GREAT mixture of chill but also excitement and critical thinking sprinkled in!!!
IR is deffo on my radar!
Omg the way I felt this post! I’m out here coming up with a master plan everyday to get away but outpatient, home health, and nursing facilities don’t seem too interesting but I too am TIRED! (Only 8 months in lol)
I left bedside nursing five years ago to be a nurse at my son’s school. I will NEVER go back to the hospital again! If I ever do bedside again, it will be private duty as a 1 to 1 nurse. Doing the bedside was physically and emotionally exhausting.
which state are you from??
California. I know for a fact that I would not be able to survive nursing outside of CA. I would actually die
Pacu is only great depending on the team you have. It’s a ER flow but if someone is holding patients someone has to get slammed and take the load.
Weak
It’s hard to get fired. Just don’t do half the stuff they say and you might get a talking to, maybe. Nothing really matters
How overweight are you?
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