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Baby_Hippo posted:L&D preceptorships are pointless because you're not going to be hired straight into L&D (could be wrong) I know this was from a while ago but I just wanted to say...I did an L&D preceptorship this spring. While I knew it was essentially useless in getting me a job once I graduated I have to say it was the most fun clinical experience I ever had. I enjoyed every second of it and still hope to get into L&D one day. I would do it again in an instant. I too am part of the ranks of the unemployed new grads. Graduated in May, passed the NCLEX in late June, and I have had a grand total of ONE interview. Luckily, I have yet to hear back about whether or not I've gotten the job (please GOD let it be so) so there is still hope! If I don't...I have no other real prospects. It seems like the only way to get a job at one of the hospitals in town is to have some sort of connection which I unfortunately do not have. Not sure what I'll do...I really never thought it would be this hard to find a job as a new grad. Ugh.
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Sep 10, 2011 01:22
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Baby_Hippo posted:Things I've HEARD.... Mangue posted:I know this was from a while ago but I just wanted to say...I did an L&D preceptorship this spring. While I knew it was essentially useless in getting me a job once I graduated I wanted to work in our CV SICU(we land heart transplants, VADS, in addition to the valves and cabbages, and weird congenital fixes like Fontan procedures now and then) and snagged a externship while I was in school. And then hired onto my Cardiothoraic Surgical ICU immediately, as a new grad as soon as I finished my boards But my hospital has a new grad preceptor program(where you are now an intern(full RN) where you work paired with one of the experienced RN's for four months before you start taking your own you also go to critical care classes like once a week on like EKG's, pacemakers, advance hemodynamics. Anyway it was great, for example I came in Wednesday night next thing I know I was called to the ER for a patient with a malfunctioning driveline for her Heartmate II LVAD(it kept resetting and stopping and she could feel it rattling and winding down in her chest). Got her to the unit on the systems monitor, watch the pump totally reboot and stop again(not a suction event.) Plan was made to lets replace that faulty thing(first time we had done it.) I was in CVOR by 3am manning the heartmate until 9 in the morning as we explanted her old pump and reimplanted her new Ventricular Assist Device. Pretty fun poo poo. They should hire new grads into OH poo poo areas. Just get them a long preceptorship when they're licensed. For one it teaches them THIS IS HOW YOU DO IT HERE, and they don't come on with a bunch of stupid floor nurse baggage and preconceived notions of being safe. When we got four nurses hand squeezing in blood as fast as you can while cranking the levophed up to 30mcg/min, while we're giving repeat doses of novo-7. You don't need some being like "Oh transfusion reactions, and shouldn't you give those over an hour with lasix inbetween" and "isn't the dose higher than max shouldn't you titrate up slower" No gently caress that baggage, get them young and smart and mold them into a SICU machine. Bum the Sad fucked around with this message at 15:03 on Sep 10, 2011 |
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Sep 10, 2011 14:54
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Bum the Sad posted:They should hire new grads into OH poo poo areas. Just get them a long preceptorship when they're licensed. For one it teaches them THIS IS HOW YOU DO IT HERE, and they don't come on with a bunch of stupid floor nurse baggage and preconceived notions of being safe. When we got four nurses hand squeezing in blood as fast as you can while cranking the levophed up to 30mcg/min, while we're giving repeat doses of novo-7. You don't need some being like "Oh transfusion reactions, and shouldn't you give those over an hour with lasix inbetween" and "isn't the dose higher than max shouldn't you titrate up slower" No gently caress that baggage, get them young and smart and mold them into a SICU machine. I wish more departments thought like this! I want nothing more than to work at the Birth Center where I did my preceptorship...but it's hard enough getting a job on an acute floor let alone a specialty floor. I thought perhaps I could get lucky but nope...they only wanna hire nurses with experience. I just want to march in and say "teach me! Mold me to your ways! Who cares if I don't have a ton of experience, I will get it HERE and here I will stay!" Alas, I don't think the hospitals have enough time and money to train many new grads into specialty areas. It's really frustrating and disheartening. I can't really think about L&D at this point though...I need to focus on getting ANY sort of job so that maybe one day 5 years from now I can apply to the Birth Center. 
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Sep 10, 2011 22:49
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Bum the Sad posted:They should hire new grads into OH poo poo areas. Just get them a long preceptorship when they're licensed. For one it teaches them THIS IS HOW YOU DO IT HERE, and they don't come on with a bunch of stupid floor nurse baggage and preconceived notions of being safe. When we got four nurses hand squeezing in blood as fast as you can while cranking the levophed up to 30mcg/min, while we're giving repeat doses of novo-7. You don't need some being like "Oh transfusion reactions, and shouldn't you give those over an hour with lasix inbetween" and "isn't the dose higher than max shouldn't you titrate up slower" No gently caress that baggage, get them young and smart and mold them into a SICU machine. I'm new grad, and the hospital that I am working at is doing exactly this. Several people I graduated with were hired straight into the CVICU. I just can't imagine doing that right now. I'm developing enough crippling anxiety caring for six patients on a Med/Surg floor.
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Sep 11, 2011 07:44
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Who else trying to juggle full time work with post-grad study? I am half way through a Masters of Health Communication. I have found that I have discovered a love of health policy as I study. I regret picking comms instead of the full policy masters. Comms is bullshit, full of PR flacks.
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Sep 11, 2011 10:48
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Just finished my first year in the ER. Graduated at age 21, and was hired into the ER out of school with 4 years prior experience as an ER tech, and 5 years as an EMT Basic working 911. That being said I'm self made as far as critical care goes, and I spend a lot of time reading about it when I'm not at work. Or browsing SA/Reddit. Zeo fucked around with this message at 15:43 on Sep 11, 2011 |
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Sep 11, 2011 15:39
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Mangue posted:I know this was from a while ago but I just wanted to say...I did an L&D preceptorship this spring. While I knew it was essentially useless in getting me a job once I graduated I have to say it was the most fun clinical experience I ever had. I enjoyed every second of it and still hope to get into L&D one day. I would do it again in an instant. Where are you applying? Don't count on just hospitals. Have you called up pediatric clinics to ask if they need a nurse? I've taken care of babies (just as a babysitter though) and it seems like every two months they have to go to the doctor's office for shots or just a well-baby check-up. You'll miss out on the "labor" component but it would get you some experience as a new grad. Good luck on your job search, it's rough out there.
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Sep 11, 2011 23:59
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leb388 posted:Where are you applying? Don't count on just hospitals. Have you called up pediatric clinics to ask if they need a nurse? I've taken care of babies (just as a babysitter though) and it seems like every two months they have to go to the doctor's office for shots or just a well-baby check-up. You'll miss out on the "labor" component but it would get you some experience as a new grad. Good luck on your job search, it's rough out there. I've mostly been focusing on the hospitals right now because that's where I actually want to work. If this job that I've interviewed for doesn't work out, I will start looking elsewhere. But I've sort of been resisting because I don't want to work in a clinic...I want to work in a hospital! But I have come to the realization that beggars can't be choosers. I'm at the point now where I want a job, any job, anywhere. I just want to work.
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Sep 12, 2011 15:57
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Anyone here have any experience with the field of nursing informatics?
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Sep 12, 2011 19:53
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Hughmoris posted:Anyone here have any experience with the field of nursing informatics? No, but that seems to be the hot field as of late. I'm kind of interested in finding out more myself...
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Sep 13, 2011 05:38
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Hughmoris posted:Anyone here have any experience with the field of nursing informatics? I have 3 colleagues who are starting informatics degrees this year. I suspect it's a bubble. Mangue posted:I've mostly been focusing on the hospitals right now because that's where I actually want to work. If this job that I've interviewed for doesn't work out, I will start looking elsewhere. But I've sort of been resisting because I don't want to work in a clinic...I want to work in a hospital! But I have come to the realization that beggars can't be choosers. I'm at the point now where I want a job, any job, anywhere. I just want to work. Prisons, nursing homes, vaccination drives, blood drives, construction sites, factories, reservations; the list goes on. My employer has over 50 RN openings this week; no external new grads are being considered, but individual managers are (and have been) permitted to hire internal new grads. A curious position for a university hospital with its own school of nursing within walking distance, no? I am precepting a senior student this fall, 24 hours per week through December. It's my first time having a student for more than 2 days, and I'm finding that it's really sharpening my evaluation of my own skills and behaviors, as I'm trying to teach and still set a great example, give my student room to step up while also trying to engineer a few learning experiences here and there. It is also requiring me to pay much closer attention to my tongue, as I occasionally need to explain to my student "the night RN hosed this up" while ensuring the patient & family hear "we need to make a small adjustment to correct this."
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Sep 13, 2011 13:18
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Just out of curiosity (because I have no plans to relocate) but is the job shortage just a grad thing or would I have just as much trouble finding employment in the States as an experienced ER nurse with post grad qualifications?
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Sep 13, 2011 16:52
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Pretty sure it's just a new grad thing.
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Sep 13, 2011 17:21
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My significant other is a PA, and she's found that while there are plenty of jobs in Southern Cali, they either require much more responsibility than usual, or pay less than they should. It's a bit of a buyer's labor market. She has plenty of offers that undercut her current salary but want her to do more things like taking blood, vaccinations, etc that are generally done by MA's in her current clinic.
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Sep 14, 2011 01:16
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Mangue posted:Pretty sure it's just a new grad thing. In my area, hospitals are doing massive layoffs, and a lot of experienced staff are having to look for new jobs. New grads are getting hit the hardest, but it's not limited to them.
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Sep 15, 2011 01:59
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leb388 posted:In my area, hospitals are doing massive layoffs, and a lot of experienced staff are having to look for new jobs. New grads are getting hit the hardest, but it's not limited to them. Can I ask what area this is?
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Sep 15, 2011 02:25
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I'm pretty sure jobs are tight just about everywhere right now. Hospitals may have a need for new nurses, but they don't have the budget to hire. I was lucky enough to find a job as a new grad, but I had to move to a small town to get it.
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Sep 15, 2011 03:35
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Space Harrier posted:I'm pretty sure jobs are tight just about everywhere right now. Hospitals may have a need for new nurses, but they don't have the budget to hire. It's so frustrating because the first thing out of ANYONES mouth when they find out I just got my RN license is, "OH SO YOU MUST HAVE LIKE A MILLION JOB OFFERS 'CAUSE NURSING SHORTAGE, RIGHT?" 
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Sep 15, 2011 22:16
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I might be moving to the D.C. area soon and am looking for jobs but I'm coming from Florida and after looking at rent and cost of living in the area I'm freaking out. I'm in Gainesville now making about 26 dollars an hour but there's no way I could afford to live up there making that much and still be saving and do grad school. Does anyone know about how much nurses make in the D.C. area? I've got 4 years experience med/surg, 1 year teaching experience in a nursing program and a bachelors. For the record I'm not in it for the money but drat if I'm not looking at rent and thinking I'll have to choose between having a roof and grad school. Just looking for general med/surg floor type stuff.
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Sep 16, 2011 01:03
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Hughmoris posted:Can I ask what area this is? Western MA. At least 3 hospitals have done layoffs within the last 1-2 years, some doing repeated layoffs or hiring freezes.
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Sep 16, 2011 02:30
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Hot Dog Day #31 posted:I might be moving to the D.C. area soon and am looking for jobs but I'm coming from Florida and after looking at rent and cost of living in the area I'm freaking out. I'm in Gainesville now making about 26 dollars an hour but there's no way I could afford to live up there making that much and still be saving and do grad school. Does anyone know about how much nurses make in the D.C. area? I've got 4 years experience med/surg, 1 year teaching experience in a nursing program and a bachelors. For the record I'm not in it for the money but drat if I'm not looking at rent and thinking I'll have to choose between having a roof and grad school. Just looking for general med/surg floor type stuff. I really don't think the increase in pay in DC will offset the cost of living in it sadly. Don't go to D.C., it's the devil's armpit
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Sep 16, 2011 20:52
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I might be going to Scotland next year for nursing (might) does anyone know anything how nursing education is there? like very generally, obviously. In Norway I feel like it's very focused on geriatric nursing and not on, well, what I like doing which would be to focus more on trauma and suchlike. I've heard that in England the nursing students specialize more, and I was wondering if there's something like that in scotland.
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Sep 19, 2011 00:44
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Jiriam posted:I might be going to Scotland next year for nursing (might) does anyone know anything how nursing education is there? like very generally, obviously. In Norway I feel like it's very focused on geriatric nursing and not on, well, what I like doing which would be to focus more on trauma and suchlike. Are you a first year student? I agree that the first year is very weighted towards the elderly, but I feel it's to be expected since the first clinical is at a nursing home and the majority of patients in hospitals are geriatric as well. I'm in the second year in Trondheim now and it's completely different. We've only been focusing on psychiatry and surgery, including trauma, since we'll be doing 6 months of clinicals at St.Olavs hospital. The first year can be a massive drag, but if you get through it there is a lot of cool stuff waiting.
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Sep 20, 2011 21:02
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nordavind posted:I agree that the first year is very weighted towards the elderly, but I feel it's to be expected since the first clinical is at a nursing home and the majority of patients in hospitals are geriatric as well. This is true - you're likely to encounter some portion of aged care regardless of where you study, unless you happen to be doing a psych speciality course, for instance. The fact is, most Western countries have an ageing population, and even if all your patients aren't going to be over 80 with senile dementia, some will be. It's much like doing a psych placement - even if you work on a general med/surg ward, you're going to run into psych patients occasionally, and you need to be prepared to manage them appropriately. Additionally, doing aged care generally gives you a pretty solid foundation of 'basic' nursing care, which is arguably one of the more important aspects of your job. It's all good if you can manage complex trauma patients with 15 different medications and several concurrent infusions without breaking a sweat, but what's the point if you leave them lying in their filth all day? I got 'lucky' in that I was in a very small group of students that didn't do aged care as our first placement, but I missed out on practising most fundamental skills until my third year, which made me constantly terrified for when I would have to give someone a wash or whatever. It's probably much better to get it out of the way as soon as possible. As for your question, Jiriam, I'm pretty sure Scotland and most other UK countries follow a similar structure, in that you can do either general, psych, or paediatrics. You wouldn't be doing specific adult specialities in great detail until post-grad. Obviously you need to research specific universities before you commit to moving.
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Sep 21, 2011 04:20
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How's the situation for nursing grad school in the UK (primarily focused on Scotland)? Worth it, or should I stick with my original plan of getting it in the good ol' US? I'm looking to do something in the Clinical Nurse Specialist field, maybe with GI diseases.
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Sep 22, 2011 22:39
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Asclepius posted:in that you can do either general, psych, or paediatrics. You wouldn't be doing specific adult specialities in great detail until post-grad. Side note. I'm in my senior year of BSN and doing research. Is that how pediatrics is spelled in Europe? I seen it today spelled that way on a research article and my group dismissed it as a typo. Starting at a nursing home was a good to get us acclimated in communicating to the geriatric population. In the U.S more than half the clients on med/surg we get are older or have some type of psychiatric disorder. We pick our own assignments on med/surg now and I usually take the older or psychiatric clients. They provide a good challenge and have multiple diagnoses with a ton of meds.
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Sep 22, 2011 22:42
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I've been lurking here for a while. I just got accepted into Pitt's accelerated 2nd degree BSN program so I will start in January. Anyone else completed this program? I'm looking forward to it; I have really been enjoying the prerequisite courses. After that it's the ICU and then off to an anesthesia program.
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Sep 23, 2011 15:40
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Private Label posted:How's the situation for nursing grad school in the UK (primarily focused on Scotland)? Worth it, or should I stick with my original plan of getting it in the good ol' US? I'm looking to do something in the Clinical Nurse Specialist field, maybe with GI diseases. You talking about post-registration training? Most nursing schools/universities do a lot of nursing related masters degrees and phds based on various fields, and there's other post-grad training you can explore like the nurse practitioner role or becoming a nurse prescriber. The NHS is in a bit of trouble at the minute, so jobs (in England at least) are thin on the ground in speciality areas, but not so bad that you couldn't find a cushy job somewhere if you are motivated enough and not dead set on a particular hospital/area to work in. To reverse this, MY GIRLFRIEND and I are interested in spending a bit of time in Norway after we qualify working as nurses, and we were wondering if anyone has any advice (apart from learn Norwegian :P).
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Sep 24, 2011 10:08
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Asclepius posted:The most recent best practice, as far as I'm aware, is the ventroglueteal site. Get the patient comfortable, lying down on your non-dominant side. You place your hand (non-dominant, should be the hand opposite to the leg facing you) on the greater trochanter of the femur, stretch your index finger to the anterior superior iliac crest, and slide your middle finger open as much as possible. This gives you a triangle which goes into an area without much in the way of vessels or nerves, and the amount of adipose tissue is usually fairly consistent between people, minimising accidental subcut injections. Don't forget to aspirate.
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Sep 26, 2011 09:52
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Risky posted:Don't forget to aspirate. Really? I did some research on this a while ago and just about every piece of evidence said don't even bother. It increases pain with injections and isn't a reliable indicator that you've penetrated a vessel.
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Sep 26, 2011 17:43
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Space Harrier posted:Really? I did some research on this a while ago and just about every piece of evidence said don't even bother. It increases pain with injections and isn't a reliable indicator that you've penetrated a vessel. Yeah, I'm currently in nursing school; we've just learned injections and my instructors all said not to aspirate for those reasons. After lurking in this thread for over a year, I can't believe that I can finally say I start my first clinical rotation in two days! I'm equal parts excited and terrified.
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Sep 26, 2011 18:13
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Best practice and hospital policy so rarely go hand in hand.
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Sep 26, 2011 18:15
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My instructors really hammered it into us that you need to aspirate.
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Sep 27, 2011 01:18
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Yarbald posted:My instructors really hammered it into us that you need to aspirate. Same here and I only graduated a year and a half ago... You would fail the clinicals if you didn't aspirate for IM. Zeo fucked around with this message at 05:07 on Sep 28, 2011 |
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Sep 27, 2011 01:35
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ApplePirate posted:Yeah, I'm currently in nursing school; we've just learned injections and my instructors all said not to aspirate for those reasons. First year nursing student represent! I learned in my clinical skills classes that for subcutaneous aspiration was not necessary and not recommended but that for intramuscular injections it was recommended. 23 Skidoo fucked around with this message at 05:26 on Sep 27, 2011 |
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Sep 27, 2011 04:52
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Yarbald posted:My instructors really hammered it into us that you need to aspirate. Number of times I aspirated while doing an IM: once, during skill check off.
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Sep 28, 2011 04:49
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Baby_Hippo posted:Number of times I aspirated while doing an IM: once, during skill check off. Not even at clinicals? We're giving flu shots tomorrow and we were reminded again today to aspirate.
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Sep 28, 2011 05:09
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ICU RN here. Get used to completely conflicting and contradictory medical information from several different sources throughout your career. Welcome to medical!
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Sep 28, 2011 05:28
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Jim Jones posted:ICU RN here. Get used to completely conflicting and contradictory medical information from several different sources throughout your career. Welcome to medical! I know you don't do a whole lot by the book, but couldn't doing an IM without aspirating cause an OD if you've hit a vessel?
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Sep 28, 2011 21:59
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Just like you should always come to a complete stop at a stop sign during a driving test, you should strive to do things as close to by the book as possible while you're in school. Realistically, however, aspirating before an IM injection is not something I concern myself with very much. No large blood vessels exist at recommended injection sites, and given the size of the needle coupled with the 90 degree injection angle renders the actual possibility of injecting into a blood vessel to be insignificant at best. The CDC and Advisory Committee on Immunization Practices do not recommend aspiration as well.
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Sep 28, 2011 22:48
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