So I started working PRN at the ICU where I did my externship. I'll be working 4 shifts a month, which works out to one a week, but it's nice in that I don't have to work them that way, I can clump them if I like.
It works well since the hospital is about 10 minutes from my house, as opposed to 45 minutes minimum to my other job. It also works well considering I have only 6 months experience, 3 1/2 months really if you look at my experience since coming off orientation. Most hospitals around here won't even glance at you until you have one year plus at least. My manager had to go to the CNO to get me approved. It's nice to have people willing to go to bat for you though.
One thing I've learned quickly though in my short career thus far is that experience doesn't necessarily equal competence. This has been vividly illustrated to me a couple of times recently.
This past week I sat through hospital and nursing orientation, (again) at my new job. Part of that orientation process involved a pair of EKG exams. The first of these exams was 15 questions long, but only the 4 lethal rhythms held any point value--25 points each. The other 11 questions weren't worth any points--information not announced to us, but readily available because the computer displayed point values for each question during the exam. The lethals were not difficult. Predictably there were strips showing asystole, v-fib, and a couple v-tach (one even a torsades, but that wasn't even an option to be picked.) Not rocket science, not tricky.
The nurse next to me there in orientation had been quite vocal about her 1 1/2 years of big-time experience at an ED in a medium-size town about an hour away from our metro area. She unfortunately failed the lethal EKG exam. Studied for 30 minutes, and promptly failed it again. Now she has to complete an EKG/Dysrhythmia course, just to keep her job.
Secondly, my wife is currently precepting at work. Her intern is a nurse with 18 months experience up on the floor and transferred into the PICU. But this nurse lacks basic skills like passing meds on time. She's been sent to a couple codes, only to stand around and watch. Even tasks such as recording vitals appears to be beyond her skill-set. In fact, it seems what she's demonstrated she's best at is letting the PICU nurses know, "That's not how we do it on the floor..." The scariest part of this situation is that she's already started her acute-care nurse practitioner program--online of course.
So on behalf of all us with less than that magic bullet of one year's experience... I rattle convention's cage!
Nothing much to say except (maybe?) it sucks to be not very smart?? It IS sort of scary, though.
ReplyDeleteI'm so glad you got this new job. I hope you like it better than where you were working before. How are things going otherwise for you?
Yeah. I think experience is what you make of it. The people that coast along and don't seek out challenges are pretty much gonna stay dumb. Hence why I have to start IVs for the 15 year nurses that can't get them because they've done delegated all their skills away. You're obviously one of those who looks for a challenge, so you know your shit now.
ReplyDeleteOMDG: Haha, I'm just picking up PRN shifts. I still work full time at my "other" job.
ReplyDeleteNNITH: When are you going to change your blog name? You seem kind of past the "new" label...
Orientations, precepting and personal experience vary widely where ever you go. When I was a travel nurse and going to snowbird states in the winter, hospitals opened up whole floors for the winter season, and brought in tons of seasonal staff. Sometimes we were assigned to orient and precept each other.
ReplyDeleteAh, I understand now. So much for 3x12. I still hope it's better than that other place you work.
ReplyDeleteI was actually thinking about that today. I still feel new-ish, but that doesn't really have the same ring to it.
ReplyDeleteYa, very irritating to have those on the floor that don't really know what's going on. They tend to vocalize inversely to the level of competence. It gets tiring being the "go to" person when you realize that's because others are too lazy to learn.
ReplyDeleteIt will be nice to have the other job. I did that for a while (3 different places) and it was a good change. You might find that sometimes 4 per month is a lot.
In my second job we were required to do 2 per month before having to go to "refresher" classes...and sometimes with another full
time job plus family commitments it's a squeeze...