[cassioo]

they've just reinstated our clinical ladder so I'm doing that it's 7% more then base for clinical II and 3% for Clinical 1. Actually your pay is about the same as it is here for 10 years experience. Then we also have the weekend and shift diff, weekend option, if you work straight evenings or nights it's an extra $1/hr, charge pay, and on-call. Or ladder really is much better then it was in years past. We have several catagories and you get points in each one. Only 10% of nurses on any unit can get the ladder. You get points based on educations BSN or MSN, points if you are working on BSN or MSN, points if your certified or working on it, points for CEU's above required for state or certification, have to do minimum 1 inservice with points up to 3 inservices. Points for unit improvements, patient educations handouts, community service, years of service. Before it was a pain in the butt they wanted you to make copies of your charting to show how good you charted (ok chart really well for ladder stuff)writing care plans lots of busy work. Now its not so busy just credit for what you do. I do think the panhandle pay is lower that's where I've been looking just don't see it right now.

[butterflydog]

From what I have found the smaller area's seem to pay less. It also seems that the further south you go in Florida the pay seems to go up. I have friends in south Florida that make a few dollars more than me and a few in Jacksonville that make a few dollars less. (just an observation not really scientific) The beaches hospitals usually pay less too. Our clinical ladder is similar to yours, but any nurse can do it. We also have points for being a resource nurse in different subjects like Diabetes or pain or customer service. At our hospital they are so focused on customer service... it is crazy. I had to code a newborn in a labor room with 15 people (family in the room. We aren't allowed to limit the number of people that are in the room for deliveries for better customer service. You wouldn't believe some of the things they are doing in the name of customer service, it is just crazy.

[cassioo]

we do limit 2 at a time to L&D rooms but today there were 6 in a room. I really don't mind 6 if they are there and helpful to the pt but I do mind just 2 if they are useless and in the way but it really is for safety sake and we use the HIPPA reason too with people standing out in the hall because they don't want to be in when pt's are getting checked and we're small so the rooms all go around the nurses station and you can hear what goes on. Those 6 weren't in my room though I was the c/s, recovery nurse today so I did that today..only 2 but by the time I got the first one in, IV, labs, cath, OR and recovery it was lunch time then another came in 35 weeks with back pain but once on the monitor had 2 minute spontanious dcels so had to do all the getting her ready moved her out of recovery at 1845 so pretty well took up my day.
Are you using the On-Q pain pump for incisional pain? We just started with it today don't see it really being worth much...I didn't have lots of incisional pain with my c/s I couldn't tell anyway with all the uterine pain (no duramorph just pca and old and out of shape did't help either) just looking for thoughts on it for c/s. I hear they help in joint surgery.

[butterflydog]

I agree about the number of people in the room, we are small too, 6 labor rooms, 2 triage, one antipartum. We seem to have family who come and then the pt. doesn't want them in the room for exams and pushing. So we have large groups of people sitting in the hall. Our Nurse manager says she wants to "make them feel at home" so she lets them sit in the halls and wonder around the unit. So much for privacy huh?? We have one doc who uses the on Q pump. I am not impressed, I still see the same number of pain pills being requested. This doc is so conviced it works he sends c/s home at 48 hrs with a script for anaprox !!! I think that is mean. I really like fentanyl epidurals for post c/s like a walking epidural. Awesome relif, they get up and walk and can be pain free for first few days, also less gas. But of course anesthesia doesn't like them because they have to manage them. I was in a lot of pain after my c/s I really felt like I was hit by a mack truck. But after the first couple days I felt a lot better. Its been a loooonnnnggg time tho. It is so funny how similar our units are and so far away, it really is a small world.

[cassioo]

That Q pump ended up being a pain but the doc plans on using it again on Wed for his 2 scheduled sections. The patients gown was wet all weekend and the steri strips and tegaderm wouldn't stick. The patient didn't seem impressed with her pain relief either. This same doc give out Lortab 10, Morphine and Phenergan etc to anyone who's pregnant and say they hurt. He doesn't see how much they hurt doesn't think I guess there should be any discomfot with pregnancy. We have 4 L&D & 2 observation rooms and OR & PACU.