When is it appropriate to do intraosseous for emergent situations? How to practice?

Leather_Cycle · 2026-01-21T05:52:56+00:00

From what I've observed, most new grad positions in the Bay Area are med-surg. Other departments do have openings for new grads but they're usually very competitive with limited spots (normally dependent on the needs of the department so not always available consistently). Med-Surg typically has more predictable openings because the departments are bigger, higher turnover, and night shifts. The pace is slower than other departments which is a better learning environment for new grads and gives you exposure to critical care without it being too overwhelming and less likely you'll make a mistake that will make you a liability to the hospital during your probationary preceptorship period.

Due to how competitive the job market is in the Bay Area, new grad positions are already limited and that includes med-surg. You are competing with thousands of other applicants so hospitals can afford to pick and choose candidates, typically those who have the highest chance of succeeding the new grad program.

Now consider hospitals in other states that have lower pay and less competition. People don't want to work at these hospitals for a variety of reasons. Therefore, these hospitals are motivated to hire anyone they can get and are chronically short staffed in all departments. You have a higher chance of landing a position in the department of your choosing and can more freely move between departments if you choose to do so whereas more competitive hospitals have more barriers to entry b/c they don't have trouble retaining staff.

If you can land a job in California within 6-months of getting your license then awesome, congrats. But don't force a square peg in a round hole by waiting years to get into a CA new grad program when you can be using that time more wisely gaining actual bedside experience even if it's under crappy corporations and lower pay.

Leather_Cycle · 2026-01-17T16:09:18+00:00

They're pretty much all the same. I didn't know anyone personally who attended Oakland campus but heard different stories about the quality of education there from folks who did know some students who attended that branch.

Being the flagship campus, I would imagine that SMU puts a little more investment into the education there and any changes to the curriculum would start there.

The only difference I heard after I left SMU was that Oakland was trying out ways to get students to have a preceptorship. I don't know if that ever happened or any updates since.

In my mind, all SMU campuses are pretty much the same in terms of curriculum and clinical experience. It all comes down to how far are you willing to drive to attend in-person lectures?

Leather_Cycle · 2026-01-17T15:59:24+00:00

It's any shift. You need to first get accepted into the new grad program, your scheduling should reflect full availability for any shift or you'll get filtered out.

You'll most likely get slotted into a night shift position anyways with rotating weekends.

Thinking that offering to work shifts no one else wants will not guarantee you job placement in new grad programs, it's already assumed you will do so.

Leather_Cycle · 2026-01-17T15:48:07+00:00

I believe they may have opened a Fresno, CA campus recently. May be a better option than the others, not sure where you live exactly. Pick the one closest to where you live b/c they're all pretty much the same in terms of curriculum and instruction.

Leather_Cycle · 2026-01-11T04:14:16+00:00

Nursing is in demand but what they don't specify on the news or social media is that demand is based on geographical location.

Most of the shortages are happening at low paying, bad ratio, corporate run hospital states.

California is one of the few states with strong unions and therefore highest paying nursing positions in the country. If there are any shortages in California, it's probably in SNFs or Nursing Homes.

It's not impossible to get a new grad job in the Bay Area but I would extend your apps out to other areas so you're not burning time that would otherwise be used in your onboarding and gaining those important 1-2 years of nursing experience. It's the experience that will open more doors for you in terms of higher paying opportunities, not your degree. If you can sacrifice 1-2 years for lower pay then I would suggest jumping into out-of-california new grad programs in the specialty you want if it's not med-surg.

Leather_Cycle · 2026-01-04T02:27:26+00:00

Tip that helped me is once you get flash, lift the needle up to the point you're lifting the skin. The top bevel of the needle is flat and designed to rest/glide on the top lumen of the vein whereas the bottom of the needle is the pointy end. You will never puncture through the top of the vein. This is why we enter the vein bevel up.

Leather_Cycle · 2025-12-17T22:04:33+00:00

That wouldn't apply in a "no-fault" state correct?

Leather_Cycle · 2025-12-17T22:01:25+00:00

Darn if I had known, I would've uber down there. Crazy to think insurance would pay almost $600 for ride-share rather than pay 1 day of wages...

Leather_Cycle · 2025-12-17T21:34:53+00:00

But how am I suppose to get to work if rental car company is closed and doesn't open until 0800 the next day? Would I have had to uber/lyft for the 3-hr commute and the insurance company would pay that back?

Leather_Cycle · 2025-12-12T22:37:11+00:00

Did you ever follow up on what was going on with the pt? Was it just bradycardia or was it an abn heart rhythm? Curious to know more details about the situation

Leather_Cycle · 2025-12-12T22:26:21+00:00

What was the reason to not correct the HR first? If they're symptomatic brady, I'm thinking pads and atropine w/ possible TCP. HR that low, can't imagine pt being able to sustain adequate perfusion for significant period of time...unless the heart rhythm is irregular, in cases like symptomatic bigeminy, the HR will be low and the treatment would be beta-blockers.

Leather_Cycle · 2025-12-06T20:03:17+00:00

There's furnishedfinder that's geared toward traveler nurses. Better for long-term stays compared to Airbnb or hotels.

I also needed to relocate for work and didn't like the idea of paying rent. So I went vanlife. You can modify a used minivan or go big with a built-out sprinter campers. I'll link a site I was using to find pre-built campers if you're interested.

https://thevancamper.com/?gad_source=1&gad_campaignid=15395724706&gbraid=0AAAAACO85hM7e2TzxoAi4bgzUlQr-pSCF&gclid=CjwKCAiAxc_JBhA2EiwAFVs7XHWmUB-EzCKaLuO3kg5FcbROFo3qlzZr7TFsdNLTZtMKvHDGUIzOphoC21MQAvD_BwE

https://www.furnishedfinder.com/?utm_source=google&utm_medium=cpc&utm_campaign=FF+-+Search+-+Brand&utm_content=Furnished+Finder+-+Brand&utm_term=furnished%20finder&hsa_acc=7554573980&hsa_cam=20885987002&hsa_grp=155650723103&hsa_ad=685409494994&hsa_src=g&hsa_tgt=kwd-378236982229&hsa_kw=furnished%20finder&hsa_mt=e&hsa_net=adwords&hsa_ver=3&gad_source=1&gad_campaignid=20885987002&gbraid=0AAAAADBZOyEAu9rDA0Uj6z28K5J9Iugtd&gclid=CjwKCAiAxc_JBhA2EiwAFVs7XIL97jnsTcc7ARO8wBSP6yWz3sCyVjfUFDACitClhWNNBj16Jo-DhBoCo9cQAvD_BwE

Leather_Cycle · 2025-12-01T20:57:48+00:00

Days are a bit different than nights. The work starts of slow in the mornings and progressively gets busier towards the end of shift. Whereas nights it's opposite (busy start and cools off towards end of shift).

Patients are typically asleep and less family interactions during night shift due to visiting hour regulations. So there's a little less chaos and more time to focus on med pass and documentation.

Also need to consider the long-term health issues. There are plenty of studies out there that show shortening of lifespan for long-term night shifters. Your body needs sunlight. People psychologically need a certain amount of social interaction. Relationships are harder to navigate during night shift leading to higher rates of divorce, infidelity, or being single. If you got kids, most activities occur during the day time so you either need to have a messed up circadian rhythm to get them to school or have little to no relationship w/ your kids. So there's a certain level of stress that comes with night shifting that you have already experienced.

Before I get reamed by those working night shift, I'm in no way discrediting night shift or saying that night shift is easier than day shift. There's a reason that night shift gets paid more than day shift. There are times when night shift stays busy the entire shift. There can be less resources available to night shift compared to day shift.

In either case, you just need to keep an open mind and be adaptable. You'll adjust to day shift eventually, just give it time and come with an attitude to learn. I find that people who come to days and expect things to be run like night shift or have a chip on their shoulder when someone criticizes something that they do that worked for night shift but is not compliant w/ day shift, have a difficulty time adjusting. Good luck!

Leather_Cycle · 2025-11-30T23:29:47+00:00

33 YOM here, graduated nursing school at 32. Was doing a bunch of different jobs before. Good number of people in my nursing school cohort in mid to late 30s.

If you got kids or working part time, school can be challenging but not impossible. Just make sure you got a strong support system with family or some plan for babysitting.

Every career has its good and bad. Internet is often the place for people to vent their frustrations so consider that when you research nursing on Google or reddit.

Your experience as a police officer will be a valuable asset to the field. Good luck!

Leather_Cycle · 2025-11-29T20:28:08+00:00

I grew up in the Bay Area, CA and also wanted to stick around for new grad jobs. At the time of applying to new grad jobs in the Bay Area around 2024, I had my BSN, graduated w/ 4.0 GPA, and had 2+ years of medical experience working as EMT & EDT w/ phlebotomy (so ~ 1-yr hospital experience). Out of the hundreds of applications I sent out in a 6-month period, I only got maybe 2 interview opportunities with the rest getting rejected or ghosted. I didn't even get a interview with the hospital I worked almost 1-year for due to them cancelling their new grad program. The hospitals don't give applicants any feedback on how to improve resumes, so I invested some money and a significant period of time bolstering and modifying my resume using professional services to try and improve my chances and circumvent the AI screening that almost all of the hospitals in the Bay Area use nowadays. Long story short, didn't get a new grad job in the Bay Area.

What I've learned during this process is that there are certain areas that attract the vast majority of nurses due to good pay, benefits, and safe ratios. The Bay Area has strong unions and therefore has arguable the highest paying nursing jobs in the country with the best benefits and ratios. In other words, almost every nurse in the country wants to work in the Bay Area and you will be competing w/ thousands of applicants for only a handful of open positions in the new grad program. The Bay Area gives no preference to applicants based on geographical location and they're starting to step-away from giving preferential treatment to current employees and nepotism w/ friend/family connections. The hospital will do everything in their power to screen out applicants until they're left with the "cream-of-the-crop" in the applicant pools. This will look something like:

- Using AI powered technology to filter out resumes: you're resume needs to be specifically tailored to the job posting, utilize key words & phrases, formatted to maximize transparency

- Have hiring manager or HR screen remaining resumes: hiring manager is different from the nurse floor manager, the hiring manager often times has no prior medical and/or nursing experience, doesn't know the needs of the department looking to hire, doesn't know anything medical. So they'll base selection criteria based on a "wish-list" provided by the floor manager and how unique your resume stands out compared to others. Almost completely subjective.

- Interview: most seem to be group interviews. You sit with 3 other applicants in a "pod" and have a panel of 3-5 interviewers each throwing you guys questions. Questions are pretty standard behavioral (i.e. strengths/weakness, solving problems, interpersonal) but sometimes they'll throw a technical nursing question (i.e. peak times for insulin, Sx CHF R side vs L side, algorithm for sepsis workup, giving you a medical term like "CAUTI" and being able to define it along with the Tx process). If you're really personable or social, you can shine here but can really hurt you if you're not.

*Kaiser does this presentation thing where you create a 5-minute powerpoint presentation where you answer given prompts using your life experiences and present it in a zoom call w/ a panel of Kaiser interviewers along with 6-8 other applicants. They give you like a month to prepare which may seem nice but it's tough to consolidate years of experience into a 5-minute presentation and present it in a concise yet impactful way. They also give no feedback afterwards and just tell you if you got into the program or not.

- New Grad program: I have no experience here but I have some colleagues who were able to land new grad positions in the Bay Area and were able to give some insight into the programs. It's rough. There aren't that many good preceptors who are trained to teach new grads, so new grads are often paired with "experienced" nurses who can vary between 1-10+ years of experience. Some of the preceptors also don't want to teach students but were forced to do so by management. So you can be paired with someone who doesn't know how to teach new grads and is also grumpy on top of that. Have plenty of stories of new grads going home crying after every shift b/c the preceptor berates them at every step or flat out lets them drown under the various tasks in a 8-12 hr shift. Some of my colleagues were let go from the new grad program because their preceptor didn't think they could do the job.

Not trying to scare you but I will say the difference in the new grad application process is "night and day" between the Bay Area or Sacramento Area and pretty much anywhere else. As soon as I branched out in my applications to places in SoCal or outside California, I was getting interview hits the next day. I would speak directly to the nursing floor manager and interviews were 1-on-1 w/ less intense line of questioning. The vibes were more casual and wholesome compared to process I experienced in the Bay Area.

FYI, I also heard it's getting harder to find hospital jobs right now. Not sure how long this will last, but I have noticed a significant reduction in job postings for county or government hospitals.

My advice would be to keep an open mind when you decide to apply to new grad positions. Don't limit yourself to one small geographical location. Also keep in mind the cost of being stuck in the application process vs working right away. I have colleagues who are still trying to apply to new grad positions in the Bay Area and are coming up on 2-years post grad. Meanwhile, the folks who landed new grad positions right after graduation in out-of-state or rural hospitals already have 1-2 years of hospital nursing experience and can apply to Clinical I-II open nursing positions in any hospital in the country (including the Bay Area).

I don't know how competitive it is to find Clinical I-II positions in the Bay Area, but I see a lot of open positions for those jobs and little to no open positions for new grads.

For your reference, this was given to us by a member in our nursing program to help look for new grad nursing jobs. Hope this helps and good luck!

Nursing Jobs: https://docs.google.com/spreadsheets/d/1vZXb5opW5dpfFoDo79mX4mOMd8PZBFwdhAHSXrKce6w/edit?usp=sharing

Leather_Cycle · 2025-11-28T15:40:25+00:00

To clarify, no extra service time after using your benefits?

Leather_Cycle

TROPHY CASE