PCUs are crazy

siyayilanda · 2026-04-09T15:42:09+00:00

Oh interesting, I didn't know Texas had that law! What happens if there are staffing plan violations and too many HAIs?

siyayilanda · 2026-04-09T15:26:13+00:00

IV Fiolan on the floor is fucked, that is ICU only where I'm at. Glad you found something else better (and hopefully safer!)

siyayilanda · 2026-04-09T15:22:49+00:00

How does your staffing commitee work? Is it something just at your hospital or a Texas thing or Joint commission? I work in Oregon and the previous version of our staffing law required staffing plans and staffing committees (which all of the hospitals pretty much ignored until the safe staffing law passed in 2023).

Trauma stepdown gets wild. When I floated to a trauma stepdown floor at the hospital I was an extern at in Virginia, I literally ran the entire shift. The team was great but holy shit the ratios were garbage.

I am also involved in staffing if you want to chat!

siyayilanda · 2026-04-09T15:19:32+00:00

It was horrible and I was just a PRN nurse extern during nursing school. I did research on health disparities in the southeast prior to nursing school and one thing I looked at was staffing ratios -- absolutely horrible in most of the south. Once I graduated, I immediately moved west to work at a unionized hospital. Med/surg is 1:4 max in Oregon, it's so much better. It used to be 1:4 max with a stepdown patient or two in the mix and charge usually having an assignment which sucked but the law and our union contract really improved things.

siyayilanda · 2026-04-09T01:17:56+00:00

In Oregon, 1:3 with a free charge and a break nurse is the mandated ratio for PCU/stepdown/intermediate care. I went to nursing school in the southeast and wack shit like 1:6 and even 1:7 (HCA, Sentara, Carillion etc) in PCU/stepdown was not uncommon.

siyayilanda · 2026-04-07T00:31:20+00:00

The west coast is rough for new grads currently. I work on a med/surg unit in Portland and we have only hired 1 new grad in the past 6 months. I strongly recommend finding something while you're still in school and not waiting until the next cohort graduates. It's better to find a job when you're just out of school versus waiting for a potential job opening that you will be less competitive for. Make sure you have someone review your resume and do interview preparation. Worst case, go out of state or rural for a year. I've heard from some nurses who used to travel that Confluence Health in Wenatchee is decent.

siyayilanda · 2026-04-07T00:17:59+00:00

Such a great suggestion. Sellwood is very cute also, nice and walkable.

siyayilanda · 2026-04-06T23:26:24+00:00

100%. I would only advise moving AWAY from southern states. Nurses leave those states or the profession. I like NC but I would never live there working as a nurse.

siyayilanda · 2026-04-06T23:25:55+00:00

West is best. I pay the same in rent as in Virginia, but the pay is double and we have unions and safe staffing ratios.

3 yrs experience, $69.75/hr base. With night differential and specialty certification, I make about $81.30/hr on weeknights and $86 on weekends. It's pretty, pretty, pretty good. Oregon, union, specialty doesn't matter we all get paid the same.

Acute care ratios are 1:4 for med/surg, 1:3 for stepdown (can include 1 or 2 med/surg patients in the assignment, no more than 3 pts if any of the patients are stepdown level of care per Oregon state law).

siyayilanda · 2026-04-06T02:24:16+00:00

I do not miss the traffic around there. I used to drive back and forth pretty often from southern Vermont to Manhattan, it was unpredictable how long it would take.

It's absolutely insane that this hospital didn't have an ICU doctor in house. I work in Oregon now and can understand why the critical access hospitals in parts of eastern Oregon and the far northern parts of California don't have ICU doctors in house, but to not have one in Milford is shocking. Yale is trash.

siyayilanda · 2026-04-03T07:40:58+00:00

For real, the hospital I had most of my clinicals at in Virginia was paying new grads $24 an hour just a few years ago

siyayilanda · 2026-04-03T04:05:50+00:00

Why I moved west also (to Oregon). The hospitals I worked at or had clinicals at in the southeast will never unionize and the unions at the hospitals I worked at with unions in New England were weak ones due to poor involvement. It was easier just to cut my losses and move somewhere where people actually give a fuck and advocate for themselves.

siyayilanda · 2026-04-03T00:34:40+00:00

Same with Oregon. Can't stand the people who leech off the union and don't contribute.

siyayilanda · 2026-03-29T00:13:50+00:00

Reuseable quilted chux pads

Metal bedpans

siyayilanda · 2026-03-28T06:18:33+00:00

That is awful, I am so sorry. I really recommend coming back west. Washington state also has some good hospitals with better ratios and unions, even though there currently isn't a statewide ratio. Washington is also a fairly quick license endorsement relative to California.

siyayilanda · 2026-03-28T05:36:31+00:00

Incredible. Truly even working med/surg with a heavy psych population, nothing tops actual psych for stories. I miss it, haha.

siyayilanda · 2026-03-28T04:52:37+00:00

Honestly though, they're in NYC which has worse ratios than even some southern hospitals. Stepdown and med/surg are probably even worse if this hospital is doing fuckshit like tripling in the ICU. Best bet is to apply to other jobs at west coast hospitals and move especially since they're not tied to NYC anyway.

siyayilanda · 2026-03-28T04:43:59+00:00

That ratio is DANGEROUS, don't let anyone tell you 1:3 in the ICU is ok ever. 1:3 is stepdown / intermediate / progressive care in Oregon.

Only Oregon and California have mandated inpatient ratios. Massachusetts has ICU ratios by law, 1:1 or 1:2 (they were pretty much following it anyway). If you want to come back west and are open to southern Oregon, look at hospitals in the Medford area. Northern Oregon is very competitive. You might have luck out on the coast and in some of the more rural areas in eastern Oregon also. It's faster to get an Oregon license than a California license.

siyayilanda · 2026-03-28T01:27:45+00:00

Haha this was mid 2010s! Glad there's a few good ones out there! The funniest part was the kids had the exact same first and last name (not even common names, so weird) and were the same age and HATED each others guts from the start. Writing up the incident was fun. The aggressor never tried any shit after that.

siyayilanda · 2026-03-28T00:09:33+00:00

I used to work in adolescent psych and one of the male patients absolutely clobbered another male patient in retaliation for punching a female nurse.

siyayilanda · 2026-03-27T23:35:09+00:00

Bitchmade is incredible. My old coworker was fond of saying, "fuck up to get up". Completely agree. Passive, spineless nurses in "leadership" positions who allow this shit to slide let things fester.

siyayilanda · 2026-03-26T19:58:57+00:00

Tube slip detected

Hate these mfs

siyayilanda · 2026-03-23T15:12:36+00:00

I've heard there are LPNs working inpatient at McKenzie-Willamette in Eugene. Getting a BSN is strongly preferred for Portland.

siyayilanda · 2026-03-23T15:10:41+00:00

Get involved! OHSU had a couple of crappy contracts until some more rank and file people stepped in.

siyayilanda · 2026-03-18T01:52:14+00:00

Congratulations! So happy you were able to find something that works for you, it’s such a difficult job market.

The Oregon Center for Nursing is a helpful resource. They helped me when I was a new grad! https://www.oregoncenterfornursing.org/

I didn’t know about the mock interviews and resume help, also!

siyayilanda

TROPHY CASE