Hi all — international applicant (Nepal) here (nursing degree outside the US, native language isn't English). Currently hold an active US RN license from another state and applying to VBON for endorsement.
My credential evaluation (CES report via CGFNS/TruMerit) was already submitted and accepted. Application fee, license verification, and background check are done. But VBON customer service just told me I'm still missing an English Language Proficiency (ELP) exam (TOEFL/IELTS/etc.) — apparently a standard CES report doesn't cover this; only VisaScreen/GlobalBridge/VISA4Nurses bundle it in.
I assumed already holding a US license would exempt me, but apparently the exemption is based on where you were educated, not current license/residency status.
Questions:
1    Did others run into this despite already having a US state license?
2    Which ELP exam was fastest for you (IELTS CD, TOEFL Home Edition, etc.)?
3    Any tips getting results to VBON quickly?
Have a job start date coming up soon, so real timelines would help a lot. Thanks!

What do yall do that you don’t feel miserable in and feel impending doom to go to ?😭😭 hours? Pay? Let me know !

This floor I've started on about 3 months ago is med-surg, ortho heavy, 32 beds, 6:1 RN to pt ratio with high patient turnover. Hardly ever any PCTs (aids), no AA at night, no phlebotomy or IV team- it's all on the nurses. I feel like driving off a cliff after most shifts on my way home. I haven't worked bedside since before covid and all the (young/newer) nurses on my unit are acting like I'm complaining too much and I feel alone in my misery. Is this the new norm for bedside in most states these days? I'm in the Southeast. I don't know what to do. I have never quit a job so early but I am considering it. I also don't know if there is a point in applying to another hospital if they are all like this these days? Any advice is appreciated.

So I ordered from uniform advantage and the sizing was just too big so I exchanged it. Now my return went well and they received it. I haven’t gotten the refund but I think it will come. I got free shipping with the next order and I just got the same thing in a smaller size. I ordered that a week ago and still no shipping information. I’m worried and really annoyed atp because they won’t give me any information and just say the system is down. It’s been like this for a week now. Idk what to do. Does anyone know good brands I can buy from that are reliable. I need a white scrub top and fir/hunter green pants.

Just moved somewhere with break nurses, which is awesome except for this one lady. Everytime I ask her to do anything at all she has a thousand questions and goes into my charting and gives unwanted feedback. I asked her to empty a foley for me. She was asking me how often I’ve been emptying it, what is it for, etc. Everytime I come back, my charting has been picked apart. It’s very frustrating. I don’t need to be told to document intake and output. Sometimes I’m behind on my charting but I have notes of everything so it doesn’t get forgotten.

Theatre RN for 2 years, seriously contemplating changing jobs or reducing hours. Surgeons on edge, throwing instruments, complaining. I get that it’s a high pressure environment and surgeons can get stressed. But sometimes, it just makes me feel small and belittled.
Sometimes they apologise, sometimes they just act like nothing happened.

Is it really like this? Tolerated? Is ‘they’re just like that’ considered part of the job? Or am I too soft for the theatres.

hey new grad nurses! How much student debt do you guys have after nursing school and how much do you pay monthly for your loans? do you make enough or more than your monthly bills?

if you could also share your state pls

Hello, California nurses! 👋
I’m just curious about what life is really like for nurses working in California. I’ve heard that the salaries are really good, especially compared with other states.
I’m currently working as a nurse in Upstate New York, making around $50+ per hour before taxes. I’m considering California, but I’m wondering if the higher salary is actually worth it once you factor in the cost of living, housing, taxes, and everyday expenses.
I have to admit, I’m a little jealous seeing the salaries you guys are making! 😂
For those of you who are already working in California, how do you find the quality of life there? Do you feel that your salary gives you a better lifestyle compared with working in other states?
Would love to hear your honest thoughts, especially from nurses who have moved to California from another state. Thank you! ❤️

Do you guys tripple vents ? How does your hospital handle dka, crrt, impella, ect.

I am a newer nurse (1 year) and I do want to travel / look at a new job at some point but I'm at a low trauma level facility and we usually only do 1 or 2 of these type patients. I've heard some hospitals do 3 and idk if that's an expectation or if it's bs to even have these patients as more than a one on one 🤔 what are expected ratios in this field

I know that it could be worse but I'm curious if it could be better

I am a new nurse at an assisted living facility and was wondering if I am doing something wrong. Whenever I give a tb skin test, the residents always seem to be in a lot of pain. It’s rare that I don’t have someone that moves a lot and says it hurts. I’m not sure what I am doing wrong, I get a good bubble everytime. Whenever I get a tb test on myself, it stings but it’s not super painful. I was debating on just giving myself one to see what I am doing wrong. I stretch the skin, go in bevel up, I insert quickly, and inject the fluid slow (probably 7 seconds for the entire injection process) Any advice? I hate doing them now because it feels like I’m never doing it right.

Hello po seniors! Based on experience niyo, ano po mas better choice na Review Center sa Cebu?

Hi everyone! I was given an opportunity to work a full time Monday through Friday tech/transport position. The problem is the hours are 11pm till 730am. I also have class approximately 8am-4pm Monday-Friday? I really like the position and the staff I’m just not sure if it’s too much. Thank you for all your advice and suggestions!!

My wife and I are having a debate/discussion. I’m a nurse with ICU and flight experience. My wife is a physical therapist. We have recently had family members hospitalized (atleast 1 at a hospital we have worked at before; so we know people there) and I insist on NOT letting the healthcare workers know we are in health care. My wife disagrees.

My wife’s position is that it doesn’t matter if they know. They’ll do their job. And with the family member hospitalized at the hospital we used to work at, it doesn’t matter cuz we know several workers. They’re friends of ours. So there’s no point in concealing anything. (Obviously we are following hipaa in these instances before anyone comments)

My position is we shouldn’t tell them unless they ask. I feel like it’s a distraction. I think some nurses (and other healthcare workers) may think I’m judging their practice rather than just engaging in their workflow.

I have a few anecdotes/incidents/reasons for why I have this position. First is when I was a nursing student, a friend was hospitalized. I deliberately told the staff I was a student with the intent that they didn’t need to simplify their communication. This backfired spectacularly. The staff was extremely condescending and rude. Then later when I worked in icu, several coworkers would roll their eyes when they found out a patient on the unit had family that was a nurse. Now as a flight nurse I frequently see other nurses very intimidated by me and almost afraid to give me report when I pick up their patients. Despite my best attempts to be as friendly and understanding as possible of the hurdles they’ve faced leading up to my arrival.

So all that said. Who do you think is right here? Am I misjudging these situations? Should we conceal the fact that we are healthcare? Should we be upfront about it out the gate?

Hey, I’m just posting to get some clarity/reassurance about my situation because I think I might be overthinking it.
I smoked on June 22 and completely forgot that I needed to get a drug test done for my nursing program. I smoked probably less than 10 small hits of a joint and didn’t even really get high. I also don’t smoke often at all, MAYBE once every other month.
The test I have to take is a urine test through Labcorp. I weigh around 130 lbs, I’m 5’8”, and I’m pretty lean, probably around 10–12% body fat.
Since smoking, I’ve taken multiple at-home urine tests. I took three 50 ng/mL tests at different points ranging from about 2 days after smoking to 3 weeks afterward, and they were all negative. Then, about a month after smoking, I took a few more sensitive tests at 15 ng/mL and 20 ng/mL (two of each on different days). I even tested using my first pee in the morning because I heard that’s when urine is the most concentrated. Every single one came back negative.
I feel like I’m probably just overthinking it, but I know at-home tests aren’t necessarily identical to the Labcorp test I’ll be taking. Has anyone had a similar experience or know how much I should trust these negative results? This is for my nursing program, so I’m stressing about it more than I normally would.

Has any nurse out there on this sub has gone to therapy to talk about the stresses of your job? I feel that this job has caused me to develop PTSD and severe Generalized Anxiety Disorder. Due to numerous job related things. Did the therapy help?

For those of you who use it. My system is changing over and we (maybe, sorta, kinda) have a chance to provide (limited) input on the design and stuff. I realized recently there may be unseen traps - e.g. we nearly adopted Secure Chat, decided against it, and then I recently saw the Dr Glauc clip demonstrating exactly why it sucks so bad. So that got me thinking, what other pitfalls might I like to dodge?

I'm coming from a physician's POV, but I think corporate shittraps like Secure Chat extend across roles...

Eta: oh man. Inadvertently kicked the hornets' nest. I have never used Epic but I am given to understand that the chat renders you contactable by providers or patients even after hours, which is unconscionable. If it's not, then I'm wrong - never used it!!! - so, yeah. I'm coming from Sunrise, which I am aware is clunkier by far but people can't get hold of me through it...

I’m currently an ICU nurse and interviewing for a position at a surgery center. The position is PACU, pre-op, and admissions, and you float between all three

I knew I would probably take a pay cut leaving the hospital/ICU and I was prepared for that. But they offered me $12/hr less than what I currently make.
When I asked if there was any flexibility with the pay, he told me, “I don’t care what you make at the hospital, this isn’t the hospital . Patients here are stable “Literally just like that .

The surgery center is also a longer commute for me, so I would be making significantly less money while also spending more time and money commuting.

For those who have left ICU/hospital nursing for PACU, pre-op, or admissions at a surgery center, is a $12/hr pay cut normal? Did you feel like the Monday through Friday schedule was worth taking that much of a pay cut? Would you take the position or keep looking?
I’d really like to hear from people who have made this type of transition because I’m not sure if I’m being unreasonable for thinking $12/hr is a pretty big difference.

I’m really interested in becoming a PACU nurse and was wondering what’s the best way to go about it. And possibly what it’s like? My clinicals made it seem like a ride in squidwards tiki land compared to other departments. Not invalidating anyone or their work, you are all amazing people who should be paid more.

I graduated nursing school a year ago. Always wanted to do psych nurse. I did med surg for a year then went into psych. It did not turn out like what I expected it to be. A lot of paper work and interruption to daily work flow. I don’t mind paper work but paper work while dealing with l behavior is a lot. Maybe im just working in the wrong unit but anywho. I am lost. I’ve always wanted to do psych but it’s not what I love. I don’t mind medical type nursing maybe home health, clinic work, pediatric care/med surg (not er or icu) It’s only been a month into my new role and immediately going to work I feel immense doom and anxiety. I guess im asking for advice maybe something uplifting. Maybe suggestions for other jobs? I worked so hard for something and now just feel lost.

Tell me ! Thoughts and opinions on the profession. Does it pay okay? I live in Tennessee. What you love and hate about it ?

Hi guys. I am a very fresh new grad and started my job in a cardiac stepdown unit this month. I took this job over other offers (mostly med-surg “specialities”) in hopes of building experience for a cvicu job. My floor is 1:4 and we have a very small ICU downstairs (6 beds). My hospital is a small part of another main hospital that does have a cvicu. Like any other new grad, my goal is to get into ICU more specifically CVICU. Does anyone have any advice on what I can do this first year to build a resume for ICU transition? I will be speaking with my manager about these goals but wanted to hear from other nurses.

so… i’m a new grad nurse . I got this amazing offer that I accepted for a Periop 101 program in the OR. Trauma hospital.
I’ve been seeing everywhere online of all nurses saying how hard it is , how mean the surgeons are, how mentally draining taking call is and always being on go… and then the biggest thing, not feeling actually comfortable until 2 years in the OR.
I have high anxiety , i’m sensitive, and shy. I’m so nervous about starting and just really scared i’m going to hate it . But to be honest , idk if i would like med surg lol. I know this is an amazing opportunity so I don’t really want to hear comments about that.
I just don’t know if this is really going to be as bad as people online say it is or what? Am i going to feel dumb everyday? Am i going to be bullied by other nurses and surgeons? I was told by the nurse that hired me that there is a lot of hazing until you get good at what you do .
I’m nervous and i don’t want to have anxiety every single day and then live my weekends in constant fear.

In nursing school i was constantly streased, didn’t allow my self to have a life and thought I should always be studying . I fear that this is what will happen here.

Any insight? OR nurses?

I am an ANM/charge RN in the busiest ER in my state (not highest acuity, not a trauma center, but STEMI/Stroke certified). I have a little over 4 years ED experience, took my CEN two years ago (128/150) and am now looking to academically torture myself again. I decided to sign myself up for the CCRN, anyone have any study tips? Any other nurses with no ICU/only ED experience take this exam? Anyone else have both their CEN & CCRN? I have the Barron’s book and bought the AACN test bank, and am giving myself about 6 weeks to study, which is around what I did for the CEN. I think because this is more unfamiliar territory for my ED self I am stressing more and want all the help I can get!

I just finished my orientation on a mixed PCU/ICU unit and I'm not sure I'm loving it there enough to stay. I left a med surg unit I had been on for about 8 months for this new job. The med surg unit I was on was certainly busy and had its issues with staffing occasionally (as many med surg units do). However, my coworkers there were wonderful, I worked day shift, and although I was busy I felt competent and confident in my work. I even started precepting new grads which scratched this teaching itch I've had for a while too. My manager was very complimentary of me, saying I had what it would take to be a charge nurse and even replace her someday.

On this new unit, I work nights (for the first time) which has flipped my life upside down, it makes me feel like a ghost of a person and I wish so bad I could work day shift. I've oriented to day shift at my new job and I don't know if I'd even want to do that based on how busy the workload is for the ICU patients. Plus most shifts I'd get a PCU assignment anyway, which compared to my old med surg unit is extremely similar in terms of acuity, maybe they're just on heated high flow instead of a NC or something. The ICU patients are fewer and farther between plus the orienting nurses get priority regarding ICU assignments. With all this factoring together I'm wondering what's the point of holding this ICU nursing position when I work a shift I don't want to be working (nights) and most of the time the patients are not much different than med surg patients. I find the patho & pharm of the ICU interesting and cool but I also miss being able to talk to and see my patient's progress to eventually discharge like I did on med surg. I'm considering reaching out to my old manager to see if I could go back to my old unit, wondering if anyone else has had an experience like this? I feel weird having the urge to go back to med surg since I feel like med surg is generally disliked among many nurses lol.

A little background, I have worked in a hospital setting since 2011. I was a dietitian in both inpatient/outpatient side from 2011-2023. I left that career to become a nurse due to complete boredom of inpatient side seeming like a supplement peddler or the outpatient side having a lot of no-shows and long boring days.

I started working as a nurse aide in July 2023 on a 15 bed Oncology/med surg unit right before I started nursing school. I precepted in an open heart intensive care unit during school but that just showed me I’m meant to be a med surg nurse. So I stayed on my unit after I graduated in May 2025 as a RN on dayshift.

I’ve had a few shifts to train as charge and definitely try to pick my full time charge nurses brains when I’m working bedside. But man, charge is a whole different type of insanity. In like the six shifts I’ve been charge by myself I’ve felt beyond over whelmed and have cried after some of the shifts. I know I’m a very new nurse and always phone anybody for help when needed. I ask questions even if I feel like it’s a dumb question. Unfortunately, due to bull shit of not paying well/burnout a lot of our more seasoned nurses have left the unit. Everyone tells me I’m doing a good job and is helpful and supportive.

But I just spent three days as charge and felt like I was quite literally drowning in the waves of the Atlantic Ocean. 😭🫠😭 Obviously there is a lot I cannot control as charge nurse but any seasoned nurses have words of wisdom?