Latest Comments by Jolie

Jolie 27,672 Views

Joined Oct 17, '01. Posts: 9,502 (48% Liked) Likes: 13,563

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  • 0

    Generally speaking, terms of endearment don't bother me. But I had to peel myself off the ceiling today following a phone call from a representative of administration at a local hospital.

    A family member is being treated there and had an outrageous encounter with a hospitalist physician, which I witnessed. I was too flustered to address it right then and there, so I called the Patient Advocate Hotline when I got home, reached someone's voicemail with a cheery message that I would receive a return call within 24 hours. Today (2 days later) I called again and got a live person who took my information and informed me that someone would promptly investigate and get back to me. Yeah, sure.

    But throughout the conversation, Ms. Perky kept referring to me by a cutesy version of my first name. A version I. NEVER. USE. Even if she misunderstood the pronunciation of my name, there is no way she would have come up with this name. Perhaps it was compounded by my utter exasperation at the situation that prompted my call to the hotline in the first place, but I wanted to reach thru the phone line and choke her. I probably would have if she'd called me that name one more time.

    Vent over. I feel better now

  • 1
    Susie2310 likes this.

    I recently had a course of PT for an ankle injury. The first thing I did was to take a survey on an iPad about my reasons for seeking treatment, goals and expectations, limitations, etc. It seemed like a pretty efficient way of gathering that data, which was then compared to a survey at my last treatment. The therapist reviewed the final results with me to demonstrate my progress and what I should continue to work on at home. I found the immediate feedback useful for that purpose.

    If I had been handed an iPad to read instructional material, I would have been much less impressed. It sounds like your hospital has found a way to turf the responsibility for education back on to the patient, at a time when interaction with an experienced nurse is needed for clarification and reassurance. I would not be happy, as a patient or as a staff nurse.

    Your description reminds me of my recent experiences in doctors' offices where the almighty EMR apparently trumps thoughtful conversation and interaction between the patient and provider. I regularly see one doctor whose office is not set up with laptops, but rather uses desk top computers, forcing the provider to have his/her back to the patient during most discussions. In my OB?GYN's office there is apparently a Wi-Fi "dead zone" that prevents reception in some exam rooms. My NP literally had to run out to the hallway to enter information at multiple points during my last exam.

    In many ways, this is not an advancement, but an impediment to good relationships and patient care.

  • 12

    My daughter, now a college freshman was in 1st grade when she outwitted the PE teacher and got her entire class out of the pacer test. It was one of my proudest Mama moments

    On an unseasonably warm spring afternoon, the little darlings were informed that they were going to do the pacer test. It also happened to be picture day, so they were all dressed to the nines. My daughter, never one to shrink from a challenge, let Big Hulky Gym Teacher know that their mamas would be sooooo disappointed if they were all hot, sweaty and red-faced in their special spring pictures. He relented and let them play four square instead. Little did he know that pictures had been taken at 8:30 that morning, but then no one ever accused him of being overly-observant. Amazing that they managed to successfully enter 2nd grade that fall without a current pacer score!

  • 4
    SopranoKris, Meriwhen, roser13, and 1 other like this.

    You may be able to find a state that will grant you a license if you pass NCLEX after a 4 year lapse and multiple attempts. But that does not guarantee that TX will extend you the privilege of endorsing that license to your home state.

    Each state sets its own licensure requirements, and few (if any) limit those requirements to graduation from a nursing education program and passing NCLEX. Virtually all, if not all, have additional standards including specific testing requirements, remedial education, background checks, health requirements, etc. which you may or may not meet.

    Also, when a nurse has an established license in one state and wishes to practice in another state, s/he does NOT transfer that license. S/he applies for a second license by endorsement, which is a process by which the new state determines whether or not the candidate meets the above requirements that are specific to the new state. This is the point at which candidates who "worked around" licensure requirements are likely to be denied.

    The only other alternative I can suggest is to obtain a license elsewhere, then work elsewhere for an extended period of time (a number of years). At that point, the state of TX may be willing to issue you a license by endorsement, based upon a long track record of successful practice out of state.

    Frankly, obtaining remedial education sounds a whole lot easier, quicker and more certain. Good luck.

  • 18
    cyc0sys, LadyFree28, h00tyh00t, and 15 others like this.

    Quote from Strugaaa4eva
    So I am seeking some advice as to why this occurred and am still pondering on what could have I done wrong for this to have such a bad ending. After searching and searching years and years for a hospital job (I've always worked in subacute rehab settings) and have been craving a hospital job for nearly 5 years as it will be 5 years this coming May that I graduated from nursing school. Long story short, I was hired by a local hospital and all was going well with the first week of orientation. I mean, c'mon it was only classroom work and I passed all the required exams such as the IV and medication administration. I had to take a personal call during the last 1/2 hour of our last day of class and when I returned the nurse educator was saying how I shouldn't give her a heart attack next time about not telling her where I was. I explained what had occurred and I didn't realize that 5 days later I was going to be reprimanded for that. I received a call from the unit manager I was supposed to work at stating that I was technically supposed to come this weekend for my first day of clinical orientation (I was hired as a per diem nurse) she told me that I don't need to come. Refusing to provide further information, when I asked her if the position was terminated she said "yeah kinda, you'll get a letter in the mail explaining everything." I'm really baffled about this? I seriously didn't do anything and am unsure why did this lead up to here?

    Please take note, only constructive comments will be accepted otherwise demeaning, ridiculing words will be flagged. I just need to get some advice as to why this happened and if it is something usual?
    As a former nurse manager and now a business owner in a different field, I see a number of possible reasons for the unfortunate outcome of your brief employment. I'll try to keep my comments constructive so as not to "be flagged," whatever that means. I'll start by answering your question of whether this is "something unusual?" It depends. In a job-seeker's market where there are more positions to be filled than qualified candidates, your experience is probably rare. Since you come from a LTC setting where jobs typically outnumber qualified nurses, the standards and expectations of hospital personnel may have seemed uptight and excessive to you. But in a setting where full-time, benefits-eligible positions don't become available every day, personnel managers can be choosy. Very choosy.

    Without belaboring the point, your remarks regarding the classroom portion of your orientation seem a bit flippant. Let's face it, this is no one's favorite part of the job, not the educator teaching, nor the candidates enduring long lectures and skills checks of basic material, but it is critical for standardization, patient safety, regulatory compliance and legal protection. It helps to put forth one's best effort for all of these reasons. Is there any chance that your lack of enthusiasm and/or disdain for these activities may have come across to others? I would be willing to bet so.

    Near the end of that class period, you went missing unannounced for 30 minutes. While I seriously doubt that anyone was concerned for your safety, the instructor was responsible for knowing the whereabouts of her students in the event of a disaster, drill or emergency phone call from your family looking for you. Nothing makes people more anxious and defensive than being held responsible for something completely out of their control, like the disappearance of an adult student.

    The issue of carrying and answering your personal phone during hospital orientation is a divisive one, on which we here will never all agree. It is something of a generational divide, with those of us over 40 remembering well how to survive and thrive without constant contact from the outside world, and many under that age unable to fathom that very circumstance. I will simply say that as a new employee it is best to learn upfront the expectations of your employer. I encourage new employees to come right out and ask, so there are no misunderstandings. Had you asked the instructor at the beginning of the day if it was acceptable to keep your phone on you and excuse yourself to answer it, I believe you might still be employed. Had you answered the call and immediately notified your lawyer that you couldn't talk, and would call back later, you might have endured a lecture, but still had a job. But disappearing for a 30 minute phone call, I'm quite certain, did you in.

    The delay between your phone incident and receiving notification that your services were not required probably represented the discussion between human resources, the educator teaching your orientation class, and the manager of the floor to which you were going to be assigned. These 3 people all had a stake in your employment and reason to discuss your progress. They probably had a meeting scheduled sometime between your week-long class and the beginning of floor shifts for the nurses in your cohort. They identified the apparent strengths, weaknesses and special skills of the group to best place them. With an obvious negative, you didn't make the cut.

    With no intention of placing you on a clinical unit, there was no reason for HR or the nurse manager to bring you in for a meeting or exit interview. Exit meetings rarely are productive when they involve employees with such a brief tenure. They saved you time, hassle and embarrassment.

    Please move on with a better understanding of expectations in the workplace. Good luck to you.

  • 0

    My native tongue is Sarcasm. That isn't as well accepted in the workplace as it should be, so I have to fall back on English, much to my dismay.

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  • 3

    By federal law, your employer must have a written policy and procedure regarding implementation of FMLA. I suggest familiarizing yourself with it as a first step. They may also have a policy regarding maternity leave for those who don't qualify for FMLA or request time beyond the limits of FMLA.

    To qualify for FMLA, you typically must have 1 year seniority and a minimum of 1020 hours of service in the 12 months preceding your leave. If you qualify and take leave under those conditions, your employer will maintain your insurance and other benefits for the duration of your leave, with you continuing to make your financial contribution toward your premiums. Whether or not you must use all available PTO is a matter of your employer's policy. Some will require you to do so, others not. If you fail to return to work in a benefits-eligible status for a minimum amount of time following the end of your leave, your employer can bill you for the cost of benefits provided to you during that time (essentially the employer contribution to your premium.) Not all employers do this, but by law they are allowed to, so you should ask in advance if this will happen. This is intended to protect employers for paying for expensive benefits for employees who have no intention of working a significant amount of hours post leave.

    As far taking an additional 3 months of leave beyond FMLA, it never hurts to ask. The hospital where I worked when I had my children allowed this, and they were smart to do so. The nursing staff was comprised overwhelmingly of women of childbearing age. If they had cut every nurse loose who asked for extended maternity leave, they would have been replacing staff constantly. It was far more cost-effective to keep staff happy than to replace and re-train a revolving group of staff nurses.

    You are smart to be researching this information in advance and considering your options. Best of luck to you!

  • 0

    Just to clarify, you are not "transferring your license" from one state to another. You are applying by endorsement for a second license. If granted, you will have 2 licenses in 2 states to be maintained. When your original license comes due for renewal, you can choose to renew, place it inactive, or let it lapse (not recommended.) But please understand that it does not move with you, or cease to be valid when you receive a new license and/or move to another state. Good luck with your application.

  • 0

    Quote from SmilingBluEyes
    There are flat-rate "boutique" primary care practices popping up in varying states. The flat rate buys you a system free of the insurance industry meddling and gets you in quicker and for preventive care before things become a big problem....that is forward thinking and I believe, a model for ushering in single-payer systems. No it won't fix everything but it increases access for relatively low flat rates. It makes sense. The suits hate it, of course, as it cuts into their status-quo profits which naturally, they cannot abide. But the barn door is open and the horses are out, so to speak. It's coming and it's gonna change a lot.

    There are a few of these practices in my town. One is a large, multi-service practice with multiple specialists, lab, pharmacy, therapists, etc. Others are more typical family practice providers. They are meant to be combined with a no-frills, high deductible catastrophic plan, which we are not allowed to have under Obamacare because we are "too old."

    So we're forced to carry an Obamacare compliant plan that is much more expensive and covers a multitude of services we'll never use.

    We receive most of our healthcare from a specialty practice due to a condition that affects more than one family member. I would love to see their practice offer a subscription service, and would even be willing to help fund and/or staff a start up. But for that to be practical, the individual mandate requiring fully Obamacare compliant insurance coverage must go away.

  • 4
    poppycat, chare, Swellz, and 1 other like this.

    If you have any questions after reviewing the IDPFR website, please contact your school of nursing. At the risk of sounding like a COB, it bewilders me that colleges and universities apparently fail to prepare their graduates for basic professional tasks such as job searches, applying for NCLEX and initial licensure, meeting continuing education requirements, endorsing licenses and maintaining licenses. If this was covered, and you didn't realize that it would one day apply to you, an advisor at your school should be able and willing to guide you. If this was never covered, then shame on them!

  • 3

    Quote from teachable
    ...At least then there's an explanation even if their assumption about what is going on is inaccurate.

    I don't blame anyone but myself. I do think that the surgeon was a bit of a jerk insisting over and over that I handle and touch the organ just for the experience when it's clear I was trying to learn not to be woozy from the sight of surgery for the very first time ever. We hadn't even covered this material, so I didn't know what to expect.
    You state that you don't blame anyone but yourself, and in the very next sentence, you blame the surgeon for insisting that you touch a surgical specimen and for not knowing that you were woozy, even though you had not informed anyone that you felt ill, and you tried to conceal your queasiness.

    Please take responsibility for your actions, mistakes, misjudgments, etc., or you can expect next semester to follow a similar path.

    Good luck to you.

  • 10

    Having precepted students in the OR, I can assure you that no one expected you to be involved in patient care, but they DID expect you to be aware of safety issues. When you felt ill and woozy, it was your immediate responsibility to alert someone and/or remove yourself from the room. Remaining in the room, closing your eyes and trying to compose yourself may have resulted in you falling, fainting, vomiting or who-knows-what else, compromising safety and infection control. The last thing the OR staff needs is to be forced to attend to an observing student who failed to take responsibility for him/herself.

    Feeling ill may have been unavoidable. Remaining in the room was your choice, and it was one you should not have made. You were correctly criticized for that.

  • 6
    NanaPoo, TriciaJ, BeckyESRN, and 3 others like this.

    In our district, the nurse's decision to call 911 is respected. A call to parents follows immediately. If the parents arrive before the child is transported by EMS, they can interveve and decline the transport, assuming responsibility themselves. Unless documentation is in place in advance, grandparents can't do that. Granny's job should have been to comfort & calm the child. If she wasn't doing that, I would have sent her out of the office so I could focus my attention on the child.

  • 6
    RNqueens, scuba nurse, GdBSN, and 3 others like this.

    I agree. It is not the nurse's job to make or enforce attendance policy as it relates to excused or unexcused absences. Your job is to promote health and wellness and enable students to attend school by managing health needs that might otherwise impact attendance.

    The policies you set would be those that indicate health conditions for which a student should be excluded from school, such as vomiting, diarrhea, fever, etc. & the conditions that must be met for the student to safely return to school (such as being symptom free for 24 hours without medication.) If those conditions are met, it makes no sense for you to continue to exclude the student.

    I suspect that the administration has set the 3 day limit as a means of enforcing attendance, believing that parents won't keep a student out for non-health reasons if a doctor's note is needed. It won't work. If parents are going to pull their kids out of school for a vacation or other elective reason, needing a doctor's note won't change their minds. It will only create issues of excused versus un-excused absences, which are not your problem.

    If you are convinced that a child is returning to school safely, without a health condition that poses a risk to himself or his classmates, turf the enforcement of this policy back to the school administrators, where it belongs. You are the nurse, not the truant officer.


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