Hello, I have accepted a primary care NP position with a VA affiliated clinic. I have been working in a nursing home providing care to residents with acute & chronic diseases for nearly 3 years (it was my 1st job out of grad school). Since cost w...
Have you talked with any locums agencies? You could take a short term assignment in Houston or nearby region to see if you like the area before settling in permanently. I'm planning on moving to San Antonio (I'm from Ohio) to be closer to my son who ...
Castelgates, To my defense, I had a rough week and I was fed up with the level of disrespect encountered at work. I would never address an NP (or anyone regardless of title/position) in the manner of which the staff at this nursing home have addresse...
Jules, I'm not fighting hard to stay in this work environment. I asked how others handled this type of experience, in hopes of learning from it and avoiding it in the future if possible. I am currently searching for another job. If I could simply pic...
Mavrick, I have addressed each instance in a firm and assertive manner. There have been multiple occasions. I have first addressed the instances with staff, then went to unit managers, then went to management, then went to my collaborating MD and my ...
Hello Spidey's mom, Some examples include: Confrontation on several occasions where staff raised their voices & verbalizing rude comments, refusing to follow through with my requests, gossiping, etc. I've discussed the events with the DON, the ad...
Hello Springchick 1. Yes. I've addressed it with them and the DON & administrator. I was reassured that they would address the situation on 2 separate occasions. It was implied that I was "too nice". I am firm, but not demeaning. I am always resp...
Hello, I have encountered several situations as a newer NP. I went into this field naively when I assumed that I would have a decent amount of respect from fellow NPs and among staff/administrators/RNs/LPNs. I work in post acute care, which was a new...
Hello all, I wondered what your experience was like when you obtained direct hours from an NP and or MD. I was in a busy primary care office and saw pts, provided my assessment findings, dx & tx plan with the NP/MD who then provided their input....
Thanks for the input OregonGNP23!!! It's comforting to know that someone else can relate to my concerns. I was starting to question whether or not I had too high of expectations for staff & for the manner of which care is delivered within the pos...
Would Alk Phos be elevated in the 300s from a fx? I'm just wondering.... I'm not sure if I checked her thyroid to be honest, but good point. Na level was WNL, no s/sx overhydration. Thanks Teacher First
To pt's knowledge she never had elevated liver panel labs. No previous work up (liver function) from the hospital was sent over. The elevations in Alk Phos, ALT & AST came at a surprise and the pt was d/c'd 4 days after receiving the lab results ...
Thanks for the input. Consulted w/ collaborating doc. Statin was d/c'd & Hep B & C panel ordered- results still pending. Pt will be d/c'd home tomorrow. PCP to f/u on Friday & our labs will be faxed over for review. Ankle fx was from mech...
Hello all, It's me again, the newer NP stationed at the post acute care setting....Please have mercy on me, as I have another question and I need your advice!!! A resident c/o fatigue so I ran CBC and BMP. Hbg dropeed 2.0 since transfer from hospita...
Thank you for being so kind!!! As a new NP I second guess myself quite a bit. To make matters more complicated, I am stationed at this nursing home by myself so I don't have another NP or an MD to bounce ideas off of on site. I do use Lexicomp and my...