Latest Comments by KaroSnowQueen - page 34

KaroSnowQueen 10,313 Views

Joined: Oct 12, '02; Posts: 1,176 (21% Liked) ; Likes: 764
Medicare claims review for major insurance company; from US
Specialty: 30 year(s) of experience in telemetry, case management

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    I've been an lpn for 23 years, and have oriented many an RN. I have worked in states where lpns can do push drugs and have instructed new rns on how to do it. It isn't the fact that an LPN is orientating an RN, its is the LPN as qualified as an RN to do it? And in some cases, that answer is yes indeed. In other cases, such as yours, the answer is perhaps not at all. You would have felt just as miserable being orientated by an RN who was just as worthless, and I have been oriented by some of those too!!!

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    Don't be a spoil sport. So it wasn't an Australian or a dentist, but Peter Ferrara, an associate professor of law at the George Mason University School of Law in Northern Virginia. His commentary was originally published in the National Review on September 25, 2001.
    It's still a good article, and I think its great.

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    Vanc is first rx of choice for mrsa. I haven't had much experience with vrsa, so don't know what they use. ????

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    Should have called the hospice nurse in charge of his case. They usually were very good about getting new meds started,changing things around to make pt more comfortable. We used to have hospice come in one of the LTCs I worked out and they were really great, did most everything other than hands on care (and sometimes that too if a need arose) for the pt.

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    Truthfully, it depends on you. How truly intelligent are you? How organized are you in terms of time management? Is your family flexible about spending time with you? Can you multi-task?
    When I went to school, my family was non-supportive. My parents wouldn't babysit in emergencies. My (now ex-)Dh was a worthless drunk. I had three kids, 3, 2, and a newborn (born after first quarter). I have a clear clear memory of sitting at the dining room table at the typewriter (long before computers were common) nursing the baby, typing a paper with one hand, my 3-year-old at my knee talking to me, and the 2-year-old at my feet playing.
    On the other hand, I passed, more than passed without a whole lot of trouble. I had time to take my kids to the park. I had time to go to Sunday dinner at my grandmother's house. BUT I didn't work a full time job either.
    My oldest DD has no children, does have a DH. She worked a 36 hour week job, but is a screaming perfectionist, and barely came up for air all during RN school. I would have to call her and nag to get her to show up for twenty minutes at a family gathering.
    So, it depends on you. You can make it what you want it, IMHO.

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    I didn't until I got stuck with a dirty needle and the infection control nurse was yipping in my ear about statistics and how much LESS likely you are to catch something during a dirty stick IF you had on gloves. I don't remember but the percentage was large, like 30 to 40 percent less. So now I do.

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    My three cents worth? Go to the surgical floor. IMHO, going straight from LTC to ER would be too big of a culture shock, for me anyway.
    On the other hand, if you're sick of LTC and looking for something to get your adrenalin pumping and your nursing interest revived, it may be just the thing.
    However, if it were me, which it isn't, I would go to the surgical floor.
    Good luck, hope you get the job!!!!

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    Your charge nurse sounds like a micro-manager. Place a clean sheet of paper on your clipboard and make a note of everything she tells you, if you're on the phone, do it, smile and motion to it, and continue on about your business. If the pt needs CNA help more than yours, if you're busy, ask them to page the CNA.
    Yes, this does happen, maybe not to this degree, but it does happen everywhere, everyday.

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    43 miles one way. Looking for a job closer to home, altho not necessarily because of gas prices.

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    I have seen this happen in other LTCs. My primary thought is somewhere up above, management has changed, maybe in a main office somewhere, even in a different city and/or state, and the bottom line is money. It seems everyplace is cutting staff, as payroll is the biggest expense.
    My advice, as one who has been there, is to find a new job. They will indeed expect you to do two or three people's work and to do it in an unbelievable time frame.
    My last LTC job, six years ago: on hiring five years before that, I had a med aide and five CNAs on day shift, and a med aide and two aides on second shift. When I quit, I had no med aide on any shift, three aides on days and one on second. And one week a month, I had to serve in the dining room, leaving the aide to pass trays to 40 pts and feed about six or seven alone.
    And was supposed to get supper meds passed before all this!

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    Came into work Thursday. Charge nurse grabbed my arm as I walked to the time clock "Clock in but then I have something to say to you". I'm thinking, oh great, what did I do now?
    She says they are closing our unit today. Where will we go? What will we do? She isn't sure.
    Grab the Adon as she comes off the elevator (notice she didn't come right over and say this is what's going on). She says that the unit will probably close today (Thursday, and it did). That all staff on our unit will BE TREATED AS REGISTRY :redlight: until Wed or Thurs of next week. Which means we can be budgeted out the wazoo as hospital census is waaaaaaaaay down. IF census all over comes up by next Wed or Thurs, then they MAY re-open the unit. If not, then they will shut the unit down completely and work on renovating it entirely and we will all be "temporarily" re-assisgned to another unit until ours is done, estimated 18 weeks, (which means at least four months, most likely more).
    One, surely they knew this before Wed. night. We get emails for every sniveling little thing, why couldn't we have been warned about this?
    Two, REGISTRY? If I wanted to work registry I would. We are full time staff, who's bright idea was this???
    Three, we are all concerned we will cause the other units to be overstaffed, and they will resent us for causing them to be budgeted more than they normally would.
    Many of the staff stated they were going to look for other jobs. We had a nurse manager the last year or so[EVIL][/EVIL] who made it clear to us we were her "problem" to be solved, and our morale is in the toilet. Just got, just did get a brand new manager.
    A. WHY get a new manager for a unit you are closing down?
    B. Did the old manager convince the powers that be that we were a "bad" unit, and convince them to weed us all out by shutting down?
    Or are we all just paranoid and this is the way things are?

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    Yes, I have major depression, currently treated with medication. I have seen my friendly shrink. I do have episodes where it gets worse.
    We talk about it freely among ourselves at work, and almost everyone who works my shift on my unit takes something, either antidepressants or antianxiety meds.
    Does work make us crazy, or are us crazies (just a figure of speech, please don't get all upset with me) drawn to the job? Don't know. Six of one, half a dozen of the other?

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    Sounds like you did the most and best you could in a bad situation. You made known what needed to be made known, and no one took up the responsibility. You did all you could, so don't feel bad.

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    The question is, do we really KNOW she is doing drugs. A lot of people talk alot of crap. It's just hearsay. I don't know that I would report someone just because they run their mouth about something that may or may not be so. Some people stay the gosh-awfullest things thinking they will make themselves look "cool" or "big" or whatever.
    Now if she shows up to work and is visibly impaired or smells like something (booze, pot, do any other drugs have a smell??? I don't know.), then I would say something to someone higher up and in a hurry.

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    survey regarding job stress

    1. What department/setting do you work in?
    Med-Surg Telemetry (the most stepped down of the step down units)

    2. What shift do you work?
    a. Days

    3. What is the typical nurse to patient ratio in your department?

    7 patients to 1 nurse.
    Management says thats a rarity but they're full of crap. Happens five days out of seven at minimum.

    4. Does your department employ CNAs and/or LPNs?

    We have CNA's and LPN's.

    If your department does employ CNAs or LPNs, what is the CNA/LPN to nurse ratio?

    Our LPNs function just like the RNs with a few small duty differences.
    We usually have 5 to 6 nurses (RNs and LPNs) to 3 CNAs.

    Has the nurse to patio ratio ever caused you to feel stressed?
    1 2 3 4 5
    (1= Never, 5= Often)

    5 OFTEN!!!!!!!!!!!!!

    7. Do patients ever complain to you that they aren’t receiving adequate care/ attention because you are too busy?
    1 2 3 4 5
    (1= Never, 5= Often)

    5 OFTEN!!!!!!!!!!!!!!

    8. Do you feel your job satisfaction is adversely affected by staffing ratios?
    1 2 3 4 5
    (1= Not at all, 5= Often)

    5 OFTEN!!!!!!!!!!!!!!!!!

    9. What has your management done (if anything) to address staffing ratios?

    Not a damned thing but tell us its not a need for more staff, but harder work on the part of the staff that's there. Like we can work harder than we already do without blowing a major gasket?