SharonH, RN

I would never relax my hair for a job interview. Get the braids and wear them in a professional looking bun. If that is offensive to your potential employer, it is probably best you find out ahead of time. Also, I speak from experience; I have been natural for 12 yeas now and I have worn every natural hairstyle you can think of including full afro.

Oh geeeeeeeeeez...................

From the article: Personally I don't usually get the flu shot because I question its value for young, healthy people. Most years I don't take it, but one year I did and became ill within a couple of weeks. While I know I didn't get sick from the vaccine, what good did it do? I've never had the flu and were I to ever get sick, I have no problem staying home and not exposing others. I have a real problem with this guy claiming that nurses do not put patient safety first.

I wouldn't be insulted; I'd be embarassed that they had to ask me to do so in the first place.

I agree with you Leslie, but I would go so far as to say that even in a non-management position a professional person should wear their teeth. It is the societal norm. I have never worked with a nurse who did not have teeth. The only time I have encountered people in the workplace without them, they always work in positions like housekeeping or the kitchen and even that's rare. My grandmother worked in the laundry at a nursing home and she wouldn't have been caught dead out of the house without her dentures.

I'm frankly surprised that you were able to get hired at all without any teeth. Lack of teeth is not something I associate with a professional appearance, nothin personal. You should get your dentures re-fitted.

Thank you! A physician order to flush an INT, good grief, never heard of such a thing.

I've worked with many, many professionals from other countries and I can count on one hand the number of them I have had difficulty understanding. It happens but it's rare. The fact that they have had a string of nurses they could not understand is.......odd. Maybe it's as Sandra Dee explained to Bobby Darin: "People hear what they see". You betcha Sandra.

They didn't dumb it down, they told him what it was about but he tuned them out. See the OP: I bet he wasn't the only one rolling his eyes at the boring details so they reduced it to a corny mnemonic. Oh well..........

You're welcome. It's funny but when I responded, neither you nor your opinion was even considered. Go figure. I was sharing MY opinion of the tone around her and I will continue to call it as I see it. And I cheerfully remain available when you need help knowing what to think......you're welcome.

Congratulations!

Heh-heh, of course there are. I have argued that very point many times on this board. buuuuuuuttttt, many of our colleagues simply do not concur. I was merely trying to save OP some trouble and letting him/her know how it is around here.......

It'll never work, nurses on this board are vehemently opposed to creating their own plan and following through, they only want to follow doctor's orders. Sorry.........

Yes I have so I speak from experience. As for matching up patient needs, as I stated before HH nurses need solid assessment skills and the ability to problem-solve that comes with experience. Recently I have been seeing some very poor quality from HH, so you have provided another piece to the puzzle. Just today, I had to follow-up on a patient with HH in the home who has not had her medications reconciled from her hospitalization 1 month ago including a PO antifungal that her husband never bothered to fill because the hubby didn't understand why it was needed. Where was the HH nurse in all of this?

No way. Source?

Under no circumstances should a new grad work in home health; you need strong assessment skills which means experience and a fairly good knowledge of the healthcare system as you will need to facilitate a lot of care for your patients. I'm disappointed to hear that there are new grads working in HH; what were those hiring managers thinking?

For God's sake, get another job......

It sounds like you need to reduce your taxable income. Are you maximizing your 401K? What about flexible spending accounts? If 1/3 of your paycheck is going to be taken out, at least the money would be going directly to your benefit. That's much more therapeutic and practical than grousing about welfare patients.

So every two weeks, your facility steals between 45 and 50 dollars from you? Over the course of a year, they will have stolen approximately $1300 from you! You will either take your break or get compensated for your time. If they refuse to honor your break or give the money owed to you, call the DOL. This should be non-negotiable.

77K in deductions? I think your Dad needs to look at what is being taken out of his pay.

That seems impractical. I won't work pediatrics. Not ever. No matter the practice setting or the type of care needed. I am excluding a whole population from my practice. See? Lots of us have restrictions for what we will and not do. Should we all have a mark on our license? Of course not.

The advice not to go into nursing if you don't want to give blood products is simply wrong. I haven't touched a blood product in 10 years and even before that, I infrequently administered blood and I worked med-surg! OP, you will simply need to choose a specialty in which your exposure to the likelihood of giving blood is extremely limited. Many of the specialties have already been mentioned: psych-mental health and mother-baby are first to mind. Once you get in a couple of years of bedside experience, you can leave the bedside and need never worry about it again. Also, you will find that people IRL are not nearly as uptight as they are on this board about it. If you offer to take over a really difficult task for them in return, they will gladly spike a bag of blood for you especially if they don't have to be bothered with all the monitoring afterwards, which is the biggest hassle of all. Good luck.

I am constantly amazed by nurses who are so against the nursing process, fighting hard against making their own contributions to the care and recovery of the patient instead preferring to complete tasks and focus on following doctor's orders. The real sad part is that over and over again patient's suffer as nurses abandon the nursing plan of care......the basic care that makes the difference in how quickly and well a patient recovers.........to focus on medical care.......IVs, monitors and medications. So patients get respiratory treatments and IV antibiotics on time but nurses can't even be bothered to walk post-ops and encourage cough and deep breathing. It's too simple. All this effort fighting nursing diagnosis and plan of care is baffling, just baffling.

I'll take it piece by piece. As for not laying eyes on her, I totally agree that the idea is to visit the home, meet with her and the son, etc. There is no question of that and certainly no devaluing of the direct care component. It comes down to a matter of resources. I can review 20-30 charts like that a week, but I certainly am not available to see them all. Those who we determine would benefit from a visual are in fact scheduled for an appointment with our team. These are usually patients who have more complex problems that cannot be addressed during a brief phone interview or chart review including memory and cognitive problems. As for the providers not putting it together, you would be surprised (and disappointed) at how often that happens. There are a lot of factors: they only have 15-20 minutes to see the patient and that doesn't leave a whole lot of time for extensive chart review especially when the patients tend to minimize problems or not tell them at all. They may see different providers who who wouldn't catch on that the patient has been in for the same problem 3 separate times in the last year. And I've found that physicians are not really comfortable assessing psychosocial or functional status unless it is a glaring problem staring them right in the face. That is one area they are perfectly willing to cede to nursing or social work. This whole thread gives me an idea for a poster presentation. I think it's important for those of us who provide care of patients in the community setting to communicate about the work we actually do and the value of that work to other nurses who may not understand that all nursing occurs at the bedside.

I'll be glad to field that question for you: In my case, we review the medical record extensively. We look at physical status as well as functional, cognitive and psychosocial status. These are all issues that impact health. So for example: 83 y/o lady was recently in the office for a fall, suffered only a wrist sprain. Extensive chart review reveals that she has been in the office 3 times in a 12 month period for falls. Each time, her injury was treated and she was sent home. She has never had a bone density test, vitamin D level was low and she has not had her eyes checked in over a year. She has diabetes and the last foot exam was abnormal. No podiatry follow-up. She lives alone and still drives. Oh yeah and she's on Coumadin. None of her providers have put this picture together. The patient is contacted by phone and asked about the circumstances of her falls. She minimizes it and states she is just clumsy. If she were to fall and unable to get up, she has no way to call for help. No emergency response. Her son does call about once a week. She states it is important to her to remain independent and live in her own home. Obviously, falling and breaking a hip or cracking her head and getting an intracranial bleed is a threat to that goal, this is a disaster waiting to happen. In collaboration with the rest of the team, we then create a care plan that centers on her fall risk. Interventions recommended to the provider are: -bone density testing to check for osteoporosis or osteopenia; treat if found -vitamin D supplement; calcium supplement -annual eye exam -follow-up with podiatry re: potential neuropathy; assist to schedule if needed -gait and balance assessment by the provider to determine if she needs physical therapy; order if needed -check for orthostatic hypotension; adjust meds if found -stop Coumadin until falls are addressed -personal emergency response system; ask son to check in with her more often -teach about home environment and safety; ie throw rugs and wall rails, lighting, etc At 3 month follow-up, it is found that she did indeed have a gait and balance problem. PT has made significant progress with her, she is now using an assistive device. She has an emergency response button and took the throw rugs out of her bathroom and kitchen. Bone density test found osteopenia so calcium supplement is sufficient for now. 6 months later, she remains safe in her own home. No additional falls and she reports that she actually feels more confident and has started going to a senior center 3 times a week. The patient met her goals, did not need bedside nursing care since we kept her out of the hospital and I never laid eyes or hands on her.