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ihavealltheice

ihavealltheice

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ihavealltheice's Latest Activity

  1. ihavealltheice

    schedule change

    Wow, that's awful! How do schools think they can get away with that? They need to be finding a sub for you guys, not the other way around. My admin is aware of my situation. I told them I wouldn't be able to change my schedule when they tried to change my schedule on me a few months back...mid school year. Not wanting to lose me mid year, they said they would allow me to continue leaving when I do-after student dismissal. They claim it to be a student safety issue, which I partly understand, but the other part of me wonders why they don't consider it a student safety issue when I'm in the other building.
  2. ihavealltheice

    schedule change

    I don't think there's someone waiting persae, but I think there is some sort of plan.
  3. ihavealltheice

    schedule change

    No, I don't work in my kids' district.
  4. ihavealltheice

    schedule change

    We had one issue with a student earlier this year who had already been dismissed for the day and someone other than me had to figure things out. They complained, threw the principal for a loop, who then went to the superintendent. Superintendent is now claiming "contractual hours" as in everyone is supposed to start and end at these speific times. However, my current schedule (while meeting the specified contractual hours in the union contract) was agreed upon when they changed my schedule a few years ago...unfortunately, it was just verbally and not signed.
  5. ihavealltheice

    schedule change

    When I was initially hired for my position 4 years ago, my schedule allowed me to leave with enough time to pick my kids up from school. The next year, they changed my schedule so that it barely worked to pick my kids up from school, but I made it work. Fast forward a few years now, they're not happy with me leaving at that time (even though I'm in the building for the entire student schedule) and now want to push my schedule back even later, which won't work for my family. I've ultimately been told to adjust my schedule or I won't have a job next school year. Half of me is relieved because I haven't been entirely happy with my position since day 1, but the other half of me is very hurt. I have worked so hard to start this program from scratch. I have put so much extra time and effort into this job and I do my job well. It is now extremely organized and I am constantly told how great of a job I do to multitask and manage everything. They know my home situation and they know that me staying those 10 extra minutes just isn't possible. So, for them to do this, it just stings. Bottom line: don't kill yourself over a job that can let you go just like that and not have any remorse about it. It's not worth it. On a happy note, I do have contacts with other districts, so it is time to start exploring.
  6. ihavealltheice

    **NEED ADVICE-NEW IN ONCOLOGY OUTPATIENT

    I'm not in outpt oncology anymore, but I was for 10 years prior to switching to school nursing. Neither scenario is safe nor best practice for either you or the patient. I'm sorry that you're experiencing this. It really is a great field of nursing if you're in the right place.
  7. ihavealltheice

    Considering ICU.... among several other options

    I totally understand the book smart vs street smart. I graduated with straight A's, but struggled my first few years out of school. It took me a while to realize that textbook and tests are not the same as real life. Here are some specifics to try and help. I copied and pasted your situations and bolded my advice to try and help you. We had a resident.... parkinsons.... baseline shaky and not very verbal. When mad/irritated, resident became markedly more shakey and yelled out We had a newer aid that day. Aide came to me and stated that he was having one of these episodes..... I stated to her that he does this sometimes and to just ensure his safety and let him calm down. Aide wasn't happy and went to other nurses and management. Honestly I am not sure how I feel about this situation. I honestly thought I WAS using my nursing judgement and didn't believe that it was an emergent thing that I needed to go and assess. Perhaps if it had continued? Again, I don't know how to feel about this situation. Even though you thought that you assesed the situation and used your nursing judgement, you didn't. With this situation, you can't use your nursing judgement if you don't go and assess the patient yourself. Your aide was obviously fantastic enough to come to you with their concerns (believe me, that doesn't always happen) and it was interpreted as you blowing them off...and you did. Some of the concerns at the second hospital were as follows "lack of progression in orientation, mis-prioritization of nursing assessments, reminders to assess and document routine cares, lack of asking questions when uncertain...." While I don't necessarirly say that this is "unfair", I am a much more quite person..... I don't always say outloud what I am thinking/planning/questioning. I believe they took that as me not being safe and asking questions. To my recollection, there were no specific "incidents" at the second hospital that were of concern. It was more an underlying concern. Then you need to start thinking out loud, whether you're a quiet person or not. No one knows what you're thinking so no one can help you. Maybe what you are thinking is not accurate (and that's perfectly OK!), how are they to know if you don't tell them what you're thinking. I'm a quiet introverted person too, but to think/plan/question out loud when you have the luxury of a preceptor, someone who is dedicated to helping YOU, you need to take advantage of that. At the first hospital, I did make one major mistake, and to this day, I regret it. I had a patient that was a known difficult straight cath. I was on "transition" at that point, so my preceptor wasn't right next to me. I had the assistance of the nurse aide, but attempted to cath that patient too many times (3-4). I was not aware that there was a policy of how many times that I could try. And even when I had asked for another nurse to come and take over, they stated I was doing fine and declined to attempt to cath the patient. Yep, same goes for IV sticks, NG insertions, anything. When I worked in infusion, we had a max 2 stick rule. Even if you're the BEST at it, you can still have an off day. Get someone else. Don't be afraid to ask for help, don't be afraid to advocate not only for yourself, but for your patient. BUT, don't give up. Maybe you didn't get this one, but you'll get the next one. I learned something that day, and honestly I hate foleys now. I avoided them as much as possible. I would NEVER make that mistake again. Again, DON'T GIVE UP. You'll never learn if you do. You want to be at the bedside, you better believe you'll be inserting foleys and if you refuse, you're going to make yourself look bad. Every nurse has their weakness and that's OK to admit that and then ask for help. I HATED starting IVs before I took the infusion job, guess what, I was one of the best before I left there. I've been gone for 5 years now (switched to school nursing to spend more time with my kids), and I always say I miss starting IVs the most! Some of the other concerns at the first hospital, There was a situation where I was dealing with a brace on a resident. I had stepped out of the room and had asked for help (which I believed at that point that I was following the coaching to ask for assistance. There was also the orthotics provider in the room asking me a bunch of questions about the brace. I honestly believed that he would be the expert about the brace and was throughly confused as to why he was asking me all the questions. The patient/family became concerned because they believed I didn't know how to handle the brace (I hadn't dealt with one before, so no I didn't, but i would have learned!) Doctors aren't the experts, nurses are Never assume that the doctor knows. Different brands of braces can be different and different doctors order different stuff. I'm sure your facial reactions indicated your confusion and that may not have gone over well either. You say you would have learned, but did you show them that you were taking the time to learn? Again, saying "I'm pretty new at this, I don't know your answer, but I'll find out." will go a long way. But if that situation happened the way you describe it, I would have been concerned as well. Put yourself in the patient or family member's shoes, would that situation make you comfortable? There was another incident with a patient where we recieved a call from central monitoring. I said something about that I was concerned about his head, rather than his heart. It was a neuro floor and his heart rate was increasing or something.... So I believed it was possible that perhaps there was some swelling in the brain or something neuro related. They also stated that the preceptor had to prompt me to go and get vitals and assess the patient. This I completely DISAGREE with. As stated earlier, I was kind of quite. I already knew and was planning on getting into that room asap to assess and get vitals. OK, 2 issues here.... 1. I don't care what specialty unit you're on, you need to take into consideration the whole patient-ALL systems of the patient (neuro-yes, but heart, lungs, GI, whatever as well). Maybe this patient had a heart condition that lead to a stroke, the stroke is the primary reason he's there, but that doesn't mean the heart condition is not a factor. THAT kind of nursing knowledge and assessment skill does not come right away, but it will come with time. You need to learn from that and ask questions. Ask yourself-what did you do miss and what can you change in that situation so that it doesn't get missed again? 2. If central tele calls you, you get up, go in right away and you assess the patient, you don't have time to plan. By you writing that you were planning on getting it leads me to believe you didn't act fast enough to assess your patient. And I don't even mean getting vitals, you know his heart rate already-go LOOK at him yourself. (The delay of physical assessment seems to be a common denominator since it was brought up in the SNF as well). I hope this helps. Good luck and please don't give up!
  8. ihavealltheice

    Exciting possibility...

    I don't think they can work as a student nurse without their instructor present (I remember this issue coming up when I was in nursing school). But, if they already have a CNA or are simply hired as an unlicensed personnel apart from nursing school, then that would probably work. Based on your location, what college/university would you be pulling from? Do you think this population of students would be "second career" students? (ie, they're older and have more life experience than just what they have learned from the textbook, maybe they're parents themselves) or are they fresh from high school 20 year old students with little "real life" experience? If they are older second career students, then it may be worth it, if it's the latter then I think it could potentially create much more work for you. As far as pay, I would contact neighboring districts, ask what they pay their health aids or go by what the paraprofessionals make in your district. Good luck!
  9. ihavealltheice

    Really?!

    Today I had to hang up on the person I was talking with on the phone, run down the hallway to tend to an EMERGENCY...bloody nose...for a 7th grader...who gets bloody noses...bad ones... ALL. OF. THE. TIME. I'm laughing about it now. Not so much earlier.
  10. ihavealltheice

    Quit my CNA Job ???!

    I don't have any advice, but wanted to tell you that the best nurses, NPs, PAs, and doctors that I have worked with all started as CNAs. They truly understand what it's like to be in the trenches. Good luck
  11. ihavealltheice

    School nurse questions.

    I don't know why it won't let me quote anyone... Anyway, much like in the hospital, when you as the professional RN delegate something to a CNA, you are still ultimately responsible for it. Still works the same way when you are in the school setting.
  12. ihavealltheice

    School nurse questions.

    I agree with @NutmeggeRN. Schools put us nurses in difficult situations where we delegate to unlicensed personnel and I think this is one of those difficult situations. I am a full time nurse that manages multiple buildings. I very much dislike that I'm not in 1 building at all times. I think your main concern right now should be to find out if the aid has any medical background and what exactly you will be professionally responsible for when you are not there the other 4 days. If there is an emergency, will you have to be available via telephone? Do you train this unlicensed personnel to care for students with chronic medical conditions and emergencies that could result from those conditions? What about medication administration-can you legally delegate that to an unlicensed personnel in your state? You need to research that yourself because the school certainly won't and they'll justify anything that they're asking you to do. I'm not trying to scare you, but unless you were hired on as a pure consultant, you're technically delegating and professionally responsible for everything that health aid does whether you're there or not.
  13. ihavealltheice

    Screenings

    I find that in the middle school setting especially, the moment I send out an email saying please don't sent students, they'll send more than if I just didn't send it out at all. Not purposefully, not vindictively, it just happens. So, my recommendation to you is not to send the email. Pretend it's a normal day as far as the rest of the staff is concerned. You can also call students down for screenings a handful at a time and see ill students in between the screening groups (unless it is an emergency). That way, you don't get a huge backup of students in your office and it's less frustrating for you.
  14. ihavealltheice

    How to help coughing student?

    Lots of warm water and have them blow their nose. That tickle is an awful feeling!
  15. ihavealltheice

    School nurse roll in IEP + 504

    Think of an IEP as in special education, they have low test scores and they're struggling, so what are we MODIFYING/CHANGING in the educational setting (testing and learning accommodations) specifically for them to help level the playing field. The 504 for when they have something that can limit your basic needs. This is not considered special education. What are we ACCOMMODATING for them to get through their school day safe and/or learning. Think of your kids with foods allergies, kids with diabetes, maybe cerebral palsy. We also use 504 plans for kids with ADHD or mood disorders who don't necessarily qualify for special education services (ie, they get super distracted or have outbursts in class, but they're still scoring above the 25%). Clear as mud?
  16. ihavealltheice

    "The Nurse doesn't really DO anything" -Middle school students

    I don't work in the same district as my kids' school, but we're in the same conference. This past fall, we were facing each other at a cross country meet. One of my 8th grade students told my daughter that I do nothing for them. That stung, but then my 6th grade son annihilated him in the race, so that made me feel better
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