JKDON

See also the responses in the Long Term Care/geriatrics forum.

I agree with One Lone Nurse. Don't burn bridges. Your reputation is on the line, and if you choose to become an instructor, get offered a big promotion or position, it could come back to haunt you. I can't imagine any nurse, with the shortage being what it is, not giving 30 days notice. The patients deserve our professionalism. This is not factory work. Most professionals should give 30 days at least. Having said that you gave your notice back in Dec 05, I think you said. So if you have the other job already, and your new employer can't wait, you aren't going to lose anything unless you ever want to go back, or you use them as a reference. I would also put you on a do not rehire list if you did not give notice. As an employer I have had to wait for people and even if they offer to stiff their previous boss on the notice, my next question is "so when you decide to quit here, does that mean you will do that to me?" That usually makes them work out their notice. I want to remind them that as of now you are rehireable and in good standing. If you don't work your notice, you would not be leaving your previous job in good standing and that would change the way I feel about hiring you. For some reason nurses think that they are in such high demand they can get away with anything. I would not think much of an employer who would not let you work out your notice. Do the right thing. You may need to go back to that place sometime.

Sorry I must have clicked reply already. Here's the rest. I would suggest that a couple of nurses try to form a group who will be willing to meet with your administration on a solution. Honestly look for solutions, not just complain. Bring some of your own solutions to the table. Perhaps get other professionals involved, docs, lab, etc who may have insight. Would you get more aps if people knew the place was run better, and staffed better? It takes time. I'm surprised that the census hasn't dwindled as well as the public surely knows your staff feel this way by now. Otherwise, if you've lost faith in your facility, yes by all means move on as it will be reallly hard to stay objective and be a part of the solution. It takes positive attitudes by all involved to change that culture and get nurses to come and stay. I wouldn't want to apply if I knew all the staff were unhappy. Good luck.

It sounds like the original poster is fed up but committed enough to want to stay and make it better. That is tough. I see that in my facility as our agency numbers climb and the lack of "qualified aps" dwindles. (I mean those who are not limping when they arrive, have no criminal history, problems with their licensure, worked their 30 day notice and showed up to work at their last 10 jobs) These people are hard to find, and my staff as short as we are feel they'd rather have someone worthy to train than someone to fill a hole who will be gone as soon as the place down the road offers 50 cents more. We don't get near enough applications so we used agency. Not the best scenario but our residents mean that much to us. No matter how many staff we have on hand, we feel these people are worthy of our care, the best we can offer with what we have. I admire all of us who are working short and making it work, but it is tiring and scary. I would not be allowed to keep anyone who "refused" an assignment but that's in a nursing home and I do have to go in from time to time to help. Of course our census and acuity do not change like the hospital. I would

We do have a progressive discipline program for med errors but i developed a new tool that helps the person filling out the form, identify what the possible causes were. (overtime, new to assignment, med packaged differently, poor communication, Written wrong on the MAR. Lots of info and helps by having the person finding be a part of the solution. Of course there is a place for suggestions. It breaks my heart to have a med error come in as I remember having them. LTC is hard with the amount of meds to give. I also helped my nurses by doing a study of the actual number of doses given in a month and the rate of erros was .002% or some infinite number like that. However the focus is not on the employee but the process. We try to correct the problem that caused the error, and yes many times it is not actually checking the MAr against the label with every dose. So several of those would lead to termination.

We used the brand "Glowgerm". It came with a gel and powder you can use adn then several sizes of lights. We borrow the large one from our local clinic for health fairs etc. I used the powder at Halloween time and placed some in the bowl of candy we handed out at the anual IC inservice. Before we adjourned, we had everyone stand by the light to show how the powder had spread. People were amazed to see where the glowing showed up (lips, eyes, hair, clothes etc.)

Anyone willing to share wages for new grads outside of Omaha and Lincoln? I'm talking more rural areas, and in both hospitals and nursing homes. You can PM me if you are willing to give this out.

Anyone willing to share wages for new grads outside of Omaha and Lincoln? I'm talking more rural areas, and in both hospitals and nursing homes. You can PM me if you are willing to give this out.

I'm in NE and find that several clinics allow Medical Assistants to do this. In our local clinic, the MA gave injections. I wonder if you are talking about administering meds such as giving the med to the patient, or are you talking about dispensing, such as packaging for them to take home, or handing out samples which should reallly only be done by the physician. I'd check with the board of pharmacy.

At our last DON conference there was one facility that was piloting a skin tear prevention practice of having high risk residents drink 1tsp of olive oil daily (I believe). They saw a significant decrease in skin tears, sheering, breakdown all together. I'm not sure how many got on the bandwagon, but several have reported similar results. We've not implemented this yet. But have any of you heard of such a thing? Not sure where the idea came from but no literature yet to be found. What do you think?

Who takes care of the other 33 residents? Is there another charge nurse on duty? Make sure that you aren't just assigned a cart on one wing and not in charge of the entire place. My evening nurse is responsible for the entire building, but does have to pass the med cart on one wing. (the easier wing) In a nursing home that size, i'm surprised there would be two nurses on evenings unless acuity is high. Good luck, I'd hate to be on my own on 4 days orientation, but agian if there is another nurse one, may not be so bad.

I would want to see the job description, and find out what kind of support you would receive from your supervisor. What would be your fill in responsibilities if short staffed? sounds like you have what it takes, or you wouldn't be asked. I would be flattered. Go for it.

Send those nurses to Nebraska, we seem to be in great need right now.

I like my CNAs to go to report. There is no way they can give safe care without it. Have to know who has changed, who is sick, who's going out, and what to look for. I think 80% of what my nurses chart on comes from the CNAs and the housekeepers. I can't imagine a facility discouraging open communication between levels of nursing staff. How would anything get done and done safely?

How sad. I am so thankful that we use the dot system on our room plaques. Next to the resident's name is a blue dot for full code, and a red dot for no code. Interesting that years ago, we'd have about 2 full codes, and now we have about 20 out of 72 who want to be resucitated. I agree with Daytonite about the fact that there is no confidentiality if you get sued. You will be deposed, and asked all of the uncomfortable questions. It IS the responsibility of the state and fed agencies AND the facililty to get to the bottom of this. Too bad they had to learn about the poor orientation and its results the hard way, but hopefully they will take it seriously and work on it. I know what it is like to need a nurse so bad and want to put them on the floor early. It always comes with a price.