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midcom

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  1. My first job as an LPN was very similar to the above poster- float in Primary Care & urgent care clinic on weekends.I loved it. Our urgent care clinic was an extension of the primary care clinic so we used the same computer system & the same facilities. We had one doctor & 2 nurses & saw around 25 patients during our 8 hour shift. I learned so much. Of course we mainly saw patients with UTIs, URIs, migraines, strep, tetorifice shots, reading TB tests, and minor injuries(falls, lacerations, etc). The serious cases were advised to go to the ER or sent there by us. I also took triage phone calls, dealt with nursing home calls & faxes (our on-call doc was the one who worked urgent care ) and sent prescription refill requests to the various doctor's worklists. For the first year or so I worked with a RN but we both did everything, although when possible, I let her take care of the triage calls. When she left, they hired a MA to work with me & that was ok too although I then did all the triage work. As far as orientation goes, I worked many days in the primary care clinic before I got to work the urgent care clinic & then they assigned a third nurse for a few weekends. I no longer work in urgent care. A position with a provider opened up in the clinic &, since it meant no longer floating & full time work, I jumped at the chance. At the same time our system decided to change how the urgent care clinic was run. It was no longer staffed by our doctors (something they really appreciated!) & moved to a separate area of our building. I have to admit that I don't miss working weekends. I agree that good co-workers & adequate orientation will make or break it for you. I was fortunate that we had excellent workers in scheduling, records, the lab, x-ray, nursing, & doctors. I worked with 10 different doctors. Dixie
  2. We put our stickers on a whiteboard, using a small roll of tape to adhere the sticker to the board. The board is mounted child height in the hallway so the child can choose the sticker as he/she leaves. There still is a bit of touching more than one but at least this way they can see them all. It only takes a few minutes to refill the board.
  3. I'm a Kaplan grad, actually Hamilton College; they changed the name right after I graduated. I agree that the tuition is high, but in my case it was a matter of waiting 2 years working minimum wage while waiting for an opening in the local CC or starting right away. When I pushed the pencil, the higher tuition wasn't such a bad deal. Kaplan is a for-profit college so it's tuition will be higher than the community colleges that are supported by the state & can afford to offer a lower tuition. I had a good experience at Kaplan. My instructors were great & always available. The school offers excellent remedial help to all their students, if you are willing to take advantage of it. Some students just want to be spoon fed everything & just complain when they can't pass a class or don't get the grades they want. They didn't bother to ask for help. I admit that the curriculum was not the best. When I went our A&P had no lab. Any grads who wanted to bridge to RN had to retake A&P before starting RN classes. They have rectified this now & do have a lab with the classes. And, although we had lots of clinical hours, they have recently increased this too. I had no problem passing NCLEX or finding the job I wanted - and it wasn't in LTC. I am now proctoring a new employee where I work & she is a Kaplan MA grad. I am blown away by her knowledge & skills. I have recently been asked to be on Kaplan's Nursing Advisory Board. They ask for our input & suggestions for changes. It will be nice to be a part of those changes. Dixie
  4. Actually, I'm the one getting called in. If someone calls in sick, I can expect to get a call because my supervisor knows I usually will work. I agree that there are good parts about being a float. If I don't have the time, I don't feel guilty leaving a few items in the regular nurse's worklist, especially getting prior authorizations, for instance. For GeauxNursing, my former job was in IT, which actually has been very helpful. Since I started working we have gone to electronic charting. Several of the older registry nurses have quit or retired because they were intimidated by the computers. I'm usually able to pick it up pretty easily & am often asked for help by the nurses who work with it daily. I live in Iowa ( unfortunately the state with the lowest nursing pay) and part of my job is to work at something similar to your "Care Now clinic". In our area they are called Urgent Care or Convenient Care. I work Convenient Care every other weekend. The patients we are supposed to be seeing are minor injuries, UTIs, URIs, acute things, not physicals or routine vaccinations. Those patients are required to make appointments to see their caregiver during the regular work week( we have coverage until 8:00PM). Unfortunately, many of our patients think that since we are called "convenient" it means that they can come because it is inconvenient to come during the week. Our intention is to treat the people who would normally go to the ER but don't really need to be treated there. This is the area at our clinic where we have the most turnover but even it isn't often. I guess they get tired of working weekends. However, they rarely hire new nurses for this job as there is so much to learn and we only have 2 nurses working. I was a new nurse but didn't get set loose on weekends until orienting & working many days during regular work hours and then, when I did go to weekends, they had a 3rd nurse for a few weeks. The nurse who I have worked with on the weekend since I started recently quit so they are hoping to hire someone soon. I know that the other nurses hope it's soon because they have to take turns filling in for her. Oops, sorry, I tend to go on & on. Dixie
  5. I think you're missing Maalox in that combo. Dixie
  6. I apologize for not updating sooner. My job is everything I hoped it would be & then some. I work with great people, both nurses & providers and, since I work as a float, I get a real variety of experiences. This week, for example, I worked on Saturday in our urgent care clinic, Monday 12-8 with a doc who takes mostly walk in & acute cases, Tuesday I spent the day with one of the pediatricians, mostly giving shots(not my favorite thing to do). Today I worked for a family practice PA and Friday I am with the gastroenterologist. He, by the way, is the only provider I'm not fond of working with. However, I am one of only a few nurses who have trained to work in his practice so I usually spend at least a half day a week with him. Shortly after starting my job, I had to undergo 2 months of chemo due to the breast cancer diagnosis. My fellow nurses & the providers were all wonderful. When my immunity was compromised and I had a patient who was contagious, that person more often then not would just appear in one of my rooms, with the intake already done for me. Some of the doctors kept an eye on my WBC counts & were especially concerned for me when they got very low. Now that my treatments are done they celebrate with me whenever I get a good report from my surgeon. I'm still hoping to someday to be assigned to just one doc & be his/her nurse. I want my own spot at the nurse's station instead of using someone else's spot. I want to be the nurse that the patient expects to see instead of being the one filling in for the regular nurse. I did apply to be the nurse for our most recent hire but was beat out by a nurse with more experience. My time will come eventually. Today I received a compliment. The PA I was working for pulled me aside & told me that the patient we had just treated had told him that he wished all nurses were like me, professional & caring. He had been treated very rudely the night before in a local ER and acused of being a drug seeker. I suspect he is an addict but he was also a man in pain who needed our help, not our judgements. Thank you for your concern & interest. I love being a clinic nurse! Dixie
  7. I work every other weekend in our Urgent Care clinic, although we call it convenient care. I LOVE it! I see things that I don't usually see during the week in the regular clinic setting & as a LPN, I have more responsibility. It's more fast paced & we don't do immunizations or physicals. We do tend to see lots of strep throats, UTIs, URIs, & migraines. Occasionally it gets boring, especially when we get one URI after another & each one thinks they are the only person to ever get a URI. Dixie
  8. I work for approximately 25 providers as a float nurse. I have gotten quite a bit of experience dealing with different personalities. But I am happy to say that the treatment you receive would not be tolerated. The clinic director( one of the nicest physicians I know & I love working for him) would be all over that person & I assure you, you'd get an apology. We do have one intimidating MD. He's one of our few specialists & very high maintenance. Most of the nurses don't want to have to substitute for his nurse because of his personality. I work for him usually 1/2 day a week & that's about as much as I care for. Dixie
  9. The schools like to tell you that there is a very large shortage of nurses but they neglect to tell you that the shortage is for RNs, not LPNs. If you are set on nursing in a hospital, you'll have a hard time finding a job in most states. LTC are always hunting for good nurses & if you like working in that environmnet, you probably won't have any trouble finding a job, although you'll probably start on nights. I chose clinic nursing. We nurses do everything the RNs do, except work the triage phone lines. It's probably the lowest paying of all nursing jobs but what I enjoy & for me it's worth it. Unfortunately, many clinics are hiring medical assistants instead of LPNs to do much of the work the nurses do because they can pay them even less. They can get along with a few RNs to do the "real" nursing duties & let the MAs do the rest. Dixie
  10. "I think people that only have breast cancer, no mets, are the luckiest people in the world." Wow, you might want to put yourself into those individuals' shoes once. Cancer is cancer, whether it's stage one breast or any other. Try going to nursing school, graduating at the top of the class & finding out you have breast cancer 2 months later. Try starting your first nursing job just 3 weeks post mastectomy & try to continue that job while undergoing chemo. Try returning for your first post treatment mammo & find out that now the other breast is "of concern" & then tell me that breast cancer patients are the luckiest people in the world. Ya, you may be only 22 years old. Maybe you need to grow up & stop feeling sorry for yourself. Or at least get into a different field of nursing. I would not want you to care for me next time I ended up on the oncology floor. I certainly would not welcome a nurse telling me how lucky I was while I'm picking up handfuls of hair, like I did the last time I was hospitalized. Dixie
  11. During my LPN training while doing our only rotation at the hospital, 2/3 of my class worked on an oncology floor. They got to experience so much more than we who were assigned to the skilled nursing floor. Sure, they said it was sad at times but not everyone was dying. Many patients were there because of complications with chemo. I, actually spent 3 days there myself last spring when I got a lung infection while I had neutropenia, due to chemo. Unfortunately, it was a holiday weekend & there were no students. Dixie
  12. I'm glad to hear that you feel this way. I wanted to be a nurse since I was 4 years old but didn't get the chance for over 50 years. I, too, feel I was born for this. I have been working for just 10 months & only part time but if there are too many days between work days I get really antsy. I'm ready to go back. Dixie
  13. You probably couldn't pay me enough to work in a hospital or nursing home and I never did. My first and only job so far has been in a clinic. I just don't want to work in those settings. Too much lifting in LTC & too much stress in acute care. Instead, I love working in the clinic. It can get boring at times, lots of swabbing throats during strep season, etc but every day is different. I get to work with trauma as well as the routine. Pay's not so good but the hours are really nice. Dixie
  14. Wow, I could have posted this exact same thing just a few months ago. While going through chemo, the same regime as Robin, by the way, my supervisor was so accomadating & so were my fellow nurses. They seemed to know instinctively when I was having a bad day or when I felt tired. I don't work in acute care, but rather a very large family practive clinic, and there was always someone who would pitch in if needed. The extreme fatigue was what really got to me. I was just hired when I started chemo & I decided that I really didn't want to have to quit my dream job because of the chemo. I, fortunately, only worked part time (3/4) & on the days that I worked, I did nothing at home after. Heck, even now, 3 months after the end of treatments, I am exhausted after a day of work & do practically nothing when I get home, just cook a meal & throw in a load of laundry. I hope soon that the fatigue will let up. One thing good that comes of this is that you definately can empathize with your patients who are going through chemo, even if you are lucky like me & didn't experience nausea & vomiting. I have been asked some pretty blunt & personal questions by patients that I wish I could have asked someone before I went through it. I was happy to answer all but the most personal questions. I'm now getting questions again, now that I have tossed the wigs & scarves & am going "natural." Nothing screams "chemo" louder than 1/2 inch long hair.:chuckle Dixie
  15. Don't worry about it. The math questions range from easy addition/subtraction to algebra, some of which can be figured out just by using common sense. They don't expect you to get them all right so if you miss the algebra ones, it probably won't hurt. It's been over 40 years since I took algebra & I admit that a couple questions had me stumped. It didn't stop me from passing the test. You'll be fine. Dixie

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