biltz

I'm a Med-Surg RN in between jobs and I have a question about liability with providing care to neighbors. I live in a very large retirement community in California. My neighbor asked me to assist her after knee surgery. Her daughter and she wanted me for my nursing skills and to monitor her post-surgery and then to progress to simple ambulation, ADL's, and light housekeeping. I told them I was concerned with "representing myself as a nurse" as I didn't carry individual nursing insurance and didn't want to jeopardize my nursing license if something went wrong. I insisted that I didn't want to be paid and would just volunteer doing it as a good neighbor. In the end she insisted on paying me a nominal fee. Ironically, right before discharge she suffered extreme orthostatic hypotension and ended up staying in the hospital an extra couple of days and went home with an agency home health nurse. I came a few days later and just helped with ambulation and light ADL''s and housekeeping. She's mentioned to several friends and neighbors how much she appreciated my services and now they are asking her to ask me if I will work for them. A friend who's husband has dementia would like me to come and sit with hIm so she can have some relief. She mentioned though that she liked that I was an "RN and came with that background". I would love to help her but I'd also like to get a little compensation for my time. I might also like to do this for a few other referrals. It's been a long time since I took my healthcare law class. Am I setting myself up for a huge liability case or losing my license? I don't want have to carry insurance, set up a business, contracts etc... I also don't want to do this long term, just until I go back to full time work. I also don't want to get in to discharge orders, doctor communications, medication administration, etc.. I just want to go and offer simple "nurse's assistant" services. 1. Would I need to carry insurance to cover my a$$? 2. As an RN with a current license am I liable to perform to the highest scope of my license even if we agree on a limited scope of work? 3. Would a contract limit liability in terms of scope of work? 4. Would any of this jeopardize my license or do I have to be working with an agency? 5. Anything I'm forgetting?

I need some advice. I have the choice to choose between two new grad opportunities at the same hospital. One is in oncology and the other is in the renal/diabetic unit. I have always imagined myself as working in renal with the goal of eventually working with a transplant center. I have close personal ties with transplant and dialysis patients in my family and have had a passion for transplant nursing since starting nursing school. I even precepted in a rental unit and enjoyed it. Oncology has always been the farthest from my mind Through a strange set of circumstances I ended up with an interview in the Oncology department and decided "what the heck it's another opportunity to practice interviewing skills". As I discussed the role of an oncology nurse with the manager I realized there were a lot of similarities between what appeals to me about working with renal/transplantpatients and what working with oncology patients entails. Both are more wholistic types of nursing - i.e.seeing repeat patients, following them through the long arc of their illnesses, lots of patient teaching, dealing with families, complex care, multi-systemcomorbidities, etc. By the end of theinterview I not only sold the interviewer on me, I started to sell myself on Oncology Since then I've been talking to my BFF who was an onc nurse and loved it. The more I look in to oncology the more interested I am in to it but it is still all very new to me. I know a lot more about renal than I do about onc. She tells me that renal patients are much sicker and stay sicker (they are usually the most non-compliant patients when they come in and stay that way when they go out - and that's why they are frequent fliers) - vs. - onc patients who have been healthy and have a new diagnosis but fight to stay alive and do whatever they can to comply with the regime. She hates working with renal patients but loves working with onc patients. I'm wondering if it's just a bias or a perspective I've never encountered before What are any of your thoughts/input? Have any of you worked both units? What do you think gives one a better new grad experience/basis of learning the profession? If one didn't stay in either renal or onc their whole nursing career, does one offer more opportunities to branch out and/or limit you in the future? Any input would be of great value! Thanks!

I need some advice. Ihave the choice to choose between two new grad opportunities at the samehospital. One is in oncology and theother is in the renal/diabetic unit. I have always imagined myself as working in renal with thegoal of eventually working with a transplant center. I have close personal ties with transplantand dialysis patients in my family and have had a passion for transplant nursingsince starting nursing school. I even preceptorin a rental unit and enjoyed it. Oncology has always been the farthest from my mind. Through a strange set of circumstances I ended up with aninterview in the Oncology department and decided "what the heck it's anotheropportunity to practice interviewing skills". As I discussed the role of an oncology nurse with the manager I realizedthere were a lot of similarities between what appeals to me about working withrenal/transplant patients and what working with oncology patients entails. Both are more wholistic types of nursing - i.e.seeing repeat patients, following them through the long arc of their illnesses,lots of patient teaching, dealing with families, complex care, multi-systemcomorbidities, etc. By the end of theinterview I not only sold the interviewer on me, I sold myself. Since then I've been talking to my BFF who was an onc nurseand loved it. The more I look in tooncology the more interested I am in to it but it is still all very new tome. I know a lot more about renal than Ido about onc. She tells me that renalpatients are much sicker and stay sicker (they are usually the most non-compliantpatients when they come in and stay that way when they go out - and that's whythey are frequent fliers) - vs. - onc patients who have been healthy and have anew diagnosis but fight to stay alive and do whatever they can to comply withthe regime. She hates working withrenal patients but loves working with onc patients. I'm wondering if it's just a bias or aperspective I've never encountered before. What are any of your thoughts/input? Have any of you worked both units? What do you think gives one a better new gradexperience/basis of learning the profession? If one didn't stay in either renal or onc their whole nursing career,does one offer more opportunities to branch out and/or limit you in thefuture? Any input would be of greatvalue! Thanks!

Oooops, and its in June 2013 not July (had something else on my mind....)

Yes, it's invite only. I applied to the new grad program and then those chosen to interview are invited to the "open house fair" to interview with the different unit managers.

I will be traveling to the new grad fair from out of state and wanted to get some background information regarding the fair. I read some posts from last year's fair that it was a "loooooong" day. Has anyone heard anything more about the event than what was in the emails? What units are hiring? How many positions? Anyone from last year's fair have any insights or input? Thanks, B

Hello, I and a fellow classmate have received invitations to attend this year's (2013) new grad fair. Any suggestions on how to prep for it and/or hints for being successful at it? How do we find out what units are hiring? Any input would be helpful! Thanks!!!!

From the original email sent out did you take it that the references had to be mailed via postal mail from the original source? The last email I received it was mentioned that they were expecting letters to be mailed/emailed/faxed. I don't remember receiving any email or fax numbers for my sources to send to UVMC. Did any of you see that it could be emailed to them? Any of you have that contact info?

Did that work?

What is your FB profile name?

I would contact ----- and ask her who to talk to and tell them that you are interisted in switching if a position opens up. I would assume that if a position opens up they are just going to go down the list that they already created. I think that Hayward is typically the more desired location so its more difficult to switch to that campus than it is to Concord. We did have one student switch at the beginning of either Winter or Spring quarter when someone dropped out of the Hayward program so it can happen. Hayward also has there own form of a Blackboard message system just for their students. You might ask ----- if you can post on there if someone wants to switch.

Definitely come to orientation. Stuff like that happens all the time. They will work it out in time. You don't want to miss all the info they will give you tomorrow!!! KB

Search for CSUEB Concord Nursing Class of 2013 on FB. Did they tell you that orientation is on Friday at 8AM?

Andrew, I just sent you another private message. Biltz

.... After reading your question Andrew I realized I probably didn't answer your question properly in my last post. Defending yourself in such a situation is very, very difficult. As a matter of fact, "being defensive" is one of the major issues they will use against you in any kind of review setting if you are not 100% agreeable to the instructors recommendations. Therefore you have to be really carefull in your approach to all this and how you carry yourself. You want to show that you remain "teachable" and that you are listening to corrective instruction even though you have some "difficulty in agreeing" with the same facts as your instructor. Once they brand you as "defensive" they will usher you out the door. The next thing to remember is that as professional nurses, your instructors are masters at documentation and privacy and they will use it to their advantage. Therefore you have to do the same. Document, document, document!!! Write notes on everything you do. If a nurse or your instructor note that you did something well, document exactly what they say. Get the first and last name of every nurse you work with. If you do a skill with a nurse or your instructor ask how you did and document their reply. If things are really going back and you think your instructor is picking on you, ask for a student to be a witness. If your instructor wants to talk to you 1on1 and pulls you in to an empty supply room or pt. room, ask for a student to come with you as a witness. If you think your instructor unfairly judges your skills find out if the department will call in another instructor to supervise you for one day. Just always have a second pair of eyes and ears on you. That was how my instructor got away with everything. She would pull me into an empty supply room or pt. room, tell me one thing and then do something different or write on my evaluation something totally different. Also, I'd do something with a nurse and it would be fine and when she got report from the nurse later, she'd totally twist the facts around and misinterpret how things went down. I didn't keep a record of the nurses I worked with so I couldn't go back and use them as witnesses. Be as diplomatic as possible with your instructor. If that's not working, read your nursing handbook and find out what the policy is for handling complaints. The department will fall back on that always AS THEIR protection. If you don't follow the handbook, the nursing department or University will use that as an excuse to throw your complaint out the door at any point down the line as they choose. Miss one step or jump over one person's head and all your protections go out the door. Document in writing everything and prove that you have attempted to work with everyone up and down the chain of command and document how you've done it. Also, follow everything up with an email or a letter documenting what you have done. Also, ask the same from your instructor. If he/she repremands you, ask for it in writing, in an email, or something written. If she compliments you, follow it up with an email, thanking her for the compliment. Then, start printing everything out and building a hardcopy file b/c you will need it if you go to the university or a lawyer. I've sent you my email privately Andrew so if you want more specific suggestions, contact me.