SweetSue16

I think you have been thrown to "wolves" with only 5 days orientation. Ask for more orientation.Try to identify with a nurse there that you admire, some one you think is doing a good job. Model her. If you are the only nurse in the building for 200 residents from 11-7, that's dangerous.

Log rolling laminectomy patients for weeks. Hospitalization for cataract surgey...feeding them, bedpan and no moving the head. Cardiac precautions, up to a rocking chair after bed rest for 7 days. I could go on and on. Graduated from nursing school 1971.

Hi Nursegirl, What part of the country are you working? Working with famlies that are in crisis or guilty ( particularly if a grandmom is in a nursing home) can be very difficult. I have found that is not always what say or the way you say it that is the problem. It is the way that family member choose's to hear it. Several month's ago I was met by a drunken son in a nursing home. He accused me of saying hospice would pay for his Mom's new glasses and than reneging on that " promise". The reality of that original conversation with him revolved around her recent hospital stay and NO hospice would not be getting her new glasses. He than threatened to revoke hospice. I called the office and documented exactly what happened. The office was supportive of me. The pt's son did not revoke but he really never spoke to me again. That was ok with me because he was a drunk and kinda of scary. Sue

Lindarn, I think your comparison is" right on". Sue

EM1995.... I requested a miniteam in Dec regarding my pt's no decline status. The clinical coordinator went to to the nursing home and scoured her chart. She called the hospice medical director, who ordered a lab draw for albumin. The result was actually an improvement from an Oct. resullt. Her arm and thigh measurements are unchanged. She has had no infections, no skin break down. No change in cognitive or functional decline. Her pps is 30% , fast score is 7f. These scores have not changed since admission. The clincal coordinator will have to do the re-cert. Thanks for listening

I have been working as a case manager for a not-for profit hospice since May 07. I took a paycut when I accepted the job. I have 11 patients for now. 8 patients are in LTC facilities. During the past summer most of the case mangers were caring for 14 or 15 pt's. The paper work is overwhelming and very repetitive. Many deadlines exist that include team meetings, supervisory visits, skilled nursing visits routine and in emergencies. Phone calls. We make medication and treatment decisions from standing orders while in the field. We are sometimes in filthy surroundings or unsafe situations. All 37 years of my nursing experience is utilized every day. Unfortunately I can't pay my bills on the hospice salary. Hospice pt's must be re-certified for contiued eligibility every 2 months. The re-cert must show decline. Currently I have 1 patient with a diagnosis of debility. She has been in hospice for a year. She has not declined. Our census is down. Staff has been told no mini-teams, no discharges. I am being told to re-certify her. I am having a lot of trouble with this situation.

I to have been saying since 1971 ,without nurses patients wouldn't come to the hospital. Without nurses most settings in healthcare would cease to exist. As nurses we could do most of the jobs non-nurses do in a variety of settings. In fact we already do. In the last 37 years I have worked in a variety of settings. I have never worked anywhere that was ideally staffed. We staff to acuity is a lie.I have prepared food when the cook didn't show on the weekend. I have moved furniture. I have answered the phone and taken messages. I have cleaned up mess's that defy description. I put up with constant interuption and still finish a med pass. I am not unique! Nurse's do it all. But non-nurses cannot do what we do.I will never understand why we aren't treated as valuable. There is a shortage of us everywhere! We bring a variety of skills to every healthcare setting there is. We should be paid accordingly. Nurse's are the largest department in most work places and we have the least input. Administrators sometimes with no healthcare experience are making healthcare decisions. Is being burned out a surprise?