aaspender

I worked at Methodist main and somedays I was the only actual staff member on the floor with every other nurse being agency or float. It was pretty scary. When I started I had 15 years experience and they are just short of experienced floor nurses. I saw some pretty scary stuff and would go home and cry about how hard it was to provide sound care. I left after a year. I do know that they were interested in figuring out how to provide more support to the nurses that were new (poor babies). I did learn more as a nurse there than when I worked in teaching hospitals I think because more of the burden fell on me rather than the intern or resident. In that regard it was good. An internship if properly done is wonderful. I did a 9 month internship at the old Hermann Hospital (seriously, I cannot believe how I made it now that I think back) but honestly, it made all the difference for me in the long run and I had so many learning opportunities. Methodist has a ton of CNS, MSN nurses that mentor so make them stick to the plan and you will be fine. Just don't let them throw you into the fire early. Oh, the staff that floated from MSTH always said they liked it better over there. The docs are for the most part very cool there. The renal guys (and 1 female) are real good teachers if you ask questions. Wanted to add that because it makes a difference. Avoid the MD with "Gold" in her name. urrghhh!

i just had the worst week of my don life doing my annual survey. i tried to explain my policy and procedure for isolation to a very stern and egotistical federal surveyor and 10 minutes into the "interrogation" i knew i was heading straight into immediate jeopardy land. cms is really pushing the revised f441 tag for infection control and before you think any further on this read the whole million pages. it is crazy. they want to know why if 1 person on a hall is sick w/ gi symptoms that you did not test for c-diff, why they were not isolated, why... seriously, what i thought was prudent care did not fly. i think it was perhaps worse (i am being kind) because a fed was drilling me but after reading the entire thing i can see where i will have to revise our program. oh, they did repeatedly comment on how all my staff washed their hands for 15 seconds, used sani-wipes on the bg meters before each use, that every peri-care observation was perfect but still considered giving me an ij for infection control. anyway, i have a little ptsd right now and am ranting but start with the tag. as the fed guy said to me "there is this book called the som, it has the instructions... arrghhh!

Whoops

Thanks.

Today I was reading about a care plan report card that you can send to the residents family member who does not come to the care conference meeting. I really like this idea but have no clue what a template would even look like. It would be really nice to ensure we "communicate" with family, especially those families that we have never seen! Sometimes I feel like the only time we talk to some family is to "notify" and that is usually not a happy call. Any ideas? Thank you all for being here:cool:

I want to work at home but luckily my administrator knows better than to give me access to the server at home. Therefore I am forced to forget about work the minute I leave. Then the phone rings at 9pm... and I am working at home again. I fantasize about how much work I could get done in my pj's if they would let me bring those charts home. I am torn I tell you, torn!

I have never responded to this type of thread before but I read something on here about the ANA stating that a BSN is a professional nurse and an ADN is a technical nurse. I looked at the current license in my wallet and it states that I am registered to practice professional nursing. I passed the same NCLEX everyone else did regardless of the base education. When the NCLEX comes out in two versions, one for the less educated and one for those with further education then I guess we will see the difference. Until that time I suppose we should all just respect and care for each other as peers. :redbeathe

If medicaid paid for this few if any people would end up in a nursing home. Medicaid only pays +/- 150$ per day for 24 hour nursing home care her in Texas. That is only a few hours of nursing care in the home environment. I wish they did though, the thought of having to put my father in one kills me and I work in a nursing home. Good luck in finding care.:heartbeat

I don't differentiate when I hire. New RN BSN nurses are terrifying at times and actually cost more in training on the job. Too much analyzing and not enough work. I have one of those simple 2 wrinkle ADN brains and maybe BSN nurses have more wrinkles in their brains requiring more pay up front. It is a puzzler.. just kidding people. Anyway I make enough money not to care anymore. Being an ADN has NEVER cost me a job I wanted.

disclaimer: the content you about to read is an editors nightmare. the girl can't help it. i was just browsing on here after a rough day at work where i had to term a cna for snorting coke at work. wonderful lady, she called right after she left and said thank you for waking her up. it reminded me of 9 years ago when i lost my second job for some serious performance issues due to being chemically impaired. i went the tpapn route the first time on my own and quit after 9 months, they said "you'll be back". the second time i was referred and fired by my employer and was actually sober and happy soon thereafter. that first year of tpapn i was rejected from over 10 jobs, filed bankruptcy, almost divorced... it was the best year of my life. i was sober and at peace. i finally took a job in a nursing home (big fancy rn's work in big fancy places and well, i am not too big but...) and when i got home i whispered to my husband, who is also an rn "i got a job in a nursing home, don't tell anyone". well needless to say 21 months later i got kicked out of the program 3 months shy of my completion because i never mailed my paperwork by the 5th. old habits die hard (nobody is gonna tell me how to...) when the tx bne came calling i was so damn tired of it and they wanted to do this investigation blah, blah, blah. i said "look, it is all true. it was bad. what do you want me to do?" they sent me back to tpapn and i did it by the book with all my nursing home friends there with me. they bought me roses on my final day of tpapn 2 years later. now after all these years i make great money, am a passionate nurse, am sober and still working in a nursing home. anything you put in front of your sobriety you will surely lose. bless you all and shout out to the bne for assisting me to become a safe and prudent nurse who can still practice. getting sober made me see that and if that is not the craziest thing. peace.

There is a federal regulation for what the temperature can be in a home but the regulation for sufficient staffing it is basically defined as ability to meet basic needs. It is really hard to get cited for insufficient staffing because if the feds/ state cite you then they ACKNOWLEDGE that they must pay to reimburse the care they say you must provide. The feds/ state are not willing to do that often enough to make it an issue that requires probing. It is a vicious cycle. I have seen some horrendous examples of staffing reviewed during a complaint survey that were not cited. I am talking 2 nurse aides for 120 residents. It astounds me.

I will be the real picky lady who takes an hour to get ready every morning. I may be a stroke on my dominant side therby no longer able to pluck the stray hair on my chin, apply my lipstick, ensure my bra is on correctly etc. I will be frantic if I miss my hair appintment and they will fear my daughter if she comes in and I am poorly groomed. I will also have way too many clothes packed in the closet and will refuse to get dressed if they are wrinkled. I will also only drink vanilla Ensure unless someone makes me a special order in the kitchen. I will also love my caretakers immensely and rat on the ones who have no compassion. I won't be private pay either, I will be flat broke when I go in and will spend my 60$ a month (that gift from medicaid!!) on lipstick and clothes at Walmart.

I am familiar with this topic having been in the Texas Peer Assistance Program for Nurses a few times (3x) and also being married to a bi-polar nurse. What the BON is interested is that you if have been diagnosed and treated for the condition you are fit to practice. They recognize that if they refused licensing for a nurse diagnosed with a psychiatric/ addiction condition that a huge number of persons would be disqualified. Full disclosure is the best option, trust me, I have been through the wringer and am still a Registered Nurse who can practice. My husband checked that box and all he got was a renewal approval. He didn't have to provide any details but would have if they asked. You want to be friends with the BON, give them grief and they push back hard. Good luck with your NCLEX.

No one seems to run my floor. I've just come from 6 years as a DON in LTC to the hospital. My floor is intermediate so it is primarily RN's. Today we had a tech and he was doing the never ending vital signs for us. This afternoon an MD asked me about pt X and I gave him an update...stable..no change..pre-op... A few minutes later this MD asks me if I thought a temp of 101.1 was stable. I was confused and sure enough when I checked there was a temp charted an hour before (too early for the V/S) for 101.1 by the tech. When I asked the tech if he forgot to notify me he said "No. If you don't like it I guess I can go home and cry and you can do your own vitals". I was speechless. When the doctor asked me what the tech said I repeated it. The doctor went after the tech and told him how it is. As a DON I really hadn't had anyone speak to me that way and can't recall that in the 10 years before either. All the other nurses thought it was horrible that the "sweet" tech got into trouble. I left tonight asking myself how nursing has come to this. Nothing will happen to the tech and it blows my mind. If I had the authority he would have gone home. https://allnurses.com/forums/images/smilies/uhoh3.gif