blondegenes

I detest people when they choose to ignore ADD or ADHD, simply because it is not an obvious disability to their eyes. Such people wouldn't think of depriving a quadriplegic of a wheelchair, but they would deny people with ADD/ADHD meds and/or reasonable accommodations. Such people wouldn't think of depriving an amputee of a job/employment, while they would deny people diagnosed with ADD/ADHD of gainful employment. Unfortunately, many of those types are also administrators or supervisors. Before you decide to reveal your diagnosis to your place of employment, go to see a knowledgeable EEOC http://www.eeoc.gov/ Know what your rights are concerning having your diagnosis protected under HIPAA. If you are considering formally notifying your employer of your diagnosis/meds, you may also want to inform them of your own HIPAA protections. The last thing you want to happen is to have the word of your diagnosis put out to your fellow employees and have some small minded person start treating like you're a dummy, because of their own uninformed bias. There is a sample letter that you can present to your employer, putting them on notice and making it possible for them to link up with reasonable accommodations. Having said that, however, also know that you definitely risk your job,,may not get even the most simple reasonable accommodations you request, and may be fired or let go from your job (for some other bogus reason) simply because that's the real world. It is a little known fact that amphetamines DO NOT have the "speed" affect for those with ADD or ADHD. If they do, you probably DON'T have ADD or ADHD, because those drugs have the effect of "leveling out" someone who has ADD or ADHD. Different meds and behavior management/accommodations work for different people. Stratera made me throw up. Ritalin is very difficult to obtain even as an adult with confirmed diagnoses, due to the number of drug abusers who illegally obtain the drug(s). If you're using a prescribed med, check with your EEOC officer to see if it's a good idea to let your employer know before or after you're UA'd, and weigh your options. Most people who have ADD or ADHD have higher than average IQs and are able to hyperfocus on tasks that average people cannot. Most people who have ADD or ADHD are also gifted. If you stimulate the gifted end (art, music, etc) with activities it will bring up the deficient end (learning disability, etc). Another good test is having the person suspected with ADD or ADHD to write a paragraph before taking the meds, and having them write the same paragraph a few hours after taking the meds. If the diagnosis is appropriate, while under the influence of the meds, the handwriting samples will appear as though two completely different people wrote them. This was discovered at John Hopkins University where research was done on the effects of various meds on ADD and ADHD. If average nurses thought nursing school & clinicals were difficult, walk a mile in my shoe! I did it with dyslexia and ADHD and was 3rd in my class. I burnt the candle at both ends getting through nursing school.

Charting and vitals on medicare patients every shift should be a BIG RED FLAG.

I swear by TED hose. They make your legs feel great even for days after you've worn them!

Never chart when off the clock. I read of one instance in which a RN had her license suspended by the state nursing board for doing so. The executive director said it a thousand times, if she said it once; "it's doable on paper",,,interpretation; she would rather you do it on paper, make it look good and neglect the patients. Why? Because, given the skilled nursing load, it wasn't doable at all. Previously, the skilled nursing unit was staffed by two nurses, but the executive director enjoys a rich bonus by nickel and diming the patients, literally, to death. (Yes, I've documented and reported neglect to the appropriate agencies). Subsequently, all of the other night nurses that were hired and retained for any length of time were the kind who started charting the moment after they took report from the previous shift, and never got up to check on patients, pass pain meds, check blood pressures, blood sugars or any vital change on the skilled nursing unit. Previously, any nurse who would not risk their license by following suit took employment somewhere else as quickly as possible, or was fired under false pretenses just to open up a slot for another nurse. The executive director and DON publicly praised the nurses who clocked out on time, even knowing full well that they slept on the job and refused to get off their duffs. The executive director is unaware that I know she had dialup service on which she could get four different camera angles (at any given time, on her cell phone) of the nurses and CNAs who were sleeping and/or watching tv. There are mediocre LTC/skilled nursing facilities, and then there are horrific LTC/skilled nursing facilities. They all receive the same amount of money from Medicare and Medicaid as every other facility, but you can tell if the facility is taking care of the patients, by the appropriate nurse:patient ratio. If you are uncomfortable with working over at the end of the shift, ask yourself if it is because you are in fear of losing your job by justifiably doing so. If that's the reason,,find employment somewhere else, quickly. It's a lot easier to find another job when you already have one.

Every LTC facility gets paid the same as every other LTC facility by Medicare. Just looking at the condition of the facilities and its employees should tell you a LOT.

Sounds like Piscesgirl was orienting at PMC. I went through the same thing. Sounds like some hospitals are just all about the bean counters. The bottom line is that you can refuse to take on the full responsibility of the patient load. You know, like we all do, that we risk our jobs by doing so. It's a better alternative than taking on the load and then messing up and risking your license. You can bet that the hospital won't stand behind you if you mess up. I'll be praying for you.

We nurses were just discussing this very thing the other day. Dr. comes in and spends 3.4 minutes with each patient, doesn't even look up from his clipboard to examine physical sites being pointed out by patients and nurses, mumbles orders (afterall, why should be bother to write them down legibly) and is treated like "God". This would not happen in a male dominated occupation. Nurses do not fully realize the power they possess to bring about change in nurse/patient rations, and make this occupation a great and honorable one, instead of an occupation that washes/burns out thousands every year.

There's one in Kansas City and the night staffing is 1 RN to 40 patients on skilled nursing. I wonder if that's even legal in Kansas. If anyone has the answer, please respond. It's sister facility in Granview, Missouri has a much better reputation.

Longterm care nightmare job - Page 2- Nursing for Nurses

Not only can you become a CNA at a certain point in your nursing school in the State of Kansas, you can also sit for the exam to become a CMA (pass some meds) once you pass a particular point in nursing school. Your school or your State Board of Nursing should have that information available to you.

I've been called everything from a CNA to a RN,,but these days my patients think I'm their very own concierge.

I heard about this color transparency therapy for ADHD about a decade ago. I was very skeptical at first, having dyslexia and ADHD, but surprised when a pink filter worked wonders for me! Some things work better for some people than others, but it worked for me.

I commiserate with you about the financial aid office. They are the worst! One year they sent out over 3000 letters to students and former students telling them that their grades made them academically ineligible for financial aid. I knew it was a mistake and faxed the letter to the college President along with another letter I got the same day for making the Presidential honor roll. The President's office chewed someone's butt in the financial aid office, but the other recipients of the letters still suffered. Most students took their word for it, accepted the letters at face value, and struggled to pay for their own books and tuition or sat out that semester. Some took their letters to the financial aid office where the employees "never make mistakes" and became psychotically defensive about it. I'm surprised they have as many students as they currently have. It's tough enough to get a nursing degree, let alone having to fight financial aid to competently do their job every single semester!

Some acute care/skilled and LTC facilities use CMAs or med aides to dispense some meds, take vital signs, and do finger sticks. LPNs with IV certification are more desirable in those facilities at times, only because they have a broader scope of practice of things they can do, but are cheaper to pay than RNs.

Been there and done that! At a certain skilled and acute care nursing facility in Kansas City, KS, anyone who actually does their job gets brow beaten and their hours cut if they work overtime charting so the facility can get paid by Medicare. Employees jobs are perpetually threatened who are actually doing the work. Management style is to emphasize the negative and downplay your hard work. It gets old real fast. If you actually clock off your shift on time it's either because; 1. you've worked that hall so long that you know what everyone's needs are and where everything is and/or 2. you don't actually do vital signs, finger sticks, skin assessments, G tube flushes, bolus feedings, IV anti-biotics, treatments, or pass everyone's meds and insulin, etc. For the unlucky nurses who have to switch working on North and South halls all the time, if you aren't working overtime, you're not doing the work. Period. The med carts are not uniform and the carts and med rooms are a complete and utter mess. Treatment supplies are routinely missing, unordered. Necessary supplies and pharmaceuticals are always insufficient to get your job done. There is one working vital sign machine per hall for two nurses to share, which means one nurse or CMA has to do something else while you wait for the other to finish. There are never enough glucometers to go around. These things eat up your precious time and are always YOUR fault. Some people who are actually doing their jobs buy their own equipment just so they can do their jobs in a more timely fashion. The facility requires you to sit through moronic meetings on payday that will bore the snot out of you, before they "give" you your paycheck that you've already worked your butt off for. For example; body mechanics to save your back from chronic injury. Most of the beds in the facility are the old fashioned crank-on-the-end-of-the-bed type. You're left with the option of wrecking your back to constantly get down low enough to crank the old timey bed, or getting down on your knees to work with the patients, because, remember, time is of the essence. What a joke. Incident reports are not made if the bruises are not "fresh" and can be qualified as "healing". Therefore, it's advantageous to belong to a group of slackers who will cover for each other, look the other way, and only report "old" incidents so you don't have to take the additional time to write an incident report and be bothered with things like neurochecks. If you're a nurse who actually does the work, expect the nurse who caused the neglect accident to call off work the next day to call in sick, and their CMA partner-in-crime to "discover" the injury so you have to write an incident report. They will also bad mouth you and cast dispersion on your character to put blame on you and take the focus off of themselves. I don't know of any similar facility where this kind of thing is not happening. But it gets worse. Forget about giving the prescribed psyche meds to patients who are agitated and up all night. The nurse is too busy chatting on her laptop and conning other people to do her work for her on 12 hr shifts, to be bothered with a resident. Just put the resident in a wheelchair with a "lap buddy" to keep them somewhat trapped and turn off their wheelchair alarm and leave them alone. So when the resident worms their way out of the wheelchair, and falls on the floor, their chair alarm won't alert anyone. Any other resident who witnesses abuse and neglect knows that they are subject to the same kind of mistreatment. Many of the employees get even with the administration by getting "free" food from the kitchen and taking supplies from the facility, belongings, and large sums of money from the resident rooms. Employees have been warned not to carry ID, money, keys, etc., because, as I was told, they WILL be stolen and your vehicle entered and other things stolen, too. Although I never heard of it happening, it's not a stretch to say that, once they have your car keys and/or house key, they could steal your vehicle and/or enter your home, too, or hand them off to someone else who will. The real hardworking employees are so afraid of losing their jobs working overtime to get all the loose ends tied up according to law, that they clock off and finish up working for "free" on their own time. The DON would love it if they clocked off at the end of their shift and work doing the rest for "free" and have zero overtime, I'm sure. Employees are required by company policy to report abuse and neglect, but if you do, you are the one who becomes the target and you will be verbally beat up in front of your coworkers and your life made hell until you either quit or you get the message that some bosses don't want to know anything that they will have to deal with. Especially if you're reporting offenses that their favorite brown nosers have committed. If you report a real offense, look to be set up by the offender/butt kisser/slacker and their cohorts who have found themselves a slacker niche where they can slack to their little hearts' delight. Somewhere on this website there are other posts about how the emphasis is placed on charting for Medicare and MDS so the facility gets paid, over actually caring for the patients. Relatives and "friends" of employees have been found roaming the hallways of the facility and in the rooms of the residents and it is common knowledge that the residents are allowed to keep their wallets, purses, and large sums of money in their rooms and on themselves. This is not an isolated incident. There was an old warning sign in the break room warning employees that their friends and relatives were not to go beyond the entrance. I doubt that any of this has ever been reported to the police. The worst? The parking lots were poorly lit. There was no security. The facility can be entered by anyone who has obtained the lame code from a former or current disgruntled employee who wants to steal the narcotics. The solution? We were told to call 911 if you see a suspicious person. So many people come and go, who would recognize a suspicious person before the staff were overpowered, outgunned or murdered? Complaints about serious concerns like this fall on deaf ears. You risk being fired just for bringing genuine concerns to the attention of anyone in charge. The whole thing is a huge lawsuit waiting to happen. I just hope no one dies over it. Another center in Overland Park is under scrutiny for pretty much the same. Whistleblower protection? Good luck with that. If anyone knows more about that subject I'd appreciate the input. I can't tell you what to do about that. Remember this, it's a lot easier to get a job while you have a job. Some facilities/hospitals won't even consider you unless you're currently employed. Good luck!