TakeTwoAspirin MSN, RN, APRN

TakeTwoAspirin is a MSN, RN, APRN and specializes in Peri-op/Sub-Acute ANP.

TakeTwoAspirin's Latest Activity

1. 

   Seeking Advice: Direct Entry Blues

   TakeTwoAspirin replied to mk989's topic in NP

   It doesn't sound to me like they are letting her go because she does not meet a minimum level of basic competence. If you read her OP, they are allowing her to stay for several "months" while she finds a new position. Please, nobody is that nice. She works with peds. I doubt they would assume the legal responsibility of having someone who was endangering patients to continue to work for them. She would be gone! If I had to guess, she just isn't making them enough money. She is likely making enough to cover her salary - or again, she would be gone - but they are not seeing her speed up enough for them to be able to project that she will meet their anticipated profit. While I don't disagree that more training and experience is needed, there is something being missed in this instance and I'm not sure that her "competence" is what is at the heart of the decision to let her go.
2. 

   triage help

   TakeTwoAspirin replied to mp1965's topic in Correctional

   While I am not familiar with how the chain of command works in correction facilities, it worries me that you mention that heart pain/chest pain is often used to get off the unit. If this influenced your decision not to have this addressed immediately, then at some time or another you will get burned with this. You will never be faulted or reprimanded if you practice from the standpoint that chest pain should always be assumed to be cardiac or pulmonary in etiology, until definitively ruled out.
3. 

   Help! Please talk me out of quitting!

   TakeTwoAspirin replied to Wanttobeamom's topic in Nursing

   Torn between brutal honesty and encouragement..... Honesty: As a surgical tech, you will most certainly be multi-tasking - far more than you realize. While it is true that you will only have one patient to deal with at a time, during most surgical procedures you will need to think fast, anticipate, be constantly preparing for the next step as well as responding to emergent problems/complications requiring you to communicate efficiently with other team members while remaining focused on the task at hand. Despite the fact that everyone wears personal protection in the OR (sterile gloves, gowns, face masks etc) you will be exposed to bodily fluids every single case, every single day. You are also working with sharp objects every single case, every single day. While sometimes we do know the patient's HIV or hepatitis status, there are times when we do not. The truth is that the best techs on the best days can and do get stuck with a sharp object that exposes them to bodily fluids. Blood/fluids splash. Surgical plume..... don't even get me started on surgical plume. Myths: Not all surgery centers are abortion clinics. Yes, generally, you can decline to scrub in on abortions at most/many large hospital facilities, but at the end of the day if a patient is crashing and there is nobody else available, you will be expected to do your job. Surgery centers will offer less call/weekend commitment, but you cannot always be certain of getting off work on time - and there is no second shift to come and relieve you. Encouragement: The work is awesome and you will have the honor and privilege to be part of a life-changing, life-enhancing team. The standards are high; the expectations are high; and the commitment is 100%. While it can be difficult to find a starter job as a surg tech, once you have experience you will be a valuable commodity. It is hard work, in a challenging high stress environment, but as an ex-surg tech myself I can honestly say that I wouldn't have missed the opportunity. Good luck, whatever you decide to do.
4. 

   What happens to my career as a nurse if I sue a doctor?

   TakeTwoAspirin replied to RN135's topic in Nursing

   Be careful you don't win the battle, but ultimately lose the war! I would have to have been physically messed up pretty bad to pursue action against a doctor (or any other provider) in a community in which I worked.
5. 

   It's time to vent!!!

   TakeTwoAspirin replied to MegRyanGirl's topic in NP

   My favorite is the rash that was there yesterday, gone today, but pt wants something just in case it comes back!? Rule of thumb: If I can't see it I can't fix it!
6. 

   Checks with no funds

   TakeTwoAspirin replied to OCRN3's topic in NP

   If this guy is not paying you, how can you be sure he is paying your malpractice insurance or the taxes he is deducting No pay = no work. You have too much to lose and this whole thing sounds sketchy.
7. 

   MD co-signing inpatient orders

   TakeTwoAspirin replied to Alicia777's topic in NP

   Sounds like they are billing your services "incident to" a physician for the higher reimbursement rate.
8. 

   Failed FNP AANP again (4th time) seriously I give up!

   TakeTwoAspirin replied to Wakes's topic in NP Students

   There is a module on the ANCC website that walks you through how to read the test questions and what key words and phrases they put in the questions that give you an indication of what kind of answer they are looking for. If you truly know your stuff, but are still failing the test, you may be missing something in how you are interpreting the questions.
9. 

   First NP JOB.. Should I stick it out

   TakeTwoAspirin replied to newnp31's topic in Advanced

   It sounds like you are being flat out abused. Do you have a contract to fall back on? Any kind of per-patient bonus structure? Benefits? It's hard to tell just how badly you are being abused without further information on compensation, bonus structure, specifics of contract, etc. And, no, it wouldn't ruin you or your career to move on for greener pastures. I think it is fairly common in the industry for new grads to be taken on their first job - wish it wasn't true but I see it more and more. Believe me, employers know and understand the game and I doubt it will be held against you so long as you leave in a professional way.
10. 

    New grad first job

    TakeTwoAspirin replied to Junondfnp's topic in NP

    How many patients does he expect you to see in each of the locations? Will you primarily be office-based, or rounding in two different locations? Will he pay travel expenses? If you are on call a lot, will he provide you with a phone or pay for your phone? If you are the first NP he has hired, and you are a new NP who doesn't really know a lot about contracts, etc., either you or he (or both) need to buy Carolyn Buppert's book, Nurse Practitioner's Business Practice and Legal Guide so that you can both start with a basic contract that will address all of the issues that generally come up when hiring NPs. Without a well-defined contract framework both of you are liable to be unhappy with whatever may evolve as you figure out what you are supposed to be doing, and he figures out what your role is going to be.
11. 

    New Grad - First Job

    TakeTwoAspirin replied to LoloFNP's topic in NP

    Two weeks vacation is nowhere near enough, especially given how many patients they expect you to see. Up to 30 is A LOT. They are going to be making a ton of money out of you with the kind of numbers they are throwing at you. Your base is OK, but for a two year contract I would want a documented increase at 6 months, 12 months, and 18 months. The hours are too long, you may have a scribe to help with some of the charting, but you still need time to review charts, read labs, follow up on labs, etc. You must have hours built into your schedule that are not office visit hours, but administrative hours. I would not agree to a two year contract at any point, but a two year contract for a new grad tied into such big numbers is terrible if you are not getting a bigger piece of the pie. While it is possible to build up to 20+ patients a day with the proper support, you need to negotiate a bonus structure that rewards you for every patient over 15. You also have to have documented what support you will have - how many examination rooms will be dedicated to you so that you can "stack" your patients in rooms. Will you have a dedicated MA or have to share one (which means you may not be able to push through patients efficiently). It sounds to me as if you will be killing yourself for these people for two years while locked into a new grad pay scale and benefits. Don't be fooled - they are making more out of you than they will be giving you in "experience". Everyone dangles "experience" in the face of new grads as a reason why they should give up much of their power. If you accept this offer without having them document some of the things mentioned here (along with other contributions from members here, I'm sure), they will be laughing all the way to the bank while you are burning out and hating life!
12. 

    INR LABS

    TakeTwoAspirin replied to nikita12's topic in Nursing

    This answer is perfection! Not only do you need to tell them what the labs are, but it is helpful to let them know what the last labs were (so that they can note any trends), and what the current dose is. If you are calling with INR it is also wise to know the prior H&H to see if it has dropped any since the last INR (especially if you are having trouble titrating a patient who is elderly, frail, or has a history of gi problems).
13. 

    Dealing with mean docs

    TakeTwoAspirin replied to MillyPeets1234's topic in Operating Room

    Or.... the more of an attitude they have, the worse their skill level is. There you go again with glass half empty! (Note the exclamation mark.)
14. 

    Dealing with mean docs

    TakeTwoAspirin replied to MillyPeets1234's topic in Operating Room

    The exclamation mark at the end of that sentence was supposed to give the reader a clue that the post was tongue-in-cheek. You can extrapolate meaning, misinterpret, and put as many words into my mouth as you want. Anyone who actually reads my post, without trying to put spin on it or read it with a chip on their shoulder, can parse out that my post was actually a dig at surgeon in question. But hey, go ahead and be enraged if that's what makes you happy.
15. 

    Dealing with mean docs

    TakeTwoAspirin replied to MillyPeets1234's topic in Operating Room

    I never said that the OP should accept the behavior If you read my post again, I am saying that in my experience the worse surgeons are normally the meanest - most likely secondary to their overcompensation for what they perceive as their own inadequacies. I never once said it was OK for her to be treated this way. Please read posts more carefully before shooting off indignant responses.
16. 

    Dealing with mean docs

    TakeTwoAspirin replied to MillyPeets1234's topic in Operating Room

    In my years in the OR I have noticed a pattern with mean surgeons: the amount of talent they have as a surgeon is usually directly inversely proportional to their bad attitude. Be kind to them. They are doing the best they can!