webbiedebbie

I just started working in a nursing home/rehab facilility at the end of January. I spent 3 weeks of orientation on one hall with approximately 30 residents in semiprivate rooms and 2CNA's. During orientation I moved on to 2 halls and then 2 halls again and the last 2 halls with one being behavioral health. On nights there are only 1 CNA to each hall. I don't feel safe having to pass meds to 2 halls and keep an eye out on my 2 halls. Is this normal staffing?

I have over 30 years of RN experience and I have an interview scheduled for a nurse educator position in a nursing home for this coming Tuesday. Although I have no experience as an educator, I am doing some research so I can be prepared. I'm excited to be asked for the interview. I do have some experience in working in a nursing home. Is there anything you could share to help me? I know I need to brush up on colostomy and trach care as well as infection control, wound care, etc. Thanks in advance. ?

For the past 4 years, I have been trying to reenter the Nursing profession. I took the Nurse Refresher Course and even shadowed a position but was turned down because I didn't have recent experience. My specialty is L&D. I acquired over 70 CEU's to keep abreast on any changes in my specialty. I became a Birth Doula to hone my skills in assessment and watched the nurses in their duties. I had nurses ask me for ideas for positions to benefit labor. I'm certified in NRP and Advanced EFM. I've applied to a Nurse Residency position at a local hospital in hopes of getting the opportunity to work in my specialty. With my years of experience, I figure I am between a seasoned nurse and a new grad. Any words of wisdom?

Sorry, I'm "by the book" also. Its too bad the doctor doesn't want to be called for things like this. It is their responsibility to write the orders and I think too many MD's do not "pay attention to detail".

Well, unfortunately, I am considered "remote" which means like "contractual" employee and they don't have to offer insurance or other benefits that way.

I was laid off from a full-time telephone triage job 4 years ago. I could only find a part-time telephone triage job. I need benefits! I also was able to collect unemployment. I found a position that I knew I was not qualified for and really didn't want, but I would lose my unemployment if I turned it down. It turned out to be the worse 2 1/2 months in my life. They finally let me go. I couldn't quit or I wouldn't be able to get unemployment and I had to plea a special case d/t circumstances in order to be reinstated. I finally (Thank God) found a job 1 year ago doing remote chart reviews. I am required to work 40 hrs/week (YIPPEE!) BUT they DO NOT PAY BENEFITS. I have been working with them for one year and have not had a vacation because I can't afford to take off 1 week from work. I AM VERY GRATEFUL FOR MY JOB, though and I LOVE doing the work. While I was unemployed, I too, took some online classes to further my education and then I thought, "wait, there are no jobs out there and I have no guarantee that I will find anything in the near future". I have not done bedside nursing in 6 years and would need to take a refresher course. I have no desire to work in a hospital at this point in my life. I have been a nurse since 1989 and never thought it would ever come to this. I'm sorry, but 12-hour shifts at my age would probably kill me. I feel bad for all the new nurses graduating and I feel bad for the older nurses. I CANNOT AFFORD COBRA, so don't even suggest that! My husband is not working and it is all I can do to make the mortgage and car payment, as well as high utility costs. I was recently diagnosed with Graves Disease and Diabetes II...seeing a doctor costs me CASH up front. I miss the nursing I used to do!

I have been a registered nurse for 21 years. I chose telehealth nursing because 12-hour shifts were too much for me. I love the work but it depends on the company you work for. I started in a call center and enjoyed everyone I worked with. When I moved to another state, I was able to take my job with me and work from home. Then I was laid off after 4 years. I started with another company that was small and offered no benefits and was part-time. I stayed for a year until I got a full-time job working in an office but this one did not have guidelines to follow and I was told to use my nursing judgement. Needless to say, I left after 2 1/2 months. Good luck in your decision. I sometimes miss the bedside care but have found telephone triage to be just as exciting. It can be very frustrating, though, because you cannot see what they are talking about and they often don't take your advise. You do use nursing judgement but you should have standardized guidelines to follow.

Thanks for responding so quickly! I understand your reasoning for using RN's.

I just accepted a position and have been exposed to prior authorizations. I knew about them but never had to do them. Anyone have information that might help me? I was given 4 to do and I felt like the deer caught in headlights. Since there are so many different insurance companies and forms, I feel overwhelmed. I have heard the common complaint that prior authorizations are time-consuming and a waste of money. Does it have to be done by an RN? Would it be more economical to have someone specifically trained in doing these? Any other RN's responsible for these? It's probably such a simple thing to do which makes it more confusing to me!

I was laid off by a major company 04/2009. Telephone Triage can be expensive, so it is one of them to go.

McKesson has been laying off since April 2009.

UPDATE: My dream job was cut last April (2009) due to the economy! Other companies I have looked into do not compare. I am having to do telephone triage with a smaller company part-time.

We know, as nurses, it is our reponsibility to teach....but when your company tells you that you don't have time to do that, just get yes or no answers and give a recommendation and end the call within a certain time, it is very stressful and I think Mike is just venting. Many nurses feel Telephone Triage is a "cushy" job. IT'S NOT! It is very frustrating, especially with time constraints from the company. The protocols are guidelines, but we have to think between the lines many times. My company requires that when someone calls to ask what medications to give, we do an assessment first. That makes sense. But I have seen times when a nurse did not do that.

Yep, have to take time to clarify lethargic, which eats into my call time....mostly I say "limp like a rag doll" to give them a better picture of what it means and they come back and say "oh no, he's been laying on the couch and watching TV".

Mike, I agree with you. Protocols are guidelines, but some companies use them as carved in stone. I have to use a book of protocols and have to document which one I used (sometimes, I've had to use 3 depending on the sx) but have been told to use nursing judgement but then be counseled because I did not use the "recommendation" in the book....geez! If they want cut and dry answers, them mail everyone a book and let them come to their own "recommendation" and they won't have to call a Nurse anymore!