Dierdre

When I had my now 15 year old daughter my now ex-husband asked the doctor to put an extra couple stitches in for him. The crusty old ex-army physician barked at him "Get an implant!"

I hate 12s. Period. There is no redeeming quality to them whatsoever. I never got more days off with 12s anyway. I will never work at a facility that does not offer 8 hour shifts.

I'm married to a guy with Asperger's Syndrome and pregnant. Have to admit I'm a little scared. I love him, and he's definately difficult to handle sometimes. He has some behavioral issues that are a little weird (I've caught him running in place in the corner when he's overstressed more than once) and some odd social problems (one of the things that we are working on right now is looking people in the eye, he never seemed to get the knack of it). I'm slightly concerned that the baby will also have this problem. I have a friend that is a psychiatrist, and he assures me that there's about a 17% chance of this happening. I guess that means there's an 83% chance that it won't and after living with hubby for several years I think that I can deal with the baby. Think being the operative word. I have some anxiety about it. Anyway, if any of you would like some perspective on how these kids behave when they grow up lemme know.

There is no excuse for nurses to be ugly toward CNAs (and vice versa, see below). If you feel like you have a legitimate complain, you can go up the chain of command, and to HR if necessary. Unlike physicians (which isn't right, but there are already plenty of other threads dealing w/MD-to-nurse hostility), nurses do get disciplined for mistreating subordinate staff, and no one should have to take ugly behavior from anyone above or below them on the chain of command. On that last note, respect is a two-way street, so make sure you're not guilty of the same behavior you don't like to receive from nurses, either.

Wow. That ratio isn't even acceptable in Oklahoma, which I consider to be seriously behind the times in LTC ratios. Find another job, STAT. Even in LTC there'll be plenty of them. There's plenty of jobs for new grads out there, I'd try to get one in home health or hospice where they are a little more appreciative of your efforts. Other options include your local plasma center if you have one. They generally need a nurse or two, and are also generally flexible with scheduling. Good Luck!

I strongly agree with the previous poster. What in the heck were they THINKING? A new grad simply does not have the experience to make the kind of decisions that a SNF coordinator needs to be able to make. Also...working at least 84 hours per week is NOT conducive to decent grades in RN school. I strongly suggest something with very flexible scheduling...is there a plasma center in your area?

I would leave out the medical diagnoses (CHF, multiple MI's, CAD, etc) because you could be accused of 'diagnosing' the patient, which can only be done by a physician. Also, I would have notified the physician IMMEDIATELY on a systolic bp "in the 70's". You will get called on that if you let it go most of the evening. Anything under about 85 is reason to notify the physician immediately if not sooner. Also, I wouldn't bother to mention the stuff the patient doesn't have (the catheter or feeding tube). No reason to write extra stuff. Also, if the patient reported chills and cough an additional temperature wouldn't be amiss. You wouldn't want to find out later that your patient had a temp of 102 right after you left the shift. Mostly, cover your bum by making sure that you answer all the questions that you bring up. If something is normal, there's really no reason to address it, unless the facility's policy is making you do so. There should be one complete head to toe assessment done every day, then after that the usual rule is charting by exception (if it's weird, write about it.) I hope that's helpful.

It's not Oklahoma. New Grads make about $14/hour in LTC, nurses with a prodigious (read 10+ years) can start at about $16. Physician's offices will pay about $12/hour, and prisons start at about $15/hour. Hospitals bring up the rear at between $10-12/hour.

Hmm, I'd spring for less money and less responsibility. Get thee to a physician's office, minor emergency clinic, plasma center, blood bank, or something where you're not responsible for other people's lives. If your state doesn't have medication aides and cna's that are allowed to take vital signs, find somewhere else to work. I did, and I'm much happier with my life now. I make $.46 less an hour, and boy is it ever worth it.

Hmm, I have had very few office romances, generally speaking they end in disaster...however, there's the little matter of the one that did work too. I met my hubby at work, we worked together successfully for over a year, and the only time we ever got into any trouble was over a hug when I brought him dinner one night (we worked different shifts..at least MOST of the time). I left after several months to take another job, and now he works at that job, too. He's an awesome nurse and an awesome guy, and can be relied upon to NOT pull any office hanky-panky that would get us into trouble. He's awesome, but not everyone is.

You know, in my experience the only thing that bucking the system has ever done is get me fired. Trying to advocate for better staffing, better conditions, better anything can be compared to beating your head against a brick wall. I remember being young and idealistic and thinking that one person can change the world, but the system is strongly ingraned in well...the system, and believe me the bosses like it that way. Then again, maybe I wasn't THE ONE for whom the world was going to change. If it's you, great! More power to ya! I hope they listen to you, because all I got for my trouble was horribly frustrated, and finally a job in the Plasma Industry (which I love).

It really hurts to be forced to leave your friends over a difficult situation like you've found yourself in--where you're being actively persecuted by management. Best of luck with your new (and better!) job, and hopefully the next politics will be someone else's problem.

Don't worry about it. They were asking if you could come in most likely because the doc would have had a few minutes to meet you before (s)he started seeing patients for the day. If you couldn't make it in half an hour, it's best to say you can't, because at least you're being honest. So far as your age on the application goes, while you're there looking at them they're most likely going to figure out that you're young, so I would say present a conservative-appearing package. No facial piercings, tie your hair up if it's long enough for ties, and wear either tasteful scrubs (ready to go to work right now, yes!) or a dark colored dress with low heels, and makeup if you wear it. Also, you can use the power of positive thinking to get things on your side. (A little metaphysical help) Start thinking about this job as if it was already yours. Repeat things like "I'm starting my new job Wednesday at 9:00." "I love my new job at the pediatrics office." That will give you confidence (really!) when you walk in the door on Wednesday morning, and that shows in your interview. Very best of luck to you! (although you won't need it )

Welcome to the wonderful world of LTC 'management'. Dang, it seems like even after eight months out of the job I keep finding ways to get angry at the place I was working before, and seeing your plight really torques me off to the maximum. I'm mad at them again, and they had nothing to do with the situation. (sorry, that was completely off-topic.) Most likely, the above poster is correct, those two nurses have been at the nursing home for a long time and are running the show. Most likely, the administration thinks that they are angels of mercy, and hasn't seen the ugly/lazy/cruel side of them. Also, they most likely have the corporate staff buffaloed as well, I'd be horribly surprised if they didn't. Unfortunately, this is a reality of the system in LTC. Management and the Corporate Office see the patients as cash, and the floor staff see the patients as people. The unfortunate thing is that you will never really be able to convince (upper) management (in your case) that those patients are not cash cows. If you systematically work through your staff and question them you will also most likely find that they are assigned too many patients to be safe, that they are most likely angry and frustrated with their jobs, and that they feel trapped because they don't know what job they can go to because of the family life that restricts them into that role (babysitting and things of this nature.) Unfortunately for you, if you go too far into trying to fix the problem, the most likely thing that will happen is that you will get fired. Of course, by this time you will have a large bruise on your forehead from beating it against the brick wall of LTC as well, which your insurance won't cover because it happened at work. The problem with LTC is that the system is broken. It is so deeply malfunctional that one person cannot change it, and that if any one person tries they will eventually lose their job because of the pressure that they put on the established system. The only way that things are going to change in LTC is legislatively, and it's going to take intense lobbying by the nursing community to get anything changed because the owner PACs are so strong. From the ads you see by lawyers on tv, you've gotta know that things are broken, but repairing them is beyond one person's ability to do. Best of luck to you! Sorry I'm so pessimistic on this subject, but I spent six combined years working in LTC and this is how I see the situation.

LTC is not possible without shortcuts. The last time I added up the amount of time needed to take care of my LTC residents including meds, breathing treatments, eyedrops, inhalers, treatments, fingersticks, insulins, other injections, assessments, charting, and actually managing the staff, I came up with a need for 22 hours of work a day. I spent three hours a day in the dining room uselessly feeding people that any competent nursing assistant could have fed better and faster than I did, another hour a day in 'stand up' (a daily 'meeting' that was basically a report for administrative nurses so they could get their care plans done without looking at the charts), and didn't take a lunch break for three years. This left me five hours (if I didn't have an admission or a death) to deal with 22 hours worth of work. I told my boss daily that I didn't have enough time to do my job. Caring about that was not in her vocabulary, about every two weeks I was in the office getting a solid orifice-chewing about not being able to get thus-and-so done (always 'essential' paperwork, the patient care was done). I went to work eight months ago in the plasma industry. I strongly recommend that people leave LTC in droves until the management is forced to staff to appropriate levels.