maestrotee

I do actually. Thanks! :-)

That is precisely my point. Thank you.

I am def not saying I don't plan my care. Oh, my gosh. I am planning my care every moment of the day. It's called prioritizing. A piece of paper doesn't ensure that everybody's on the same page regarding certain dx or problems. I would surely hope that our education and licenses do that already.

What do you mean I won't have to do another one in the 'real world'? I wish. I'm an ADON in the real world at a LTC facility and I bet we spend almost half of our day staring and obsessing over these stupid pieces of paper that don't meet any specific patient need at the very least, and at the very worst takes away from patient care, worried that the state will come in and hang us because we didn't update the care plan with the latest coumadin dose adjustment! It's absolutely asinine to even conceive that writing something on a piece of paper somehow contributes to patient care! I was a floor nurse for a few years before the admin thing, and I don't ever remember opening a care plan for ideas on how to better serve the needs of my patients. I grabbed their H&P and meds and let my assessments dictate how I took care of that patient. If they tell me they are in pain, and they have an order for PRN tylenol, I'm not going to take a break to go find out that they like a calm quiet environment as an intervention to pain. Duh! I don't know anyone who prefers a loud, busy, bright environment to help them cope with pain! The only reason that nurses are still burdened with this arbitrary regulatory mandate is so the board of health can find tags and generate revenue. I absolutely hate the concept of them. The end.

That is all.

WHAT THE ...?!?! I think I just threw up in my mouth a little! Blechhhhh!!!

Merry Christmas from South Bend, IN. 40 degrees, and the snow has melted, turning my backyard into a mud pit . Good food, family, friends. Let the festivities begin!

Carl, thanks for the response. There is much to consider. One of the biggest emotional factors will be going away from my five year old for a time. He is still young enough that I will feel the devastation more than he will, but it won't be forever and it will provide much more security for us in terms of financial stability as well as propel me over the final educational hurdle towards my bachelor's. I work in a long term care facility on the rehab unit and feel like I am stuck. This might just be the next step for me. We'll see. I have an appointment with the medical recruiting office this coming Tuesday morning. I hope I hear what I want to hear. I'll keep you all posted.

gabirder, thanks for the response. Yeah, that's what the recruiter was saying, 2LT, 22 months of pay to secure my BSN. Heck, it would probably only take half that time cause I have tons of undergraduate credits already ... was a junior pursuing a psychology degree before i switched over and got my ADN. The quicker I finish, tle less time I would 'owe' the reserves. He mentioned that too, that I could go active with the permission of my commander. Either way, I have a god job in a rehab facility right now, so the 'extra' money would be just that ... extra. Of course, I want to go active asap. Does the Army pay for 'any' accredited degree, such as college network, all on-line BSN? That would be nice, too. Anyway, thanks. Keep the replies coming. This is very encouraging! Trashcanistan ... ROFL! I think I lived there once! By the way, half way through typing this post, I got another call from the recruiter. Looks like there is a way for me to go active right away with the Army Nurse Candidate Program. He's gonna meet with me and go over the requirements, but it looks good so far. It's 10,000 sign on, 1000 a month stipend, and same thing, Army pays to finish my degree. It just looks like I would not 'owe' the reserves any time.

Oh yeah, of course that would make me a CO, commissioned officer in the end.

So, apparently the army is still hiring. I just got off the phone today with a medical recruiter who told me the army would give me 1900 a month to go from my ADN (licensed RN) to my BSN, and be reserve. I would love to go active duty, but I guess if you let the reserves pay the schooling, then you owe them time. Along with all of the above, there is a 16,000 sign-on bonus. Has anyone done this? My ambition is to be in a chopper in medical transport and, so far, this sounds like the quickest path. The hospitals in my area are in a hiring freeze and I was just passed over for a job in the ER that I was seriously hoping for. It kinda took the wind out of my sails. This has been an encouraging prospect. Please, anyone with some experience here. I am not a teenager anymore, married, one 5-year old beautiful little boy. I would hate to be away for a year or so, but it seems like a great investment for some great experience! To be honest, I thought I was too old, or else I would have considered this years ago!

Note to self, must have talk with family clarifying the removal of necrotic body parts ... LOL! Seriously, that is the truth! Sometimes when I look at these people's feet, wounds, whatever, I just don't think they can see the same thing I see! I wish I could be straight up honest and tell them, "Hey, sir, that is not just a flesh wound you got there, and the smell is not coming from down the hall ... it is your rotting flesh and it's not going to 'get better' no matter what we do here. Sorry, but it's just got to go. If it were me and I owned a hack saw ... "

Very interesting. I guess I just never did the research about that particular drug. No surprises, not the first time. Okay then, maybe my dog could benefit from it after all ... :paw: Holy cow! I just read some of the info @ drugs.com and it is FILLED with warnings about addiction! Wow, I'm usually more informed about the meds I give. I just figured that since it wasn't a CS that it was pain relief similar to tylenol, motrin, or aleve. Guess I should do more research!

I have seen wounds that I could fit a small child in, cleaned trachs with caked on goodies that took an eternity to scrub clean, been witness to the olfactory insult of a GI bleed, even been vomitted on, but never felt like I was going to lose my cookies until today. For dinner, I was beginning to feed a 90+ year old demented lady, very little interaction even with her hearing aids in. I gave her one bite of a toasted sandwich on the end of a fork and she began to chew. About a minute later, she put her hand up to her mouth and removed a very large piece of what HAD to be lunch that she had pocketed in her cheek five hours earlier. As soon as the smell hit me, my stomach began to turn. I had to get up and walk away to recover. She didn't end up eating very much either. Gag! Not real sure why that, above anyting else, bothered me so much ...

What? That is truly bizarre! I've never heard of anyone using tramadol to get 'high'. It's mood-altering characteristics are similar to that of a Flintstone's vitamin. Honestly, a doctor prescribed tramadol for a dislocated shoulder I had a while back and I ended up throwing the majority of them in the trash! IMHO, it does very little to reduce pain and nothing to alter mood. LOL, my dog has a bottle of tramadol in our cupboard for arthritic hip pain. I don't see it helping him much, either. Maybe this nurse thought they were getting something else? BTW, we just lost a nurse a short while back for stealing vicodin and fentanyl. Sad story, new nurse, too. She was removing fentanyl patches off patients and CHEWING ON THEM! Addiction sure is an ugly beast!

I have been glued to this thread for hours today. I am scheduled to test Aug 6. Been answering hundreds of questions from the Saunders review book and CD-Rom and listening to the whole Kaplan audio review course I downloaded online (probably something like 16 hours of instruction). I will post some questions tomorrow ... must ... sleep ... zzzzzzzzzzzzzzzzzzzz

Oh, I absolutely agree with you 110%. They should not be fed or maybe it's not appropriate to give the meds. Most of these nurses would rather just not have the responsibility of simply calling the doc to ask for comfort measures and call the family. Shoot, the family would probably be real happy to sit there for hours for you. Usually, they don't want to be interrupted much and there's not a TON of paperwork. I'd rather do that and write a brief note in the chart detailing what was happening than the paperwork involved in a fall! Gawd, or an admission. But I get that done. I don't know, maybe it's not as obvious to others that someone is dying, or maybe have their own issues with it. Who knows?

Looks like I sparked a lot of other horror stories with the OP. I've had fun reading them. Keep 'em comin. My little annoyances don't seem too horrible compared to some of these ...

I just wanted to vent a little here. I was just assigned to a floor I don't usually work and I knew that I would be spending plenty of time locating the meds on the cart, reviewing the treatments so I could manage my time, blah, blah, blah. I ended up making about five different calls to the pharmacy to locate the medications that were not there. A couple of them were on their way, so I was reassured that they were being given. One, in particular, was a transcription error in the MAR, was not even the right medication that was written in the order in the chart. The pharmacy told me they hadn't filled the medication several WEEKS ago because the order was not the medication that they have faxed off the original DR order! The kicker is, nurses have been signing off as giving it and it has not been there! I placed the correction order with the pharmacy and changed it in the MAR so at least those nurses initialling the med can produce the med if anyone ever asked! I'm a little neurotic, so a great deal of my nursing practice is run by, not only integrity in my own practice, but also a good dose of paranoia. What kind of response would I give a state auditor following me around for a med pass, not only unable to produce the medication, but also a confirmation from the pharmacy that it has never been sent with my initials all over the MAR?! Some of the treatments I was supposed to be giving were not available either, Triamcinolone, Lotrisome, etc. A good friend and co-worker on my unit called me into a pt's room the other day to be witness to a pt actively dying, you could hear the fluid in the lungs from outside the door, non responsive, dropping BP. This was only two hours after shift report, in which the day shift nurse said, "so-and-so is fine" (her reports take about 10 seconds as she is walking out the door, by the way). The MAR had been initialled all day that this pt had been given meds. There is NO WAY this pt had been swallowing meds! All these situations are revolving around one particular nurse that I would not let take care of my sick tomato plant, let alone a family member. I no longer wonder why she looks rested and relaxed when I walk in, when the rest of us rarely get to sit down. It doesn't take long to sign the med book and call it a day ...

To answer many of these inquiries so far, no, there was no written agreement and, therefore, most likely don't have a case. I have several months of paycheck stubs with the higher wage I have been working for, but no signed agreement. Maybe I misunderstood you, but you would not leave under these terms? What exactly are some hypothetical terms that would make you leave if not taking your paycheck away? How about this one ... new organizational policy ... you must bring a baby kitten to sacrifice to the corporate gods every Mon morning :bowingpur. Would you stay?

Dear, I've been a pre-paid legal member years before I got this job. My membership has nothing to do with their benefits package. They don't offer it. However, looks like my questions have been answered so I won't waste my attorney's time and mine when I could be doing other things like investigating the free market of opportunity.

Wow! This has all been a very interesting read. I already have 2 different opportunities that have been mentioned to me by individuals at other facilities (in only the past 48 hours, I might add), before I have even had the chance to update my resume ... . On the other side of things, I don't dislike ANYONE in management inside the walls of our building ... it is someone from corporate; nameless, faceless individuals that are pulling the strings. People that don't even know me or see the product of my work! And, I HATE learning policies and units and patients all over again from brand new. Guess I wouldn't like travel nursing too much. However, I do have a responsibility to provide as best as I can for my wife and little boy. We need to eat and stay warm and dry. So many things to think about ...

That's what I thought. It sure sucks, tho. I hate looking for a job, but that is what I will be doing.

Our CEO just pulled me into his office today to inform me that 'corporate' is not happy about the raise I just got 2 months ago and he has to 'readjust' my pay, giving me over 2 dollars an hour cut in pay!!! My job as a charge nurse has not changed, just what the 'company' is willing to pay me. I have never heard of such absurdity. Needless to say, my resume is in the works as we speak and I am out of there after just shy of a year. They must think I'm a fool! By the way, I am a member of prepaid legal and will be investigating this with an attorney, but does anyone know off hand if this is a violation of wage and labor. It sure should be!

Thanks for the replies. Sounds like I certainly have my work cut out for me if I intend to be an agent for change in this area. Your comments are very helpful. Keep 'em coming! :)