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Thank you everyone! I’m still trying to figure out how to reply to each individually. I plan on orienting at a local hospital next year. The last thing I want is to work with COVID positive patients again. I will continue working in LTC when I travel out of state. Thank you! Cissy

Hi I am a skilled RN in long-term care and skilled nursing. I have been in the field for eight years. I work Perdiem as an agency nurse locally. I have also traveled out of state during the pandemic. I want to jump in to MedSurg as a traveler. Do you think it’s possible for a skilled RN to get my feet wet in MedSurg via my first MedSurg contract? LOL I’m asking, due to a decrease in contracts for long-term care in the state I want to work which is California. I’m used to having 25 patients, some with Alzheimer’s some long-term care. Multiple issues during a shift. I almost think MedSurg might be a relief. Any insight is appreciated Cissy

WOW!! Thank you so much. Haha, I’m thinking I have it made here as a local travel nurse. No hassles, excellent income and more. I’m still going to investigate. Time will tell the rest of the story.

I currently work for three separate travel agencies in Cape Cod. As you have said, it’s good to have a back up if one agency cancels me. I filled out an application for Nursfly and I see several other agencies listed. You are saying to contact one or two others working with the same facility? Is it cost effective to maintain my primary residence? This is the only thing keeping me from leaving local agencies to travel the world as a nurse. I only work in LTC and skilled nursing. thank you for your insight!

WOW!! Awesome info NedRN. I live in Mass I am a per diem local travel nurse. I make between 38 and $42 an hour. I have a residence here in Massachusetts. I recently filled out an application for NurseFly have you heard of them?

Hi fellow nurses I am in the middle of applying to nurse fly. It’s a healthcare staffing agency with dozens of travel positions across the map. Any advice on whether I should look for my own housing or let the agency?

I have been thinking of this seriously for a year. I am applying to Nursfly soon. My name is Cissy. I’d love to correspond.

Yes I realize Dee and I are just doesn’t mean do not treat . His most said transferred to hospital. Skilled nursing facilities frown on transferring patients out. However, this patient needed to be diuresis therefore he needed to go out. I was simply hoping that he would at least be admitted overnight so that my transferring him seem legit. Does this make sense.?His most said transferred to hospital. Skilled nursing facilities frown on transferring patients out. However, this patient needed to be diuresis therefore he needed to go out. I was simply hoping that he would at least be admitted overnight so that my transferring him seem legit. Does this make sense.?

Hi nurse community I need some nursing knowledge from seasoned nurses. Crack down on transfers to hospital. Scenario 72 year old IDDM, Copd, CHF, Afib HTN squamous cell lung cancer to name a few CKD this patient was not on a single diuretic. I understand he most likely wasn’t on Lasix due to his kidney disease. However, he wasn’t on torsemide either. First time I met this gentleman. During morning care he seem to be having some respiratory discomfort. That time I didn’t check his O2 sats and continue to monitor. During morning care he seem to be short of breath. At that time is O2 sats were 93% on RA. Went along with my med pass. I got to his room to administer his medications checked his blood pressure and his O2 sats. Blood pressure was 90/58, heart rate fluctuating between 70 and 120. Both extremities with +2 to 3 pitting Adema. No air exchange entire right lobe. Diminished in the left lobe. Alert and oriented times three. I reviewed his medications and noticed he wasn’t on Lasix. I looked at his history and noticed he had renal disease. I talked with the unit manager about why he wasn’t on a diuretic, question torsemide Long story short he continued to decline quickly. O2 sats dropped to 74%. I put on O2 at 2 L up to 76%. Went in search for a non-re breather there wasn’t one. I asked the staff member to please get a nonrebreather. Call the doctor. The doctor came in 15 minutes later(must have been close). He placed his stethoscope on his chest for about 15 seconds and then walked out of the room. I gave him all my assessments. He went out and looked over the chart and talked with the unit manager. Meanwhile the patient was on 15 L and his Satz were 60% Blood pressure 102/50 heart rate from 70 to 130. No nausea, skin pale. The doctor says to transfer to the hospital. The patient is a DNR. I’m walking out the door at 4 o’clock and incomes my patient in no distress. I guess you could say I was surprised to say the least. Skilled nursing facilities frown on transfers to the hospital. I tried all nursing interventions before I really felt he needed to go as well as the doctor. I’m thinking that they must’ve given him diuretics which stabilized his respiratory and cardiac status. Any thoughts? Sorry for any typos cissy

Thank you so much for the good information!

I need help understanding all the different wound dressings on the market. I work in a skilled nursing facility with many different dressings that I'm on familiar with. I'd really like to become more knowledgeable about wound care management without paying $100s of dollars. Any suggestions? thank you Cissy

If you can afford to take a refresher course I would take it. You can do this!! Trust me. You won't regret giving it your best shot.

I'm on the right track. I also looked up glucagon administration which was very helpful. I realize that the facility has policies but I didn't have access to it today . I'm going to do a little bit more investigation. I would very much appreciate your taking the time to respond!

Hi fellow nurses Our unit was informed tomorrow that we will be having a mock code for an unresponsive patient due to hypoglycemia. I work in a long term skilled nursing and rehabilitation faculty. Last Friday is 66-year-old female died from a hypoglycemic reaction. A nurse was suspended and now our facility is under fire. I am fairly new nurse as well as agency. Can anyone simplify step-by-step. So I don't flounder tomorrow? Thank you so much

Hello group, I cannot seem to find the answer to this question regarding Hemoccult testing. The question is (Hemoccult testing cannot be performed on the incontinent resident)? One more. If frank blood is produced in the bowel movement o be sampled, (It is still appropriate to continue testing)? Thanks guys Cissy