handyrn

Abcde, pronounced Ab-si-dee.

As an RN who is also from the same Iowa/Nebraska/South Dakota area, I have to ask: Are you nuts?!?! The job market is terrible here. It is hard to find a job in nursing in this area. Why would you even risk it? And as the wife of a cop, don't fool yourself, the cops probably already know that your relative is smoking dope in your back yard, they are probably just too busy to bust some small time user, but when they get bored and are looking for something to do, your relative (and you) may not be so lucky. Just tell the guy to stay away from you, your property, and no rides in your car if he's going to smoke the stuff. Didn't you stress and work too hard to obtain that nursing license? Why would you risk losing it?

HIPAA-it's supposed to be such a good thing, but all it does is take the love out of nursing if you ask me. It just goes too far! This is one reason why I cannot do floor nursing in a hospital. It rips my personality right out of me! It's just sad.

One of the saddest (and scariest) patient stories I have is that of a little boy. When he was not quite a year old (still only crawling) his dad dropped him off at daycare. About 10 minutes later the boy was unconscious. The EMS was called and he was taken to the hospital. After a month or so on a ventilator with no brain activity they finally did a chest X-ray with the mother's insistance and found a little plastic toy lodged in his lung. He had aspirated it. It had been on the floor of the daycare along with all the other toys. At the time I took care of the boy he was 10 years old, in his home, still on a ventilator.

...and the more we talk about how bad it is in a nursing home and that you are un-hire-able afterwards, the worse reputations the nursing homes get. Nursing homes (contrary to popular belief) are great places to learn! By the time a person is elderly and entering a nursing home, they will many times have multiple diagnoses and be on multiple medications. You will get quite an education in both areas if you care to learn.

Does anyone know the CMS regulations that speak to the different roles and responsibilities?

If there really is a problem with turnover, how about talking to your nurse manager about a mentor program on your unit? Get the mentors to be people like yourself who have relationships with the docs (and others) that normally intimidate people. If you are the one who introduces the newbies to the difficult person, maybe you will act like a sort of bridge between the two during their first meeting and maybe the newbies will learn that he is not such a bad guy like they thought.

I guess we are getting a little off topic here, but I will add my own experience. I can handle anything. Suctioning anything snotty looking used to be my grossout, but I have gotten used to it. I was really surprised when I worked (a short while) in surgery and hip replacements turned my stomach! It wasn't the procedure itself, it was when they took the leg out of the socket. Legs are not supposed to be able to turn that way! It's not natural! It turned my stomach every time. I suppose if I had stayed in surgery I would have gotten used to it in time.

The area I live in in Texas has big need. The three hospitals within 50 miles of my house are hiring. I just landed a great job in one of them. Also, one of the hospitals, Val Verde Regional, in Del Rio, Texas is giving $24K sign on bonuses. I think the problem is that the three towns are small. Also, they are border towns. Look on indeed.com for jobs. Someone posted that site here once and I love it! It's a great site.

I am a new hospice nurse. I am so excited! I have mucho nursing home, home health, and geriatric experience, and was super excited to get this job. I have good assessment skills, but little acute experience. I was reading some of the hospice posts and am realizing that I have a LOT to learn. However, what I think I have to learn is the textbook stuff, and that is the easy part. I am doing that. I have been assigned 2 of my own patients now after being in orientation for 2 weeks. And the hospital I work for is very good about helping me out with anything I need such as questions, or if I want someone to see my patients with me because I am not sure of something, they are very accomodating about sending someone with experience with me. So far it has been a great experience and I feel like I am "at home" in this setting. I felt, however, that part of my due diligence included reading the stickies on the hospice forum. I didn't make it through very many, which brings me to my question. There are threads on the forums with a contributor by the name of Michael, with a username something like req_red. I found that after reading his posts, I now need to just stop and process his posts in my mind. His few posts have given me a lot to think on. I love it! What I am wondering is, who is this person? More specifically, he referenced some writings or books that he has. What are these? I really want to read more of his work. Does anybody know the titles of any of his books or articles? Thanks! Oh, and by the way, get ready! Since I am a new hospice nurse, I am going to have a lot of questions and foresee posting a lot of them on here.

Yes, to xtxrn's answer. I recently read an article about pain and sufferring. They are two different things, but is it being differetiated? Physical pain is just that-physical pain. But sufferring is referring to the emotional turmoil that might be going on due to various reasons such as the ones xtxrn brought up. Most people lump pain and sufferring together. Does your questionnaire/survey specifically ask if the patient had adequate physical pain control and then give a definition of what physical pain is versus sufferring? Maybe the patients aren't able to differentiate between the two and are giving low scores because they feel crummy, and are calling it pain, when in actuality, it is really emotional sufferring.

Charge you with theft how? The police? First of all, I don't see a cop wanting to write a ticket like this. And if they do, you have a right to your day in court. At that point, I would contact the media and invite them to do a story on it. I think your hospital would be very embarrassed with an article like this in the paper. Especially if you use the "key words" in your trial, like, "I had to stay late to ensure patient safety," or "for the comfort of the patient, I did A, B, and C, towards the end of my shift and ended up clocking out late." Can you imagine any judge, especially one who has ever been in the hospital or had a loved one in the hospital, finding you guilty for doing things that promote patient safety and comfort? The very things that are a part of our job description.

Small retirement town in southwest Texas. I bought my house (3 bedroom, 2 bath) for $20,000 and I make $32/hr. When I lived in South Dakota $25 and hour was generous. Those people making $25 an hour were working temp agencies. The usual rate was around $20.

I have a couple of ideas for the flyers. When we hung flyers for our assisted living facility a few years back, we got a really good response from hanging flyers in laundry mats. I'm really not sure why, but it worked so we did it! I would also say, look at your population. Elderly and disabled. Where do the elderly go? (I'm familiar with the elderly so will address this population.) Banks (This one is big. Going to the bank every day or weekly is something the elderly have done all their life and continue to do because it is routine.) Post office (same story, it is routine), coffee shops or gas stations where they hang out for coffee in the mornings or afternoons, senior centers, the local hardware store (not the big box stores) or other small businesses that have been around for decades. I guess the idea here is that by the time you are an elderly person you have routines and have visited the same businesses for many years. Get to know the owners of the small family run businesses, they could be a good ally for you. We had a change of mindset when we were doing this. Everyone thought that we needed to target the adult children of the elderly. What we found out is that if we also targeted the places that the elderly people themselves visited, they would call for information on their own!

The one thing I was taught and continue to do these days, I have not seen anyone address. Ask the pt to do ROM on all 4 extremities before getting them up. If they are unable, then I do passive ROM to make sure there is no pain with movement in any extremity. Also, I have always done v/s and a neuro check BEFORE getting them up off the floor. And be sure that you are sitting them up and letting them stay in a sitting position for a couple minutes before standing them up to avoid dizziness. (I find that I have to stop at that point also in order to change MY body's position so that I can properly lift them to their feet.)

When I was running an ALF, we had to assess everyone before admit. We had an assessment tool that included these things you asked about, including the clock test. The answers had scores to go along with them. If they didn't score high enough, we would refer them to their Dr. for possible nursing home admission. As far as the meds, if they chose to self administer, they had to show us that they knew what the meds were, what they were for, side effects to watch for, method of admin, etc. If they didn't do it correctly they were not able to self administer in our facility. We also had to assess self admin monthly. This was state regulation. Maybe check with your department of aging to see what the laws are.

I have learned to be really careful on this one. I held a job once where a new supervisor came in that didn't like me. (I was fine under the old supervisor.) The new one brought me in one day and told me I needed to resign immediately, and if I refused, he would fire me because the application has a disclaimer on it that you sign saying that everything on the app is true to the best of your knowledge. Well, I had forgotten to write one of my employers in there. It had been a job I HATED, and it only lasted a couple months, and I forgot about it when filling out the app. So, this supervisor claimed that I broke the law because I didn't divulge that employer on my app. He threatened a lawsuit if I didn't resign immediately. So now, when I fill out an app, if it's in person, I explain that I usually hold more than one position at a time, like in addition to my full time job I usually work contract or temp nursing too and do not include those on the app. I explain these things before signing the application. Online you have to sign, but if I get an interview, I make sure to explain this so that I don't end up "breaking the law" again. That was a horrible experience. By the way, not only did that supervisor not like me (I didn't much care for him either), 2 weeks after he forced my resignation, the company closed down and they had to pay severences. I was one person who they didn't have to pay I guess.

Wow! I want that nmemonics book! I will have to look for one. This is also how I studied but had to make up my own. Sometimes the nursing instructors I had would give us some too. My husband has a photographic memory, but seems he is able to turn it on and off when he wants. And, yes, he is a straight A student. Always has been I guess (according to his school report cards.) I am so jealous!

Dang! Now I gotta go back and find that post that I liked so much so that I can copy/paste it onto a document to keep in my datebook along with the other stuff in there that I reference on a bad day to make me laugh. Oh, and by the way, you all are wrong in your answers anyway, cuz I have 2 inch acrylic nails, tattoos all over my neck, 7 DUIs, and I date one of my residents at my LTC, and nobody says anything. So I'm ok, right? Because if this wasn't all ok, wouldn't somebody say something to me? I mean, I only have 8 write ups so far and I've been working there for a whole 3 months! I didn't have the tattoos, nails, oh, or the facial peircings when I got the job, but how can they say that I can't do what I want? It's my body. Can I file a lawsuit against them if they fire me for expressing myself? I mean, the handbook says you can't have these things but it doesn't say you can't GET them after you've been working there and have proved that you're a good nurse. And I know I'm a good nurse because my male nursing instructor told me so after we had drinks one night.

I know this is gonna sound bad, and I don't mean for it to, but I was under the understanding that OB nurses didn't do c-sections? There was always one or two there to take care of baby when the section was over, but when I was in the OR, it was the OR crew that did all the work because it's an operation. Is this not the way it is everywhere? I agree, OB nurses are great. I could never do it! Never had the desire to do it. The c-sections as an OR nurse were bad enough if you ask me! OB nurses can have 'em at the beginning of life, I much prefer them at the end of life (geriatrics).

Always living in a rural area, this is normal for me. I have seen many staff work at places that their relatives were residents. It was never a problem. It has also been my experience that in a LTC facility, there are people that inadvertently become "favorite" residents due to their personalities. These people tend to be a little more tended to. Why would someone's grandma be any different than this situation? And call me controlling or whatever you want, but I would want my grandparent to be in the facility where I worked so I could keep an eye on his/her care. My grandparents have been in nursing homes and I don't think I was very well liked in those facilities because I was there making sure she got the best of care, and I knew the rules and regs so there was no pulling the wool over my eyes. It would have been much better if I had actually worked at those facilities because then I would be a caring presence, advocating for my relative, making sure that he/she got good care along with everyone else in the facility, as opposed to the ***** that complained when grandma's care was not what I expected it to be.

here is a link I found to the actual questionairre for blood donation. Yep, they ask about sleeping with prostitutes and such. http://www.aabb.org/resources/donation/questionnaires/Documents/dhq/v1-3/Full-LengthDonorHistoryQuestionnairev1.3.pdf

Now that you are an adult with the freedom to live as an adult, to live at home with your mom being verbally abusive is your responsibility. YOU are allowing this to happen. I know it sounds cold and hard, but it's life. As long as you stay and put up with it, it will keep happening. Go get a job at McDonald's and get a cheap apartment, rent someone's basement, go to a women's shelter. Whatever you have to do, do it. If you don't then you don't really want out of that situation and no one can help you until you decide you have had enough! It's your move. Also, get some counselling. Without a job you should qualify for some free counselling. If not, go to your community resource center and find some groups like alcoholics annonymous (There are groups for the families of alcoholics but I don't know the name of them right now.) or other support groups or to church.

Actually, I think you are doing it the correct way. The others are taking illegal shortcuts. Sadly enough, this tends to be common practice in LTC.

I have a friend who got a pair of those. He was wearing them yesterday. They were the ugliest things I have ever seen! (And I told him so.) He says they are the most comfortable pair of shoes ever!