Buggus

I was notified last week that I would be getting an offer by place A. I was so excited and said "yes" though no official offer was presented, but I was told I'd get it soon. It's only been 2 business days but I haven't heard anything but expect it to come tomorrow. Place B called me today to notify that I'd be getting an offer either today or tomorrow (tomorrow at this point). My plan now is to ask both places for a little time to compare the pay and benefits of both. But I feel terrible for getting all excited about Place A and saying yes, especially because I'm now leaning heavily toward Place B. I don't want to burn bridges with Place A if I have to tell them "nevermind". Plus, I hate saying one thing and having to call back and take it all back, I've been there before and it was SO AWKWARD. I guess there isn't really a question, but would appreciate hearing any thoughts. I have options, and I'm thankful.

I was offered a position on Friday, they said they'd be sending over my pay offer real soon. I have no idea what their benefits look like. Today, I was offered another position, same situation, I'm not sure of the final $ offer nor do I know anything about benefits. I'd like to compare the benefits in detail instead of looking at only pay, and I'd like at least a day to look this. Is this "ok" or frowned upon?

You should always dress to impress in an interview. I've had to do this before and in one situation, I was lucky enough to have a boss that knew I was interviewing and she told me to clock out like 15 min early so I could change into a suit and touch up my hair and makeup and go. In the other situation, I worked my shift, then headed straight to the bathroom and pulled a Superman and was in my suit in 2 minutes. That's really all it takes. Good luck!

The positions are for a large variety of areas in nursing such as utilization review, case management, health coach etc. So it sounds like it's for nurses that have worked with health insurance companies. I coordinated with case managers in my hospital positions, to get the right services for the patients, but I wasn't the one doing all the legwork with the insurance companies and fighting them for services, so I guess it's a no for me.

I'm sorry for the stupid question but what is managed care, exactly? Is it referring to working with an HMO insurance company? I keep seeing this requirement pop up in some job descriptions, and I'm not positive that I can say that I have experience in managed care.

Looking for some insight. I am currently an RN in a split elementary school position and oversee about 1100 students. Not only am I overwhelmed by the double work (2 sets of state reports, shot records, screenings, ARDs, puberty films, parents, kids, staff, etc), I've been having issues at one of my schools with admin and am ready to move on. My boss needs RNs in the float pool. Pros: in and out for the day, really expand my experience and learn what's beyond elementary school, if not enough call ins then I'm placed with a nurse to help lessen her load for the day, people are happy to see you because you're there to save the day lol, and no state reports/screenings/puberty films, ARDs, immunization records! Cons: driving everywhere in the district and not knowing where I'm going until that morning at 6AM. I'm terrified to discover the unknown world of MS and HS (drugs, fights, attitude), the thought of walking into a clinic I've never been in and start running it and giving meds and doing procedures and finding supplies gives me a mini panic attack. If you float, do you enjoy it? What don't you enjoy about it?

@Kooky Korky: As a commenter after you suggested: if they remember me for money, gifts, potluck items that they need me to bring, surely they can remember me for the event?! The hungry nurse sitting right there in the office with them lol! It sucks that I would have to ask, rather than be treated like part of the team and be included, but I guess that's what it will take from now on if I do pitch in ever again. I truly did hope/assume that it wouldn't keep happening, but it has and it finally really got to me -_- Btw, they just released the "weekly" for next week that goes out to all the staff, detailing every day's events/occasions. No mention at all about Nurse Day/Nurse Week...whomp whomp.

Yeah, it's like if you're going to expect money or gifts, at least include me in the occasions! And the bday thing I'm not even be mad about because it's in the summer so nothing they can do about that, but they've never even asked when it is and I've been there two years. So it's like don't pretend to plan on celebrating it when you don't even know or ask when it is lol!!

My front office staff is made up of 6 ppl plus they count me and counselors as part of the front office staff, so whenever there are holidays, celebrations, birthdays, random special occasions, I'm supposed to participate with them in parties, gift exchanges, whatever. So this week we had a few things going on: we were supposed to make some kind of basket for the PTA to raffle off so I was assigned to bring an item for the basket. It was also administrative workers day so I was asked to bring an item for each of the three secretaries as well as a few dollars to contribute to buying them lunch. It was also the counselor's birthday today so we were having a bday celebration for her and once again contributed a couple of bucks for that. I heard nothing today about the party so around 1 I asked if we did something for her today after all and was told "Oh yeah we got food from blahblah restaurant"... no one bothered to let me know this was going on when it did... no one bothered to ask me if I wanted to eat or grab a slice a cake or mingle at the party... and my clinic is in the front office where I'm in plain view. Funny, there's no issue when it came to asking me to contribute to everything this week plus all other occasions. They've told me before that we all contribute to these things but it's all good because they'll do something special on my birthday too, but my birthday's in the summer so, no... you won't. Maybe I'm overreacting but I'm almost always left out of these parties but yet have contributed whenever asked, so I guess I'm just frustrated and saying I'm absolutely done contributing. Thanks for listening...4 more weeks! :)

I'm feeling so deflated right now. On Friday, I had a teacher send me a student to get checked out after falling off the monkey bars. She hit her right arm so I checked it out. No complaints of pain, I touched her arm up and down and she denied pain and had no signs of pain on her face whatsoever. There was no swelling, no redness, no bruising, no changes in color. I did some exercises with her to test her ROM and she had full ROM, once again no signs of pain with movement. There were no changes while I had her there in clinic and the arm looked completely normal and equal to her other arm. So I gave her ice and sent her back to class and wrote on the pass for the teacher to send her back if she had any complaints. I did not call home as nothing in the assessment seemed abnormal and the student had no further complaints for the rest of the day. Mom comes in today yelling How did you not see her arm was broken? What kind of a nurse are you?” and all kinds of other stuff. Mom says that around midnight (12 hrs after the incident), she saw that her child was trying not to use her right arm and noticed that her forearm was white. She took her to the ER and it turns out it was fractured. I was truly shocked to hear this…the principal and teacher came in and we sat down to discuss the incident. I had my documentation with me and showed the principal and the mother. The principal agreed that I had assessed fully and appropriately and followed protocol and told mom that I don't normally call home for every bump/fall/pain and that based on my assessment, there would not have been a reason to call home. The teacher supported my findings by adding that the student not only had no complaints for the rest of the day (3 hrs) but that the student was also doing all her classwork/writing/coloring with the affected arm (she's right handed) and was doing so without difficulty and she had not seen swelling to the arm. The ER doc apparently told mom that the fracture would've bubbled up” right away so I guess this made mom feel like her child came in with all these obvious signs and I just ignored them when in reality this student had absolutely no signs at all and the assessment was normal and she even continued to function normally in class. Oh by the way, another reason mom's extremely upset is that the ER called CPS on her over the situation… I just feel so terrible about this. Terrible because this poor little girl went 12 hrs with an untreated fracture and terrible for mom who now has CPS on her case. We told her we'd back her with whatever documentation CPS needed to explain that the injury did indeed happen at school but that doesn't take away the stress of the situation right now. I also am afraid of what this means for me…but at the same time I feel like I assessed properly and, short of having xray vision, there would've been no way to know it would turn into all this. I don't normally call for every fall on an arm, leg, knee, elbow, etc, when everything else in the assessment looks normal, but now I think I will just in case it could be a fracture.

I'm guessing it depends on your district but my district does not have paid leave. You can take up to 12 weeks off without your job being in jeopardy, but in order to get paid you must use your vacation days, assuming you have any. Heck, even the major hospital system where I previously worked did not offer paid maternity leave. You had to use your PTO if you wanted to get paid. I don't think paid maternity leave is a common thing. You could try to time things so you can have your baby in the summer, that way you're still getting a paycheck and you have time off with your baby. Or you can purchase short term disability insurance (I've heard Aflac is great) so you can still get some pay while you take time off but those insurance policies usually have to purchased a year in advance before your pregnancy, so you may want to start looking into it now.

Oooh my turn, my turn! A 4th grader came in with a pass that said "tip of nose itches". Me: "Oh wow how did you manage to break every bone in your hands?" Student: "I didn't..." Me: "Oh good, so you can scratch your own nose. Back to class!" Ok ok, that dialogue didn't actually happen. But C'MON NOW!

Hey everyone! How do you handle phantom boo boos? You know, the ones where the student comes with some random pain that just started right now while sitting in class/walking down the hall/getting ready to do something they hate (math or PE, anyone?)...it's usually something like "I was just sitting in class and then it hurt right here" and the student points to a specific spot like this spot on their elbow, or forearm, or thigh, etc. No injury at all. Just a random pain. I get so many of these and I will not give ice for them because there was no injury and I feel like that will just encourage the behavior to continue any time the student wants to get out of class or wants a bag of ice just for fun. I've started looking at the kids like *seriously...* and telling them to walk it off . I honestly just don't know what to do about it or if I'm handling it the wrong way. It's the not the same kids doing it, btw. I'd call mom if that happened multiple times with the same kid.

RobinMRn, thank you for that attachment! I used info from your attachment and also asked some of the other elementary school nurses in my district for help and they sent me their PowerPoints which covered pretty much everything on your attachment too, plus a few extra things we struggle with specifically at my school. The presentation went very well and seemed to be a real eye opener. The teachers gasped in shock and laughed in disbelief at much of the info because they couldn't believe that these things were coming to the clinic (hello...neither can I and I'm the one that has to deal with them and assess them and document them and this is why I had to put together this presentation!). We went from 90+ visits a day to 60 a day, immediately. It's still a little higher than it should be since all other schools in our district that are our size get 40 visits a day on average, but hey it's a heck of a start! These kids were missing so much class over ridiculous stuff! And right now we're so close to testing time, so it was a good time to set the ground rules.

I am a new elementary school nurse this school year (though I've been a nurse for over 5 years) and I LOOOOVE my job, but I've encountered some challenges with things being sent to the nurse that should not be getting sent here. I'm seeing about 100 kids a day when our director of health service says I should be seeing between 30-40 like at our other elementary schools, especially because we're one of the smaller elementary schools at under 500 students. My boss wants me to give a presentation about what things must absolutely come to the nurse, what things are not appropriate to come to the nurse, and what can be done in the classroom with some of the small things to also help cut down on visits (ex: paper cuts). I once saw an allnurses member post a list that they send to their teachers and it had wonderful points but I can't find it for the life of me! I believe it was posted as a comment. I have a few points I've already come up with, but if anyone out there has a list or presentation that they like to use I would definitely appreciate it if you'd share it since I still feel new in this role and can use all the help I can get. I am hoping that complaints like "please clean glasses", "needs to blow nose", "shoelaces came out of the shoelace holes", "loves bandaids, just wants a bandaid", and "would like to nap" will soon be a thing of the past!

I'm sorry I did not update sooner, it's just the Winter Break happened and I'm still getting back into the groove of things So I did end up taking this to administration who informed me and the office staff that getting signed out of the clinic creates an excused absence, but it is still an official absence and would count against the student. The office staff misunderstood that previously and this misinformation created all this confusion. As I clarified with admin, sure enough, they told me parents doing this repeatedly are parents that have warning notices due to truancy issues. Admin didn't know how often this had been happening until I showed them and they were quite shocked. Admin and I had meetings with those parents and clarified the policy with them. As soon as they were made aware that every absence counts against them, even the clinic ones, these "let me just sign my kid out through your clinic real fast" stopped! Their attendance improved and they were not being sent sick to my office, further confirming my suspicions that the kids were not really sick a lot of the times these parents brought them to me. I suspected this because I started getting firmer and telling these parents (before I met with admin about all this) that I was not going to be able to send the kid home unless I could confirm the fever/vomiting/whatever other ailment myself and that in that moment while they were in front of me there were no symptoms. This was all being said while of course the kid is swinging from the imaginary chandelier in the clinic. No symptoms+kid is acting normal = no reason he or she should not be in school. Sure enough, the kids never got sent to the clinic throughout the day and parents never called to check on the kids...so obviously kids couldn't have been too sick. Anyway, I'm happy this was resolved and I'm no longer feeling used through my sign-out book and these kids are in class WHERE THEY BELONG!

I don't think they're "complicit" or trying to be fraudulent but it's definitely a problem, at least at my school, and I am planning on meeting with my admins to see if there is a way that I can get around this since the parents are taking advantage of this policy. I hate to see a kiddo racking up absences because they are sick and it's beyond their control but I can't stand that their parents are willing to put everyone else at risk just to avoid accepting an absence. I'm guessing they have had truancy issues before and found a loophole now.

The "present for the day as long as they're signed out from the clinic" rule is not my policy, it's the district policy. The only time it is counted as an absence is if I sign them out as a parental choice meaning I do not feel it's necessary to send a student home but the parent chooses to take them home out of convenience or whatever other reason (ex: parent prefers to take student who peed their pants home rather than bring a change of clothes because they don't want to make another trip later to pick up the kid). If the kid is actually sick, I can't sign them out as a parental choice because they really can't stay in school. I can't send them back to class because I KNOW they are sick and they need to go. So I feel like I'm just left wide open for abuse of my sign-out book. I was just now thinking that I might start telling them that they do need to go home but that the student needs to be signed out as a parental choice because the parent chose to bring them even though they were obviously sick. But I think what'll happen is that either A) claim that they had no idea that the kid shouldn't be at school and that's why they wanted me to give the final word, therefore they should be allowed to sign them out with me rather than take an absence or b)just let them come to school sick, tell them to go to the nurse right when class starts and say they don't feel well and get sent home that way, even though it exposes the other kids and staff to illness (this one's already happened before). Sigh...I just wish there was a way to discourage it, but since it's the district policy to count them present for the day by signing out through the clinic, I can't think of a way.

If a student comes to the clinic and I feel that it's necessary to send them home, the parent can sign them out from my clinic and they are counted present for the day, even if they've only been at school for a few minutes. Well, I'm having parents that know this that are sitting in the office waiting for me to arrive at 7:30, and the moment I walk in, they want me to evaluate their kid. Some of them bring them in obviously sick and tell me so: Johnny just vomited 3 times before we got here but I wanted you to take a look at him first and see if you think he's ok to stay in class”, or He had a fever all night/all morning but I wanted you to check first”. It's usually the same parents that are coming in doing this over and over. I started telling these parents that if their kid is sick, that they shouldn't bring them to school and so I started declining to sign them out since I saw them before school started. Front office staff says it's actually ok for me to sign them out even before school as long as I've evaluated them but I said NOOO, this is ridiculous because how can I sign them out of school if school hasn't even started? So then these parents started waiting until the bell rings and immediately step in to my clinic to say Johnny threw up, has fever/whatever, can you pull him out of class and check on him to see if he needs to go home?” They're doing this on purpose so that their kids aren't counted absent and therefore parents don't have all these absences building up that they have to answer for or so that their kids' perfect attendance record isn't ruined. I can't really refuse to send the kid home because they really shouldn't be there, but I can't stand that they are abusing my sign-out abilities this way and in the process are putting the rest of the kiddos at risk, not to mention dragging their own sick kid out of bed and into school just for the sake of attendance. Have y'all dealt with this and what did you do to discourage it?

Dear missmollie, It's wonderful that you've got it all figured out, and after only 6 months as a nurse! In all seriousness, anxiety at work can be a result of many issues such as hostile co-workers, unsafe patient loads, unreasonable patient/family, personal problems at home, preexisting anxiety issues, etc. I hope you never find yourself in any of those situations that can bring about anxiety issues but please do realize that just because you're oblivious to the world of nursing right now, it doesn't mean that you'll never find yourself in this situation especially with the alarming rate at which new nurses are experiencing burnout. You said it yourself in the title "I don't get the anxiety...", and it's true that you don't. You really don't. So please don't lecture anyone on it.

I have 5 years of experience as an RN. 4 of those years were as a floor nurse and this past 1 year has been as an office nurse where I managed the office alone except for the 1-2 days a week that our surgeon would come in for outpatient procedures. I really loved that job and loved the independence, but we had major changes last month and long story short, I had to go. This was my chance to finally go for a school nurse position and I just accepted a position in an elementary school and will start in less than 2 weeks. I'm very excited for this new experience and opportunity to grow in my career and help care for some of our most vulnerable little humans! I will not have an aid or assistant, just me as the school nurse. Any tips for how to prepare for working with these little kiddos with very little experience working with peds? (Most of my peds experience was in nursing school and occasionally when I'd float down to the ER at my hospital). Any lifesaver tips? Also, I will be floating between two campuses where I swap places with an LVN every other week. Why they don't leave me at one campus and the LVN at the other campus, I don't know. I probably should've asked but there must be a reason. Anyway, any of you fellow floaters have tips on how go through the year smoothly while going back and forth?

Assuming that your state allows it, if a plastic surgeon's office/dermatologist wanted to train you to administer Botox and other injectables, would you be willing to train in that and eventually inject Botox without the MD in the room?

They called me about 2 days after I submitted my application and did a phone interview and sent me forms that day which I had to fill out. It took just 2 business days from then until I could see available jobs. I'm incredibly disappointed though. The next available shift in my area, San Antonio, TX is at the end of August and I know I'm already scheduled to work that day so I can't even pick up that shift. And the shifts all appear to be around 5 hrs. Maybe it'll pick up around flu season.

I was offered a position with Summit Health doing health screenings and they require their employees to fill out W-9 forms because this is "contract, per diem work". I've never filled out a W-9 form, I always do W-4s, so I am unsure about which is the appropriate box to check. The document says: --------------------------------------------------------- Check appropriate box for federal tax classification (required): Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate Limited liability company Other Exempt Payee: (there is a check box here) ---------------------------------------------------------- Does anyone know what I should be choosing here? Especially someone who has worked for Summit? As for the exempt payee box, again, I'm unsure about this option. Any guidance? I don't want to check the wrong thing and get in trouble later. I'll be contacting the company tomorrow but I wanted to see if anyone here knew.

For my BSN, I ended up with about $11,000 in student loans and I was able to pay it all off within 5 months of graduating! I wanted to make sure that I paid it off before interest kicked in. I worked part time all through college and got a good amount of scholarships, so that really helped. I did my 2 years of prereqs at a university and got the full college experience (and met my future husband!) and and then went to nursing school to complete the last 2 years of my degree also at a local university. If could do it over, I wouldn't