mama_bird

I punched out an hour over the other day. There had been three interruptions before dinner (someone was bleeding, someone else coughed during suctioning and blew snot all over my arms, and someone else's machine would not cooperate). When I went up to feed in the dining room we were short some CNA's and I had to go between two tables and feed four people! I spent an hour up there, thus went to lunch late, took only twenty min., and started my 8pm med pass/treatments at 7 but the charge nurse had been on since 7am so it was me and the other nurse to man the desk, 60 patients, and the front door buzzer/alarm plus answer patient calls and do extra paperwork. By the time I finished meds/treatments it was 10:45 and it took me until 11:45 to write report, give report, type report into computer, put narcs away, count with the oncoming nurse, sign the treatment book and sign the sheets the desk nurse usually does, AND give info to my oncoming replacemtn who was from an agency and had only been there once and needed to know who was a crush, whose extra stuff was where, etc. I was exactly one hour over. It was the end of my third week. I know that the Coordinator told me that it happens more often than not, and not to worry about getting in trouble for being late, because interruptions happen, but I used to work for places that made you punch out and keep working (of course, it wasn't a nursing home, but in home care they expected me to take total care of a paralyzed person in two hours and sign off and not get overtime). Also, I am new at this but I can't help feeling that the nurses who have been there for a long time are thinking "She needs to be faster." Well, I must be pretty frigging fast because I've lost 8 pounds in three weeks! I am getting better every night and these interruptions and the loss of a desk nurse were unexpected. I have a routine down now and was not behind at all the day before. Is this common? Do I have to worry about getting written up? My total overtime for the week probably added up to a total of 2.5 hours, but still...:imbar I love this job and I adore my patients. I do not mind the physical activity, but I don't want to live in fear of being pressured to always get done exactly on time. Sometimes I think the ones getting done early are either letting the aides put the creams on (not supposed to) or they are giving 8pm meds with the 4pms so they can skip those people! HELP!!

I have always multi-tasked every where in my life and I am getting it down here as well. When I come back from dining room at 6pm, I put my one guy on his nebulizer, grab vitals on the five or so people who need them, and then shut him off before I go to lunch at about 6:20. When I get back from lunch and start passing at 7, I put all of the creams on my cart and do them as I do the pills. I tried doing meds and going back and doing creams and I ended up taking longer, constantly re-checking my list, and waking people up to put periguard on their groin. Some nurses do all the meds then go do their creams, I just can't be as efficient that way. I have learned who goes to bed early, eats in their room, etc. and plan for that now. It has taken time but it is getting easier every day. Also, many of the things in the tx book are done by the aide (taking out hearing aids, taking off teds, so I check when I go in the room but I don't actually do it (although I initial it in the book at the end of the night). Most of the nurses there have been there for more than ten years. Morale is good and people seem to get along well. We have a few agency staffers to cover but now that I was hired FT, it has cut down on the need. I know my 30 residents so well now that I am afraid of getting thrown on the other side and taking 5 hours to pass meds! Or getting thrown on the desk!! LOL!!!

I just posted in the Geriatric and LTC forum. I wanted to be in a SNF because I am a passionate genealogist and I knew that if I ever went back to nursing, I would have to be with The Greatest Generation (Although some day they will be gone and I will have the Baby Boomers, etc.) I have 30 patients on each side of the floor. I was hired FT 3-11 and will end up on the desk in charge eventually but I wanted to pass meds to refresh myself, get to know the people, knew equipment, protocols, and lose the 40 pounds I gained working at a desk. On the first day I thought "I don't know if I can do this." Last night was my 13th shift. I count narcs, pass meds, including 2 g-tubes, do the dining room, take lunch, pass meds, do treatments/dressings, house report, charting, computer charting, clean the cart up, restock, count narcs again, give report, and last night I actually did it all, alone, and left on time. I also have a little time when doing treatments to chat with the residents about their life history which is why I wanted this job. I had to take a medication test for the job. There were 100 questions, T/F, multiple choice, fill in the blank, matching, and I got 95 right. Everyone has told me from the third day on I was doing fine, that I just needed confidence. Two weeks ago I wondered what the hell I was doing, now I am glad I made the decision to treat my RA with Enbrel and get my life back. Good luck. It can be done without a refresher course if you were textbook smart in school. I went to college from 1993-1997 and I felt like a new grad all over again!

Well, as you can see, I haven't posted in a while and that is because I just finished my 13th shift yesterday at a LTC facility (the job I wanted) :loveya:I start at 2:45 and work until 10:45. The first day I watched. The second day I watched in the am and was shadowed in the pm. The third and fourth day I was shadowed/helped with popping and passing. The fifth day I had help near the end. The sixth, seventh and eighth day the nurse didn't shadow me at all but was there to help with treatments toward the end if I needed it. On the ninth and tenth day (Sat and Sun) I was on my own (from there on) and got out at 11:25 pm. Monday I finished at 11:05pm, Tuesday I finished at 10:52 pm and last night (my 13th shift), I finished on time, did house report, charted in the computer, counted narcs and punched out at 10:50! I have 30 patients. Two have g-tubes and alot of meds. Two have dressings for sacral wounds and one has diarrhea all the time and sometimes needs more than one change. About 12 people are a crush. I get in about 1/2 hr early, fill out my sheet, etc, so I am ready to push the cart at 3. At 5:15 I have to go to the dining room and feed/supervise with another nurse until 6. I come back, do a few treatments, go to lunch, come back and start pushing 8pm meds at 7 and try to integrate the treatments. Now I can pretty much get done by 10:15 and that leaves me a half hour to chart, enter it into the computer, put narcs away, fill out house report, and sign the treatment book plus clean up my cart, etc. Any advice would be appreciated. I was out of clinical nursing for 9 years. I did have to take a medication test (100 questions) and I scored a 95 so needless to say, that God I am just a smart cookie. All of that crap pounded in my head from 1993-1997 really did come back to me. Thanks for the help!!!

I was offered a job at the SNF I wanted to work at (2 miles from home!) with the hours I wanted. This is strictly skilled care and custodial/personal care, no ventilators, etc. Some people may be on IV antibiotics. Most seemed to be in wheelchairs, very clean and in a very nice facility (all carpeted, new, etc). I was very honest about my situation (no bedside care other than family members for several years) and stated that I wanted to ease in with precepting and LPN duties (because I want to pass meds, etc), with the goal of being the charge RN 6 mos or so down the road. I told her I do not want to jeopardize the integrity of the patients or my unmarred license. They agreed to do it that way and my home care cases of three paralyzed clients will come in handy. Anyhow, this is the ratio: Shifts are 7-3, 3-11, 11-7. They tried 12 hr. and said it was too much for most people. 60 patients to a floor, 2 floors, currently all beds full (good sign, the other place was down 30 beds). There are three distinct wings on each floor branching off of the central station. Each wing is 20 beds (private rooms on one side of the hall, semi-private on the other side) One RN per shift in charge of the 60 patients. This is mainly a paperwork job and she said I would be at a desk all day once I feel comfortable taking this on evenings and or nights. There is a total of 6 RN's because there are 3 shifts and two floors. I would always have another RN on the other floor. 3 LPN's per shift, 20 patients each. Each LPN has one wing of 20 people and does the meds/etc. for just his/her 20 which the DON said is about all they do because it takes a long time to do 20 people. 6 CNA's per shift, 2 assigned to each wing. One CNA per ten people. DON said that they are the only ones who sometimes come and go. The DON has been there for 14 years. The other RN's and LPN's have all been there close to or over 10 years. I asked about the turnover because if other people are unhappy and constantly leave, I don't want to find myself unhappy. Monday I am going to orientation (general for all new hires). Tue and Wed I will work 7-3 to follow the LPN and RN and learn the ropes (since that shift has the most activity...they bring the doctor's to a room there instead of taking the patients out of the building because it can be stressful.) After that I should be going on my evenings/nights but not alone as charge until I feel ready. The last person I changed a dressing on was myself when I got bit by a spider last year and had three puncture holes and a staph infection on my stomach LOL. I am not looking to leave after a year and go to a hospital. This place is near my house, 8 hr. shifts, beautiful facility, and I have a friend who was a CNA for there for four years and said it is a very nice place to work and few workers ever leave. I know once I am in charge I will be sitting doing paperwork (which is all computerized now) so I am not worried about stressing my body too much as I get older. The pay is excellent for this area, ($23/hr.$24/hr when in charge), good benefits, certainly more than the other interviews I went to. I realize it is A LOT of work to be an LPN with 20 patients or an RN with 60 patients and having to delegate to staff, but I have been building my stamina with a lot of physical activity all day from pretty much 7am to 10pm for weeks now. I'm excited and I can't wait to get back in. Most of the people I volunteer with are elderly and I love talking to them about their decades of experience. I have been reading the threads here to learn the good, the bad and the ugly. Can anyone recommend a good geriatric text? My books are ten years old and I have a good clinical companion for fundamentals but I would like another book. I thank everyone for their help and input! If you have ANY advice, please give it.

I had two years outpatient...before that when I was awaiting my license I took some LPN cases in homecare. I never stopped being a nurse when I left. I myself have a chronic illness (rheumatoid arthritis), I dealt with infertility treatments and surgery and fibroids, I have a child with special needs, asthma, migraines, and multiple allergies, a friend with MS, and another friend with multiple medical problems and on a ton of meds and for over 10 years I have been her personal nurse consultant. I was there for my sister's pregnancy and labor, her pregnancy with an IUD in place (yikes), I have a mother with dementia, I have three rescued dogs: one geriatric/incontinent and one geriatric with dementia and cataracts. My sister is an attorney and I helped her with medical review or a battered-child death case, which involved reading 2- 5 in" binders. On a whim, last year I took a practice NCLEX and got 80% right. I needed to brush up on pharmacology, cardiac and renal. I have always been available as the family nurse and if I didn't know something, I knew how to find it. I keep up to date on new drugs and treatments for illness. I think I am going to recite that during my interviews, LOL. Wish me luck, I go this morning. It's a 6 minute commute! I love that!

Is this better? LOL, I'm sorry...it's just so frustrating. I am going to mail out this page only. (I took my name and address of the top). I have an interview tomorrow morning at a SNF. I hope I get it...something...anything. I look forward to waking up and seeing your input. EDUCATION 8/1993 - 8/1998 D'Youville College, Buffalo, NY B. S. in Nursing, Cum Laude 22 cr. in M. S. Community Health Nursing HEALTHCARE EXPERIENCE 6/1998 - 8/1999 Planned Parenthood of Buffalo & ErieCounty Community Educator/Registered Nurse □Implemented the Baby-Think-It-Over Program □Created/published first newsletter □Began local website development □Created educational programs from the ground up □Taught at various locations to children, adolescents, adults □Provided telephone counseling □Implemented Walk-In Pregnancy Testing Program □Implemented Morning After Contraception Program □Appeared as media liaison □Traveled to various workshops and conferences □Assisted marketing with selection of promotional items □Established a presence at local health fairs and events 8/1997 - 6/1998 Planned Parenthood of Buffalo & ErieCounty Clinical Specialist, Registered Nurse □Intake interviews and assessment □Exam preparation □Assisting with procedures □Dispensing and administering oral and intra-muscular meds □Contraceptive disbursement and education □HIV testing and education □Phlebotomy □Lab testing □Counseling/referrals for pregnancy and social services □Preparing medical records □Clerical functions/maintaining patient library/materials □Assisting disabled and physically impaired clients 12/1996 - 8/1997 Allcare Family Services, Buffalo, NY Home Healthcare Assistant/LPN □Personal and home care of disabled clients □Some LPN duties after 5/1997 graduation

I put my non-relevant stuff on there so they can see I am not "lazy" LOL. How would you view a resume from someone who was out for 9 years and had no volunteer experience, self-employment at all? It must be common. I am going to take the class in the fall; for now I have 2 interviews to go to: one LTC and one an easy paperwork job that is not med-surg at all. I wish I had never gotten RA!

Hi to everyone: I thank you for your input and advice. I have several reasons for wanting to pursue this option as opposed to other options. I did 1/2 of my clinicals at 3 nursing homes in college. I know how hard it can be and you are often short-staffed. I really enjoyed it though. I have been doing genealogy since I was 12 years old and it is my addiction. I really loved talking to the clients while I was doing treatments/meds and they seemed to be very happy that someone was interested in their careers, military service, children, instead of being regarded as second-class citizens. I understand that as an RN I would have limited time with them, esp if I work overnight shift, but knowing I have the ability to engage them is a plus when you have to deal with dignity and often uncomfortable situations. Also, being out of the house 3-11 or 11p-7a isn't really about my husband and daughter who have been enabled and need to get their own dinner. They are both gone during the day, from 7am-5pm usually, and we have three dogs, one who suffers from beagle dwarfism and is therefore incontinent and in diapers, and I need to be home in the daytime to take care of them and take them for their walks because God knows nobody else in this house cares for them the way Mama does. If I didn't have the dogs, I would work days or whatever. I wanted 3-11 or nights so I could get them out the door in the morning, take care of the dogs, and have plenty of time to get ready esp in the winter when it is cold. I REALLY, and I can't stress this enough, REALLY want to be on my feet working. That is why i walk these dogs. I have been a size 14 pants for the past four years and I really have the energy now and am getting back into shape and thank God I am not on steroids anymore. I don't just want my life back...I want my body back as well. I was always a size 8/10 and I want to feel good about myself again, looks and feelings. I have an interview tomorrow at a facility. The DON said she would take me as an RN either 3-11 or 11-7 or both/flexible, and that they kinda change RN's/LPN's depending on who is available, and that I would be doing mostly paperwork and giving meds and maybe changing a PICC line dressing which she will go over with me. I told her I am worried about someone coding and she laughed and said I have to take the CPR again anyways and she understands my apprehension but that I would be ok. I fully disclosed to them my situation and that I want to take a refresher course and she had no problem with it. She said to bring my license, driver's license, social and references and come tomorrow. I really think this is a better option for me. It is close to my house and the hours are more what I want. The other job I interviewed for is days and that means I would only be home at lunch for the dogs. And it also would mean a lot of chaos in the morning. I really don't have "plenty of time" because we have had to cut back to pay for my medicine ($556.00/month in premiums and $60.00 in Rx co-pays) that I really need to get to work and get in a job that is going to provide me with cheaper health insurance than the ridiculous amount coming out of my husbands check. Besides, and this is a WHOLE other thread I won't go in to in detail but I am sure many here can relate: my husband is a recovering alcoholic and not working a program (read: dry drunk, his behaviors and attitude often svck) and not very happy that I all the sudden want to go back to work so I can't count on him to stay sober and keep a job and insurance. He keeps saying that "he got me insurance and medicine and now I want to go running around" which is NOT TRUE. He married me because of who I was, how educated and smart I was, how capable I was, and now he is mad that I am better? I think he is afraid of losing his "maid service." I don't put it past him to screw up or thwart my attempts to work and I NEED this medication.

I cannot take a refresher course until the fall. I have been out clinically for 9 years. prior to that I worked in an OB/GYN office for 2 years. I am thinking of applying at a nursing home as an LPN and easing my way in. MY RN license is valid and always has been. I have not been "just a housewife" for 9 years. Far from it. I have so much to offer and yet I fear my applications are getting tossed. Here's a chopped-down (no descriptions) version of my resume; contact details eliminated. Critics, advice, please. BTW, I worked FT before college but it was in a bakery and non-relevant: EDUCATION/PROFESSIONAL LICENSURE 8/1993 - 8/1998 D'Youville College, Buffalo, NY B.S. Nursing, Cum Laude. 3.59 GPA. 22 cr. towards M.S. Nursing. 3.33 GPA. Licensure: NYS R.N. License No: 49%$#^. PROFESSIONAL EXPERIENCE Health-Related: 6/1998 - 8/1999 Planned Parenthood of Buffalo & ErieCounty Community Educator/Registered Nurse 8/1997 - 6/1998 Planned Parenthood of Buffalo & ErieCounty Clinical Specialist/Registered Nurse 12/1996 - 8/1997 AllCare Family Services, Buffalo, NY Home Healthcare Assistant Managerial & Administrative: 8/1999 - Present The Edwardian Book Cellar - Owner & Sole Operator 9/1991 - Present Researcher/Editor/Typist 2/2003 - 6/2005 Piciulo & Associates - Administrative Assistant OTHER EXPERIENCE OF INTEREST 4/2008 -Present Historical Society of the Tonawandas Volunteer/Researcher 1983 - Present Genealogical Researcher References Available Upon Request

Hello all: I have decided that if I don't get this job as an Admissions Screener, I am going to apply to my local nursing homes for a 3-11 or 11p-7a. However, having been out of the clinical arena for 9 years and prior experience was in OB/GYN, I do not want to be put in a position of being the only RN and in charge of everyone. Just because I have a BSN it doesn't mean I am confident. I would like to take the refresher course at a local college but I won't be able to until the fall. At this point, I am willing to take an LPN role and ease my way back. Hell, I'll take a CNA job if they have 3-11 (I want that shift because I am tired of waiting on everyone when they get home from work/school. I want to be unavailable to my 42 child/husband and 17 y/o child so they can see how much I really do for them. It really sucks when you have a chronic illness and find yourself unable to manage a job, illness and kids and have to wait until the kids are independent and you have better drugs to resume your career. Not to mention the emotional abuse I have tolerated from a husband who has made jokes that I am just lazy and that if I really wanted to work outside the house I could have all these years while I was running a bookstore online. Yeah, I willingly went to college for four years and gave up $35K a year to sit home with rheumatoid arthritis and sell books online!! I thank everyone so much for their help. Should I go and beg for a job? Thanks!:heartbeat

I printed out the MDS thing to read the screening part and get an idea of what a screening is going to involve. I understand that the entire 35-page thing is part of the chart at the facility and not something I would be doing. This job is for a screener outside the building. I don't make the decisions. From reading articles and posts here, my understanding is that I would be filling out about 10 pages on the patient, reading the chart, faxing it over to the facility and waiting for them to make the decision. I can tell you this much. I cannot take this job if I would not want to go there myself for post-op rehab or LTC. I cannot sell something I don't believe in. If I am offered the job, I am going to want to see the whole facility, a room, and I have a list of what I would look for in a facility for myself personally before I say yes. Biggest things for me are are no roommate, my own phone and tv, computers, a library, private shower/bath, exercise room, transportation and not being rtreated like a child and told lights out at 10 pm. If this facility couldn't get me to go there, I am not going to go for the job. I can sell something I would want for myself; I cannot sell something I would never ever want myself or a loved on to have. Nascar, you and CapeCod have been extremely helpful to me here, esp. with posting what is important to you and how to approach this. I want a full understanding the facility services and benefits before I am expected to be on my own. I would hate to be asked a question and not know the answer! Thanks!

Just when I feel hopeful and confident that this is a good re-entry for someone in my situation (thanks to all who have posted).....I put a similar question on another forum and this is the reply I got: "Its a hard job. As soon as census goes down it is your fault and they will replace you. Salary sucks, in Indiana it is about 14.00 and hour. You do not need a degree to be a admissions screener. In Northwest Indiana getting patients is very competitive. You will get calls all day and night. I worked as an Assistant Director of Nursing and have seen admission coordinators come and go." The thought of being replaced if the census goes down is scary. The last girl was there for several years. How hard can it be? This is not a crappy facility, but one in a beautiful area, with separate wards for assisted living, rehab, and dementia/behavioral problems. I was not told about being on call after 4:30. I would think they would have disclosed that. She said there will be no working after 4:30. I am going to go to the second interview with a list of questions and I would like anyone who has time to give me some questions to ask. I printed out the 35 page MDS Assessment form yesterday (I am aware that only about 11 pages are what I would be filling out initially, the rest are for ongoing monitoring and re-admits) and I am reading over them. I am really doing what I can to succeed at this job. I even took out my copy of "How To Become An Assertive Woman" LOL. I have been reading the boards here. I am wiling to learn more aggressive sales techniques. It can be hard to be aggressive when you are a 5 foot tall Italian woman LOL. I really appreciate all of the help and I am glad you have posted because I have read several of your threads and I know you guys are experienced. My biggest fear is taking the job, having severe competition, not getting the clients because I'm not aggressive enough, and getting fired. I don't know why I "mid-f&%k" everything to death, but I suppose it is because I am thorough and want to know all the good and bad before I accept a job. I wanted to take a refresher course before jumping back to a 3-11 med/surg and this job will give me an easier transition. Other than clinicals, all of my experience has been in clinics, community health, and admin. I have never worked bedside (latex allergy). I love this forum. Thanks!:heartbeat

Thanks Nascar! I had no idea how much money to ask for. I looked on salary wizard and put in my zip and $39,275 is the 50th percentile for an Admissions Coordinator but that is the title of the person who interviewed me and she is above me. The ad very clearly stated screener and I would not be making any decisions. I can deal with the in/out of the car and the walking. Hell, I want to walk. I have 40 prednisone/arthritis/fatigue pounds to get rid of. This facility has separate wings for a range of impairments, including psych. I told her I want to be VERY familiar with the facility, what is can handle, what meds it will pay for etc, before I am left to my own devices. It is to my understanding that I would get a cell phone, a pager, and be going to the hospitals and gathering data, faxing it over (I would assume) and waiting for an approval before a bed is offered, as well as trying to market the facility to the patient/family. I was told the referrals come from the case manager so it's not like I have to randomly wait in hospitals for people to enter. I would also have to follow current patients. I do not understand how any LTC can have this job done by a non-nurse or just a business person. I understand the "marketing" aspect but how can a business person with no clinical background know why certain drugs are used and how serious certain diagnoses are? This ad specifically asked for a person with clinical medical knowledge and insurance knowledge. She didn't mention "You'd be fired if you didn't meet a quota" but after reading other posts on here from people in LTC, I have come to the conclusion that it comes down to that. I have no idea how many other screeners will be there at the same time trying to sell their facility. I really hope that if I am offered the job, I will be able to get an accurate picture in the first two weeks so I know if this is going to work or not. And what do you think is a good salary for a BSN who also worked in marketing at other agencies to ask for? I feel like an idiot because I have been working from home for so long that I almost feel like a new grad who should ask for the minimum. We are talking about using my car and gas here though, but I was told mileage is reimbursed. Hope I hear more!:uhoh21:

Hello all, I went to an interview today for a FT M-F 8-4:30 position as an Admissions Screener for a 200 bed sub-acute LTC and Rehab Facility. The Admissions Coordinator, who still screens, spoke with me for an hour. She then asked what salary I was looking for. I said minimum of 35K because I know I will have to look elsewhere if I can't get that. She did ask me to come for a second interview after I stated that. I am an RN with a BSN and rheumatoid arthritis trying to get back to work FT in a job where I won't kill myself physically. I haven't worked clinically in several years because of my RA and spent two years working as an Admin Assistant for an advertising agency where I learned all about marketing and sales. I guess my eclectic experience combined with a BSN appealed to the HR Dept. I fully disclosed and discussed my RA and the fact that I have been out disabled and just started Enbrel which changed everything. The interviewer herself is a nurse and completely understood and even said if I was having a rough day she would fill in. She was very encouraging and said I'd be basically getting in and out of my car and visiting about 2-3 hospitals a day. I would have to come to the office on Mondays but otherwise I would be out following referrals and keeping track of our current patients who are in the hospital and making sure another home doesn't snatch them up. I am worried about quotas and nasty people. I need advice. She is going to interview one more person on Monday and then they will be making their decisions. She said she wanted me to meet the other people (after I disclosed salary req.) so I take that as a good sign. The benefits are excellent. If I don't get picked, I'm going back to my offers of 3-11 in hospitals. I wanted to work 3-11 for a variety of reasons, but this job seems good as well. If I do get picked, I'm going to be nervous! She said she would precept me for a week or two and make sure I am comfortable. She did say that some of the case managers at some of the hospitals are sharks and she wasn't going to make me deal with them right away. She also said they want someone who is aggressive but not abrasive. I always worry about looking like a b&%ch. However, I really want a job and I am definitely independent and a fast learner. Once I know what to do, I don't need a hovercraft over me. I am also a very good investigator (hey, I've been the family genealogist since I was 12!) I read and research everything I do. I am reading about MDS online. I'll be doing alot more reading if I get called! I need insight and advice of what I should expect and how I should prepare myself to be an Admissions Screener. I understand about the census and I certainly don't want to ever get fired. I've gotten every job I've ever interviewed for and I've never been fired but when you work from home for yourself for a long time you lose confidence/assertiveness. Maybe I'll need to read up on assertiveness! Or sales techniques! My grandparents lived a block away from the facility so I know the area well and it is in a beautiful area. Help!!