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registerednutrn BSN, RN

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  1. registerednutrn

    Old patients unsuccessfully clinging to independent living

    Sometimes it not that they failed to prepare for the future but rather putting food on the table, cloths on your families back and a roof over their head took priority. It’s easy to say prepare for the future when you make sufficient money to do so but not everyone gets to have jobs making larger amounts of money. All you can do from a nursing standpoint is educated the patient and try to encourage them to at least accept home health type services. But it the end it is their Choice. I have not seen very many well run nursing homes and the ones that are usually cost 12,000 to 15,000 a month (yep that’s the amount they charge) plus other expenses such as foley kits or wound care and medications Medicare pays very little if any and they usually won’t accept Medicaid anymore (at least not here). And sometimes even those facilities are not that well ran.
  2. registerednutrn

    Fall Coordinator

    I have accepted the position of fall coordinator for my facility covering, med/surg, ICU and ER. Has anyone on this forum ever filled such a position if so will you share you experience with me so I can kinda know what to expect. It is a brand new position here so I kinda get to define the role. I want to be able to provide education to patient and staff. I know that I will audit all falls and intend to do rounding to see if all fall precautions are being met for the high fall risk patients as well as educate those patients on the reasons for the precautions. I just know that I need some perspective on what expect for the role.
  3. registerednutrn

    Disposable Vs. Reusable Pill Cutters

    We do not cut pills at all that is done by the pharmacy where I work. The tablet is then packaged at sent to the floor which I feel is safer because not every pill can be cut in half
  4. registerednutrn

    Patient ratios in VA hospitals

    Depends on facility and department I’m on medsurg and we are anywhere from 2 -5 each one time I had six for about 3 hours but all are low acuity. We also have a med nurse sometimes as well. Right now since the VA is union some days we have more staff than patients ( so no low census or on call) Example today we had 12 patients 7 RNs 4 LVNs and and 1 CNA but in all fairness 1 RN was on orientation. Usually we would have 3 or 4 RNs and 3 LVNs or CNAs. Now our nursing homes it’s different but is usually about double what other nursing homes here have. You would love the VA
  5. registerednutrn

    4dimension nursing practice

    I sent you private message hope it helps you
  6. registerednutrn

    4dimension nursing practice

    It is a paper that you have to write about your nursing career. You will be sent the form to fill out. It is then reviewed by a board to determine your pay example I was boarded in as a Nurse II step six. I’m sorry I don’t have the questions but the main thing is to make a list of everything you done in your nursing career such as projects, committees, super user, preceptor, organization memberships, etc. The better your paper is the better your pay will be
  7. registerednutrn

    Does the VA pay better than private hosptial?

    It depends on the area. I have 13 years experience and just started at the VA a few months ago. I am also a BSN RN. And I got about a $6 an hour raise as a nurse 2 step 6. I also found out I am the second highest paid RN on the unit. I can actually be a nurse there not just running from room to room with no time for the patient and family. You can google the VA pay scale and look up where you live. One thing to remember is that everything is by seniority so example I am low man on the pole so I get to pick my schedule last so I work almost every weekend and holiday. They are super strict with their leave as well you pick vacations in October for the next year and that is set in stone so say you find out in January you have a big family reunion coming up in March you probably won’t get off unless co workers can trade shifts to give you some days off together.
  8. registerednutrn

    What city do you work in and how much do you get paid hourly?

    Amarillo T.X 40.63 an hour 25% diff for weekends and an extra 15% for nights so if you work weekend nights it’s 40% diff we never hav trouble covering weekend nights. Also double time and a half on holidays and really bank on a holiday weekend. I have 13 years experience as a nurse. Here in Amarillo this is pretty much the high end of the pay for nurses unless your in special areas like NICU
  9. registerednutrn

    Wow

    Actually yes we do have about 4 spots coming open
  10. registerednutrn

    Wow

    Texas
  11. registerednutrn

    Wow

    So I don't normally post much but I have to share this. I worked on a very busy (insane busy) medsurg floor for 11years. My typical day would generally be something like this. 1. post ( usually 1 day sometimes fresh post op)esophogogastrectomy with ngt chest tube j-tube requires q4 hour flushes tpn and ambulation. and constant pain med ( our facility did away with PCA so pain med was usally q 1-2 hr. 2. post(sometime fresh post op) heptatectomy usually with ngt to liws, a j-tube needing flushing a foley and constant pain med. 3. Post TURP (fresh post op usually) with a Murphy drip running at full blast ( usually changing a 5000 ml bag every 15-30 min. 4. A fresh sleeve gastrectomy sometime with a duodenal switch as well 5 A cabg about 18 hr post op with chest tubes tele sometimes an external pacemaker 6. Lap chole or appy that is fixing to discharge I kept telling my self it would get better but it only got worse as more and more stuff was added for the nurse to do. I did all of this and precepted the new GN's as well. Then we had a computer error that resulted in 2 write ups and i decided enough was a enough when they refused to remove the write ups after was discovered was a computer error. I was ready to completely quit nursing. I have a friend that had been after me for about 5 years to come work with her. I put my app in and got the job so here is my day now. 3 medsurg patients low acuity but they can be really sick ( more chronic CHF COPD ect.) But it gets better our floor census today is 8 patients (max is 14) we had 4 RNs and 3 techs plus an LVN that was floated to another unit. ( now today is a little atypical. we can have up to 5 patients but I have only had it happen once so far.) I am able to sit with my patients hold their hand talk to them laugh with them in other words be a nurse and not a medication pusher running my backside off. And I get my 2 15 min breaks and my lunch break. So there are greener pastures out there ( just wish i had not waited so long) so those of you that work on a unit like my old one know that it can be better.
  12. registerednutrn

    How do you handle touchy/feely coworkers?

    Why can’t you say you don’t like being touched. There is nothing wrong with saying it. I have told people that when it was needed. Some individuals don’t read body language as well as others so if you don’t tell them it bothers you how will they know it. It really is ok to set boundaries.
  13. I usually don’t post much but.. I read the enditment papers for 2 of the cases and the dosages listed for patient one was 1000mcg fentanyl and 10 mg hydromorphone and patient 2 was 1000 mcg fentanyl and 6 mg versed. Now I have to believe that any pharmacist or nurse would know that these would be fatal doses.
  14. registerednutrn

    Inmate patients- keeping the guard happy too

    Depends on your facility policy but if dr ordered nicotine patch I would give. As far as extras like soda jucce and coffee the agreement the facility where i work would not allow those. Some of the prisoners we get are pretty hard core so the will have a guard at bedside a second guard in the room and one outside the room as well as one of the hospital security guards at the nurses station. The guards don't allow the prisoners to ask for extras.
  15. registerednutrn

    NCLEX-RN: What does it mean to pass with 75

    It's cuts you off anytime after the 75th question if you are clearly failing or clearly passing
  16. registerednutrn

    My role in student nurse clinicals

    I am a clinical instructor in a LVN program I take a group to a nursing home. My role is somewhat limited due to the facility's rules not ours. So for my student to give meds the nurse has to log on for and watch us prepare and give the meds so we only get to give meds once other wise I do any skills that come up such as foley changes or placements with the students Now I also work on a busy medsurg floor and I will usually have a management level student from either of the 2 RN programs assigned to me so they follow me everywhere the only way they get to do anything with me is to show me that they are competent. If they are not I communicate that to the instructors. It can be overwhelming at times but is what the schools and hospital agreed on I can refuse to have a student if I want. Please forgive any crazy misspelling as I am typing on my phone e and it autocorrects really crazy