lashuna1028

The agency I work for delivers medications for a 2 week supply so pt will get exactly enough for 2 weeks. If he is running out early than I would inquire why. If he is saying he needs to take more to relieve pain then the pain medication regimen needs to be changed immediately. Get with hospice doctor and come up with a medication that will work for him. Dont assume, dont get yourself mixed into the patients personal affairs. Just stick to the nursing.

In LTC facilities you have to follow policies and procedure for that facility. If the facility requires an order for their residents to smoke than you have to follow their policy. Hospice or not. It is different with home hospice patients. If a patient is on hospice you are supposed to report any change of condition to Hospice so the hospice case manager can come and assess. IE no urine output your whole shift should have been reported to Hospice nurse.

No, its your choice to work on call as a case manager UNLESS you agreed to it when you were first hired. You can simply tell them you can't. They would have to hire a PRN nurse.

This is my first home health job. Well I was actually hired to be their Hospice case manager but they have me helping with home health patients since hospice census is low. And I really dont mind BUT I was not formally trained to do home health and was told nursing is nursing.. While that is true the philosophy of home health is different and also the documentation. So I ask because it seems as though most of their patients do not have a need of skilled nursing that I can identify. Some of their patients have been on service for at least 2 episodes or more yet the SOC or 485 have not been completed so I would go in blind of what patient needs. Seems like they have a lot of Abnormality of gait, DM II, type patients where the visit seems redundant and pointless to me. So I dont know, I dont like it. I dont feel like I've made a change with HH patients. I feel like Im missing something mentally with the whole concept and trying to figure it out on my own.. I only have one direct patient care wound care patient so far that requires a wound vac.. Another problem is, someone else in the office does all the assigning for the patients and they switch nurses around all the time for the same patient every week. I dont like that. As a hospice nurse, I am used to being with a patient from beginning to end.

Honest answers pls. On average how long do you spend in each home? Im not talking about when there is a need like wound care or something serious going on that need your direct care. Im talking about the visits where it seems like all you do is check their vital signs and fill their med case for the week and after thinking and finding something to "educate" on ??

What are some other ways I can write Pt or PCG understands teaching besides "understanding verbalized/voiced"?

I found a job! Started working 2 weeks ago at a skilled nursing facility! I am leaving this comment because I remember feeling like I was the only RN in Texas with my issue and no one was able to guide me. If anyone is in a similar situation please feel free to PM me. I will say this, when I started making finding a job my full time job, getting up and dressed like I was going on interview, calling places in area first before going there to see if they were hiring and filling out applications.. it didnt take long at all to find this job... ANYONE in a situation like mine online applications WILL NOT WORK, you have to go out and show your face. Don't mention anything about stips to HR or anyone else but the Director of NUrsing (the person that will be signing your stip papers) which is usually the one interviewing you. Be upfront and direct (the hardest part) before you even start the interview. Something like " Before we proceed, I need to be upfront and tell you that I have stipulations for x amount of time with board of nursing for x" and ask if he/she would be willing to work with you. Sell yourself, be genuine about your mistakes, and show your passion for nursing. Please PM if any questions

Getting frustrated now, Texas Board gave my license but with stipulations for 1 year due to criminal background. Not to get much into details of my charges but they both deal with domestic violence from being in an abusive relationship. 2009- Deferred adjudication for disorderly conduct and 2011- Deferred adjudication for assault to family member. There's nothing else on my background except for these two. These charges are listed publicly on my license for the one year, but I have to be working as a nurse before the 1 year starts. I CANT FIND A JOB, I have been applying any and every where. I recently updated my resume to include getting my ACLS certification and also I am starting UTA's RN- BSN program this year. I need help, how can I move forward with my nursing career if no one will hire me because of my background?? Where are some types of facilities that may hire me??? Any advice or suggestions are greatly appreciated

Yes it did help, so I will apply anyway even though it says "unrestricted license" and just explain if they ask. Thanks

ok, i know this may sound like a dumb question but i just want to make sure if the terms are the same. i have stipulations due to a criminal charge of assault to family member and the stipulations are to provide direct patient care in nursing home, hospital or any clinical setting, work at least 64 hours per month and work where there is at least another rn on facility grounds. i can still perform all rn duties within the scope of a rn so would this be considered a "restricted" license? on some job qualifications it states [color=#454442]full unrestricted licensure required so does that mean anyone with any type of stipulation is excluded?

Ok, thanks for the advice, now I just need to come up with a speech to present the information without being too detailed about it

I know its quite odd to do such because I am trying to sell myself on a cover letter but I was advised to just be upfront and disclose it which also gives the opportunity to sell regardless of the blemish. My background and the stipulations placed is due to the domestic violence relationship I was in. Does anyone else think this is a good idea? At least I'll know if I am interviewed after disclosing it wont be that I didn't get the job because of it, or else I wouldn't have gotten the interview anyway. They're going to find out anyway and it's so much easier for me to write about it then to talk about it in an interview. Any other advice or suggestions will be greatly appreciated.

True and again with that being said does it also tell you if that medication is expired or contaminated? That pill could be 2 years old or even coated with cyanide or lead poison. Isnt the quality of the drug also important? If these are not legalities then maybe its ethics. I work with Alzheimer's patients so I am even more of a patient advocate... maybe I am being a little over protective??

Well being able to identify the drug is not the only point here, even if I could identify the pill (which most of them I can) that still doesnt validate its expiration date or contamination, especially with capsules which can be opened. I like to be able to open my pills out of the package or bottle it came in. Thats just like giving a prefilled syringe to someone with a written label another nurse put on it for you. If I didnt draw it up out of the bottle it came from, I'm not giving it. Its not that Im so suspicious of foul play but this should be standard nursing care. And Im not saying its not okay to use your home meds because I know people are on a fixed income and etc but whats not okay is to just hand me some lose pills in a sandwich bag or cassette and say give this to my father at this time. For those that want to use their home medicines they should be required to have them still in the prescription bottle or OTC bottle

Ok, for the nurses working in long term care and assisted living facilities you may have run across this issue. We have a respite client admitted from home that will be staying with us for a few days. I have orders from MD in the chart for his meds but the family brings all of his meds already prefilled in those home cassettees (you know the ones with the days of the week on them) UNLABELED. No prescription pill bottles or even OTC bottles for that matter...just these cassettes...And whats even more surprising is the director of nursing here, RN BSN knows about this and these pills were actually written on the MAR for us to give. The morning nurse has been giving them and has been signing them out on the MAR but I am the only one that seems to have a problem with this. I am NOT giving these pills to this man and I am going to sign them as NOT given! I dont know what they are and even if I could identify some of the pills I still dont know if they are contaminated or expired! I need input from other nurses regarding this. I would like backup on my decision and even where I could find where it talks about this somewhere in Nursing Practice Act as a resource. Thanks

Whats the appropriate or professional way to refer to self while writing a nursing note? Do you say "this nurse" "writer" "me"...?? I see "this nurse" alot but it just seems weird to refer to self like that..

I have a concern regarding unpaid break times at my facility. I work at an assisted living facility where theres only one nurse on the floor per shift. During the day though the Director of Nursing and Assistant Director of Nursing is also here along with the floor nurse. But at night which is what I work, there is only one licensed nurse here, so my employer requires that I remain on premises during the unpaid break time. I am aware of state and federal law section 785.19 stating that the employer can require the employee to remain on premises and still count it as unpaid time just as long as he/she is "completely relieved from duties" during that time. So my question is how can the one and only nurse on duty be "completely relieved from duty" during an unpaid break time? I am still in charge and still liable for anything that happens during that unpaid break time. Who am I "relieving" my duties to during my break time if I'm "completely relieved" ? I can't "relieve" my duties to unlicensed persons. If a patients dies or goes into cardiac arrest while I'm sitting in the break room during an unpaid break I'm still responsible right? This doesnt seem fair at all. I am being automatically docked 30 minutes of my time here on duty and my employer says its legit. (those 30 minutes add up!) I have already inquired about this to HR and was told that they are in accordance with federal law. And that I should take the unpaid break time in the break room or take a walk outside just as long as I dont leave the premises. Just so long as I am completely freed from duties during that time. I think theres a misunderstanding with the duties of a nurse because they were referring to "duties" in a technical way, ie physical labor. But as a nurse our duties include more than physical labor. We are held accountable for the overall well being of the patient, we have to critically think, make judgements and mentally assess. So just because we are sitting and not passing meds, not answering call lights (anything physical)etc that doesn't mean we are "relieved from duty" right???

I will not be intimadated by my employer and I don't work for free. My time is valuable and I expect to get paid for my time working here. So whatever consequences you are talking about ie maybe getting fired for requesting to be paid the full time I am on duty that is fine with me. It is a legitimate request and also I am employed by will so I can quit or they can terminate me by will.

You system at your job sounds very fair and that is how it should be where I work. But it is a very small facility only one other nurse works there at night and that is when Im off and she seems to not really care. But I do! During the day time the day nurse can take a break if wanted because they work with the Director nurse and Assistant director nurse on duty. But at night its just one nurse. So really I'll be the only one out of the nurses complaining which can look bad..but I dont care

Can I legally request to be reimbursed the 30minutes each day that is being automatically deducted from my pay? Since I am the only nurse working at night I cannot legally by state board leave the facility since it would be considered patient abandonment. My employer has also told me I cannot leave the facility. I asked about the break time being automatically deducted and the reply was "you can still take a break you just can't leave the premises". Ok I've done my research and the Dept of Labor states a bona fide meal break is 30minutes AWAY from the workstation. It also states forcing an employee to remain on duty or eat at their workstation is not a bonafide break. I am actually ok with not being able to take a bona fide break and be able to leave and come back. BUT what Im not okay with is them continuing to take 30 minutes out of my time as unpaid every day. I know this may sound petty to some but those minutes add up ( thats $120 per month for me) and also it is simply unjust. So my question is I want to write a letter to HR requesting to be reimbursed (not since I've been there) but since the day I was written up 4/28 for leaving to go and get something to eat and coming right back (one of the employees snitched). Do you think that is a legally and genuine request?

I work at an assisted living facility during the night from 6pm-6am (12 hours) where its only one nurse on duty (me). I would like to know if I left the building for less than 30 minutes to get something to eat and come back and I notified the caregivers I was leaving and coming right back AND to call me if anything happens is still considered job or patient abandonment??? I thought leaving the premises and NOT coming back at all was considered abandonment. I was written up and threatened to be reported to BON for abandonment if I left the premises again. Also my employer takes 30 minutes out of my 12 hours time for a break (when I dont truly get a break) since I cant leave the facility. Doesnt seem fair

DONT QUIT! Keep going. I can imagine its hard but take some time off, get refreshed and continue. THat one more year would go by so fast. In my opinion I think you would regret it. I am an LVN and currently in progress on getting my RN and I totally regret doing this but I had my reasons so I cant totally discredit my actions. But as an LVN your options are very limited and geared towards geriatrics and long term care (well here anyway). You have an advantage because your school offers you to get your LVN WHILE you are still in school for your RN. THeres no such thing like that here, you would have to get your LVN then apply for the RN program, which would end up taking way more time. SO take advantage of that opportunity you have. If you choose LPN over RN you are choosing to make less money, have less options on where you want to work, people will judge you based on your LVN title; that you are less competent then an RN etc, and I will say again you will make alot less money!! Here in dallas, TX and LVN starts between 20-25/hr while RNs start between 35-40/hr. and thats ADN RN not BSN. My dad is an ADN and makes 43/hr at a hospital. And this is not based on experience (Actually, I have noticed in nursing the pay is not based on experience. A nurse with 15 years exp. would be making the same or maybe .50 more then a grad) also,RNs have options like working seasonal. I saw an ad in the paper from Methodist hospital looking for seasonal RNs where they work a total of 3 months. 3 days/week -12hr/shift at $65/hr

As Systoly stated, the experience there is really good so though it is very busy I would still stay because of the challenges. But that really depends on what you ultimately want to do. Because that nursing home doesnt sound like a common nursing home. Most nursing homes dont have IVs, chemo, etc... Just those dang G-tubes! So, if you are more geared towards getting into Med Surg/ ICU etc then I would stay but if you are geared towards being in long term care/ geriatrics/ alzheimers etc I would leave because that place would just burn you out when you could go to another "normal" nursing home making probably the same amount with less work.

First off I can tell you YES, employers do discriminate with online degrees and for some good points. Some online programs dont even require clinical rotations and to just do the CLEP exam (or whatever its called to pass on clinical skills exam). So most employers would feel like a traditional school would have a more knowledgeable and experienced grad versus an online school. And for example when it comes to an online programs YOU have to find your own hospital and proctor to do the rotations at. The hospital/clinic/ etc would have to agree and sign documents with the school to allow you to practice there. ANd this is because most online programs have only so many hospital/clinical sites in each state that they have already found for their students. So for example if you live in texas and the online school has 5 places to do your rotations at but you live 2 hours away from the nearest one, you would then have to find your own in your area and have them agree for you to practice there plus an instructor/proctor there and then the documents are sent to the school. If you are in a dilemma like I was in, yes I would go ahead and get my LVN simply because its less time and you would be making more money in 1year versus going to school for 3 years broke. But I will say it is HARD. Reason why is because first off, (Im going to exclude a person not being strong minded and determined) the LVN-RN bridge programs are few. I am in Dallas, TX and there is only one school in Dallas that has an LVN-RN bridge program and that is EL centro college, which is downtown dallas. THat one of course is very competitve, so most LVNs start to look into the out-of-town schools offering the programs maybe 45-1hr away or more. Then you have to meet that particular schools requirements to apply. Its hard to apply to several at once because they all want different prerequites. Maybe one school wants A, B, and C prerequisites and another school wants you to have A, C, and E. Some schools require you to be an LVN for at least one year before applying Or like El Centro it is required to have at least 6 months experience working in an acute care facility. I graduated in Sept 07 and finally completed all prerequites needs for one partticular school which is starting its bridge program in May this year. I applied and just praying that I get accepted because its based on a point selection. If I don't I will just have to find another school and apply there, keep trying and never give up. Thats why you see some LVNS working in nursing homes for 15-20 years and you wonder, why? Determination is the key. Sometimes I feel regret on doing the LVN instead of RN because if I would have gone straight I would already be an RN right now. But I have to remember I did it for a good cause because after one year my pay scale jumped from $13/hr to $22/hr (plus working whenever, overtime unlimited. can have so many different jobs at the same time because nursing is 24 hours) THats a big difference for one year.... So I think it really depends on your current situation. Since you really need to make a change faster I would go for LVN then bridge to RN

Well it really depends on what type or field you are applying also. Most hospitals and clinics would prefer to really hire a RN and might take a LVN that has experience in the area. Most LVNS have jobs in the geriatric world ie. Nursing homes, assisted living, home health care.. also pediatric home health care will take on an LVN without much experience. But I never experienced that what you are going through cause in school we were already told about the RN/LVN preference thing. Even while I was still in school, employers came to my school looking for GVNs. My first job was at a skilled nursing home. I pretty much had the job when I applied, no interview or anything like that. And thats how most nursing homes are. Its just took about 3-4days for them to verfiy my license as that step is required by state. I really didnt want to go into nursing homes or work in geriatrics, Im more interested in ICU. but as an LVN here Dallas, TX, thats pretty much the only option which would hire you fast and pay you pretty decent. New grads start out at about $20-21/hr. If you are forced to go into an area you don't like because employers dont want to hire a LVN just make it a stepping stone and work towards your RN so you can work in whatever field you are interested in.