americanTrain

americanTrain

ICU, ER, MS, REHAB, HOSP ICE, LTC DON

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All Content by americanTrain

  1. ADON misleading title? Rant from DON

    americanTrain replied to americanTrain's topic in LTC: Directors, Assistant

    wow , the other night I actually had to work the 10p to 6a shift as a charge nurse. (only nurse in faciility for 61 residents with 3 aides. They tried to write me up for missing a med dose at 0600. In...

  2. ADON misleading title? Rant from DON

    americanTrain replied to americanTrain's topic in LTC: Directors, Assistant

    Thank you, I knew I was right, but am getting backed against a wall. I try to do it the nice way, and then I try to be firm and assertive,but it backfires on me. I can find no happy medium. The...

  3. ADON misleading title? Rant from DON

    americanTrain replied to americanTrain's topic in LTC: Directors, Assistant

    No union here in Tx. But if the ADON and PCC would pick up extra responsibilities and I was allowed to delegate, there would be no problem. This is totally crazy. I am just trying to ride out the...

  4. Bosses

    americanTrain replied to lovingtheunloved's topic in LTC: Directors, Assistant

    Thank you! I hope my facility feels this way about me. I sure do care for them and always try to make it

  5. part time Rn casemanager, full caseload and Lvns in office

    americanTrain posted a topic in Hospice, Palliative

    Scenario 1: hospice nurse part time working 3 days a week. Should it be ok for the manager to make that nurse take a full caseload? Caseload of 13. Rn visits twice a week on each pt. Rn is to do both...

  6. part time Rn casemanager, full caseload and Lvns in office

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    Yep, you are right. And mine were all in homes, with only 5 in nursing homes. I was driving 250 miles a day, not included commute to work and back. Well, I finally left hospice and now for the last 8...

  7. Nausea

    americanTrain replied to ErinS's topic in Hospice, Palliative

    sometimes the morphine can cause the nausea. This would be called opiate induced nausea. I had a pharmacist at a convention say that Haldol routine doses would help this. She was pretty convincing on...

  8. Two job offers...accepted both.

    americanTrain replied to GhostsWerePeopleToo's topic in Hospice, Palliative

    Been in that position once, but arn't you lucky to have two offers to choose between? If you know that the 2nd offer best suits you, don't feel bad about turning the other job down. They do not need...

  9. Need some experienced nurses to help solve this problem

    americanTrain replied to nsgmjr's topic in Hospice, Palliative

    How long ago was this procedure done? Usually after the TURP, the catheter stays in place for just a few days. The fact that you mention no clots, and urine flowing freely with just a leg bag...

  10. part time Rn casemanager, full caseload and Lvns in office

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    While I hate changing jobs, Iam in the process of looking for another job. 8 out of 10 days I feel like Michael Douglas in "Falling down" the movie. Just get out of the car and start walking, do not...

  11. part time Rn casemanager, full caseload and Lvns in office

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    I was told that unless I had 7-8 visits a day, I shouldn't ask for a back up nurse. The lVN gets mad everytime you ask for them to see pts. LVN wants to stay in the office, looking at facebook,...

  12. part time Rn casemanager, full caseload and Lvns in office

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    True, but when management keeps saying, we will hire a new nurse when we get our census to ---- or ----; and when we reach that limit and over, she changes the numbers on us. I know is all about the...

  13. Dress code.....

    americanTrain replied to indianahope's topic in Hospice, Palliative

    Our boss is ok for dress clothes, ie.. dress slacks, nice top. white lab coat preferred over top. She states that the pts in home are much more likely to feel frightened by the "doctor or nurse"...

  14. Swallow study in ES Dementia patient

    americanTrain posted a topic in Hospice, Palliative

    How would you approach this situation. A family member comes to you after many weeks of pt occasionally coughing while eating. Pockets food in mouth and sometimes coughs with thin liquids. Family...

  15. Swallow study in ES Dementia patient

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    Yes, I have a few families that are emotional traps for me, thank God I have a wonderful SW who answers her cell anytime I call. And will meet me in a moments

  16. Case Management in Hospice Care_____Please Read And Help....

    americanTrain replied to dobletruble's topic in Hospice, Palliative

    Try doing a search on Cicely Saunders, this is where it all starts. Great biographies on her are all out

  17. post hospice interview question

    americanTrain replied to Marshall1's topic in Hospice, Palliative

    I agree completely with all the others, she should have called you back. That is unprofessional at best, how does she treat her employees when they ask for a date to meet and discuss their progress....

  18. Allscript

    americanTrain replied to ShayRN's topic in Hospice, Palliative

    At our hospice, we also use HP - Hospice Pharmacia, I really like it, though it took some time getting it set up. I hope Allscript is as

  19. Swallow study in ES Dementia patient

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    Yes, I have invited the family to IDT's. This is a family that is not new to hospice, as we took care of another family member as well. I think its just an education process, as diagnosis of the...

  20. significant dates or occasions to die

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    The elderly lady I mentioned earlier that died on what would have been their 75th anniverary? When the family asked me what she was waiting for, I had asked them if they could think of what Dec 1st...

  21. significant dates or occasions to die

    americanTrain posted a topic in Hospice, Palliative

    :heartbeatWill others please share of their experiences where the patient died on a particular date of significance. Iam really interested in this as it seems to comfort the families. Do you think...

  22. Interview 2 weeks ago...

    americanTrain replied to KatieNoelLPN's topic in Nursing Career

    I had a very similar situation happen to me. I went on interview and was told that I'd like it there and that I would make a good fit. It went very well and I was to contact HR later on that day to...

  23. Worried about new job

    americanTrain replied to Halinja's topic in Hospice, Palliative

    I would say that if this is really what you want to do, give it at least 6 months. I felt the exact way you did when I first started. I had a hard time transitioning to 5day work week schedule. Im on...

  24. frequency on RN visits

    americanTrain replied to americanTrain's topic in Hospice, Palliative

    Angie, like you, we were told twice a week no matter what. I really think this is a matter of PR since the company is fairly new, so maybe I just need to buck up and place my skates on. I want to see...

  25. Rant About On Call

    americanTrain replied to Sue Damonas's topic in Hospice, Palliative

    wow, thats tough working with a full caseload and 130 census. oncall hours like that would kill me and i'd be out of hospice in a heartbeat. my job is f/t mon-fri, 30-40hrs week. we take every other...