lvan0904

Hello, I have accepted a primary care NP position with a VA affiliated clinic. I have been working in a nursing home providing care to residents with acute & chronic diseases for nearly 3 years (it was my 1st job out of grad school). Since cost w...

Have you talked with any locums agencies? You could take a short term assignment in Houston or nearby region to see if you like the area before settling in permanently. I'm planning on moving to San Antonio (I'm from Ohio) to be closer to my son who ...

Castelgates, To my defense, I had a rough week and I was fed up with the level of disrespect encountered at work. I would never address an NP (or anyone regardless of title/position) in the manner of which the staff at this nursing home have addresse...

Hello, I have encountered several situations as a newer NP. I went into this field naively when I assumed that I would have a decent amount of respect from fellow NPs and among staff/administrators/RNs/LPNs. I work in post acute care, which was a new...

Jules, I'm not fighting hard to stay in this work environment. I asked how others handled this type of experience, in hopes of learning from it and avoiding it in the future if possible. I am currently searching for another job. If I could simply pic...

Mavrick, I have addressed each instance in a firm and assertive manner. There have been multiple occasions. I have first addressed the instances with staff, then went to unit managers, then went to management, then went to my collaborating MD and my ...

Hello Spidey's mom, Some examples include: Confrontation on several occasions where staff raised their voices & verbalizing rude comments, refusing to follow through with my requests, gossiping, etc. I've discussed the events with the DON, the ad...

Hello Springchick 1. Yes. I've addressed it with them and the DON & administrator. I was reassured that they would address the situation on 2 separate occasions. It was implied that I was "too nice". I am firm, but not demeaning. I am always resp...

Hello all, It's me again, the newer NP stationed at the post acute care setting....Please have mercy on me, as I have another question and I need your advice!!! A resident c/o fatigue so I ran CBC and BMP. Hbg dropeed 2.0 since transfer from hospita...

Hello all, I wondered what your experience was like when you obtained direct hours from an NP and or MD. I was in a busy primary care office and saw pts, provided my assessment findings, dx & tx plan with the NP/MD who then provided their input....

Hello everybody, I am a new NP, been on the job since 11/2013 at post acute care in a small nursing home. Although I enjoy seeing residents and meeting the challenges of my job, I am ready to pull my hair out when it comes to dealing with some of the...

Thanks for the input OregonGNP23!!! It's comforting to know that someone else can relate to my concerns. I was starting to question whether or not I had too high of expectations for staff & for the manner of which care is delivered within the pos...

Would Alk Phos be elevated in the 300s from a fx? I'm just wondering.... I'm not sure if I checked her thyroid to be honest, but good point. Na level was WNL, no s/sx overhydration. Thanks Teacher First

To pt's knowledge she never had elevated liver panel labs. No previous work up (liver function) from the hospital was sent over. The elevations in Alk Phos, ALT & AST came at a surprise and the pt was d/c'd 4 days after receiving the lab results ...

Thanks for the input. Consulted w/ collaborating doc. Statin was d/c'd & Hep B & C panel ordered- results still pending. Pt will be d/c'd home tomorrow. PCP to f/u on Friday & our labs will be faxed over for review. Ankle fx was from mech...

Hello, I am almost too embarrassed to ask this question, but still bold enough to do so- even though I may get mocked or criticized by some readers. So here it goes: I am a new Adult NP working in a nursing home. Today, an LPN reported to me that a r...

Thank you for being so kind!!! As a new NP I second guess myself quite a bit. To make matters more complicated, I am stationed at this nursing home by myself so I don't have another NP or an MD to bounce ideas off of on site. I do use Lexicomp and my...

November 2013, Ohio, post-acute care $88,000. No weekends, no on call

Thank you traumaRUs. I appreciate your feedback. I am coming from a hospital background and the post acute care setting is managed quite differently. They use paper charting and the rules and regulations are loosely held in place by the DON. One staf...

Thank you. I am following up w/ this resident tomorrow. It was a long day and I was starting to question my treatment approach. Thanks again for the input. I'm sure I'll be posting more questions in the future:)

Hello everyone Wondering if I could get some advice as I will be starting a new job at a nursing home (recent grad ANP 5/2013). I am wrapping up with my direct hours (500) and will begin my unsupervised hours (1000) in early Feb. Although I feel that...

I wish you all of the best in finding a job that fits your needs. Sounds like you shouldn't take what happened to you personal as this physician doesn't have the best track record w/ other NPs & he sounds like a jerk (just my opinion). I have tal...

I had a patient complain that I "didn't make good eye contact" and I "seemed busy". Really? I seemed busy? Probably because I had 6 patients with barely any help from ancillary staff. Forgive the lack of eye contact as I work on a tele/med-surg floor...

I have been interviewing in Akron OH and I have been offered $85,000 with no tuition reimbursement. We negotiated the salary and vacation time ($80 to $85K and 2 weeks to 4 weeks vacation/year) but I declined the offer because there are some conditio...

I was told that I could start in July, then they told me that hospital privileges can take months to process so I should be able to start in Sept. or October (which I can understand). But I still did not receive a finalized contract. They have had ot...