mondkmondk

A psychiatric nurse told me that Ambien definitely comes up as a benzo on a urine drug screen. I know it is a sedative/hypnotic, but other people have told me that too. When I said she passed her drug screen, I meant she didn't have any other meds on there besides her Ambien. She was negative for illicit drugs and alcohol. I haven't talked to her today but will keep everyone posted on the outcome. Thanks for all the advice... Blessings, Michelle

Ugh. In response to the meds being their business question, most health care facilities in our area do a drug test upon hire and random ones they feel as necessary. I know Ambien and Xanax would come up as a benzo...however, I don't see how they could hold that against you if you had a valid prescription for it and could bring your med in as proof or a written note from your doc. Just a thought.... Blessings, Michelle

Well, I know she takes Ambien CR and they've given her static over that in the past. I think the place she works wants healthy hearty nurses on NO meds at all. I know another nurse who used to work there too that was on Paxil and Xanax and they railroaded her too. It is so sad that in this day and age, mental illness still carries such a stigma, especially with health care professionals, who should be the most understanding! My friend was told that since she is only "prn" that she should never ever call in unless death. She has only ever called in once and has worked there like 5 years. Then this happens to her. I personally don't think it's fair. My friend is very honest and has no reason to lie. I believe her; I know you all don't know her like I do so it is easy to assume there is more to it. Basically, my friend is an awesome nurse and "everybody's friend" and someone there has it out for her. Blessings, Michelle

I just got off the phone with her; she is already notifying an atty who is a friend of her parents'. She says she has never had any action taken against her license of over 20 years and cannot believe this is happening to her. They are threatening suspension and revocation because she came in "over-medicated" and this made her "unsafe" to care for her patients. She also said she wasn't even there one hour and made no errors while there, no one fell or got sick or anything while she was there. She said she was simply dizzy and laid her head down so as to not fall down and hurt herself on the floor...she said that was a mistake, she thinks now, but doesn't feel she should lose her nursing license over it. Thanks for all the advice so far...I feel really bad for her, I've known her a long time and she is an excellent nurse. Blessings, Michelle

I have a friend who is an RN who just got out of a psychiatric hospital. She has problems sleeping and today was supposed to work and did try to go to work although she was very groggy. She tried to call in and was told she would lose her job if she didn't come in. So she went in and said she felt very dizzy and laid her head down on the nurses' station for about 10 seconds...however, another employee saw her and told everyone she was sleeping. The nursing manager shows up and gives her a drug screen, she passes, but they place her on suspension anyway and are threatening to call her BON and get her license revoked. Doesn't she have any rights at all in this matter? I want to help her in any way I can... Please advise! Blessings, Michelle

One facility I worked in a couple years ago had a sex offender as a resident whose crime was molestation of female children...his own granddaughter being just one of his victims at the age of 6. He came to that facility from jail due to decline in health. He stayed in his room mostly and kept quiet. But one day a CNA came to me and told me I needed to come to the dining room NOW. When I got down there, I noticed he was trying to get a little girl that had come in to sing for church to sit in his lap. He was offering her candy. I immediately grabbed the little girl and carried her back to the church people and escorted him to his room. I immediately notified my DON and the administrator and had to chart a book on him. The whole situation made me very uncomfortable to say the very least. I think personally, that there should be some kind of LTC for inmates that are too frail to be in a jail's general population. I don't think inmates should be in a regular LTC....just my personal opinion. Blessings, Michelle

Ditto what CapeCod said in our state too (Missouri). One facility fired me for excessive abscences. I did put on the next application that I was fired, but never asked why. Claiming you were terminated on your app still makes you honest, but I wouldn't go into detail unless the next facility specifically asks you why. Just my less than 2 cents'! Blessings, Michelle

The DON that used to be a staff floor nurse that when she was a floor nurse, used to cut up with you and joke and laugh and was a great person to be around. But once she got "DON" behind her name, she decides to ridicule you in front of other employees, write you up for the stupidest things, and basically uses her title to belittle and humiliate all who are under her. ARGH! Blessings, Michelle

I wouldn't complain. The staffing sounds adequate to me. 3 CNA's and a nurse to 30 residents? That is approx. 7 residents to each staff person. That for LTC is really not bad. Anxious to hear other responses you'll get...good luck! Blessings, Michelle

I had my RN clinicals at a big teaching hospital notorious for the nurses playing practical jokes on the students. My patient was just out of OR for a hip replacement and was cold. The only blanket warmer on the floor was broken, so the nurse I was assigned to instructed me to put a bath blanket in the unit microwave. I thought she was kidding and just laughed. She got really serious and told me to do it ASAP or she would go get my instructor. So I complied. I remember I didn't put it on for very long, but did leave the room where the microwave was. Next thing I knew, the whole unit smelled like something burning and the fire alarm went off! The head nurse came out of the microwave room with the blanket with burnt holes in it and asked who did it. I was terrified and didn't say a word. The nurse that told me to do it was standing there laughing and told the head nurse she thought one of the students did it but "couldn't remember which one". I did tell my clinical instructor and she told me she'd take care of it with the head nurse. I will never forget it. One of my friends in RN school was feeding a little old man a cup of broth. She said the whole time she spooned it into his mouth, he would make a face and shake his head. When she got to the bottom of the cup, she picked the cup up and noticed the packet of broth underneath. She had fed him a cup of plain hot water!!! lol Same friend in RN school (we rode together so we exchanged many stories)...we chose the locked ward in psych nursing in order to see many different diagnoses. Her assigned patient that day was a real doosy. She said it was all she could do in order to keep a straight face while talking with him. He told her that he had fathered a horse baby and his goal in life was to find a transvestite horse and father its babies. I will post more if I think of more! Blessings, Michelle

I was placed on a wing last night that I had never worked before. 45 residents. I told my boss I wasn't comfortable working without at least one shift of orientation. I don't even know where half the supplies are kept for this wing, let alone important papers etc. They weren't happy with me, but gave me 2 nurses to orient me. Each nurse split the shift, so I had 4 hours with each of them. The first one orienting me who I usually get along with just great, yelled at me about 4 times. She didn't tell me that 4 of the 5 meds at midnight were to be crushed; I had a question about a narc card with a dose that didn't match the MAR and she told me to just set up my meds by the narc book (uh, NO!), then she pretty much treated me like dirt the 4 hours we worked together. The second nurse to come in for the next 4 hours yelled at me about the evening shift nurse forgetting to sign out a narc so count was off. I didn't even do the count, the nurse "orienting" me counted with the evening shift nurse, but the day nurse blamed the off count on me. Then without thinking, I accidentally put a capped syringe in the sharps container and the day nurse lectured me on that. The first orienting nurse told me I had to pass the 0600 meds and I did and the day shift CMT yelled at me and stomped around and threw stuff around on her cart even though I apologized. I think I would've been better off just winging it on my own. Why oh why can't we just all be team players and go on without all the drama??? Blessings, Michelle

Well, I hate gossip/rumors etc. so I'm going to let this drop. If the nurses in question want me to know, they will surely tell me...or tell my hubby since he works with them. I was just worried about what this means for the rest of us nurses on staff. I guess I will start double checking all my charting and if someone goes bad on me, I will contact the DON to see how she wants me to proceed. Thanks everyone... Blessings, Michelle

Well, I took a CNA class when I was a senior in high school and worked in a LTC facility while going to LPN school. I stayed on there after graduating and worked several years as an LPN before I went back and got my RN. After I got my RN, I went to a different LTC facility. My advice to new grads? Don't do LTC until you've had at least 1 year of hospital experience. I wish I would've done hospital when I was a new grad...just for the experience. Blessings, Michelle

Was interested in hearing how much liability amount you get...and who is the provider? I used to have this back when I was full time through NSO I think it was but when I went prn I let it lapse. However, here lately our DON is write-up/suspension/termination happy, and I'm thinking it is about time I get back on something. How much coverage and through who do you all recommend? Thanks and blessings, Michelle

I never worked the wing the patient was on, but she was on my wing upon initial admission for about a week. I don't think back then that she was a DNR, but that very well could've changed. My hubby seems to think that when the night shift nurse initially assessed her, they weren't maybe thinking the emesis was blood...because she had just eaten a candy bar. That is the only thing we can come up with. I work this weekend, filling in for someone, and I'll quietly ask around and then let you all know. Blessings, Michelle

So as many of you know, my hubby and I work in the same facility. He is a CNA/CMT going to nursing school. He works full time nights and through the grapevine, I am hearing so many good things about him. The residents adore him, the nurses love him because he never calls in, is always on time, does his job, and coaches other CNA's to be the best they can possibly be. He will be a really good nurse and I'm soooo proud of him! He came home this morning from work obviously upset about something. I was sleepy but got up so I could listen and help him. He said 2 really good nurses were suspended and he thought it was really unfair. I asked him who and when he told me, I did a double take. One of the nurses used to be our DON and was the one who hired me. She is more than an excellent nurse, so of course I wanted to hear the story. Allegedly, a resident went bad on night shift and was assessed by the night shift nurse, an LPN. Her main symptom was coffee ground emesis, but she had been seen by a couple different aides eating a candy bar right before she vomited, so the LPN called the on call doc. She was basically told to monitor the resident and report any further symptoms. So the RN comes in for day shift and she vomits again, again coffee grounds. The RN does a full assessment and again notifies the on call doc and gets an order to send her to the hospital. They send her out. Hospital sends her back on same shift, saying she is bleeding internally and is to be kept on comfort measures only. She dies a few hours later. The day and night nurse are both placed on suspension pending investigation by our head DON, for allegedly, lack of proper nursing intervention and questionable assessments. Does this sound justified to you all? After my own write up for the resp. distress thingie, I am beside myself now to make sure I am adequetely assessing and documenting...and I plan to notify our head DON if I have any questions. I sure don't want this happening to me! Blessings, Michelle

I only work every other weekend right now. Our youngest we adopted and I envisioned myself being as close to a SAHM as possible while he was young. I think I will wait until he starts full time school to start any classes. By then, my hubby will be in a BSN program as well and maybe we could do a traditional program together. The local community college in our area is projecting having a BSN program by that time...so we'd save a lot of money going that route. Plus I've never taken any online classes; I think personally that I would do better in a campus setting. CapeCod: Hubby is currently doing his LPN, then will bridge up to ADN. When he gets his ADN, he will have been an LPN in LTC for a year. He would like his BSN prior to accepting a management position. So technically he will have one year experience in LTC as an LPN and 1-2 years experience in LTC as an RN before accepting a DON/ADON type job. Our current ADON where we work is only an LPN. He has been a CNA/CMT in LTC for years..I would like to think that experience would count for him as well. Blessings, Michelle

I've been a nurse 18 years now, mostly in LTC. I have been an MDS/Care Plan Coordinator and did work for a year in home health/hospice. My desire is to become an adult NP. However, when I think of all the schooling ahead of me in order for me to do that, I feel tired. Has anyone here worked this long in LTC then gone back to school in order to do what they want in nursing? I have wanted this for years now...and have talked to several schools, online and offline campuses. I can finish up my BSN online, then transfer to a masters/NP program. I'm looking at about 4 more years of school. My hubby is currently a nursing student himself, all with LTC background. I'm pushing him to go for his BSN as well and then taking a management job, like DON or ADON. He would be a really good manager in my opinion. But I really don't want us to be in school together either. But I could take some classes here and there to finish up my BSN online, then go from there. What would you all do if you were me? Blessings, Michelle P.S. My youngest will start 3 year old preschool this fall...we currently don't plan on any more kiddos.

Things I have learned in nursing: Compassion is key. Blessings, Michelle

You are good to go. My hubby is a nursing student right now with a felony for forgery. He has tried several times to get a pardon, but no success. Our state BON will accept criminal backgrounds, so long as the felony isn't a class A or B. My hubby's is a C. Blessings, Michelle

Right now I'm having an issue with the night shift LPN. She is always crabby when she comes in and criticizes almost everything I do or say to her. Supposedly she has a bad home life, but she shouldn't take it out on me. Sunday evening when I worked, I was really busy...and when she came in, she jumped my case about all the changeover paperwork not being done. Every other facility I've ever worked in, this was night shift's job. I apologized to her and offered to stay over and help her with changeover. Her response? "I don't need your help; the only thing I need you to do is stay the hell out of my way!" I'm seriously considering filing a grievance against her. I asked my preceptor yesterday when I happened to see her which shift is supposed to do changeover and she said nights. So this night shift nurse is really chapping my hide!!! I'm sure I'll think of other pet peeves too....what are some of yours? Blessings, Michelle

Morte: Yes, the hospital personnel ran some tests on him and he came back positive for illicit drugs; they didn't say which ones and he is not allowed any visitors alone in the room with him per their policy. I told him when he told me he was going out that he was considered to be sick from running a temp. He blatantly stated "I don't care what my temp is, I'm still going out." I documented this and reported to my DON and administrator both when he came back acting drowsy. I think I did all I could do in this case. I have another question though; what do LTC's typically do when a resident goes out and comes back stoned/inebriated? Is it enough to discharge them completely from the facility? Thanks and blessings, Michelle

I worked this past weekend. I took report from the day nurse on Saturday about a resident who had developed a UTI. Someone overlooked the pending C&S and the lab I guess never did it so the day nurse obtained another specimen and sent it to the lab and started the resident on Cipro. Since he also had a fever the on call doc ordered him a one time order for Ibuprofen. (This patient also has Hepatitis C and can't take Tylenol). So I come on and am going to get a full set of vitals on him. We currently use one of those thermometers where you run it across the forehead and down below the ear. His first temp. was 104...this was after the Ibuprofen and after his initial dose of Cipro. So I called the on-call doc. While I was on hold, one of my aides checked it again and it was 102. So when the doc got on the line, I told her of the temps. She got snippity with me and told me I hadn't given the Ibuprofen and Cipro enough time to work and to just monitor him. Well, so here comes this guy to the desk wanting to take him out of the facility for an hour. I check his temp again and it is 99.4 and this resident is his own person and tells me he's going out, temp or no. So I sign him out and make sure to document all this carefully. A CMT passing through from another unit, stops and is watching me sign him out. After they leave, she tells me that I will probably get in trouble for letting him go out with a fever. ???? He comes back and is lethargic/drowsy and I check his temp again and it is 99.2. His other vitals are fine. So should I somehow have tried to make him not go out? Today he spiked a 102 temp and is now in the hospital. Same CMT thinks I'm to blame because I let him go out. For one, he is his own person; I cannot make him stay in the facility. Should I have done anything differently? Blessings, Michelle

Sorry, nursing only had one deficiency where I work. It was for documentation. Blessings, Michelle

I'm not sure how many total we got, but nursing only got 2. One was for documentation and I think the other was for someone's wound or something like that. I'll look in the survey book when I go to work this weekend. Blessings, Michelle