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mikeicurn ASN, RN

ICU
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  1. mikeicurn

    Lessons Learned - Choose Your School Wisely

    They didn't dismiss her from the program, she quit. How is an attorney going to force the school to take her back when she voluntarily quit? She just had to take an English class to graduate, and she quit. She fought all the way to the dean over these other issues, but when they won't take her English class she just up and quits? That sounds awfully fishy to me. I am sure there is much more to the story.
  2. mikeicurn

    so i called in sick today...

    Well, that is true. Of course if she is in a unit that requires ACLS, and she doesn't attend the training, then she can't work. Once again causing a hardship on the others working in the unit. So it would matter to them. We just don't know the whole story. This is one of those situations where Occam's razor comes in handy. She may be this incredibly hard worker that has never been late or missed a shift, and her boss just completely flew off the handle and fired her for no reason. Of course that sounds a little crazy. What is more likely is that this a not an isolated incident, but a pattern, and her boss got sick of it. I know the usually way this happens on here is everyone piles on and talks about how unfair it is and how the boss is being unfair, but I have worked with these people. It is unfair when they are constantly late/no show and everyone else has to pick up the slack. So she needs to learn from the experience and move on.
  3. mikeicurn

    so i called in sick today...

    So what you are saying is you were a "so show, no call" yesterday, then you called in today with out a doctor's excuse. Where I have worked that would probably get you fired as well, especially if you had a history of this kind of behaviour. I am sorry to sound harsh, but this sounds like you brought it upon yourself.
  4. mikeicurn

    Nurse's aides are running the the floor.

    This is what I was thinking. I get along great with my aids. I will jump up and grab a call bell if they are busy rounding or something, but I will occasionally do it if they are sitting down taking a break, but when I get busy with my work, I don't have the time to do it. Someone (sorry, I didn't get your name before I started this reply) posted about their nurse taking more time to hunt them down to do something, than just doing it themselves. I have done this before, but I am usually sending a message. If I find something that should have been done, and it is a repeat problem, I may spend time tracking down an aid to make her go fix the problem, as a "gentle" reminder that it needs to be done all the time. Back to the original poster. You said the aids have been talking on cell phones, hiding out, etc... and it hasn't been reported, well maybe it should be. One or two bad aids can throw a lot of extra work load on your good aids. I have a great team, and if I get a "bad apple" I jump right on that problem so they don't throw extra work on my good aids and upset the team. If all your aids are working like they are supposed too, then the work will get done and there might be less griping. Just a thought.
  5. mikeicurn

    Expected to do other nurse's work

    I understand how this could be annoying, but how often does this happen? Since you are complaining about it and use the word "frequently" I am curious how much is this happening. I haven't missed a shift in months. Are you requesting time off and someone is filling in for you? If I were to ask someone to cover my shift, and had to sign off on some skin assessments when I got back, I wouldn't care a bit to do that if they were nice enough to cover my shift.
  6. mikeicurn

    Flushing IV sites?

    Our facility has the same policy. Every IV, running or heplocked, get flushed and charted on q shift.
  7. mikeicurn

    LTC interview/ what types of ????

    I have only worked in LTC, but some of my colleagues have worked in the hospital setting, and I have had to train some nurses that have come from the hospital. I can only speak from my experience, others may say something different. You have to be very independent in LTC. Hospital trained nurses tend to want to call the physician for every little thing. We don't work that way. If someone has a fever at 2:00am you don't call the Dr. You check and see what they have PRN, then you treat them. My DON told me when I started that I would really have the opportunity to hone my assessment skills, and she was right. We can order labs, and bring in portable x-rays when needed, but that takes time. Our labs are usually drawn in the morning, and you get the results that evening. So it is often 24 hours before you will get lab results. So you really need to rely on your senses, and assessment skills. I started working LTC part time as I was finishing school, I never thought I would enjoy it as much as I do. You really do use a lot of skills. You will need to start IV's, Change G-tubes, Draw blood for labs, insert foley's, head to toe as well as focused assessments, the list goes on and on. So to sum it up, I would expect to be asked some questions about being independant, and your assessment skills.
  8. mikeicurn

    IV starts in nursing school

    My school used to have the students practice on one another, but stopped the practice years ago. The reason that was told to me was that starting an IV requires a physcian's order, so it was illegal for them to practice on each other.
  9. mikeicurn

    Are all nursing homes the same?

    The LTC facility I work at is a lot like that. I am running at least one CNA short at least 75% of the time. When they are there it is a battle to get some of them to work, which makes it harder on the good ones. Some nights it seems like all I do is deal with "nurse aid drama" as one of my colleagues calls it. My aids can definitely give me more grief than the residents some nights. I like the idea of the extra dollar per hour if you are attending in-services and not calling in. That sounds like a good solution. I might suggest that we look into something like that.
  10. mikeicurn

    Being trained by CNA to do procedures

    I wouldn't really worry about this if I were you. You said you had done enemas on mannequins, so I assume that at some point in time you were formally trained by either a CNA instructor, or Nursing instructor. Just because a CNA showed you how they do a skill, doesn't mean they trained you.
  11. mikeicurn

    Do you think this is fair?

    Well, I too only work Sat & Sun, but I have only been at this job for 2 months, and haven't dealt with the holiday pay issue yet. I guess I should look into it myself. I have a base pay rate, then I get extra per hour for working weekends, just like everybody else. If I work the occasional weekday shift because of a call in or something, I only get my base pay. Is your situation similar? If so, then the argument that "you are already getting paid more" doesn't hold water, because when your weekday coworkers work on the weekends they should also get paid the higher rate. If you only get weekend pay when you work a weekend holiday, then your coworkers should only get weekend pay when working the weekend holiday. That is my opinion.
  12. mikeicurn

    Confused on Charting in LTC

    I have been working LTC for a month, and I have some of the same problems with charting. I have to chart Med A, ATB and for 7 days on any new admissions. Also vitals, O2 sats, fluids on G-tube Rt's. I also do a census as well. You are right, on night shift it is harder to chart information about behaviours when the Rt's are usually asleep. I have been charting kind of general stuff like. Rt A&O x3, feeds self with tray setup, ADL's with assist x 1-2, incontinent of bladder with briefs in place, etc... That is about the best you I can do in the situation. We started using Point Click Care recently and with the computerized charting it is quite a bit easier, but for the first couple of months we also have to do the paper charting as backup. With the Medicare charting you select their primary diagnosis (let's say respiratory) and there are boxes that ask you to fill in the specific information you need to supply. So for example it will say "Lung sounds (ronchi, absent, diminished, etc...)" so you will get some guidance as to what they are looking for. That helped me a lot. For the midnight census I can just print out a midnight census report and it will list all the Rt's that are not discharged by room number. I just have to confirm it's correct and sign it, so that has become a lot easier. I am in KY and LPN's here can hang blood and push IV meds. There is no RN on duty when I work. I can call one of them if I need to, but I am responsible for call MD's, sending Rt's out, etc... It is a lot of responsibility and can be a little overwhelming to a new grad like me. Good luck and God bless.
  13. mikeicurn

    Looking for LPN jobs

    I don't know anything about how this works. If you go to the top of the page there is a tab that reads "region" then select "international" and you will see a forum for Philippine nurses. You could probably get some helpful answers in there. Good luck
  14. mikeicurn

    after passing nclex pn,when can i start working?

    I can only speak from my experience, but I would assume it is pretty much the same everywhere. After you graduate you must apply to the state and pay them, you must complete an online background check and pay for that, and the state must receive proof you graduated from your school. Then you will get your authorization to test and your provisional license (which is good for 6 months), and you then go to pearson-vue's website with your ATT and pay them and schedule your exam. You can start working under your provisional license, around here you are considered a nurse "applicant" at that point. So you are an LPNA (or RNA if appropriate). Next your have to pass the boards, and complete 120 hours of clinical time. If you start working under your provisional license, you can count that time for your 120 hours. After you pass boards, and complete the 120 hours, you will then get your regular license. I did receive mine in the mail, but it was weeks after I was assigned my license number. On the Board of Nursings' website you can verify nursing licenses. I just kept checking mine until it updated with my license number. It was only 1-2 days after I sent in my proof of clinical time. I ended up getting a job right after that, and my company just verified my license online. I understand that not all states require the 120 hours clinical, so without it I would guess the rest of the procedure is about the same. Hope this helps.
  15. mikeicurn

    What is considered the weekend shift for 7p-7a?

    I work Sat and Sun 7p-7a. We get extra pay for working the weekend, but that is paid on every hour from midnight Fri till midnight Sunday. So, on Sunday I get extra pay from 7p till midnight, then drop down to my base rate.
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