LookUp2Sky

Now that I’m re-reading my previous post, I’m thinking….I should just give up & file for my social security (I’m single). There will be no pension since the majority of Ohio nurses are non-union. Oh yeah, there will be NO medical coverage either! I won’t qualify for any public assistance since I’ve been working! Even if I found a new nursing job, I’d have to wait 30, 60, 90 days for medical coverage while I take care of SICK patients!

This is exactly how I feel. I’m 64 years old & again looking for a new job, after working PRN for 2 years while caring for my mom in my home! I have 10-15 “electronic” resumes & applications out there! I’m baffled why no responses…nursing shortage, understaffed but overlooking a senior nurse with 15 years experience? Well, I googled myself…my age is ALL over the internet! Age discrimination? OK, I’ll travel nurse for a while….Nooo, I live in Ohio, a non compact licensed State, until 2023? OK, so now I’m being discriminated against, can’t find a job in Ohio, and can’t travel to another state to work, unless I pick up & move? I’m soooo tired! I just renewed my license, my CPR is due, had to pay for CEU’s. Unbelievable!

Hi HillieRN - I totally understand your concern! I was the first, full-time, on call nurse hired with a not-for-profit agency, with a census in the 50's. No rules, no boundaries, no back up, etc. After over 1 1/2 yrs, I am still there desperately, diplomatically trying to make them aware of the "potential" harm in not providing a back-up. Mostly, it will be the patients who might suffer. We serve a huge geographic territory, with one-hour minimum between some patients. In hospice, family members are not happy with that type of response time, and no matter how diplomatically you try to explain that you will be there as fast as possible (because of no back up)...they perceive it that someone else is more important than their loved one:(. I work 7 on and 7 "off." It is straight salary for 5pm Friday straight through until Monday morning, at 8am...back on Monday night at 5pm until 8am Tuesday, etc., until Friday morning, then supposedly "off 7." However, they want me at team, weekly, mandatory inservices, etc on my "off" time, with no additional pay. It consists of 123 hours of on-call, 63 straight hours for weekend. So, even though paid for 80, I am available (or reserved) for 43 hours over the 80 hours I get paid for. I am not a quitter, and continue to diligently/gently take suggestions to them, which have to go through corporate, but am not sure any adjustments will be made:( I do admissions, deaths, triage, lab work, respite visits and on-call visits...all for one small salary. I guess I'm thankful to have a job, but most thankful to have "riches of heart" in working with hospice patients. Long story/response later-lol. Yes, it's quality of care/patients that suffer when there is no back-up. Feasibly, it is not possible for one person to do the work after hours, that it takes a whole team to do during the day/week. "There is no "I" in team."

Hi Stella - I am looking at my score report right now. There are 150 questions total, however only 135 of them are actually scored. There are 15 pretest items for future tests that are not included in the final score. Different questions may score different points. According to my score report (9/18/12), you need a passing score of 101 correct answers or 75 scaled-score units. If you read (& comprehend) the core curriculum then try the questions in the study guide, you should do just fine!! I did find a lot of the material familiar, however, I certainly learned quite a bit too. Wishing you passing success!! Good luck:shy:

Today (Thanksgiving) I am so thankful for so many blessings! One of those blessings includes this site, where I have vented, been informed and asked so many questions over the past couple of years! Thanks to all who have supported and responded to my sometimes "tiring" posts-lol. Today's questions is this: I have read many posts (dating back over a year) with regards to the testing for nicotine/cotinine levels for jobs in mostly the hospitals, due to the "no smoking/tobacco" policies. I have not read, however, any actual responses from those who had quit for 3-4 days, and the outcome of their tests. I have been a light/stress smoker for about 10 years (started in my 40's...grrrr). I recognize it is a nasty, filthy habit. I only smoke at home, in the corner of my basement...not in public, not in my car, never while working, etc. God is the center of my life and have been praying over the last month for strength and determination to quit smoking. I have reduced the nicotine levels from 8 cigs a day to 4 a day, in attempts to finally put them down, without any huge withdrawal symptoms. Well, God does have a sense of humor, because last week I received a call from a hospital with a new hospice in-patient unit, asking me to interview. The interview was successful, but did not delve into my personal bad habits. I am a good person with a BAD habit, trying to get better at my life. Not a BAD person. I have been doing hospice work for a couple of years now, which takes me into patient's homes.....yes, smoking homes. I currently caregive for my elderly parents, with a mom who is a heavy smoker in her early 80's. In other words, I will not be able to change her habits, after all these years, even while I'm in her home. So today, I am asking anyone who has undergone the nicotine/cotinine testing the following questions: Do the hospitals test by urine, blood or saliva? If by urine, has anyone quit for 3-4 days, with a passing result? I plan to be honest, either way, because honesty is the best policy. My "plan" was to drop to the lowest patch to finally break the hand-and-mouth part, but now that will not be an option. Will be expecting an interview with HR "sometime" next week...don't know if that includes testing or not. Also, I have not discussed or been officially offered the position. I am, however, very passionate about the opportunity of the job...and the quitting smoking:) I am not trying to "cheat" the system. I do plan on being smoke-free for my own benefit. I still do believe it is crazy to tell anyone what they can and cannot do in their own homes, but as you can see I don't live in a glass house, so I do not throw stones. I would truly appreciate any answers/advice to this ongoing and in some places, upcoming question. Thanks to all, once again, for taking the time to read my lengthy question(s)!! Have a blessed Thanksgiving day! (I am working today).

Thanks and kudos to all of you for your ongoing updates and feedback. I have been contemplating OU for quite some time, then ran across this thread. Think I will move forward with the next step...thanks to all the positive nurses on this site!!

Thank you so much Lykeen!

Woo hoo Nursecheryl That is so awesome!! I am so happy for you. It's such a good feeling, isn't it? And, we don't have to do that for another four years!! Just think, we'll have to support each other again around the same time 4 years from now-lol. CONGRATULATIONS! You are now RN, CHPN! Great job. Please say hello once in a while. No more studying, go have some fun!!

Well, I'll be....put some tinsel on me and call me a tree!!

Hi Nursecheryl - Just checking in with you to let you know that I said a prayer, and am wishing you all the best for your test tomorrow (Friday). You can do it. I'm sure all will go well. Go get 'em Let us know how things went!! Good luck.

Hey, do you think it could be a bowel obstruction? Four twelves, boss? No problem! What makes you think I'm jealous that you get to clock out and go home? Hang a few ornaments on me, and I'm all ready for Christmas! Now do you think I look like a Christmas tree for the kids?

Hi Nursecheryl - Thanks for the congrats. I am really glad to have it behind me. I think a lot of hospice agencies are starting to require certification within a certain period of time. Not ours...so far. I will try to send you the testing site (for the practice test-$35) in a private message. Don't get freaked out, I have no doubt that you can pass it. Especially, like I said before, if you are a good test-taker. I am not always a good test taker...anxiety kicks in! I figured I would take it, before I have to take it, so I wouldn't have that additional pressure-lol. Again, breathe, think positive and all will go smoothly. I marked my calendar, and will be praying for you. Good luck:nurse:

Thank you so much, CannondaleRN!! So happy to have that behind me-lol. I have been looking on-line, and have been unable to find any information whether the certification qualifies for any CE's? Do you happen to know. I know NBCHPN is accredited by the American Board of Nursing. Went to their website to see, but didn't see anything there, either. Let me know if you happen to have any idea. Thanks for your prayers and support! Congratulations to you, again, too

Hi Nursecheryl - So happy to report that I PASSED the CHPN exam!! (Thank you, God) I have every faith that you can too, especially since you report feeling better about having studied a little more. There is a practice test available on the AMP testing website, same place where you scheduled, if you did it on line. I think there is also a link on NHPCA's website. If you still have trouble, let me know and I will see if I can get exact web address for you. I made a mistake (I think) by taking it one day before, cause I only passed by one, which sent me into a panic!! However, these tests are not based on raw scores, but more on scores within several categories, as described on instructions. The Core Curriculum and Study Questions were very pertinent study materials for the test. The questions were straightforward. I felt that several times, I could get the answer down to two, but sometimes had to give it my best shot. My advice would be to take the practice test at least one week out. It is good practice just being introduced the computer format, etc., and the questions are very similar. Go for it. Again, I will say a prayer for you and your success!! Good luck.

Hi CM - I think if you truly want to return to hospice, you can negotiate with them. For new grads (RN's) that may be comparable. However, I wish more credibility would be given once in a while, to LPN experience! If I were you, and you are impressed with the company, and they do not have high turnover, I would negotiate the sticking points. Ask them for six weeks orientation, and maybe $26.50/hr, since no benefits. Remember too, that gas reimbursement is tax-free income (so to speak-lol). They can always negotiate back, but at least you put it out there. Good luck!!

Hi Nursecheryl - Do you have the Core Curriculum and book of Study Questions? That's is what I've been focusing on. The Core Curriculum is a little tedious, but I have learned a lot, especially over the last week. So, I think that's a good thing. I am going to take the one-time only practice test, online, on Monday. I drove to the test site today, as it is one-hour drive for me. I sure didn't want to increase my already escalating test anxiety-lol. I think from a lot of previous posts I've read, the Core Curriculum should cover the material. At least I hope so! I am my own worst enemy when it comes to testing. I can know all the necessary information, but it goes right out the window with nerves-lol. I am sure you will do just fine. Please know that I will mark your date on my calendar, and will be sending up a prayer for your success too. Best of luck to you!

Woo hoo CannondaleRN!! Way to go:nurse: I bet you will get some great sleep tonight, now that it is behind you!! Now, I wish I was in your shoes-lol. Were the questions similar to Study Guide questions? I am so happy for you! Thank you too, Westieluv for your good luck wish! Back to studying, had to check in on Cannondale!!

Hi Westieluv - Here we are again-lol. I would say there are pros and cons to both opportunities. The new (start-up) hospice may offer opportunity for advancement for a nurse, like yourself, with hospice experience (plus your CHPN), into something like Director, Clinical Services or Administrator, if that's something that interests you. That would give you the opportunity for the longetivity piece. The cons (I've experienced), is the growing pains with little to no orientation, minimal policies and procedures for their particular hospice yet in place, a lot of room for error (in the eyes of immediate supervisor), depending on their individual preferences of how things should be decided vs. your independent thinking as well as a lot of turnover. Smaller hospice agencies tend to pay less and more likely to attract "new" hospice nurses who need a lot of initial guidance. Sometimes when they realize what they've gotten themselves into, they leave, creating a shift in assigned patients and turnover of nurses, which impacts the patient's continuum of care. I always enjoyed case management (PRN or otherwise), knowing that there was always an in-patient unit possibility should the patient require it for intractable pain, out-of-control medication stabilization, family crisis, etc. I'm guessing that would be an opportunity with the large, hospital-based hospice. Sometimes distance, as you know, is irrevalant since we do so much driving anyway. With the larger hospice agencies, I find they have more fine-tuned territories, and nurses are not geographically, criss-crossing so much of the time. Also, a well-established hospice agency is doing something right, if their turnover is low. Maybe that means that the current case managers are happy! I think it boils down to what you find happiness in doing. You seem to be gifted towards hospice nursing which equals patient satisfaction. So, your personal happiness is important. Good luck in your decision. I hope this helped in some sort of way! Take care!

Hi CannondaleRN - Tomorrow is your big day! Not to worry, I have a good feeling about you passing!! Remember, take time out for yourself today, i.e., soak in a hot bath, sing in the shower, go to bed early, read a non-relavant book, etc. I'm pulling for you, and will say a prayer for you too! You can do it....go for it, and know it will be over for four years!! Good luck:)

You are so right, Westieluv...on many counts. After several years of hospice nursing, mostly in case management, I am now three months into an on-call only position. I was very impressed by the fact that a company would respect their case managers enough, to take the extra-heavy burden off of them, by hiring on-call only nurses. It is working out well, but does require flexibility and a good attitude! I always say I'm on call for God. When He calls me to go, I go. However, I know He wants me to be safe as well. It is a hospice nurse's dream to actually be available for when the patient's need us. I sent you another reply under CHPN topic too. I appreciate your dedication to helping out all of us other nurses, with good, solid, practical advise. Keep up the good work:w00t:

Westie -that is a wonderful response! Great job!

Hi Cannondale I just wanted to wish you the best towards your CHPN exam! I am scheduled right behind you, for the 18th of Sept. I am not the world's best test taker and am already nervous! I just pray I'm covering all the pertinent study materials! If you have any helpful pointers, please let me know. Again, GO FOR IT! Our patient's need us:)

To anyone who may have taken the exam in June... I am scheduled to take the exam in a couple of weeks. I have been studying the recommended Generalist and Questions book. I have seen the "Exam Secrets Study Guide," mentioned as well. My question is this: Am I on the right course in reviewing the questions in the Study Guide? Are those questions similar to the actual exam questions? I am a detailed person and keep finding myself trying to study for the NCLEX all over again-lol. I'd like to be able to fine-tune my studying to more pertinent topics and questions. Any assistance/advice would be greatly appreciated. Thank you!

Tewdles and Hospice Nurse - Thank you both for your responses. I totally grasp and understand what you are saying Tewdles! It is a very delicate situation. My employer had a meeting with the facility DON, and backed me as a professional. They truly felt that the family member misconstrued simple conversation between us, to lash out at the facility due to unhappiness with the pt's care. My employer felt that changing case managers would not be good in this instance due to my solid working relationship with a challenging family member. There is a large turnover at this facility, which makes it even more challenging! I thank you both, again, for your prompt feedback, advice and support! Have a great weekend.

Hi All - Whenever I have a question, and attempt some research on finding the answer, I envitably find myself right here. Guess I will have to learn to start here from now on. We have many patients in various assisted living facilities around town. I'm wondering if any of you find it more challenging to provide care for your hospice patients in these facilities (in general)? I have been told that they only prefer hospice agencies that will provide everything from Boost/Ensure, to dressing supplies, briefs, etc. I am employed for a not-for-profit hospice who will provide some of those items, usually on a case-by-case basis...keeping in mind we also provide care for those in need, free of charge. I have had a recent situation, where the assisted living facility management, is requesting that I no longer be allowed to come into their facility. I have a well-established relationship with the pt's daughter and family, not to mention the patient herself. The daughter (of the patient) is unaware that this has transpired yet. They are meeting with my boss to complain about me communicating things about their care to the daughter, i.e., unreported falls, unreported fever. (I'm thinking, if you don't have anything to hide, why would you be so bothered). My obligation is to the patient and her respectful family members! I have always been very professional and respectful while in any facility, and am not sure what this is all about! My question is..is the facility allowed to ban me from coming to see my patient? The daughter pays a large sum of money for her mom to be there, and there are no relationship problems between us. Does she have the final authority of which nurse is able to visit her mom? This same facility is part of a chain of facilities from around this area, and over time, have all developed the same type of reputation...sad. Any feedback would be greatly appreciated. In the meantime, I still love hospice nursing!:redpinkhe