bossynurse101

HELP! Ok so we are going to move to CO in a couple of months & I plan to apply for licensure by endorsement. I currently hold a FL RN license and have an "exemption" for a 25 year old felony conviction. I recently realized that I will not be able to apply the CO license until I have a permanent CO address. Since we are moving out there and plan to spend the first couple of months in temporary housing until we find a home we like, it may be a couple of months before we have a permanent address. My question is this, I won't be able to work without my CO license obviously and this may take an extended amount of time given my "exemption" circumstances. I have no idea and can not get a live person on the phone to ask. I was planning to start working within a couple of months of moving out there but gosh, given this information who knows how long it might take? I am the major bread winner of our family and this may be a total gamble now. . . . Any advice from the ALLNURSES community (or reassurance) would be greatly appreciated. THANK YOU in advance :)

OK --- oops and double oops! Should have posted this thread first and days ago! Am interviewing for DON position - my first after years of being an ADON. Problem is, my most recent ADON position was only six months long and I have only been at currentl job for less than two (admissions marketing) months. The six month ADON job was awesome. Til my former DON left and the new one (we'll call her Satan) came. When S. came, EVERONE left. People who had worked with her prev told me she was AWFUL. Good people too. She had been walked out of three bldgs. She was in the building constantly - twelve hr days every day, etc. Wanted all of us managers to do the same but denied it of course when confronted. She had unethical practices, badmouthed people excessively, etc etc Both UM's quit, and some nurses, as she proceeded to fire as many people as possible without Admin. getting upset and tried bringing in her own people -they did not come incidentally. (Mind you - HE the admin, appeared to be enthralled with HER as she was very persuasive and pretty). So, seeing the writing on the wall - I left too. I had excellent repoire with everyone - gave 30 day notice, had CNAs cry when I left. I did not want to go but felt I had too. So the dilemma is . . . . how to approach this in an interview. Should I be completely candid? If Im not, I will look very unstable. The ADON positions I held prior were one year and before that five years (only left to move to different city) If I am honest, I look like a drama queen and worse -unprofessional. WHAT TO DO??? Interview is in two hours! OK, I will let you know how it goes!

Hi everyone! Well I am finally going to take the plunge and go for a DON position after years of being ADON. I never had the confidence before, but I feel good about the facility that I am interviewing with and the administrator seems to be on top of her game. Still a little shy clinically as it has been a while since I've been on the floor and to be able to jump in and help is important to me as a supervisor and role model, but I have signed up for a refresher course which will be in June. Soooooo, the most important question is . . . what should I wear for the interview? Trendy? Conservative? Strictly business? Seriously, any tips from you all would be appreciated. :)

In my state oxygen is considered a medication - and - it is out of their scope of practice.

What a great idea! However - I can see it making me crazier than I already am trying to keep up with all of the constant and continuing education after education etc. You finally get ALL the CNA's on board with proper peri care technique, and no holes in the MARs, finally get everyone trained on the behavior monitoring forms, everyone's knocking on doors, when low and behold - there are personal items found in one of the bathrooms and carts on both sides of one of the hallways -and yikes! A nurse was caught doing an accucheck and did not wipe down the glucometer properly afterwards, and oops - she also forgot to use a different kleenex between eye drops . . . does it NEVER end?? We wont even mention the dining room. Our company routinely shares issues with all of the facilities and its almost a nightmare as everytime someone is cited on something goofy - then every facility has to do a (very time consuming) audit on the issue. For example one building was found to have not offered a Hep B shot to an employee within the regulated amt of time, and now we have to audit every employee hired within the last year. We also have many contacts in the area and so have a good idea what our survey team is focusing on. This year it seems to be pain - particularly pain control before dressing changes, therapy, etc. One never knows - that is the problem and the scope is sooooo broad, and the number of regs so ridiculously cumbersome - you could drive yourself nuts trying to keep up. My advice - do the best you can and then some. Most surveyers have a soft spot when they see that your building is genuinely trying to provide quality care everyday and not just during survey.

Best of luck to both of you! I know exactly how you feel - yesterday I went round and round with our pharm consultant - Not sure what color the sky is in his world, but he truly expects our nurses to get diagnoses from the docs for all of the meds they verify vs using thier best judgement. Yeah, right. Meanwhile admissions dept gave us a 450 pound pt with a stage IV wound which is about 40 cm in diameter who keeps them in his room for an hour at a time (did I mention he has psych issues as well?) while the other 19 patients wait (not patiently of course) for their meds, the MDS coordinator's complaining about documentation, Med Records is handing them back charts left and right, the new DON is wanting them to attend 40 minute inservices just about every day, and the administrator is screaming at us about incidental ot. Is there no end to this crap? Wish I could find something that paid halfway decent in our area and I would leave too. Problem is, I'm not willing to put my daughter in the public school in our area, & we're stuck here til we can sell our house. Even if I could find something that could pay OT or 50+ hours (thats what im doing now . . . oh well. At least you two are getting out, . .

Am wondering if anyone else has felt like this. . . . . Have been a nurse for about 9+ yrs. Started in the hosp (brand new on the most hectic floor - felt constantly overwhelmed, hated it but did a year of it) did another yr in LTC on the floor (thru agency) then went to MDS, then to Staff Dev/Inf Control and finally ADON for 3 yrs. Just came back as an ADON for about 7 mo now after a 2 yr break in Admissions Marketing. Am feeling pretty inadequate clinically although I am determined not to let it show - dont want to get eaten alive. When I take call, I am terrified I am going to get called in to take a cart. The LPN's that I work with are very critical of the RN's that are on the floor, and like to ridicule them every chance they get. I feel I have earned a degree of respect as I am very supportive of the staff nurses and try to help them when I can. I dont want to lose that respect, and dont want to be made fun of - yes I know how childish that sounds, but im just being honest. I almost want to take a refresher course or something but my extra time is nonexistant - I already work about 50+ hrs a wk. HELP!!

I also started out as a CNA (in the 80's), but only for a couple of years as conditions were pretty bad back then. Didnt go for my RN degree til late 90's and got my degree in 2001. I worked in the hospital for a year - would strongly suggest every new nurse do the same so that you get a couple of skills under your belt. Worked in LTC on the floor another yr or so after that, then MDS for a couple of years and have been an ADON for 3+ years now. I am just now feeling somewhat qualified to be a DON - but only for a company that believes in training/mentoring for a little while. Recently however, (although I dont let it show) I am actually feeling pretty inadequate, as I feel like I've lost my skills, and that my floor nurses might know more than I do clinically. Its not a good feeling, I wish I had a better foundation (will start a new thread i think!). You can know rules and regs front & back but there really is no substitute for good old fashioned hands on. As a staff nurse I could never truly respect a DON that did not have LTC floor experience, and at least a couple of years of management experience. It's not all its cracked up to be - it isnt easy to get people to do what they are supposed to . . . . it is an art, and the effective DON's that I have worked with all had a good foundation, and much experience - with LTC, management, and life.

WOW. I must say, I am a bit shocked at your pay rate. I am an ADON in central Fla (we are considered one of the lowest pd states for nsg) and am currently at 68K salary with seven yrs exp including MDS & Case Mgt as well as ADON. HOWEVER . . . I am responsible for Restorative, Infection Control, Hiring, General Orientation, Staff Development, Employee Health, and various other management duties. I take call for a week at a time every five weeks and I usually dont work less than 50 hours a week. That is usually the norm for this locale though. Most of the nursing management jobs are salaried - and you do the work of four people - for alot more than 40 hours a week. Translated, I guess that would be about 25-26. per hour. If you want more info on pay rates you can go to Career Builder and it will tell you what the going rate is for all kinds of specific jobs in your area.

Not sure that the issue has to do with credentials (I know many LPNs who could leave me in the dust with critical thinking skills) as much as those of us who supervise anyone are responsible for thier actions as we supervise them or delegate to them. My friend who works in the ER (RN) just went before the board and was fined almost $3000 because of something that another nurse (RN) did who was helping him. He was up to his eyeballs with too much to do, she offered to help and took one of his pts and then neglected to perform an essential task which fell back on HIM. Cant say where his supervisor was - just know that he would not have allowed the other nurse to help if he thought she was a dimwit. I agree with those who have said that this second subordinate nurse was insubordinate, defiant, and more concerned about her ego and showing Sue that she doesnt have to do what Sue tells her to do. Hmmm . . . sounds more like my kids when they were toddlers than the behavior of a competant, caring nurse who is licensed to perform pt care. Write up? That was being easy on her. But appropriate for the first nurse who needed counseling and education and possibly the start of a paper trail. Suspension? Absolutely, for the second "nurse" who refused to perform her job duties as requested. Good luck Sue and keep us posted.

Actually, I did MDS about six years ago in a different facililty- and was on call as well. Was pulled to the floor but not very often. We just hired a new MDS RN who does not have to take call (the old one did take call) but that is because she came in with specific demands -no call being one of them. Smart girl, huh? Some places do "put out" for exp'd MDS people. Although - she does work about 50 hours a week (as most of us salaried people do). That's my next gripe. Being made to feel guilty when I leave after 8 hrs. Will have to start a new thread, lol! But thank yous to the kind reponses, sometimes it's nice to just know youre not alone.

Here in FL we used to be required to monitor hypnotics on BMF's but not anymore. Not trying to be rude but I cant imagine adding yet more to my 11-7 nurses, asking them to monitor number of hrs slept! Yikes! But I do see the point of trying to monitor for sedation as it relates to falls.

Thanks Sue, I needed that!:)

Am very sorry for the blow to your spirit, but maybe it was a blessing in disguise. As everyone else pretty much said, sometimes the DON is the sacrificial lamb so to speak. Often times the ED (or Admin) or corporate has to cover thier own butt and so . . . well you guessed it. My own DON (Im his ADON) is experiencing this and will be giving his resignation this wk prob. You can go to Career Builder or similar & see this first hand -the turnover for nsg admin in LTC is ridiculous. Sometimes I think we're set up to fail. Dont mean to sound neg tho, you dont need that. I am sure there are good buildings out there (I was in one once where I used to live). Problem is, they're like good husbands - not too many available coz noone leaves the good ones!! Good luck, you'll land on your feet I'm sure.

OK - so we all know the drill. Decent pay as ADON or DON but I am to the point where I am wondering if it's worth it anymore. As an ADON I am on call a lot and hate it. Constant calls, constant staff drama, constant abuse from the non-nursing depts about how the nursing dept did this or that wrong. The company I am working for now will not allow us to deny anyone and so the train wrecks we have been getting are just insane - and God forbid if they fall! I am constantly trying to keep the morale of the nursing staff up through all of this nonsense and smack dab in the middle of it the ED announces there will be no raises this year. I have CNA's who are single moms, working their tails off for a little over $9.50 hr. I feel like I'm in the middle of chaos. My DON is quitting and so lately I am doing his and my job(s) which are four in one anyway (staff dev, inf control, hiring, restorative, etc, etc). I am so physically exhausted I have nothing left for my family when I come home - but then when I worked at the hospital (eight years ago) it felt just as exhausting. I dont know where to go. I even tried a short stent in the marketing/nurse liaison scene - but it was very very cut throat and finally ended up getting screwed over by a very nasty case manager. I feel very insecure about my skills at this point, and dont know if I am willing to take the pay cut by leaving management. Also, I'm not a spring chicken anymore - I'm turning 50 this year. I realize I sound confused and have a lot of fear of what lies ahead with the imminent continued cuts, Medicare failing, etc- I have discussed this with my husband and a couple of friends but thought maybe some other nurses could shed some light on this or have gone through this. Thank you and sorry for such a long winded post.