Crazy Mama

My husband and I are both RN's and we plan on traveling in the near future. We are finially debt free. We plan on selling our home and buying a fifth wheel. I have been concerned about what to do with our things. Do you recommend storage? This is a difficult decission for me. We have been offered a job doing QA for Workmans comp etc. and this will allow us to travel. At the present time I am the nurse mgr. for a psych unit and my husband does hospice. I am concerned about finding agencies that have positions. The QA will be a side job on the road when I am between jobs. Any suggestions?

If you plan on starting Nursing school, I would recommend that you get all of your prerec's out of the way. Once you start the nursing program you need to be focused on nursing and nothing else. Depending on where you want to go depends on what subjects you need prior to applying. Make sure you keep up your grade point average, because getting into some of the Nursing programs go by your average. SAC has changed its program since I went there. My dtr n law goes to SAC nursing school and she is doing well. A/B average. If you want to be in management go on and get your BSN. Once you get your prerec's out of the way, it still takes about 2 years either way. You just have to know which path you want to take. I have my ADN and I've been a floor nurse to a nurse manager. Some hospitals will pay a BSN $1 or 2 more per hour. Good Luck

I have worked Geropsych for 5 years. i love what i do. the patients have more medical problems and a whole lot of medications. Don't let the elderly fool you, they are strong and can go off before you realize whats happening. At the facillity where i work, we take patients that others will not accept. usually half of our patients are total care. you have to get the pt up each morning (physically). They all eat in the dining area so, someone has to stay with them to make sure no one chokes (has happened). You have incontinent patients, ones that need to be fed, bathed. There are times that we have to hang blood or iv flds. at those times, we have to have the patient on a 1 to 1. Then there are times when you can sit down with a patient and talk about the past. its wonderful. I found out from a pt that in WWII the soldiers were sent to the Phillipines for a rest on the way back to the states. It made me understand my own fathers route at that time. Did you know during the depression that rubber was not available to the civilians and people would put burlap sacks in their tires when the tires went bad? If you've worked with the adult patient, you'll be fine. some are just lost and afraid. Some know that they are losing their memory and that's sad. They will come out of their room for the 50th time and do not know which way to go to group or to the dining area. You have to be more creative in giving meds and getting them to sign for the psych meds. It all depends on when you can catch them at a good moment. I hope this helps. I can go on and on at times.

I spoke w/ a nurse that taught ethics for the BNE. She said there is no mention of abandoment of patients anywhere in the regulations. She said it may fall under JCAHO but not the BNE. We do have safe harbor that can be filed and it is internal. I also spoke with the education RN in our facility and she stated that if you report to the supervisor that you can not take the assignment because of??? then you are safe. But like someone else said, then you aren't a "Team Player" and your job may be in jepordy. But at least you are safe and you kept the patients safe.

Depends on which hospital you go to, but you can almost quote what you would like and see where it goes. I know at the hospital I work for we need an ICU nurse really bad. We have been remodeling and besides it being an older facility, it is a nice place to work. The nurses coming on board make more than the nurses that have been with the facility for several years. But I know thats how they get people to come in. Pay ranges from 22/hr and up. And since u work ICU the pay is higher.

Sometimes I feel as if I'm at the wrong hospital. I currently make 28.50 an hour. I get no OT since I am salary. I figured that I make less in this current position (Nurse Mgr. ) than I did on the floor. At least there I received the differincial. Now I just work 24/7. If I'm not at work I'm on the phone. And, its my cell. I'm seriously thinking about travel nursing. My husband and I are 5 years from retiring and we would like to travel.

Thanks for the feedback. The hospital I work for is just now "coming of age". We still handle labs/x-rays by written message. We are unable to get lab results etc by computer. Recently we were bought out. The new company will be putting new computers in place and the other units will be doing bedside charting. On our unit I'm assuming that we will continue to chart at the station. We have 2 computers on our unit and unless I've put the info in, nothing else is there. I did get to speak with a representative from the company that oversees us and she did a quick walk through w/ me as far as the unit goes. She did say a plan of correction would be good for JCACHO. There was so much that needs to be corrected, that I typed out 4 pages for maintence to correct. Did you know that kids use broom straw to put in the elec. outlet to light cigarettes? Clocks if not secured can be used as a weapon. Exposed pipes can be used for pt. to hang themself, even the ones under the sink. Need non tampered screws for all the rooms so the pat. can't unscrew something and hurt themself. There is so much that I was unaware of. I did find another unit manager that is like me, searching for answers. I believe with the right attitude and if we pray hard enough things will be ok. I let you know how things progress.

I sure hope someone out there can give me some insight on what to expect. I will be in charge of a 15 bed unit on a Gero psych unit. I have been w/ this hospital for 5 yrs. on this unit and the 2 Physicians that we mainly use asked me to take the position. We have went through 4 NM in 5 years. I turned this position down several times, but the staff have encouraged me to accept the job. I went to HR and they only wanted to give me a 6% raise which would have been 27 per hour. I told them I wanted 32 at least and I ended up at the 29 mark, or so I thought. I spoke w the DON and an admin. and was told 29/hr was ok. I was also told that they thought that was fair because I could get a bonus if I kept OT limited to I was wondering if there is a guide line on what we need to do as a unit to be up "to snuff"? can I start a plan of correction and will this show JACHO that we're trying? Is there somesort of guideline I can use? I love what I do or I wouldn't be at this hospital (the pay sucks). I also don't want to be blamed for past NM errors. Thanks if you can help. I read the previous threads, and NM are not a favorite w the staff. I hope I don't fall prey to the same thing.

You asked about injectables, Geodon, Zyprexa and Respiradal Consta can be given IM. Have you thought about having your son put into a psych unit to get his meds regulated? Of course you have! I'm not sure if all laws regarding psych nursing are the same, but if your son is in the hospital and he continues to refuse his meds then the doc will usually do an emergency medication which is one of the above meds. (I spoke w the Seroquel rep. and he does not know if they will ever have an inj.) They can do this based on the fact that he is not getting enough nutrition/hydration, due to his parinoid state(if this is the case). Once the meds are in his system, he may be agreeable to continue the meds. then he may be released to home w/ a HHA that can give psych meds. But he still has to agree to take them. Have you thought about guardianship? W/ the new law, a guardian can sign for the person to go into a psych unit. This is good for 24 hours and then it is up to the judge if the pt. stays for treatment. but the good thing is the guardian can sign for the patient to take the meds ( pts on a psych unit have to sign for all their psych meds when admitted or they can not be given unless under an emerg.) Remember, even if you sign for your son to take the meds, I do not know of a home health psych nurse who will give them if he refuses. Good luck! Please check into the laws of your state, keep asking questions.

Appears that the pay scale for nurses is to low. I have been a nurse for 10 yrs. I work in a psych unit in TX. I started out in Tele, > Home health> ortho/med surg. then to the present. My salary when i passed my boards was $17 per hour, now I make 20.19 and that was just recently. My friend across town makes $42 per hour. She works in a new cardiology hospital in the day surgery area. Recently I was asked to become the nurse manger of our unit. I guoted a wage of 32 per hour at first. Then I told them 30 per hour. This would be on salary. Because I make 20.19, they thought that was too much and would only allow a 6% raise. They were not basing it on the job. They then went to 28.50. I turned it down. At the present time I am on the baylor program, I work 32 for 40. They are trying to do away w/ it, and they have in the rest of the hospital, but the doctors in the psych dept went to bat for us and we have it with the current peo. if we leave we are unable to return to the prog.

Where are you located? sounds wonderful to get paid what you deserve. I'm of course in TX and about 2 hours from the border. No union here! and the pay scale is low also.

Holiday pay? I forgot there are people that do pay their employees extra if they work the holiday. The hospital I work at does not pay extra, they will give it to you off and you can use that day as one of the holidays for the year. That's the only way to get paid, either you take it off or you use it w/n 6mths or you lose it.

good idea about the leaves. CP are done for falls on each pt, once the goals are met the fall prec. checks are lowered. we also doc. that while making round we observed the pt on the floor etc..

Tiggur, State says you document every fall, but there are times when the pt has a habit of sliding out of a chair, or is able to tell you that he/she slid to the floor when trying to stand. These are not occurances and we do not doc. on them as such. We do state in the pt record that the pt stated he/she slid to the floor. You really have to use your own judgement. I really hate to say this, but there are times when a fall should be documented but because it would be 2 in a 24 hour period which means we would have to place the pt on a 1:1 , it become a sticky situation. we usually do not have enough MHT's to cover what we have. No one is willing to come in because we are not allowed to have even an hour of OT. so we will place the pt up close to the nurses station in a GC w/a tray and place a book,snack or drink on the tray. we draw a fine line at times to keep the patient safe. As far as knowing which pts are high risk, we have an eraser board at the nurses station that we write the pt 1st name, code #, MD's, Q15FP (fall precaution) and we will change this if the pt is Q5 along with this info is Sz.prec. DNR status, Last BM/bath, SW, If they are a diamond or an emerald and their intake status(vol. or OPC/ED) We give report to our Techs and they do a good job of watching them.I know this is not much help, but falls are a big issue. the state ties our hands on the psch unit. We are not allowed to use posseys or wrist restraints. we have chem. and a seclussion rm. there are three forms that have to be filled out for them. Be glad to throw stuff back and forth. Thanks, Von

This is always a concern of ours. On the gero psych unit were I work, We range about 1 fall QOD. At other times its up. Of cours we do 15 min rounds on all pt's unless they are Q5min. We use wheelchairs w/ lap buddies and use the medical restrant. If a patient is in a GC with the tray, it is a restraint unless the pt needs the tray for eating, reading, writing. If a pt. slides out of a chair it is not a fall. But usually everything else is. once they fall 2 times in a 24 hr. period then we place them on a 1:1 for 24hrs. Von