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Nurse Case Manager

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  1. Loribabble

    Meet and Confer Questions....

    Hi, Let me just start by saying that our union rep is awesome - just would like to see if anyone else has any input for us since I am so new to all this union biz. Kind of a long story, but our administrator is a non-licensed person overseeing nurses in what has been determined at the state and federal level to be a nurse driven program. Previous admin have also been non-licensed but understood the purpose of the program and supported the nurses. To put it mildly, the nurses (and many others) have been at war for the last year with this administrator over her poor leadership and neglect of duty. She has been exposed and we have the support of her supervisor and the administration above her, our human resources, etc. Unfortunately, in our county, firing or demotion is next to impossible to happen... but, there is a MAJOR re-org planned for our department that would remove her from overseeing the licensed (75% of the department) and be relegated to only supervising 8 clerks. We have a meet and confer about the re-org planned in 2 weeks.... 90% of the department is 100% behind the re-org and super thrilled with it. Our administrator is kicking and screaming, refusing to acknowledge any culpability; trying to get our rep fired because she can't attack the nurses anymore.... etc. The 2 main players, the nurses and our administrator are in the same union but have different reps (it's been interesting.... ). I know our rep with help with preparing us, etc... just wondered if anyone else had any thoughts on what we can expect etc... Thanks!
  2. Loribabble

    You just can't make this stuff up!

    I work as a nurse case manager for a state/federal mandated program that is supposed to be nurse driven; office is 45% nurses - other positions are to support the nursing team. 1 of 2 nursing supervisors announced her retirement last February with an effective date in May. Program Manager drug feet and position not posted until July... list of candidates was posted in September, we JUST started having interviews last Fri. Remaining nursing supervisor not on the panel, the only nurse on the panel is a new hire still on probation instead of one of the 14 experienced nurses in the building. The panel consists of our brand new to the program Medical Director ( During this time, we have rotated 5 nurses working out of class 4 weeks at a time and now that we have started interviews... 3 of those are working out of class for 2 weeks at a time... talk about chaos.
  3. Loribabble

    Nurses' Week - Upended.

    I work in a smaller office for an organization that is supposed to be nurse driven. Our 'celebration' was held today and I stayed home because I couldn't stomach the fakeness of it all. Our non-nursing admin has been nothing but hostile toward the nurses over the last 3 years and one day of ignoring that was more than I could take. Never been one for token gifts, a sincere "thank you" would be wonderful!
  4. Loribabble

    Would love your input...

    Thank you so much for your response ktwlpn... much appreciated. I will set something up and keep pushing.
  5. Loribabble

    Would love your input...

    Hi All... First let me say how much I admire and appreciate all you do to take of this special population! Thank you! I know the majority of nurses take great pride in the care they give and do a great job with the limited resources and support. Thank you! My father is currently in a SNF for a 1 month stay for IV antiobiotics / wound care only (home infusion co-pay was $1600/month on his $1200/month SSI... don't even get me started on that one!). Otherwise, he lives independently, still drives, still putters in the garage doing odd construction projects etc. I'm concerned about some of the things that have happened and would love your input as I have exhausted speaking with admin and his case manager. His PICC line came out 8-10 inches in his sleep for an unknown amount of time - not happy but not upset as these things happen - problem was NOC RN tried to push it back in... no hand washing, no gloves, no swabbing. My dad threw a fit as he was concerned about infection so the RN didn't succeed. It ended up being pulled and new one placed. An ARNP came in and took his dressing down, left it open and then left the building without telling anyone. This was confirmed with the staff. His hemovac hadn't put out for days. The day before it was scheduled to be pulled, there was so much output that it was no longer compressed. He repeatedly asked staff to assess it and got no where. He ended up draining it himself with my instruction, estimated the amount and re-compressed it to keep track of any further drainage. The staff do not do proper hand hygiene and when asked to do so, he gets push back. His antibiotic is a 24 hour infusion and there have been several unexplained instances where he didn't get it for over 8 hrs. He repeatedly informs them but there's no follow through. I have inquired but have had no response. Between being woken up at MN for vitals, 2 am for labs and 4 am for levothyroxine and the noise, it's difficult to sleep. We have both asked to have this changed and he was told by admin that he was being unreasonable. The DON was agreeable and supportive of giving him a chunk of time to sleep, was able to get his levo changed to 6 by the Dr and was put on the MAR but for some reason it keeps getting changed to administer at 4. We've inquired but haven't gotten any feedback. Things are in disrepair - dining tables are all wobbly, PT stairs not sturdy. When he first moved in the heater above his bed wouldn't turn off, the toilet bowl wasn't securely bolted to the floor and his bed didn't lock. My dad requested that they be repaired and nothing was done (his roommate had been requesting for the last 3 months!). My dad is a journeyman carpenter so he has some experience in this area. I tried and tried to call but kept getting put on hold >15 mins each time, was transferred as soon as they thought they knew what I wanted... only to be put on hold again. I was so frustrated that I ended up sending a fax with my concerns. This resulted in a phone call from Admin within the hour; but besides the glaring safety issues in his room, everything else has been lip service. I get no response to my questions from the case manager. The State came in last week - but the resident panel was by 'invite' only. One of the friends He's out in a week and we can ride that out but my heart breaks for those who don't have an advocate and/or unable to advocate for themselves. The stories he shares with me are painful. My dad is a nice guy, very appreciative and doesn't speak up unless it's a safety issue and is respectful about it. He raves at how wonderful the day nursing staff is but the night crew and admin are another story. Any thoughts from those that work in the trenches would be wonderful! Thank you!
  6. Loribabble

    Physician Bullying of Nurses Reaching Epidemic Levels

    No bullying from physicians here... have had some wonderful experiences though. Had a nightmare 3 hour "Code Grey" (out of control pt) on my birthday no less! My pt was becoming more and more delusional and her roommate had borderline personality disorder... was NOT a good mix! My favorite doc actually came and sat with my patient to keep her distracted and safe while we worked on getting her a private room while I was also dealing with a rapid response with another of my pts. Once things returned to a state of calm... she went down to the cafeteria and bought me ice cream. It was such a crazy frazzled day and it meant so much to me that she made the time to be in the trenches with us. On the other hand.... when I was working overseas, my RN supervisor who was also from the US, was a true bully. Oh the stories I could tell about her! I was just one of a long list of those who were run off by her and the board that oversees her refuses to address it and thinks she is just the bees knees.
  7. Loribabble

    Black Humour

    Laughter was what got me through many a rough days, especially working at a bush hospital overseas... my favorite black humour moment was in the States though. I can't remember what the patients diagnosis was but they came in for a procedure. He was non-responsive, total care, etc. Had a wonderful family, who took excellent care of him at home... were hard working folk who refused to rely on silly things like ambulances to transport him back and forth to appointments and such. Procedure was over and I went to offer to call transport for him and found that they already had him dressed, up in a wheel chair, strapped in to keep him upright, hands and legs propped into position, etc. As they were walking down the hallway, they realized they were going the wrong way and turned around... causing his body to slightly flop to the side and his head to bob. All I could think of was "Weekend at Bernies!"
  8. I wasn't even in nursing school yet when I was at a conference with a group and an older lady in the group pulls me into her hotel room to show me the boil on her butt before I had a chance to even know what was going on.... needless to say, I avoided her at all cost after that!
  9. Loribabble

    Girl brain dead part deux

    GoFundMe was updated 6 days ago.... apparently Jahi can hear and knows right vs left. Money still coming in....
  10. Loribabble

    Girl brain dead part deux

    I'll admit it, I am obsessed with this story! What gets me is the amount of false information being spread by main stream news agencies - it is just appalling! Just watched a segment on the news, they showed her moving her foot to her mom's command but it looked a lot more like a twitch to me.... and her toes looked horrible, lots of dark discoloring which I am sure is necrosis.
  11. Loribabble

    Girl Brain Dead after Tonsillectomy

    I am so beyond words....
  12. Loribabble

    Girl Brain Dead after Tonsillectomy

    I was being facetious.... she was bragging on her fb page about just getting her dream job as an ICU RN, location CA. Has same last name as grandma so probably related. I'm home sick and bored and will admit that I was doing some fb stalking.
  13. Loribabble

    Girl Brain Dead after Tonsillectomy

    Turns out that Jahi also has an aunt that is an ICU RN, maybe she can provide the care?
  14. Loribabble

    Girl Brain Dead after Tonsillectomy

    From the lawyer' blog at the San Francisco Examiner... . I have been following this case and I am totally sick at how the media, lawyer and family are spinning this. My prayers go out to her loved ones, I hope they can find the strength to do the right thing and find peace.
  15. Loribabble


    If you are an employee you get a discount... esp for the noc shifts. The $20/day is if you pay what the visitors pay. I either paid $30 or $60/month for nocs full-time. (sorry about not knowing the exact... I'm per diem now and canceled it a couple of months ago).