dondon44444

hey, sounds like things are coming together for you. thats good that they are listening and taking the bp like they should be. i think the inservice is a good idea, but i kind of doubt they will always do a manual bp. i know that the automatic ones are sometimes inaccurate, but sometimes its hard to get them to even take the blood pressure, let alone do it manually. let me know how that turns out, i just know in my houses that would never happen. the people that work at my houses are very good at what they do, but they dont really do things that are "above and beyond" they stick to their job description and if a task falls outside of it, then it will rarely be done. i have a questions, are your people working in the houses in a union? at my company, they are all in a union, everyone that works for them, except me and the managers. they formed a union just for them. im just curious to see the differences between nonunion direct care givers and union ones. ive been so busy lately. i have until the end of december to finish my audits, which have been going well, but i have a few houses that are completely far away from the others. ive got to spend a few days going to these far away areas and hopefully things are going well over there. it would suck if there's lots of problems and people arent filing things correctly. do you have lots of people with pressure ulcers? there's a few in my houses, especially the people confined to the bed. all the other are up and about all the time so we dont have to worry too much about them. are people you work with educated on how to prevent them....turning, putting pillows under their ankles to lift their heels off the bed, etc? how much medical information do they know? are they licensed or just trained in the tasks they have to do? my people dont know much about healthcare. they learn as something comes up, but most of them have no background in it whatsoever, so im always teaching them things, etc. just curious. well, have a good rest of your weekend!! good luck with your audits.

I forgot to mention, i used careerbuilder.com to find my job. i was having trouble finding a nursing job for a month then i put up my resume there and they found me. It was pretty cool bc i've never heard of my company before and they are an awesome place to work. You should definitely try that website...it really works!

HI!! i saw someone posted about abington hospital's dixon school of nursing, i went there and graduated in 2006. i did the day program, but i have a friends that did the evening weekend program which works out well if you have a full time job or alot going on in your life. i took my pre-reqs at Manor College, I loved it there. you could also try mont county community college, its a little cheaper. i liked manor college bc its a nice small school and the class sizes are alot smaller. its not too expensive either, they have a great nursing program. and the dixon school of nursing is awesome. they really prepare you for becoming a nurse. its one of the best schools around, especially with all the clinical hours you get doing hands on training instead of just sitting in a classroom all the time. its alot of work, really hard, but any nursing school will be. i got over 1000 clinical hours just in nursing school, i would highly recommend their school, though they only accept about 100 students each yr. good luck with everything. i hope this helps! donna also, dixon is really good for the price too. i didnt have to pay a dime for school until afterwards. if you work at abington hospital after you graduate, for two yrs, you dont have to pay for your school, or you can pay it back six months after you graduate, only 100 dollars a month, which is nothing once you're making your nursing salary.

hi, i used to work on a telemetry unit at abington memorial hospital...its one of the biggest hospitals on the outskirts of philly. i dont know if you are looking for actual philly hospitals, but this is a nice suburban area about twenty minutes from the city. it actually pays pretty much the most out of all the other suburban hospitals, and its pretty big, not some small hospital. i used to work night shift there and we got about 5 patients apiece...twelve hr shifts. during day shift they tried to give the nurses between 3 and 4 patients each. also, i believe the base pay there is around $25. if you worked night shift there you make around $30/hr. and the other plus is not having to pay philly wage tax if you work there. it is a magnet hospital. i hope this helps. i dont work there anymore bc i dont really like hospital nursing myself, but i wanted to get some experience there right out of nursing school. its a very high tech unit, they do open heart surgery there, cardiac caths, transplants, and all kinds of other procedures. hope this helps you

i work for an amazing organization called jevs, its a nonprofit organization with numerous programs that always need new people to help care for our consumers/patients. try their website...jevs.org. the program i work in is called clhs...it is a program that offers housing/group homes for people with mental disabilities, mainly MR. i dont think you have to be licensed to be one of their "direct care givers" but they are an awesome company to work for, they take care of their employees, and im pretty sure we need some more people to help. check it out. let me know if anything happens. i hope this helps. good luck, im sorry you're having so much trouble finding a job.:wink2:

i work for a nonprofit organization that has numerous programs to help people. i manage thirty group homes for people with mental disabilities, mainly MR. this is my only experience in the group home field, but from what i know, the state does come out and audit/inspect the homes. myself, im the "wellness manager" an RN whose job is to come out to the homes and do my own audits including medication audits and make sure all the paperwork on doctors appts, labwork, etc is filed correctly. but i do know the state comes out and does very meticulous inspections of the homes. im pretty sure this is the case with any group homes for people as long as those living there are getting some kind of healthcare or service by living there, which im guessing is the point for you to open one. good luck with it! feel free to ask me more questions if you want. donna

hey, sorry it took me so long to get back to you. this week has been so so busy at work. ive been working on these audits, which have to be turned in by the end of the yr. since i have so many houses, its pretty stressful and a lot of work, pretty slow going too bc i have all these houses spread out all over the place, so just driving there takes awhile. im doing well though. my boss saw the audits ive already completed and she said that she's never seen an audit so thorough before and ive done such a good job she wants me to teach the other nurse....who has been there for months, she trained me....how i do them. so i guess im doing well. i just hope i dont cause any conflicts by creating more work for the other nurse whose been there for awhile. anyway, about what you did with the bp issue, i dont know who you are supposed to report to, but for me, i give my boss all the problems i found with the audits, she forwards them to the house managers, associate directors, and directors. then the staff will eventually get it too, and hopefully fix the problems. they are given a two week period to fix the problem and get things up to date, then i go back out to the house to see if they did it. do you have someone overseeing all the houses in your program? or are there only the two houses that you work at? either way, you have to document that you found the problem, and document what should have been done in the first place. and it would be a good idea to talk to the staff as a whole, or at least the manager and tell them what to do. then your ass is covered, the documentation is a must, then when the state comes to audit your job is documented there for them to see. what i would do in that situation is also check the patients blood pressure myself whenever i was in the house. at least it shows that you yourself are taking action to check it. i know you cant do it everytime they get their meds....but thats in a hospital. remember, the reason you do that in the hospital is bc these people arent stable so they need to be checked for these things. once they are living in a group home, they shouldnt have problems with this stuff, it should have been worked out during a hospital stay, or their doctor would have ensured their bp meds were regulated correctly so as not to cause any major drops in their pressure from their meds. do you get what im saying? i dont know if i worked it correctly. its easier to speak this stuff rather than write it. with my job, i dont have anything to do with med administration. i do quarterly audits, checking that they are following procedures, and i do narcotics counts too. thats about it. again, ive written alot to you, i cant help it. sorry. one more thing. for your hospital job that you want to get, have you thought about getting some relief work at a hospital? most of them have the option of working just one or two weekends a month, or one shift a week. that way you can get your skills and still focus on the job you love. i think that might be a good idea. you should do it soon though before all the knowledge from nursing school starts slowly getting forgotten. it just happens unless you are exposed to it on a semi regular basis. i know ive forgotten alot of things already and i did work for a year, though from that year i learned and do remember so many things that ive found useful in my current job. i know i keep mentioning it, but i think it would better your nursing career and you would be much more sure of yourself. either way, its your call. did i answer your questions? i like writing to you too. i dont know anyone, except for the part time nurse i work with sometimes, that does what we do. its fun to compare notes and see the similarities in our jobs. did i tell you that one part of my job is to educate the staff? i have to give inservices to all the people that work in the houses...two hrs each. that is something im very nervous about, but i know its necessary. im starting with one about the importance of documentation...tying it in with all the paperwork i find missing from the patients binders during my audits. the next one im doing is on pressure ulcers, how to stage them, prevent them, and treat them. both of them are so important. these people that work in the houses are not trained/licensed healthcare professionals. they are awesome at their jobs, but they dont have a strong background in medical, so this stuff i think is very important for me to teach them. i just HATE public speaking, but this will get me over my fear of it i guess. well, thats enough for now, ive written you a novel. get back to me when you can. i enjoy reading your responses. let me know about any potential jobs you see in hospitals. see ya! donna

sorry, just re read your questions. about nursing care plans...we dont really do specific nursing care plans. we do have a form for them, but dont use nursing diagnoses, or care plans...officially that is. didnt do that at the hospital either. again, the hands on nursing assessments that we do isnt due to a set standard or policy on how often they must be done. its to my discretion. and after im done with all my audits...they are due at the end of this month, then im going to tackle all my assessments. especially for the patients that dont cooperate at the doctor's office. there are so many of them where the doctor wrote: "unable to assess, patient was fighting me the entire exam" some of them havent even had a blood pressure reading recently. i dont want ANY of my patients to be unassessed like that. so, im going to try my best to see everyone and get a baseline of what im dealing with....this is something that the nurses that were there before me never did, but im very thorough and pretty anal about my work, but i really care about my license and dont want to have a patient under my care and not even know their baseline blood pressure you know what i mean? and instead of doing an official nursing care plan, im just going to go by each individual's needs and perform, or order the workers to perform the interventions that i see fit. thats one of the things i love about this job, the freedom and the way i can decide what i can do to better their care. for instance, this one guy eats way too much everyday. there is no protocol, or plan in effect about lowering the amt of calories and snacks he eats, and his weight isnt being managed except when he gets his annual physical. im going to implement a diet plan for him, with weekly weights and teach him and all the people in the house about the importance of all this so he can drop some pounds and get back to a healthy or healthier weight. so instead of actually writing out a nursing diagnosis for that and the interventions, i just do it in my head and do what needs to be done? i dont have to follow the care plan formula. does this make sense the way i wrote it? i cant find the right words to explain but im sure you get my drift. do you have to write out care plans and nursing diagnoses? i might end up starting something like that, but for now im not going to. my department is kind of just growing and finally staffed the way it should be, so im going to be implementing alot of new changes, procedures, and such. so im not sure exactly how im going to set everything up yet, but i'll let you know. tell me how you guys do it, maybe i could get some ideas from you. we dont have any strict rules to follow as long as we get our work done, and until i set up some rules. it would be interesting to compare how you do it, then i can get some good ideas from that. sorry i know i wrote alot. i have a problem with that. anyway, thanks again for writing back. its good to talk to you. hope all is well. feel free to keep asking me questions. :)

to answer your questions... right now i dont carry liability insurance, i used to back when i was in nursing school and working at the hospital. i was actually out of work for about a year bc i needed surgery on my back, it expired and i never renewed it. i am going to though once i get a paycheck from my new job...thats how new i am. i dont think the risks are as great as they were in the hospital...for being sued that is...but its still a good idea to have. for what you call med techs...i guess they are similar to the home health aides, or "direct care givers" as we call them. they are at the houses 24/7, they do everything, give out meds, cook, clean, toilet them, etc. they aren't licensed or anything, but they do an amazing job. my job is basically to make sure they are doing everything correctly, from paperwork, to doctors visits, to any random problems that come up. and example...one of the ladies at one of the homes just came up with a positive tb test...all the employees are being retested and the other that live at the house. i am the one that communicates with the doctor, implements her orders, and the people working there dont know how to get a sputum sample, so i have to get over there and tell them how to do it, and show them how. basically, they call me with any questions they have involving medical or basically anything. im like a consultant almost. as long as i have my documentation that i was at the house, and recommended certain changes, and assess any new situations, my "ass" is covered. i cant make them do the things they are supposed to do, but im there to teach and instruct, you know what i mean? you work at just one house right? is that your main site, or do you have an offsite office? i work out of an office, but travel everyday to a few houses to check up on things and keep in touch over the phone. plus sometimes attend doc visits, hospitalizations, etc. if you really want this acute care setting experience, i'd say go for it now before you get too settled in where you are, while the nursing school stuff is still fresh in your mind. if you wait too long, you're not going to want to do it and you'll just fall into the setting at your job and might forget alot of the other important parts of nursing...all those hands on skills and experiences you get from working at a hospital. but, if you know for sure that you have no interest in that, and you have a secure job where you are, then just stick with it, but when it comes time to look for a new job, if you havent been at your job for a long time, you might have trouble finding something without at least a yr of hospital nursing. i had enough trouble with just one yr experience. luckily this job fell into my lap. most jobs like ours require years of experience with psych patients, and hospital experience. you did say you've worked here during nursing school right? i know it sucks....getting a hospital job, but maybe you could just do some part time work somewhere back in cardiac. my floor wasnt the heart failure unit, it was for open heart surgery, MI's, cardiac caths, valve replacements, etc. i personally found that more exciting and interesting than heart failure. maybe you'd like that. what state are you working in? when did you get your RN? all i can say is that you are lucky to have the opportunity you have now bc i LOVE my job, and alot of my nurse friends that still work at hospitals wish so much to have the opportunity that i got but there isnt much out there. realize how lucky you are to have this and if you truly love it, dont leave...which it doesnt sound like you will. its nice to talk to someone that is doing the same thing i am...pretty much. i forget if you had another question, hope i answered all of them. keep me posted on what you decide to do with the hospital job search. i might have some more tips for you on what to avoid, or what might be good.

one more thing, i worked twelve hr shifts, night shift at the hospital, which i feel is a much better time to learn things and you are somewhat able to keep up with things. you usually get more patients at night, but they arent always leaving the floor for tests/procedures so you can sit back and figure out what you're doing before you're bombarded with the next task. night shift really might make a big difference to you, i loved it...as much as i could. day shift would have not been for me at all, i know i wouldnt have learned as much as i did.

hey, thanks for writing back. well, it sounds like we do alot of the same stuff. i think i mentioned that there are about thirty group homes that i manage. i have about eighty clients. ive just started my yearly audits...checking through the books, making sure all doc appts are up to date, meds, labs, diagnostics, etc. its quite a project i have, but i like that kind of stuff. we also have the mar reports, and i have to do quarterly audits on those as well. as far as nursing assessments, we dont have a policy on them, we just do them as we see fit. after im done with all my audits, i have until the end of the month to finish them, im going to go to each house and assess as many people as i can. we are pretty much supposed to do them with patients that have a problem going on, but i want to do them more often than that. there is one other nurse at my company that works part time, she has about ten houses in a different area and does the same thing i do. there arent any other nurses working in my company. its just us. each house has the home health aides, there 24/7, and a house manager, but they arent licensed health professionals. so, all the medical expertise is left to us! its only my second week on this job and i love it so much. i feel like ive been there for months, i understand whats going on and just basically jumped right in and got started with everything. another responsibility i have is to provide education for all the people working in the homes. i have to give two hour inservices every month on various topics that i pick. thats kind of scary for me, but i will get over it im sure. we dont have med techs. im on call for emergencies only, but they are pretty much supposed to send the people to the hospital when anything out of the ordinary happens. im sure there are some things im missing bc i just started this job, but im getting the hang of it. i also worked telemetry for a yr at a hospital. i was not too fond of it. i just wanted my year of experience and now that its over, im done with hospital nursing. its not for me. i like management, and the freedom of this job, plus its so much more laid back, which is awesome. from what i understand, a med surg floor would be pretty similar to a telemetry floor, but a more broad range of problems with the patients. i understand you want to get your experience in, do you have any interest in other fields? what was it you hated about the telemetry floor? i thought it was a good place to get my experience. i could focus on one thing, cardiac, and i learned so much. i did hate it for the first six months, it was scary, i felt like i had no idea what i was doing, but after that, i sort of got the hang of it, it just takes time. most people i know felt that way with their first hospital nursing job. let me know what you think of this. good luck with your current job, as far as i can tell, its an awesome one and you should stick with it if you like it. maybe you could go back to the tele floor part time to get some of your skills down before concentrating on your mental health/community nursing specialty. i know its tough being new, i still feel that way sometimes, but that one yr really changes things. wb if you can! and good luck with everything!! donna:p

Hi, I actually just started a job that manages thirty group homes that sound pretty similar to the one you work in. I am new to this field, I have one yr experience working on a telemetry floor in a hospital, I just started this job a week ago. Our positions are a little different, but it seems we are both starting out in similar fields. How has it been so far? Do you have a nurse that oversees, manages numerous homes including the one you are working in? Part of my job is to audit the homes, check the paperwork to make sure policies are being followed, being present at discharge from the hospital if any patients were to be admitted, and education of all the staff by giving inservices. What kind of company do you work for? Have you had any experience interacting with nurses in my position? Good luck with your new job, I think it seems like an excellent field to be getting involved with!