chad75

Okay, I am thoroughly confused by the nurse compact. I am relocating soon and need to figure out what licenses I need. My current home state is Arkansas, which is a compact state. I am moving to DC, which is not a compact state I plan on doing agency stuff at first etc and would need to be able to work in DC/VA and MD. (those 2 states are with in minutes of DC obviously) So, I was thinking by keeping my Arkansas license, that would allow me to practice in VA and MD since theya re all compact states, I would have to get a DC license of course since they don't participate in the compact. I was reading the rules and regs though, and I am thinking that since my new states of residence DC, is not a compact state that I would not be able to practice in VA/MD with my Arkansas license once I change residence. I'm thinking since Im going to be living in DC, Im going to have to get a license in VA and MD also, since my home state won't be a compact state... *sigh*. Are you all confused yet? I surely am. If the rules permit I would like to only have two licenses, AR and DC and still be able to practice in VA and MD with my AR license. Can I do that if my residence is in DC? If anyone has any answers I would greatly appreciate it.

No I wouldn't think anything in Immodium would cause a false positive. However make sure you tell them all the meds you are taking when they ask :).

I don't see how this wrong unless there was an order to administer all meds via NGT. I have had many a GI patient with NG tubes to LIS take meds PO (after clamping the NGT). If someone has difficulty swallowing or isn't concious enough to take meds PO and they have a NGT with orders to crush meds and admin them through the tube, then by all means give through the tube, however it is not intrisically wrong to give a patient PO meds just because they have a NGT IMHO. Anyone else have input on this?

You received 2 years of license probation for 2 reported med errors in a two year period that didn't result in harming the patient !!!?!!! Much less a documentation error... Oh you forgot to sign off a med, guess what your on license probation! ? What state are you in? Are they seriously handing out fines/license probations for commiting a couple med errors that never harmed a patient? And since when do hospitals fire a nurse for making 2 documentation errors?

I think the nurses that do charge for anything less then a 5$ differential have lost their collective lost their minds. You are responsible for the unit, depending on the unit that can be a lot of responsbility.

Thats the sort of BS I hate about some SBON's. Go to school for a couple years, get a few thousand dollars in debt, then we will decide if you qualify for a license...The board of nursing needs a "fair practice act" of its own.

It depends on if your family is a full time job, would need more information..do you have help? How many kids? Can you hire babysitters etc.? A&P 1 & 2 are pretty heavy courses General Psychology is pretty easy depending on your instructor. Nutrition is pretty lightweight. Pharmacological type courses are usually pretty heavy. Medical Terminology is lightweight, especially if you have a good memory. Oh, and given that A&P 1 is a prereq for A&P2 I don't think you could take both in the same semester at most schools.

Can you copy/paste the story? I really don't want to have to sign up for an AoL account to read the story.

We did it on a fake arm, then eachother, then patients. After 6 years its still hit or miss with me, I can walk up to someone that no one else could get an IV started on and hit him/her the very first time with no problems, then get a young patient with awesome veins and blow it .... nothing more frusterating then not being able to get an IV started on a patient that you should be able to hit no problem.

I hear ya, this is my last hurrah. I haven't had a full time traditional floor nursing job in over two years. Strictly agency and contract. Alot of the hospitals/facilitys out here though have over 50% agency/travelers as their nursing staff. Its a sad situation when the agency people are training the hospitals core staff. The last couple of years I have taken on a pirate attitude just to get through my shifts. Basically whats in it for me, I go to the highest bidder. The place that pays the highest with the least amount of BS gets this burnt out nurse for a few shifts. Oh don't get me wrong, I provide good care to my patients, I always smile when I walk in a room but if I see you at Walmart and you tell me your thinking about applying to nursing program X, you better grab a chair lol. I work in a big city mostly, but its a small world when it comes to nursing, usually end up working with a couple of nurses I know most of the time. We do our best to just get through the shift, sometimes we get pretty jovial and are consequently written up by some old haggard uptight unit clerk or housekeeper lol. I received one write up because I played a prank on one of the other nurses during a never ending slow moving shift at 3am (it involved warm apple juice in a specimen cup, was hillarious), the victim thought it was a laugh riot, but the RT thought it was unproffesional conduct lol. A few months ago I stopped carring about things that didn't involve patient care. I refuse to clean breakrooms I didn't mess up or take out trash that was full from the shift before. I'm not quadruple charting anything. Have some convoluted charging system for supplys that takes me more then 1 minute to charge a patient for something...guess what , they are getting a free bedpan and box of kleenex, I know insurance companys only pay according to DRG's so its pointless anyways. Don't have working equipment I need for patient care, or are the people in central supply so slack *** it takes 6 hours to get some critical piece of equipment? Guess what, I'm calling the Physcian, telling him that his order for a cooling blanket on his patient with a 105.9 fever cannot be completed because I can't get central supply to even answer their phone, much less give me a working one (Did I mention I had to argue with the central supply person for 10 minutes to convince them that it didn't work while your patient is having hyperthermic dellusions and on the verge of seizures? And after that I paged the house supervisor several times, no Dr. I don't know where she is, please don't raise your voice to me, I'm honestly doing the best I can.. here is the # to the house supervisor/administrator etc. I'm sorry Mr. Patient's wife, I know your husband is extremely ill and burning up, let me tuck a few more ice packs around him, no the Dr. isn't coming, but he has been notified....please don't sue me, I let my malpractice insurance lapse because any free time I have I don't even want to think about nursing. The next day----No Angie (Angie is my agency scheduler), I didn't refuse a physcian order. I did what was in the patients best interest, I couldn't get him a cooling blanket, central supply couldn't get me a cooling blanket, the house supervisor couldn't get him a cooling blanket so I felt it was my duty to inform the physcian that 2 hours after he gave me a stat order I was not able to fulfill it and didn't want to take the fall when said patient ends up in a coma. If I had the ability I wouldn't have pulled the cooling blanket out of one of my orifices. Oh, Im being written up for not completeing a stat order with in the hospital policys stated time period..Um okay. Angie: "They also want to know if you can work a 14 hour shift tommorow since they had to fire that new nurse for failing her drug screen." Um yeah, I will get right on that. *sigh* I heard utilization review is a little less stressful

Yes, the pros to nursing are awesome. It was enough to keep me working this long, the scale is getting weighed the other direction every day for me. I know my post was bitter, and not representative of every floor nurse, in every hospital in every localation. Just my general concensus coming from a frusterated nurse

I've been coming to allnurses for a while. Mostly lurking. I have been a nurse for about 6 years and I am curious if nursing is really as bad as everyone says it is. We all know its just "nurse nature" to come here and write about an awful day they had then it is for a nurse to come on here and say there day went smooth. I've only worked as a nurse in one state and my personal opinion of floor nursing is really negative, but nursing is my livelyhood. I don't think I've spoken with a single nurse that has been floor nursing for any period of time that has felt good about the proffesion. I have run into the occasional Florence who is on a mission from God, but I don't really count those since they are in the very small minority. My personl concensus on floor nursing (Having worked pretty much every speciality except general peds inpatient med floors). Pros (going to try and start off positive) 1. Pay: I don't know any other proffesions where you can compensated for two years education and make >50k a year. Yes some nurses work in small rurual hospitals, don't want to travel etc. but if you really wanted to, and were willing to move and work any unit you could approach near 6 figures in some areas with overtime and agency work. 2. Job security: I am the consemate job hopper. I could find work in 3. Variety: There are so many different fields you can work in, everyday brings something new. 4. Independence: Depending on where you work and what your speciality is you can have a large of amount of indepedence, especially if you are like me and work nights. No supervisor breathing down your neck telling he needs the tps reports yesterday. You make informed decisions alot on your own etc. 5. Respect: I know this one is debateable, but there is a certain amount of respect received from lay people being a nurse. Alot depends on enviorment though, if all your friends/family are CEO's and PhD's you may not get much lol. 6. Meaninful work: We see people at their worst and through proffesionalism and knowledge are sometimes able to alleviate concerns, save a life or get warm fuzzys from thankful pts./family. 7. Schedule: We aren't tied to a 9-5, we can work 3 days a week and take 4 off, or like some work 6 in a row and get a mini weeks vacation between shifts. 8. Comradery: As nurses we share a lot of the same burdens and experiences, were sort of a dysfunctional support group for eachother lol. Cons 1. Patient ratios: Health care providers continue to lay tons and tons of paperwork and double/triple, sometimes quadtruble charting on nurses to be JCHAO compliant, yet excpect nurses to perform "customer service." 2. One mistake away from loss of livelyhood: One unfortuate mistake and you can loose your ability to ever practice as a nurse again. If a CPA messes up in a calculation he may lose his/her job, but as long as nothing illegal was done he will still be a CPA. 3. Were disposable: Hate to say this, but were immently replaceable, if we weren't, hospitals wouldn't treat us in such ways. They know there will be another new grad, foreign or travel/agency nurse to take your spot. 4. Egos: We work with the most egotistical, ill tempered, god complex proffesion on the planet. Physcians...yes there are some excellent ones but in my experience for every physcian that treats me with respect as a member of the health care team there is one that ignores anything I say, yells, throws charts and just generally acts like a spoiled child on their birthday. Then we have the egos of the supervisors/DON's and other such people that haven't worked the floor in their life, or worked the floor back when the BeeGees were #1 on the charts. They have no idea what the average floor nurse is expected to do. They won't get in the trenches for a shift or two either to get an idea, however they will tell you its perfectly reasonable for you to take on 8 patients in a primary care setting while they attend the 4th meeting of the day to discuss the increase of bad marks on the patient satisfaction surveys. 5. BON: I have never had any issue with my license (knock on wood), but from what I have read and the experiences of other nurses that have there tends to be a holier then though attitude. Mitigating circumstances don't count, reality of the hospital doesn't count. All that counts is that you, the nurse on the frontline did something 99.9% of floor nurses do, but you were unlucky, too bad so sad...next. 6. Responsbility: The buck stops at the floor nurse. You would think it stopped at the physcian, but in reality it doesn't. Things can be twisted. Oh you called the physcian about the patients critical PTT, he didn't give you any orders? What did you do about it? Oh, the physcian says you never mentioned that, your word against hers, of course its your fault the patient has a brain hemmorhage now. Would you like us to schedule your BON hearing now? 7. Lack of respect: For as much respect as we do get, there is still heaps of disrespect, especially by those in our own proffesion. 8. No one has the time: More and more nurses such as myself are getting burnt out. No its not agency nurse_01's fault our unit is a revolving door, its still frusterating for me to have to train a new nurse every other shift though, especially when I am overloaded as usual. 9. Nurses can be cruel: They can be hateful, burnt out witches that should have left the proffesion 10 years ago. They trudge on though and make sure everyone knows they have been a nurse for a 100 years and you know nothing as they walk right past a room that has an IV beeping in it, because it isn't "their patient." 10. Hospitals in general despise us: We are a neccesary evil, if they could fire us all tommorow and still run a unit they would...don't doubt it. I'm sure there is some lone Non-profit (not "not for profit") hospital in some rural town that truely loves all its employees, gives a xmas bonus in years that they can afford to and in years they can't afford to the executives don't get a bonus either. 11. Jack of all trades: I'm not sure if I came up with this on my own or heard it somewhere else but its a true quote none the less. "A nurse can do everyones job, but only a nurse can do a nurses job." We play unit secretary, CNA, Housekeeper, dietician, accountant, pharmacist, central supplier, receptionist, social worker, security, therapist, QA, etc. etc. To top it all off were expected to do such things on a regular basis, and if we don't were negligent and might end up answering to the BON. 12. Constant changing policys, new "systems" Policys change constantly in a hospital, one day what you were doing was right, the next day its punishable by termination, its chaos. Not to mention complete new ways of doing things, to "improve." Computerized charting and the new med administration systems which make you scan ten different things come to mind. I could go on with negative, but I think you can guess my general concensus of front line floor nursing 04 (soon to be 05). Why am I still here? I'm asking that of myself more and more everyday. I have decided I'm going to get out of nursing all together or get as far away from bedside nursing as I can. Infection control sounds sort of groovy, or maybe diabties educator lol. To all those floor nurses out there, you aren't alone. Merry Xmas.

In this day and age working any sort of LTC or RCF setting is like playing russian roulette with your license, especially if your on the front lines. If you go look at your SBON's website (if they list such actions online) you will almost always see about 50% of actions on licenses are for nurses working LTC, and the other half are usual drug diversion actions. I work for an agency and occasionally pull a shift at a state run LTC facility because the agency pays real well for LPN's to go there. Every time I leave I say I will never come back lol.

Well, your biggest mistake was refusing to take a UDS, unfortunately I think a refusal is considered an admission of guilt by the powers that be. I will take UDS any day, any time, any where. My job could call me up right now and I would drive up and take a UDS...its that important that you cooperate when it comes to some SBON's. Its not that I don't believe, its the fact I don't want to believe its true lol. I had a situation where I had a lung CA patient and a patient that had pancreatitis, basically hitting up the pyxis q1 hour for large doses of dilaudid, valium and demerol. I guess pyxis flags such behavior and my charts were reviewed. Well the chart reviewer decided I didn't chart well enough and I was basically told I was being suspended pending the results of a UDS (not your average everyday uds, the sent the sucker out for super duper test lol). Of course it came back negative, the hospital reinstated me and said I had to take charting classes etc. I explained I knew how to chart but having 8-9 primary care patients with only 2 aids for 30 patients on the floor was not conduscive to even the minimal amount of CYA charting. I also felt guilty until proven innocent and was basically treated like a druggie by the DON and unit supervisor until my results came back negative. I gave my notice, that was the straw that broke the cammels back. I wish you luck and pray you have a positive outcome, hell for every door closed another opens. Some days I feel like ripping up my nursing license and going and working at walmart.

No offense but I really don't think we are hearing the full story. To my knowledge unless you had a med error which caused a death or an adverse reaction I don't see why the hospital would report it to the BON, there just simply is no reason to. If they started doing that I guaurauntee the amount of reported med errors would drop to near zero lol. Two missed doses being means for action on your license? Well I guess myself and 99.9 of the nurses on this board need to turn in our licenses.

Yet most every nursing program in a metro area gets 200 applications for every 1 seat available. Personally I wasn't offended by it, but I learned to lighten up a long time ago.

I have never traveled but have had many nursing friends who have, they all have a similar horror story to tell. From getting stuck 3k miles away from home, the hospital having terminated the contract for some innane reason, then having the travel agency freeze their account so they were broke. There are lots of nice travel assignments out there I'm sure, but I think if you travel long enough you are going to have a horror story to tell. All I can suggest is keep enough your personal bank account for the trip back home. (don't put all your eggs in one basket, if you are assigned somewhere for 90 days you can also hire on at some of the local nursing agencys).

KNOCK ON WOOD, I have been a nurse over 6 years and have never had one of my patients die on my shift (sheer luck, I'm not super nurse). I have worked just about everywhere from ICU to ER.

Well currently I'm an LPN, and if I receive a directive from, report a condition to or consult with an RN I use their name. I.E. Reported to J. Doe RN that patient continues to be in uncontrolled a. fib one hour after administration of po cardizem. She directed me to notify Dr. Heartsalot, Physcian contacted and received orders for a cardizem drip etc. etc. As you well know if things go south J. Doe RN might say I never reported the patients condition to her and being an LPN you work under the supervision of an RN according to the LPN scope of practice (I knew before consulting with the RN that we needed to get an order for a cardizem drip, but its all about CYA). This way I have a written record of the time and person I consulted with.

Hehe sorry, thought it fit the situation and it wasn't directed at anyone without a funnybone

May I suggest google. Without going into detail, and increasing the chances of getting something wrong :chuckle , yes you could get septic from any type of wound that becomes infectious especially if you have a compromised immune system. The main sympton is hyperthermia. http://www.sepsis.com *disclaimer* As always, if you think you or someone you know may be "septic" the best course of action is a trip to your physcian.

Listen, the sandwiches obviously belong to night shift, since we always get shafted on the goodies! What ever happened to people who didn't take themselves way too seriously. If you think immaturity isn't present in other proffesions, such as finance and education you are sorely misinformed.

Blood cultures, and sepsis is basically an infection of the blood (usually caused by infection elsewhere).

Its varied from facility to facility I have worked in. One of the most common though is the infamous 5 or 10 and 2, Haldol and Ativan. I have noticed as of late alot of facilities are switching to Injectable forms of Zyprexa, which looks exactly like the zyprexa zytis tabs in little vials. Its a pain in the butt if you are in a hurry because you have to reconstitute it adding a couple minutes to the whole process (or longer if your med rooms is unorganized and you can never find the vial of NS lol), which doesn't sound like much...but I'm sure you all know 2 minutes is an eternity when you have several nurses/techs *assisting* an out of control person from hurting themselves, someone else or whatever happens to make a handy projectile on the unit. Haven't used a whole lot of injectable CPZ, but once in a while a physcian will order it or I will work in a facility that uses it as its primary form of pharmecutical intervention.

Well, you probably shouldn't be putting a patient in seclusion if they aren't a danger to themselves or others, so that issue pretty much solves its self. If they are a danger to themselves or others and on voluntary status you couldn't let them go either. Call the doc and get an order for a 72 hour hold . The whole thing is pretty subjective, having worked places like state mental health institutions which occasionally end up keeping patients a very long time (>1 year on an "acute" unit) you have to wonder if just the fact of asking an instutionalized patient if he would please take a time out is not in and of it self seclusion since he/she knows if they refuse 9 out of 10 times they will end up in seclusion. Same thing with the unlocked door quiet room, come out and we lock it...isn't that truely seclusion? Yeah Its semantics, and we all have played that game, even JCHO, with the no chemical restraints issue...umm okay no chemical restraints, we just have an order for 10 and 2 q1 hour until "no longer emergent" ROFLMAO...