dianajh73

OMG - Reminded me of my first death as a home hospice nurse. I was in training. My preceptor had actually discharged the pt from service the week before because the pt had been on hospice for almost a year and had actually improved so she no longer qualified. It was a small company and we had told the family to contact us if they needed anything. Apparently her aide got her dressed that morning, went to get coffee and came back to find her dead with a smile on her face. We went and pronounced and prepared her, which was kind of hard on my preceptor because she had been working with this client for a year as the only nurse. The, as the mortuary attendant wheeled her out, they passed the family TV. The grandkids had been watching cartoons and at that precise moment I see porky pig announce in his stuttering voice "That's all folks". The most surreal moment EVER. I did keep from reacting, but seriously???

My friends still tease me about the call I got during dinner about "redness under breast from bra strap". Yep - ended up in 3 calls because they can't use anything without an order and had no powder on hand.

Huge coincidence that you asked this today. We were just informed that, going forward, we will be taking our calls 24/7 without stipend and that if we want to cover for one another it was up to us to work it out, but we would not be scheduled to cover for one another. This is a corporate change and we are encouraged to bill for any time spent working because of calls or texts. Our Direct Support Personnel are required to report ANYTHING unusual, ANY change of condition, and if they want to give any PRNs. Last night I got a call about a medication that was not given in the morning, this morning I got calls on blood pressures for 2 clients which resulted in repeated exchanges and contact to primary care. I also got a call on an appointment and what was needed for Dr. Usually I get daily calls from each house on who needs MOM per protocol. I also received a 1am call to report a bruise. When a client is in ER I get regular updates, regardless of time. When the client is discharged I have to go to the home (all 45min-1hr away) and assess and write instructions and plan. Technically they do not "Control" my time, in that, I have no mandate not to drink or socialize, but if I have to respond it is on me. I ended up 2hrs late to my own birthday party because I had to go assess 2 clients regarding hospital discharge. Our company frequently defers to ER, but there are many instances that just require notifications or appointments. One weekend recently I had 50 TCs from 5:30pm Friday to Sunday 11am. Even when clients are in the hospital I am asked to check on them regularly over the weekends. I love my job, but on the lookout for better environment. I LOVE DD Nursing regardless and I HATE when another RN sends a client in when it isn't necessary because they don't know client. I'd rather they call me, but it does cause huge interruption in my life. If I had children it wouldn't work at all. Just off the top of my head based on the last 2 weeks.

LVNs in our ICF-N homes function as DSPs with extra duties. As someone else pointed out, your co-workers can make or break you. While the administrators usually try and schedule 2 DSPs for the shifts with LVNs, if there are call offs or there is short staff, they are rarely replaced, which means you spend a fair amount of time on the floor doing direct care and housework. In CA our ICF-N homes only require LVNs 8hrs/day by the way, not 24hrs. One of the homes only has an LVN 5 days a wk because they can't find a part time person to take the other 2 days. Typically our part-time LVNs work on weekends, which are the worst days to keep DSPs, so they are frequently covering for DSPs. LVN duties include: scheduling appointments, bi-weekly assessments, med passes, medication check-in and maintaining supplies, monthly reports of client condition and appointments, attending appointments when possible based on schedule and routine monitoring of health care plan.

I cover 4 ICF homes (total 24 clients) taking all calls 24hrs during the week, developing plans, doing assessments, checking meds and certifying passers among other things. In the Central Valley California area, pay is $35/hr. With a Masters and because I cover a geographic area that they had difficulty hiring in, I negotiated $37.50/hr (sign of their desperation, rather than any keen negotiating skills on my part) but with the understanding that this company absolutely does not do raises.

Too late to help the OP no doubt, but I'll answer in case there is anyone else out there looking for feedback. I currently work on call 24hrs Mon 8am - Fri 5pm for my 4 ICF homes (24 clients). There is not additional pay for answering TCs during the week, although we can charge or flex time for any time spent handling calls. Otherwise I am paid $35/hr for 40hr wk with OT as needed. Weekends we receive $100 stipend to cover on-call Friday 5pm to Monday 8am, plus billed hours for time spent handling calls for 8 ICF homes (48 clients). This is pretty consistent with what we demanded when I worked for a hospice company - $2/hr to be on-call. When I started with that company they paid $0 and couldn't keep anyone. I finally convinced the owners that there HAD to be something because it required us to be available at all hours and is a huge commitment.

Thank you everyone for your feedback. She has passed probation here and it is a government agency, so they will not be able to fire her without serious cause and our former co-worker gave 2 week notice because her new job was beginning training immediately. She would have given more if possible because our supervisor is really supportive, even though she is encouraging everyone to stay for 2-3 yrs because of the nature of the program, she understands the need to make the right decision for each persons individual circumstances. @Marshall1 - I had the same thoughts you do - I had spoken with my current co-worker since, and asked her is she wants to be the type of person who does the "legal" thing or one who does the "right thing" for the program? Her main concern is how she is treated by our supervisor because she doesn't want to be left out of trainings etc..., but none of us really thinks that is likely. They cannot hire someone in the interum - our other co-worker left in August and they just posted the opening last week, so we will be lucky to have someone in and trained before the next leaves. Even knowing she is leaving they won't be able to consider looking for someone until she is actually gone. Re: 4 months - The position she accepted had two possible start dates because they are planning for the role-out of computer charting and hired staff now so that everything can go smoothly once it starts. Thank you again for your help in allowing me to solidify my thoughts - I will continue to encourage her to tell our supervisor, but also be honest in saying that I am not comfortable waiting until December either. Our boss does know she has been looking, so it isn't as if it will come entirely out of left field, just going to take planning.

There are 3 of us working in a Public Health Program - Home Visitation. Our co-worker has been looking for another job in order to move out of the area. She was recently offered a job, but it doesn't start until January (4 months from offer). She is planning to leave in December, but is not going to tell our Supervisor until she is ready to give 2 weeks notice. We just went through this process with another co-worker and it has a serious impact on our program and our caseloads. While we have supported her decision to look for other work and have encouraged her to find a position that fits her needs, she has now put us in an uncomfortable situation because she outright lied to our Supervisor at a staff meeting when the supe asked her if she had any offers or plans to leave. The 2 of us that will remain are both unsure where to go from here. This is a government job, so they cannot replace her until after she leaves and she passed probation, so they cannot let her go without going through union. Her feeling is that she shared this in confidence and it is her business not ours, while we feel that government paying for additional training (2 day out of town training with no application past this program, plus additional days intermittently) for someone who isn't staying is selfish and uses money from the traning budget that could be used for her replacement once there is one. Along with the fact that we are a small, tight-knit program and WE will still be here after January and we have a really good relationship with our supervisor who is incredibly supportive. Any advice?? Neither of us wants to "go behind her back", but there are months still to go and we are both trying to prepare.

You need permit for all of the lots, except for weekends, but you are right that Q and P are closest to the nursing program. Daily permits are $3 and the semester pass is around $60, so if you have less than 20 classes you can just get them daily.

Glad you got the info you needed. You need a good Assessment book (Ndidi used Bates & the 2007 version is only $17). If you have a different one, then it is really reference material more than anything. It is more skills based, and practice, culminating in a full physical on a partner. We did some online quizzes, but no in class tests as I recall. Of course this was when Ndidi Griffin taught it at an accelerated pace like that. Took time outside of class to get the hang of much of it. If I had it to do over again I would get one of these Amazon.com: Professional OPHTHALMOSCOPE Otoscope Diagnostic Set + Zippered Leatherette Case.: Health & Personal Care but that is because my partner and I had not used ophthalmoscopes or otoscopes and did not get much time to practice in class. Good luck You are welcome to email me at yahoo.com using the same name

I understand. We had to take that class as well and I believe it is the only class that is required in addition to regular BSN, but because we were in a cohort that was designed to go on, we took it during our 5th semester of the BSN, before the MSN started in Spring. It is not the same as the assessment course that you take at the start of the BSN (1 unit N111 - integrated health assessment). This is a 3 unit Health Appraisal class (more hands on practice using equipment etc...). It is probably just not on the schedule yet, which doesn't mean that it won't be. They are constantly adding and moving classes, sometimes up until classes start. I agree it is odd though. Call and talk to Carol Rainer (she is the one who does scheduling and gives out permission numbers etc...) because you will wait FOREVER to get an email response. Glad you got registered for your other courses though.

May 21st is listed as the start of class for the summer, but I do not see Nurs136 available yet. Afraid you may have to call the nursing department to clarify what you need to do about that class.

CONGRATULATIONS!!! It sounds like you will have to take it. Yes, we did take N136 in that first summer. At that time, Health Appraisal was only 4 weeks long - I believe that it is still short, although I am not sure if it is 4 or 6 weeks long. I am assuming it is something you did not take during your initial BSN or it is something that they have added in the last few years. Again, Congratulations and Good Luck!!!

Re: FNP starting in Fall Due to cutbacks, any program that starts would have to be in the Summer or Fall, because there are no new students allowed in to the university in the Spring at all. This is a budget issue within the state universities.

NO!!!!! LOL Most of us are incredibly burned out on school after doing 3 years straight without a break (since the program goes through the summers and winters are busy) and the increased costs (started at about $2500 per semester and now at just over $3600 I think) make it necessary for many to work full time for a while, including myself. Advanced programs are also difficult without more hands on experience. CSUFresno is really pushing the DNP (Doctorate in nursing practice), rather than the FNP at this point. Our understanding is that they will be phasing out the FNP in favor for the DNP, but that process may be much farther in the future than I think. Initially I know only a few people who considered doing the FNP after this, because the DNP was not started yet. We were told in the beginning that the FNP takes an additional 18 months, although because of changes in the program which allowed us to qualify for national CNS certification in Adult/Gero or Peds, that may have changed. As it is, we have to take 2 more courses, after graduation, in order to get the national certifications in education and adult/gero. This would be another reason I doubt too many of our cohort will be rushing in to sign up for an additional program - the fact that the national certifying body changed their criteria and dropped the general certification is not the program's fault, the fact that they wait until rumors abound and did not communicate with staff or students in a timely or accurate manner is absolutely a failing of the dept. and has made most of us ready to be done for a while. In Fall we are basically repeating one class in order to get the national cert for adult/gero and taking an elective course to qualify for the ed cert, which also requires 3yrs full time experience teaching. We also have to pay for the clinical course that goes with the adult/gero class, although we completed it before. We are waiting to find out what kind of "discount" we may be getting since we will be registering for 3 more classes, even if they are technically optional since we will have our state CNS in June. Sorry long answer to the question. You do not have to decide now whether you will continue with the Dept. after the MSN, so wait and see how things go. We have also heard that you will not be able to get your BSN until you are done with all 3 yrs, although you will have the RN, so that may play into the decision since it remains to be seen what effect that will have on employment opportunities. Good Luck