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heathert_kc

heathert_kc

LTC, AL, Corrections, Home health
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  1. I am fairly new to rehab nursing but like it so far. The rehab hospital I started at this past fall pays for nurses to take their CRRN and offers a free study course but looking at the requirements it says two years of rehab experience without clarification. I previously worked in a Medicare approve long term care facility who took short term rehab patients. I was wondering if that counts??
  2. heathert_kc

    When is it time to move on?

    I can certainly relate. I have great co-workers for the most part, but management which has always been questionable has had some recent changes and it is so frustrating. New DON was never a floor nurse, no real in service or meeting of the minds in months. Things are changed on a whim and communication is horrible... Telling one nurse on one shift doesn't mean we now all know, responsibilities are simply shifted from those who aren't doing them, or not doing it properly, to those who are competent. Concerns aren't taken seriously. The ADON they hired is related to several staff members (though that breaks company policy) and she has zero experience in management and is unprofessional at best. I am dreading the job I have been at for more than 4 years I have to have insurance for my children), but am afraid of the demon I don't know (any possible new job). I feel stuck, though I know I'm not the only one second guessing my future here.
  3. heathert_kc

    6 patients at once? How do you do that?? Any advice?

    There is a difference in staffing between day and night shifts, so is this on night shift?? If so I would say that is not far out of the range of what is normal. Did they say that is the max, 6 pt per RN? Because that may mean the majority of the time you have 4-5 but have to be capable of carrying 6 in the event they are short staffed or at full capasity. The number of tech/aids/LPNs they have matters too, some hospitals train support staff to do a lot more than VS and baths/toileting. As stupid as this may sound to you right now, I think new grads are at an advantage to work an a challenging environment at first. Because in learning you are capable of handling that, you then have confidence you can handle anything. I have been an LPN for nearly 3 year in a very nice skilled nursing facility, but as a new grad RN I have decided to start at a very fast paced acute rehab hospital, just because I know I will not fully delevelop my nursing skills if I work in a cushy, suburban ltc facility for the next five years. And god forbid, I lose that job or if my family relocates and I have to work at a 'real' nursing home, not sure I could manage. I love it where I work now, but it is not expanding my horizons. Just keep in mind that there are lots of other nurses who do it and manage just fine. Nursing is definitely a tough job. You have to start orientation without such ideas in your mind and all those pre-concieved notions that you have and just be open to learning and taking in the experience. Even I start 'class' orientation tomorrow, and am nervous. Hearing older nurses talk about the old days of nursing is even scarier. Relax, breath, and be confident; You can do this!
  4. heathert_kc

    Accepted acute rehab job, then took a pregancy test!!

    That's what the doc said. 'Lift is okay, just do it properly and get help when needed; No being superwoman. You will probably be more careful with any of the isolation pts than the other nurses considering, just NO CMV pts.' Yes, that is what I ment I am not gauranteed a job after maternity leave, which is a scary situation, new baby and bills to pay but jobless. I don't mind moving on in time from any position if it is necessary or a better deal for me and my family (that's just the way of the worlds anymore) but would hate to be forced to and feel the pressure of needing to find a job right away despite being a busy new momma. Thank you for your input. I am going to talk with my hubby, think I will give them a call tomorrow and just go to this interview for the telephone based office gig, you never know...
  5. heathert_kc

    Accepted acute rehab job, then took a pregancy test!!

    Thank you, Congrats to you as well! You made some great points and gave me a lot to think about.I have never used FMLA and haven't done much research yet, not sure why but I was thinking it required a minimum of 6 months employment, but you are right it is one year. So I think the office/phone job is out. My current job does not offer paid materity though luckily I was smart enough to opt for short term disability, which give me 60-70% pay for 8wks (vag delivery) or 12-13wks (c-section). I do live in an 'at will' state, but I want to be fair to them. I mean, nursing is a small world. I was hired because they are adding one nurse to each unit, so they need at least two full time RN for each day and night, plus some. I was considering at least asking her if they might be able to utilize me one shift a week or something, while keeping my current job, which only requires me to work an average of 30 hours per week in order to be considered full time and get full benefits. So that I would still be an opportunity for me to get a little experience, a foot in the door, and a little extra something on my resume. Of coarse there is no telling whether they would go for that but it is worth a shot, right?
  6. I was really happy to get offered a job in an acute rehab hospital, as I wanted something more acute. But the week before my orientation I failed to have my monthly and took a pregnancy test and sure enough...POSITIVE! I have been married several years with no children, as I just finished my RN in December and my husband is set to finishing nursing school (his 2nd degree) Dec of this year, we are excited! The excitement died down a bit as it is very early in the pregnancy, and all I can think about is how the director who interviewed me talked about how busy, fast-paced and crazy it is. Plus looking at the information they gave me, the insurance will not go into affect for another 2.5 months and 2-3Xs what a pay now in LTC and will only increase when I add a baby, my current employer is Catholic funded so insurance covers whole family: you, spouse and as many children as you can have with no extra cost. Plus she said they have a lot of isolation patients and there is heavy lifting, so I have a call out to my doctor about that. But I am suddenly less excited about this job offer, Is it do-able?? Safe?? If I wait until early next year I won't be a new grad any more. Then just as this realization came to me I was called about a telephonic contract to hire position for a medical research company, I interview on Friday. It is not exactly what I want but is less active and stressful. I do not need either as I currently work in a great snf that is not too hard and I have been there nearly 3 years, mostly as an LPN, though I am starting to feel burned out there. I have yet to hear back from any large accute hospitals I have applied to, and I can not bank on that happening in the next two months, before I start to show as I have been applying for the last 4 months. I am just really confused and don't know what to do?? How would I even take back my acceptance of the position?? can I request part time or PRN if my OB says it is okay?? I really did not want to tell anyone as it is so early.
  7. heathert_kc

    Have a serious problem with night shift CNAs

    Oh to work in such a place, where anyone can be fired for not doing there job.... jk they just don't take things seriously and management is too lax, not that everyone walking on egg shells is better, but in time I think things will correct themselves as far as management is concerned, with families complaining and problems not getting fixed. I think you guys are right. I definitely think that I could do a little more praising, though I generally have a good and appreciative relationship with most of the aids. More follow up may help as well. I am meeting with the DON this week. So we will see how that goes. I just start thinking if I don't do it, it won't get done so I do so many 'CNA tasks' (not to down such tasks, I was a CNA not too long ago) that my own work suffers and I am exhausted.
  8. I am a new RN in my mid-20s, though I have been at the same facility as an LPN for 2+ years, a CNA for 2 years before that (though at a different place). Because I was in school last semester I had to transition to working primarily weekends. I work mostly nights, and some evenings. Night shift on weekends, one day in particular, is a real makeshift crew. On that night one aid is a relatively new CNA (scares me to death she wants to be a nurse) ,she has an attitude and is down right lazy. She fell asleep while the other aid was on break!! so basically I was the only one on the floor Needless to say I was not happy. The other one is a bit older, and been doing it a bit longer but still lazy!! There is a resident who is at the front of the hall and he cannot remember to use his call button and he whistles when he needs help, though I explained to them that that is so and so and when he does that he is trying to get someone's attention, he whitles and they just sit around. When they are busy doing rounds call lights are all but ignored and in the morning I leave an hour earlier and am very busy with med pass, but the idea of prioritizing is so foreign. I had a meeting with the DON, we drafted a list of espectations for them to sign, little that has done. The very same day half were broken: the men they get up were not shaved, a motion alarm not being heeded led to a resident having a fall and skin tear, the break room was a mess, and she fell asleep. This was this past week. I thought I was about to have a panic attack, I mean I help out more than probably any nurse, but I am coming to the realization that I cannot do it all! Compaining to management does little or nothing. I had my ADON (who is less tolerant of bs, though has little power, unfortunately) to print me extra write-up forms. I wrote them both up, but the young ('I know how to do my job') with an attitude girl refused to sign so of coarse the other one followed. The DON wants us to meet and talk about it, but I really am not interested in working that shift at all. In fact the idea of going in next week as me anxious. I am not usually short tempered, but the frustration is making me act like someone even I don't like. I take my work personally and I work my tail off only to hear countless (legitimate) complaints about my shift/ staff. I used to trade one of my shifts with another nurse, when it was convenient for one of us and she has since told me that she cannot take my shift any more because she, who has been a nurse a lot longer than me, cannot handle my staff... I am feeling so discouraged. I used to truly enjoy my job, but now I am considering just resigning. Not sure if that is a rational thought or me being overly emotional. Don't know what else to do.
  9. heathert_kc

    No call no show?

    The fact that you take your job personally shows you care. But this tends to be the type of individuals who do no call no shows, those who call in all the time, have countless 'family emergencies', car break downs, mysterious illnesses, or simply 'I can't make it', etc. It certainly should be grounds for dismisal, though that all depends on the policy at your facility. My facility is horrible about sticking to there own attendence policy, which can be frustrating. From my experience every no call no show I have ever had was a person who should have been fire a long time ago, not my opinion, but if our attendence policy had been followed. I mean if god forbid I were in an accident and/or in a coma or extreme circumstances I would hope my job would excuse me. So there has to be some discussion, but for those who are notorious for being unrelible, show that they obviously don't want to work there, and that is how I see it. You gotta look at your policy and speak up when it is not being followed, remind management that it is you and all the other staff members who suffer as a conscience.
  10. heathert_kc

    New grad RN transitioning from LTC

    Thanks for the input, I appreciate it and I hope you are right!! Either way I am up for the challenge, just a bit nerve racking to start something new.
  11. I worked as a LPN for 2.5 years in ltc; it was a beautiful new facility and relatively cushy compared to most nursing homes (ratio 16-18 pt per nurse on day/evening, 1:32-34 on noc, with 4-5 medicare at the most, only one gt, rarely one IV) or so I am told, I have never been a nurse at any other snf. Finished my RN bridge in December and despite the last 3 months of applying everywhere my only more acute job offer I have had is a small free standing rehab hospital on the acute unit. I have not yet starting, job offer is pending my background check and physical. But I was told there is a great deal of online simulations and then a minium of two weeks training on the floor, but that could be extended if I needed. There are 14 beds on the unit if I remember correctly, and they are hiring an extra nurse so that there will be 2 on day and night. I will be working noc 12hr shifts. I am really nervous, it is a short stay facility with most patients in and out in 10-20 days. That means lots of admissions, and I am told they have pretty high acuity: trachs, complex drsg changes, g-tubes, IVs, etc. Any advice for making this successful transition in to a faster paced environment?? I would really appreciate it.
  12. Think you want to go to addiction nursing specialty; this is more for physical rehabilitation for paitent post CVA, spinal injuries, tramatic brain injuries, etc.
  13. heathert_kc

    Rehab Nursing advice please...not a real nurse?

    I too am in the same boat. A new grad RN, with 3 years in ltc as an LPN. A rehab hospital was the first place willing to give me a shot on the acute unit and I was thinking is the 'real' acute care experience, but after seeing the 6 page documention sheet that has to be done q shift on each patient to justify there stay in acute rehab over a skilled nursing facility, and learning about the isolation patients, dressings, wound vacs, IVs/PICCs, trachs,etc. I have no doubt it is very much real. have not started orientation yet, but I am hoping everything goes well... In fact I am now thinking the opposite: 'CAN I HANDLE THIS??' I am really excited though as I really do not know what I want to do in general in my nursing career, but wanted something a bit more challenging than my ltc job in hopes that it will open up additional opportunities for me in the future.
  14. heathert_kc

    Take a job in New Mexico or hold out for job in CA?

    I think this partially depends on your situation in life and your priorities. If your family is not able to support you or you have a lot of student loan or other debt without savings, I would have to go where there is a job offer. I would assume if moving to CA was your plan then you have already been applying there with no luck?? Having children and/or spouse can change things too. Kids need some sense of consistency and your husband being unemployed too would be very tough. I understand it is a tough choice to make, but if you do have to move somewhere else just keep in mind it is not forever, get a CA license and apply, apply, apply as you are working elsewhere. So what if it takes a year + at least it is not a year of applying while sleeping in your aunt's spare room without a job. The day you start that job you get to add it to your resume. Just my opinion. Just weigh your options and look at it realistically, I know you want to stay positive, but what if crossing your fingers and hoping does not work and it take more than 8 months, then you are no longer a new grad and the search gets tougher especially if you are in one of the larger metro areas. Look at it from every prospective. Is the pay in NM ok? Cost of living there is fairly low, plus it is close to CA so you could visit your family during the time you are working in NM. Ultimately it is up to you, but I have heard of CA grads jumping ship and going to places like the Dakotas for work, so many would not pass up a shot like the offers you have.
  15. Remember you are a student you are not supposed to know everything and instructors cannot expect you to know how to do something perfectly that you have never done or practiced. Even if you have practiced it lab and real world are totally different. I know it can be really nerve racking. Just review the book stuff regarding charting/documentation. Hands on is just different. Of coarse you want to do well, but ultimately your goal needs to be taking every opportunity to learn and experience as much as you can. Take advantage of lab, if your school offers additional lab time outside of class. Not sure what your background in math courses is, but nursing math is not that hard. I had dropped out of college algebra, because it was over my head, and then worked my butt off to get a B in intermediate algebra; definitely not a strong math student. Then when I was doing my LPN the pharmocology math was a breeze. If you are not getting something, see your instructor they are there to help you. Check into getting a pharm math book, it may explain it in a different way; if you are still struggling. Math is a bit more cut and dry than those tricky nursing questions. Be sure you know the class policy. Often times, yes you have to pass with really high if not perfect marks, but can you re-test if you do not pass the first time around?? I think we were given a second shot. Plus you are not going to take that test the second day of class it is probably once you have covered all the material and reviewed it taken quizes, etc. so you will know if you are understanding it or not. You seem to be doing great so far, though it may get harder you have to be up to the challenge and keep your goals in mind and stay focused. 97% average is a long way from failing, not being perfect at a hands on tasks is not automatic failure. You have to take a deep breath and relax you will do fine.
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