Michigan

For Christmas and New Year's Day, I had bagels delivered to the 2 units I manage for day shift (could not get pizza delivered before their lunch break) and pizza for 3-11 and 11-7. Just a small thank you. Wanted to stay away from the holiday candies and cookies. P.S. Personally ordered the times to be delivered 1. fresher and 2. most important the food was there for the shift meant for.

Not going to debate the use of pot, but meth or pot, either one will put on a fast track defending your license.

I would not even mention anything. How will you respond when ask how you know the child??? Big red flags.

????? Backwards, why??? Not meaning to flame or cause tension, but that comment IMO is so wrong. Have you ever worked LTC? Yes, LTC nurses deal with many of the same issues as a nurse in a hospital, plus many no hospital ever deals with. I've worked both and home care also, and trust me LTC is very stressful, you must be spot on with assessments, ever watch an elder go down hill in less than an hour? And don't even get me started on families and all the state regs. I took almost a $3.00 hour pay cut for my LTC (yes, perks for my job- no weekends, holidays or call).

At the camp I work, if you are in a cabin with campers ( yes even all adult counslers ) the nurse has your meds. In the case of adult workers we do not record when they take the med and they may keep the med in their car. But every camper must turn in all meds,even OTC. Privacy is of course a high standard. Goal is two- fold: we know that meds every camper is on in case of emergency and prevents chance of a meds being "shared" or stolen. Oh, we also have the small fact that our state requires this policy and if meds are found in a cabin- whew not pretty. Yes. they will ask people about their meds are.

Anyone have deju' thoughts of the worst rumblings of 2000? Only I think it will be the reverse- poor planning and #&$* hitting the fan come Oct. 1

When I did Home Care, I had a section of the county and if someone lived in my section, unless I was completely full-- I had them. Sometimes we changed due to a number of factors (past history with the person, family members, special skills required- wounds for example) but I was not able to just pick and choose.

First, I'm so sorry for what you are going thru. 2nd- once you've made a decision--DO NOT second guess yourself or let ANYONE put a guilt trip on you for you decision. Do not play the would've, should've game. Remember hindsight is always 20/20. That said- I wonder about his pain control. CVI can be painful and of course his stress level is thru the ceiling. You didn't say if he was on any other pain/anxiety med- I would ask Dr. to consider a med review. Consider LTC for a trial time, to give you time to do more research into your options. I work LTC and while I know bad LTC can be, I also there are plenty good ones with hard working, loving, caring staff. Ask about your options for payment: MCare, maybe an option, it may pay due his skilled care need for a limited time (maybe enough for you to decide futher options). If you choose this route, you can be there as many times during the day or night as you feel you need to be to monitor his care. Find a close friend (in my case I would probadly use my pastor) to monitor YOU- for increased stress and help your focus. Sometimes nurses make the worse family members, turning small problems into a huge crisis. (Please no one flame me. I know because I've done it myself. When your Mom is crying because of pain, you (I) didn't give a royal leap if another person needed help, or what was going on around the floor.) remember to step back and ask what if the roles were reversed (you was the nurse and you the nurse). My Mom recently had a bad fall with 2 fractures. I stayed home with her for a long time (thank GOD for FMLA- you do have one right?) and sometimes in the middle of the night (funny how is worse in the night) I would cry thinking I was making a bad decision keeping Mom home and any nurse at the nursing home could take better care of her. Again, so sorry for what you are going thru. I'll keep you my prayers.

Regarding the nebs we were cited a couple years ago. State views nebs as medication (which as we all know can not be left at bedside unless the RS is able to self-medicate. We assessed all RS who received nebs to determine if they are able to "self-med theirself" (only a few are able). If they did not "pass" the nurse must stay with them the entire time. "State" okayed us and we passed the re-survey.

Please, please Call your Dr. for appt ASAP/NOW/TODAY. Next have a frank talk with your manager. While most places have a 6 month "stay with your unit" policy. Rules are not always in stone and exceptions are made. A decent employer will want to "save" a good employee, even if that means bending the rules or giving you more training. Please do not beat yourself up. Nursing is a stressful job and every nurse has at least one area/department they avoid at all cost. You are not failing at being a nurse and after time you may even love ER---BUT NOW you need time and help.

Ww also post on face sheet. Of course when family or RP is called to be informed of the RS death, the funeral home is confirmed at the time. IMO makes it much easier for all involved.

It's much better to have a very "unique" peice of equipment. Much more difficult to "walk off on it's own." I "lost" many plain black, red, blue ones.

I'm in the minority here, but I agree with the OP. Think if you kept the snake in a secure area it would be a great idea. I bring my dogs to work ocasionally. You would be surprised, at the number of employees who are scared of a dog. But the residents love them. I am very aware of RS and employees who are scared, or allergic, of the dogs and avoid their "space" (everyone has their own idea of a safe distance). You know your snake and know how much stress it can take- talking of toting it back and forth. As our population changes, so will their idea of "pets." PS- I don't have a snake, don't care to have, probadly never will have a snake, but my sister and her family have multiple snakes, lizards, fish, hamsters, etc and also cats and dogs. Maybe you could have a set day when you bring the snake in and announce it so the people who want to see it can. I realize germs are a concern. When I walk my guys around I carry a container of hand wipes. Actually I worry more about what my dogs may pick up than what someone petting them may get. Look close at the handrails, w/c wheels, etc-- yuck.

Always answer truthfully. Most places I've worked at (been on both sides of the table) you also are seen by a Dr. for the physical and you can ask questions then. Be aware the physical is confidental- probadly no one you actually work with will know anything you marked-as the poster who commented about DM and having a problem while at work. If you have a medical problem that may occur while at work, please find a couple trusted people and let them know, should something happen at work.

LOL, I remember when it was a long. long way to 2000.

FYI. In my building, cited by state because we did not have current Creat. levels for RS receiving ATB. Now whenever an ATB is ordered a new level is drawn and dosage adjusted according.

Please call the Police and go see your Dr. explain what happened and have a drug test done ASAP. Results will be for your Dr. only, but you will have something if they attempt to blame you. Understand it will not stop the blame "she was selling" but will show you are not using.

I pray I have a nurse like you if I'm ever in the hospital. Of course my "muscle spasm" being 90 lbs may be a problem to hide. LOL

I disagree regarding having Dr. write order to cover the error. If the med was given or missed prior to the order, then a med error occurred. An order after the fact does not change the timeline. However, I also disagree about med errors as a reason for firing- unless there is pattern or very far from normal. Med errors should be used to track why the error occurred and find / solve the problem to prevent another.

Check with your state guru. I was told (by our guru) to code the meds for the "classification"- thus would not code as diuretic. Does not make sense to me, I agree. I saved the e-mail for proof should state guestion my coding. and all MDS staff in our building also code meds this way. Your guru should be listed on CMS site. I'm lucky, we subscribe to Briggs, so always have updates (maybe not always timley but eventaully) and it also lists the MDS contact state by state.

If I missed a post where you said something about seeing your Dr. sorry, but please see your Dr. for a complete workup. And be honest with your Dr. about all the changes in yourself as you have posted.

I leave Friday to start camp on Sat. I believe HIPAA comes into play anytime you have access to medical info. I review the campers info on Friday (all regristrations must be in proir to camp time)for red flags- serious allergies, behavior problem, serious medical condition. I then determine who else will need this info: check with kitchen food allergies, but not telling what camper; epi pen use with the dorm counslers, DM with counslers. Also on Friday we have staff meetings and I'll go over any special items then also- s/s hypogly, KEEP THE KIDS HYDRATED, etc. I agree your time frame does not allow to setup meds, need more time. I know I will need to call at least 6-7 parents to question meds. Thank you God for cell phones as this normally is a process. Campers arrive with med info and ALL meds in original container. If info does not agree with bottle- parents receive a call. NO meds can be the dorms (Exception- inhalers, epi pen- if serious allergy and counselor holds the pen). Would not believe the meds kids come to camp (Xanax??) with and parents have no idea how they obtained the med I was trained by nurse who did camp for multiple years and we have changed some things. Still seems the best way is to use plastic bags with the med bottle in them. We take our list and meds to every meal. Campers come to us, we normally sit at different table, so would be difficult for some to tell what med another camper is taking. If a camper does not show we find them, but again do not tell what meds they did not take, only that the camper needs to see us.

LOL...herding squirrels, I love it and will use it.

I don't understand why the meds are removed from bottles prior to the campers being present. All meds brought to camp must be in original bottles. We double check the med, dose, and times with the bottle vs the consent paper. Any disagreements- we call the home. Any meds brought and not listed on form- call home (scary sometimes with what the kids bring). Meds not in labeled containers, are not allowed. Campers and counselors are not allowed to have ANY meds in the dorms (exception- asthma inhalers, also epi pens, kept with the counsler after education how to use, with severe allergies, ). We then use large zip lock plastic bags to store them (one bag per camper) in a plastic container and we bring the container when we pass the meds. The camper takes meds as we watch.

:lol_hitti Way too funny. My favorite was a co-worker falling asleep on the toilet. Woke up with elbow dents on her knees and a BIG circle on her...well let's just say gave new meaning to circling the drain.