focusedvalpn

Well to each his own but I love them I have 5. Two on my wrist that no one has notice yet (4 months and counting) because of the watch and bracelet I always wear. My tatts mean things to ME I am a nurse because it means something to me to help people when they can't help themselves. I know people judge others but honestly people judge you on your clothes, car, hair, teeth, education, and etc. I can't control that so I don't worry if someone doesn't like my faith and serenity wrist tatts written in my hand not my issue. I've worked on the floor and in management and my tatts have not limited me. Now that being said I wouldn't go and tattoo my face but really you have one life be a blessing and live your life like you see fit. Someone is always going to have something to say one way or another.

"Look at me how do you think it went! My hair was straight, combed, my clothes were clean, oh and I I'm glad I did stop to urinate BEFORE I came here. They're sleep, fed, breathing and pain free have fun! " counts cart and walks off. Calls back " oh I typed report ....sorry it was crazy today" 12 hours from the 3rd realm of hell is all I can say luckily I did type report and my coworker was my regular.

Not medical advice my experience is what I'm sharing. I had something similar this year. I have never been positive on a ppd but I've had a lot over the years bc some facilities here won't use another facility ppd and I don't want to go to the hospital or wait for xray for hrs to come. Anyway I have developed an allergy/ to the ppd. I noticed this last time I had one. I had redness, crazy itching, and was swollen about the ez of a big lemon it looked like a spider bite very soft though. I Had to take benadryl but just do what the other poster said and do the cxr saves a lot of headaches. Ended up with a cxr and a new allergy listing from my md

Have u gone to the NC forum to see if anyone can help? I don't know where u are but here in VA u can take the iv classes and you can look into taking the class online to see if that will help you. Ask the NC nurses and check with the bon too

Because it is what is best for them and they get to say they did have the meetings you just didn't show when they find something wrong even when it wasn't covered of course

Be overly honest! I feel like if it doesn't make sense then it doesn't make sense. Oh and if you ask me to do the impossible and you ask if I can do it ummm I'm gonna say no or not now or not today but I'll get it done but I get the face. Working on controling my facial expressions even when I try if I'm pved it shows.... Oh I'm trying not tell people they are doing incredibly stupid things that they are are killing me or making my job hard I've offered to help but when my pt keeps getting skin tears I educate, say to come ask for help if they need it) or giving them that look ..... I promise my coworkers love me I'm not a pain but a work in progress they know me and laugh at me when the don looks at me like u really just said u can't stand on your head, put in a foley, and start 6 ivs, and start the feeding in the room I just left with the bottles there.... She just wanted to make sure I knew it was 30min before I ran out .. really is all I could say??? Oh and I'm tryin to tame my sarcasm

Psych consult for the xanax if you feel like that is not managing the issue in ltc u usually have that standing order. But if not notified the md of your concerns and let him/her know that u have a pt that u feel anxiety and pain meds are not seeming to control the problems and your observation r/t pain, meds, n comments and ur thoughts of abuse. Reminded them that he is a new admit so u may or may not have the total hx so ask the pt to fill in. Then let them know u would like a psych n pain management consults to help identify other issues. We all know depression causes/ exasperates pain so he may have some pain. But I'd let my in md know what I am noticing never just stop his meds if he has had prolonged use he needs to be weaned off. Ltc is very tricky for pain I had a man taking 50mg lyrica tid, 1mg ativan tid , 20mg oxycodone tid, 5mg ambien q hs all at one time plus percocet 10mg n ativan 1 mg prn q6. He told family he was in pain but told staff she was depressed n just wanted to get her high to get away. We reported it his md dc'd meds to bid n no prn and he got mad and changed md kept requesting to be sent out bc of chest pain. When the er md wouldn't give the meds he wanted and the new said no he and his family called state n he got them. Then when he went to .being so high he couldn't remember if he had stuff or care bc by know he all the old stuff plus fentyl patch 75. His family was mad bc she called them confused all times of the night. they dc'd the patch. This was a person who had documented manipulating behaviors but because he said he had pain he had pain. I think he did honestly have pain but the meds really did provide his with an escape. All we can do is provide the pt, md, rp, a nd administration with the information and document document document. I even refused to give the meds when he was out of it and was reported but bc I documented that he was out of it it saved me from state bc I had another nurse n supervisor document each time always at least one witness.

I've never tried this brand but I have flat feet n I pronate. Needless to say I can go through shoes like no bodies business and I love timberland hiking boots. The style I use is Men's Chocorua Trail w/Gore-Tex membrane it runs $130 on their site but in stores u can catch them on sale for less I paid $79. I've been using these for about 12 yrs I used to work in a speciality shoe store in hs and fell in love with them. I can stand on the cement floors we have in nursing for 16 hrs and get off and do it again with no worries and I have done 40 hrs of ot plenty of times in these. No swollen feet, aching feet or back, or burning calves. In these I can work my shift put on a 4.5 inch heels and not die the next day from my feet hurting in my work shoe the heel towards the end of the night is a different story lol. I have worn the same pair for 3 yrs b4 I replaced them. Granted I did try other shoes during but they were a waste of money and ended up being given away so I cut the total 4yrs to 3yrs. Plus they are waterproof aka urine/vomit proof, easy to clean, great for snow n mud, and they last and feel sooo good. And despite the look they are not heavy to me anyway the cloggs feel heavier.Another shoe is the Nike shox they are good and cost from 80-130 depending on where u get them. but they hurt my feet after a while but friends who don't pronate while walking had no problems. I know u asked for a certain brand but I have had no luck with "nursing shoe brands" thought is share what I know.

47000 salary no weekends day shift 7-4p m-f. took a pay cut for it though but if I have to come in and work about 32/hr for those hrs (time and a half) needles to say I don't work OT much. Was making 24hrly 3-11 ltc with every other weekend working short and stressed out no breaks

But don't forget the cost of living there. I know when I was looking to move there I found great paying jobs but the rent was outrageous in some areas then there were places similar to what I pay here in VA but less space. I know ladies there who are cna's and they made $17+/hr but when the came here they made 13-14/hr. But again they are paid well but cost of living needs to be accounted for where ever you go.

FYI for those who wanted an update I got the job put in my two weeks I'm so pumped!!

document behaviors, psych consult, notify MD, low bed, and floor mats. i had a resident like this and i told the um and don and they had to just tell him that a fall is any UNINTENTIONAL change of position so if you put your self out of bed they dont have to send you out to the hospital for no injuries and if you continue to do so we will make safe accommodations if that is where you would like to be. now of course we sent him out but it did work for a long while then we just reiterated when he starts up and comes back to the facility on the same meds. also send him to the same hospital after a while they will recognize him and catch on that always helps and call in report to them. my resident would crawl feet first onto the floor mats and lay there or crawl out in the hallway. and then say im grown i can do what i want to do then cuss us out to pic him up off the floor.

but when it comes to vac time i take what i want when i want but i do give notice ahead so im first in line. like now i have my vac for jan and may in and approved because i was first in line

i kinda skimmed through this kinda long so sorry if this is not that helpful, but if you and your friends wedding is next year put the request in now. then six months from the first date remind your don about it. That's what i did for my wedding despite the fact it didnt happen because of the hurricane when had here i was the first to put in the time so i had it off if i needed and i was able to reschedule with time off. but if at six and the time leading to it they cant find someone to fill that spot then you have your alternative. Plus the sooner you let then know exactly what you need the sooner the can hire more prn closer to the date to cover you and you have less chance of scheduling stopping you or making compromise. i find that if you are dependable and are a team player the more they will compromise with you.

yup when i'm gone i dont need them might as well keep doing what i've been doing and help someone else feel better:hug:

when my dad passed from CA in May I was really upset not only bc of his passing but I was supposed to get married this aug. > ( thanks to Irene the hurricane it was a no go) and he would not be there. one of my resident's told me to come here she wanted to talk to me because i had been gone for so long (4weeks) and she she had heard what happened and had guessed because i was gone longer than normal ( i drove 3hrs to go with him to chemo) and she said i know you are smiling because you are here and you might cry on the inside but dont let his passing be the death of you and your spirit. and then she asked if she could pray with and for me and my family and she told me how they had prayed for me at work. needless to say i cried a little. we had called off the wedding because of my dad's passing but rescheduled it after talking with her oh and some of my other resident joking with me saying i was an old lady i needed to get to getting married and having babies lol. I'm a daddy's girl and she said she was too .

VA it is 85 questions... thought I had failed when it shut off at 85 but I didnt

ok so I am soo there with you and the other poster I'll take a festering stage 4500 wound ANYDAY of the week instead of having to deal with phlegm!!! I just hate it!:sofahider I can't even breath if I have to give trach care, oral care- the spitting part, collect a sputum culture, or even swab a mouth idk what's wrong with me lol. I have a women with advanced sinus ca and the stuff that comes out of there is UNREAL. Not to mention she dementia so she likes to grab you after picking in there. I mean she has the most horrific mucus coming from there it's thick like a slug and feels like a spongy cord:barf02::barf02: you have to GRIP it to get rid of it. poor thing doesn't realize it's laying there on her lip so we are constantly as we call it "de-slugging" her.

Is anyone here working there on the east coast? Thinking about the hwc position no one ever really leaves this company here in my area.

Yea I hope it gets better the cnas n nurses are fantastically team work but there is only so muc:Dh you can do and take... Again thx

Ps nobody leaves this place it's extremely hard to get in their turn over rate is barely 1% for this building people retire there . I met a lady who lives there that worked there before she moved in. While I was waiting I met the receptionist of course and she lives there and works there too the first woman was telling me about when she trained the lady now working there.

Good luck psych! Needs I'm female and this position is still in my local area it's actually a hop away jump on the highway jump off and I'm there in 10mins with traffic. It's a health coordinator position in alf the atmosphere is awesome I've met a few people in other states in the position on other sites and the last person in the position who is retiring after 8 years in the position and 27 with the company due to declining health. Learned some of the challenging aspects seems to be universal with the different people in the position. But I'm super pumped for NEW challenges and atmosphere. It's day shift job but we're looking to start a family so day shift is best for us if this turns into what feels like the best place for me. It's not surgery but it's an area I have worked in outside of skilled ltc and enjoyed. So fingers crossed all smiles over here in VA finally. Plus they are matching my pay 50k and giving me the option of choosing pay per hr or salary too so long as I get the executive's thumbs-up per the director for health services I'll be in there. Any advice on which way to go? I'm thinking per hr bc there will be times I have to cover the med pass it's not a big deal to me I've done it as a floor nurse and a supervisor.

this is so funny to me my old administrator watched house and would quote of things she saw and turn around and say she saw it on house and that was supposed to justify everything she said and don't call the doctor... examples hey focused mrs smithwind says she is constipated she hasn't had a BM today can you give her an enema now and at bedtime and then tell them to give her one in the morning too. i dont want her to get impacted . mind you mrs. smithwind has had 2 BMs today and she obsesses about her bowels. and my all time fav. hey focus mr. adams is so confused i think he has a uti can you give him cipro? mind you no UA/C+S, NO MD, and he has an allergy mr. adams is 75 yrs old and in end stage alzheimer's disease and has thought for the last 4 years i have worked with him that is toothbrush is his walkie talkie or a knife he uses in battle to call for help or cut the ropes. smh priceless.. and she wondered why i just looked at her and then asked before i knew it if she was serious. ohh administration the joy they can bring when out of my presents lol

thanks everyone for the words of encouragement I had a wonder interview for a postion I really really want both interviews went fantastic one more to go then I'm on my way out!

Needshaldol Thx for responding I've got thick skin I also understand it's business if they don't paid neither do however respect is something I feel we always should receive. I know that a unions can't fix things all things anyway but I know that and I did have a horrible day lol. Buy what I mean is if I work 3-11 and I pass on a ppd on a readmit really no one else can do that especially when when 3 admissions at 9p then I still have 27 others to care for with on my set one that required one hr for tx. Plus the pysch pt that came from a locked unit from other places. I've been in nursing for over 9 yrs. ( I know that's a drop in the ocean for some of you) but I like to think I know the ropes pretty well so far but when. Come in to work to people fussing over little stuff or my don forgetting that her rn does not mean Dr It's a problem. When they say keep people in here until 12am so they get paid but the md said send them out. Or ppl having things amputated or worse bc of listening to them It's an issue. I send ppl out if they need it not bc I don't want to deal with them and they say I'm wrong the md says I'm right and the hospital stay, the state, my conscience says I'm right. All I'm saying is healthcare should focus on the health of people a little more and the outcomes as well as the bottom line. I know when I feel like I need help I go where my health is important. I refer ppl where their health is taking into consideration. I mean make money but don't let it be obvious that all you want is the money. I understand they have bosses too and a job to do but I've seen an know other nurses who have seen these same things all over the place. I'm a skilled nurse I love what I do I just don't like what it is starting to become. It could be I need a change from where I am to back in the md office for out pt surgery so I get the stimulation I like on skilled units.