blinks

No, they don't. It is just a professional myth that people like to repeat because it is fun to say. Back in the day when nurses were handmaidens to MDs, the older nurses were burdened with resentment and bitterness which spilled over into their relationships with younger nurses. Nowadays, with the advent of collaborative practice, these poor behaviors are isolated to troubled individuals and do not qualify as a meme for the entire profession.

Failure to treat pain is abuse. Failure to assess pain is neglect. If the management of your facility does not take this seriously, does not intervene on behalf of the patients/residents, you may want to consider working elsewhere. I am certain your State Board of Nursing would be interested in this matter. The facility's Medical Director should be advocating as well. Communicate. Again, this is not a personality issue, this is abuse. In the meanwhile, why not share your assessments regarding specific patients/residents with the primary care physician and request routine, around the clock analgesia orders? Good luck.

I work on a surgical unit (primarily G-I patients). We average 3-4 days and evenings and 5-6 nights. 2 CNAs days and eves and 1 CNA on nights. I think this is a reasonable load for us.

After 10 years at a SNF, I returned this past year to acute care bedside nursing. When I left acute care at age 48, most of my patients were older than me. That was certainly the case in long term care but now most of them are younger than my 58 years. I am grateful for my health and I appreciate that my nursing skills now include the wisdom that comes from simply having survived this long.

Thanks. Sounds good. And I like the idea of peer reviews designed by a work group that I assume included line staff. Interviewing other staff as part of an evaluation is always dicey at best. This sounds like a good solution. Thanks again.

Hi, I am looking for an effective evaluation format to be used for our line staff. I am an Asst DON at a 50 bed LTC/Rehab facility w/ about 60 staff to eval. We are interested in linking annual evaluations to pay increases. Any ideas or online sites to recommend?

My first marriage was coming to an end and the local nursing program was converting from LPN to ADN curriculum and advertising for candidates. I thought nursing might be a good place to meet chicks. No joke. To my surprise, the work turned out to be unexpectedly gratifying. (And I have met some wonderful women along the way, too.)

Hi, I have been treating a chronic diabetic leg ulcer with negative pressure since January. Initially, the wound presented with exposed tendon in a 3X5 cm woundbed following a failed autologous graft attempt. The progress plateaued in March and the vac was removed with the tendon then covered with granulation and the size at 2X4 cm. The wound deteriorated and the vac was resumed in late April. It has now plateaued again and I am wondering if some other approach might enable me to finish this one off. The margins are rounding and I am thinking sharp debridement might be in order but the plastic surgeon in our community is reluctant to intervene due to the graft failure, the patient's unwillingness to stop cigarette smoking. We could probably keep her on the vac indefinitely to prevent regression but this is an expensive maintenance program. The problem is, as soon as the vac is stopped, the tissue becomes pale due to lack of perfusion and the deterioration begins again. Anyone have a similiar experience and success with an alternate approach? The patient has already lost her other leg to a similiar problem which was left untreated. She is only in her mid 60s and would suffer for many years as a double amputee. Thanks in advance for any advice.

and how cute is that?

I am a 54 year old male RN (will be 55 in July). I spent the first half of my 20 year career in med/surg & oncology and the second 10 years in LTC. To be honest, I am finally getting tired of working with women. Too old for the drama, I guess. Maybe being in management magnifies that issue. I am thinking 7 more years full time then maybe half-time after that. Depends on how the market treats my 401K. I came to this board to get some ideas for semi-retired work opportunities.

I was once fired from a job as a CNA for filling in all the "holes" with my initials. The surveyors were coming and I thought I was doing the staff a favor. Terminated me for "falsifying documents".

hi, i am new to board. i come with a question. i have been working for the same company for 5 years. during that time i have been promoted from med nurse to day charge to clinical care mgr to nursing assessment coordinator. this last position includes all the duties of the previous job plus m.d.s., care planning, etc. which goes with assessment job. during all of this i have received 2 "time served" raises and a wage increase when i took the clinical care mgr position 3 1/2 years ago. i have requested merit increase in wages for the last 2 years and have been shuttled back and forth betw the DON and Administrator who have played this good cop-bad cop game with me. now...we have a new administrator who has asked me to join a committee of co-workers to suggest a merit increase/evaluation format for licensed staff. i suspect that this is another form of avoidance. the truth is i don't care about changing the system, i just want a raise. all that being said, my questions: if i do join this committee, are there resources out there for researching the pros and cons of the merit system? is a merit system too subjective if there is no union to support the staff? what other issues should i consider? what questions should be asked of the administration?