Ephemera

Wow. Wish that I had read this thread before taking what I thought was the job of my dreams. Today, I finally ran screaming from a job that defeated me. Should have been two nurses, but they fired one, leaving me to work 70 hour weeks for months. On call 24/7. Constant pharmacy issues? Oh, you betcha. The day my daughter graduated from high school, the corporate nurse did me a favor and actually allowed me to have my scheduled day off...off. One of the biggest problems with Assisted Living is that "Protective Oversight" can mean so very many things. Acuity is going up, up, up...and the large ALF corporations do not want to lay out the money to staff appropriately. But if they can find a nurse with a stubborn streak and bad boundaries (like me) they can use her up and burn her out for the price of one nurse.

I recently went to a documentation seminar where the Q & A inevitably came around to State. The folks giving the conference tried to smooth the waters, saying, "Well, you know, state has a purpose - they are there to make sure that the care our patients receive .... blah, blah, blah." One smart ass in the audience piped up with, "With all due respect, terrorists think they have a higher purpose, too!" Bwah!

Hospice in my area will admit an Alzheimer's patient with a diagnosis of "failure to thrive secondary to Alzheimer's dementia."

One of the most important things that I learned as a new RN going through my first survey: Do not get chatty with the surveyors. They are not your friends, and are trained to remember everything that you say. Answer only the questions that they ask, and do not volunteer information.

When I started nursing school, I wanted to be a geriatric nurse, maybe even becoming a geriatric NP at some point in the future. My first clinical was in a LTC, and my clinical instructor told me, "The best and the brightest DON'T wind up in long term care." That sentiment stuck with me, even though making connections with the elderly is a particular gift of mine. After graduation I applied EVERYWHERE, but eventually got a job in a Memory Care Unit. Those nurse who look down on what I do should indeed walk (over 15,000 steps - I've measured) a shift in my shoes. Perhaps twenty years ago geriatric nursing consisted of only passing meds to warehoused patients - these days I manage care for twenty-five patients at a time. My patients have diabetes, congestive heart failure, heart block, wounds, broken limbs, broken hips - AND they're all demented. I fall into bed exhausted every night. And, ironically, the better I get at my job the longer it takes me to do it. Caring for the same patients day after day, managing their care and trying to give them the best quality of life that I can, and singing to them as they die. Loving them even when they don't deserve it. These may be the greatest challenges of my life.

My mother graduated from Mount St. Mary's College in 1974, and lost her pin many years ago. Any thoughts on how I might be able to get a replacement pin for her?