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NCIANurse's Latest Activity

  1. NCIANurse

    How many do this?

    We cover 7 counties, my territory is at least 20 miles from the office, but I get paid milage. I see between 6-8 pt's per day (but last week hit my all time high of 12) we are on call from 4:30pm to 8am next working day, and we each do this 1 out of every 3 days. We are also on call Friday from 4:30 till Monday at 0800 every third weekend. On the weekend we see daily dsg changes, SOC, admits, etc. Right now if we are on call on the weekend we work Monday of week 1 straight through until Friday of week 2. They are working on implementing policy to have us take the friday before the weekend off, which would mean 4 days on, 1 day off, 7 days on. I'm TIRED, but the $$ is goooood, so I don't complain too often.
  2. NCIANurse

    Medication Reconciliation

    Our Med Rec is done on admission, recert, DC, and when a new med is added. Ours is like this: How we reconcilled (using hospital dc sheets, ect) allergies look alike sound alike (are they on metformin and metoprolol? how will they keep them straight?) how meds are stored. (away from light, heat, moisture?) high risk meds: coumadin, diabetic meds, etc. what teaching we've done to keep them safe, handouts given, etc. oxygen: if on supplemental o2, has safety sheet been done? back up tanks stored appropriately? duplicate medications potential interactions between current meds compliance of meds effectiveness of meds reported side effects
  3. wayyyy too low of pay to deal with this! I am hourly, get paid more than $20/hr, and get 55 cents per mile. This is the norm for my state.
  4. I case manage probably 25, my standard day is between 6 to 8 visits, does not matter if these are every 2 week supp visits or all SOC's. My manager really tries hard to make sure we nurses (there are 3 of us) each have a good mix of daily pts (like dsg changes), every 2 weekers, twice weekly, etc. I prefer cardiac/neuro pt's, another nurse prefers wounds, but we do get a good mix of all. Managing 40+ really depends on frequency of visits/primary dx. We've managed that many each at certain times, but when that happens alot of them are just weekly med fills, biweekly supp visits, etc, and when we get high on census my agency is really great about only taking referals that we can handle.
  5. NCIANurse


    I know I'm a little late, but what exactly did you want to know about a recert?
  6. NCIANurse

    Need reassurance

    I injured my back as an aid back in 2003 just carrying something down the hallway... I have horrible back pain everyday and need surgery to correct the pain, which the MD says will never completely go away. Protect yourself! As they say: "What do you call a nurse with a bad back? Unemployed!"
  7. I'm a nurse with LTC and M/S experience about to start my first HH position. I do have a few questions for the experienced: 1.) My company states that we should wear "Business casual" to our patient's homes. Anyone else have to do this? I was shocked, I can't imagine doing a dressing change, putting in a cath or drawing blood wearing my nice clothes? I wonder if this is a rule that they look the other way at? 2.) Did your company provide you with a bag? I see there's tons of threads on the right bag to buy, but do I really need to? Also, with supplies; I have my great stethoscope and my BP cuff... anything else I should buy that my company probably wouldn't supply? 3.) Do you feel you get a lot of clinical support when needed? If not, what do you do? IE: I've never had to draw blood, we always had phlebotomists that came in to do that, and I'm sure I will need to with my new position. I'm nervous to be out in the field and not have a clue what I'm doing. Any info you have would be great, I really want to hit the ground running!
  8. As a new grad LPN in LTC: $17/h. Same facility when I got my RN: $21/h. This is in Johnson County.
  9. NCIANurse


    I currently work at NHRMC.... pay SUCKS (about 3$ less than where I moved here from), I love the facility though. They just did a huge renovation, and it is beautiful, all private rooms, ect. LOTS of new grads very few experienced nurses though. Any other questions I'd love to be of assistance!:)
  10. NCIANurse

    Wilmington NC Area Salaries & UNCW FNP Program

    I'm interested in what you found out about WIlmington area salaries? I am a recent grad with LPN experience and I was just hired in Wilmington with a base pay of 19.95/hr. A little bit of a pay cut from where I moved from, but wanted to be closer to family.... I thought the pay around here was pretty low compared to may other areas, but I don't know if that is everyone's experience?
  11. NCIANurse

    Stupid things said by your non-nurse significant other

    Yes, however the exceptial part of the story was the dramatic spiking of the beer bag IV!:) Actually, this happens quite often. The treatment for delerium tremens due to alcohol withdrawal is alcohol, often beer. Originally Posted by kirkwoodLPN2009 My sister-n-law swears up and down that some guy she knew that is an alcoholic was on the verge of death in the ICU, when his wife came running in and yelled "he's not dying, he needs a beer!" so the Dr. spiked an IV bag of Coors and now the guy is alive and well! *I'm* the dumb one though because I don't believe her.... HA!
  12. I FINALLY had my first interview today for an RN position. I am a new grad, but I have my current LPN license and work in LTC. I have been applying like crazy to one hospital in particular where my husband and I want to move. I was on the phone with an HR rep for almost an hour last week and hung up feeling on top of the world! The HR woman made me feel like I was a prime candidate. I was called yesterday to schedule a telephone interview with a nurse manager on one of the floors I wanted most. I had my interview today, and I hung up with the worst stomach ache! I know the first interview is when you really have to sell yourself, but other than being asked a few behavioral questions, the nurse manager did all of the talking, without breaks for me to interject and *really* sell myself. At the end of our convo, I did manage to squeeze in "I'm very excited about the posibility of working on your unit!". However, now I have to wait 1 week to see if I'm one of 5 she's interviewing to fly down there and do 3 face to face interviews.... 1 with HR, 1 with nurse manager and 1 with peer panel. I for some reason feel totaly dejected, that after I FINALLY got the phone interview that there are still soooo many hurdles left to cross and I'm still 1 of 5!!! Waiting 1 week to find out if I even get the next interview might kill me!! So, according to old rules, you would write the nurse manager a card to say thank you. However, I cant find her email adress or even unit # anywhere! Could I send it to HR? And everything I read says to wear a "suit" to an interview. Now, I'm a very respectable person, but what 25 year old wears a suit nowadays? What is appropriate to wear for an interview in 2010?? Thanks for letting me vent!:)
  13. NCIANurse

    Stupid things said by your non-nurse significant other

    My sister-n-law swears up and down that some guy she knew that is an alcoholic was on the verge of death in the ICU, when his wife came running in and yelled "he's not dying, he needs a beer!" so the Dr. spiked an IV bag of Coors and now the guy is alive and well! *I'm* the dumb one though because I don't believe her.... HA!
  14. NCIANurse

    How many residents do you care for Per Shift?

    I would tell any new grad to stay away from LTC. Not that I don't love my job, I do. However, especially for a new nurse, LTC is the worst place to start (believe me, I know, it's where I've started). Long term care facilities are the second-most highly-regulated (and crucified) industries in the US behind Engineering Plants. For a new nurse that has little experience with making critical decisions, accurrate charting, correct communication, blah blah blah, this is the worst place to start out, and I wish I hadn't done that path. For example: A fellow new graduate of mine worked the night shift at my LTC facility. Resident had bed alarm as she did not understand the need for assistance. Res got up without assistance, without putting call light on, and attempted to walk to the bathroom. Bed alarm did not go off. Res tripped on cord attached to call light, fell, broke her neck. New grad nurse charted that alarm did not go off, that Res tripped on cord, ect. This kind of inexperienced (though TRUE) charting made her close to losing her license, because as charge nurse these things should not have occured (it's your job to keep paths clear, check alarms, ect) There are just too many things that can go wrong in LTC and your facility typically does not cover you in their insurance, so your A** is on the line every time you chart a single word! Not to be a debbie-downer, but LTC can eat you alive. I am so lucky to have made it 6 months as a new nurse without getting written up nor having a mandatory report sent in for something that happened on my shift.
  15. NCIANurse

    How many residents do you care for Per Shift?

    See, my issue is that we can't do that at our facility.... Say I work 1400-2230. Our meds are labeled and scheduled as "1430" "1500" "1630" 1700" "2000" "2100" and "2200". You can only pass pills 1 hour before or after scheduled times. Then you run across patients who have pills all scheduled at 1700 but one pill is labeled as 1700, but is labeled as needing to be given 30 minutes after meals. Well, if the Res doesn't finish dinner until 1830, then i'm out of compliance. I've heard of other facilities not having specific times labeled on meds, because some facilities have a policy against administering meds while Residents are at dinner. I'm not clear on how this works but something needs to change at my facility because the only way for me to pass my meds "according to state standards" and "according to good-practice standards" would be for me to hand off cups of meds to any CNA working that also has their oral-med tech certification and get them to give them to the residents... which would of course **** off/delay my CNA's in their work.
  16. "Go ahead, move back in with your irresponsible family that will end up killing you!" after my LTC res threatened to move make in w/ her daughter when I told her I couldn't give her 4x the laxitive that was ordered. She then threw her cup full of meds and a glass full of miralax at me. She spent 2 days with her fam over xmas and came back with a blood sugar of 506 (they never checked it a single time even though we sent a glucometer/insulin/syringes) and the dialysis clinic called and b#*$*ched me out about her not following diet restrictions (she steals funyuns and cheetos from other resident's rooms)