belfry

Belfry was the nickname my grandpa gave me. I was an extremely picky eater as a child, and once for breakfast I ate 2 eggs...unheard of for me....and he called me Belfry Two Egg after that. Weird, I know.

A bottle of wine! LOL. A gift certificate for a massage....a phone charger....Kleenex....those little toothbrush things, wisps, I think they are called....nuts or pretzels......water......a little tool thing with a screwdriver and a knife, cause you just never know....one of those little flip books about wound care....a good map.....

Good idea...but the guy had all scripts so prescribing was not the issue, and our MD never dictates what is covered, it is a nursing call. All good until we run into uncharted (LOL) territory, then the MBAs get their panties in a twist since the dollar signs are so big. because we all want an MBA and her niece the gum smacker in billing who thinks nurses are paid way to much to make those medical decisions.....

Thanks, everybody. Maybe this will get us a little help for next time we have a CF admission, so nobody makes the same mistake! Oh, I just realized I need to change my profile....I now have a big FIVE years exp, 4 of those in hospice!

Thanks...I had a Friday pm admit on call, one hour before pharmacyclosed...no meds at home, 6 weeks in pt, MD nor admin available for consult....had a bunch of meds prescribed on dch from hop....I approved most of them, as I had no formulary and so went with my heart and nursing judgement....so all lung meds, allpain meds, all digestive meds, all pancreas relAted meds..then got busted for over approving. Didn't help that the poor little guy passed 4 days later.

I work for a smaller hospice, and we recently admitted our first (and so far only) CF patient. I wondered if anyone out there has a list of commonly approved meds, I didn't have a list when I admitted and went overboard approving, because to me, all the meds he had seemed to be appropriate for hospice payment. I have looked online to no avail.

No no union here. And I am not asking for more than they were giving me, just to make it equal, if I am not getting the PTO, just reimburse me that same amount. What they are offering me is a ten percent cut for the same work!!!

I have worked for the same hospice as a case manage for 4.5 years....love it, love to patients, staff, and have good evaluations. Was full time, for the past 2 years part time /PRN. With the economy like it is, nobody has gotten raises ina couple of years, and mileage reimbursement is not great. But...good place, good people, etc... Anyhow, suddenly upper management decided I should be straight PRN. Well, i say okay, but if I will not get PTO I need to have my pay adjusted accordingly....which is 10 percent as we get one hour per ten worked. They wuss around for a week and then tell me they will give me 50 cents more an hour. i just stared at my boss, and he said is that not going to cut it? I just said "no" and walked away, i was afraid i would cry or cuss. Well now i feel like I just need to go, if that is what they think of me. i have been there longer than anyone except one other nurse, I take full time call tho I am part time, I do anything they need, work FT when someone is out sick or on vacAtion, do after hours stuff, and evidently all that matters to the powers that be is cutting corners. I am angry, hurt, and sad that i feel like I have to leave to keep my self respect. Responses???

I work hospice...and we have had several gay men work with us. No problem, ever...and we are in the rural deep South, with all that it entails! As long as we all do our jobs and help each other out as teammates, there is no friction whatsoever. I could honestly care less. The only discomfort occurred when my coworker was not comfortable sharing with us, and that made for an elephant in the corner...if you avoid the issue, or dodge it, it becomes fodder for gossip. And looks like you are ashamed or afraid of saying who you are. Is he?? Isn't she??? Just be straight (pun intended) with the facts, saves time and tiptoeing around an issue that should not be an issue! :redbeathe

no worries! as a home health/hospice, we see stuff like that all the time...usually the patient is so eager to get home the hospital nurse is rushed and forgets... Beth (psst..bethany, is that you? miss you on the mom group!)

On Old Olympus Towering Top A Famous Vain German Viewed A Hop (doesn't make sense but somehow I have remembered it for years!)

I learned by White on the right Clouds over grass (white over green) Smoke over fire (black over red) and poop in the middle (brown)

I was an older student, as nursing is a second career for me. I did one year med-surg tele on the floor, and then went to hospice. For me, hospice was a $3.50 per hour raise, add to that flexibility, no weekends, and no aching feet and legs, plus the pace is so much healthier 99% of the time. Where I work is flexible, when you see your folks you are done, as long as you keep your phone with you all is well.... It is rough emotionally at times, but look for a place that has good support for the staff and you will find that peer support counts for a lot. I, too, hated the "keep them alive no matter what" mentality that I saw at times at the hospital. But to be perfectly honest, I do miss the hospital too...did a lot more "nurse-y" stuff and I did like that....IV's hanging blood, learning about tons of different stuff all the time. It's all a trade-off, I suppose. But hospice works for me, now. And I do feel that what I do makes a difference, both to patient and family. Lots of time to educate and support.

Oh, for Pete's sake! Less than a year experience on ICU and you are an expert in dementia care??? Part of being a good nurse is being open to learning from others' experience and getting off your high horse occasionally to see that people who have been dealing with dementia patients longer than you have been alive just possibly may know a thing or two more than you. Before I became a nurse I did counseling on an inpatient geropsych unit, worked with HCFA on a grant with non-institutionalized Alzheimer patients, worked as resident care director in a LTC facility, and was on the board with the Alzheimer's Association, leading workshops for families with a new diagnosis and also led a monthly support group. So here is a news flash...what you read in a book last year and heard a lecture on one time does not make you an expert!!! Experience is the teacher here. You can benefit from the experience of others or you can wreak havoc in the minds and hearts of the most vulnerable of patients....whatever feels 'right' to you. :argue:

I disagree! I had a kidney stone earlier this year, and had 10/10 pain, vomiting, elevated BP/HR/R, the whole nine yards. I was given toradol + phenergan...didn't do a thing but make me drowsy...still in the same pain, still vomiting. No change after the second dose. After a bit they gave me something else (don't recall, was either demerol or dilaudid) Knocked the pain (and me) right out. So now I am concerned that if it ever happens again I will either have to be inappropriately medicated for an hour until the other drugs prove ineffective, or look like a drug seeker when I say, "Um, the only thing that worked was something that started with a "D"." Tell me that won't get me a special note in my chart! So be careful not to judge too quickly. I am not a drug seeker under normal conditions, but that pain made a true believer out of me...I would slap your granny to get drugs under those conditions!

This is not my story, but a good friend of mine was in nursing school in LA and as a student the nurses on her floor sent her to check the foley on a patient...turns out he was a VERY well endowed Media star...lol:lol2:

Here is a major screw up...still ashamed of myself and horrified at how simple it is to make a mistake. Had to get a urine specimen from a cathed pt, so clamped the cath, went back 20 minutes later and got my sterile sample, and sent it to the lab. Went on my merry way. NEXT MORNING right when I came on, her husband said to me, "She has not had any urine since yesterday evening, would you mind checking her out? Sure enough....had left the clamp on the tubing. Felt awful!!!! Unclamped her and got about 800ccs! Odd thing....the night nurse had documented 600 output....hmmmmm:uhoh3:

How about Toby Keith's "How Do You Like Me Now?" My daughter likes it before a big ball game....pumps her up! I also agree with Pat Benatar's "Hit Me With Your Best Shot"! Beth

EP is for electrophysiology, study of the conduction system of the heart. Another abbreviation that is good to know is EF, stands for ejection fraction, way to determone heart failure.

I live near Chattanooga, and it is really a wonderful place....warm but not horrible in the summers, rare snows in winter, mountains, less than a day to the beach, city close if you want it and plenty of countryside... We are about halfway between Nashville and Atlanta, same distance from Knoxville as well. Not the highest paying place, but then the cost of living is nice. Tennessee has no state income tax, either! Beth

Heard of it, but had never seen it happen ... until today. Had an MD get all excited when I decided to talk to him about adequate pain control for his patient: I had taken care of her for several days and long story short I believe her pain is (ignored) not controlled. (One percocet Q6 prn and this lady screams when we dress her cellilitis-afflicted leg, as well as move her horrifyingly 10+++ edematous feet). I mean this MD is hateful, and appears to just dislike this lady. Anyhow, I am trying to get him to address it and he starts up in his loud voice, ranting about how she is a faker and a baby, and when I hold my ground about the need for adequate pain control he takes me by the shoulders and shakes me a little and continues his rant about how when she is snowed and obtunded then I will be calling him whining that she is unresponsive, I see from the corner of my eye the whole staff including floats and clerks lined up behind me with their arms crossed. He backed up and said "I'm not mad at you, just frustrated.", so I responded, "I am frustrated too." After a little faceoff she ended up with some new orders...heh. Now this guy is well known to be a loudmouth and unfortunately unpleasant, but I was never scared and did not feel physically threatened at all (cause I could kick his scrawny butt across the nurse's station in a heartbeat!) but I was greatly heartened by my fellow nurses having my back! So for all the negative posts about backbiting, here is one on the other side. I have known the folks on my unit would cover me if I needed it, and stand next to me when I need it, but today I got real proof and it was a great feeling. Go us!!!:pumpiron:

I work on a med-surg tele floor, ratios 5:1 days, 6:1 nights, with 3 CNA's if we are lucky. We have patients with insulin drips occasionally, and no change in ratio to go along with... As for the CNA getting the accucheck, why bother as she will just have to hunt down the nurse to tell her what it is and then the nurse has to go adjust the drip, may as well do "one stop shopping" and get it done by myself!

I work on a telemetry floor, and we have 5:1 days and 6:1 nights. Some days it is a breeze, some days we should really be 3:1 with the acuity as it is at times.....

Had a lady push the call bell and ask to leave a wake up call! The clerk asked her, "For what time?", and she stated that 7:00 am would be fine. The clerk just laughed and told her that around here the lab comes in at 5:00 am and she would be wide awake long before 7:00!

I learned that if I have had a really bad day and am itching for a confrontation, the meanest doctor in the world (who is usually a poisonous troll) will sense it a mile away and actually be pleasant for the first time ever!!! LOL [EVIL][/EVIL]