rksgray13

Lost 2 jobs this year. Out for 2 months basically and now 4 months with this one. I have apps out, hand delivered resumes, Interview and offer decline with a long shot MDS at local NH, 1 interview with psych hospital. I was offered the job along with charge and diff, night/wked spot with shift diff, 15 min from home, pretty good pay considering, and just PERFECT. except for my childcare and school morning on mon. I was up front in the interview and with HR when offered the job. Childcare fell through and I scrambled only to fall short. they rescinded the offer. Still upset about that. This was halloween. 12 yrs nursing, 9 as LPN in offices, agencies, and specialty clinics. 2 1/2 yrs RN with majority in medical onc (as new grad), agencies, private duty, home health field nurse, and home infusions. Live in North MS and most work is out of Memphis, TN. So gas money, night shifts, 3 kids (second born first sem RN school, 3rd born 11 months after grad), SO drives a truck (also lost 3 jobs this year), 2012 sucks! The only jobs I see offering are dialysis, OR, travel, and hospital 12 hr shifts. Childcare is a big issue so exploring alternative sitters. We have a 5 floor hospital opening next year 10 min from home, a nursing home 7 minutes from home (applied her twice, 1 interview no luck), brand new assisted living 15 min from home, yet memphis is where the openings are. I did read a review very recently where they plan on raising mim wage to over $12/hr and the need to pay nurses more and hire more to reduce nurse-pt ratio. I agree. White collar hospital in a popularity contest line corporate pockets while less than blue collar (really) struggle and comprise their own sanity to survive day to day. Why does corporate get or need cushion while we do the dirty work? Take their incentives, cush, and perk/bonues and then recruit/keep your nurses. Boost on economy, happy nurses means happy work/home, etc etc. Look at exp and potential not friendship. Hate those "who you know" places. Let me in, and then we shall know one another. I have even thought of a masters in anesthesia, educate, family, and acute care then starting my own agency or practice. Work one, staff the other as an ower, and help nurses excel and love nursing as it should be. Thanks~ completelyfrustratedinms

I worked the medical onc for 2 yrs and this was my biggest challenge. And this is what I saw. MOST do not have a increased retic count, want their meds q 2-4 hrs with benedryl/phenergan rotation, do not want it diluted with NS, want it pushed fast, are fast aslee 5 min after calling for meds, smoke, do not eat right, do not stay hydrated or wear their O2, call early, get break through meds and narc suckers, blood transfusions, set their phone alarms for their next dose, and still want a last dose before wheeling out of their room. That being said and out of the way, there are a few that control, maintain, focus/channel, use less meds, and have far less visits to the floor. And I do understand staying ahead of the pain. What I really get disturbed at is why not use a PCA???? I have seen TWO, litterally, that will agree to it. Seems easier for them. JMO though. My education included that pain is subjective and will not kill you. So my prioritization would upset some SC pts on the floor. This is when I wonder about the PCA pumps. To get 2-3 SC pts in a group of 7-8 medical oncology pts with blood and chemo, meds 2-4 hrs apart (to the hr) makes a busy night and is frustrating to all. So anyway, I think benadryl is used both as an enhancer and an antipuritic in relation the pain med, which ever is their drug of choice.

I have looked into private nannies and sitters and they seem to cheaper than daycare but i also will put in hidden cameras. If I can link them to my phone that's next. And they cook, clean, do homework, read, everything a daycare does but at your home. Have you considered Home Health field nursing?? VERY flexible for the kiddos. BTW, this sounds like a bountiful franchise to start esp for 12 hr shift parents. I think it would be great for the economy. Not every person can land that m-f 8-5 job with no weekends or holidays. We have some 24 hr childcare facilities here around north MS.

Thanks for replyng everyone. Just curious

I agree the alert oriented patients DO need to play a part in their healthcare. After all it is their welfare. Evil? no I'm not evil. And I was just thinking how many things go by without notice. My questions would be "when was your dressing changed last?" if not noted on the site itself or unable to be read. "This is something we should clean and redress." Explain sterile to them and port of entry etc. Me, as patient without any knowledge, I want to know what could harm me and how I can play a part in my own care. I know when to keep quiet with sue happy follks but do know when to report. I wouldn't wave my arms around and go ballistic or say the day nurse had responsibility for this. That's harsh. I have first reactons or even without knowing I'm making a face with debriding a wound frolm last week (for example). I saw something somewhere that a central line dressing hadn't been changed in around 2 weeks and started thinking. I was thinking about home health and how things can go bad without proper patient awareness, rght?

I agree. I have been "MUM" and chart. If its severe enough I report. I know we nurses aren't perfect but our patients think we are. :)

So I was just thinking. I have seen this and witnessed a "mum" kind of speak. Personally, I acknowledge and education when faced with such incidents, be that as it may. When face with, for instance, any type of IV drg change that it LONG overdue, would you let your patient in on it? I have seen wound drgs, IV dsgs, and many other "boo boos" that have been more or less neglected from previous shift duties. I am quite emotional with my facial expressions and get pretty pi$$y with a potential for nosocomial issues. Nasty PICC lines drgs with dried blood and tape coming off. I tend to put an "attorney hat" on. Question after question to figure of the reason behind incidents and I will say to my patients, "this should not look this way or could you help make your caretakers aware when your drgs looks like... such and such?" And I chart everything pertinent. I'm not trying to blame or point fingers but these things are avoidable. I would want someone to call me out if it overlooked any part of assessment because any good attorney will if needed. The last thing I want is a patient with a nurse badmouthing their colleages or facility over this but rather that than a lawsuit for neglect or wrongful death from nosocomial infections or whatever. So are you "MUM" and just do the duty or do you speak up?

The company I worked for was very unorganized to say the least. However, I got per visit pay, mileage, office time, and hrly time in pt home past the first hr. Initial= 75/60, reg= 30, recert= 45, sup= 30, office and in home= 25/hr. mileage started at .50/mile and changed twice 4 mths after I started to .36 then to .32/mile. I was always checking to make sure I got paid for my work. the payroll guy missed things constantly and every time I asked any questions, I got run-a-round or different stories. Not to mention, home charting (paper OASIS) NOT PAID FOR AT HOME WORK, dr calls, new or pt problems throughout the day that would throw me off. I was one of two field nurses with the company having around 200 patients. I am 100% sure I was not paid for quite few things. I did like home health nursing and plan to return because it may ultimately be the happiest job I've had as a nurse. Just need a over the top company. This was my first job as a field nurse and had ZERO orientation. First visit was SOLO.

I did it and loved it. It was perfect for schooling I think. I would do shift work with my agencies. 12 hr in private duty homes and here's the pro's1. study time depending on your patients and acuity. Rarely did I go to a home that I didn't have free time2. my kids weren't with me ;)3. 99.9% of time there were CNA's4. no cleaning, no managers, no other family in home, 5. night shift6. no obligation as PRN but I knew when to say no and why7. pretty darn good money for little to NO stress8. 1 maybe 2 (at most) patients. Not an entire floor or group, etc9. Study Time10. STUDY TIME!!!!Cons1. morning after with kids, class, lack of sleep, or what-have-you's, etc2. that 0.1% of patients have have you feeling you just worked a floor shift with 9 high acuity patients. Good thing is you can request not to be placed there3. other employees chatting to you or their phone loudly4. NIGHT SITTERS for your children, if any, and having to pay them. Some might have a problem finding a night sitter. We survived during my nursing school because I could still work. I didn't have a set schedule so some weeks nothing, while some I worked 5/7 nights.

Update: Was scheduling the interview, came across cponflicts. Director of HR called me and offered the position for the exact amount I thought they would. I was very up front with her about my childcare and I would call ASAP no later than Friday. She was very understanding and "that is just fine. Look forward to hearing back from you." So now it all relies on IF I can make it work. Oh and I will Charge on the floor!

Yes ma'am and thanks for the input. The job is only about 20 mintues from my home and a straight shot from the interstate compared to a 45 drive to the city where most work. Benefits look acceptable not outstanding. Nurses and former nurses seem unhappy with the environment but I make my own at my jobs. And the pay cut, if any, would make up in gas and such. I do hve a back up sitter (family) that could possibly help out while I scout more permanent accommodations. I decided to go on the interview and talk with them some more. I will ask for at least a day to give my decision. My husband and I weren't working at the time I applied and he was to stay with the children but he landed a job a day before my interview. Decisions, decisions..... I do love working and need to have my time. As far as my experience with psych, I have an agency that sends me to an ALF with a lock down floor. Dementia, alzhiemer's, etc patients. I have experience with home health and oncology so I did inform them that while this is not continuous daily interaction with any psych I was not a deer in the headlights. I will see how it goes. I never intended thi outcome but I got a wacky hand dealt to me. Oh and an extra tidbit, this facility is where I had my clinical rotations in nursing school.

Welp decided to go on the second interview and ponder a little more

Over 12 years of nursing, I have applied to a local psych hospital 3 times. I finally get call back from HR wanting a 2nd interview. What goes on here? I don't recall ever having a 2nd interview with just HR. Now while psych will be a new experience (resume wise) I'm not just chomping at the bits to work in it. But I welcome every new opportunity to advance my mind and career. Having said this, I assume I have the position. The problem is the 4 opening are all night shifts and when I applied I was super needy of a job to survive. Childcare is my obstacle. Where it wasn't an issue when applying, it is now. The positions are 3 in a row 7p-7a. I am quite familiar with nights. So here's my questions... 1. What will happen at the HR interview? How long does it take? 2. If offered the position, is it polite to ask for time to get in order or confirm childcare to cover this shift? 3.My SO makes great money to support us and our recent financial obstacles are controlled. Should I go for the spot if offered or play the waiting game on the 8-5 shift m-f to accommodate daycare facilities? 4.From my research (no definite answer from the hospital), the pay is way off. Would it be worth it? 5. What would be some appropriate questions I should ask besides the obvious? I am asking all this from experienced nurses in this predicament, managers, psych nurses, and of course HR folks. Psych isn't in my top 10 nursing interests. I had pressure when applying but don't object to a position of such. The kids get to me. My heart is soft and I don't want to be depressed about work, ya know. This hospital has pre-adol, adol, and adult units. The told me they called me due to my adult patient care background but just might have to float. The place is very close to home and overall seems ideal. However, I don't want to get into this job and be forced to resign due to childcare issues or wages. WDYT??? I am n open book and will be VERY open to ALL comments. Thanks ever so much

It's ok to a point. We asked the visitors to step out to give the patient an "out" from making the visitor feel shut out. We didn't dicuss anything that wasn't obvious. We dicussed the plan and what happedned that day. We also asked the patient if they had any comments after. Out side the room we gave more info on the way to the next room. Plus we had those print out sheets with dx, iv and setting, wounds and location, precautions, allergies, etc. We didn't discuss these. It made report go by alot quicker and informing oncoming nurse that I didn't care about the goosip and non pertinent info. Personally, I think report went quicker plus the patient knew when shift change actually was and who the next nurse was. I always checked charts and history if I wanted to know more info.

Yes, 2012 from january 1st to present. Husband and I lost 2 jobs a piece this year, home facing foreclosure, filed bankruptcy a few days ago, cshed the pension, applications, agancy nursing, daughter in youth cheerleading, parents with serious health conditions, both vehicles breaking down every other day, a/c went out in March (finally got another one in and paid for), no food and trying to get assistance, depression, a kid with ADHD pushing us to the END of sanity ( no meds or health insurance), and all the while hearing "it'll be ok, You gotta get a job, blah blah", and keeping the home in "clean" condition. We got to a point, that we had almost everything in our home in the front yard to sell just for food money. I had the one job that made me HAPPY and no would wanted to accept that. I "had to be home or make more money or some other excuse" Now I'm facing the only interview at a place I do not want to work. Need money and it's close to home but will be my stepping stone unless something else steps up.

It's okay, you are not alone. I never want to go back there again. And it's NOT about the patients anymore. I went to home health and couldn"t love it more than anything else I've ever done. Someone wants or needs that position and would thank you if they could probably. I don't feel like a nurse at the hospital. I feel like a donkey, literally. I get piled with work and responsibility that I'm expected to handle in x amount of time and get called a jackass by the patients when they don't get the VIP treatment. I value my sanity and worth a little more than the white collar of #1 hospital. Florence Nightingale nursing should come back. Maybe more union nursing. That degree did not come easy and I will be damned it they try to take it from me that easy, like patient load. Oh my goodness, I've gotten on a soapbox. Hang in there. This doesn't mean you are a bad nurse. It says a lot more.

It all depends on what you work i think. I made the same actually. Sure I wasn't working 3 days a week BUT I didn't have to be up before the sun or have the stress of the dang hospital. I did what worked for my patients and I. My company was fairly small and it made it better for me I think. Now the other nurse needed a schedule. She worked 7:30a to 4 i think. Plus I would accept anything they threw my way. Whether it was a new admit, IV infusion, a wound care, on call, whatever, I knew I got paid based on what I worked. The sent me 100 miles at 9:30 at night for a new admit. I didn't mind cause I could say no i can't and that was it. This company CARES about ME and my family plus their patients. If the hospital were to ask me to work an extra 12, HELL NO! Because when I told the hospital that I could not take a 9th patient (oncology floor), they said "oh well, you have no choice." Really, what makes you happy makes a difference.

Right, I didn't ask for a loan or anything. I was just asking for pay from that week. I had $30 to my name on Friday. i used it for milk, gas, oil for the truck, and other essentials to make supper this weekend. I have a 18 month old, 4 yo, and 6yo at home. I was on call this weekend and had to come home early b/c i was out of gas and money. I missed 4 visits on saturday. Sitting here now wondering when or possibly how much I might get paid tomorrow to start my week. The payroll guy had all my work for the week up to Friday. His reasoning was "it just takes longer for me to put your stuff in the system." I told him what the situation was and his response was "well if that happens just call us over the weekend". I had completed visits and mileage for the week. I was flat broke. If they had said they could not do daily pay then I would understood that up front. I already feel shameful to have to explain why I need my pay. I guarantee this, I don't care what happens next time. I will not ever give my last dime to pay a bill. And this will start a "gas only" fund in my pocket from now on. I think its a good idea since I don't get a direct check weekly or biweekly.

good pop up here 1 hr after! everyone i talk to says it worked for them too.

They're usually good about giving me something. But this past week, when I ask for $ it's a pitiful little thing. For instance, I asked for something since the holiday was coming. They gave me 1 mileage reimbursement check worth a whopping $48! This was not going to last my family and I 3 days of living. I think the payroll fella was just a tad lazy to do it on Friday. He was more concerned with the private duty folks wanting a daily pay. And your right, their morgage was paid, dirving a fancy BMW, and buying tags and cars for kids.

Here's another question. Do you keep a envelope or something in your vehicle for gas money and other misc things? I should and normally do. I had to make a bill payment a week ago and have been struggling since. I was told when I was hired we could get daily pay. I submitted all forms thursday and asked friday if I could get something paid so I wouldn't be flat broke over the weekend since I was on call. They said yes and then turned around and couldn't or wouldn't help me out. Needless to say I saw one patient today and had to come home. I ran out of gas on the way home. Just wondering what you all do or what your agency"s policy was regarding this situation. I would think they want the field nurses to be able to get paid when needed. I also explained this to my DON today. Monday starts a new week and ... well... you get the picture.

Thank you!! Nail on head. That's something i was looking for exactly. I have been cutting my day short to spend some kind of daylight with my family. The company has PDN and home health and due to the lack of recerts turned in on time or them just not aware of the status, they have cut off the infusion referrals right now until it's straight. I think it all just built up and i released it here. I have tried different thing since i posted this. I have cut my visits down and spread them out. I have also grasped the concept of see the farthest out and work my way towards my house. I was not wanting to even come home after that last visit because it was such a long drive. I live at least 30 minutes from the city. So getting back home is a long drive. Its working out better. As far as the company goes, I cover my tail. Thank you all so much for replies. I'm sorry I snapped. I was also having some issues with a bill that had me on edge already. Truely I am sorry!

I'm sorry it's confusing. I thought I was giving enough information to get insight. Just "what do you think?" I have no experience in home health. It was offered and I took it. Is this unusual for home health or not? Is it just the company is small and that's what happens? The company is welcoming and willing in any way to help. I wanted outside opinion on the situation. If there is one. I can turn down patients at any time. But with the 2 nurses leaving so close together, I try to help everywhere I can. 2 field nurses for over 130 patients. The 2 office nurses help where ever they need to respectively. What upsets me is a response that makes me feel like an idiot. If I didn't love this position, I would have quit. The home health forum was the best place to come for suggestions since I know so little. I did put in the title what i was looking for along with more specific in the post. It's not big deal really. If its confusing, u have nothing to offer besides the obvious, or just plain can't relate, just don't comment. I appreciate the informative posts though, Thank you. Its hard to assess feeling or even write feeling for me so maybe i gave too much info in the post. I apologize for that. Its really not a big deal anymore, i think I just need to tell some one to get out my confusions.

It should be taken out. I have a QOD dsg change with this. It's applied feeling like the old calcium fiber packing and it absorbs the drainage making it more of a "wet skin/scab" texture.

Well alright. Some get it and some dont. and it seems I get the same type of answer for most of my FEW posts. so I'll refrain from now on.