guest2210

Family usually provides the alcohol of choice. If there is no family, the money can be taken from the patient's account and the admininstrator or other office admin goes to the liquor store and picks it up. At least, that is how I have seen it done over the past 34 years.

I can empathize...I herniated L4-5 and L5-S1 in 1990 and was disabled for 13 years. While working a part time receptionist's job got me in hot water with Social Security and they said I owed them $20,000.00 overpayment, they stopped my disability payments and I had no choice but to return to nursing. I was scared to death! In 2004, I returned and did pretty well, working FT, 12 hour shifts. Found a job that was 5 days, 8 hours, not as grueling and more assisted living than long term care. I've been an LPN for 34 years. If you have the option of going on disability, getting short- or long-term disability payments until SSD kicks in, if you file for it, it might be what you need to get back to 100%. With all of the injuries nurses suffer, this really shouldn't do anything to hinder your career, as long as you take steps to get back to being 100%, or as close to it as you can get. I herniated L4-5 again in 2014 after a discotomy and haven't been able to work since then, due to a chronic illness the surgery triggered. My first disability app was denied, as was my first appeal. My 2nd appeal is coming up. I have had no income in 2 1/2 years. Good luck with whatever you decide to do.

I see that your interviews were a few weeks ago. What happened? Where you hired by any of the 3 LTCs that interviewed you?

It's the same in Ohio as it is where BrandonLPN is. I've just had to call family, MD to release body-some places even had a standing order for that-heaven forbid we would have to wake a doc up in the middle of the night, the ME if a coroner's case, and the funeral home.

If your system tracks all users, when an audit is done, it will show that the nurses changed the diagnoses, thus leaving YOU open for possible sanctions. Some EMR systems do not give anyone access to the problem list other than the provider. Has policy been updated to incorporate what is and is not allowed with your EMR system? Take your concerns to the office manager. You need to CYA. Good luck.

I was pulled over on a 4 way stop due to a power outage affecting the stoplight, because I didn't fully stop. because it was so icy, instead I did a rolling stop. I was in uniform and received a ticket. On the way to work several years ago, I was pulled over for speeding and received a citation for 50 in a 35. So being a nurse, and having my badge visible didn't help.

I have navigated the Marketplace. Due to a few physical ailments, I am not able to work at the present time. In my case, I qualified for my state's Medicaid program. No cost to me, but I had to choose a MCP (Managed Care Plan) to administer the healthcare. After I choose my PCP and MCP, I was sent my insurance card with neither of my choices on there. They had chosen for me, even though I made my choices well before the date specified. The resolution involved calling the state Medicaid ffice and informing the CSR of my choices and then they sent me a new card. The differences I have noticed from having regular Medicaid versus the MCP is just about everything has to have a preauthorization, which will also get you a denial for whatever service you need to have done. I did a simple appeal over the phone to a CSR at the MCP, and the denial was reversed. It's better than having nothing at this point.

I train MDs, nurses and ancillary staff in Epic EMR. I started doing it when I got fired from the AL facility is used to work at. The pay is exceptional, but the field is becoming saturated with internal employees who get credentialed before the implementation, and then think they can do better as a consultant. Prior to EMR training, I Worked primarily with geriatrics for 26 years.

When I worked ICU a number of years ago, a patient had a BP of 260/140, hypertensive crisis. He was asymptomatic and was discharged a week later.

I was a TENS fitter for a podiatry group many years ago in Ohio. It was my job to instruct the patient on use and level of pain to increase as needed post operatively. The company that employed me wanted a licensed professional for the position.

I worked in a billing office and was supposed to be able to work from home when the new manager took over. Got a new desk with all the trimmings, then found out she lied to me about it. I typed " I quit" on the floating screen saver with a note with her name on it, on my computer, so when she came in, she saw it. When I worked in an AL facility, the director said he wasn't replacing any of the Care associates that left. While talking with the CA for my shift, and the day shift nurse, ( both friends, I thought) I mentioned to them that the director could do something anatomically impossible. The nurse told him and on my next scheduled day to work, I was called into the office. Once I confirmed to him that yes, I did say that to this other person, I was told my services were no longer required.

When I was in LPN school 32 years ago, there were several older students in there. One was 58 and laid off from a manufacturing job with no hope of getting called back. Another was a grandmother at 55. So at 38, I'd consider you a "youngster". Good luck!!!

Epic does have programs for iPhones and Android devices, where MDs can enter orders from their devices. Haiku is the program for entering orders. Canto is for iPads where an MD can review a patient's notes and labs as well as dictating notes after a patient visit.

Are the patients being neglected or harmed in any way? Maybe it's time to anonymously call the state for an inspection or the local Ombudsman to alert them of the dangerous nurse to patient ratio.

It's true what they say, if you don't use it, you lose it. Knowing the basics could be the step up you need to get into more acute units. Once in a unit, you would gain the practical experience of reading the EKG strips.

That is so sad. I had a patient with end-stage liver disease and ACTIVE AIDS. Family wanted everything done. He coded, went to ICU and coded at least half a dozen times and finally couldn't be revived 3 days later.

My first job was in LTC and the nurse-patient ratio was 1:50 for 7p-7a shift. Even when I did agency work at places I'd never been before, I had 25-30 pts with a new admission, and a transfer in from the hospital. So 30 pts. seems like a piece of cake.

There is at least one CNA like that in every place I have ever worked. I've sent a CNA home for her attitude towards other staff members. She did learn her lesson. (Probably the one that keyed my car...just kidding) LOL You need to talk to her first, let her know you don't appreciate her comments. Set boundaries-re-enforce that you are responsible for your patients and the staff assigned to care for them. If that doesn't help the situation, go up the chain of command. The RN supervisor on your shift then the ADON, if you have one, if not, then the DON. Is she jealous of your position? Does she aspire to further her education? Maybe she is frustrated with her current situation. Good luck.

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Some places, LTC, AL, actually like new grads with "no bad habits" . They accept their training as "this is how it is supposed to be done." No remarks or comments about how it was done somewhere else.

The assessment test might be something as simple as showing you have the ability to navigate places on a computer. You might be surprised at the number of nurses and physicians I have attempted to train that didn't even have basic computer skills. Couldn't use a mouse or use MS Office...all that does is make it a real long class for those with good skills.

Most postings that I have seen for Unit Clerks, the only requirement is high school diploma. Many facilities I have been in, once a new EMR is implemented, have done away with unit clerks or they transfer to CNA positions, with the exceptions being ICU, CCU, ER and OR. The best thing you could do is go to the web sites of hospitals in your area and look at their job openings. The job posting should include any requirements they have for the position. Then go, in person, to apply. Some places don't want to make the investment of training someone, only to have them leave after a few years. A facility may also have tuition reimbursement, which could help with your schooling. Good luck.

When I worked in assisted living, I enjoyed working as a CNA a few times. No pressures, go to the charge nurse with any issues, and still get my LPN pay.

Episode of care is used in some EMR programs to group all inpatient or outpatient visits under one specific diagnosis. For example, a patient is diagnosed as "pregnant" on an initial OB office visit. All related appointments, i.e u/s, labs, etc. are linked to the patient's pregnancy episode, generally lasting until the patient's 6 week post delivery office visit. Another example would be a worker's comp injury. All visits, PT, surgeries would all be linked to the worker's comp injury/diagnosis.

In electronic charting, there is very little need for the nursing staff to chart a progress note, IF everything they document in the doc flowsheet is there. They can even write a quick note in the specific row of the flowsheet on anything abnormal. Of course, a progress note can be done for anything that needs more extensive documentation.