CathiP

The hospital and home health agency I worked for both required flu vaccines. This is the first year the LTC facility I work for has. Some people just don’t want to have them, not that they can’t.

We currently test our residents on admit, 3 and 5 days after. Those with symptoms thereafter. For Covid and flu.

What is the current atmosphere on flu vaccines in LTC? Mandatory or not for staff? Pushback? Hospitals have been mandating them for years. This is the first year out facility has required them. How’s everyone else handling it with the rise in cases?

I, too, recently started as a new DNS at a small (67 bed) facility. I have 40 years of nursing experience in multiple areas (critical care, corrections, substance abuse, youth shelter, LTC). I was an ADON for 4 years at an 116 bed facility interim DON when the regular one went FMLA for 4 months, 2 years in a row. I feel I did a great job, my staff all respected me because I am fair and helped where I could. This facility is going to be 200% different. Younger population, a lot of behaviors. I am excited and looking forward to any advice.

In my faciltiy, the ADON's do the careplans. We do them quarterly and annually, along with new assessments at that time. Of course, if there is any change of condition, we do them again. The MDS coordinator gives us a list of who needs to be done. Sometimes we just did the careplan a couple weeks before but PT picked up the resident so the careplans have to be done again! The floor nurses do the admission assessments. The medicare residents have to be charted on every shift. Others, just when there is a change.

As a fairly new (4 months) ADON in a Rehab/LTC facitlity (and years since I worked LTC), I can say that our management is tops. So do the LPN's and RN's who work with us. Our DON has been at this facility only 2 years but brought it from 16 tags (some critical) to only 6 tags (only 3 nursing) and all were cleared in the revisit. We are "working" nurses. We answer call lights, put residents on bedpans and toilets, clean them up, etc. My staff wasn't used to that when I started and are quick to tell me the last ADON wouldn't touch a resident. All department heads take turns on call for weekends, even the Administrator. From reading the other posts, I guess I lucked out in finding the right facility who actually cares about the staff and residents!

I worked at a local hospital for around 20 years. Was making pretty good money at the end. Took a position as ADON at a LTC facility. The pay isn't as good (even in management) but the satisfaction is higher. Don't have all the "trauma drama" as in Critical care but am able to get to know the people I care for (even as ADON I get my "hands dirty"). I tell my staff "I'm a working nurse" and they respect that. It's not always about the money. Career satisfaction counts big!

Personally, I don't CARE about how the butt looks (although that would be a plus!). I DO care that since I started wearing the Sketchers (or now the "Champion" brand knock-offs--cheaper) I can sleep at night without the leg cramps keeping me awake. The shoes are awesome!!

And wrong you were. I start in two weeks, would take me sooner if my current employer would let me go early. Actually there are TWO ADON's and the DON in this rehab/LTC facility. I'm looking forward to it. Leaving ER with it's major click and 12 hour/no lunch shifts will be a dream come true!!

Don't know where you are in Indiana. I'm in Southern part. Daughter in law is graduating with ASN in May, can only find a job in LTC. One hospital not hiring, one only hiring BSN's. Starting pay somewhere around $19 to $21 an hour I believe. The hospitals here don't differentiate pay between ASN/BSN (yet) or areas (critical care vs med/surg). Good luck and hang in there!

I just interviewed for an ADON position at a 120 bed LTC/Rehab facility. I have very little LTC experience and it was 20 years ago. I've been charge nurse in a couple different units. Figure this can't be much different but it's GOT to be easier on my body than 12 hours at a flat out run!

Not in triage but in the room the patient told me "it's my stomach, I'm using it too much." Turns out N/V/D but who would know?!

I sympathize with you 100%. I've had that family!! Most of the time, after the patient finally transfers to the "Unit of Eternal care", the family can relax and they realize it was them, not you. That doesn't make it any easier while you're getting trashed but everyone deals their own way with death. These are probably the same family members who haven't seen the patient in years and are feeling guilty but taking it out on you. Don't take it personal. Just smile at them when you see them and ask how the patient is. Don't know if it's your first crazy family but I'm betting it won't be the last!

When I worked ICU years ago (back when the thump was still taught) we had a man who kept going into VT. The nurse would walk into his room and say "I'm gonna have to hit you again, Mr Jones."

How about the patient who had a tubal ligation on Monday (the usual labs including negative pregnancy test were done), did a home preg test on Wednesday because "she had it anyway", it came back positive so she came to ER insisting on a blood test.

And if we eliminate all non emergency patients, I will be out of a job!

I have a good friend who has been director of several ED's in different states. She has been telling me for years that I have an " ER personality". I finally made the transfer to ED a few months ago and realized she's been calling me a *itch all these years!

Check the Internet for "nursing unions". There are a few out there.

The hospital I have worked at for 20 years is attempting to become "Magnet" certified (accredited?). They keep saying that a Magnet hospital is a place where nurses want to work. I'm not so sure. We have been on this "journey" for a couple years. All I've seen it do is make people mad. Now we find out that all new nurses being hired must have a BSN. So all the people who are in nursing school now and will graduate this May with their ASN will not have a job even though they may have worked for the hospital for several years and are attending school on employee reimbursement. Even though Magnet says that nurse managers must have a bachelors in NURSING and most of them don't, they are only hiring BSN staff nurses. We have "shared governance" which seems more like "committee" governance. The rest of the staff gets no say in any of the policies. Does anyone work in a Magnet designated hospital and are they truly better than any other hospital? I always figured Magnet was what the insurance companies and Medicare wanted in order to reimburse. :mad:

Partial blindness with a migraine is an "aura". I get them before my migraines all the time. Migraines usually caused by stress or weather changes. In my younger days, I tried just about every (non-narcotic) drug there is. Learned to suck it up, go to bed with an ice pack in a dark, quiet room. Have worked with more of them than I care to count. Probably because I just LOVE to work sicker than most of my patients!

Sounds like you work at the same place I do. that's an exact quote! Are you Magnet? We're applying in June

And, apparently, in Indiana there is NO law protecting nurses from assault! You can't hit a EMT or a Paramedic but go to town on a nurse!

One morning, 2 different patients in with N/V that started less than 2 hours previous. "I called in sick and they wanted a doctors excuse or I would have just stayed home". And "I've been feeling a little short of breath for a couple months. The doctor said I have COPD" (O2 sats=98% on RA and smokes a pack a day) A wife brings her husband in with "chest pain" at least twice a month so she can go shopping. Just drops him off and leaves. When he gets tired of lying there, he pulls his IV out, gets dressed and leaves. My patient who got his thumb caught in a press and pulled it off had his buddies who were bringing him in stop by MickeyD's and get him a burger because he knew he wouldn't be able to eat when they did surgery to sew his digit back on. On my feet, on the run, 12 hours a day trying to keep up with 3 different doctors and 4 different patients with no chance for a potty break let alone lunch leaves me feeling a little grouchy. Then to have someone call me "mean" because I vent about drug seekers and visitors with the "wants" just makes it worse. We live in a "take a pill to feel better" society now. A place where instant gratification isn't fast enough. People want you to make them feel better without taking any responsibility for themselves and have no plans to change their way of life. People amaze me. I am new in ER but have worked critical care for my entire nursing career. In PACU, women would wake up crying in pain saying "my doctor said it wouldn't hurt!" to which I replied (to myself) "it didn't hurt HIM a bit" or "you let someone cut you open with a knife. . . it's gonna hurt!!" Or my favorite DKA pt arriving to the floor on an insulin drip "I need some phenergan and something to eat" then would get mad when a clear liquid diet was ordered. At this point, I'm too old to do something else and too young for retirement. But I keep my sense of humor at work and treat my patients right.

"And lastly, febrile seizures rarely cause any lasting damage, other than scaring parents to death. I find it questionable whether children should routinely be medicated at the first sign of fever just to prevent them. Again, I know you said you just had a bad day. But I also think all ER workers should remember that patients can and will vote with their feet based on word of mouth about ER experiences" Ever worked ER? If you have a fever, we will treat it. One patients mother brought her baby in with a fever because she didn't know HOW to give it tylenol or suction it's nose. Another mother kept calling me to the room because she didn't think the syringe pump was working because she "couldn't see anything in the tubing." and let her other child pull all the clean sheets out of the cabinet and get tangled in the EKG wires.