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ER, Cardiac, Hospice, Hyperbaric, Float
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Leda1st has 9 years experience and specializes in ER, Cardiac, Hospice, Hyperbaric, Float.

Leda1st's Latest Activity

  1. Leda1st

    Frontier Waiting List for FNP?

    It's serendipitous that you posted this TODAY. Guess where I am? In Hyden at day 1 of Frontier Bound. :-) So, I did not get into the term for which I initially applied, but I DID get accepted the next term. Unfortunately, there really isn't anything you can do to speed the process or find out where you are on the list. But, if you are wait listed, that does NOT mean you are turned down for admission. It means you meet the requirements, but they only accept a certain number of folks each term. So, hang in there and keep hoping and hopefully next term you will be traveling to the KY mountains for Bound. :-)
  2. Leda1st

    Frontier Waiting List for FNP?

    I just got "wait listed" for the FNP program at Frontier. After initially crying my eyes out until I could barely see, I have pulled myself together and am considering what to do next. I read some of the threads on here about folks who have been wait listed, and some of the folks seem to have actually been admitted, so I have hope. I do have a few questions, though. In the threads I read, folks talked about calling and/or emailing to ask where they were on the wait list and things like that. They also talked about doing things like emailing and/or calling their admissions counselor regularly to inquire about their status. However, based on what I read on the "Wait List FAQ" page ( Waitlist Facts | Frontier Nursing University ), it seems that Frontier no longer allows applicants to do that. Obviously, I feel powerless just sitting here waiting to see if I am admitted, and I wish I could do something to help move the process along, or at least get a "feel" for my chances. Has anyone applied recently and had the same thing happen? Did you get into the program? Did you do anything beyond accepting wait list status and then waiting for a response? Unfortunately, I really have (had?) my heart set on Frontier for multiple reasons and I have not applied to other schools. I even took the Statistics and Physical Assessment classes that Frontier requires through FNU hoping that might help my chances. (FYI: Yes, I made an "A" in both classes.) Any feedback would be appreciated. Thank you!
  3. Leda1st

    Worst doctors orders ever received

    LMAO!!!! Actually, I think you posted this in the wrong thread - it should go under "Most BRILLIANT orders ever recieved!"
  4. Leda1st

    Worst doctors orders ever received

    ACTUALLY, funny as that sounds, it is a legit order when someone has severe scrotal edema. There is even a contraption (can't remember what it is called, sorry) sort of like a "sling" for the scrotum to elevate it. Seriously! BTW, this whole thread is just cracking me up.
  5. Leda1st

    Accuracy and Patient Safety vs Time Management

    I agree with the poster who suggested that you not float, at least for awhile. You should NOT skimp on your assessments (and I have noticed the same "oversights" from time to time in charting), but I think working in one area for awhile will help you get a better "rhythm" down and will thus improve your ability to be a thorough nurse AND good at time management. Little things like not being sure where things are on a unit (I float also) can take a LOT more time than you realize.
  6. Leda1st

    Something Smells (And It's Not the Roses)

    LOVE it! Sounds so very much like a certain hospital in my town - I'd almost put money down that you are writing about that particular hospital. It's probably the "purdy-est", most well-decorated hospital in town, but imho it also provides some of the crappiest MEDICAL care (although you will get plenty of warm blankets and a GIFT if you are upset about something). I fear the hospital where I work is thinking of heading in the same direction - and I hope I am wrong. Thank you for an article that was RIGHT ON!
  7. Leda1st

    More Hospitals Banning Elective C-Sections

    Anyone who has listened to the lungs of a baby born via c-section versus a baby born vaginally would know that VAGINAL is the best way - for baby and for mom. There are reasons for women to have c-sections, but convenience should not be one of them. (FYI: I went into preterm labor at 35 weeks gestation and I CRIED when they told me they were going to stop the labor - I was THAT uncomfortable! That was before I was a nurse, but when my midwife explained that my baby's lungs might not be fully developed and she could have problems, I quickly wiped my tears away and "sucked it up".)
  8. Leda1st

    Orientation question

    I personally don't see anything wrong with saying (diplomatically) that you felt you needed more orientation as a new grad. I'd rather have a nurse who felt she needed more orientation than one of those who thinks they know everything right away - those are the scary folks. Wanting adequate training is a GOOD thing, in my opinion!
  9. Leda1st

    ER Nursing vs Floor Nursing

    I am a "float" nurse, so I work everywhere, but I consider ER my "home" so to speak. ER is not all excitement and trauma - lots of people use it as a free clinic and come for the STUPIDEST reasons. Because of that, I like working the floor (as I became a nurse to work with sick and injured people, not deal with BS). Having said that, I love the adrenaline rushes when they occur, and ER nurses seem to have a sharper sense of humor, which I enjoy. I also like having the doc right there instead of having to page them, and it does feel like more of a "team". But remember, even in a Level 1 trauma center, it is usually "feast or famine" in the ER: either all BS patients, or all really sick folks all at once. You have to be ready to deal with that, AND be able to take report (from EMS) and pitch in to help/be a team at a moment's notice - those things don't seem to happen as much or as well on the floor. Best of luck to you!
  10. Leda1st

    Escorted out of the patients home.........

    *SIGH!!!* Although I UNDERSTAND why hospices have "marketers", it still leaves a bad taste in my mouth that Hospice is "marketed". It is a disservice, not just to the nurses (and CNA's, and SW's, and Chaplains) to "recruit" people that are INAPPROPRIATE for Hospice, but it does the patient and the family a disservice as well!!!! Hospice is not just a SERVICE, there is a PHILOSOPHY involved, and it is ESSENTIAL that patients and families SHARE that philosophy in order to get the services they need and want!!! If a person has stage 4 metastatic cancer and has been told they are terminal, etc., if they STILL want to "do everything they can" and go to the ER and try experimental stuff, and be hooked up to everything, etc., THEY ARE NOT READY FOR HOSPICE!!!!!!! There are people on this planet who will DIE before they are ever ready for Hospice - they will die long, slow, painful deaths, and they (and their families) will CHOOSE this! These folks need home health, long term care, or another service THEY DO NOT "NEED" HOSPICE!!!! I get so SICK AND TIRED of hearing from Marketing and from the ED that we "just need to educate the patient/family" when we get these kind of admissions. B*##!T! Yes, I think that education needs to be done, but at some point, out of RESPECT for the patients and families (as well as respect for the folks who work in Hospice), there are folks who, no matter HOW MUCH education is provided, WILL NEVER BE READY FOR HOSPICE! NEVER!!!! And these folks need to be referred to another agency/service to help them. Sorry, I know that makes the "census go down", but it's the RIGHT THING TO DO. I love Hospice, and I think it is a WONDERFUL thing (if I didn't, I wouldn't do it), and it makes me sad sometimes to see the choices that some folks make for themselves and for their family members - but I just have to DEAL WITH IT because that is THEIR CHOICE!!! And, as wonderful as Hospice is, IT IS NOT RIGHT FOR EVERYONE WHO "QUALIFIES" FOR IT PHYSICALLY! Somehow, there needs to be a way to educate and market to the public in such a way that the folks for whom Hospice can be of benefit, they get it - but without essentially forcing people to take/accept a service they don't really want. :spbox:
  11. Leda1st

    Really Tired of Fighting Hospice Ignorance......

    As a nurse who works PRN for a Hospice agency, and does Med Surg, Tele, and ER for a hospital (also PRN), I can tell you that the biggest thing I have learned is never to "judge" other areas of nursing. The friction between the ER and the floors is a primary example (I won't go into all the issues). I do my best just to educate people as best I can - to a certain extent. If someone were to use the phrase, "What kind of a nurse are you?" to me, I probably wouldn't bother to try to educate them. They don't want to hear it, because they are probably "always right" anyway. If someone ASKS me, "Why are/aren't you going to do that?" I will explain. One of the biggest things I get regarding Hospice is this attitude that I am somehow Kevorkian-esque. I personally don't advocate assisted suicide, and I make a point to explain that very firmly. And I always make sure to inform people (especially other nurses) that we are ALL going to die someday (including myself and them), and that I think we should ALL be able to decide if we want to die hooked up to everything (which some people DO want to die that way, and although that is not MY preference, I respect a person's right to make that decision) or to die at home as peacefully as possible given the circumstances of the illness. Somehow, reminding people that THEY TOO will face death one day can sometimes help with their perspective. Very few people that I work with in ANY setting say, for example, that they themselves would want to have a feeding tube placed - most people say they would NOT want that. And, as some folks in this forum have pointed out (and that most folks in Hospice know from experience), it is really, really hard to "shift" from the "saving lives at all costs" mentality (prevalent in hospital settings) to the QUALITY of life mentality that prevails in Hospice. After my rambling, I'm not sure what my point is anymore - I guess to say that nurses need to try to understand that different areas/specialties in nursing have different philosophies and foci, and we all need to try to respect each other (even if we don't agree with or understand each other).
  12. Leda1st

    Weeping legs and wounds

    Unfortunately, I am a newbie as well, so I don't have any good suggestions. I just wanted to say how creatively COOL the poise pad and diaper suggestions were! I would NEVER have thought of those! To the OP: I hope some of these ideas have helped.
  13. Leda1st

    End of life delirium?

    I wouldn't say it is "sundowner's" necessarily. In my very brief hospice experience thus far, I have noticed, however, that my folks with dementia seem to have most of their falls and their "episodes" of getting out of bed, etc., in the very early morning hours. This has also been the case with my folks with metastatic cancer (mets to the brain looks so much like dementia to me - I could be wrong, but as I said, I am still new to hospice). The doc I work with likes to give folks Risperdal at HS, although some of the nurses I work with (who have been doing this a lot longer) like Haldol better. Giving at bedtime helps them sleep through the night (at least that is the thinking - sometimes it works, sometimes not so much). I'm not sure if any of this helps, but at the very least, be reassured that it is not that unusual a behavior.
  14. Leda1st

    End of life delirium?

    Regarding the statement that opiods and benzos can also cause confusion: PLEASE don't hesitate, however, to use this if needed to keep your grandmother comfortable - try to figure out the best dosages and combinations to do this. I have a patient with mets to the brain that I am working with, and I had to have a talk with her family where it came down to these choices: let their family member be in pain, but not confused at times, or let her be confused at times but not in pain and not agitated? Hang in there - and I wish you, your grandmother, and your family peace during this time.
  15. Leda1st

    case manager turnover

    I am still very new to hospice, and our "veteran" nurse CM has been there less than 2 years. Yikes. I am planning to dig in my heels and stay for at least a year, hopefully more. I have already picked up on the fact that the agency I work for will definitely take advantage of you and "dump" on you if you allow them to do so, and this leads to very quick burnout. A lot of nurses seem to feel like if they say "no" they are somehow cold and uncaring or a bad nurse or something, and the agency seems to feed this. I have had to really struggle with being "okay" with establishing "boundaries" in this job. If I am not on call and it is after hours, I turn off my phone. I do my darndest NOT to work more than the 40 hours a week that I am paid a salary (not hourly) for (I have only succeeded in working about 42-45 hours per week, but I am DETERMINED not to get to the 50-60 that some of the nurses I work with are already into). I know that nursing is a "calling", but it is also a JOB. If I were asked to choose between my job and my family, I would choose my family with NO hesitation. If I quit this job, there will be someone there to step in and take my place. My patients "need" me, but I am replaceable. This is not so with my family - my family needs ME, specifically, not just "me", a nurse CM. I work with a few nurses who seem to take pride in the fact that this job has consumed their lives, as if they are a better nurse than me. Well, in some ways they may be "better", but in other ways _I_ am better because I am not as likely to become "burned out" as they are. I am not sure how it is with other agencies, but the general "feel" I get is that it is generally a widespread problem in this specialty. I hope I am wrong.
  16. 1.Ask specific questions about pay. I was quoted an hourly amount, and then told that I would be salaried based on a 40-hour week at that amount (I have YET to only work 40 hours, so they get the benefit in this case). 2.As for on-call, there are SEVERAL different questions: -What is the pay for just "holding the phone" whether you get a call or not? Some places pay hourly, others pay based on the census, others may have a different way to pay this. -When does the "clock start" for call? Is it when you leave the door of your home? Is it when you get to the patient? Is it when you get the call? Confirm the rate and make sure it is IN ADDITION TO the "hold the phone" pay, not IN PLACE OF it. -What if you need "back up"? How does this work? -What are the hours for call? (That is, what time does the "on call" nurse take over as the primary person to be called instead of the nurse assigned to the patient?) -How soon after you start (since you are new to Hospice) will you be expected to take call? You need to get a specific time on this (not just "when you are ready", but something like, "we expect you to be ready to take call after 6 months/90 days/etc.") -Do you get paid mileage for on call? What is the rate? 3. Obviously, ask if you get paid mileage what it is. Some places pay WAY less than what the Feds say. 4. Clarify how holidays are handled and what holidays you get. If you are salary, do you get paid holidays, or do you have to use PTO/vacation time for these? If you take call on a holiday, to get bonus pay and/or time and a half? How many holidays are you expected to work and/or take call? 5. Finally, I would ask what the typical caseload is at that particular agency. I know that every place is different, but with as much time as we have to dedicate to our patients, I think 12 is an "ideal" caseload, and any more than 14 or 15 is getting to be too much. This is a profession where you need to manage your time wisely and establish boundaries (in a firm but professional way) - although this is a "calling", when it comes down to it, this is still a job, and if you have a life/family outside of work. It sounds callous, but you will burn out quickly if you don't make and keep time for your family/self/life. It is a great profession, and I really do love it, but you DO have to make a living and you DO have your own family and life. Some places will try to make you feel guilty about this, like if you "really cared" you would work for peanuts and neglect your own family for your patients. This is not true. To be a great nurse, you have to be ready, willing, and able to give your "all" to your patients when you are working - so take care of yourself and your family/life so you will be able to do this. :-)

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