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Brekka ADN, RN

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Brekka has 6 years experience as a ADN, RN and specializes in Geriatrics.

Brekka's Latest Activity

  1. Brekka

    Price of Patient Satisfaction

    I work in a rehab/LTC facility, and the rights of employees is far outweighed by the rights of patients and families. We're told to refer to patients as guests, as if we're striving to achieve a 5 star resort rating. Anything they want, whether it's healthy, safe or correct, we're supposed to provide it, or at least try. Our admin staff emphasizes customer service over everything else. I agree we need to be as tactful as possible, but we're still in healthcare, and sometimes people just need to hear the truth. One of my very aware, continually educated diabetic patients will routinely be mid 300s-400s by lunch, because he has cookies, candy and soda at his bedside. When I check his sugar and he's high, he'll always ask, "Well I don't understand why I'm so high." He'll have 2-3 empty soda cans at bedside between breakfast and lunch. I've educated him on how his habits and lifestyle are the ones effecting his glucose levels more times than I can count. When confronting admin staff about it, I was asked what I could do to minimize his desire to eat and drink between meals, and make healthier choices. They tell us (nursing staff) that the patient is never responsible for what happens - ever. How is this acceptable? We are currently on semi-lockdown with an outbreak of noro. 15 people one side of the building have been diagnosed, and we're basically shut off from that side. We also ask sick family members not to visit, and it's a policy. We had a family member come in who was symptomatic with an elevated temp, who intended to sit in the dining room at lunch with their family member. Another nurse and I confronted him, stating our policy and making the suggestion not to visit at that time to keep their family member and others from getting sick. The family member had a very short fuse and started yelling and screaming at us, just in time for admin staff to come up and tell the family member that they could stay and eat with their family... in the dining room with 40 other patients. They then turned to us and said, "He gets mad easily, just let him stay. We'll make an exception." We've also had a mentally ill family member come in drunk with a baseball bat and threaten the staff because their mother wasn't getting any better (80+), and he nearly hit one of the nurses across the face with the bat. It was a big deal, a lot of chaos and drama. In the end we were confronted by admin and asked what we did to provoke them - the facility didn't press charges. For months a topic of the monthly staff meetings addressed what we did wrong in that incident, and how we were to blame for it.
  2. I had a funny, frustrating call at work today that was too good not to share. I changed the names, but the rest of it is factual. I'm still debating whether or not it was a prank, or someone was really truly having difficulty. This is between myself and another staff member (receptionist, no less): THEM - "Hi, do you have a private caregiver over there?" ME - "No, I don't." THEM - "No, do you have a patient with a private caregiver? I have Betty Smith here in front of me." ME - "Is she the caregiver?" THEM - "Yes, she's from Helpers." ME - "I don't know of anyone here who uses a private caregiver." THEM - "No, she's here looking for her." ME - "She's looking for the caregiver?" THEM - "No, she's looking for the patient." ME - "Who's the patient?" THEM - "Betty Smith. " ME - "Betty Smith is the patient?" THEM - "No, she's the caregiver. Is she here?" ME - "Who?" THEM - "Betty Smith." ME - "Is that the caregiver? Betty Smith is the caregiver?" THEM - "Yes, is she here?" ME - "Yes, she's standing in front of you." THEM - "No, the patient. Is she here?" ME - "What's the name of the patient"? THEM - "Betty Smith." ME - "No, she's not here, sorry." *click* Mind you, this all happened at the end of my shift during shift change, and the chaos at the nurses desk didn't help, but it was still one for the books. What are some odd conversations you've had at work, phone or not?
  3. Brekka

    Black Humour

    Truthfully, when I was a nursing student, I believed that the black humor I heard from the nurses was simply a burnt out nurse who needed to find a new career. I swore I'd never be like that, I insisted that since I genuinely cared about my patients, I would never do something like that. Black humor is definitely not something most students are prepared for, and they certainly don't address it in nursing school. Fast forward 3 years later, and I have a severe case of black humor. Luckily my co-workers do as well, so it fits. I make jokes with coworkers that seem dark and uncaring, I even think a lot of normally inappropriate things with some of my patients, but that does not mean that I don't care about my patients. That does not mean that I am not a good nurse, and cannot provide good care. All it means is that I've found a way to cope with the constant loss (I work in rehab and LTC, and can grow attached to my patients). Black humor even runs in my family. My mother was a paramedic for over 30 years, and my various other family members, from Air Force career, to school teacher, they all have a strong sense of black humor. A few years ago my grandmother died of a brain aneurysm, combined with coumadin therapy... it was not pretty. Her BP was sky high, 1/4 of her skull was filled with blood, and she was completely unconscious and unresponsive the entire time. We understood her wishes, and had agreed to make her comfortable and let her pass. She was admitted in order to die comfortably, with frequent PRN morphine (one nurse refused to give it because "the patient might die"). Family came in from all over the United States. One got leave from the AF to come, another drove all night to get there. With dozens of us together, we too used black humor to help us through. Black humor comments were common, such as "She was dying to get us all together, but she couldn't make it because she had a headache." This didn't mean that we loved her any less, or that her loss was any less tragic, but it was the way that allowed us to cope with the 4 days it took her to pass. This is one of the reasons that I will never look down on anyone for using it, so long as it's used correctly. If you can make it through your nursing career without a twinge of black humor, that's great, but that gives you no right to judge or ridicule those that use it. It does not make you a better nurse, or a better person.
  4. Patient: "I need another percocet, I threw up the one you gave me." Me: "When did that happen? Can I see?" Patient: *shows me a kleenex with some clear saliva inside.* Me: "I can give you some Tylenol." Patient: "No, that's ok, I'll wait for the next one." Patient: "My daughter said that I need to take a pain pill." Me: "Are you in any pain?" Patient: "No." Patient: "I think you need to get the doctor to prescribe me something really strong for pain." Me: "Are you having any pain?" Patient: "No, but I have a buddy whose cousin had something like this once, and he said he had a lot of pain."
  5. Brekka

    Why do you think nurses leave the profession?

    I see that you've gone ahead and made the assumption that nurses who complain about legitimate concerns have done so without any evidence or conclusion. I'm not denying that some nurses complain and don't take action, but I do get irked when people assume complaints about working conditions are unfounded, and require excessive effort to justify their concerns. Power point presentations shouldn't be required in order for management to address concerns, especially when those concerns are well know, and simply overlooked or ignored. These same concerns put their patients and facility at risk, and should not be taken lightly. The patients are our main focus, and they are the reason the facility exists, so there's absolutely no point in ignoring the issues that threaten them. There are massive amounts of peer reviewed articles supporting safe staffing and workloads for nurses. In 5 minutes time I was able to find a multitude of articles supporting safe staffing and workload, as well as those on effective management, communication, and professionalism. There are even countless news articles on the subject, for instance: http://www.cnn.com/2013/11/12/health/ohio-nurse-worked-to-death-lawsuit-says/ , http://www.cnn.com/2010/OPINION/05/10/brown.nurses.week/ . It's obvious, and has been for years, that these issues play a vital role in patient care and recovery. Management where I work, as well as others, are very well aware of the issues, and the many solutions available to combat these issue. There's usually no sense in beating a dead horse, but in this case continuing to air concerns, be it through complaints or suggestions, is the only way things will change. Reading from your response, you seem to have assumed that I too have not taken action. You feel I've done nothing but complain, without taking responsibility and making an effort to change that. Again, you are wrong. I have done everything you've mentioned, and more. Three of my fellow floor nurses and I have in fact charted our daily duties and routines down to the minute. We have charted the amount of interruptions that we received each shift, the reason for the interruptions, and the negative impact they have had on our work and our patients. We have compiled this information and presented it in meetings, to corporate, and to the state. We address it monthly, with updated articles and evidence to support it, as well as lists of solutions. Through investigation, no fault is found, and no changes are made. This is mostly due to the fact that the nursing staff care a great deal for their patients, and refuse to give any less than 110%. The fact is that the staffing and workload are doable to some extent, though it is at the expense of their staff and patients. The quality of patient care shouldn't end at "acceptable" levels, it should go well beyond that. Management has shadowed the floor. Management has also worked the floor, and still does when necessary, and absolutely despise doing so due to the issues brought up in this thread. Believe me when I say, they are fully aware of the issues, but continue to state, "I know it's bad, but that's just the way it is." It comes down to the dollar, and how to make the most profit. Why do I stick around? I care about my patients and residents. Not just for them, but about them. I was called to be a nurse because I care about the health and welfare of people I know, I've never met, and those I will never meet. I put forth my best effort every single day in pursuit of enriching lives, and supporting those who need me. I am passionate about this subject as I see the negative impact it has on those around me, whom I work with and care for. I have seen so much unnecessary suffering and death, all due to the need to profit off of the pain and suffering of others. The human life these days is only worth what insurance will pay. Just this morning I lost one that I had cared a great deal for for many years, I was even the one who had to pronounce her. The death was unnecessary and avoidable, and took place because my facility sacrificed her well-being for the sake of money. Though it's impossible to prove it, the nursing and care staff see it clearly. Unfortunately this isn't the first, nor will it be the last. So yes, I will complain, and I hope many others complain as well. We will complain daily with our every last breath until these legitimate concerns are addressed. In the end, some will give up and leave. Like watching a mass slaughter and being helpless to stop it, you just can't take that kind of stress forever. I'll assume you won't read this far, so here's a potato:
  6. Brekka

    Why do you think nurses leave the profession?

    They do, at least once a year when State comes. Twice if corporate visits.
  7. Brekka

    Why do you think nurses leave the profession?

    For me it comes down to 3 big issues: Staffing, workload, and management. The sad thing is, even with mediocre pay, if these three areas improved, the retention of nurses would rise. Not enough staffing leads to increased workload, which weakens nurse-management relations. For example, I work in a rehabilitation center where I'm responsible for everything for 26-30 patients. I work (in theory, I was hired for) an 8 hour shift, 0600-1430. In this time all of these patients have 0600 medications and 0900 medications, half have 1000 or 1100 medications, and about a quarter have 1200 medications and 1400 medications. About a quarter are on PRN narcotics every 4-6 hours, and request them frequently. I have 6 AC finger sticks (I'm responsible for these), and weekly lab draws (also responsible for). Currently I have 8 dressing changes, one that takes upwards of 45 minutes. I have 2 IVs with medications due at 0600 and 1400. I have 6 foley catheters and a PEG tube. I have 6 wanderers who are high fall risks, 3 tissue-skinned patients who get wounds by simply pulling down their shirts, and 4 anxiety ridden COPD patients who work themselves up several times a shift and require frequent attention. Throw in there 3 unnecessarily needy patients who are on their call light a MINIMUM of once every 20 minutes - that's right, for two weeks straight I have timed them. With all of this I get 2 CNAs. I also have to hand write a DAR note on each patient, and chart vital signs in 3 different places. If I'm lucky and find a bruise or other injury, I get more paperwork. Or with even more luck, I have an admit roll up to my desk without orders or a doctor. This is an example of my day WITHOUT the toast. What is toast you say? Toast is a facility term we use to refer to the little interruptions to our days, coined when managements solution to meals running late was to have the nurses run coffee and butter the toast. In the end, management gets upset that we're going over our 8 hours. We tell them how unreasonable the demands are, and their continued response is, "It has to get done, just try harder." This is the same management who get hourly smoke breaks and a full hour lunch. You try and explain that it wasn't possible to take a lunch because your 0600 med pass ran into your 0900 med pass, which ran into your wound care and noon med pass, which was interrupted by a patient with chest pain and shortness of breath, which was interrupted by Mr. Smith's request for a stool softener 'right now', which delayed the 1400 medications and 2 Lortab requests for mild pain, which was also interrupted by pesky shift change - but it's never heard, and the same issues continue. So, there's my personal 3 issues with nursing with examples, though I do acknowledge that nursing differs. Part of this was a response, but part of it was also a rant, so kudos to you if you read the whole thing.
  8. Brekka

    Dealing with calls from work

    I have a special ringtone for calls from work (Exorcist theme fit well) and I just don't answer it if I don't want it. For my first year, I volunteered and worked so much overtime, I burnt out and pretty much just refuse everything now. Don't feel guilty. It's great to help out if you want to, but unless your ran your coworker over with your car and then refuse to cover her shift, you have nothing to feel guilty about.
  9. Brekka

    State Surveyors

    Definitely one of the most stressful times working as a nurse. Always puts me back into the mindset of being in nursing school where I second guess a bunch and get intimidated. By far the worst survey we've had was when state came for their survey and we were in the middle of a NV outbreak with 70+ on isolation, short staff due to NV, and were exhausted working as many hours a day as we were allowed to make it through. Good news is we made it. Oh, and yeah, state is in town and we are in our window. Rumor has it they'll be there on Monday...
  10. Brekka

    Sometimes I just feel terrible

    Hello, welcome to AN! You've worked at a nursing home for 8 years, was it as a nurse or CNA? 8 years is a long time, what made you want to leave? I had worked at an Alzheimer's unit as a CNA long ago for several years, and decided I wanted to become a nurse so that I could do more for my patients and spend more time with them. Unfortunately I learned that although I do get to do more for my patients health wise, I actually lose the time I get to spend with them. Nurses don't necessarily have time to bathe and dress patients like CNAs do, that's why we have them. The higher up you go healthcare career wise, the less time you get with your patients. And yes, hospital nursing is very different from nursing home. Working in LTC/Rehab center I see the difference well. While I may have up to 3-4 times as many patients as I would have in a hospital, they're generally not as sick as they would be in the hospital (it has and does happen).i enjoy the fact that while I don't get to always spend a lot of time with them, I do get to see them for a long period of time and get to know them more than I would a patient staying for a few days. I do get to feel connected with my patients and their families in this way. Although it doesn't help your time issue, it may help you get to feel like you connect with them more. I did my preceptorship in a nursing home while in NS (apparently not a lot of students want this), as I hated any kind of hospital nursing. I enjoyed where I worked, though it was too far from my house to consider full time after graduation. Once I graduated and passed my NCLEX, I applied at nursing home and rehab facilities in my area, and got employed right away. I still do most everything a hospital nurse does anyway. Few nurses really want to go into geriatric care, but it is at some times more rewarding than you could get from any other area in nursing. Again, you probably won't connect with your patients in the hospital the way you would in LTC or rehab. Not being cut out for hospital nursing doesn't mean you're not cut out for nursing, you just need to change the scenery and try a different area. If you're willing to look around and try other areas, you may find just what you're looking for, and why you were called to be a nurse.
  11. Brekka

    Working as a nursing student

    I'm assuming you're referring to working in a health care role as a nursing student, and not Starbucks on the weekends. I did not personaly work while in school, but remembering back to my first year of practice, I can spot some negatives and positives that may effect you in school. Also, you may get more responses from other SNs in the SN section. First and foremost, the benefits. The biggest benefit that I can see would be the patient interaction, and actually becoming comfortable with patients, bodies, and bodily functions. Unless you've worked as a CNA before, or some other similar role, being able to comfortably approach and interact with your patients is something that gets easier with experience. I've noticed my students tend to be shy and reluctant to go in the room and assess their assigned patient, much less talking with them about their bowel movements or other embarrassing topics. Being able to work with people with a sort of calm confidence takes some time and experience. Learning new ways to do procedures, organization and prioritization, and getting an up front look are some benefits (these can also be a negative as I'll explain later). Also, actually seeing and caring for people with issues you've read about in books or lectures helps to cement what you've learned already, and may bring up some more questions that you'll want to research later that can only help you later on. Now along with the positives, there are some downfalls. As I mentioned earlier, learning new methods to procedures may also be a negative. Nursing school crams a lot of information into your head in a short amount of time, and trying to remember everything is exhausting. Now throw in a new way of completing a procedure or two, and it's easy to get mixed up and miss something. It's sort of like learning how to run without learning how to stand first. Usually the methods taught to you are basic, and usually they're the easiest and safest ways possible, and new methods could prove more detrimental at this point in your career. Another negative that most student nurses aren't prepared for is seeing how nurses function throughout their day. You may see them in passing throughout your clinical days with your instructors, but actually working with them for an entire shift is very different. First, some nurses have developed bad habits, short cuts, or cheats, that can be negative to adopt, especially in school, and some may not be safe. It's scary, but it does happen. Nurses are human, and our responsibilities and job duties increase every day. We are fallible. A big downfall is the exposure to dark humor. This is a normal everyday part of nursing, and it can hurt or offend you if you're not familiar with it. When I was a student and I experienced it, I told myself I'd never be like that, that it was horrible, and the nurses who I encountered it with must have been bitter and mean people. There was no way I was going to be like that. Alas, it didn't take long for me to learn that it was one of the best ways for nurses to cope with the amazing amounts of stress we experience every day. Heck,the only way my family made it through my grandmas passing a few months ago was through dark humor, to which we this day still joke about. While there are many more negatives and positives, I had tried to go to bed 4 hours ago and am failing in my ability to make sense of what I'm writing. In the end, if you do decide to work while in school, talk with your instructors and question them on any concerns you have. If you were in fact referring to working at Starbucks on the weekend I can't help you, though the free coffee may make it worthwhile.
  12. Brekka

    How important is your 'look' as a nurse

    This is not about the health care professional, it's about the patient. I could afford to lose about 20 lbs, but at the same time I'm well aware of the risks and how to reduce them, I just don't. The same can be said for most other overweight health care professionals educating a patient on a healthy lifestyle. Patients come in to the healthcare system because problems arise that they want to learn about and have treated. If I get a patient who is overweight and they ask me what they can do to manage or improve their DM, aching joints or shortness of breath, I'm going to educate them on a healthy lifestyle. My life choices have nothing to do with why they came in, and the education would be the same whether I was a supermodel or obese. Yes, it is best to lead by example, but I'd also rather talk about weight issues and options with a healthcare provider that I can identify with. This may just be me, but being able to identify with and be willing to work with your provider is more beneficial than working with the image of perfect health. Healthcare education isn't sterile. Patients and doctors will need to connect to ensure optimum results. Being overweight and receiving healthy lifestyle education from a toned, healthy person may seem more like criticism than actual concern, and it places the patient on the defensive, leaving them less likely to hear what is being said, and possibly unwilling to seek help for other issues. Not following your providers professional advice because "he's fat too" is simply an excuse for your own faults.
  13. Brekka

    I'm not the doctor!

    While I do agree that nurses should be respected for their knowledge, and acknowledge their own achievements and abilities with a sort of professional pride, I don't necessarily agree that statements such as the one in the OP are subservient. I tend to say things along this line frequently, but I am **** proud of what I have accomplished and my role in the healthcare system. Statements such as "I don't want that much responsibility," or even "I'm just a nurse" should really be taken at face value only. What you heard may not be what was intended. CNAs don't have the knowledge or training that nurses have. I've heard CNAs in my facility outright state frequently that they didn't want to go on to nursing school because they didn't want the responsibility that the nurses have. That doesn't mean they aren't knowledgable, capable, competent, caring professionals, or that they are in any way lacking intelligence. They simply, "don't want the responsibility." The fact is, like CNAs to Nurses, Nurses do not have as much responsibility as doctors do. We do not have the training, knowledge, or experience that doctors do. We are knowledgeable and well trained in what we do, but we are not doctors, and should not be expected to be. There is increased responsibility with each step up the health care ladder, and that additional knowledge and responsibility should very well be acknowledged. Pharmacist, doctor, nurse, CNA, social worker, etc... We all have different roles to play, different responsibilities, and are all very important in achieving the best patient care. Lose one and everything changes, and patients are put at risk. Some have more responsibility or knowledge than the others, but that doesn't make them any less important, and it shouldn't be looked down on to acknowledge the differences.
  14. Brekka

    I feel like a glorified maid

    I completely know the feeling. I went into nursing because I love helping people, and I genuinely care about them. That's all we heard in nursing school - how wonderful nurses are respected, and how much they're there for their patients. Unfortunately I learned that that isn't anywhere near the truth. I work days in a rehabilitation center, and I'm responsible for between 24-28 patients (depending on our census, though never less than 24). I work with doctors who think I'm an idiot, and belittle my suggestions and input, and then turn around weeks later and implement what I had already suggested as their own idea. It's commonplace for management to bad-mouth us floor nurses, insinuating that we're lazy because we can't care for 28 patients, answer phones, deliver meals, fix coffee, chart, finish admits, and handle various fires that ignite over an 8 hour shift. Recently we've been having difficulty filling empty beds, so without any thought to the capabilities of the staff, they admit anyone and everyone who can pay. In a 2 week period we received 3 patients who all passed within 4 hours of admission, before some of the paperwork was even complete. Another patient we bounced back to the hospital within the first hour of being admitted, after we had discovered that they were septic, and they were admitted to ICU. Another was boasted as an easy patient, though we soon discovered after admit that they required a 24/7 sitter, and we struggled losing one of the few CNA's we had to watching them. Some days the doctors come in and scold us if we didn't know that they had a cough over the weekend, or a scratch on their belly. Some days I feel bad not being able to answer the health questions the doctors have for me, but by God I can tell you what they like to eat, that their biscuit was too cold this morning, that they wanted corn flakes instead of rice krispies, how they like their coffee, and that they mask their 10/10 pain with a relaxed expression, smiles and laughter. I can explain to the doctors why the patient isn't making any improvements, not participating with therapy, and be accused of lying, "That's not what the patient tells me." Any concerns my coworkers and I bring to the attention of management is met with, "Well, that's the way corporate wants it, so that's the way we have to do it." Nursing certainly isn't what it used to be. It's a business, unfortunately. I've decided that unfortunately my mornings will be spent bringing my patients percocet, and coffee with 2 creams and one sugar.
  15. I am doing some research regarding benign stroke symptoms in the elderly, and thought it may not be a bad idea to stop here to see if anyone else has experienced this. I am still a new nurse, a few months away from my second year, and I work rehab and long term care. So far in my year and a half of experience here I have seen this three times, all three in females over 60 years old. I don't want to provide a whole lot of information here that may put me or my patients at risk, so I'll give some basic information. Present in each case: Female over 60 Rehabilitation patient Independent wheelchair use, walking with therapy Social with others Alert and oriented x3 All three cases have a completely different diagnosis, and no similarities in medications or medical histories. Case #1: A rehab patient who is alert and oriented, independent and social. She wheeled herself all over the facility, loved to chat with anyone who would listen to her. She loved her therapy, and was progressing well. No difficulty talking or swallowing. She was like this when I left work on Friday, however when I returned on Monday I found a completely different person. I found her disoriented, slumped over to her right side with general weakness, more noted on the right side. She had notable right sided facial drooping with excessive drooling noted. She was unable to respond to questions, and was slurring the words that she could make out. She wasn't able to follow commands, unable to swallow. No foreign object was present, vital signs were all well within normal limits for this patient, FSBS was 106. Apparently this had started on Saturday, but the weekend nurses didn't address it. I sent her out immediately to the ER with the doctor's order with a diagnosis of a stroke. Two hours later she was sent back. All tests came back negative, not even a UTI was present. She has returned and improved slightly, but there is still a noted decline in cognition, strength and balance. Currently there's no known cause. Case #2 Again we have a social, independent rehab patient who enjoys talking with care staff and other patients. She's alert and oriented, very active, and likes to know who's around and what's going on. Her family is in frequently talking with her, and she has an astounding memory and loves to share hers. Again, she was perfectly normal when I left work the day before. When I come in the next morning, I'm notified that she's acting strange. I find her in her room with 4 briefs on, her shirt on her legs with one leg through one arm, and the other through the neck. She is topless and 'can't figure out how to get her second shirt on.' All vital signs are within normal ranges, and are normal for her. She had difficulty speaking, difficulty following commands, and would just stare straight ahead with a blank expression on her face. When asked to squeeze with both hands at the same time, she would push with her left hand and pull slightly with her right. FSBS was just over 90 (don't remember the exact number). The doctor was called and the resident sent out to the ER. She has a history of TIA's, and had her last one a month prior. She was sent back the same day without any diagnosis, no issues found. Like case #1, she has not improved much since this began. Case #3 This patient is not mine, though I was the one that sent her while her nurse was out to lunch. Again we have an independent woman who is on her way out of the facility in a few days, and is using a walker for most of her day. She's alert and oriented, able to speak clearly and easily. The nurse I was working with this day handed me over her keys while she took 20 minutes to get some food. In that time the resident reported that she felt as if her blood sugar was getting low and wanted it checked. I immediately checked it and found a FSBS of 231, which was normal for her PC. She stated, "Ok, I just feel a little weird." She then became completely unresponsive. All vital signs were obtained and within normal healthy ranges, and were around her baseline. We had one of our patient physicians/medical director was there as well.He assessed the resident and found her unresponsive to any stimuli. He said to call an ambulance, she's having a stroke. Ambulance responded, and she continued to be completely unresponsive. Pupils were pinpoint and sluggish to react. She went right out to the ER, and came back within hours. They didn't find anything wrong. Now all three of these patients have gone for multiple CT scans, had MRI's, UA's and a variety of other repeated tests. To this day all three of these are unexplained. Not even their physicians have an explanation. No, I am not a student asking for homework help. I'm just curious to see if anyone has seen this, and if so, have you found a possible cause?
  16. Brekka

    Working the holidays

    At my facility we're not allowed to buy gifts for residents unless we buy for all of them, and I can't afford to buy 200 people gifts... Luckily my facility does give gifts to the residents here so I just have to bring a cheerful attitude. I do buy little gifts and goodie bags for my daytime CNAs.