BackfromRetirement

Check into a compact license.........there are several states that recognize your license if it from one of those states. Nurse Licensure Compact (NLC)

No VA in Knoxville, Murfreesboro is closest VA.

Sometimes new nurses opinion's are not appreciated. What they don't tell you in nursing school is how to navigate through the sharks. You might consider asking one of the older nurses to advise you on things that you are still learning. Ask the NM office for a preceptor/mentor. It is tough on new nurses and we have all been through this at least once. Confidence will come in time.

Some labs include it in the blood screening.

Request update on CNA's and skin creams....the laws. At one time, over-the-counter skin protectants were ok for CNA's to apply. Some places say no to CNA's using anything cream on a resident in LTC. Previously no therapeutic creams could be applied by non-licensed folks. There is a southern term called "gaulding" for red, raised skin irritation in the groin from moisture and heat. What is allowed by state law in TN for non-licensed personnel?

Trust? Imagine what an attorney would do to that in a court of law? If LPN misses something and RN signs off on assessment, you already know the answer.

LTC staffing has been an issue for all the 20 yrs I have worked it. I have learned to accept the things I cannot change. It may not be right, it may not be fair, but it's just the way it is. I stay because it's where i fit. I like the elderly, especially the way they "tell it like it is" without fear of repercussions. I admire their moxy. Nurses are restricted in how they express themselves due to professionalism. If it were not for the dry humor of the residents, work would be dull and devoid of laughter at times. They also have some fascinating life stories to tell. They give me a view of my not too distant future.

In this state, an RN must do the admission assessment.

Have you checked out the pay exchange? I have heard that you lose money when paid in Canadian dollars.

Many docs will write an order for "laxative of choice" every third day if no BM. Miralax and MOM are common. If pt is difficult to take meds PO, suppositories can be ordered.

When I worked at the VA hospital back in the 80's this was a common diagnosis. I remember one pt that was ordered lactulose enemas q2h. The smell of the ammonia diarrhea is very distinct. Although most delirium cleared up in a few days, there were a few who remained in delirium for weeks. Major behavior/safety issues. It was always a 2 person assist for any care given. Now days there are better methods of addressing the aspects of HE.

Fire the call-ins, pay enough to attract the dedicated CNA's. Too many call-offs are given too many chances.

Frustration is part of the LTC scenario. You can always consider hiring a private sitter/cna. Perhaps it may be best to look elsewhere for your GM. Sadly, call-offs and short staffing is a fact of life in ltc. Until healthcare corporate decides to pay the price, things will continue the way they are.

Wherehas, you don't seem to fully understand the nursing home side of the problem. CNA's have the most difficult and trying aspects of the facility. In order to keep the good CNA's from burning out, they rotate sections to have a different workload and it helps to keep their observations skills sharp. Not all sections have the same workload. Most times CNA's work short and take on more than their scheduled load.

As i understand it, activities of daily living include detailed descriptions of toileting and dressing in the CNA duties and the Careplan.. Independent living? In a long-term care facility? Have heard of assisted living but that may be a private insurance thing. Please share what you learn from the meeting with us.

WOW P-Medic2, you are sooooo correct! Sign a contract for 2 yrs, never be able to drive a car or have a drink! Always cover your head outdoors and always have a female escort! Sounds like fun, travel, and adventure, right?

Is there more to this story? I too applaud your moxy and dedication. Yet, this may not be over. I have trust issues with the powers that be. They can throw you under the bus in a heartbeat when you ruffle feathers. Standing up for what is right is rarely appreciated. They call it different things; lack of professional demeanor, "rudeness", and similiar things when the correct term is "assertiveness". Tip of the hat to you abbaking!

After UTI's, pneumonia's and falls, mental status changes, never forget impactions. Yes, gurney's suck, had to lie on one 12 hours myself before they gave me a bed. Incontinence pads? Friendly known face? No, all strangers.

The thing about RN school that I remember was lab values. Being able to have a clue what's going on from UA's to blood gases. Yes, its rote memory and boring at first, but you can spot things that you know that contribute to cause and effect.

Pineapple, are you sure? Ck Louisianan or Miss. The Virgin islands are low too.........$15.hr.

Why, why do you young gals do this? Money? Money the government will take most of? Please consider the tax implications. After earning so much a week, the gov may get up to 50% of it.

Sorry, do not have a crystal ball. Staying safely employed helps if you need a check.

Geeze, hope you can do that in your 50's.

And why is it, nurses still crave "the extra time off"?

Don't lie. It is guaranteed to trip you up.