labonita271

hey there! i'm also working in acute rehab in florida, palm beach county, and we've been hit hard by the new rules. very VERY low census, almost half the hospital closed. there have been rumors that if it keeps up like this we'll go SNF :uhoh21: and as if the new rules weren't bad enough, soon reimbursment will be based on pt satisfaction. we try our hardest, but not everyone can have therapy whenever they want, have their own room and lobster for dinner. and that is honestly what some people expect! it's a hospital, not a hotel. jeez.

Thanks for your response. I haven't been in because I haven't been scheduled, but I don't think I will be going back. My supervisor's response made me think that they've had problems like this in the past. When I spoke to the DON she told me that yes, I'm an LPN, but they trust my clinical judgement. I was like, "I've been a nurse for 2 weeks, I don't trust myself and neither should you!" They're currently using paramedics to triage, so I guess in their eyes hiring an LPN was a huge step up. Ugh!

Hi everyone! This is my first post here and it's going very long, so please bear with me. I just graduated as an LPN last month, and was hired into a rural ER. I was concerned about working in the ER, because as an LPN I am not allowed to triage as it is outside the scope of my license. I expressed this in my interview and was told that I would not be triaging, but may have to do something called "first contact" on occasion. My very first day I was shown the ropes by another RN (I did not have a preceptor or official "buddy"). Here's my problem: all day I sat in the room labeled "triage." I was shown how to enter everything into the computer, etc. I watched her do it 5-10 times, and then was left, on my first day of work as a nurse EVER, to do it alone for the next 5 hours or so. I was told to call if i needed help. This is pretty much what I was doing: calling the pt. from the waiting room after they registered, taking their vitals, brief history, complaints and treatments for it, putting in the standing orders for whatever they're presenting with, classifying them as "non-urgent," "urgent," "emergent," or "critical," and then either returning them to the waiting room or bringing them back to the floor and assigning them to a nurse. I again expressed concern to my charge nurse, because to me, this sounds like triage and I am not willing to put my license at risk. I went home that night very upset. There are no other LPNs on the floor so I had no one to ask for advice. The next morning when I went to work, I again approached my supervisor and told her that I was very uncomfortable with the situation, particularly the fact that I was not trained to triage in school, and the only training I was recieving in the facility was how to use the computer. I was very calm and open minded, but within 15 seconds she became irate and defensive and demanded to know who in the hospital told me I was doing triage. I told her that it wasnt a coworker, but that in the computer I was listed as a triage nurse, and also on the paperwork. She claimed that I knew what I was getting into when she hired me, but then also repeated that it wasn't triage. She insisted that I see the DON, who was also upset with me for causing problems. The DON then told me that what the admitting clerk was doing could be considered triage, so I shouldn't worry! I have not been back to work since then. Advice, please?! As a new grad, I don't know if I am over-reacting or justified in my suspicions. I'm not someone who takes a job and quits a week later when things get tough, but I'm not going to put myself at risk because they're understaffed and cutting corners. Can anyone help me? -Lola