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HisTreasure

HisTreasure BSN, RN

Pediatrics
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HisTreasure has 10 years experience as a BSN, RN and specializes in Pediatrics.

Nurse, foster mommy, BSN student candidate.

HisTreasure's Latest Activity

  1. Is your hospital currently hiring PCTs? As a student you may be able to be employed as a tech which will bring a lot of useful experience and opportunities to learn. You will already have a working knowledge of the technical aspects behind phlebotomy and tele which will prove invaluable once you start skill labs and clinical. Your employment as a tech may also count towards your overall tenure at the hospital once you become licensed which may help you get moved into an RN position of your choice or give you preferential standing if you apply for a BSN residency program at your hospital once your pass your NCLEX. After your first semester you can probably challenge the CNA exam and get certified. This will be useful if you want to work LTC or perhaps rehab. There is a lot of value in going that route, as you are the first line care giver and the time management aspect of floor nursing will be lessons you learn early on. There is still a likelihood of future employment as a nurse, especially if your facility is associated with a larger hospital system that you can transfer within, should you so choose. Working in acute rehab I was able to better mentor the CNAs, especially the student nurses or those who showed an interest in completing school in the future. CNAs are able to form a closer working relationship with both the staff and the patients, as they are longer term. Maintaining multidisciplinary relationships and perfecting your bedside manner are important skills whose importance should not be overlooked or underestimated. To think outside of the box, I know a gentleman who finished his pre-reqs then took an EMT course in the interim between pre-reqs and waiting for his time to start nursing school. He would do 24 or 48 hour shifts while in nursing school. The pay wasn't what he hoped but he said the experience was invaluable all around. The schedule was also a good fit for his education and studying. He still works pre-hospital on a volunteer rig a couple of shifts per month for our town. He's a great guy, planning to go for his PA in the next few years since he does have an interest in the medical model and feels he can be a better provider coming for both an EMT and nursing background.
  2. HisTreasure

    The worst job you had before becoming a Nurse?

    Worst job was as a child care associate. I loved the kids- always had a tender place in my heart for them, always will, however, this center was poorly managed and inadequately maintained. I didn't know about child-adult ratios at the time but I knew it wasn't right for a 17-year-old to be left solely in charge of 6 toddlers for any long stretches of time. Sometimes the main teacher would be floated to another room and I would have the whole 2-year-old room from nap time until around 4, 4:30 when kids started going home and the rooms could be combined. The director was mean and nasty from day one, and the last straw (or close to the last straw) was when I witnessed the main teacher withholding lunch from one particular baby for the third day in a row for "misbehaving." I thought it was cruel the first time it happened, but by the third day I realized she just didn't like the little boy and would use any excuse to abuse him. I reported her to the director, who in turn wrote her up on suspected misconduct and the teacher started being really mean to me but at least she left the little boy alone. I quit a week later.
  3. HisTreasure

    How much do you make?

    $24.31 for low tech/adults, $33.71 for high tech pediatrics. No benefits and no taxes taken out (independent). However, I rarely work PDN. I work in ALF as a supervisor making $20.50 with benefits. It's not the highest pay I've ever seen but it pays the bills, especially as an LPN. When I work agency I make $22-23/hr. In the end, however, it's not how much you make, it's how much you spend. I have CNA friend ecstatic to make $15.50/hr and are living quite well.
  4. Has a family ever asked you to chart more interventions than required or done during your shift in order to make the patient appear more fragile than than they really are so they won't "lose hours" or in some cases, to get even more hours? Don't purger yourself if you have, but if you have a story to tell please do!
  5. HisTreasure

    Just a tee-hee moment

    Seriously!!!!! And it took him two attempts for a barely competent job. When I was roomed in ED I was advised the one he got in was kinked! LOL! The otherwise super rad medic said I was a hard stick. I looked at him incredulously. I'm like, "dude, I'm a Coumadin patient. I get blood drawn on a regular and 'hard stick' is a term I've never heard in relation to myself!" Plus I could visualize a couple good IV insertion sites on myself and I was barely looking!
  6. HisTreasure

    Just a tee-hee moment

    Yesterday, against my will, my job called EMS because I was having a full blown asthma exacerbation after two doses of albuterol inhaler. I refused transport to ED, and the paramedic (because they called in ALS) said, "You're a nurse? Well imagine this: your patient has NO air moving in their lungs that can be auscultated in either lung, they're diaphoretic, slightly cyanotic, and their O2 sat is 86% after two inhaler treatments. What would you recommend?" I was silent but truly the rig was already moving. " I really think you need to go to ED." LOL, yeah... 2L of O2 via NC to maintain my sats, chest x-ray, two boluses of NS and two "1 and 1" nebs later I left with a RA O2 of 96% RA, steroids and nebs at home. Plus the fun diagnosis of "walking pneumonia" which is really nothing. I escaped, at my behest, sans antibiotics because my pneumonia is very mild. Anyway, as I was leaving the awesome DC nurse said, "you are so pleasant and I enjoyed caring for you but I heard about the hell you gave the medics about 'just' giving you a neb tx and letting you go back to work so they can go take care of someone really sick! [LMBO]. Nurses make the WORSE patients to SOMEONE on the team." LOL. Love it! THEN I got a text from a non-medical friend who told me to "be a patient, not a nurse today." I love it! Seems to be true true! And I thought of you guys the whole time~ I always do if I have to go to ED or urgent care. Medical professionals make the worse patients: Agree or disagree?
  7. HisTreasure

    Well, don't come back

    I sincerely hope she does, too. She actually mentioned going back to reapply with some of the agencies, including the infamous "M" because she has a family to support. However, those who live in NY and bill independently know that agency rates are nowhere near as high as MCD reimbursement rates and she would need to put in lots of hours with likely pretty crappy cases in order to maintain her standard of living. The tears she cried... oh, my gosh. She feels so hurt by the family and even called around to others on the case to see if she could get other coverage but it was impossible last minute on Easter. Her next scheduled shift is tomorrow 6 AM and she's debating whether she should just show up because she knows that the shift is probably uncovered. But then again, independents can be very vulture-like when it comes to hours and if the parents truly took her off the schedule those hours may have been gobbled up instantly. Every time I even hint at sticking my toe back into PDN something like this happens and I realize I just don't have the time or the patience for the madness.
  8. HisTreasure

    "Wasteful Nurses"

    I had a mom that counted everything. Think I spoke of her before. ;-) She bought the "select-a-size" paper towels and in addition to counting how many paper towels we used, she had it written how many segments were allowed for specific uses. For example, cleaning the suction catheter and then drying our hands requires only ONE section because the vinegar used on the canister is actually good for us and "a little vinegar water left on [our] hands to air dry is good infection control". In the latrine we may use "up to three" with a maximum of six bathroom sections per shift. No jokes, no drama, no exaggeration. She was tired of "wasteful" nurses, too.
  9. HisTreasure

    Well, don't come back

    Hmmm, this is a new one. At least for me. My cousin has been doing independent PDN for the past 8-9 years. She's very savvy and usually diversifies her cases so she isn't dependent on one client however this past year has been very difficult in the independent arena and she only has two clients, one of which is mostly full time, the other she fills in 1-2 times per month. She's been with this 3/4 time family for years, since the little one came home from the hospital and the child is fairly stable so I guess she got comfortable. Well, she and I just had the saddest FaceTime session EVER. She lost her job. She normally works every other Sunday but traded this Sunday with another independent because she was invited to Sunday service by her brand new fiance's family. Towards the end of this week the nurse she swapped with developed a stomach bug and the family won't have her back until she is symptom free for 48 hours. At this time it's obvious she's not going to make the Sunday deadline and therefore the Sunday shift reverted back to my cousin. My cousin, who is usually so sweet and accommodating told the family she could not and would not work Sunday because she already has very important plans. The family told her, paraphrased, well, if you don't come on Sunday don't bother to come back! You nurses are so insensitive, don't you understand trach parents deserve holidays, too?! ...and nurses don't? So now she's down to her fill-in because she will not choose work over her new family and I don't blame her. I just feel sorry for her but I can guarantee she will go back to having her hands in several pots as soon as she can! As for the family: I have never!!!!!!
  10. HisTreasure

    What do you like least/most about private duty?

    I love the pay, the patient, the 1-on-1 time/attention/care. I appreciate the ability to get to know my patient and her needs, I love that I am able to care for the entire family and leave each day knowing that I made a difference. I really enjoy my coworkers, and the way we all lean on one another to ensure a smooth-running case. I feel like I get paid to play for most of my shifts, and that is really awesome. Now, my dislike list will appear longer but it's all relative: I DISLIKE the instability of caring for a chronically medically fragile child. Yes, she's stable NOW but that can turn on a dime (after all, isn't her fragility why she qualifies for home care?!) and that not only affects the income, but it takes an emotional toll as well. Along that vein, I dislike the constant "hustler" state of mind I have to be in; always having a backup plan, which sometimes means working more hours per week than I need or desire to because I have to keep my foot in the door at so many different gigs "just in case." I am not a fan of the politics and games that can come from private duty nursing: with others nurses and with the families. Yes, some parents can and will play nurses against one another-- and yes, other nurses can get ugly and territorial, which can present itself in a multitude of unexpected and oft-unpleasant ways; especially in the independent sector. I do feel comfortable in the home I'm in now, but there is always there initial discomfort- and sometimes you may find yourself overhearing or witnessing something and feeling unsure of how to (or even if you should) react. Do you pretend you didn't hear/see it? Do you offer a comforting word or hug following a marital blowup? What do you do, and why can't I just sink into the floor right now????? All-in-all, you get a feel for whether it's your forte or not, and if so, then the you'll find a way to minimize the negatives and celebrate the positives.
  11. HisTreasure

    Peds private duty nursing experience

    SDALPN has a lot of great advice! I would only differ in mentioning that it depends on the area, whether hospitals will hire LPNS. Our area hospitals certainly do, and in fact, one of our hospital systems has its own LPN program- so don't immediately discount acute care as an option in your search. I very ignorantly believed the hype that LPNs weren't hired in hospitals, and as such missed out on a great opportunity in ED when I first moved back home. My mom encouraged me to apply because the listing did not specify RN-only, and it so happens a classmate from my PN school got the job (saw her when my DH was admitted a few weeks ago)! You never know, but the sky is the limit. And continuing your education, even slowly, is always a good concurrent plan to have.
  12. HisTreasure

    Is 21$ an hour for new grad (ADN), home health too low?

    Medicaid reimbursements are categorized into high-tech and low-tech, and the reimbursements are relational. There should be an LPN reimbursement rate and an RN reimbursement rate, but $22-30 per hour in private duty for RNs through agency isn't unheard of; and honestly isn't too off target of Medicaid reimbursements. There are enhancements that can come into play, but I don't know if that's state specific. If your state offers these enhanced rates, however, those do need to be passed on to you on top of, or part of, your hourly rate.
  13. HisTreasure

    Do you work full time?

    I work independently and I could work enough hours to be considered full time, but of course there are no benefits with that and it would be foolish to put all my eggs into one basket; for both the family and myself. I am signed on with two agencies and I work the bare minimum (8-16 hours per month) to stay active with them; they are really just backups should my primary PD case become unavailable for whatever reason. Lastly, I picked up a full time office job that offers my insurance and is not private duty at all, so I am working anywhere from 54-70 hours per week most weeks. Interestingly enough, it really doesn't feel like it since many of my private shifts are short shifts or weekend overnights.
  14. HisTreasure

    Job Description, Head Start Program Nurse

    How did your interview go? I am also interviewing for this same position title in NYS soon and I have no idea what to expect. As you mentioned, there is not a lot of information available, either.
  15. HisTreasure

    Sleeping Nurse = No Agency?

    Ultimately, because she was my foster daughter I was responsible for her safety whether we had nursing coverage or not, which is why when we caught her sleeping the initial time we became more vigilant with our spot checks the following nights. I do believe in first chances, and even second chances in some instances, and therefore I felt compelled to allow her to come back. As I've very honestly said, I've dozed off on night shift before. Not laid out, but I recall my eyes getting heavy, reminding myself I needed to walk and opening my eyes 6 minutes later and I knew I had dozed off. For SIX WHOLE MINUTES! Unacceptable!!!! It happened and I am not proud. I went into that shift well rested, I drank coffee before and during the first half, I had busy work, I was in a well-lit area, everything... and it happened. So, I can't, in good conscience, hold someone to a higher standard than I hold myself knowing I've made mistakes. I had a second chance. I re-evaluated how I worked at night to ensure that I never dozed off again. I learned from my mistake, and thank God, no one was ever harmed. I wanted to offer that same chance to her to become a better person, a more proficient nurse, and/or learn that nights does not really work for her. Meanwhile, we were hyper vigilant in the following nights to ensure our child's safety. Does that make sense? We misjudged her. Plain and simple, and I am thankful nothing bad happened. And yes, I would've felt responsible if something happened on her shift, but I would've felt responsible should anything had happened on anyone's shift.
  16. HisTreasure

    odd case

    I had a case where the baby was kept on blankets on the floor. Mom said Baby had spent most of their life in NICU in a crib and she wanted Baby to have a sense of unrestricted movement and freedom. Baby is immobile and has very few purposeful movements. She did expect the nurses to sit on the floor with baby (interacting, therapies, tube feeding, etc) but as soon as it was brought to her attention that there was no place for charting, eating or the occasional lumbar supporting position she purchased a table/chair set for the room. Her intentions were good for her baby, she just didn't really think through the logistics for her nursing help.