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Case Management

Content by NCRN2010

  1. NCRN2010

    CM initial test for certification

    I am taking mine tomorrow and am freaking out a little bit. I have not been able to study as much as I would have liked. I usually test well but have already accepted that I am going to fail í ½í¸•
  2. NCRN2010

    Called off too many times?

    Although this may sound harsh, I totally agree with Kooky Korky. Nurses are held to a higher standard on many things. If you were working in an office job in a clerical position it might be fine to call out because your cat got run over or you fell on the ice trying to get to your car, but if you are a nurse, you need to show up! Absenteeism causes extra stress on your colleagues therefore creating a less than ideal situation for patients. Before I became a nurse I would call out for any little reason. That changed when I took on the responsibility and care of patients. I have held my attendance to such a high regard that I probably was bordering on negligent parenting. Being a nurse is not a job. It is who you are.
  3. Narcissistic behavior at its finest!!
  4. NCRN2010

    Need advice Please- Call Center RN job?

    I currently work as a Call Center nurse for a very large insurance company. I have been doing it for 4 months. It is not all rainbows and unicorns. It is extremely mentally taxing. The money is great but some days I don't think it is worth it. Good luck to you.
  5. NCRN2010

    RN. To Me Means Real Nurse.

    The title of this article caught my eye and for a split second it made me defensive. This defensive reaction encouraged me to read the article. This is a wonderfully written article and in no way belittles the important role that all nurses have in healthcare. My personal journey in nursing began in the supply department in a rural hospital. I witnessed the compassion and professional attitudes of the nurses and I was in awe. From my exposure at that rural hospital I was motivated to pursue my CNA, LPN, RN, and BSN. I possess more knowledge than the person I was working in the supply department, but I am fundamentally the same caring, empathetic, loving person, regardless of the initials after my name. It is impossible to teach someone the necessary personal characteristics it takes to be a nurse. It isn't a job, it is who I am. My precepting experiences as a student were for the most part pleasant. I didn't experience hostility towards me. If I did I was too oblivious to notice. In my career working side by side other nurses and witnessing the interactions of student and preceptor, I am embarrassed and ashamed of many of my co-workers. I love the role of preceptor. I view it as an investment in the nursing profession. The nurses I train may be the nurses taking care of me one day.
  6. NCRN2010

    ADHD/Anxiety issues at clinicals

    I experience these same symptoms at work and at clinicals when in school. Talk to your doctor about your meds. Maybe you need them increased, or changed. Don't give up. Also, I have learned several great relaxation techniques that have worked wonders. Your therapist should be able to help you out with that. Anxiety produces more anxiety. It is a terrible thing. No one can relate unless they have experienced this type of debilitating anxiety. Good luck to you.
  7. So last week I was assisting one of the providers at my employment and witnessed something I have never seen before. The patient we were caring for had a large leg wound. The provider wanted to culture the wound. So I prepared the patient and the room. The provider comes in and takes the swab of the culture and runs in under water from the faucet. She stated "I always get a better sample if the swab is wet first". Is this an accepted practice? Seems to me the culture swab would be contaminated from the tap water, and therefore the culture would not only be from the wound, but whatever else was lurking in the spigot, :sofahider and the city water.:barf02:Has anyone else witnessed this?
  8. NCRN2010

    Has anyone ever seen this done before?

    I totally understand where you are coming from. Usually when you wash a wound, soap would be used as well, possibly eradicated any pathogens found in the tap water or spigot. Also, using ones own facilities is much different than water from a facility that has sick people in and out all day long, possibly contaminating the faucet. I'm not saying what she did was wrong or right, I have just never seen it done before. It would not be something I would have done. Whats ironic to me is in the beginning days of my nursing career, I vividly remember being chastised for taking a culture swab out of the package and holding for the provider to use. The provider told me it was now contaminated just by exposing it to room air and made me discard the swab and get a new one...
  9. NCRN2010

    Has anyone ever seen this done before?

    Actually, no the provider was a female ARNP. Had been a nurse for 15-20 years. Critical care, L&D, and med/surg. I was surprised at what she did. I expected more from her.
  10. NCRN2010

    Relocating to Winston-Salem or Greensboro

    Wages in NC are comparable to that of FL. The good thing is the cost of living in much less. There is alot of opportunities for nurses in the piedmont. I live just outside of Greensboro and I love it here. Was born and raised in Naples, FL. Have been living in NC for about 8 years now. Like most areas, LTC pays the best, hospital is probably about the lowest. Good luck to you. Let me know if you need anymore info.
  11. NCRN2010

    Tell me your favorite things about being an RN!

    Having been a LPN for 10 years, my favorite part of being an RN is getting the respect I should have been getting all along.
  12. NCRN2010

    You know when you are a good nurse when...

    Just being concerned enough to evaluate your practice shows me that you must be a good nurse. It takes years to get to a place where you can reflect on your day and say...I was a great nurse today. Dont let all the seasoned nurses backstabbing get your down. Keep doing what you have been doing. You have to be true to yourself. When ever there is a place with women are the primary employees, there is going to be alot of competition and backstabbing. It is just the nature of some women, unfortunately. Good luck!
  13. NCRN2010

    CPAP: Use It And Live

    Love this post. I too wear a CPAP. I hate it. It took me several weeks to get used to the idea of having to wear it. I have tried numerous masks trying to find the right fit and one that doesnt give me pressure ulcers all over my face. Sometimes I do fall asleep without it on, and I can really tell the difference. I am a strong advocate for my patients and CPAP usage. I work in an ambulatory care setting and everytime I see sleep apnea listed as a diagnosis, I open a dialogue about it with the patient. I dont know if it makes a difference for them, but I would like to think that it does. Also, alot of doctors are not on the bandwagon with CPAP. I see patients all the time, obese, diabetic, hypertensive, etc, etc..complaining of depression, fatigue, headaches...the first thought in my head is sleep apnea? I have suggested this a few times to different docs, but have learned to treed lightly with some docs. They dont appreciate nurse's knowledge.
  14. NCRN2010

    Things you'd LOVE to tell coworkers...and get away with it!

    Can you shut up and take this report? I would like to leave now. You are not the only one that works hard here, you just complain the most. How many smoke breaks do you need?? You are real good at telling nurses how to do their job, but can you practice what you preach? Nursing is not a fashion show. Take off all that jewelry and makeup. Can't your husband/children make a decision without having to call here? I know you are diverting narcotics. You will be caught!! Did you have to work hard to become such a ******, or does it just come naturally for you?
  15. NCRN2010

    new RN - income questions

  16. NCRN2010

    what do you want to be when you grow up?

    I'm going to Wendy's. Would you like fries with that???
  17. NCRN2010

    Overwhelmed, is it too much work or just me?

    Got to love LTC. This, unfortunately is a common scenario. One thing I would try is to tell you CNAs to bring resident A, B, and C to you before lunch or supper. You have 50 residents to chase, your CNAs have fewer residents to chase. Same with therapy. If they are carrying your residents away, they can carry them back to you to have their sugars checked. Also, I just love administrative nurses telling you about time management. How many ADONs or DONs could get done in 8 or 12 hours, what you have to get done?? Especially if they do it the way the are supposed to. And before I start getting alot of negative responses from CNA's...been there done that. I started as a supply clerk in the purchasing department of a hospital, then CNA, then LPN, then RN.
  18. NCRN2010


    The job market for new grads are not so hot right now. Hopefully you can depend on your husband's employment, until you can secure a nursing position. Good luck to you.
  19. NCRN2010

    LPN job market in NC

    I recently became a RN after being a LPN for 10 years. I made well over 20 an hour as a LPN, but unfortunately, did not go up much in pay once acquiring my RN. Most high paying jobs for LPNs are in LTC. Many nurses do not wish to work in this environment. I love geriatrics. Jobs are difficult to find in NC right now. I would secure a position or at least get several good leads before packing up.
  20. NCRN2010

    Mental-illness, Nursing & Me

    I love the story you posted about your mother. My mother is very similar to what you have described. It is very hard to deal with having your mother, the one that is supposed to teach you to become a woman, be so delusional and paranoid. My mother and I are estranged at this point in my life. It is healthier for me not to have her in my life. I do grieve the loss of her, and not having had a "normal" childhood. Being a nurse, makes it even harder for me. I am full of guilt taking care of other people's loved ones, and I can not do anything for my mother. I wish you good luck in your job. Take one day at a time. Allow yourself time to breath. And know that you are a much stronger person than you give yourself credit for.
  21. Vitamin K and some Kayexelate probably wouldn't hurt!
  22. Let me explain my story first. I have been working LTC off and on for the past 10 years. Currently, I have been at my current employer for the past 3 years. I started my career as a CNA, then LPN, and finally this year, I received my RN. It was a great feeling to have accomplished this. I thought surely I would get some type of a raise at my current job. Wrong!! My evaluation was due in July, and I was told I may get a 50:twocents: cent raise at that time. Big deal. I immediately started looking for a new job. I hate changing jobs, and finally gave up, and decided to wait until my evaluation was due, trying to be optimistic. In the mean time, one of the places I applied gave me a call. I thought why not, I will go for the interview just to see what they are talking about. Great opportunity for me. More money, better working environment, great benefits. So, I put my notice in, and planned on continuing PRN for them. So my evaluation came and went, no raise...Today I called HR. I was told, well, you are quitting, so the Administrator said you get no raise. What kind of crap is this? This place has left such a bad taste in my mouth. I am seething mad:devil: about this. I told the HR person, which happens to be related to the Administrator how ****** off I was. There are LPNs in the building making more money than I am. She said, well they have worked at the facility longer than you have. I explained to her, if I am the only RN in the building, then by default, I am in charge. Also, the facility gets higher ratings based on how many RNs are in the building. So why should a LPN be making more than me? I am so discouraged. I am regretting ever wanting to better myself. To all the LPNs reading this who think they can make more money as a RN, think again. You may have a rude awakening!!
  23. NCRN2010

    Okay I have a vent about the business of LTC

    Excuse me if my comments have come across uppity or elitist. I am sorry if I am disappointed for not receiving compensation for all the hard work it has taken me to achieve what I have achieved. I don't expect to ever receive a six figure salary as a nurse, but it would be nice if companies would reward their employees for further advancing their knowledge, expertise, and career. Oh, and I will not settle for "It's just the way it works." I question authority, buck at rules, and refuse to conform. This is why I am a damn good nurse, and a great patient advocate.
  24. NCRN2010

    Okay I have a vent about the business of LTC

    Im not bad mouthing all LTC. Just the one I currently am employed at. I love LTC. I had planned on working at this facility for a very long time. I too have received glowing reviews, never call in, never late, flexible, etc, etc, This facility is privately owned and run by a family. I think this has alot to do with the decisions they make. They manage with their emotions, not their business sense.
  25. NCRN2010

    Okay I have a vent about the business of LTC

    I was trying to stay optimistic, and I planned on staying PRN. So much for optimism. I am a firm believer in "When one door closes another one opens.";)

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