stervets

Trying to find current laws regarding Florida LTC Nurse/Patient ratio. Searched cms.gov, dohfl...etc. but couldn't find anything concrete. Any ideas? Thanks.

I recently picked up a PRN job at a local SNF and there is this new nurse who was given a bottom management position who is going after everyone for basically nothing. Long story short, the her most recent obsession is IV ABT infusions. She writes up everybody who leaves tubing full of liquid (the bag is empty but there is some solution left in the tubing and a little in the chamber). I have worked in multiple hospitals and other SNFs and have never seen anything that ridiculous. Usually pharmacy slightly overfills their infusion bags taking this into consideration. Most ABT are therapeutic based on their levels and I am yet to see a low level caused by leaving 3ml of mixture in the tubing. I mean if a bag is a 250ml bag, 3-5ml is 1/50 of the total amount and seems so insignificant that it would be highly unlikely to affect therapeutic levels. What do you think?

Why are you so worried about being sued? People sue for money and nurses do not have a lot of money so why would someone spend money on lawyers, court fees etc if there is nothing to gain? Companies and doctors are the ones that will be sued....

I had no intention to hurt anybody`s feelings. I used "real medecine" term for comparison only related to school material, not what you learn at work. No doubt there is plenty of great knowledge that can be learned through working. School on the other hand is a joke. They make you study nursing theories and metaparadigms of nursing, while there are thousands of patients dying from med errors, inadequate knowledge of disease process and lack of nursing assessment skills. Nursing needs more medical education and less BS. More clinical pathophysiology, lab interpretation, pharmacology, and such. Thanks to schools like this doctors think majority of nurses are idiots.

Hi everybody, I have a final assignment in the final semester of my BSN program(God help me I am so sick of this ridiculousness) and I am totally out of ideas. I need to make a power point on nursing volunteer opportunities that are only available to nurses. I thought this would be a good place to ask, maybe some of you have experience volunteering somewhere and can offer me some good suggestions. I need something that I can find lots of info about, something broad yet interesting enough(for my instructor) to get a decent grade. Hopefully it will be over soon I can finally get my ARNP school started and study real medicine lol thanks

Hi everybody, I have a question regarding lunch breaks. I'm an RN currently working PRN in a hospital and full time in a Long term care facility. In long term, I work nights 8 hour shifts from 10-6am. I'm the only Nurse on my unit at night and I have never taken breaks as well as other night shift nurses that work on my unit when I'm off. We have only 3 nurses(sometimes I'm the only RN in the building) and about 120 residents. It seems like clocking out and leaving the facility for 30 min, while leaving 120 residents with 2 nurses is not a very safe/legal idea. Also I like the idea of getting extra 30 minutes to my paycheck. Recently due to the economy our company, as probably most other ones started desperately trying to reduce all their expenses, sometimes to they point of ridiculousness. A few days ago we had a meeting with the administration and we were told that everybody had to take 30min breaks now. I asked them how I am supposed to take a break when 2 other nurses will have to share 120 residents, plus the fact that sometimes they both are LPNs. Is it safe for residents? Is it even legal? All they could say to me was "Well you know it is the law that everyone has to take breaks" I tried searching for some federal regulations and it appears that it is not a requirement. I have been working there for almost 3 years without taking breaks and all of sudden "That is the law" I told them that they didn't have to be concerned with me making overtime since I only work about 75-76 hrs without taking 30 min breaks, but they again assured me that it wasn't about overtime, but about laws. I do take breaks in a hospital, but that is completely different environment there. There is plenty of nurses, ratio is not 40 to 1, and instead of 8hrs, you work the entire 12. However even in a hospital I can skip a break and get paid for it. So my question is what laws are the talking about? I suspect it is a complete BS, but want to make sure before starting to try to change that. Any info would be appreciated as well as your thoughts/opinions? Victor

Hi everybody! I need your advise. I'm 29 male, married. have been RN for 4 years now. I worked in ortho surgical unit for a year, then on medsurg for another year. Burned out and decided to try long term. I worked basically alone on a 30 bed unit with 4 CNA that always minded their business and knew what to do. I liked it but the second year the company decided to sell the facility, and cut every possible expense including nursing salary, overtime and bonuses. I went back to hospitals and worked PRN for 6 months. That hospital was a disorganized mess. I couldn't handle 2 jobs. A couple months later finally decided to go full time to another smaller hospital that paid better. Now I'm working full time in this hospital and prn in my nursing home and I feel like I once again made the wrong decision. My thing is that I although not antisocial I hate working with many people. I am motivated and hard working, quite reliable and love working with all types of patients, and patients love me(especially older ladies:D) I am now considering home health because it is independent job and I wouldn't have to deal face to face with supervisors, doctors, charge etc. If anybody has experience in home health I d appreciate some info.

I have worked 12s, 16s, and 8s and can tell you that it is only good as a change from time to time. Weather you working 10,8,16, or 12 hrs you still have to work the same number of hours and you will feel stressed no matter how you break it. working 2 16s gives you 5 days off but actually working 16hrs is a pure torture, 12s, if you work 3 in a row leaves you drained for the rest of the week, 8 are not bad but you have to work all the time, feels like you at work every day. So IMHO the best way is to change things up once in a while and work 12 for a while, then switch to 16, then 8 and back to 12etc.

Thank you for being tactful and respectful( Seems like the first normal response to my thread) There are different LTC and and I understand that not all of them are slow paced. Now please note that even my facility gets crazy during a day at times, so I only refer to night shifts. There are different LTC facilities some are more critical then others, for instance there are acute long term care places that specialize in ventilators, complex treatments, cardiac, post/trauma etc. My facility(like the majority I believe) has 3 units Post acute rehab, small dementia Alzheimer unit , and long term/ nursing home. Usually our census is about 115 residents. The post acute is mostly focused on ortho and respiratory although recently they hae been taking anyone. We do have PICC lines, ABT IV, DRSG, Wound care, Respiratory TX(no vents). At night, most of the residents only need a few meds plus a few prns, so most of my job consists of charting, checking day shift orders, changing equipment, labs and a few more boring duties. The other long term and dementia unit basically do not have much going on at night, except 2 med passes at 12 and 6 and a few chart checks. I have not worked at any other long term but have a few friends and have been in a couple long time ago during my nursing school years and they all seem to be similar to the place I am working at now. I do not know what type of LTCF you work at but no matter how advanced any LTC is a Hospital will always be light years ahead in most aspects. That does not mean that LTC is a bad place to work, hospital is just a better learning environment in my opinion that is all.

You did not read my post did you? Please read carefully and pay attention before getting emotional and typing whatever comes to mind. I said I make money while take a break from a hospital. I would rather be on the beach but it doesn't pay anything. It does not mean I sit around on my ### and watch TV all the time. It is just soooooooo much less stressful then a hospital. May be you should take your own advice and go have a glass of wine on the beach and relax a little, cause I feel a lot of tension in your posts.

Males usually prefer more critical, high paced atmosphere(ER,ICU) whereas females(not everyone) generally go for areas that require more sensetivity, caring... And please do not argue with me, since I'm only expressing my opinion which is a subjective thing.

WOW ! you sound so professional and motivated. One day you will become a DON and that will be a great position. Good luck

I am sorry you are still getting offended, you sound like you are a good LTC nurse. Plus it seems like you have a good sense of humor as well. I only expressed my opinion and once again did not intend to make the truth sound so hurtful. Bottom line if you truly think that your LTC is a great place to work then you are the right type of a nurse for that area of nursing. I'm sure LTC needs more nurses like you. Somebody has to work in LTC right?

Let me say that when I posted my reply, I did not mean to offend anybody who works in a LTC, I only stated my opinion and comparison from personal experience. To each his own. Being a male I have slightly different idea of skills. I consider skills as primarily medical knowledge, hemodynamics, vasopressive drugs, good knowledge of physiology. Medical knowledge is what I consider the highest skill. Being around M.D. complex procedures, hi tech equipment, etc all that and more makes a hospital the best place to develop skills. Bringing a cup of tea, giving an extra blanket, asking about grandchildren, spoon feeding, all those might also be done with skill. I ll take back my statement "There are no skills" Instead I say there are much much more higher level medical skills in a hospital. Ultimately it is what you like doing better. I like working in my LTC facility because it gives me a break from hospital's fast pace, I recover from stress while working in nursing home and at the same time make money.

i am currently working in a rehab/nursing home as a house supervisor at night. before i worked in a hospital for several years trauma/medsurg and pcu. after couple years i burned out and wanted a more quite less stressful job. i can compare long term and hospital from my own experience and i can tell you that people do not have respect for nursing home nurses for a reason. there are no skills there. when i worked in a hospital i considered myself a healthcare professional, when i came to nursing home i did not feel that way. there is a world of difference between a good pcu nurse and a good nursing home nurse, so if you want an easy job that does not require skills work in a nursing home, but if you want skills knowledge and self satisfaction hospital is the only way imo. especially if you plan on advancing to a np,pa crna etc. that is why after 2 years in nursing home i went and got a prn job in a hospital and now i experience these two different worlds on a daily basis. i personally enjoy this change, and have no problem working in a nursing home, but i would not work in a nursing home only.