nurse1109

Thank you for the advice. This was my gut feeling. I really want an MDS job, I have a type A personality and I think it is the challenge I am looking for. This just may not be the best place to start out.

I just interviewed for an MDS Coordinator position and need some advice. I would be the only nurse in the facility completing the MDS for 80 residents (there are 100 beds total). Right now 60 are Medicaid and 20 are Medicare approx. In addition to this I would be doing all the Careplans and in charge of the Restorative program. This is a salaried position. Is this too much for one person to handle? I am new to MDS. I work in a hospital now but have worked for 2 ECFs and both places had more than one person doing the MDS. For those of you who are MDS Coordinators, how many residents are you responsible for?

I agree. I have had my first interview. This facility has 2 unit managers, I wonder why they would not want the position as the company policy is to promote within first.

I am interviewing for an ADON job. I have been an RN for 4yrs now and have worked LTC, PACU and currently Acute rehab at a hospital. When I worked LTC I knew my long term goals were management preferably LTC. I only left because the hospital pay and benefits were better and was offered a job no weekends. In my current job I am an alternate Charge Nurse, I am involved in all aspects of my patients care (toileting, meds, tx's, assessment) and I write their care plan and attend team conference meetings twice a week and set FIM scores and goals for them. My question is am I out of my league in applying to be an ADON since I have never held a full-time supervisor role? I know enough about LTC to work the floor ( and after 2 days of training was on my own and did a pretty good job). I just don't want to be in over my head. I have not had any children yet and would like to start a family in the near future. In this role will I be on call all the time? Is it as crazy/stressful as the other posts on here make the DON role sound? I know I do not want to be a floor nurse forever, I just know it is not for me. I am a fast learner and very organized and detail oriented, I don't want to pass up a good career opportunity if offered. Any advice would be appreciated!

If I had it to do all over again I would have become a therapist rather than a nurse. Having worked in the Rehab setting it surprised me to see how much more respect the therapist get from the Dr.'s and the impact they have on the patient's care as opposed to nursing. As a nurse in Rehab you are included in team planning but I feel like an overworked housekeeper most days while therapy has scheduled 1 on 1 time with the patients for their care. It is exhausting to be consistently pulled in all different directions and to have tons of charting that you are forced to do in the hallway so everyone (therapist, family, visitors) can stop and interrupt you for help. Nobody cares that you have a job to do as well. I think I would like SLP as opposed to OT or PT due to the physical demands ( I don't plan on having a physical bedside nursing job forever, I will never make it to 75-80 yrs old in this job lol!). Rehab is very rewarding, our therapist do an awesome job and I wish I had the same satisfaction in my own job.

Hi everyone. I am currently an associates degree RN thinking about going back to school for my BSN. In nursing school my best clinical days were school nursing, I loved it! These jobs are hard to come by though. Do most schools want BSN nurses? The pay does not seem that great. Just curious what some of your salaries are and do you get the same benefits as the teachers? (I am learning money is not everything though as I am always tired and stressed from my hospital bedside staff nurse job!)

I am wanting to pursue a job as an MDS nurse in the future. I have worked LTC and am familiar with what MDS is and its significance. I currently work acute rehab in a hospital. What is the best way to prepare for an MDS position if one becomes available somewhere? I really think this is something I would like to do as I am slowly becoming burnt out on bedside care. I have also thought about getting my BSN, MDS coordinator jobs seem to be administrative positions and so I thought the BSN experience may help. Should I start working on an MDS certification? Or would this be too confusing since I have not actually done MDS work? Any advice would help. I had been offered an MDS assistant job at a LTC that I had worked at that the working conditions were awful. They picked me because they know I am a very dependable, fast learner. I turned the job down after much thought to stay full-time at the local hospital, but am now kicking myself seeing as these jobs are hard to come by and should have taken the job for the experience. Do you have any advice as to making myself marketable to a facility even though I do not have on the job experience with MDS?

Job shadow some nurses, be sure that it is something you would like to do before incurring the debt. I know after reading lots of post on here people have different experiences based on their own personal situations and where they live. I graduated 3.5 yrs ago from RN school and was offered a job right away at the 3 places I had applied. Now things are very different. There is no nursing shortage and starting Jan 1 my hours were cut due to increasing nurse to pt ratio on my unit. That means no breaks or lunch for me. I am paid very well but I am to the point where I don't care about the money. I just don't want to be stressed and physically drained. I have an associates degree and want to go back to school for a bachlors degree but want it in something else! I know the grass is not always greener on the otherside but I have been considering becoming a teacher. When starting school I had equal interest in both professions and chose nursing over teaching due to better job prospects. Boy was I naive, I never considered the physical slavery of the job along with high stress considering the patients are ultimately your responsibility, not the LPN or PCT you are supervising. Plus all the patient satisfaction administration crams down your throat while they take away your staffing to cut budgets. It is sad. So I urge you to do your research, I wish I had. I know both careers are different in different parts of the country but most the teachers I know are very happy. It is predicted that when the baby boomers retire that will open lots of teaching opportunities since they hold a lot of those jobs. I know to say hang in there is easier said then done when there are bills to be paid though :)

My first job as a new grad was in outpatient surgery pacu and it was rough. This was because the nurses idea of training was to let you take all the patients and watch you struggle. We all floated between inpt and outpatient and these same nurses stood by watching while another new hire's pt going bad and they did not step up to help, they sat behind the nurses station until anesthesia was there giving orders. The pt later died in ICU. This is wrong on so many levels. You should always treat your patients as you would your own family member. If that persons family had been standing in pacu what would they have thought? The nurses all justified this by saying this is how they were trained. So my advice is don't let anyone take advantage of you. You should always be willing to step up and take as many patients as you can (variety) this is how you learn but if you are not comfortable or not experienced someone should be willing to help and offer advice. I hope you have a good group of nurses to work with. It took me about a year to be fully comfortable (with inpt and outpt). Deciding how much medication to give in pacu was challenging at first, every patient is different. Once I had a young gyn pt who had never had surgery before. A pevlviscopy is very painful with uterine cramping and the gases they use for the scope. This patients was crying like crazy so I kept giving her meds. Well her pain never went away but she became very pale, nauseated, and bp was too low to release her so she had to stay all day. So sometimes you can only medicate someone so much before you are doing them more harm than good. At my facility we uses mainly Fentanyl, Morphine, and Dilaudid. A good nurse told me to start with Fentanyl because it has least side effects. You can also give this to someone who has lower BP. Morphine and Dilaudid will decrease the BP. Dilaudid makes a lot of patients very sick, but does a better job for your chronic pain patient. Good luck and congratulations on your new job! Where I live ambulatory surgery is a good job and turn over is low (especially if there is no on-call).

I am very anxious and frustrated with this career as well. It has now been 3.5 yrs into my nursing career and I have not once been happy. I feel like I have made a big mistake but then I feel guilty and I do want to like it. I am just tired and stressed all the time. I am fed up with no breaks and no lunches and all the physical requirements. I don't care how many "body mechanics" you learn 2 small 130lb women are not made to transfer non wt bearing 250lb ppl! I just feel like I worked so hard through college to give this up (math and science were not my thing but I worked hard for As). If I think about what I truly enjoy learning about it is English Literature and History. I feel like maybe I was more cut out for a job in Education, I am very detail oriented and organized. I just feel like I don't want to be trapped in this job feeling like someones servant (not just in reference to ungrateful patients but hospital administration as well). I have considered my BSN but I don't feel like good managers just get their job because of their degree, it takes experience. A BSN is a requirement but not a guarantee for administration/mgmt. My family has been driven crazy hearing me obsessive over what to do. Some say teach nursing school, but I feel a good teacher has a passion for their subject and I don't think it would be fair to hopeful students to have a cynical view of this profession. So I recently in the last few months took a position on a less hectic unit and now we have adequate staffing and guess what? Good old budget cuts mean no raises and nurse to patient ratio is cut so that is back to no break or lunch for me....and I can forget about leaving on time. I feel like my options are: 1) Suffer, make a decent paycheck but turn into a bitter person, 2) Pursue a non-bedside job like MDS Nurse where I am not worked like I am in a factory I will be a respected valuable member of the health care team. (Actually nursing Is worse than factory, my husband does it and he always gets his breaks and lunches and holidays/wknds off) . 3)Start working on my degree in something else such as teaching (although I would plan on job-shadowing and research prior to going to college for something I may hate) although teachers are loosing their jobs in this economy and the pay is not great, but I have $ and am miserable now! Like I said I feel trapped and guilty. My grandmother told me this should be a ministry I should not have these feelings about working to help other people. (she was also an English teacher who had summers off, and was offered more money to take an early retirement). Oh and I have work outpatient surgery which physically is much better. But it has its downfalls as well. Reimbursement is better outpatient so Drs will try and squeeze anyone in they can even if they are not "healthy". Even though you "close" at 5pm I have spent many nights at work until 9pm because someone takes that long to pee or for the spinal to wear off or there anesthesia to wear off enough to have decent VS. Drs don't care, they will add on a case at 4pm and tell you that you are lucky to have a job. I worked one day in primary pacu with one other nurse and me to recover 18 outpatients in one day. I was fed up with crazy, that is why I left. I am now starting to think there is no "good" nursing job, I know there is never a perfect job but at least when I graduated I had hope it would not all be crazy.

Either start with a fresh irrigation bag and fresh foley to start your counts, or mark your irrigation bag and start with an empty foley bag when you get the patient. Our bags are 3000ml so when a bag is done going in you empty your foley (or I have used a 24hr urine collection container if you have to empty the foley before the irrigation bag is empty,keep this urine in the jug until your irrigation bag is complete to keep your I&O organized). 3000ml is recorded as CBI in and 3000ml of output is recorded as CBI out and whatever is left from your output ml's is recorded as urine output. For some reason this was hard for me to get the hang of right away as a new nurse in PACU, a seasoned nurse finally said "Look it is not that difficult, when you get your patient start with a fresh bag and fresh foley!"

My dream job would be to be a librarian!

I hear you I have been there and done that and am still doing that about 75% of the time. At least about 25% of my days are manageable now. The other 75% of the time I question myself as to why did I go into this crazy profession. I think most would say to help people but most days it feels like I can barley keep my own head above water.

Having worked LTC before I do not think it is a dead-end job. Most ECF's have large skilled rehab units because that is where reimbursement is. Patients are dc'd from the hospital much sooner than they were in the past. Almost every week at the nursing home I worked for there was at least 1 emergency situation. This requires and builds your assessment skills. Working with the elderly can be very rewarding. As an RN after some experience you will have management opportunities as well such as Assistant DON, staff development, admissions/marketing, and MDS. Eventually you may even work your way up to DON. I have a friend who is a DON and recently got a corporate job as a regional manager with her ASN. I myself would not be opposed to going back to an ECF one day. Good luck! First jobs can be hard, your 1st job may not be what you had in mind and its difficult to know what you will and won't like until you try it. I hope this helps :)

TO MINDYKOZ: I recently started working on an acute rehab unit in a hospital. I transferred there from PACU. My pacu experience gave me some critical care, abc, and quick assessment skills but since you only keep your pt for about an hr I had a limited set of skills. I was a new grad when I started in PACU and decided to do prn work at a nursing home on their skilled rehab unit to learn additional skills and med pass, dressing changes, treatments. ARU is a great place to start. I am learning better time management, I attend care-plan meetings with the physician, discharge planner and therapist. While the patients are stable I still have to give blood, have pt's on IVs, manage hypoglycemia, they are always getting labs and x-rays, some develop dvts or pneumonia. The nurses I work with have worked on this unit a very long time and say the pts are moved from med-surg much sooner than in the past. Since health care is insurance, money driven I think this will be the current trend. I don't think there is any "skill" that a pt may need that we won't provide, the pt just needs to have the physical stamina to meet 3hr/day therapy requirements. Good luck to you! It is hard to know what to do when you first graduate but I think any experience as counts towards building your resume :)