Destinystar

the staffing pattern you described makes no sense to me. i think they should shift the load so that everyone has the same amount of work to do.

sounds like a good reason why schools should have a school nurse employed at each and every one of them. my son is having problems with seizures, etc. i do not have any confidence in the school. so i decided to give up my career and home school him this year.

i live in southern california. nursing homes pay well for certain positions like don, mds coordinator or staff developer and for some rn positions. sometimes better than a hospital. hospitals here pay better for more experienced nurses or nurses who have a specialty. cant say that pay is a deal breaker. seems like the turnover in nursing homes is far greater than in acute care. it might be a good idea if you shadowed someone for a day on the day shift before you signed up with these folks. then you would know for sure. :)

i have been in nursing ever since i was 16. i have no regrets. however i am fascinated by law. you sound like a very ambitiouse person. i am in favor of you doing whatever your little heart desires:)

the problem is with the state regulations that allow unlicensed people to adminster meds in assisted living facilities. until the state regulations require that only an lvn or rn can pass medications the problems will continue. :uhoh21:

if you are done with your don position it might be better if you moved forward and did not look back. it might be difficult for you to step down as a don and find yourself in a position at the same place taking orders from someone, or the new don might feel somewhat intimidated by you. you sounded really positive about the position offered to you at the hospital. when i left long term care i went to work for a nursing registry, got paid twice as much with 1/2 of the headaches. the mds position can be just as much responsibility and work as a don if not more. :)

if you offer child care they will come. :)

:) sure employers are going to advertise for what they hope and wish for but getting it is another thing. the hospitals in the area where i live are not in any position to be picking, choosing and refusing. most of them offer training to just about any rn experienced or not. rn positions and many, many of them do require 2++ yrs of experience. this worries me ! i have no problems looking aggressively for a job, but one of the problems with my last career was the lack of jobs and opportunities. i am getting too old for that ! :rotfl: if i am going to spend another three years in school , and more $$$$, etc. etc. i hope there are jobs out there (entry level) once i am out...... did anyone have trouble finding a job ????

Nurse practioner

after living and working in california for most of my career i obtained a fl nursing license and went out there about 2 years ago (to sell off my home there after the renter passed away) and practiced nursing in a ltc facility. this was in the palm beach area. i worked for a large well known nursing home chain. i believe that the biggest need for nurses in ltc exists in fl. the working conditions were about as bad as they could get. i was hired as an assistant don given a salary. i would work my 8 1/2 hours then in addition to that and for no extra pay i was expected to work the 3-11 shift every time some one called off (which was everyday) and to work on the weekednds. the patients and the family members were demanding and it seemed the wealthier they were the worse the problem was. the place that i was at had a lot of the employees working between two jobs and they were always coming in late, going home early and calling off sick. the health dept. that licenses these places come down hard on these facilities. like nothing i have ever seen before. and floridians are law suit happy. ever see all those signs on the bill boards and ads in the papers from attorneys soliciting cases for elder abuse etc? as if that wasnt bad enough i found out that fl was a right to work state. all employees had a right to was their pay check and no recourse when the employers gave them a hard time. it was so different than california. but i love florida. great weather. great people. home care in florida is a lot better. sorry i cannot recommend ltc in fl to ya. teaching seems to have better working conditions.

i enjoyed reading your post. i lived and worked in the palm beach area of fl for 6 mos. about 2 years ago. i really enjoyed all of the green trees, the rain, the tropical climate. but the one thing that i did not like was the mosquitos. could not be outside for any length of time without one biting me. i found that annoying. was that a problem for you?i am in the desert now. i hate no rain, no trees, but i love no mosquitos. hope to sell my property here and move out there. just trying to find an affordable, safe area. most of it has really gone up in price. it is definatly a good investment as far as real estate is concerned. i think a lot of people are getting on the band wagon and starting to move there. :)

tell her you'd love to help her out. help her out of nursing. :rotfl: :rotfl: :rotfl: :rotfl: there is no excuse for elder abuse

a few of the places i worked at employees were allowed to bring their kids or just showed up with them. i cant believe that some places dont have policies about this sort of thing. only in ltc.:uhoh21:

it's part of our job. we are obligated to promote comfort and safety and equipment that will acommodate people based on their individual differences. we have special lifts to assist patients with mobility. we train the staff how to use them. most people are overwieght including the staff. :) i am not about to minimize a human being just because they are obese. no this issue is not the highlight of my career. my daughter when she was 15 did volunteer work at the hospital and cared for a lovely woman who had a gastric bypass done. she died as a result of the surgery. we still have the wreath that she made by hand and gave to my daughter for christmas. we take it out every year and remember how happy she made everyone in the community with her crafts. my daughter loved her more than any one else and did not mind helping her out cause she was a sweat heart. :)

meds are aimed at treating the symptoms therapy the cause.sounds like you have seen professionals about your problems. i have seen people with all kinds of problems overcome them through professional therapy and time. you already know that you have some serious problems that interfere with your ability to function. you have stated that you prefer biofeedback. since you have found something that works stick with it until your problem is resolved. as long as you keep thinking about things that have nothing to do with your life like a fantasy played out in a movie then you dont have to face what is going on in yours. you take your pulse because again it prevents you from moving onto a functional behavior that would benefit you. doesnt sound like you are enjoying this. find one thing that brings you joy and pursue it. that would help to drown out all of the things that you dont.

the best part about being a nurse is if you do get fired before the ink gets dry on your termination papers you will have another job lined up.:)

your lucky to have an assistant when i did mds i had no assistant. i had to work overtime, on days off and take work home. the biggest advantage i had is that i could type at lightning speed and we had a good software program. that is one job i would never take on again. yep, a lot of meetings, from care plan to department head and whatever else the facility wants to involve you in. hopefully you will be sent to some formal training soon. i didnt have any when i started out. i had to read the manual and figure it out on my own. they have a formal organization for mds coordinators. you might want to join to get as much info. as you can. the position is not for everyone. either people love it or hate it.

The scary part when you are the only licensed nurse in a facility is when you have emergencies like when someone codes, has to go to the hospital, etc. Then you have to stop what you are doing and follow up. Could put giving medications on time way behind. Especially worrysome when pts. need something as time sensitive as insulin. Or when they are in serious pain and left to suffer. In LTC only RN's can be DON's and MDS coordinators, give meds in an IV. I have a license in FL and worked out there for 6 months. Found out it was a right to work state and employees period did not have all the protection that they do in my home state of California. FL is a VERY litiginous state, the families are law suit happy and the state that regulates nursing home licenses is very strict. I improved my organizational, management and assessment skills in LTC, but I did not develop my skills for acute care hospital things. Depends on what your interests are. The turn over rate in LTC in FL is enough to make anyones head spin. YOU R NOT ALONE!!! Glad to hear you notice that somethings is not quite right.

unfortunatly some patients in nursing homes have dementia, alzheimers, and mental illnesses. these disorders can cause the patients to wander into other residents rooms and steal things its called hoarding behavior. nursing homes in california are supposed to have a theft & loss policy. when something is missing a form has to be filled out and the staff has to make an effort to find it. often time patients items wind up in the laundry and in other residents rooms. the property that is brought in is supposed to be logged into an inventory sheet and labeled. i cant recall all the details but there are instances where the facility is responsible for replacing the lost item. there are also times when a police report has to be filed. this needs to be brought to the administrator of the facilities attention so he/she can utilize there system for correcting the problem.:stone

you definatly bring up some valid points:p

farkinott what do you suggest as a solution that would allow employees to bring their kids to work without compromising patient care or violating any policies, etc? i agree that the parents are doing it out of desperation. i think it has a lot to do with the nursing shortage. people dont know what to do with the kids so they can work these odd hours. :)

its just a numbers game. whenever a unit works short a person just goes through the list of employees who might be able to fill the spot. you are under no obligation to work on a day you are not scheduled. i dont think the unit would have any problem taking your name off of the list if you asked them to do so due to the fact that you are unavailable. my allegiance is to my children. i feel guilty if i have to go to work on my day off because it interferes with my routine with the kids. you are a professional, your time is valuable and reminding your employer what your original agreement was as to your schedule is just good business practice.

i was wondering what people thought of staff who bring their kids to work with them. do you think this is ok? i have worked at quite a few places where workers have brought young kids to work. i kind of thought it was inappropriate because the workers in ltc complain constantly about having too much to do & i think that it takes away from their patients if they try to take care of their kids and the patients at the same time. i also think that it might be in violation of hipaa and exposes the kids and the patients to unnecessary germs. i also think if you allow one to do it you have to allow all. but i know that one of the biggest problems that nurses face is the availability of child care especially when we have to work before child care centers open until after they are closed as well as on weekends and hollidays. not to mention the expense. if an employer could only find a satisfactory way to deal with the situation. :stone

validating our feelings about the situation is of some benefit. and maybe knowing that we are not the only ones who feel this way. i agree the questions asked on these forms do not benefit the patient or staff. i love the question about the level of education. like what difference does it make? jacho duplicates the nurse practice act and state and federal guidelines. how many different times and different ways can all these agencies and forms say the same thing??? any suggestions to reform this process??????

i wrote a memoir about the highlights of my 27 year career in ltc, i recall the day i saw an lvn break open a vial to give an im med then taped it over, etc. whenever i reported these things i never got any support and was made to feel like i was being critical. it sounds to me like you were a very dedicated effective don and what took you 5 months to figure out took me 27 years (like what was i thinking?). the trail is littered with people like you who have given their all and have walked away with nothing not even a good feeling for it in return. you mentioned you have a son. ltc don is not compatable with family life. your story is famaliar, one that we can all relate to. i am proud of you for telling the administrator off and sending him the message that you were above sticking around and putting up with anymore of his foolishness. in california a don can not be held liable for a ltc facility until she/he has been there at least for 30 days. i think you spent more time than you should have at that place and did not leave a moment too soon!!!!!!:imbar