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LTC, OB, psych
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etaoinshrdluRN has 2 years experience and specializes in LTC, OB, psych.

etaoinshrdluRN's Latest Activity

  1. etaoinshrdluRN

    Do Not Send to Hospital From Nursing Home

    I do wonder about some DONs . . . had one rip up a repeat telephone order for eye drops because they were not on some formulary. Never would I want to work in a for-profit LTC place, ever again.
  2. etaoinshrdluRN

    Ever lost a job offer because of your reference?

    Employers do check references and I've heard back when references weren't reachable. Also got asked to offer supervisors as references because "I know the people you've listed will say you're a good joe." Don't know that I've lost a job offer because of any reference.
  3. etaoinshrdluRN

    Bedside hand-off/report?

    Been doing bedside report for almost a year, and it's the rule in my hospital. I love it. The reports are concise, the pt. feels he is more involved, and anything sensitive (work in psych) can be done at the nurses' station. I appreciate laying eyes on my patient and even establishing a rapport, and getting some aspects of the assessment done. Privacy is seldom an issue; the pt. is asked to come with us to a private spot. Some don't even think that is necessary. Any time a patient is awake, we must do bedside report . . . the exception being someone who is experiencing s loss of control or who is too agitated to handle it.
  4. etaoinshrdluRN

    Do Not Send to Hospital From Nursing Home

    Well done. I have sent pts to the hospital for needful things, and sometimes there have been pretty specific occasions when the POA does want pt. to be sent. Am also reminded of the time my DON dressed me down for getting hospice orders for a pt. "That is taking money out of our pockets!" I didn't even want to know what her bottom-line reasoning was; the pt. would have benefited from the aggressive pain control that hospice care provides.
  5. etaoinshrdluRN

    Nurses with ADD/ADHD?

    Carol, I appreciate your post, especially the bit about needing to know all aspects of a topic in order to integrate it. I've often felt that way about different paperwork procedures. I deeply need to know why I am doping what I am doing. Might be perceived as impertinence and restlessness by some, I suppose.
  6. etaoinshrdluRN

    When someone else gets terminated

    In the days when I worked as a charge, one of the first things we had to do when someone was hurt on the job was to send them out for a drug screen. I never had anyone refuse . . . not sure what the consequences would have been, had they. Seems to me that someone may be fired at will in most outfits, and speculating on impairment or lack of it is probably of no use. You're right that you need to keep your thoughts to yourself about it. Some thorny ethical issues about what to do if you suspect impairment (and therefore a person unsafe and unfit for working). If you intervened and did not report, what could happen to your license?
  7. etaoinshrdluRN

    medication to dry up breast milk?

    Seems a bit over the top to give anything, considering the lengths they go to to prevent DVT postpartum. And the mother may change her mind early on and want to nurse. I nursed my second one, but my first was born still, very preterm, and as I recall, the worst of the engorgement was over in 3 or 4 days. No big deal.
  8. etaoinshrdluRN

    Nurses with ADD/ADHD?

    I went from LTC to acute care. Found myself faced with much of what you seem to be faced with. A couple things helped in my case: 1) got a diagnosis and stimulant meds, because there was a "ditz" factor that scared me, when I would do something careless, despite efforts. Meds really helped me focus, as well as tune out interpersonal chit-chat that tended to distract me from my job 2) approached unit nurse educator for specific time management tips. She spent 3 shifts with me, came up with more suggestions and lots of encouragement 3) Learned to delegate as needed. 4) Made it a point to learn and know what resources were available to me. After being the sole nurse in the LTC facility to being one of hundreds in a large hospital, it required effort to identify what I could and should do, and what could and should be farmed out to the team. Diabetes education, for example, which is so comprehensive it could take all day, even with a motivated patient. 5) Really internalizing the difference between a charge nurse LTC role and that of a staff RN in acute care. ADHD people are often great at getting the big picture and properly advocating for patients. In LTC, that role is so much more limited. Task-orientation should not obscure the big picture, or patient advocacy. HTH
  9. etaoinshrdluRN

    payscales are secrets huh?

    I did not learn until I was given a job offer. Later, I found that our pay scale was lower, but in return, so was our nurse/pt ratio. I consider myself lucky, to the extent that the buck less and hour is immaterial.
  10. etaoinshrdluRN

    Pre-spiking IVF

    "LEAN" is a philosophy of simplifying operations in order to save time, errors, money. etc. "Kaizen" being the buzzword of the LEAN philosophy. But God help me, I have no idea how pre-spiking IVs is lean. Wouldn't that waste at least a few more IVs if they weren't required, after all? Could it possibly take 5 more minutes to draw a drug from the Pyxis and inject in it into the bag? ???
  11. etaoinshrdluRN

    Employment gap

    Verification of employment is a frequent background check. I left off a tentative charge nurse job because I accepted the offer, found out I had no time for it, and retracted my offer within days. I sent a note to HR about it, stating that it was so very tentative I didn't think it belonged on my résumé. I would rather disclose and plead uncertainty, than have a nonstarter employer show up in a search and THEN have to explain. She sent me a not back thanking me, and that she'd let me know if there were any "issues" with my check.
  12. etaoinshrdluRN

    Day in the life of OB RN?

    Feast or famine, in a small hospital. The one where I worked was fairly steady work, much of it unexciting. Lots of "false alarm" calls who come in, are tested, and go back home. When something goes wrong, it can be anything from scary to horrifying. I think there's a need for nurses who know how to help breastfeeders better, and who are sensitive to the vulnerability of new mothers. The small hospital where a friend works skeeved her, despite several weeks' training in a major lying in hospital, because in the small place, she was the only RN in the OB unit. She was not comfortable with it and is looking elsewhere. Anecdote: my first day in OB, my preceptor admitted a woman and literally caught her baby 29 minutes later. There's always something going on!
  13. etaoinshrdluRN

    What do you pack in your lunch box?

    Greek yogurt, hardboiled eggs, string cheese, random leftovers. Once I packed peanut butter on sprouted rye and my supervisor said, "What the f*ck are you eating? It looks like dog food! Guys, this girl needs some decent nutrition!" I just blinked at her and said, "I take it you're not accepting my invitation to lunch at my house?" String cheese is a staple because I can carry it with me and eat it on the fly. The times I have packed something big, most of it comes home with me because I have no time to pee, much less sit down and eat.
  14. What Snowstar4 said! Our program also provided us with on-line practice tests and booklets for each area of the NCLEX. You can do these kinds of things to diagnose your weak areas, if any, and study up. I've never had a particular problem taking tests, so grazing in the study guides for a couple of days was enough to help me. The test shut down after 70-odd questions and left me feeling as if it were like rolling off a log compared to my program's tests.
  15. etaoinshrdluRN

    New grad RN in LTC & HH - how soon did you find a job?

    I want to add that you should probably talk to employees (not the interviewer) of LTC places and ask them about turnover. Read their faces and sample the atmosphere. My last place took great care of its residents, but the work culture there was poisonous. The work load was insane, as well. Older nurses would join up and then resign without notice within days because the charting load was unusually heavy. I was let go, myself, after a couple years because I was, as they put it, and excellent nurse but a lousy ward clerk.
  16. etaoinshrdluRN

    New grad RN in LTC & HH - how soon did you find a job?

    It took me one application and interview to land a job in LTC, both times. I can't tell you what sort of facility is better for reinforcing technical skills . . . I got a regular workout with cathing (including a 400# pt. No small feat!), with flushing ports, dressing same, starting an IV or two, tube feedings, and myriad types of wound care. But the real education came in with finding my footing as a nurse, supervising people, working with other disciplines and managing demented people with behaviors. FWIW, it took 10 weeks for me to land a hospital job. I am told that the hospital that hired me is not hiring anyone much these days (Mayo). I suspect a selling point with me is that I am bilingual and have worked as an interpreter.