pa715

Since you have been there less than 90 days I don’t think they can ding you. You can say it’s not the right fit for you, and then say you are moving. Most places have a 90 day probational period. If you quit after 6-12 months that would look worse.

I work in an outpatient psych clinic. We are a specialty clinic within a larger primary care clinic. I was asked by one of the MDs I work with to tell a new patient via telephone (all of our patient contact is via telephone except for in person MD visits) that at the initial new patient MD visit, the MD will not prescribe a controlled substance. In MDs review of the chart, this patient has a long standing addiction problem which is the reason why MD will not prescribe said medication. I also was told to tell the patient that patient can be prescribed other medications and be treated for other conditions. I went ahead and did it, patient not happy of course. Yet ethically, morally, I really don't think an RN should be doing this over the phone. This is a conversation to be done in person, face to face, by the MD. The MD should work with the patient in person, by offering to help the patient either go thorough detox or be treated with other non-addicting medications. Afterwards, I brought it to the attention of our doctors. The MDs reasonings were that it's a safety concern, and that no matter who is telling the patient this, a RN, MA, the secretary, MD, it's not going to be a pretty sight. But I disagree. I nor the MD have any relationship with this patient. It was strictly chart review and no face to face conversation was had before coming to this decision. Im sure this patient has been told 1,000 times No, but who has actually sat down with her and worked through her addiction? I am just a RN, but the MD has more power to work with this patient. In this age of addiction, I think we need to work with these patients to help them, give them options, instead of just doing a blind judgmental no. Thoughts?

I completely understand your frustration. You are so right how we are constantly making sure the doctors don't "accidentally" kill the patients. I think there's even a facebook page called that. Nurses we do so many jobs and get no credit or appreciation for it. However, I think your talents are not being used in the best environment. I'm assuming you work in a hospital? Have you tried considering Home Health? I hate when people just assume that nurses only work in hospitals. You work normal hours and might have to work a weekend once a month or be on call. But you have 4-6 patients (depending on your agency), rarely have to deal with doctor crap and politics. You get to call the shots and the doctors will actually thank you because you are keeping the patient out of the hospital. You are kind of an extra set of eyes and ears for the doctor to keep tabs on the patient, but you are not having to cross all his Ts and dot all his Is. You get to make your own schedule. You get to form relationships with your patients and their families. They appreciate you! They thank you! There's a lot of paperwork yes and there's a lot of driving, but it was one of the most rewarding jobs I ever had. Administration isn't breathing down your neck, you rarely see your coworkers maybe once a week for a meeting or a joint visit with Therapy. I really encourage you to try this avenue. You can do peds, elderly, hospice, etc. You could also try private duty but the pay tends to be a bit less and they might not have something fulltime. I really encourage you to just give it a shot. Who knows, you just might love it!

A couple other ones are IVHQ, GVI, and Project Cure. You pay to do this, it's voluntary.

is it computerized charting? I think that's the way to HH. That way you don't have to go in to the office every day and can chart in the patient's home. I try to chart as much as I can in the home, then try to finish my charting in the car in the patient's driveway before heading to the next patient. Otherwise, at the end of the day I will forget everything. Other nurses I work with finish their charting before they return home. That way you don't have to literally bring work home. I think your hourly pay and mileage is great.

Jeesh? A real nurse? What's that supposed to mean? We are all nurses, whether we are school nurses, home health nurses, hospital nurses, retired nurses, former nurses, nurse managers. We need good school nurses, too, because perhaps you may be the only caring adult in that child's life! Our children are our future and we need someone to take care of our children. And perhaps you can even inspire children to become nurses! While I appreciate our hospital nurses and paid my dues, they aren't all that. Hopefully our patients are only in the hospital for a few days and are discharged. We need nurses that take care of people year-round, not just short term in the hospital.

Maybe get a small used car like a Yaris, Ford Focus, or Honda with really great gas mileage, is cheap, low maintenance, and inconspicious. Then buy a nice car for your husband/weekends. It's a bonus to have a small car cause you can fit in tight spots and maneuver down difficult driveways and it won't matter if you run into a rock wall or something. Also, you wouldn't want to flaunt the money that you have going to patients' homes. They want to know you are doing it to take care of them, not for the $$. I would not want a luxury car for home health. You are in your car all day, at the end of the day you won't want to get in it whether it's a junker or a Bentley. You'll spill coffee, lunches, water, etc and will need a car that doesn't mind getting messy. Plus, you don't want to go someplace nice, open the trunk of your BMW only to find a whole bunch of catheters and bedpans! LOL!!

While I do not have any experience in nurse research, I would suggest find work on a gero or gero-psych unit preferably in a teaching hospital/hospital affiliated with a university. Stay there for at least 2 years. Maybe even work part-time/per diem on a Alzheimer's unit to get the LTC experience with such patients. Once you have a few years, try applying to research jobs. Most of these jobs require at least 2 years bedside experience. Subscribe to nursing publications and get any sort of certification in Alzheimer's, if there is such a thing. Maybe just geriatrics. Try volunteering at research places to network. Scour the nursing publications for any leads to research. It may take a while but that's really the only way I can see getting there. As for graduate school, I really have no idea what area you would pursue. Psychology? Sociology? MSW? For researching Alzheimers, what exactly do you want to research? Nursing care? Causes? Medications? Prevention? Determine that aspect which should put you in right the direction for graduate school. Who knows, maybe a PharmD, Research Science, or MD is in order.

I think the best thing that your employer should do is hire a safety officer (a vet to give them a job and put their skills to good use as a civilian) to be on-site should any threats occur. I think it's absurd you would bring a gun to work and even think of killing a patient. You work in pain management which is one of the most difficult areas of healthcare and those patients may have some mental health issues, etc. But you choose to work there and work to care for these patients. Alabama is a very racist crazy state so I am not surprised that this is tolerated there.

LOL. I'm sure there's plenty of times I would've loved to do that!!. Pack some power bars that you can just chow down for a half minute in the break room and finish the other half before you see the next patient. Or you can get that guu stuff that runners eat on the run! LOL!

hi everyone, I came across an embarrassing situation last week and want to know if I did the right thing. We have our patients write down their medications and we go over it with them to double check for accuracy. The patient had their BP and chol medications which was of course QD. Then they wrote their medication for ED and also wrote once a day. I put that into the records as I was just going down the list a bit hurried. Looking back on it, that medication probably isn't taken daily but it's in his records now. I should've put prn out of respect but pt did indicate once per day. What would you have done in this situation?

Two questions: 1)how to remove IVs without getting drops of blood on patients? 2) Do you always glove your removed IV and then throw in trash? I just feel like I will stick myself doing that.

Thanks guys. I understand the whole iodine thing, but the tech(?) was like, ask if they are allergic to shellfish if they are allergic to Sulfa? WTH? Ok well I ask a patient all of their allergies but this was a bit strange. English wasn't his first language so I'm thinking that is the confusion.

Is there any correlation with Sulfa, shellfish, latex, and iodine? A coworker tried to tell me that I need to ask if pts re allergic to shellfish if they are allergic to Sulfa? Is this true? It must be wrong. So confused! What do I need to know about allergies to these things?

I HATE Diabaet-ez. Isn't it Diabeeteez?

I was recovering a patient who was a doctor and could not get the bed to go down straight. so I had to do the head down then feet down back and forth so it was incredibly embarrassing for me. After the patient was discharged, I tried to put the bed down and of course it goes down normally. hopefully he won't remember me with all that Versed... When I was working at the hospital, I remember a young male new grad was putting a catheter into another young guy and the nurse fainted!! I felt horrible for the guy, so embarrassing. But also too funny!

Thanks everyone for your responses! I think I will check with the WA BON about making my license inactive. Luckily, it doesn't need to be taken care of until May.

Hi Nurses, I recently moved to AZ (a compact state) from WA state (NOT compact). My AZ license lasts for 4 years, my WA state license needs to be renewed every year. Do I need to keep my WA state license active, or do I let it lapse? Would I be able to transfer it back to WA if need be? I don't really want to move back to WA, but if anything were to happen, it is where I was born and raised, and all of my family are there. Thanks in advance for your replies!!

You could always try home health for a year or two. You are essentially a case manager for a caseload, and lots of what you do is help them manage their disease on a day to day basis in their home. So different from the hospital or clinic.

I would suggest doing home health for a few years before transitioning into this type of position. I just got a job with a similar company with 2+ years of HH. You'll learn case management as well as the insurance woes. Good Luck!