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  1. rainbowsandsunshine

    How do you determine what is a good facility BEFORE you work for them?

    Once, on a weekend, I was approached by a potential job applicant (I was on the nurse cart doing my rounds) and she introduced herself and asked if I liked working there. She then asked what I struggled with the most at my job. I fumbled and struggled to be positive, but it was obvious how miserable I was. I dont think she ever bothered applying. Maybe try that? Catch them off guard and try to get an honest reaction.
  2. rainbowsandsunshine

    question about job hunting

    That place on the application that says, "May we contact your current employer?"... I always check 'yes'. Because I think it would look bad to say no. However, I am kinda worried my current employer may get word that I am out looking for a new job before I get any offers, know what I mean? Any suggestions about this? My HR department and DON office are buddy-buddy, so I dont think they keep many secrets :/ Thoughts?
  3. I really need to find a new job ASAP, because of a variety of factors.... things have just become unbearable for me there. At any rate, I am having a really tough time finding a job ANYWHERE, and even LTACs are ignoring my applications. Am I stuck with SNF forever? I am worried about jumping from the pan to the fire, if you catch my drift. Any advice on how to find a better facility? This job market is terrible
  4. rainbowsandsunshine

    I have your meds, please take them:)

    I agree, I always watch them take their pills, and frequently check their mouth to make sure everything went down (if they are not Ox3). I would never leave pills at bedside. If the patient did not want to take them, I would put them back on the med cart or lock them up to offer at a later time. You never know who might wander into the room and take those pills.... think of what would happen if somebody took an unprescribed BP pill, narcotic, or other serious drug? Many medications can be very dangerous, not everything is colace!
  5. rainbowsandsunshine

    Postfall Neurochecks. What's your protocol?

    witnessed with head injury or unwitnessed = automatic neurochecks. q15min x 1hr q30min x 2 hr q1hour x 4hr q4h x 24hr the worst is the frequent fallers.... Sometimes they fall so often that you cant even finish one sheet of neuro's before beginning another. Of course we have alarms, low beds and floor mats, but many of these people are skilled at turning off the alarms, and doing as they please. Just not enough staff to watch them 24/7 and they choose not to ask for help (i.e. USE YOUR CALL BELL!!!!)
  6. rainbowsandsunshine

    Needing some realistic perspective....

    In nursing school, I really enjoyed my psych clinical, but I wonder how much of the 'real' psych world we actually saw. Most of our day was spent out in the milieu, going to activities with patients and sitting in on a few patient/psychiatrist evaluations. I enjoyed it, but Im sure there is a much more expansive view of the psych world that I never saw. Now, I am working in LTC and we have a few patients who have chronic behavior issues. I have the hardest time dealing with the patients who yell non-stop when they want something. Even if you are in the same room with them, if you are not immediately meeting their need, they keep yelling. These patients are usually on psych meds, but are rarely re-evaluated by the psychiatrist. At any rate, since it is LTC, they will likely not be discharged, so I will be working with them daily until I find a new job or they pass. I would like to pursue employment at a psych facility, based on my clinical experience.... but I am worried that I will find myself in a situation much more like the current non-stop yelling situation. I wonder if I am seeing the opposite ends of the spectrum? The best case scenario and the worst case scenario? So I guess my question is...... what is your average patient load really like? Lots of difficult, high needs people, or a mix?
  7. rainbowsandsunshine

    Favorite Dr or Nurse Name

    Dr. Winkle, urologist. "If you cant tinkle, call Dr.Winkle!" btw, he is awesome :)
  8. rainbowsandsunshine

    Wound care nurses in LTC, question please?

    If you are a wound care nurse in LTC, what are your duties, and what treatments are done by the floor nurses?
  9. rainbowsandsunshine

    Skin Tear and Duoderm Question

    Working in LTC, we also use steri-strips (if small and skin flap intact), or tegaderm (large or missing/altered skin flap)
  10. rainbowsandsunshine

    Best Nursing Quotes

    Showing up is half the battle. Never be afraid to call for backup!
  11. rainbowsandsunshine

    My LTC experience doesnt count :( HELP!!

    So frustrated..... After months and months of searching as a new graduate and coming up empty handed, I felt blessed to get a good paying job in LTC. Now, almost a year later, my "blessed, good paying job" has turned into a nightmare situation. I am desperate to find a new job, but everybody wants acute care experience!! Seems like all this time in LTC has been a waste (Career wise). I just dont know what to do I am going to take ACLS, and apply to LTAC's, but the hospitals still wont even talk to me. All they tell me is to apply for their bi-annual new graduate residencies, which are even more competitive than nursing school. (Plus, my GPA was just a 2.9- a smidge below their required 3.0) Really frustrated... I need a new job STAT, and I need one with at least equal pay, plus some affordable health benefits. I am a good nurse, I am just in a bad situation and I cant get out Any other ideas of places to apply??
  12. rainbowsandsunshine

    What career step got you into OB?

    I really want to be an OB nurse!! (and so do LOTS of other nurses!!). My question for you is: What did you do in your career that enabled you to get into OB nursing? I dont have acute care experience yet, which is a major stumbling block for me. I hear about new grads being lucky and getting hired on, but apparently I was never that lucky! My plan right now is to find a more acute job, and hopefully in a hospital, and then work in the OB direction by gaining experience and rubbing shoulders with the OB nurses. Any other tips? I hear lots of nurses talking about increasing your certifications.... if you do not work for a hospital, how do you get certified in these areas? Do you take local classes or college classes? I would like to boost my resume, but most of the classes I see are ACLS or BLS.
  13. rainbowsandsunshine

    How does Safe Harbor work??

    Lately at work, I have been very worried about our staffing ratios and the difficulty of caring for so many patients. These concerns have fallen on deaf ears with my supervisors. I was looking at the BON website and it talked about Safe Harbor... but the descriptions were pretty vague. Can somebody tell me (Step by step) what happens when you request safe harbor?
  14. rainbowsandsunshine

    So done.

    Makes me sad, but I am so done. Done with LTC, or maybe just this facility but it is making me sick. Mentally and physically sick. I have so much internal anger... and I am never able to express it at work, so it gets vented out on my poor family. Our facility is WAY WAY overbudget for staffing. Mostly because they were so understaffed that they kept hiring agency to fill in the gaps (which costs more, of course). Now their new cost-saving policy is that if somebody calls in sick, you just deal. Other people pick up the slack. Nobody is allowed overtime, and you can forget about picking up those extra non-staffed shifts. This sounds like a good idea in theory, but not in practice. Today, my fellow nurse had to fill a lower, yet absolutely essential position, so I was the sole nurse for almost 60 patients. And we had 2 admits. In fact, I was so busy that 1 of the admits arrived, and I was not even notified (somebody else must have signed with the EMS). At the end of my shift, the night nurse said that the patient was in their bed... I was certain they had not arrived yet, since I did not know. Turns out, I walked down the hall, and there they were! Now, how is that safe nursing care? I am so exhausted. I cant even talk about my day with my husband when I come home, because the expletives and cursing are not appropriate in front of my children. Counting down the days until I find something new
  15. rainbowsandsunshine

    The 5 things you love & hate about being an RN

    I work LTC... Love: 1. My favorite residents. The ones who are always kind, happy to see me, and tell me they miss me when I am gone 2. The co-workers I trust. Working with my favorite nurses can really make a day 100% better 3. Plenty of overtime options, meaning I can make as much money as I need. 4. Managing ongoing care for my residents. I know their medical histories, what is "normal" for them, when to ignore the little stuff and when to freak out about the big stuff. 5. Working close to home. My work is a 5 minute drive from my house, and I love having a minimum commute. Hate: 1. Overwhelming?! Overextended?! Yes!!! omg, my entire 12 hour shift is packed full, and even when it is time for me to leave, I am never fully finished. Then management comes up with some new task for me (usually babysitting the CNA's), which will only take up more time and steal my time away from the important tasks like NURSING CARE! And if you try to voice your concerns, your DON goes into her "when I was a LTC nurse, I took care of 50 patients by myself, all the med passes, all the tx, all the everything". ..... Well, that sounds great, but since I dont have wings on my shoes or a magical teleportation wand, that seems unrealistic to me. 2. CNA's who do pi$$-poor work. Some are really fantastic, but the bad ones make me want to scream! Non-existent incontinent care, refusing to get residents up/lay them down, ignoring call bells.... ARRGGGGGHHHHH!!!!!! 3. Discipline is a joke. At least in my building. My DON/ADON will tell me "just write them up". But nothing ever comes of it. Seriously, it is pretty much impossible to get fired from my workplace..... which really sucks because we have some horrible staff members who need to go. 4. The mean/horny/hateful residents who abuse the call bell and grate on your nerves. Of course, the facility will never discharge them (why give up the money? we'll just suffer through instead!), so your only hope is that someday they will die or you will find a new job. Even after UA with C&S, psych consults, behavior intervention from the social worker, they still make your job miserable. 5. The nurses who make you crazy. Either they talk smack behind your back, are in constant "freak out" mode or just too lazy to do their work. Working with them increases your stress and makes you constantly worry about "CYA=Cover Your A$$" Sorry for the vent, I really need to find a new job!