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SineQuaNon MSN, RN, NP

ED, Family Practice, Home Health

Content by SineQuaNon

  1. SineQuaNon

    Difficult doc

    It's time to fight fire with fire. A lot of these types of arrogant assholes simply will not respect you until you ramp the dialog up a notch. I recall a memorable conversation with a doc where I ended up saying "Hey! ***! You DO NOT speak to me in that tone of voice and you better do the job you are being paid for. Grow up and act like a professional adult!" I literally never had a problem with him again.
  2. SineQuaNon

    Negligent Charge or Endure?

    I would be very clear with her. If she says she has to work on staffing while you have a patient with acute respiratory issues that you need help with, your response should be "I'm sorry but that won't work for me. I need your help now in the best interest of this patient's safety. Or can I have a written note confirming your refusal to help with this critical patient?" Document everything with dates, times and witnesses. Write it in an email and send it to yourself. That way it is time stamped. If necessary you can then forward these emails to management.
  3. SineQuaNon

    Any nurses had arthroscopic knee surgery?

    I had surgery and they cleaned up my meniscus. It is just now beginning to feel better and it's been six months. And I don't know if the surgery had any effect or if it was just time that did it. If you can ramp up the PT I would try that first.
  4. SineQuaNon

    New grad overwhelmed

    I think it's going to be a madhouse for bit. Eventually you will get a system down and will find ways to maximize your time. In the beginning you will constantly forget things or just not organize well. For instance, go and deliver the AM meds and forget to also do the CBG sticks, so you'll go back to get the glucometer, and then forget someone requested Tylenol and then go back for that. Give it a few months and you will be a well oiled machine. Ask the other nurses how they manage med passes, there are tricks that make it go faster. It does get better.
  5. Hi All! I thought I would share with you all my basic form response when I get an email or call of interest about a job I've applied for. So far it has worked really well for me and I'm actually turning down offers whilst looking for the perfect fit. " Hello, Thanks for your interest in scheduling an interview. I can make myself available, but before we schedule, I want to inform you that I have a felony. I realize this a a deal breaker for some employers. Many years ago I was a horrible drug addict and I did not make it out of that time in my life without legal repercussions. But, to be honest, I personally am OK with it because it was those repercussions that helped me get clean. And if a felony is the price for this life I have now, it was more than worth it. As horrible, debasing, and humiliating as that time of my life was, it has honestly made me a better person. Kinder, more empathetic, and more humble. There is no one in my life that isn't aware of my past and I'm blessed to have a number of professional contacts who know my skill set and would unhesitatingly recommend me. But! I completely understand if this is a hard stop for you. Regardless, thank you for your consideration and have a lovely day. SineQuaNon" Literally everyone I've sent this to has responded that they still want to go ahead with the interview.
  6. SineQuaNon

    As an LPN, I can't help but feel like I'm not a "real nurse"

    I think you should try to do an LPN to RN bridge. Not because I don't think LPNs are awesome, you are! My aunt was an LPN her entire career and I've had many LPNs guide and mentor me over the years. But I think you deserve the pay and recognition of your skills that is just harder to come by as an LPN. You were smart to get your LPN first. If you play your cards right you can get your employers to pay for you to get your RN and you won't incur nearly the debt I did. There is more education that comes with the RN that I believe may become helpful, particularly if you want to move out of LTC. And, at least where I live, RNs make about $15 more per hour than LPNs. That works out to $30,000 more per year. Over a lifetime that really adds up.
  7. SineQuaNon

    Practicing in another state than where you got your NP

    Many states also have compact licensure agreements. For instance, if you're licensed in New Mexico you can also practice in Colorado, Arizona, and Utah without having to endorse.
  8. SineQuaNon

    Felony conviction/ OIG list

    See about working in home health as an independent contractor. I work for Giving Home Healthcare and they hired me with a felony for prescription fraud. When I called to ask about the job...or any job I apply for....I tell them about the felony right away. I always include how recovery and consequences made me a better person. My charges were almost 7 years ago though, so I think that helps.
  9. SineQuaNon

    NP in recovery

    Hi Suz9081, I'm also an NP in recovery. I live in NM but was originally licensed in Cali, which has revoked my license. I worked as a nurse for a while and have recently become licensed as an NP again and am looking for work. I was able to get back into nursing despite a felony by applying at nursing homes and home health agencies. I'm always very upfront about my past and how, despite how horrid it was, it made me a better person.
  10. SineQuaNon

    How to help coworker with substance abuse

    As an addict myself, she needs to be told to self report to the board. Or to quit or take a leave of absence to deal with her addiction or YOU will report her to the board. Probably the best way to handle it. She could not be using....but she likely is, and she needs to be called on it. Getting caught saved my life and is the best thing that ever happened to me.
  11. SineQuaNon

    My patient an addict or does he actually need it?

    Hmmm. Yes these types of patients are annoying but there really isn't much you can do about it except bring the ordered meds when requested. A doctor ordered the medications after doing an assessment. Even people with legitimate pain develop tolerance and can experience withdrawal. You don't know what that person feels and "pain is what the patient says it is". With this type of patient I try to remind myself that their life is horrible. If pain medication makes it better, either through actual pain relief or through a placebo effect, it's not for me to judge. With someone on long term pain management they are unlikely to be getting high on the doses ordered for them, they have built up a tolerance and are likely staving off withdrawals and/or preventing pain, both legit reasons to give someone meds.
  12. SineQuaNon

    IPN question (enter or not?)

    I have to agree with the previous post, it sounds as if it sucks, but once you get into it, you just do what has to be done. In Cali I have to go to an NA or AA meeting EVERY DAY, RN support group once a week, intensive outpatient treatment for 9 weeks, and random drug testing at $100 a pop 4-5 x a month. The program here is 3 years and I've just started. But something odd happened once I began. I actually enjoy going to the meetings! The experience is really good for me. Once you surrender yourself to the process I think you'll find it will change you in positive ways you never imagined.
  13. SineQuaNon

    Please Help...should I self report?

    I'm curious what the OP's decision was. I would recommend staying away from the BON. But please, please, please take a leave of absence attend an intensive outpatient or inpatient drug treatment program (often insurance will cover this), go to 30 Narcotics Anonymous meeting in 30 days (for real), and enroll yourself in some kind of random drug testing. Why? If your previous employer has turned you into the BON it can sometimes take months for them to send you your letter. When they do finally catch up to you it will go miles in your favor to have a paper trail documenting your recovery process. Get a piece of paper signed at every NA meeting you attend. Also, by taking a leave of absence you get yourself away from the immediate temptation and give yourself some room for recovery to really happen. I wish someone had told me to do these things before I was "caught" by my board. I'd tried to quit numerous times on my own. Even attended a few NA meetings, but I didn't stick to the program.....now I have no choice. But I wouldn't trade it for anything. My recovery, while not complete, has been amazing. I LOVE narcotics anonymous. I WANT to go to meetings. And I enjoy the accountability of random drug testing. I'm blessed. I'm doubly blessed living in California where I'm able to receive disability while in my first year of recovery (state, not federal, I payed into the pool as I worked). It is unlikely I will be able to get a job for at least two years though, so I have to be frugal and make the money last for two years. But I can do it. You should see if you are able to receive disability in your state, either for addiction or depression. Best of luck to you.
  14. I don't know the answer but if you look at it statistically, 10% of healthcare practitioners in any given profession at any given time have some form of substance abuse issue. Of this 10% only 10% is likely to be in any kind of diversion program (I'm guessing at this). Not all states have diversion programs, so those states would be out of the calculation (but not clear of diverting nurses). Then it becomes an issue of the most populous states that also have some form of diversion program. Likely California, Texas, or New York. But again, why are you asking? And why couldn't you figure out the above on your own? It's ain't exactly rocket surgery.
  15. I don't really understand the idea the that first responder training is all that. As the previous poster said, first aid is a 4-8 hour class. Anyone with basic common sense could figure it out. TNCC cert is only a two day course, most of which is also common sense. Another poster made it seem like scene safety is a constant battleground.....really? As a former firefighter, medic, Search and Rescue tech, and current trauma nurse, unless you live in Compton, the scene survey takes all of 15 seconds and 99% of the time is completely benign. Keep your wits about you, but it's not rocket surgery. First responders have a basic, elementary school level skill set....and I say this as one of them. It's not some unattainable holy grail that requires 15 years of experience to do properly. I've saved lives by pulling over and being of service when no one else was around. In the instances that happened any competent nurse would have been able to do the same, whether med/surg, NICU, or ED. Also, the numerous times I've stopped to see if I could be of help it has never been for some nefarious scammers. The media makes it look as if that is the norm but it isn't. That should never influence your decision to help....the likelihood that that is what's actually going on is very, very slim.
  16. I would stop, and have, on numerous occasions. True there isn't much I can do without my hospital supplies, but often the most important thing is just to tell someone NOT TO MOVE. Even after pretty bad accidents with open fractures and lots of blood, I've seen the injured try to get up and walk. In addition to that I can clear airways, stabilize c-spine, and apply pressure to bleeding wounds. I believe it's my moral obligation to assess the scene of an accident as a first responder to see if I can lend a life saving hand. Most often I visually scope things out from my vehicle and drive by without stopping. Obviously if EMS is already there I leave them to do their job, but if they're not, and I can be of aid, then I do so.
  17. I didn't get the feeling that the OP was putting down long term care or dialysis nursing. Different strokes for different folks right? While I expect that when I'm allowed to work again it will be in dialysis or LTC, it wouldn't be my first choice. Does this make me a bad person or undeserving of a chance to work in those fields? Of course not. Will I make the best of a bad (or less desirable) situation? Of course I will! We're here to support each other. And that means not taking offense where it isn't intended. If you WANT to get offended by something, you will. That doesn't mean it was the intended outcome. Eleanor Roosevelt said that "No one can make you feel inferior without your permission." I would extend that in this thread to mean, "No one can insult your chosen profession without your permission."
  18. SineQuaNon

    lpn with actions against license to rn

    It will also depend on what you were sanctioned for. And if you can show/prove that you've taken steps to rectify this behavior/keep it from reoccurring. You will want to establish a record of some kind proving this. If it was a DUI, then AA meeting and completion of some kind of program. If it was fraud then classes or education etc. Good luck.
  19. SineQuaNon

    Chronic lateness- what is that about?

    I'm one of those chronically late nurses. I don't know what it is but I'm always 3-10 minutes late. I set my alarm clock early, I'll even get up early but by the time I get out the door I'm barely holding it together. Oddly enough I have great time management on the job. Honestly, it's the sleep thing. I've been a chronic insomniac for my entire life. By the time I finally get some shut eye it's usually 0300, so by the time the alarm rings (at 0600) I've just settled into REM and I press the snooze a few too many times. I HATE that I'm late. I certainly don't think my time is more precious than anyone else's. But there it is....
  20. SineQuaNon

    Clean and Sober! California Nurse Wants to Reinstate.

    Hello, I'm in the California Diversion Program. Just started, 3 years to go. At the end I will be allowed to keep my license with no restrictions and no notes. I will be able to deny ever having been in the program if I want. I just have to make it through the next 3 years. What the BON wants is proof of your changed life. Immediately begin attending NA meeting, get a paper signed every time you go, they like a meeting every day for the first 90 days, and then you can drop down to 3 a week. Get a sponsor. Minimum of 7 years sober. If you have not already, attend an Intensive Outpatient (IO) drug treatment program. It needs to be 9 hours a week for 9 weeks. It will be expensive. Get some record of clean urine tests. You can call First Lab and try to set this up on your own. Also the IO may have some ideas for how you can get this done. The testing needs to be random and the BON likes a year of clean tests minimum. Begin attending a nurse support group in your area. The CA BON website has a list of nurse support groups listed by city. They are confidential and you will find amazing support there. It's a lot to do, especially in the beginning with calling every day to see if you'll be tested that day, going to q day NA meetings, PLUS the 9 hour a week IO meetings. But if you do all that, which is what the diversion program is, then I think you'll be setting yourself up for a good chance of reinstatement. SineQuaNon

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