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Clovery

Clovery

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  1. Clovery

    new grad at LTACH

    I worked in an LTACH as a new grad. Read through this subforum, there are a lot of informative posts. Emse has posted loads of good info. My suggestion is to review: trach care and ventilators, different types of central lines, TPN and enteral feeding tubes, infectious disease, and wound care. Know standards of care when sepsis is suspected. Get ready to work hard while sweating your butt off in an isolation gown. Stay hydrated and good luck! Good luck
  2. Callbell goes off for the umpteenth time... "Yes, Can I help you?" "Why don't you have bendy straws?" "We do have bendy straws" Points at bent straw in cup. "Well they don't bend enough. Do you have straws that bend beyond a 90 degree angle? It's hard to drink laying in a bed." I just laughed and got a handful of straws. This was an observation chest pain patient, not even admitted, who was independent at home just hours ago. We were just going to put him on a treadmill stress test and send him home in the AM.
  3. Clovery

    Rules for Per Diems

    Of the 5 different places I have worked, all have had a minimum requirement for per diems which generally includes two weekend days per month (not necessarily on the same weekend) and one winter and one summer holiday. Some facilities extend the holidays to "special days" that aren't official holidays like easter, mother's day, halloween, etc.
  4. Clovery

    Looking up patients previously in your care

    Which FAQ? Here on the site or HIPAA's FAQ? Do you have a link? It's more than out of curiosity, it's clinical learning experience to follow up your assessment of the patient and the final outcome.
  5. Is it a HIPAA violation to look up the outcomes of patients you cared for? For example, you had a patient on a med-surg unit who you transferred to ICU. You come into work the next day wondering about what they did for him and what was the outcome (out of concern for the patient and for your own knowledge). Is it a violation to continue to access this medical record if you previously cared for this patient but transferred them to another unit? Thanks for any answers and I apologize if this has been discussed before, I searched but didn't find anything.
  6. Clovery

    Bedside Reporting

    I have worked on units where bedside report turns into "let me give you a long list of things to do before you can leave". I work nights and I understand day shift has the pressure of administration on their backs about every little thing (I've worked days, too). But sometimes it just gets ridiculous. Once I was giving bedside report and the patient decided at that moment to finally cough up their sputum sample into the container on their table. The incoming nurse said to me "You're going to send that to the lab, right?" I didn't want to argue in front of the patient so I just did it but I couldn't believe she asked me to take care of it. Other things like I didn't put a chair alarm on the bedside chair for the fall precautions patient who came in at 2 am and has been sleeping in bed all night. Although I have to admit getting bedside report "right" for the most anal nurses has become somewhat of a personal challenge. I prefer to give "real" report at the desk, then make rounds together, the incoming nurse updates the white board, checks the IV, asks about pain, and mentions the patient's upcoming procedures and treatments. I think this is good customer service, gives the patient the security that their needs have been communicated without wasting too much time in the room.
  7. Clovery

    Would You Report Me for This?

    You were definitely in the wrong here. As your co-worker I would not have written you up but would have advised you not to leave meds at the bedside. As your manager, after a family member complaint, I would be forced to write you up in case that family member reported the incident to the state. I would need to have the incident documented and show that action was taken to correct it. Try not to blame your manager too much, she really had no choice but to write you up. And she's right that it's poor practice. I have worked in LTC and I know how little time you have to pass meds to all the residents. I found it nearly impossible to get the med pass done on time while still following all the rules. However, I always made sure the meds were actually taken. If you leave a pill at the bedside, another resident may take it. This is one shortcut you really can't take because, as you learned, it will come back to bite you somehow. If the resident is slow to take pills try to convince them to take them in applesauce or pudding so you can just feed it to them and be on your way. If they won't take it right then and there, save it for later and try again. If they still won't take it for you, they have refused that medication and you can document their refusal.
  8. Clovery

    Should I take this job?

    $19/hr? Is this a decent rate for your area? I assume you are an RN? I would worry about the drive home after working nights. I have never minded driving to work. I work 10 minutes from home now and I miss the drive time of previous jobs. Driving into work gave me time to drink my iced coffee, listen to some good music, be alone, and mentally prepare for my shift. One hour would be my limit, though. 30 minutes is just right. Now I spend just as much time walking from my car to my unit as I do driving into work. I can never complain about the short commute home, though. Especially when I have to work another 12 the next day. A two year contract is a long commitment if you find that you can't stand the drive.
  9. Clovery

    Attack of The Killer Poop

    I worked in LTAC for over a year. Whenever someone asks me what it's like I have to mention the poop. It's all total care patients, mostly vents. Many of them have c. diff. So basically we run feeding into their tubes and then it just streams out their butts and all over the bed. I always warn CNAs especially.... "you don't want to work at an LTAC".
  10. Clovery

    12 hour shifts - sub-acute

    I'm from further south, but I know Genesis does and they have facilities all over the state. I haven't heard good things about working there, though.
  11. Clovery

    Poll: Nurse and law enforcement couples

    My husband isn't a cop, but my mom is a nurse and my dad was a police officer.
  12. A quad patient with a chronic infected sacral wound became infuriated with me for waking him up at 0900 to take his meds and encouraging him to eat his breakfast. He didn't want to eat so I tried to get him to take his marinol to stimulate his appetite. He only wanted his IV dilaudid of course. After I gave him that, hung an IV antibiotic, and again talked about the importance of nutrition for wound healing, he accused me of being racist. He then asked to talk to my supervisor, who I brought into the room. He told her that I was extremely rude and said "maybe I'm the wrong color for her" (he was African-American). Management assigned an African American nurse to him and I didn't have to take care of him for the rest of his stay. Fine by me.
  13. Clovery

    Email Follow up

    I interviewed for a position recently, was told they'd be making decisions in a week or so. Three weeks later I got an official offer letter. Since you are past the recruiter interview stage, you don't have to worry so much about annoying the recruiter. The decision is no longer in his/her hands. I would call the recruiter, tell them you interviewed for the position and you would like to know if you're still being considered. If you get a voicemail, hang up and try again at another time. The problem with email is that it can easily be ignored. If you send the email, the recruiter might read it but not respond and then you'll be left wondering. It's best to catch them on the phone if you can. At my hospital system, it's against policy (or at least frowned upon) for the nurse manager to have any contact with applicants in the post-interview/ pre-offer stage. So you may not get a reply from the nurse manager. However it could prompt her to contact HR to send you the offer or "not selected" letter. The four hour shadowing experience sounds promising. I have never heard of anyone doing this, although it could be a form of a peer interview. Did you send thank you emails to the nurse you followed and the manager after that?
  14. Coming from an area with a similar nursing job economy, it has been my experience that hospitals aren't hiring per diem employees who have no experience in acute care. For a new-to-acute care nurse, the orientation is generally at least 8 weeks on a full time schedule. Think about how long it would take just to orient you if you are only available one day per week. I agree with the previous poster.... look for a full or part time hospital position and leave your current job when you find one. You could easily pick up a per diem position in LTC/rehab to supplement this once you are off orientation.
  15. Clovery

    Vasoactive drips

    One of my family members was in a medium-sized community hospital (admitted from ER with SVT). She was in the ICU on a cardizem drip and once the drip was d/c'd they transferred her to the tele unit. I have worked on a tele floor in an LTAC and vasoactive drips were also limited to the ICU.
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