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TriciaJ RN

Psych, Corrections, Med-Surg, Ambulatory
Member Member Expert Nurse Retired
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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

37 years of nursing in psych, corrections, med-surg, ambulatory

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TriciaJ's Latest Activity

  1. "Lacking insight" generally is not considered adequate criteria for a hold. A doctor's order is certainly not adequate to involuntarily detain someone. If the "hold" process isn't appropriately followed, you need to open the door and let the patient walk.
  2. "Oh bummer! Wouldn't you know it? I just cancelled my cell phone and had a landline put back in. Dang!"
  3. 1. Start looking into the hospitals in the Spokane area. No rush. Just start scoping things out. If your boyfriend presses, tell him you're working on it. Also check out the housing market. 2. If he is in the military, how long can he expect to stay in his current location? Does he have any assurance of a minimal duration? 3. I would not put a lot of stock in a ring. It's just a piece of jewelry. You could have a ring on your finger, disrupt your career by moving and then have things fall apart. 4. As hard as it is to be apart, a solid relationship can ride out temporary hardships. Can he not give you six months to get some (barely) solid experience before pressuring you to move across the country? Just how good is he at deferring his gratification for the bigger picture? 5. Work with him on getting yourself to Spokane as soon as it's practical to do so, based on your research. But while you're doing it, watch his behaviour. Is he mostly patient and supportive, or is he having little meltdowns because you're not jumping when he snaps his fingers? Not only are you getting some footing in your career, you have a great opportunity to see if your relationship is really worth moving for. Good luck.
  4. There are laws in your state that speak to this. If the patient is to be held against his will on mental health grounds, there should be a certification process that the doctor has to follow. There will also be an appeals process in favour of the patient's wishes. I do not believe there are any jurisdictions where a doctor's order will suffice on its own to detain someone against his will. Please discuss this situation with your manager ASAP. If need be, run this by your hospital's risk manager. You could be named in a habeas corpus suit if you go along with this. These doctors need to be hauled up short. Please research the applicable laws in your state and get your protocols updated.
  5. Smoking history is part of your medical record and your insurance carrier can access that. Smoking-related health conditions are pretty hard to hide even if you lie about actually smoking. No, overdoses and drug history are not reported to police. All medical information is protected by law. If you have involvement with the police and they need to access protected information they need a subpoena. I believe in most jurisdictions it is mandatory to report gun shot wounds to the police. As well as suspected or confirmed child abuse.
  6. TriciaJ

    700 Nurse strike - Joliet, IL Amita St. Joseph Medical Center

    Same old same old. Management cries "poor" at the bargaining table. Wonder what they're prepared to pony up for scab labour.
  7. Frankly, I would consider it a dream job. Lots of variety so you gain a lot of insight into the workings of the whole retirement home, instead of the tunnel vision we get from just doing our own jobs. I'm not sure what you're calling "clinical skills" that you're so afraid of losing. Wound care is certainly a valuable skill; assisting the Director of Care should be providing additional skills. Screening visitors provides an opportunity to improve interpersonal skills and provide education to the community, something all nurses are expected to do. Being a porter involves positioning patients for safety and comfort, and of course you're never not assessing. If they're willing to pay you nursing wages to fold laundry, then that's almost like a paid day off. Take advantage of the brain breather. None of these things strikes me as anything that's "beneath the dignity of a nurse". (That would be more along the line of having to stand when a doctor enters the room.) If you embrace all this with a willing spirit, no telling how far you can go. Doing things grudgingly will show on your face and in your body language and might hamper you in ways you don't expect.
  8. First, congratulations on graduating and passing NCLEX! Your concern is something that seems to come up a lot on this forum lately. I'm referring to the belief that the first nursing job you accept might somehow disqualify you from your desired career path. I don't know where this idea comes from. Any hiring manager will expect that anyone fresh out of school needs to land a job and start recouping the cost of the education. Having a gap on your resume from waiting for the "correct" position just doesn't make sense. However, those who have worked in home health will likely not recommend this for a new grad. You will be required to function autonomously with little support. You can speak to the home health agency about what kind of orientation and support they are offering you, but the likeliest scenario is that they are having retention problems and willing to hire any warm body. I realize I just gave you conflicting pieces of advice so let me clarify. Try to find whatever job will 1. hire you and 2. ideally provide you with a solid orientation and new grad support. This might be a job that has nothing to do with acute care peds. But it's still nursing experience and will not be held against you in any way. You can work your way to what you want to do; it just might not be as straight a path as you would like. Good luck!
  9. TriciaJ

    Paid minimum wage for quitting

    Sorry you had such a crappy first nursing experience. 1. Write down everything you remember about that place. Date the paper with the current date and keep it with your important papers. You probably won't ever need it but just in case. 2. If you don't receive any of the requested paperwork in the next 2 weeks, write them a letter requesting copies of it. Send it registered, return receipt requested,in case they try to claim they never received it. Keep a copy of your letter, as well as the receipts from the post office. 3. Do check with the labour board about the lost wages. 4. Find a new job (in a better place) as soon as you can. I'm betting all the local employers know what a pit that first place was. They have probably hired previous nurse-escapees. When they ask why you left your previous job: "As a new grad I needed more support and was constantly worried about my ability to practice safe care." If it comes up about the narc count: "I was meticulous about medication administration and documentation. When someone messed up the narc count and started looking around for scapegoats, it was the last straw." Make firm eye contact and speak in a calm voice if you have to discuss this matter. The sooner you start a new job the sooner you can resume building your nursing reputation. If the Board ever does get involved it will likely be months from now. They'll want to know how your current job is going and that will be significant factor. Take a breath. Your only real mistake was accepting a job from an unscrupulous employer. You will land on your feet.
  10. TriciaJ

    I am considering quitting after four months..

    I know it's nerve-wracking, but there's a certain appeal to your situation. You make your own schedule, you don't have a supervisor. Which means no one is going to hit you up for your eval or bug you with any other typical workplace crap. As long as you keep track of your hours and make sure your paycheque tallies. Maybe you're someone who likes structure. But this under-the-radar position might be a good way to stretch a bit and enjoy running your own program. At least until the jig is up.
  11. TriciaJ

    Help picking a Job offer

    Both commutes are even? How often would you have to work weekends? If it's every other weekend like most places, then that $8.25 weekend diff is going to add up pretty quickly. Do a bit of math. Women's Hospital might actually be a better deal. I'm also suspicious of a hospital with the reputation of being "super hard and exhausting" and willing to cross train for the ICU with a 3:1 ratio (how the hell is that even ICU?). Of course check out the bennies. What is your medical insurance going to cost you in either place and what is the quality of available options? With just the information you've provided, I'd be leaning toward Women's. Comparable pay, no reputation of "super hard and exhausting". The bigger bucks and the ICU cross training won't matter too much if it's not doable to stay there. Get a few more fine details before making your decision.
  12. TriciaJ

    Nursing Leadership

    I love the idea of better discharge coordination for inpatient diabetic patients. What I don't love is the typical scenario of putting one more thing on the backs of inpatient floor nurses. Whatever change you try to implement hinges heavily on just who is supposed to do it and what else are they supposed to do. The outpatient diabetes clinic is a perfect idea, for all the reasons you mention and more. A referral to them and an initial contact before discharge would go a long way to bridging the gap. Good luck with your project.
  13. TriciaJ

    Nurses and narcotics

    I agree with above posters. It is very concerning that she has irregular medication-handling practices and is prone to accusing other people of going through her belongings. She is setting someone else up to blame when she finally gets caught. Please write down everything you remember and speak with your supervisor this week. You'll be glad you did.
  14. TriciaJ

    Ethics question, risky nurse, reckless behavior

    I second the advice to find a new job. I don't think I could just walk away without at least trying to do the right thing, however. I would anonymously call the BON and any accrediting body on my way out the door. Time to move on. Good luck.
  15. TriciaJ

    Misdemeanor 9 years ago, pre-nursing student

    When you were 17 you and your friends thought it was a good idea to explore an abandoned house. Then you found out it wasn't. I really don't think this speaks to your ability to practice safe nursing and I have trouble believing any Board of Nursing would care about this. I think you should be okay. You can always check with an attorney who's familiar with Board of Nursing issues to be on the safe side.
  16. TriciaJ

    Resume, Cover Letter, Interview Help

    I agree with llg. Leave off the summary/objective. I always put it on there because it was recommended back then, and always felt stupid for doing so. Objective? Pay the rent and buy groceries. I agree with leaving all your jobs on there and paring down the excess details of your non-nursing jobs. Be specific about the skills you acquired in your SNF job. Include soft skills such as dealing with very involved, but anxious families. (They'll know you mean "difficult" families but you'll be too nice to call them that.) Do not list nursing school rotations on your resume; it comes across as obvious padding. If you do have a pertinent experience, mention it in your cover letter as a rotation where you learned a lot and would like to work in a similar area. Research what locales are particularly hurting for nurses. It might be the best experience you ever get.
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