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pkapple

pkapple

er/icu/neuro/trauma/pacu
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pkapple specializes in er/icu/neuro/trauma/pacu.

pkapple's Latest Activity

  1. pkapple

    meditech edm help

    I am a per diem ER nurse, having trouble with Meditech. Would anyone know of or be willing to share a simple step by step walk thru of a patient in ER??? No problem with pt care, just the documentation keys and entries. Thanks
  2. pkapple

    Florida Salary vs Take Home

    Opti.. The best way for you to figure this is simply to eliminate the % amount of NY state tax. Your example would not hold true, ie claim married 5 or claim single 0, however both state and federal are % values, not flat percent, but based on tax brackets.....gets confusing, huh. You can go to a web page to figure this out. Try one to calculate nanny tax or some such search. I am pretty sure NY state tax will not offset an $8 an hour pay dif.
  3. pkapple

    Should new grad be able to start IV at work?

    Ok folks, from the ops profile -education is as an lpn/lvn. It does not say what state she is in, but many states only allow lpn iv cert after taking a class. Here in FL it is required that an lpn take a 30 hour course and get supervised sign offs, even then it is still up to facility policy how and when an lpn does iv starts/meds. Don't ever feel stupid gradnurse. You will only learn by watching, listening and doing. Check with your facility policy and if lpns need a class-ask your NM about taking one.
  4. twist, clip, pin, headband,pony..anything that keeps it from hanging over pts or in unamed yuck. Hard to start an IV with long or half bangs across your visual field, too. Your school will have a strict clinical policy re: hair, nails, and jewelry.
  5. pkapple

    Oboy........how should this be handled?

    I did a stint in Home Health as a newcomer to a small town...everyone asked how I liked living in the ole Taylor place, if my son enjoyed Mrs Denman's 3rd grade class, etc, etc....apparently very few people moved there!!!!! I now live in a small town (work ER, DH is PA-c) everywhere we go some one says how nice our house,lawn,garden is looking... it's just part of small town life. DH always smiles and shows interest then tells them to make an appt on monday If you were in Law Enforcement, they'd ask about legal matters!!! Just let them know up front who to call after hours for questions and explain ever so nicely that you are not allowed to give advise or "help out" when off duty. Who knows you may meet a lovely new neighbor and really enjoy the relationship!!!
  6. pkapple

    Patients on Vacation????(long)

    Visitors are a problem here in the panhandle, too. But the ones that drive me batty are the locals who show up at 3am and smile sweetly...you have my records here. UHHH no I don't, and even if I could find your last visit(we don't have med rec or even a sec at night) it would most likely not be current, esp since you seem to come here often, so sorry your doc isn't open at 3am. How crass of him, he should know you would never go see him until your ear/bugbite was at least 4 days old and you couldn't sleep!!!! I am advising every patient Isee to fill out and carry a med list and allergy list...hx would be nice, but at least we get an idea from the meds.
  7. pkapple

    ER Interview Question

    I always "dress up" for an interview, well except telephone interviews-lol. I have been a nurse for over 20 years and have gotten all but 2 jobs I interviewed for. I almost always wear nice slacks/skirt and a jacket. Really make sure you wear nice shoes-male or female. A tie would be important for a management/supervisor level, staff nurse maybe not so much. But I agree you really can't overdress as long as its professional attire. The worst attire is no socks!!!!! Oh get a manicure-guy style-not fru-fru it really amkes a good impression in nursing or any other field to have impeccable hygeine!!! good luck
  8. pkapple

    Hospital to charge employees who smoke

    Oh dear..seems I remember we as nurses have to be very careful not to make a 500 pound pt feel "bad" when we about kill ourselves turning them. And didn't they make obesity a disability.....oooh the lawsuits will be so much fun, and since HTN is more prevalent in young men of black/african descent maybe Al Sharpton could help out!!!! This is getting out of hand, yes smoking is preventable, but like the sunburn when you were 10, the smoke and pollution yuo inhaled from birth won't go away!
  9. pkapple

    We're supposed to take care of the pt 1st, right?

    Best of my recollection...HHA can't see pt on day of discharge-not billable, we always saw pt next day to do intake/admit. HHA can see and eval pt prior to discharge so to have everything in place. No patient should ever be discharged without instructions, and a pt is not transferred to HHA, they are discharged and HHA is providing some services to them, pt/family will need to give meds, transfer to toilet..whatever it takes. Nurse can set up med box and perhaps they qualify for an aide to bathe a couple times a week, but incontinence etc falls to the family caregiver--Hospice can provide some heavier care, but 24/7 care is self pay or back to the LTC. Your charting was litigation fuel or at the least State survey ammo. Perhaps something along the lines of ..Pt returned for clarification of home regime, meds,wound care. Husband present, instructed and return demo given with good understanding verbalized. In a separate narrative or even a variance report I would of listed the rest of it. And verify when HHA will see a patient before thay are discharged so the family will not be frantic or confused. You should not have been fired for this, you should have been counselled unless your charting has been questioned before. You could fight this, I am sure you have a mediation/greivance process in place at your facility, do not ask for your job back, instead ask to have your dismissal listed as voluntary and 2-4 weeks pay, since you should have been warned or placed on probation and that would have been 30 days. You don't need a lawyer for that, but if they are not providing you with some satisfaction by all means call one, and let them know that is your plan. Good Luck When applying for the new job, personal differences is acceptable as a reason. Don't give any administrative people as ref, and ask your charge nurse or house supervisor if they will give you a personal ref.
  10. Ideally a float would be lateral or previously experienced, then maybe the ER nurse-but ER can't give up a nurse, they are usually short anyway. A tele nurse should have basic knowledge of critical patients, since many tele patients were in icu just 5 seconds before they became a tele pt. Any ICU that was so short they needed a float nurse-really needs that nurse, and tele is probably the best choice for safe care. I am certain the assignment would be the most stable, or least likely to crump patients
  11. pkapple

    I Would Like Your Opinion.... am I right?

    You were right to transfer. You felt unsafe in that position, and are now out of it. Good luck with your neww position.
  12. pkapple

    Need your policy on CANCELLATION

    Never got time and a half for coming in, we did get on call or standby pay and then regular pay if we came in to work.This usually occurred due to low census--but we usually had a list of nurses wanting the time off! The exception s were the traditional on call type jobs, nights/weekends in the OR or PACU. Then it was a whole preset pay scale--callback pay, certain number of hours minimum, extra time off if worked all night etc.
  13. pkapple

    so disappointed :(

    Julia, Sounds like you have more issues here than just a schedule change. You obviously do not like your job-the charge nurse being your biggest concern. the best way to deal with that-if is not just personality problems-is to document everything. IE very busy shift, requested charge to assist with med pass while soothing/cleansing agitated and confused pt for the 3rd time in an hour; charge talking on phone, doing crossword puzzle at desk aides and myself extremely busy and pt care affected, etc etc. Remeber you can complain and report all you want, but you need to keep a record, maybe turn it in weekly if there are that many concerns. As for your schedule change, we all like our scheduled rotations to stay the same, but, unless you have a written contract that says Julia will work the set A rotation on day shift with alternating holiday coverage affecting schedule changes or something similar, you're basically at the manager/schedulers mercy. Most rotations were created to make the schedulers job easier, she only needs to fill vacation requests and arrange to cover illnesses. Technically you were hired for a fulltime slot, I am sure somewhere it says what your shift difs are, it may state you will alternate weekends, at any rate you could be scheduled with any combination of days/nights/weekends etc and still earn your fulltime status hours! All that said pick your battle--is it the charge nurse or the rotaion change that bothers you most, address your priority with the manager. Good Luck
  14. pkapple

    ER nursing...

    It all depends on the hospital. Call or stop by some in your area and ask the HR or ER manager
  15. pkapple

    Florida nursing salaries - seriously????

    The cheaper coa used to be true, but it keeps getting repeated ad nauseum and keeps the wages low! Don't know any bank that reduces your car payment, credit cards or mortgage rate cause you're in sunnyFL!! And speaking of mortgages.....houses are not cheap here, apartments are getting outrageous and insurance is going thru the roof, if you can get it! And hey--CA and TX have some beaches and golf courses, too, oh and wages are well um quite a bit higher.
  16. pkapple

    Experienced RN looking for answers

    Traveled for years before TaxAdvantage was being given. In order to claim the perdiem expense --you must not be reimbursed(lol) and need to accrue actual expenses or utilize the accepted perdiem rates(see IRs webpage fro links) SOOOO the 99 bucks a day is acceptable rate for the area and is allowable--but you can not claim any deduction since thay are giving it to you. Kinda like having your insurance and 401k taken in pre-tax dollars instead of figuring it all out with the annual 1040 junk. You must be at least 50 miles from home to qualify--local agency/travel does not qualify, so all earnings are legally taxable. Now the get around it sometimes works if you stay with a friend or relative for free and get the housing allowance, but is actually the most legal if you use the money for housing. The meal portion is an allowance that is easier to take pretax cause otherwise you have to keep every receipt for every meal and then only 50% will be used at tax time on your itemized deductions or business expenses. Think of all the allowance as your expense account, do not add it in to your hourly wage!! if you are getting 14.00 its 14.00! you still have a car payment etc. and should be maintaining a home elsewhere. All that being said, I loved traveling and did make good money, now tho it seems the pay is nearly the same as staff wages-sure you get the apartment so its cheaper cost of living, but used to be a traveler got the housing and still made 10 bucks more than staff!!!! Why do you think they resented travel nurses(wink) Been on both sides!