Ele_123

Thanks for the info. Our unit originally started out as COVID overflow.... Typically patients who were being admitted for other issues, but tested positive. It's been the past 2-3 weeks we've been getting more COVID positive with respiratory issues. We only have 2-3 cont pulse/ox devices for our floor & biomed insist we're out in the hospital. Our floor definitely doesn't have high flow cannulas, this week were allowed to put them on oximizers, but they have to come from distribution. Our flow meter go to 15L & today we got permission from the manager to titrate to 15 L on a simple masks. I think the physician order might just be in their "med-surg order set. Today I saw a couple "nursing communication" O2 titration orders. I honestly wouldn't mind taking care of them if we had more resources. We are still staffed like med-surg 1:5-6 but have patients on 15L non-rebreather and a wait for step down/ICU beds several hours. No cont pulse/ox or high flow/ vapo-therm. We share RT with a couple other floors; housekeeping, wound care, admit/discharge nurses and a few other ancillary services & disciplines/specialties won't/can't come on a COVID unit. I didn't mind that set-up at first, but today they changed the staffing matrix. Sorry I'm on a rant- I feel it's about so much more. P.s. I used to work high-obs so I'm not intimidated, but we had a RT in unit 90% of the time to guide us & we could bounce ideas off each other.

How did this become religious & political? I was simply wanting resources on switching between oxygen devices.

Part of our floor is COVID med-surg. When we first opened we were told patients had to be stable on 6L or less per nasal cannula for at least 2 hours before they could come. Last week it changed to 10L or less NC or simple mask. Today they sent us a patient on an oxymizer, technically it was less then 10L, but even if it is less than 10 don't they produce higher FIO2? House Sup. said to take patient we're guessing pt was the most stable in the ICU. Do you have guidelines as to who is med-surg vs imc/ICU? Are they continually changing? Do your physicians write specific O2 orders? Our doctors usually write an order at the beginning of stay, but some patients quickly exceed it. Any resources on knowing how/when to go between different oxygen devices- nasal cannula, simple mask, non-rebreather, oxymizer? Need a refresher on this "middle ground".

Your tremors are probably worse than mine., but I've learned to rest my hands/arms on the counter or wall with injections/ivs. The pandemic was a key for me to land a job. Previously at interviews they would somehow ask if I was nervous d/t hands shaking or indirectly make a comment about how I walk. In the Spring interviews switched to video/phone so I got a couple offers and no one knew anything until my first day. What about a Rehab unit/hospital? Less If meds & more gross motor activities.

Hospitalist where I work still see patients daily most of the time. I've seen a couple exceptions, but its usually patients waiting for placement or a specialist to clear them. Consults/Specialists however are different & its a total mix of in-person, PA, telephone, or Zoom. Housekeeping only comes if a patient's discharged.

I've been to a few different types of appointments since the pandemic. The main issue I think is the screeners are not thoroughly educated. Some are just from the valet service or people from other parts of the office with little education related to COVID. I answer yes to "have you been in close contact with..." & tell them I'm a nurse & wear PPE & get strange looks and have to educate them. I did need a dentist appt for a tooth bothering me & the kept offering me appts on the same day of each week. I kept explaining I'm a nurse, I work that day every week, short staffed, pandemic/COVID, etc. & asked for a different day of the week. The response was, "we've offered you a few appt times some are this coming week (all same day) & you refuse to take off work."

Part of our unit recently became COVID overflow. No hourly/shift bonus for working on that side. Our "bonus" is that we have better staffing.

Our manager reminded us to social distance while on lunch. Due to our staffing or lack of in order to maintain minimum floor coverage we have few enough people on break if we sit at opposite ends of the table we are automatically social distancing, but occasionally a 3rd person overlaps with 2 of us.

My hospital had staff wear face shields for all patient interaction until a couple months ago when the state started opening up and we had "adequate" PPE & it was changed to droplet/airborne precaution patients only. We are now at an all time high with COVID patients compared to March/April, so I have a feeling we'll be back to universal faceshields again.

I live in a different "right to work" state. They sent me home and once they determined I didn't qualify for COVID leave/pay like they thought they tried to insist I use what little PTO I have to help cover the unpaid days. I was then told unless I tell them not to use PTO they're free to use up all my PTO for me.

I pretty much already know this & that no matter how much better one healthcare Corp looks than the rest they always have their own "quirks". I can see it getting to the point where nurses who want a COVID test after exposure will have a "sore throat" just so they can get one to help protect elderly parents they care for.

Do you think that the way employees- nurses, techs, etc. are treated after exposure by the company/hospital will effect self-reporting during employee risk management? I work on a COVID negative unit and later found out a patient I care for was COVID positive. Later I found out that out of several emloyees I was the only one who was sent home (several days later) & tested. I'm upset I'm the only one sent home & tested & later found out I am the only one who started after XYZ date and doesn't get COVID pay. Other nurses are upset they don't even get a test. I've been told the outcome is determined by who the risk management screener is. Do you think it will ever get to the point employees learn the answers to get a certain outcome?

Blindly accepting job offer? I have a med-surg job offer at a large hospital in the metropolitan area. I am an LPN and acute care is extremely tough to get- I've been looking for a full-time for over a year. Due to COVID-19 I only had a telephone interview. I have never had clinicals at the hospital, had friends or family as patients, or worked with prior nurses from that hospital. I would be accepting the job blindly. At the same time the manager is offering me a job only knowing me from paper & the phone interview. It is not possible for me to shadow/observe or meet anyone in person due to COVID-19. This makes me nervous, but it is an amazing opportunity to pass up. It is not located in an outbreak hotspot. Though the hospital could get COVID-19 patients it isn't a designated treatment hospital. The nurse to patient ratio is typical, but the tech to patient is higher than when I was a tech(ortho unit), but maybe the patients require less physical assistance? Thinking of questions to ask before them before I make an ultimate decision.

I work with a staffing agency on the weekends & am wanting to get PALS certification so I can go to have more opportunities- mixed med/surg & ED. The locations close to me- within an hour or so are only offering PALS classes during the week. Has anyone taken a PALS class online to get their initial certification? Did you get an adequate learning experience? Any problems getting facilities to accpet it? Should I just wait a few months for an in person course on the weekend?

I've worked ortho/neuro/bariatric with some general surgery mixed in. The only time we definetly didn't ambulate a patient POD 0 was if they had a suspected or at high risk for a CSF leak or if they had hip/knee surgery and were numb from a spinal block. I've taken care of patients with knee/hip replacements who walk a few hours after surgery and there are a few "stragglers" who we can barely get out of bed POD 1. All bariatric surgery patients were required to start walking the halls within 4 hours of getting to the floor. For spine, cervical, and brain surgery & general surgery it depends on the time/length of the procedure, how involved it is, and how the patient was doing medically.

I took a job in a doctor's office. The majority of LPNs work in the nurse "closet" taking phone calls all day, mainly medication refills, insurance pre-auths, & post-op questions & occasional staple removals. The MAs interact with patients directly in clinic with the patients & doctor and coordinate follow-up care after/between visits. There are several MAs, an LPN who works in the MA position, and me. I feel odd referring to myself as an MA. Medical assistant isn't a licensed position, right? Am I fine to use that term? It doesn't feel right leaving out LPN since that's something I've work for and knowledge/experience I have. Maybe there is a way I can incorporate LPN & MA?

If the patient expresses concerns to the nurse about the care the doctor is providing. It would be appropriate to remind the patient that they have the right to participate in their health care & tell them the ways they have to express these concerns- patient care hotline, house supervisor, or charge nurse. Giving the patient a list of hospitalists, neurologists, or whatever specialty and telling them they can choose a doctor if they don't like theirs doesn't seem right. If the nurse has documented concerns about the care a patient is receiving it needs to go through the appropriate channels- incident report, house supervisor, director of xyz medical service, etc.

This is what I'm thinking too. If they have several qualified applicants the doctors might consider saving the 200ish dollars a month and hire someone who has no interest in a company health insurance policy. The clinic doesn't pay extra for required overtime.

If shifts are 12 hours long & adults are supposed to sleep for 8 hours, that leaves 4 hours of the day to get in the classic 8 cups of water a day. Then figure in that a nurse could need more based on their body size or could walk a few to several miles in a shift and need more than the classic 8 cups of water a day. It just doesn't work out very well.

No, they asked me what my desired wage is. I had already been to a few other interviews and it seems like the starting wage for clinics in the area is about $17/hr, so I told the $17 was my desired wage. The response was "I don't think our nurses make that much, I'll have to ask."

During an interview can an employer ask if you need to/plan on getting/using their health insurance policy? I didn't think much of this at first because I had several other interviews where they talked about health insurance benefits, but I don't think asked that question. They told/asked me a couple other things that seemed a little odd too.

I'm an LPN and for the past few years I've worked in acute care on med-surg & ICU units. My current job is cutting hours and wants me to drive almost 100 miles (1 hour 45 minutes) to another hospital. Staff end up working very sporadically. I might work full-time one week and nothing for a couple weeks. It is very difficult to get a position as an LPN in acute care so I've been applying as an LPN at outpatient clinics/ doctor's offices. There are a couple questions that have seem to come up in the interview. One is about pay (this particular clinic asked for your previous pay rates on the application) and the other question is about why I want to work in outpatient care or at a doctor's office. One lady told me their clinic was fast-paced and asked if I was okay with it. I think I've had some pretty tough/ fast paced assignments at an LTAC. I've tried my best explaining how my experience is transferable, but it hasn't worked out very well and I have a couple more interviews coming up.

Sadly, I'm not in California, I was hoping there might be other states with that option. I talked with someone at the BON and they want the major to explicitly say "Nursing". They won't look at actual courses on the transcript. I'm in the midwest & it's actually pretty great because the cost of living is so cheap. I've found two LPN-ADN programs, one LPN-BSN, one accelerated ADN, and one accelerated ADN within an hour drive. Another issue is that some programs require your LPN education to be from an accredited LPN program not an RN program. One of the community colleges a couple of these programs are at only requires an addition 15 hours for a second degree instead of 30.

I work at a couple small specialty hospitals and they use paper charting. I was surprised and mentioned it to a couple managers and they said that although CMS requires EMR if a facility does not comply they have to pay a fine or get less reimbursement (I forget which one) and for a lot of small facilities it is cheaper to pay the fine than to pay for the EMR system, upkeep, and tech support. Kind of like the fact health insurance is "required" for all Americans, but for many it is cheaper to pay the tax penalty than to pay the premiums.

If a BSN was my first bachelor's degree, I would only need 8 credits to meet all of the course requirements of a BSN, but since I opted to go ahead a get a bachelor's degree in science after 5 years I would still only need those 8 credit hours to meet the course requirements of a BSN, but since it would be my second degree I would have to take an extra 22 credits of random classes to qualify for a second degree with Nursing listed as a major. Colleges can't give you a second degree unless you have 30 credits in addition to what already counted towards your first degree, so I just can't take those 8 credits to get a degree with Nursing listed as a major. I hope that makes more sense.