Abbys

It is unbelievable how well you have picked it up with so little support! You should feel proud. I hope you hang in there because you are going to be a star nurse for that organization. I suspect they have a high turnover.

We have a union and wages are set by #years as an RN and we are paid by the hour. Best compensation I have had as a home health nurse yet.

My agency has a 'no weapons' policy. Not only are we not allowed to carry or keep a weapon in our personal car while using it at work, pepper spray is considered a weapon and not allowed. You are within your rights to refuse an assignment if you feel unsafe for any reason. If you are sent into an area that makes you feel unsafe, you can leave.

I have only felt unsafe once when visiting a man training for a swat team. He had a huge German Shepard and a shot glass of bullets on his table. He was sweating and his blood pressure was so high I advised him to go to the ER and then I left.

new.grad.rn, First of all. You need to allow yourself at least 6 months to master time management. I have never seen a nurse fired for being late with medications. (They would have to fire their whole staff.) If you can say at the end of every shift that you applied yourself 100% and did the best job you could, then pat yourself on the back and get some sleep, you did well. Are there other SNFs in your area? While waiting for a position at a hospital, you may want to try another LTC and see if it is a better fit. You should stick with a subacute position for the best acute experience. I agree that during interviews, you should not burn your bridges and blaim the facility you currently work for. Know about the facility you are applying to and find something appealing they offer as a reason for applying to work for them. It could simply be a different shift, the location, the company reputation, the DON, their ratings, someone recommended it over the facility you work at now, etc. Don't quit your current job until you are offered another one. When offered a job, ask that your hire date be at least 2 weeks in the future or one month if they can wait that long so you can give your current employer time to replace you (which is not usually a deal breaker and shows them that you will extend the same courtesy to them when you are ready to move on/up). Your future looks very bright, hang in there!

I liked VNurse30's post and: I am NOT O.K. with fraud or cover-up. VNurse30 has pointed out some valid alternatives to reporting the patient to the Police who may or may not have determined it was necessary to take the patient to the ER in the first place (the only place I am aware of that can assess a patient on short notice to be admitted to a psych unit - I may be wrong). The ER is not really the appropriate place to send this patient. The ER would likely send the patient right back and the facility would have to persue other interventions to solve the behavioral issues. As for the DON, I think the poster did the right thing by standing up for him/herself and refusing to alter original documentation. Only Nurseredd, LPN can decide to stay or go... I cannot give advise on that because I am too old of a nurse to cower to veiled threats in order to keep any job.

Can you come and work at my facility :)

xxxxx

Many of my patients and their family members would have to disagree with you on that point. Many of them find it frightening. Others, just plain disrespectful and unprofessional.

I herniated a lumbar disc lifting my 3 yr old prior to nursing career. I elected no surgery. My injury made me VERY aware of body mechanics/techniques, abs and back strengthining. I have had to excuse myself from certain tasks. So far, knock on wood, no problems after 10+ yrs.

I've heard it said that you should use one or the other. It will eat your hands up if you wash with soap and water and then apply hand sanitizer. Hand sanitizer is effective alone, except for killing Norwalk Virus. (This is what the Infection Control Consultant tells us.)

A census that ranges from 100-110. 28 of those beds are skilled medicare. We have 4 1/2 RNs for MDS of which 2 1/2 RNs work with the SNF/ICF half of the building and 2 RNs for the all-ICF half of the building. MDS nurses only fill in the nursing section of the MDS. Each (4 of them) manage the care of 1/4 of the residents and supervise floor nurses. The Assistant DNS helps when MDS falls behind. MDS nurses rotate as on-call managers on weekends (mostly to answer questions and staff for call-ins over the phone) They fill in on the floor as a last result. (Approx. 1-2 shifts a month when agency not available) The building is staffed with 4 licensed nurses and 2 CMAs on days, 3 1/2 licensed nurses with 2 CMAs on PMs and 2 licensed nurses (and 1 CMA for 2 hours) on NOCs. The floor nurse pool includes 3 RNs. We have a total of 9 1/2 RNs employed. We admit mainly medicare and medicaid residents and have about 3-4 private pay beds at any one time. We have deficiency-free surveys and profits have been enough to enable this facility to remodel the building.

Try Aquaphor ointment by Eucerine. Rub into nails (hands and feet too!) every night before bed and use on your hands and nails periodically throughout the day between handwashing. Works like a charm in no time! :)

I too went from co-worker to supervisor. I have found that it is good to let your staff know what you expect from them, i.e. residents kept clean and dry, good oral care and re-positioning, rooms tidy, etc. Be consistent. Keep your interactions professional at all times. You have the advantage of understanding their position and becoming a supervisor that they can respect. If you want hospital experience, you should do that first. Many hospitals hire new grads and provide training so there is no need to be afraid. Either way, you have a solid beginning. Good luck.