RingaLing

Be advised, from personal experience, if you self-reported to your state and had a contract with them, you have to disclose that action to the BON of the state you want to work in. Your initial action will show on NURSYS--you might want to check with them on their website and see what pops up, because the BON will. Make sure you keep a copy of your initial contract, any revisions, and the letter from your current BON showing completion of your contract. I scanned all this into a PDF, for ease of transmittal to BONs. Also, if you don't currently live in a Nursing Compact state, you might want to consider residence in one. You have to be a resident to get a Multi-State license, but once you get it, you've got 24 states at your fingertips. The catch is that you have to be a resident. The most-important take-away....check NURSYS. Don't lie on any app to BONs, it WILL come out when you endorse. Keep every shred of documentation. Good luck!

I would definitely call this double-briefing, and it would be a major issue with me, and with the State surveyors. It's a dignity issue, IMHO.

The main reason that the "other" states have not joined the Nursing Compact is money. Particularly in states with a large amount of nurses (think Florida and New York) and high-priced licensure fees, there would be a significant drop in revenue from nursing licenses if they were to join the Compact. I'm thrilled that I finally live in a Compact state, because it's allowing me the opportunity to pursue my dream of doing consulting work across the country. Wouldn't you know it--my first big job (several month contract) is in a NON-compact state! Hot tip--don't give up your licensure in ANY state, even if you think you'll never work there again. I had multiple licensures back in the day, and now I wish I had kept them up. It would have made this easier, since they were in mostly non-Compact states. I'll never let another lapse again.

In a previous facility, we used a LTC pharmacy called Millenium. The meds were packaged in little bags like you talked about for each admin. time, and the bag had bar codes on it that represented the meds in the bag. They had a great computer system that made the whole administration process very smooth. Pull the bag, shoot the bar codes, and the MAR would be automatically populated with the admin. info (nurses initials, and her digital signature). I *loved* this pharmacy, and wish we had it at my current facility.

Just an addendum--these ratios are 24/7.

Interestingly, the nurses in my facility are at a 1:15 ratio and the CNAs are at 1:7. They all think they are horribly overworked. When I started as a charge nurse, my ratio was 1:30. Just an observation.

Bath salts--just read a whole article about the guy who chewed off a homeless man's face in Miami. They think he was high on this stuff. Did anyone see the "Intervention" episode regarding the young guy who was addicted to this garbage? They later diagnosed him with paranoid schizophrenia, but you gotta wonder?

I would be super-careful about disclosing Bipolar Disorder to the BON, depending on your state of course. In a prior state, I disclosed and got thrown into their "diversion" program, simply because I was Bipolar. I spent 6 years going to Caduceus meetings, getting randomly urine tested, and it was a general nightmare. I made sure when I took this job, in a new state, that I wouldn't have to disclose my mental illness (gawd, I hate that term!). My state application stated "any mental illness that interferes with your practice" or something like that. It doesn't interfere, therefore, I didn't disclose. Food for thought.