brendacg

Meh. This girl has bills to pay.

I went to the interview and was offered the position but passed. Personally, I can't afford to not have benefits or guaranteed hours. My commute would also be more than an hour, not worth it for me. But I have an interview at Spaulding so that's where my new hope lies!

Just wondering if anyone works here or has worked here recently, and would possibly recommend working there. I have an interview for a new grad rn posting which says csg admin. Not really sure what the csg admin part means? Anyways, any input would be welcome!

I'm planning on taking a unit nurse manager position tomorrow after trialing it for the past two weeks. I have the general idea of what the position is all about, i.e. audits, chart checks, care plans. Just curious if any seasoned nurses have tips on what makes for a good nurse manager on skilled rehab unit, or really any tips at all about being a nurse manager!

Hi all, Ive posted here before and I've always received great feedback when I've had questions in the past. I've only been working as a nurse since July on a SNF and I've really tried to stick it out to get my experience to get a hospital job. Recently, our nirse manager left and so the DON has offered me the position. I've been trialing it this past week and it's really made me reevaluate my facility. A couple weeks ago, we had our state survey. All the staff, administration and management included, had been working really hard for months to make sure everything was perfect. So our staffing was decent and it seemed like people had a little pride in our company. Now this week, it's like everyone is back to not caring about doing a good job. Our staffing is short again (on purpose, mind you), and back to the corporate agenda of cutting the budget. Back to sending staff home early if they accrue even 2 hours of OT. Now our administrator is going to switch physicians groups because our covering NP is wanting to send patients home at appropriate times while other departments are coming up with reasons to keep them. This disgusts me, especially when a patient is so obviously ready to go home, but because of the almighty dollar they are being kept for extra time. I applied to a more reputable SNF today, which is too bad because I'm not one to job hop. Are there SNF facilities that don't operate in this manner or is this normal?

I applied for a med surg position at a hospital, but instead my resumé was forwarded to the nurse manager of an inpatient geri psych unit who is interested in interviewing me. I've been on a SNF floor for almost a year, but previously worked as an aid on a locked dementia unit at an ALF for a couple years. So, I'm just curious if anyone works on a unit like this at a hospital and could tell me what the patients are generally like, duration of an average patient's stay, and any other information. Thanks :)

I have been checking the website obsessively since Friday, haha. It's possible that maybe the position was posted for internal candidates, or maybe she posted the position for a PCA and not an RN. I'm going to shoot her an email tomorrow or possibly Friday, and maybe she can let me know if she is going to post anything then. Thank you for your advice!

So, I had a great interview with a DON of an intermediate med floor on Friday for a general position on her floor. By the end of the interview, she had told me that there would be a per diem position posted and and was kind of offering me the position unofficially. Fast forward to Friday night - she had called my cell phone and left a voice mail to confirm that I would apply to the posted position on the job website so that she would be able to "take the next steps". Sounds pretty promising, right? I call her on Monday to follow up, and told her that there was no such position posted, and what should I do. And she seemed super distracted and kinda forgot she had left me a voice mail on Friday, and the conversation as a whole left me feeling a bit unsettled. I genuinely believe that she was probably super busy and kind of had her mind on other things. This position is at a large teaching hospital and I do NOT want to just let this go, but if there's no position posted - then I can't really be hired. Do I email this DON today or just wait for a position to be posted and then kind of email her then? I am really terrible at being patient and would so love this job. Any insight/advice?

I'm a new grad who has been working as an RN at a SNF for 8 months now. Is it appropriate to include clinical experience from school or just my work history now that I'm a practicing RN? Any recommendations?

Everyday I'm Hustlin' - Rick Ross

I love my coworkers! I work on a really busy and chaotic skilled floor, and we're all usually very stressed out but it kind of brings us together. I'd say there's a lot of sarcasm and even singing to try and get through the day. It may be a good thing that our floor is so busy, we spend most of our time focusing on the patients that we don't really have time to fight with each other :)

Get personal insurance for your license.

Yes, there are many issues at my facility and im really just there to ge my experience because the job market is so poor and i am a new grad... The rationale was that she was nonambulatory and had a hx of blood clots.

I'm aware that the INR has nothing to do with Lovenox. At my facility, we don't hold off on a discharge because of a high INR. I'm not sure if this is because of the fact she was at the facility under Medicare or what. The doctor and NP were aware of her Lovenox dose, and she had been discharged to us from a hospital with those orders as well. As far as the pharmacy being held accountable or being involved, they just send us medications when we run out. We rarely speak to pharmacists unless we have a question and they never call us on anything. Its obvious what should have been done by all parties involved and trust me, I'm not taking this lightly. Unfortunately, I think it's true for all of us nurses there that with a normal patient ratio of 20:1 on a subacute floor with little to no support - it's easy to get stuck in a routine when doing meds, for better or for worse.

We do not have an interpreter at our facility, we never do... I had a meeting with the DON (along with another nurse and our unit manager) and this patient is in the ICU bleeding out. There were 6 nurses who gave the lovenox when they shouldn't have. Also, our nurse practitioner who wrote the orders for the Coumadin is also at fault. She wrote something like "Coumadin 10mg X 3 days" when the pt had an INR of over 3. The DON thinks that she will get the brunt of any disciplinary action, as well as the nurse who was taking the orders off and was aware of the INR from the labs. The DON seemed to believe that this would eventually be reported to the DPH and then the *#@& will really hit the fan... I'm not too sure how this will affect me (negatively, obviously), but at least this will make me a better nurse for the future and this is something I will never forget.

Thanks for your response. What I meant was that she was receiving lovenox and coumadin but the lovenox was supposed to be dc'd after the inr reaches 2-3 range. I guess the patient being non-english speaking was kind of irrelevant, but at the time made me feel like I wasn't giving the highest quality of care because of the language barrier. I applied for liability insurance today, just in case another incident like this happens again (which I am not exactly anticipating). There were at least 7 other nurses that week who cared for the patient, I'll be able to find out the next steps of what will happen tomorrow.

Hi everyone, I had an incident happen with one of my patients, and looking back on her stay on my floor - I feel like I could have done more... but not sure how. I had been taking care of a little old lady who was receiving Lovenox 50mg injections 2x daily and Coumadin, with the intent to bridge after an INR was reached. She reached her intended INR but she continued to receive the injections about a week after though. It had not been written clearly in the orders until after - when she was discharged home and was discovered to have a peritoneal bleed. Looking back, I feel like I should have picked up on the signs of the peritoneal bleed. Her abdomen was always a little stiff since her admission, so I mainly attributed it to her very small stature. Her INR had not been critical at any point in her stay, and it was 4 when she left. She had been weepy at times, but then I would ask her family what was wrong, and I would always check in with them to ask her questions and make sure she wasn't having any pain or distress. Her CBC had been normal as well. I'm a new nurse, and this case is just eating away at me and I feel terrible. I spoke with our NP, and she thinks that she had the peritoneal bleed going on for a while - but we are still all at fault for not picking up on the order to stop the Lovenox when her INR reached the intended level. Has something similar happened to anyone else? How could I have picked up on this? ?

Hi all, I've posted in this forum before about random things and I've always gotten some good advice. Just for some background info, I'm a new nurse and have been working on a skilled floor since August. I am finally settling into a routine and getting a little more comfortable with my role on the floor. So with that being said, there was an incident on the floor yesterday which really bothered me and continues to do so... One of my LTC residents on the floor had been asking for a shower, so I asked her aid if she could give her one when she got a chance. When I asked her, the aid told me about how the "B" beds were supposed to get their showers on the 3-11 shift (I work days), but that they never give their showers. This story all goes along the lines of one of my skilled patients who said he hadn't received a shower in 2 weeks, and once again I had to ask my aid to give him a shower... simply because otherwise, I'd consider that neglect. Well anyways, I looked through the aid books and found that none of the residents in the B beds were getting their showers... I brought this to the attention of my unit manager, who then said that it was the responsibility of the 3-11 supervisor. I felt like this was not a good enough answer, so I asked the ADON what to do about this - and she kind of brushed me off as well. Am I being dramatic about this? Does anyone consider this to be wrong? I was disturbed by the fact that one of the residents had not gotten a shower for the whole month of October!!! No documentations of refusals or anything!

I just graduated with my BSN but for my junior and senior year I was going to school fulltime, doing clinicals/externship, and then working as an aid full time at night. My days and weeks were extremely structured and I studied at every free moment and ALWAYS kept my planner on me and even set reminders on my phone for random things all the time. Make time for yourself to do whatever you like to destress (I like to run) and completely zone out so you don't get burnt out. Get adequate sleep and stay healthy. Never lose sight of your goals, and I always would tell myself, "this is only temporary"... good luck!

I'm a new grad RN and 3-5 days doesn't sound that great to me either. I've had almost a month of orientation at a SNF on a subacute foor. I just got signed off on treatments and medications last week and I've been on a med cart with a staff nurse shadowing me since Monday. I think that I'll have another two weeks maybe on a med cart with the nurse shadowing me before I'm set free. Good luck =)

I couldn't even tell you where they're located on the floor. I've checked patient's rooms and the supplies room and the nurse I'm working with hasn't put any of her needles (insulin, and to check blood sugars) in a sharps bin. They're the retractable type - but they still belong in a sharps bin, right?

I've only oriented to my floor for about two days now, but I am scared to death. It is a subacute floor with a max of 22 pts per nurse, but Ive shadowed my nurse who has had about 13 pts both days and it already seems chaotic. She doesn't really have a rhyme or reason to her order of medications/treatments/assessments and whatnot. She just kind of runs around and periodically forgets/remembers things and then freaks out. Plus, she mentioned that sometimes she stays like 2 hours late to fill out paperwork.... Does anyone have any tips/tricks to caring for a huge patient load efficiently? I've seen some pretty disturbing stuff in the facility too. Or at least... I think it's disturbing but it might me considered "normal" in LTC? The nurses don't use the sharps containers and just throw them in trash. They frequently run out of essential supplies in the whole building - today, they ran out of syringes to flush the g-tubes... so we used a luer lock syringe. The turnover rate is huge, in fact, I am one of three new grads who were all hired full time for the same shift. The majority of the nurses are miserable - and constantly complaining. The nurse I'm shadowing is actually interviewing for a new job... Are these issues considered to be the norm in LTC?

I graduated in May, got licensed at the beginning of the month, and then got a job at a SNF. I would like to say that I got the job because of my 3 years of CNA experience, GPA, blah blah blah... but the reality is that the DON there is the sister of someone I used to work with. So, my advice is to ask anyone and everyone if they know someone who works at a hospital/facility and network your bum off! Good luck!

They sent me a link for the competency exams yesterday.

Thanks for the advice. I was offered a job on the 3-11 shift, but she is going to orient me on the 7-3 shift for at least a month - and she was completely against new grads working overnights because of having no backup available at the facility!