Valanda

I keep hearing everyone say that if you have a valid prescription for meds that show up positive on a drug screen, then everything will be fine if that drug shows up on a drug screen. I just wanted to say that it may not be as simple as that. One of the nurses I work with is currently on probation by the Illinois board because she tested positive for morphine. She does have a valid script for morphine (she has rhuematoid arthritis). When a vial of morphine came up missing tho, everyone was tested and she was the only one who showed a positive result. She is under probation while they monitor the levels of morphine in her system over time. Sometimes this drug testing thing really does not work. I've known several nurses who diverted drugs to sell to others or to give to ill family members. They will never test positive for these drugs because they are not taking them.

My sister has ADD, and I could see her leaving her kids in the car without realizing it. When her first child was about 2 months old, she had just finished shopping, set her son on top of the car in his carrier, then loaded all her groceries. She sat down and started the engine before she realized she had forgot to put the baby in the car! Thank god she didn't drive off and forget him.

This question came up about a week ago at my new job, a Detox facility. We found it interesting that there are 12 nurses on staff, and 9 of them are first-borns. All of our parents were dysfunctional for various reasons.

THis is what I have used in the past to cover ostomy appliances and feeding tubes for showering. Never tried it for swimming, but it might work. http://www.alibaba.com/product-free/12180682/Seal_Tight_Shield.html

I just started a new job in a detox unit, and everything is paper. Not only is everything paper, but everything has to be written in 2 - 4 places. The DON actually insisted I fill out an incident report for a work-related injury because after 2 days I had a blister on my finger from writing so much (even with a cushion grip pen). Granted, the DON is actively trying to convince administration to decrease paperwork and/or switch to computers, so i'm sure that injury report was to add ammunition for the fight!

I think the biggest one for me is to always sign every med out right away, no matter how busy you are. If someone is taking a med qid, it gets difficult to remember if you have given that same med to that person 7 times or 8 times over the past two days. I find that the two days seem to run together toward the end of the second one, thus it is very easy to miss doses -- or perhaps even worse: give something 9 times instead of 8. I have seen nurses who work double doubles who will sign all their meds off for both shifts at the end (or beginning) or their shift. No matter how good they thought their memories were -- pill counts always revealed mistakes.

For a couple years, I worked for a national home health equipment company. I loved doing travel plans for people who were on oxygen. We would pour over maps and locate oxygen suppliers nearby, I'd contact those companies and negotiate contracts to ensure that the people had a source of oxygen refills wherever they went. Other than that, I helped teach people how to use their CPAP or Bi-Pap machines. Also included selecting a mask/interface that would work for them. Most of my duties involved patient teaching and product selection. Everything from post-mastectomy supplies, to ostomy appliances. Even a few times taught people how to use crutches. I found this very rewarding. Customers were always so happy when we were able to solve some of the complaints that would have lead to non-compliance. The biggest problem I ever had with it was that it was also my job to get the authorizations from the insurance companies. Sometimes fighting with them was heart-breaking. I think if they had separated that part of it from the nursing duties and left it to the customer service. I would probably still be there.

If you do find an answer, let me know! I've worked nights for 19 years. Once I tried to switch to days and had the exact same problem. Had to go back to nights. I even tried staying up all night, all day and evening, then going to bed after being awake for 24+ hours. As soon as the sun set I was wide awake and could not sleep til sunrise.

Also, I always sync my watch to the time clock at the beginning of each shift. Seems to me that the clock I get paid by is the one that counts!

I have to agree with RN1989. I often write on the inside of my lower arm. Just quick notes like time and abbreviation for what happened. I have managed to lose little scraps of paper too easily, at least if the info is on my arm it doesn't get lost!

I can be a little evil at times, but if other avenues don't work, I'd suggest a "planned accident". Bump into that cart good and hard and watch the meds go flying. The nurse will quickly learn that her practice is unsafe and can possibly cost her alot of time instead of saving it. As far as the CNA's administering medication, at least in my state, it is sometimes acceptable. I have had a few times where a resident trusted one or two CNAs, but none of the other staff. In these cases, I have prepared the meds, handed them to the CNA, stood near the CNA and the resident, and watched to make sure that every bit of the med was given. I am talking about direct line-of-sight and full attention. Not handing the med to the CNA and preparing meds for another resident. This was acceptable even through 4 state surveys in LTC.

After my mother graduated from Veterinary school, I had to call her Dr. Mom for years after. Needless to say, I find it very hard to call Doc's by their first names. Even if they ask me to call them by their first name, then it's "Dr. Lisa". I guess my Dr.Mom trained me too well.

I do get holiday pay for Easter, but what I'd really like to see is holiday pay for Mother's Day. At least when I worked LTC, that was the worst day of the year. Seemed like all the kids from across the country would decide that Mother's Day was the one day of the year that they could manage to see their Mom. I always hated dealing with all the "long-lost" children who acted all indignant and wanted to know why mom wasn't walking, or talking, or feeding herself.

Thankfully my MD still uses voicemail. I've known her since I was 14-yrs-old, and I can just tell the desk to put me through to her voicemail. For most things, she'll just call in a script for me or my kids. My husband is a different story tho, she's only known him for 5 years, and usually wants to see him first.

When I worked for a DME company, one of my responsibilities was to teach men how to use the penile pump for erectile dysfunction. Because it uses a ring, size does have to come up. I frequently heard comments such as, "I'll probably need the smallest one they make". I never answered those in a personal manner. I would simple say, " average circumference range is ___". I left it for them to do what they wished with the info. I've done the same with issues of length, tho that did not come up as often because circumference was the important measurement.