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  1. MotherRN

    Most Frustrating Thing ?

    "Not my circus, not my monkeys."--I like that! Must remember to repeat to self often!! I'm just finding this post...bad day at work...I would say at my school the biggest frustration is that the administration doesn't understand that it's a problem when a diabetic kid is on campus without medical orders or insulin...for two weeks!! Then, once I get the testing supplies, there is no insulin with it. And the kid is testing at 450 with moderate to large ketones (DMII)- still admin sees no problem here. Took a week to get mom on board, kid coming consistently to me, insulin in the office and finally, her blood sugar to drop from the rafters! This is year two for me as a school nurse. I see from reading this thread, things are tough all over, and we all have many of the same problems (the contact #'s!!) I thought that was only me because of the student population I serve.
  2. MotherRN

    third time's a charm!

    Congratulations to you!! Great story about not giving up!! The whole testing system is from Mars, so it takes some tips and lots of practice to truly master it. Plus, all the extra study you put in...that will benefit you on the job so much! I'm sure you made so many connections during the study that you will be so fresh and ready for whatever job comes next! NCLEX is the gauntlet; succeeding on the job is the real test! Congratulations again!
  3. MotherRN

    Everyone Won't Succeed. And That's Okay!

    Interesting article. Especially interesting for me because I am working as a school nurse in an alternative program for middle and high school students. So many of these kids come from rough background. After meeting the parent of a kid who really messed up yesterday (by bring Sudafed to school on his person-grounds for expulsion), I told one of the teachers, "Sometimes you meet the parents, and you understand why" meaning why the apple doesn't fall far from the tree. There is always hope these kids will do better than their upbringing. There are programs in place to help them. But, personal motivation is absolutely going to make the difference. It makes a difference in everyone's life, even the Prince Brian's of the world (our nickname for an especially spoiled son of a relative who was never parented, but only 'coached' instead through life's lessons. I literally heard his mom tell him, when he asked at age 7 why everyone else was eating chocolate ice cream, whenhe was eating vanilla, and his mom told him, "It's because you're so cool. You're the coolest!" ). Prince Brian, unlike Eric has had everything given to him, and he is not motivated to work for anything himself. The problem is this: even with all the motivation in the world, the deck may still be stacked against you. Maybe you have to give up your dreams to go to work in a single parent household to help mom support the younger siblings. etc Yes, the especially motivated Eric could keep plugging along in night school and work three jobs- but there are only so many hours in a day and so many years in a life. The goal of being a doctor may not be achievable because time might run out! Or he could still do it for the sheer love of it and not reap any return on the investment of time and money because it took so long to complete. That's a personal choice (kinda like me and nursing degree at nearly 50 :) I think motivation is the key- for the Erics and Prince Brians of this world.
  4. Update: Things have calmed down with this student. I haven't had any trouble in two weeks. By sticking to the plan, he knows what is expected and seems to have come around. He still doesn't like me much, personally, but he does make eye contact and I can hear him when he speaks!! I recently went to a state convention. Boy was I disappointed to find that no one at the state level wants to give any specific advice when we have difficult issues in the schools. The universal theme seems to be "Don't quote me on that" and a general unwillingness to respond in writing, lest there be a record of the advice given. Interesting!
  5. Thank you all for the advice. I have managed to come to terms with my own concerns over this kid. My husband (long time manager) told me to do my job, even if it means the end of my job. I appreciated this so much because part of my concern has been financial. I really need this job!! Basically, I think the lesson I learned from the whole issue is to not involve the administration in my health office affairs-not until it's absolutely necessary. I involved them too early in this issue. I hoped they could keep him out of trouble because they all seem so involved with him. It didn't really help. They don't really understand the medical end of things. I think what helped the most was calling mom and having her give me permission to call grandma (never underestimate the power of grandma in an African-American, fatherless household!!!). Because he knows I will call her, I haven't had anymore trouble, lately. Doesn't mean he won't regress, but for now, I'm catching a break. Plus, he hated it when I took him upfront for his meds. He hated that more than me! So, he is towing the line with his emotional outburst so we don't end up there again. And, I am not rubbing it in. I am very matter of fact. I talk with respect and I expect respect in return. I'm also having him fill out his own form after he checks everything. I do verify, though, for obvious reasons. At this point, I would love for him to do the right thing, but I will settle for keeping his blood sugar in a safe range so he stays off the floor. Apparently, his diet has consisted of Fruity Pebbles for breakfast only (no wonder his BS is about 70 three hours later!) and Gatorade/Doritos for lunch (until the cafeteria cut him off). The other day, he ate a real lunch and was at a safe blood sugar before dismissal. He was actually cheerful. He had energy. He even smiled!!! You'd think he'd get a clue!
  6. No mentoring program. Single parent household, no dad.
  7. Because I basically spoke my mind and told the assistant principal I did not agree, I did not feel supported, I felt if it were the other kid, they would be supporting me, I told them I felt it was a double standard that last years nurse was allowed to bring a student upfront when she felt uncomfortable but why was I not allowed to do the same? I speculated that it was because it was the well-like student and not last years problem child. So, basically, I am on thin ice! In the bigger picture, I know my license is worth more than this job. But, in the short run, I will be bankrupt without it. So, my question is now this: I need all the documentation advice I can get on how I cover my behind when I am being put in this position? Because I said all those things above, the assistant denied them and agreed that if I his sugar is low, and he won't eat, call mom to pick him up. Well, here we are, right back where I thought we were. But, what is going to happen is as soon as I do this, the principal is going to hit the roof. She's the one who didn't let it happen today. She and the assistant can't agree on anything! One will give me permission while the other is away ( which is the case until Tuesday now), then I will get blamed for following an unpopular order! Believe it or not, my lead nurses response was "Quit worrying. Let him be noncompliant. When he passes out, call EMS, give him the shot." Seems like REALLY BAD ADVICE to me. In the end, I would be the one held responsible by his parents, doctors etc for delay of care. Thoughts on this item?? Is it enough to document refused care, called parent, notified principal, strongly recommended student be sent home, denied. student remained on campus. BTW we do have new orders now. If they get his sugar up in the morning, then he can safely not eat lunch on campus. Still not a good idea. Anyone been in the position where the principal makes it impossible to follow orders? Now that I have written it, I am very concerned about the 'delay of care' issue.
  8. Suffered a set back today. Discovered the administration is not going to do the right thing. They were doing lip service to it for the benefit of the clinical student who was with us that day and listening. I can still hear, "We're going to do everything we can to support you." in my head. Well, basically, they don't care if he's disrespectful, they don't believe he is a threat. I am to start taking him in the back because he is "shy" and doesn't like being made to come up front. Also, I have been told to not monitor if he eats. Okay. But, they made me do it today because he couldn't stay on campus with his blood sugar at 70 for 3 hours more and not eat something. They did cut him off of snacks, but I bet he'll be back on that soon as well. So, he refused to eat. They said they would send him home if he did that. Instead of calling his bluff, she made me monitor lunch to see if he did eat. He did not. When I told her so at the end of lunch, she called him out of class to "talk" to him. Yes, he got special treatment and all kinds of attention. She called to tell me he had eaten. SO not the way to go with this. Why are you babying this child? You aren't helping him live up to his potential! You are telling him instead he's a baby and needs extra special attention. If he whines, you are going to give him what he wants. I am so mad I could spit right now. The bottom line is this: I am new. They know him. He's like the school pet. Every refers to him as a sweet heart. Hey, how about teaching him to be a man?? It's also a double standard. I have another diabetes kid. He gave last years nurse trouble so she started giving him his insulin up front. They butted heads. I have no problem with this kid. I have a problem instead with the kid she did get along with. Now, the one from last year, the teachers don't like because he's ADHD and not on meds. So, if I were having a problem with that kid this year, they would be more than willing to expel him like they did last year. But, because it's their darling, I'm the one who better tow the line.
  9. Thank you for the replies. I've had him upfront with his meds in the principal's office (my office is isolated in the back of the school). Today he pulled a stunt. His blood sugar was below 70 and he said he would eat. We observed him, and he was not eating. So, we sent his teacher to check him. The teacher said the student said to "Stop spying on me." I told the principal he wouldn't eat so we agreed he had to go home. We called mom and he got picked up. The good news is it made mom made enough that she finally called the diabetes educator. And, since mom was impossible to understand, the diabetes educator asked for permission to call me directly. So, we sorted it out. Basically, if his sugar is around 72-80 each morning, then she feels it's too low and they need to adjust his meds. And, if it's below 100, she wants him to eat at school and not Gatorade and chips. So, the principal has told me to inform the cafeteria to not sell these items to him. That was he will have to actually eat lunch. If he chooses to not eat lunch, then we will have to send him home, if he's below 100. He's still on campus for 3.5 hours after. I think I finally got through to administration what a liability to the district this is and how much it concerns me personally. Administration is going to check with the lawyers to see what we do with a teen who will not allow us to treat him according to our medical orders. He's still too young to refuse. And, oh so dangerous to have on campus untreated. Plus, mom has to drop off the meds monthly. It's not a choice. We will be having a conference with mom and student in the near future about the issue. They wanted to hear back from district first. I sincerely hope we can hammer out a clear course with clear consequences that are clearly enforced! That is what it will take to solve this issue! Stop babying this teen and help him grow up! Hold him accountable!
  10. Hi! In general, the kids are working with me well in the Health Office. I am having trouble with one of my diabetic kids. I think he might have a crush on the former nurse. He's in high school and she looks like she is too, even though she is in over thirty. Basically, everything I say is wrong and he doesn't want to take his insulin coverage for lunch time meals or snacks. He tells me things like, "I'm not eating today." Then I discover him with a plate of about 100 carbs!!! worth of food!!! Or, he will tell me he is only getting a snack- Gatorade and Doritos- and his doctor says to not cover these. And, when 30 days had passed and it was time for a new bottle of novolog to be dropped off, he told me last year the nurse let him keep the same bottle month after month, because he barely uses it! More than three weeks went by before I could convince mom to drop off another bottle. During this time, he did not get any coverage because I would not give him expired insulin. I feel like Ms. X put me in this position by mismanaging his treatment last year. She basically took him telling her he was not eating and gave him no coverage (when he was surely eating the whole time or else he would have dropped at least a pound or two!!!) Plus, the not requiring him to drop off insulin monthly is crap! He doesn't believe the stuff expires. I have told the principal when I first found out he does eat (and lies to take no coverage), she talked to him. It was fixed for about two days. This Monday, he came in like a loaded gun looking to go off! So, I had to tell the principal again. And, this time I had to put him in his place because he was tossing things around and being really disrespectful. I refused to let him storm out after that behavior and told him he would stay put and behave respectfully in my office. He is a junior in high school. He will also speak loud enough to be hear and stop this game he is playing where he mutters and refuses to make eye contact like a spoiled child! I called mom as well. I requested she call his doctors to see if they want to change his orders in any way. I explained I have to follow the orders given to me in the health office in order to be compliant. This kid does not run high. He is below 100 when he comes in. I don't want him to refuse to eat, then drop, because he is often at 72-82 and his lunch is early. He is still on campus for another 3.5 hours after lunch. I'm rambling. I'm just so frustrated. Here I am, actually following the rules of diabetic management and his orders safely, and I'm the bad guy! Today, he told me, "I can't work with you! I want Ms. X!" Suggestion?
  11. I'm sorry for the slow reply. I have been so very busy with my new job and RN-BSN program. I have not been on All Nurses at all! Hopefully, you will get this reply. Basically, I graduated nursing school almost two years ago with an ADN. First, I applied for hospital jobs online and got no where. Then, I applied to long term care. I worked at two different ones for a few days on one and a few months on the other in the first year I was a licensed ADN RN. That summer, before long term care, I was desperate. I googled substitute teacher with my local school district and was surprised to see I qualified to be a substitute nurse in the district. I put my packet in with the district office. I also applied to be a regular teacher substitute because I have a BA as well. Never was asked to sub as a teacher. I did start getting calls to serve as a school nurse sub however. They were pretty desperate for subs because the pay was really lousy. It was about $12.50 an hour. I put off taking assignments for a while because I was employed in long term care and making $29.00 an hour PRN at this ritzy beach-side skilled nursing facility. It didn't last however (office politics) so I started subbing. One of the first calls I received as from a former classmate. She had graduated with me and been in my last nursing clinical. I became her "Go to Girl" by being very flexible. I basically was available. I used the time to study for chemistry because her school was so slow. As a sub, I only handed out meds and documented. I subbed for her and another school equally as much. I was always organized, respectful, and actually very appreciative for the work. I was licking my wounds still from a bad first nursing job experience in LTC. Subbing as a school nurse restored my love of nursing. It was like a breath of fresh air! I subbed for about 7 months. Sometimes only once or twice a month. sometimes as much as 6 times a month. Clearly not a living wage. So, I found another LTC job in April. It was a nicer facility and I worked part time over the summer. Then, I got a text that my former classmate was promoted to a bigger, better paying school and her position was opening up. So, I applied. I still had to write a cover letter and be interviewed and wait to find out if I had the position. I have been there now since August. I have had my nursing license since spring of 2012, so I have not been a nurse long. My school is manageable. But, I would not like to be at the bigger ones yet-not until I have done the small school at least two years. I'm not sure I want to move on. We do immunization surveillance. It's a nightmare! You have to review shot records for all the enrolled kids and fix all the problems. Plus, the potential for a crisis emergency increases with more students. There are many aspects to school nursing that are shared with being a public health nurse. I want to learn these first. I hope you get this! Not all school districts will even let you sub with as little experience as I had. The other nearby county wanted me to be a BSN and have 5 years experience! But, they paid you for it appropriately.
  12. MotherRN

    New RN how to 'manage' CNAs

    One suggestion that I feel is really worthwhile is if everyone takes 15 minutes around the clock on a rotational basis with the very confused, very difficult dementia patients who wants to get up and will just end up on the floor with a broken hip- instead of disappearing and dumping this one on one care on one person only- who then can't care for her other patients or this one safely. That would be reasonable to me! Everyone takes 15 minutes- including the nurse- then they have the other 45 minutes in an hour to get their work done.
  13. MotherRN

    New RN how to 'manage' CNAs

    When it is abused, which is probably the case at this location since management brought it up at all, there are no CNA's left on the floor to answer call bells because they are all teamed up behind closed doors. This is a real problem! They can't just abandon the rest of their patients and ignore them while they work in teams. Depending on what is going on with the nurse's 20+ patients and which procedure she is in the middle of, she can't just stop to answer the call lights of every patient on the floor, beside the one that two CNA's are working with at the time. If they can still watch the rest of their patients, while working in teams, then I have no problem. But, it has been my experience that they abandon them to me- you know, since I am not doing anything but eating bon bons at the desk anyway(not!). And, this is why I am not in LTC anymore. The answer: hire more CNA's. They are cheaper than nurses. Or at least bring in some on a short shift when everyone is being put to be. Happier patients, safer care! They could have extra coverage at say, 5 am to 9 am, when everyone is getting up and being fed. Then again from 5 pm to 9 pm so everyone gets put to bed timely. Why do we have two or more CNA's sitting around from 11 pm til 5 am with little to do, but chat and eat?
  14. MotherRN

    Why do you visit allnurses.com?

    At first, because I couldn't find a job. Next, to vent after I finally did find a job. Afterwards, to share my crushing disappointment when the job ended abruptly. During the time between jobs, to learn about different specialties by reading the posts of those who work in them. PRICELESS!!! Once I found the right job, for entertainment and community. Thanks for 'being there' fellow allnurses's ops!