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I get $30 hr for any time between 7P Fri and 7A on Mon. Full bennies. Must work 24 hours and commit to 49 weekends a year and call off no more than 36 hours scheduled time or get thrown off the program. I don't get a shift bonus if it is on the weekend, but I get a flat rate if I pick up a weekday shift, plus a bonus. I think $30 is paltry for a weekend rate; it is what all nurses should be making- at least as much as plumbers and electricians. Does anyone else get bonuses for picking up extra time on the weekends, in addition to benefits?

What is the status of this bill? Thanks!

I thought I saw a thread here that stated Pa may ban MO with the bill being in the senate now, and has passed in the house. My question is how have hospitals in other states that ban MO been able to staff. This question came up at work last nights with some nurses stating MO was necessary. I myself would encourage Pa nurses to call their state senator to encourage them to vote for this bill.

I'm not sure, but I think that the blend of staff that is dressed the same saves the hospital money-If certain attire was dictated by the faciltiy, they would be required to pay for it. So, scrubs that the nurses purchase themselves save the hospital money in more than one way. Unfortunate, as mentioned, it is a screen for low nurse staffing.

I do agree that this is not unique to nursing. I do know however, that I am not suited to workiing in this type of environment. I still dream of a lingerie shop and being my own boss. Thanks for all the support.

I thank all of you for your replies. It is a beautiful day and I am taking a former patient who turned out to be my neighbor shopping for a dress for her grandddaughters wedding. She can't tolerate the experience without assistance d/t COPD. I am lucky to know her. Then I am going to make fried chicken for my BF and tomorrow will address the situation with HR as advised above. I knew you all would be there for me!

I am 48 and graduated 10 years ago. I have found nursing to be so hostile that I cannot endure it anymore, but I keep plugging on because I am now single and need to support myself. I was recently hired for an orthopedic rehab position that, during my orientation, morphed into a long term acute care hospital. The staff is very upset about it. We get patients right from critical care and the delivery of patient care was recently changed from primary care to team nursing. I must state here that the staff has a reputation for chasing out new nurses because they are nurse eaters. I don't do well with this. For compensation purposes an RN must do a full assessment at least once in 24 hours, so the assignments are set up-(like last evening) two RN's, one per hallway and three LPNs that pass the meds and do the treatment. The RNs are responsible for admissions, discharges, IV's, documentation, blood draws, etc. Most full assessments are done on daylight, so it is possible for an RN to make herself available for prn pain meds, transfers, etc. Any way, I have had a very hard time with the other staff. It seems that if you are not easy with a quick witted comeback or in the cool clique, you are fodder for their nastiness. I have been told in report that if I press the pause button one more time (d/t interruptions) that this nurse would "break my fingers". The other day we had an inservice on hospice and the discussion was who was going and who would stay on the floor. Due to my former position as a hospice nurse, it was decided that I would stay on the floor. When the supervisor walked away, this same nurse who threatened to break my fingers stated "just last week I killed a pt with IV morphine" Another nurse said, "you had MD orders to give it" and I stated, somewhat lamely " you didn't kill him Susan, what was the dose?" and she turned around and spat at me with venom-"How long were you a hopice nurse, a month?" I backed down because she can get very mean, and I walked away stating "I just don't like to see a nurse beat themselves up because they gave morphine and the pt died." She said "I wish I could kill you with IV morphine." I was very upset for the rest of the day and into the evening. I finally went to report her but the supervisor was in a meeting. The next day she begged forgiveness, and I did forgive her but told her that I was very upset and that it was extremely damaging and hurtful. We spoke congenially after that, but the emotional toll was great. As luck would have it, the next day a pt came in and the wife and dtr told me they were told "he came her to die". I asked if anyone had mentioned hospice, and she said "what is hospice?" We don't contract with a hospice and we are still a rehap hospital, so it has been very confusing to the staff and family- the wife decided to give it a week to decide and she had much family and friends telling her what she should do. I gave her much impartial support and told her that it was not our job to tell her what to do, but to inform her as much as we could and she decided to take it day by day. NG tube feedings, copious pulmonary secretions, prob pneumonia and aspiration and ESRD. Yesterday the wife decided to let him go. On my 3-11 the pt had another nurse. I was alone at the station when the wife came up and asked me a question. I found out the answer, went to tell her and got involved with much emotional support and letting her know what she would see as far as the death process and how we would make him comfortable. He was very gurgly from the admission and I really thought he would not dry up (he had a scop patch and attropine gtts) and I emphasized that the mso4 would make him comfortable. She cried on my shoulder and I held her. We spoke about how long he could go on and her choices of inpatient if he lasted a couple days. I felt that he could since he was getting water flushes via NGT. I found out that all the nurses and techs were at the station livid that I was in there and "who did I think I was?" I was then told by the evening supervisor to stay away and let the assigned nurse "handle anything else that comes up" I agreed, but I was really disconcerted by the mentality of the people that I work with. I examined my boundaries. I do not feel I was the only one who could do the job, although my backround and relationship that was established with the wife gave me an ability to give her support in this time. She was very grateful. I just don't feel that I can fit into this profession. No matter what I do or how hard I try, I feel that my patients are grateful and benefit from my presence, but I just can't deal with the incredible hatefulness that pervades most nurses behavior. I don't have a mean bone in my body, but I come home every day examining my actions and blaming myself for either what comes my way (after all I must be doing something wrong to be so disliked) or hating myself for not standing up to them. I feel that standing up to them is a daily chore and it is just too draining. I have come to hate going to work and I am dreaming of the day I can open a small lingerie store or the like. Thanks for listening.

I too would like to travel to California. Any more input from anyone out there? The information so far has been an excellent start, but I would like to know if anyone else has had a good CA experience. Thanks,

rEAL nUT, Can you tell us why this will be the last time you travel? Sounds like you had a bad experience! I want to give this a try, but from the paperwork a company sent me, it seems I just don't have the backround! I think I can learn fast, but most of my experience just seems to have been geriatrics in some form or another: hospice, skilled and long term care. Even my new "ortho" position morphed into long term acute care, just another name for nursing home. Most of my experience seems to be comfort measures and cleaning up after incontinence. How can I travel with that? Do I need to hurry up and take BLS and ACLS? Will that give me what I need? I really need to get out of here for the winter Any input would be very welcome!

That is very interestihng. It sounds as if you like your job. I am now in rehab also. Pm me and maybe we can talk soon, Carrie

"..Requested her order for be increased to 30 gm oxycodone TID (now on 20 gm TID) w/breakthru pain meds PRN. " I'm thinking you mean oxycontin 30 mg for continued long acting relief? What are you using for breakthru pain? An addition of elavil or neurontin would probably help. I suffered with "all over fibromyalgia like pain" and elavil worked wonders. I empathize with you, as a Hospice nurse I certainly have had my fights with MD's. I have found some success with asking for Kadian, or switching to MScontin as some people respond better to one or the other for some reason. I had a pt on 300 mg MS contin BID and 2-3 cc roxanol q 1-2 hours for breakthru, taking it pretty much on time w/a. He walked around and went out and had to be discharged from the program d/t improved status (after I left the job, I heard). I would have tried methadone to improve his lifestyle, and kept him on the program for pain med adjustment, if I could have.He also took ibuprofen and elavil. Good luck and keep us posted! PS, since Kadian is 24 hour coverage, you don;t have to depend on other shifts to medicate. I also think that working with the pt gives some relief, maybe the placebo effect, or the fact that they are validated.

All look like great opportunities! Am thinking hard on this one! Thanks to all. Carrie

I don't have a computer at my new house and I ask your understanding in answering my question, as this is a long thread and it may have already been answered. My professional and personal lives are currently in disarray, and my time is very limited. Where can I find a class in foot care such as the one refered to in Ontario? Can anyone give any specific information? I could travel if necessary. Thanks very much, Carrie

Our acting medical director today addressed a family wish for over 6L for a dying elderly man. The MD stated that MSO4 is the best choice, as someone above stated. He stated that a pulse ox would determine hypoxia verses dyspnea. My thoughts are that cellular death prohibit intake and use of O2 and H2O and nutrients also. See https://allnurses.com/t12171.html and https://allnurses.com/t12171.html for a couple excellent articles, thanks to aimee and nursekaren

did anyone see the multiple ads at the right side of the screen for colon hydrotherapy? Is there a 900 number?

Awe, passing thru, Right now I feel so shell shocked by my Hospice job and my divorce that I can't even think of getting out of it. I will stick around for a year or so and fix up this house- it is like a big old dog house on a foundation- a tiny little house that needs alot of work. I will find another job and learn how to lay ceramic tile. Then in a year or so, put it on the market and move on. I just felt that I was ready now, but life has a funny way of putting down roots. Thanks for your support!

Found out today that the sales agreement for the house I am buying can not be backed out of- long story, so I am stuck here. Have to look for a new job though cuz I will be committed if I stay where I am. May be able to fix this house up some and sell it, and take off to San Marcos next year!

Right now in hospice I have a daughter that is very angry that her mother is dying, and she goes from offering me a soft drink at the beginning of the visit to verbalizing every dislike about her mother's care and things get worse as the visit goes on. "Are you done yet? All you nurses do is write when you are here." When I ask about the pain meds she gets angrier as I should know what her mother is taking. I gently explain that sometimes regimen's change or patients may be not taking the right amount to help them etc and she grabs my paper to check my med list and crosses off the ones her mother isn't taking and hands it back to me and that is supposed to be the med review. Very helpful to her mother, huh? Anyway, I just want to walk out and throw something. I don't know if I can bear going back there. I just can't take mean people. I am in the wrong job. I thought I was going to be helping people, not a target for their abuse. And people often take what I say and twist it around and then report it to my supervisor. When I call my supervisor for support she more or less just says suck it up. Just got a possible offer for OR and a super training and orientation. No families or concious patients may be just the thing I need for a while. chigap-thanks for bringing this topic to light. We are not robots. I, too, try to be professional. Look, even Presidents get in trouble when they open their mouths! They are forgiven and life goes on, why shouldn't we be forgiven for SLIGHT lapses?

mmm, passing thru, stop it some more! Thanks! Hope it works out for me!

Can't say as I love hot and humid weather, but I need the journey. Thinking of starting in Nashville for a couple days, heading for San Marcos for a while, then onto the desert then my ultimate destiny Southern Oregon Coastline. The defining and pivotal point is my Hospice job sucks- too much cilty driving, not the territory I was promised, pts too numerous and too far spread out and be at the office at the same time to do the paperwork-no computers. I feel I am putting my life in jeopardy on the highway with a cell phone and pager and the stress-geesh- I would rather tend bar in Montana or Alaska than work this job. Nice to hear from you both and get reaquainted with ya cheerfuldoer! Hospice has also taught me that I must be happy with what I am doing, life is just too short. I just don't do stress that well. Some people thrive on it, but it ain't me babe!

I have wanted to visit this Texas area for a long time, and having just started divorce proceedings, I am thinkinf of relocating for a new start. My brother lived here a while ago and loved it. I have hx in long term care, skilled nursing, homecare and hospice. Don't speak Spanish though- any suggestions? Thanks for any input, Blessings

Where did you find this course? I am very interested! Thanks

I was removed as case manager from the pt whose husband expected hospice to "come in and take over everything". He told my supervisor it was because I wouldn't commit to a four hour time period 2x a week. He told me he needed hospice there at the same time every day because he ran his own business and he needed to take his handicapped son to work and back . I hooked him up with the volunteer co-ordinator and gently suggested some outside help. This has been very demoralizing to me.

It is a tough job- from the recent husband who thought "hospice would come in and take over" to the obsessive and fighting sibling offspring that try to draw you in and get you to take sides, to the son who did internet research on alternative meds, herbs and vegan diet to reverse cellular death, althewhile eschewing the prescribed meds his mother was supposes to be taking. A sister actually called me and said to do something as "my brother is nuts." I stated that her mother was alert and oriented and of sound mind and it was her choice to follow her son's advice. He since has been banished and the pt is doing much better. I have had families where a meal could not be cooked in the kitchen due to gross messiness, garbage, stink etc and all the mom and dad did was sleep (drugs?) all day when the mom was not at her job as a privately employed cook. The patient, once again, was competent and denied any nutritional deficit. I doubt that she has adequate intake. A nutritionist would be lost on these folks. It is all very sad, and you do what you can. I agree with the comment about boundaries. Also, most patterns are set up from a lifetime and can't be changed, so I define my goal with my patients and usually they don't include feeling guilty over family dynamics that I can't control. Great luck to you all.

I just saw a sad case like this, I work in hospice. Extreme agitation that was very upsetting to the daughter. I finally did a non verbal pain scale and even though the patient was not in pain, the scale showed she was very uncomfortable. Roxanol was the only med that made her comfortable. Ativan intensol and haldol intensol were not effective. Basically the daughter and I and the nursing staff agreed that whatever it took was what we would do. Have you made a hospice referral? Great advice from the other posters.