melissa_rn

Just wondering how other clinics handle the situation of destroying pain meds. For example, say a patient was prescribed Percocet, but they had a reaction to it, so the doctor wants them to get rid of the Percocet before giving them a prescription for Vicodin. I know the pharmacy won't take meds back...and the clinic can't take the meds...how can you be sure the patient will destroy them? Can you make them destroy them AT the clinic (kitty litter/coffee grounds style)? (But then what do you do with them once destroyed?)

I never worked in a hospital after graduating nursing school. I worked at a residental treatment facility (psych), then a family practice clinic, and now a rheumatology clinic. While I don't plan to work in a hospital any time soon, I do wish I would have gotten some experience there right out of school. The recruiter for the local hospital has even told me that they do not hire nurses without hosptial experience. I've considered going back to school for my Masters, but even that, they want hospital experience. At one point, I was laid off and scrambling to find a job. The hospital was hiring, but since I didnt' have hospital experience, I was out of luck. I LOVE working in a clinic, but I do wish I would have tried hospital nursing for a little while at least. (In other words, I think I did screw myself for the future.) Also, I know more and more clinics are getting away from hiring nurses and only using MAs, which makes me worried for my job security in the future.

Don't plan to "wing" it. Plan to get instruction by the doctor (since there hasn't been an RN in the office for a few months) but I wanted to have a bit of a "heads up" from some infusion nurses before going in to it.

Just started a new job in a rheumatology office and will be giving an IV Boniva next week. I'm pretty confident in my ability to find a vein....but I'm not sure how the IV Boniva is set up. Will I be able to "pull back" to see if I'm in a vein? Will the tubing fill with blood? Or is the tubing filled with medication? Or air? What happens if I miss the vein? (Do I have to throw the whole thing away?) Also, are there any side effects or anything unusual I should know about this administration?

I was a clinic RN in Seattle for 5 years. My pay there ranged from starting at $23.50 and ending at $28.24. Then I moved to NH. Pay in NH is much lower than Seattle. I asked for $23 here (since I had 5 yrs experience) and they looked at me like I was crazy. New grads in clinics start at $19.60-ish. I know you're an LNA in a hospital so your situation is a little different than mine...but just wanted to point out the differences between Seattle and NH.

I was offered $15/hr. Is that a usual salary for school nurses? I made $15/hr when I was a secretary during nursing school.

Looking at a school nurse position for a small-town elementary school (430 students). My previous experience is 1.5 years at a residential treatment facility for mentally ill children and most recently 4.5 years at a family practice/sports medicine clinic (ages 13+). How "intense" does it get? From working at the children's home, I understand being called on to look at injuries and passing meds. I only called 911 twice: once for a "cutter" who got very deep and the other for a kid who had a vaso-vagal episode after eating 4 packets of tobasco sauce (no joke). At the clinic, I triaged many illness/injury phone calls as well as the usual clinic stuff. We had a few emergencies there - a seizure in the office, two CVAs, an MI with the ER right across the street, not to mention other nurses and doctors for assistance. How frequently are there "emergencies"? I'm thinking fractures, seizures, asthma attacks, anaphylaxis, etc. You know, the stuff that gets your adrenaline going. The thought of a compound fracture with ME being the only medical professional on site makes me shudder. What's your stress level at the end of the day? How long do school nurses usually stay school nurses? I understand the pay is significantly less - $15/hr at a nearby school for a position that could be filled by an LPN (I made $15/hr as a secretary when I was in nursing school - not enough to pay for daycare!) But it seems that most school nurses love their jobs and don't do it for the money. Also - I'm a very organized person. I was the one at my last job who made new forms, figured out better ways to do things, who kept up on changes in vaccine recommendations, ordered supplies, etc. Lots of the office-side of things as well as the nurse stuff. Would this type of mind be beneficial for a school nurse? Thanks in advance for your advice!

I recently had an interview for a part-time family practice clinic RN position. I have 5 years of experience in a busy family practice clinic but we moved to another state. This was my first interview after getting licensed and they had me back to shadow for a day to see if the job is something I would like. The nurse I was working with said that the day was "really busy" but it would have been considered "slow" at my last clinic. The office is tiny. There are 3 patient rooms and the doctor's office. You can stand in one spot and see the entire place. There are only two windows in the place - one in a patient room and the other in the doctor's office. There is a lab of sorts right behind the nurse's desk. There is one little refrigerator there which they use for specimens, vaccines, AND the nurse's beverages. Yep, all in one. There is a sink which had dirty dishes in one half and the other half was used by the MA to transfer urine from a cup to a tube (without gloves). The nurse I shadowed today did about 10 blood draws and didn't wear gloves or wash her hands or use hand sanitizer the entire time I was there. They were giving flu shots, but giving out the 06-07 edition of the VIS for the nasal spray version instead. They do paper charting but the charts were just manila folders and they make their notes on loose leaf paper which is clipped together with a binder clip. If you ever dropped a chart, you'd be screwed! The hallway is not wide enough for a wheel chair. They also have mercury sphygmomanometers on the walls and the gloves they had were latex. They do not do xrays, splinting, casting, or suturing. However, the patients that we saw today have been coming there for years and seemed to love the clinic. The doctor gets good reviews online. The daily flow (blood draws, injections, phone calls, refills, etc) seems generally the same as my last job (but less). There are only 7 employees total. The doctor is in her 60's and I wonder when she plans to retire. My schedule would probably be just two days a week, meaning I could stay home with my son the other 3. I'm concerned that I might not be "going anywhere" with this job. My last clinic was state-of-the-art compared to this clinic. I feel like I might be moving "backwards" in my career. They have offered $23/hr without insurance (since I'm covered by my husband's). I started at my last job at $23.50 five years ago, with benefits. They don't have a 401K, but starting in your third year there, the doctor starts to put 6% of your salary into three different programs (a cash balance plan, profit sharing, and safe harbor? Not sure what those mean) for basically an 18% raise starting in your third year. However, this only applies to people working 20 hrs or more a week, and I may not qualify. The people all seem nice enough. The office is somewhat claustrophobic. I'm not sure if I'd want to be seen there as a patient. And would I want to work somewhere I wouldn't want to be a patient? I probably could have a hand in correcting many of the things I see as "wrong" with the place. But would they be offended that the "new girl" wants to come in and change things? Clearly, they don't think they are doing anything incorrectly. Do I take it but continue to look for something better? Would it be awful of me to get trained, and then leave soon after? Do I run away screaming? Advice?