Nuieve

I know there's no scientific evidence... which only proves whatever research that was done on it was deeply flawed. My 15 years of experience tell me there's a connection between dementia exacerbations and severity of encephalopathy during full moon phases. I've seen it so many times, and so many times I checked the calendar on the worst days if it was a full moon, and it was. It's supermoon here tonight. My dementia patients are losing their minds. 2 ended up in restraints. The mildly cognitively impaired pt that was doing OK a few days ago gradually sundowning more every night for no reason. I know it sounds silly, however I do believe Moon's gravitational pull does affect us in some way, how - I don't know. Not goofy fairy tales, just there's some science we haven't discovered yet. " NEW YORK -- The first of four supermoons to rise in 2023, July's lunar display will appear to be brighter in the night sky than any other full moon event that has occurred this year. The full moon rose on Monday, July 3, and reached peak illumination below the horizon at 7:39 a.m. ET, according to The Old Farmer's Almanac. Local weather conditions allowing, you can view the celestial event by looking to the southeast after the sun sets. "A supermoon is when the moon appears a little bit bigger in our sky," said Dr. Shannon Schmoll, director of the Abrams Planetarium at Michigan State University. "As the moon goes around the Earth, it's not a perfect circle. So, there are points in its orbit where it's a little bit closer or a little bit farther from the Earth."" SOURCE: July 2023 supermoon: Buck moon will be 14,000 miles closer to Earth than a typical full moon event - ABC7 Chicago

I work in Critical Care, top floor. We have a helicopter pad on top of us. Whenever the helicopter is used, the whole floor gets full of fumes, I guess I'm more sensitive, I'm literally choking the whole time, other employees note the stink but don't really complain. The worst part is that it linger for an hour or so. You'd think a helicopter comes and leaves, should take 5 minutes top, but it's like it just sits on the pad idling or something because our AC is turning on and off but the fumes are not going away, for an hour or so usually. I literally can't breathe this whole time. Sometimes I'll leave the floor and go to some private room where the smell is not so bad if time allows... We're acute care, lots of resp patients, it's been like this for as long as I remember. Can anything be done about it or should I just suffer quietly?

I work in a rehab center. We're famous for accepting patients every other single nursing home refused. Mostly drug junkies, alcoholics. I noticed in hospitals they rarely get more than 5-10mg of hydro or oxy. Once they come to a nursing home (or I noticed from records from other nursing homes), their pain pills prescriptions start growing exponentially. 5mg, in a week 10, in two weeks 30 and so on... Start with hydro 5, in a month they have MS 30mg TID and Oxy 20mg QID. Now I know SOME of them do have pain. But most of them are just homeless guys with nothing wrong with them to warrant such high doses of narcotics. I know how it works, patient comes to the doc and says "it's not working for me, I'm in a lot of pain". Doc has no other choice but to bump pain pill dosage. Now I wonder, are docs required to up pts dosage of pain meds whenever they ask? Are they legally required to? Afraid to end up in a lawsuit and just decide it's easier to give these people what they want rather than deal with lawsuits later? Maybe it's my particular place, but 1 year ago 80% of narcs were hydros. Now I maybe have 10-15 cars of hydros, and about 80-90 of mostly MS and oxy with some dilaudid and methadone in between. The other problem is that once they taste hydro once or twice a day, they get hooked up and keep asking for it regularly after that even if source of their pain supposedly resolved. And then you find them drunk... and/or selling those MS tablets to strangers that come to visit them. When I was doing my clinicals in the hospital, the nurse I was with... she just completely ignored new pts with drug seeking behaviours. She would go on with her assessment and not run for pain pills or look for doc to up them. Many pts come from hospitals c/o that it takes forever to get a pain pill in a hospital. It's like hospital docs/nurses are more confident or better protected. In my place, you don't give a junkie his oxy so he can go and get drunk/high, you can get reported to the state/fired. So there dear, take all you can have. It's all yours, enjoy... go buy some whiskey with that, I heard it makes it even better. The law wants you to have as many narcs as possible, we don't have enough addicts in this country. Should I ask the doc to up your MS from 120mg TID to 180mg TID because you have a boo-boo on your finger? No problem...

Ok, a little update. So I did orientation in both nursing home. First one, luxury, very easy. Only 15 pts, most of them take just a few pills. No treatments. But the people their require extra caution as they're rich and my bosses expect you to kiss their... money. And today I got a call from supervisor, they were investigating two things - one, ulcer that was reported missing, but it was there - issue I had no slightest clue about as I didn't do admission assessment, and neither did I or had to do any skin checks on that person. I don't even know what I had to do with this. The other one, I put a wrong time on narc sheet (0900 instead of 0700) and then crossed it out after the other nurse came to see when was the pain pill given last. (it was written correctly on MAR, but she didn't check it). Apparently she went and reported this to my supervisor (and maybe added the ulcer thing to that too), which pretty much confirms the other things I've heard from people I know that work there - if you will be working there, WATCH OUT. These are nasty people working there, and they will be looking for reasons to report you all the time. Which, in other words, makes it no-brainer that I don't want to work there. I'll take a few more shifts there and will bow out in a month or two. The second nursing home: what a depressing place. Made an ok first impression, but after orienting there... what a dump. Rooms for people are tiny, and the staff there looks... depressing. Everybody's old, worn out, nobody seems to know what they're doing, disorganized, miscommunication left and right... and people look like I can't trust them either, quite unpleasant. These experiences were a real eye-opener for me. Just made me realize what a good job I have now. To be honest, I don't even care about how much of a raise I'm gonna get (if at all). Some things are just worth more than money - energetic, friendly, trustworthy work environment. Not to mention the valuable experience I get here... yes it's hard to work with these very sick people, but I'd rather work with them and get actual nursing knowledge than pass 3 pills to plain old people and not learn anything. Overall, as tired as I am, I'm glad I went to these places. If I had to, I would work there. But no way I'm quitting my job to go to any one of those. Not even if they offer me extra buck or two. Now I have to figure out how to slowly taper off my presence there and quit peacefully. Thanks for everyone's support and advice on this matter, I really appreciate this.

Oh yes, I will have to! Don't need a 4th job I don't want! My current job is my first one, so I was still inexperienced with interviews, and had that newbie "will not bring up compensation during initial interview" mindset. I guess it didn't work out, so for sure next time, compensation will be brought out during the first interview (if I grow some guts by then). Second nursing home I applied to (the very nice one), they just called me and had me write a letter of interest in full-time position (they assumed I would want one). They have a nurse going on maternity leave soon, so there's a chance she might not come back. So I'll be the first in line for her position. I guess this will be my second chance to re-negotiate the pay. I could say "for on cal 25 was ok, but for full time I need you to match my current pay, I can't afford to lose income". I hope I have enough strength in me to say that.

Thanks everyone for your encouragement. All said true. Also, I think... ok, I got lower rate now, but if I prove myself worthy to them as a potential fulltime employee (which I will work hard to do), I will have another chance at re-negotiating pay later, if a fulltime position comes up.

I feel guilty for them spending money on me on orientation. And also, I live in a smaller town, we don't have all that many nursing homes, everybody knows everybody, I don't want to get a reputation of someone who gets hired, gets their orientation money and is never seen again. Reliability is my feature, I have 100% attendance record. If I commit to something, I will follow through, and that's my burden.

I work at SNF making $26.25/hr. 12-hour shifts, 3 on 4 off. Flexible schedule (get my vacations when I want them, management very accomodating and I love everyone I work with). But the clientelle is as bad as it gets: homeless, narcs, alcoholics, mental... we don't accept just old people with money. We only accept those every single other nursing home turned down. It's very hard, but I'm used to it. Recently I had some thoughts this place is not a good long-term place. Pay and schedule are good, but the place is just dangerous, and maybe I could use something less stressful. I thought about applying to other nursing homes, check them out and move to one that meets my needs best (same/better pay+less stress). I applied to one, they have lots of facilities in many states (to some of which I might want to relocate in the future, so I thought it's convenient to have a job that can transfer you easily to another state). Stated my current rate on their application. Got $27 for on-call (no benefits, obviously) which will turn into $23 with benefits if I go full-time. Did 1-day orientation. Still need to schedule the other 2 days. I thought "ok, will keep this just for the future. not going to go full-time". Nicer place than mine, only 15 pt per nurse (I've got 26), but lots acute too. Two days later I got a call from another nursing home, this time it's a high-end, luxury private pay place. Very luxury, very easy to work in, nice place for long-term work. They offered me on-call job, I thought "why not". They mentioned the possibility for going full-time soon. I went for orientation there too today. Always wanted to work there... but... salary wasn't discussed during initial interview a week ago (I didn't bring it up). However I did state on application my current rate and expected rate - I put $28-32. Before going for orientation I made firm decision that when they tell me the rate, if it's below what I make now (26), I will not accept the job. The only problem, they threw the whole orientation at me before I even got a chance to ask about my rate. At the end of orientation, I finally asked them... $23 plus 2 for not having benefits=$25. I was asked "is it ok?"... I didn't have the courage to say "no" because, well, I was already hired and went through the day, so I just shrug and said "I guess so". Very disappointed with myself. Let's make it clear. My current job is my home. It's a tough place to work, but I got good pay, excellent schedule, flexibility, and, well for overtime, I get $40/hr (time and a half). So there's no incentive for me to work on call anywhere else, even if it's easier. If I knew that I'd get $23, I probably wouldn't even bother to apply. Now my place don't raise much... since I worked there I got 25 cents raise last year (less than a percent). We've got a new admin who looks like he won't be don't much in this regard, there's a chance I might get stuck with my current rate for years. I know second place does raises... at least they did years ago when my wife worked there. They're also 8-hour shifts, rotating schedules (I have fixed days now), and, as I said, too strict about everything, so no flexibility like I have now. But much, much easier work. Maybe 5% of what I do now. So there... I feel burdened by all these on-call jobs. To put it simply - I don't need them, as I only looked for the as trials to see if I want to move to other places. But I always thought other places will match your rate by default. I have bills and absolutely no desire to cut my income. I don't know what to do with these jobs. I'll have to finish orientations (which means no days off for probably 2 weeks), and then... I don't know, work in each place once a month just to keep myself on a roster? Or just stop working after a while if I find out those places aren't really worth the pay cut? Three bucks is a lot, could be 3 years of raises... Any advice/insight would be helpful and appreciated. If any of you been in the same position, let me know how it worked out for you.

By some accident, our RCM did the evaluation for pretty much all the stuff 3 days before my one year anniversary. However she told me HR lost? all the evaluations, so she had to redo them for everyone. When asked if this comes with a raise, she replied "I wish. They gave everyone a raise in October". Hmmm, I remember seeing my rate increase whopping 0.9% an hour in October, I always wondered what the heck was that about. So I got my "well above average" evaluation done. Now in two days I would ask for one, but now it's done, and I don't know what to do. Should I go to the DON and ask for one? I find that 0.9% flat out offensive, I need at least 3-4% like most people here get. I spoke with another nurse who works in my place, he said he didn't get any raises in 3 years working there. I spoke with yet another one, same thing. I'm just curious, is this normal, or should I fight for it and how?

I think the numbers don't mean much without info on patients acuity. I'll take 60 alert and oriented people who only take 1 pill a day, don't have treatments, and are generally stable and independent, than 20 alcoholics, schizophrenics, narcs, psychos, quadrilplegics, obese who on breathing treatments, PRN narcs q 4h, take pills crushed, on IV and or tube, half diabetics with QID checks and insulins, constantly nauseated, scared and each has their share of ulcers, and that require 2 aides to roll them just to put a patch on them, and with some MRSA sprinkled on some of them.

I'd rather do medpasses than treatments. But then again, I like routine, I find it relaxing.

I gave up on treatment carts long ago. Completely useless for anything but skin prep. Can never find anything there. Whatever I leave there is gone the next day, and no replacement. Always go straight into the med room, even for something trivial like gauze 2x2s.

Our facility pays $3 more than all the hospitals in our town (starting wage).

While for some it's a no-brainer... more money, status etc... but have any ones of you taken an upper level position (manager, resident care supervisor etc...) and regret it later, possibly going back to pushing cart? In our facility this type of job is all about logistics. Tons of paperwork, calls, issues resolving, endless meetings, there's very little nursing in that, it's just typical office/management job. And, oh, an 8-hour 5-day, Mo-Fr schedule. I have 12hr schedule (with a few 5-days off in a row periods), and I love it. Tons of free time, come get the job done and leave life. And plenty of paid overtime opportunities, so that I'm sure covers most of salary difference. What do you think about that? If you were given an opportunity to be promoted to a management job at your facility, would you take it?

But please, be honest. And by first, I mean the very first of your career. Today I had my first one (I've been working for just a month). One of the aides found the pt dead. She was still warm, but she looked completely dead. I rate my response at 3/10. I forgot about all the rules/right sequence of CPR even though I took my CPR class just a month ago. Luckily the old lady turned out to be DNR, so I did no harm but I did learn a very valuable lesson... on how to do it properly (hours after incident when I remembered every single detail of what I did wrong). I learned I'm able to remain calm and the next time I will be prepared and won't make the same mistakes, hopefully. Tomorrow I'll ask my RCM to maybe implement drill codes. I think we need them.