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EMS, LTC, Sub-acute Rehab
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cyc0sys has 6 years experience and specializes in EMS, LTC, Sub-acute Rehab.

Born standing up and talking back. Made love to the howl of the wolves, with a dark haired girl. Crawled across the edge of a straight razor. Drank until I was thirsty again. Ate more chicken then any man ever seen.

cyc0sys's Latest Activity

  1. cyc0sys

    Fired for taking vacation

    Yeah, you're wrong about that. There is a difference between being rude and being direct. I was being very direct with my communication by drawing a hard line in the sand. I explained my case very factually, without emotion or threat. Their response, "It's denied. We don't have to give you a reason" or timely notification evidently. Having worked all rungs of the corporate ladder I can tell you this. Establishing clear boundaries is the single most important thing you can do in a business relationship. Without boundaries you can't define the expectation of mutual respect and trust. When mutual respect and trust no longer exist, neither does the business relationship. Time is more valuable than money. You can always get more money. When your time is gone there is only regret.
  2. cyc0sys

    Fired for taking vacation

    I put my vacation request in 30 days prior to the new schedule as per policy. The new schedule comes out and they have me working during my requested time. So talk to the scheduler confirms I have requested time off and confirms it with HR. I had just covered the UM vacation the week before mine and 1 other nurse's vacation prior to that. Two days prior to my departure, my UM informs me that my leave has not been approved and no explanation is required. I informed her that it was not acceptable answer and I would not be working regardless of whether it was approved. Everyone else got to take vacation and I covered most of them. Yesterday, after returning from vacation, they fired me over the phone. No call, no show. Surprise right? Now before some of you go off half cocked, I'm not crying, whining, complaining or looking for sympathy. I very much knew what the expected outcome was going to be. Sometimes you just have to give zero #####. Self care is self respect.
  3. I have 25 Pts and 2 CNAs. I work at a Rebah/LTC. I have 10 Rebah'ers. 3 are 3 days postop CABGs, 2 are 5 days postop TKR, one on 24hr IV Vanco/Piper, 1 w/ a peg tube q2hr bolus feeds, 1 w/ a wound vac, 3 brittle diabetics (one of them Coded right when I came on shift) Those 3 are recovering from falls or uti's and will D/C home. The remaindering 15 LTC'ers are bed or chair bound. Demented from the pleasant range to the terminally agitation with combativeness. Most are incontinent of B&B. All require 1 to transfer. 3 are hoyer lifts. 2 are actively awaiting celestial discharge by MS04. I'll trade you any day.
  4. cyc0sys

    Will it get better??

    I'd consider leaving if you can't get more CNA. 10 Pts to a CNA is the minimum I'd feel safe working with. The first thing you need to understand is that it's not all doable. That being said, you are correct in your assumption that your playing life boat politics. Prioritize medications. Get all of your critical meds out first. If Mr. Jones doesn't get his mirlax or melatonin it's not going to kill him. Cardiac meds and IV vanco needs to run on time or bad things will happen. Treatments are similar. Start with postops and then pressure ulcers. If a bandaid on a skin tear goes a few days it's not a big deal. Some dressing don't need to be changed QD. It actually causes skin break down and slows healing. It takes a while to find your rhythm. Schedule skin checks and showers together if you can. Make sure your med and treatment carts are stocked before shift. Ideally, you should pass dinner meds than HS meds. If your working 3-11pm, I start treatments first with bed bound before dinner and then finish up with the walkie-talkies at HS. Sometimes its easier to do spot treatments than running down a schedule or list. If certain medications can be given together or earlier. Write an order and change the time of administration to streamline your med pass. Plan on passing pain meds with HS meds for postop Pts. If its possible, have the Doc schedule pain medication and minimize PRN at least for the first 3 days in facility. Document everything that can't be done and pass it on shift report.
  5. cyc0sys

    Accomadating patients racist request?

    I work long term care/ rehab in the south. There is plenty of closet racism on both sides. I've had more than one old white demented betty, with no filter, drop the "n" word on my aides. One the flip side, I've have the same number of old black demented betties refusing care and cursing me out of the room for being a "blue eyed white devil". I'm quick to inform the patient and family that type of language and behavior is unacceptable. Administration is quick to reassign the aides to avoid staff abuse complaints to corporate. Reassigning aide often comes across as another form of preferential treatment and does very little to change the reality of the situation on the floor. Ultimately, the patient suffers from their own behaviors. They either figure it out or go without. If your beliefs are outside of what is socially acceptable and civil, you get what's coming to you. I don't have time to play the political correctness game.
  6. cyc0sys

    Reasonable time frame for prn medication to be given?

    On behalf of myself, and your former patients, We'd like to thank you for retiring.
  7. cyc0sys

    Death's Perfect Timing

    Your story is anything but far-fetched. A few years ago, I switched from the Rehab wing of the facility to Long Term Care. We accept mostly palliative/hospice/respite care. It's not uncommon to lose 1 patient a week in God's waiting room. I've seen many similar things myself. Sometimes the experience, is witnessing an appointment with the divine. Other times, just a clock unwinding. The experience is unique. My experience has also taught me, very few people are accepting and ready for death, especially family members. Whether there clinging on to unresolved business or waiting the last family member to arrive. A peaceful, painless, dignified death is the last best medical intervention we can provide to our patients.
  8. cyc0sys

    It Never Occurred To Me.

    I take all reports with a grain of salt. Sometimes it reflects more on the nurse than the patient. A psycho-social approach seems outside the skill of some people. Every patient has their own story.
  9. cyc0sys

    Too ugly to be a nurse..?!?

    Try to find something about you're physical appearance you can be proud of. Work on fixing any underlying medical conditions with the appropriate treatment if necessary. Learn to accept yourself for who you are. Not what you think others think you are. Everyone has some type of God given gift or talent. "Being open with your insecurities paradoxically makes you more confident and charismatic around others. The pain of honest confrontation is what generates the greatest trust and respect in your relationships. Suffering through your fears and anxieties is what allows you to build courage and perseverance." ~ Mark Manson, The Subtle Art of Not Giving a F*ck: A Counterintuitive Approach to Living a Good Life
  10. cyc0sys

    Should I go to HR?

    The Peter Principle is a theory originated by Dr. Laurence J. Peter. It states that successful members of a hierarchical organization are eventually promoted to their highest level of competence, after which further promotion raises them to a level at which they are not competent. Her 'school yard snitch/bully' management is actually pretty pervasive in nursing. The Divide and Conquer Strategy has been around since organized management. The intention is to put people at odds by creating tension so they are afraid to unify leaving the manager to scoop up the power. 'Playing favorites' is just another lazy management tool in her Machiavellian tool box. Going to HR is just going to put a target on your back, because she'll get wind of it. Staying the course is probably going to go sideways if patient safety is being compromised. Especially if something happens to patients are in your care at the time. Whether you informed the UM, HR on the DON about said safety concerns. When it comes to the corporate musical chairs blame game, you can bet only management have seats when the music stops. I'd either look for a new job or figure out ways to out maneuver her while staying on your A game. Continue to be the professional, she is not capable of being. Lead by example, even if it's from the floor. Figure out ways to diffuse the situation among your team mates. We dance in the back when the patients are at lunch. Consider taking a course with Dr. George Thompson or picking up his book, Verbal Judo. He's an expert in verbal conflict resolution. Verbal Judo
  11. cyc0sys

    Co worker issue

  12. cyc0sys

    Do Nurse Practitioners get drug tested?

    Actually you are paying for the test indirectly. That money could be spent on many other things to improve in the work place it didn't just fall out of the sky. It is intrusive because it under minds the trust of the employer/employee relationship. It operates on the supposition of 'proving your innocence' and violates of your privacy when conducted without reasonable suspicion of drug abuse. Most companies site absenteeism as the number one reason to implement a drug testing program. But if missing work was really the concern, why would they continue to employ people who don't show up? Other companies raise the specter of 'public safety' but alcohol is the most abused drug in America. Yet every 12 panel test I've ever taken doesn't include alcohol and I've seen plenty of nurses under the influence on the job. Containing health care cost is another reason but plenty of people where I work smoke cigarettes which are the leading cause of preventable lung cancer. So there's that. Then we have deterrence. Guess what, if you have an Rx for Xanax and are abusing it. It's not 'abuse' because you have a script. Most street drugs are metabolized within 24-48 hours (with the exception of marijuana and PCP) so people will just abstain prior to work if they're going to use. If they can't, they'll eventually pop up on the radar for diverting or other identifiable behaviors away. I don't use street/prescription drugs but it does annoy me when my freedom is usurped under the guise of 'the greater good' when reality demonstrates the exact opposite. Especially when I've reported employees under the influence but management doesn't act. The majority of the time abusers are reported and fired at my facility are because Pt. Smith didn't get their scheduled Oxy a few times or they smelt ETOH on the nurse. That seems to be the best drugs testing program I've seen.
  13. cyc0sys

    Do Nurse Practitioners get drug tested?

    The bad news: Healthcare is very hierarchical. Corporations and Govts run off a 'do as I say, not as I do' mindset. Life isn't fair. The good news: Online colleges still exist. Not every place of employment does UAs. Karma happens. Oooh..., No one can take away your birthday.
  14. cyc0sys

    PT's and Medication....

    Why don't you have the pharmacy do the medication review?
  15. cyc0sys

    Is there a need for this?

    I guess that depends on what kind of online business. I've been kicking around the idea of a Tele-work Temp Nurse Portal that would allow nurses to work short term or contract telecommute jobs like insurance claims review, legal case review for expert witness, telephone triage, bioinformatics consulting, risk manager e.g. might be doable. You could even have them bid on the jobs to make it competitive. Maybe eventually adding a telemedicine component for Skype style medical consults to try break into the home health market. Licensing seems to be the biggest issue, depending on the type of services they offered and whether or not they're in a compact state. However, I'm not getting a solid picture of what you're trying to achieve.
  16. cyc0sys

    Why so much Negativity in Nursing?

    Elitist, huh?? I got a chuckle out of that. I simply meant there are easier ways to make money if that is your sole focus (think realtor, pharmaceutical rep, or day trader all require far less education, time and financial commitment than an ADN and typically make 100k per year). While everyone needs to ‘eat', chasing the dollar instead of your passion will leave you bankrupt even if your checking account is 6 digits. That is hardly an elitist concept because it requires pride, emotional and mental commitment which do not erode over time with inflation. Money doesn't equal long term job satisfaction. Pride and autonomy in your work are far better long term motivators. Ask anyone who has served in the military for 20+ years or as a professional trainer and they'll tell you the same thing. But if that's what you have to tell yourself on the way to work, so be it. ;-) "It's not having what you want, it's wanting what you've got." - Sheryl Crow