turningred15

Perhaps if the patient was going to be in observation status and responsible for a large portion of the bill he/she decided not to stay. Obviously I don't know the background or decisional status of the patient but just a thought.

This is perfect and exactly what I would recommend. AL still sounds appropriate right now.

I work as a RN care manager and recommend the appropriate level of care for my clients. Often times those with memory issues who are still ambulatory are BEST served in memory care assisted living. The RIGHT assisted living should be able to provide the care you describe. Once a patient requires the use of a lift device or requires some kind of skilled intervention SNF becomes more appropriate. The cost of SNF will be twice the cost of AL, plus moving is hard on patients also. SNF does not always have the best interventions for memory care, and their staff is often not trained in this. I agree with talking kindly but assertively up the chain with the AL so they can provide the care needed that you are paying for. You are not asking for too much.

Wear what YOU want to wear, don't worry about what other people prefer. Of course within the limits of your organizations dress code.

I often make a point of asking patients "why?". Why do they not follow the lifestyle changes? Is it financial, social, cultural or just a choice? Often times exploring additional resources to help with these barriers is key. Also I'm sure you educate your patients on what will most likely happen if they don't follow their plan. Sometimes people don't realize how serious noncompliance can be. Ultimately, despite your best efforts you will have some patients back in the ICU for one reason or another.

You can post here any time you have a question, or PM me. I love my job!

I would disagree with this statement. I work as a ER Case Manager, and determining status and completing reviews takes nursing knowledge and critical thinking to make sense of the entire clinical picture. Also, I have to call physicians if I want a status changed and explain why or why they don't meet medical criteria. In between all that, I also case manage the patients coming in and going out of the ER. I think you just have to find the right position that fits you personally. Good luck!

Part time is doable but rare! I currently work part time as a ER case manager and I also own my own consulting business. I had to wait for the right time to get that part time position because most were full time!

I am a RN with experience in care coordination and case management. I see a lot of those jobs transitioning to RN vs SW. RN's are able to understand medical, psych-social, and emotional needs. A SW cannot contribute as much medically. SW is still needed for guardianship, POA, mental health, and therapy (if LCSW).

By the way Horizon home health pays per visit, not hourly. They are just an OK company to work for. Allay home health, Seasons hospice both have great reputations!

With three years of experience you can expect around $26-28/hour plus shift diff in the hospital, LTC $25, home health $26-28 hourly, clinic $26-28 Hope you enjoy Milwaukee! There are lots of RN job options here! :)

I was hired as a PHN with 6 months of med surg as a nurse intern while in school and 6 months of home health

I don't know if you should become a nurse and force yourself through nursing school. There are a lot of nonclinical nursing jobs but they do usually require experience. I have had several nonclinical nursing jobs. I was a former public health nurse. A BSN is required. I got the job after one year of clinical nursing experience. Depending on where you work as a PHN your job might not involve much preventative care. We focused on communicable disease investigations. I enjoyed the job but working for the public sector you will be one of the lowest paid BSNs around. Shadow a PHN once to see what you think. What about other ways of using your MPH? Our health department had a public health specialist (filled by a MPH) role with a focus on education as well as statistics and numbers. What about research jobs, or working as a health coach for an insurance company or company that manages employee wellness. I would encourage you to apply to those jobs and cite "family reasons which have been resolved" as an explanation for the work gap. I don't have too much opinion on the RD option. I do know two RNs who also have their RD and went on to nursing. Good luck to you!

Sorry to hear about your situation. I was actually lied to because I was told I would get a whole two weeks of orientation which turned into those 3 days - one of which was company modules and signing paperwork.

I was thrown into a similar situation. Three orientation days. They ended up terminating my position due to budget and also stated I was a slow learner...lol (I have never been told that before)

This woman needs a geriatric care manager to help. Google this and present her with some options.

Until this problem starts costing money MAs will continue to refer to themselves as nurses and so will the docs. This is a problem in many outpatient clinics. In WI, the MA is even allowed to triage under MD approval and supervision. If I were a MD and not a RN there is no way I would let a MA do my triage. Talk about a lawsuit with huge liability. All it takes is one patient.

I don't think there is anything wrong with the way RNdynamic wrote the post. I took it as an interesting story with a lesson we can all relate to - no one likes a bully. I am always amazed at how personal some people take these general posts.

I understand where you are coming from. I have worked with this population for several years. The fact that you recognize your patience is wearing thin is the first step towards feeling better. I think when you are feeling frustrated its important to take a step back and remember why you wanted to be a nurse, specifically a geriatric nurse. We are making these lives better each day by being kind, positive, caring patient advocates. The job is not easy. It is hard physically, mentally and emotionally. Some of these threads have excellent ideas for distraction techniques to use for residents - try those! Lean on a trusted mentor or friend for support. At some point, you may decide you are ready to try a different type of nursing. That's OK too. The most important thing to remember is that you are not trapped, and there are plenty of other good opportunities out there for nursing as well. Good luck and post back if you need support or someone to listen. :)

OP I am sorry to hear about your loss. I congratulate you on taking such good care of your patient. I would disagree about crying in front of families. I think its OK to shed a few tears in front of them. We are all human and it lets the family know its OK to cry and shows how much you care.

Yes. This describes my situation exactly except there was one other RN with me. I got fired yesterday because I was told "it wasn't a good fit". Managers with no clinical experience in healthcare don't understand why nurses need to do the checking that they do or our scope of practice. Both the docs I worked with loved having an RN and thought I was doing great. I have never been fired before. Just crazy. The other nurse thinks its all because of money and she is next. They are replacing me with a MA.

If you want to pursue that opportunity I would seek legal counsel if your previous employer is slandering you. You can always leave the name of a coworker as a reference instead if you just decide to apply somewhere else.

Thanks for the help. I made a weighted pros/cons list and put a number on each pro/con depending on how important it was to me. I ended up taking the clinic job after negotiating higher pay. Thanks again!

Hello, I was hoping other nurses could shed some light on my decision. I have hospital, home health, public health, and recently case management experience. I have been a nurse for 6 years. I left my last job because I had no management support when I advocated for patients to get the best care possible. I worked 50 hours weekly and was on call every other week in the evening and entire weekend. I also have some health issues I am trying to manage. I was offered two jobs recently. My future goals include wanting to start my own business or become a NP. 1. Clinic RN - 40 hours/week. MDs are great - met them and another RN who loved her job. Less stress, normal hours, no on call. Pay is what I made at my last job. No great but not terrible. 2. Director of Assisted Living - Most likely 40+ hours/week. Top notch facility. Nice staff. I would manage several employees. This would be a big challenge but I could make positive changes. Money is great. I love geriatrics. That has been my career focus... Now, what do I do?

I quit Monday and gave the required 4 weeks. Management told HR that they didn't want me to stay the 4 weeks. So Monday was my last day. HR said I will be be paid out the four weeks like I worked it and it will say resigned when future employers contact them. So I got a pretty good deal.