swtonursing

Hey how did the interview go? I had a similar situation and I brought a copy of my transcripts and explained the situation they agreed to wait a week until it arrived.

I currently been a RN for 8 months and started a part time job at a home health agency to supplement my main job. The problem is that the agency is using LPN's to do nursing assessments and they want me to "co-sign," them. In other words the LPN puts the signature on an assessment form and I put my signature underneath theirs. I believe that this is illegal but want to make sure. My supervisor (who is not a nurse) states that it is legal for me to do this.

When I was a nursing student and gave my first IM injection I obviously was nervous and shaking. I went ahead and gave the injection and whao behold I ended up giving it about half an inch above the gluteal line and the patient mentioned it did not sting at all. When I came back the next week the word spread and several patients (A LTCF) asked me to give their injections. I am now a licensed RN and gave my first IM injection under my license with shaking and I ended up giving it half an inch above the line (it was literally a fifty fifty chance). My patient ended up talking to my preceptor and said the following "I like it when you give injections but Matt's was a lot less painful as he gives it above where you do." All my subsequent injections were acceptable (I ensured I had someone observe them) with aspiration and all necessary procedures with the acceptable placement. I talked to a psychiatrist and he saw no concern about this. Can someone please help correct me if this is ok or not? For the time being (I gave about 100 injections since then) I no longer shake and give occurring to set protocol).

Just overall in many mental health / physical health case management organizations someone with enough zeal can simply offer a better service and contract with a family member for a set fee.

I worked both as a LSW and RN (LSW before RN). You get paid more as an RN and have more knowledge. Overall in my opinion you can do a MSW job as an RN but you cant do an RN as an MSW.

During my clinicals in nursing school (when I was nieve) I accidentally gave a IM above the gluteal line which is the crack of the orifice about one inch above the line. I ended up doing this about six times. When I came back the next week the various clients (LTCF) asked that I give it again and since then I had regular customers who asked for me to give the injection. I checked with my nursing instructor and she said it was ok as there were no nerves in the area. Is this ok? I aspirate as usual but most people repeatedly ask me to give their injections in this area. It seems like there is muscle in the region.

I was a social worker as a new grad RN I am doing similar work in psych for 10k more.

I agree the patient is a psych patient in a PACT / ACT team she had her meds changed while in a hospital and I was just simply assessing the patient in a home based setting. I am a full time nurse and there is also a part time nurse (two days a week) with me. I had her speak to my supervisor and the situation was resolved.

Possibly counseling I am beginning a PMHNP program now and find my counseling degree (M.A.) to be more useful in this arena.

just a quick question are any staff supervised by individuals who are not nurses? I was tentatively written up by a social worker as I took vital signs for a patient who began recently taking Lasix for HF in a home care environment. She was afraid I would upset the patient as it was the first time I encountered him. Any tips in this situation? the client did not seem upset and actually asked me to take his blood pressure.

Just another update I graduated and have been working as a member of a team (as a nurse) for four months. It is obviously a transition but I am definitely using my "medical" training in day to day care (previously I just thought they gave decs). Being in the community offers a tremendous opportunity to deal with both case management and patient advocacy. You need to assess for everything in a med surge floor while the only equipment you often have is crammed into a book bag with three holes in it (I had a glucometer fall out and had to pick it up). Things are different here in NJ as we have 6 staff (two full time nurses) and five cars for around 70 clients. I enjoy assessing for both psychiatric and medical conditions and being a benefit for a neglected population. With the ACT / PACT model we are often in a hazy area and can / have to help in ways that hospital staff can't. The other day I went grocery shopping with a patient to purchase cranberry juice (to prevent UTI's) and then helped exterminate a trailer for roaches. I am also surprised that the majority of the staff (like myself) are male.

I used to be a mental health advocate (I got my M.A. in counseling before crossing over to nursing) and had the same complaints. I often had to double team nurses while giving decs and we had a list of patients (one that was on daily meds) that we could not see alone due to a variety of reasons. For the most part though each staff member was independent and we only really got together during our daily staff meeting. I could see some examples that would uniquely effect a community psych nurse (and myself) including trying to find patients that do not keep appointments. Both myself and nurses attended medical appointments and yes they were dealing with the patients daily medical needs including daily weights and blood sugars (some of these they delegated to us however). We had team leader, vocational guy, a dual diagnosis specialist, me, a peer advocate, and two nurses. What about yourself? What is your team made of? Overall burnout is a huge factor in this field and I do agree that the hallmark of a ACT / PACT team is the assertive nature. I have two PACT interviews (I worked for a team for 4 years but am a new grad nurse) in the coming weeks and hope to get into this field. At least we have pluses, we drive around all day in the fresh air etc. Probably the biggest challenge is dealing with violent patients / consumers / clients alone and both myself and nurses were attacked on rare occasions. Where are you from and what made you take the job?