momma2rn

I just don't see how something the CMS states can be open to interpretation- change in planes or some such thing. It worries me because they want me to chart it in the MDS as no falls- even if they have lowers which should be considered falls according to CMS.

That is exactly what I thought, but the COO thinks that if our facility interprets it a certain way that they can argue the case. Just makes me SMH.

Our facility recently decided that their interpretation of falls does not include lowers. However, the RAI manual says that even if the resident is intercepted, it is still considered a fall and should be charted as such. I am kind of at a loss in how to chart this, because I was under the impression that the guidelines weren't open to interpretation. Any advice or comments is appreciated.

I had one yesterday come in with a headache and tell me she had been swimming at the Ramada with her friends, and she was told somebody peed in the pool. Of course, this 'headache' was legitimately caused by somebody peeing in the pool. lol.

We've talked about it. He will still make more money than me even when I get a job and have been working for a while; he is a higher up at a nuke plant and has been there for 7 years. My schedule will have to revolve around his, which is hard in nursing. He also gets a lot of OT, and if he has to go in to work on a day that I work as well, that poses another problem. Sometimes we don't know he will be called in, it is just out of the blue. He always goes in when he is called, though, because he wants to advance higher and doesn't want to do anything that could even remotely risk him losing his position in this economy. That's another thing that makes this so mentally difficult to deal with, that I went through absolute hell in nursing school. I didn't get ******* at by teachers and drag my butt out of bed at 4 am for nothing. This is why I was hoping to be able to secure a position for day shift, at least for now. That way, I can continue on with building my experience without having to worry about him losing his job, and I'll be able to spend most of my free time with the kiddos (at least during the school year). I am very willing to take a per diem position or part time. There's just no openings around here for that as of now.

I do understand that, and I realize it is part of the reason I am having a difficult time. But, it isn't a choice at this point in time.

Thank you to all that posted words of encouragement, advice, and insight. I had another interview today for a hospice RN position that went horribly. Filled out an application Tuesday and took my resume in. Got a call that same afternoon and an interview was set up for today at 11. I went in, introduced myself, sat down, and the interview was over in a matter of 2 minutes. Why? Because the lady evidently didn't look over my application well enough and said that she only hires people with at least three years of experience, and to check the hospitals for a position. Even though I was irritated, I thanked her for her time and went on my way. I mailed my resume to the health department and to a behavioral center here as well. HR is out of the office of the behavioral center until next week, and I am not sure when the health department will be looking over resumes. I am still on the fence about stopping school for the BSN and going into HIT. Here is the scenario I see happening (kind of like one of those 'If you pay too much for cable' commercials lol): I have been told the only way I will get hired is to work 12-hour night shifts (the opinion of my nurse friend). I cannot work 12-hour night shifts because my husband also works the same schedule and we have no one to care for our kids. I would need someone to live at my house for 3 days in a row because I would need to sleep when I get home and then go (almost) directly back to work. I cannot afford this type of care and we have no family that can help. If I do not get a job, as time goes on it will be less likely I will get a job. If I can't get a job, there is no reason to continue to rack up school loans. Then I will crash into a pizzeria. This is how I see it playing out. Again, I do appreciate everyone posting to this. Makes me feel like I'm not quite so alone!

This may be a long post, so if you are reading, bear with me.. I was a medical transcriptionist before I went into nursing. I LOVE science, especially physiology and anatomy. I did well all through college, good grades, and graduated 12/12. I applied at a nursing home right out of school and got the job. I passed boards first time around and enjoyed my job- for all of about 4 months. I personally believe I had a less than stellar experience with my first job. There was very, very little training- I got stuck with LPNs who were too busy to really train me on the computer system, policies, basically the whole shebang. So, I eventually got the hang of all of it and cruised there for about a month. Of course, once you have been working with people for a while the true colors begin to come out. From what I saw and noticed, the LPNs had a strong dislike for the RNs for a number of reasons- example: they didn't like that they had to ask RNs to start IV meds or do flushes for PICC lines because they felt it diminished their worth or some nonsense, and of course since we as RNs are certified for that, they disliked us for it. Anyway. I had been dealing with a ton of bs for the last month I worked there, such as one LPN saying that I get RN pay to sit around and do nothing. This was a day that I happened to be an extra and was assisting with EVERYTHING on each hall, right down to doing CNA work, feeding residents, helping out the various halls with dressing changes, etc. The straw that broke the camels back was when I was waiting to be relieved at 11 and my relief never showed up (they are habitually late so I really didnt think much of it). I called her and she said she called in earlier at 6 pm. Now, there is 1 station that is set up to be the 'charge nurse' station, and an LPN is primary there. I went to her right then and asked her if she knew that my relief called off (she takes the call offs since she is CN). She said she knew. I asked her why she didnt tell me, and she stated, and I quote, she didn't 'feel like I needed to know.' If that isn't the biggest load of crap, I don't know what is. To me, that place felt like the cattiest, unorganized mess of a nursing home I have ever been in. Not to mention the administrator was walked off site and fired due to sexual misconduct a few days after I quit. I had brought all of these issue to the DON multiple times to be told that I needed to just deal with it. My issue is now this: I have not been able to get so much as a call back for any job I have applied for. I cannot work night shift because I have 2 small children at home and a husband working thirds (4p to 630a) and have no one to care for them. I will not hire a babysitter to sit with them at night- makes me way too nervous. I am down to putting in applications to grocery stores. This turn of events has made me think about changing careers to HIM. I am actually in school right now for my bachelor's degree and am ready to quit because I am so discouraged. Am I just wasting money on this expensive BSN since I cant even get a job? Any insight from people who have been there & done that is appreciated.