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turtlesRcool's Latest Activity

  1. turtlesRcool

    Choosing between husband and 2 beautiful poodles or ICU job

    What is the endgame? I could see option #2 working, but not as a long-term arrangement. Married couples do choose long-distance relationships for career advancement in many fields, and it can work in some circumstances. If this ICU residency is something you really want, you and your husband have to decide what this time apart will look like. You have to be realistic that you might not make it home some of the times you think you will, either because something else comes up at work, or you're too tired from your shifts, or inclement weather, etc. While you might be prepared to spend the next year or two just eating, breathing, and sleeping nursing, will your husband be okay with your absence? What will you two do to keep your relationship strong? Are you thinking you'd take this job and eventually your husband would relocate closer? Are you thinking you'd take this job, and eventually you and your husband would get a place half-way between, so you would both have long, but not insane commutes? Are you thinking this job would be just to get a year's experience you'd use to try for an ICU job closer to your current home? The more you can flesh out the answers to questions like these, the better you'll be able to picture what your lives will be like in a new job, and the clearer your decision will be.
  2. turtlesRcool

    Blunt Fill Needles for IM injections?

    Interesting. We don't have blunt filter needles at my hospital. Like you, we have blunt fills for drawing from syringes. Then we have filter tips for drawing from ampules, but they are straw-like, and have no point on the end. You physically could not do an injection with them (even if you wanted to) because they are clear flexible plastic - it would just bend if you jammed it against a person's skin.
  3. turtlesRcool

    As an LPN, I can't help but feel like I'm not a "real nurse"

    I bet to your patients you are a real nurse! Isn't that what matters most? Unfortunately, LPNs have been pushed out of many roles they formerly took on. Even ADNs are in some markets being passed over in favor of BSNs. As someone with a BSN, I can honestly say my degree is not what makes me a "real" nurse. My degree was what got my foot in the door so I could learn to be a "real" nurse after the hospital hired me. If you're not happy with your current job or future employment limitations, go back and bridge to RN. But it should be with the understanding that you're simply conforming to the market of what hiring managers expect. It's not because you are not already a "real" nurse. If you are happy with your current role, own it. Rock it. Anyone who tries to make you feel small is misinformed or small-minded. You are important to your patients, who are usually some of the most vulnerable members of our society. Your patients deserve good nurses. They deserve you.
  4. turtlesRcool

    Finding a job with pending accusation

    Depends on the type of restraints and the reason for restraint. Since you work in psych, I'm assuming the primary reason for restraints is for violent/harmful behavior. In the hospital, we also go 1:1 if the patient is being restrained for harmful behavior (in 4 point leathers). But we often have confused patients we restrain to prevent them from pulling at lines or tubes. A patient in mitts or soft wrist restraints does not require a sitter. The restraint order lasts 24 hours, and requires Q2hr charting when I must check for injury, provide ROM, and offer food/drink and toilet. We also have enclosure beds (that look like a big pack-n-play) for high fall risk patients, such as people detoxing. Those fall under the same requirements as the soft limb restraints. We've seen an uptick in the use of the enclosure beds on the COVID med-surg unit, as many of the extubated patients are extremely weak but highly impulsive, and we can't get into the rooms fast enough given the PPE donning requirements. Technically, even having 4 bedrails up is a restraint that requires an order, but we don't have the staffing for those patients to get 1:1 monitoring. If we had 1:1 staffing, we wouldn't need the behavioral restraints (mitts, soft limb, enclosure beds).
  5. turtlesRcool

    LTC Residents and Workers Face Tragedy

    Because there isn't room at hospitals for all the people who are covid+, but do not need acute care. I'm outside NY, and our med-surg COVID units are pretty full. They aren't bursting at the seams the way they were a week or two ago, when another patient would almost immediately fill a vacated room, but there is definitely not room for stable patients to hang around for weeks. Hospitals are intended for quick turn around, not long term residents. If those patients remained in the hospital, others who are sicker and need hospital level care could not be admitted. CT and MA have designated nursing homes for COVID+ patients, but I'm not sure when those will be up and running. In the meantime, many residents are returning to their previous nursing homes, and many COVID+ patients are going for inpatient rehab for the first time because they're so deconditioned from long periods of intubation. The truth is that most nursing homes have or will have COVID+ patients. This virus isn't going away, and we're at least a year away from a vaccine. Especially when some of the stay at home orders expire, we'll see more community transmission. All facilities are going to have to come up with a plan for dealing with COVID+ residents. At least if you get them from the hospital, you KNOW they are positive, and can take precautions.
  6. turtlesRcool

    LTC Residents and Workers Face Tragedy

    I work in a hospital, and this week I had a patient who works in a nursing home. Multiple exposures, so no wonder she got sick. I'm actually surprised we haven't seen more staff members, except hopefully they are in generally good health and are able to recover at home when they fall ill. My patient had comorbidities that put her in a higher risk category, but it's still a little unnerving to see someone in her early 20s hospitalized.
  7. turtlesRcool

    Are Sanitized N95 Masks Safe for Reuse?

    I'm sorry. That's terrible, and scary. Where are you working? What are your thoughts about possibly sanitizing and reusing them, as mentioned in the article? Would you want to use a sanitized mask for a shorter period, not knowing who wore it first, or would you prefer to keep your own, even if you have to reuse it?
  8. turtlesRcool

    Are Sanitized N95 Masks Safe for Reuse?

    We have the Kimberly Clark ones that look like duck bills. Actually, this is the first time I've googled them, and it looks like the headbands are polyurethane, which explains why they just stretch and don't retract. I think the fit is based mostly on the size/shape of the mask. The small fits me very well. As long as I could get the straps tight enough, I don't think the fit would be compromised by re-tieing them. We did get some different ones from the state that have more traditional elastics, and my colleagues who wear those can take them on and off without problems, but we didn't even bother to do a formal fit test for me, because my glasses were fogging when I exhaled, so I know the seal wasn't good with those. https://www.kcprofessional.com/en-us/products/scientific/respiratory-protection/46727 I don't know. I might be able to. I don't know how far they stretch. It could be worth a shot.
  9. turtlesRcool

    Are Sanitized N95 Masks Safe for Reuse?

    If I take it off, I can't get a seal with it when I put it back on. Not worth it. If I could, I probably would take a break. But since there elastic does not contract, the straps are permanently stretched to their longest length, which means there's no way for me to safely rewear it. The whole point of an N95 is the seal. If that's compromised, so is my protection. I'd rather be thirsty. (Well, actually, I'd rather be able to change into a new mask, but given the options, I'd rather wait to drink until I'm done with patient care.)
  10. turtlesRcool

    Are Sanitized N95 Masks Safe for Reuse?

    We get one N95 for the shift. Some people take them off, place in paper bags, and then put them back on. I, personally, am not comfortable with this, as I think the greatest risk of exposure comes from doffing/donning. My choice is extended wearing. As in, I put my mask on after I get report, pull my meds, and stock my cart, and then I don't take it off until after I've given report to the next nurse. The biggest issue is that I can't eat or drink, and I get thirsty, but I'd rather deal with thirst than increase my risk of infection. The other catch is that the N95s we use have plastic head-loops that stretch out, but do not retract back. Not a design flaw when you consider the masks were meant for disposal after a single use, but taking them off means they are too stretched out to create a good seal when reapplied. We are not saving our masks for decontamination at this point. I'm hoping it doesn't come to this. If it does, I would probably be okay with a decontaminated mask, as long as we have a solution to the current fit issue.
  11. turtlesRcool

    Has anyone left nursing job due to COVID19 virus?

    Yes, my mind is blown by the staff not ALLOWED to wear masks. It's one thing if the facility doesn't provide them (which I disagree with, but that's another issue), but to not allow staff to wear their own masks is worse than ridiculous - it's dangerous. Even a simple home made cloth face mask will filter about 50%. Obviously, not as great as N95, but better than nothing, especially if you have multiple masks that you change throughout the shift (and then wash on hot after your shift). If we think of healthcare workers as vectors, then a mask on a sick person/vector is going to do more to prevent virus spread than masks on well people who are around sick people hacking up their secretions.
  12. turtlesRcool

    NCLEX in 75?

    I think it's normal to think you failed, no matter what number you're on when the computer closes. If you answer well, you'll get harder and harder questions. It can be difficult to figure out if the questions are so hard because you don't know diddly-squat and are failing, or if the questions are ridiculously hard because you're awesome and absolutely crushing the test. I remember getting an OB question that I knew without a doubt I answered correctly, and I panicked because I was afraid it meant I was doing poorly so the program was giving me easier questions. Then the next question was back to being ridiculous-level difficulty, so I knew I was okay.
  13. turtlesRcool

    Using prn staff instead of posting day position

    I will say that from a patient perspective, having a revolving door on day shift isn't good for continuity of care. I recently went through the patient side when my mother was very ill, and it made such a difference to be able to talk to someone who had her the day before. I'd ask for updates, and keep hearing, "well, it's my first day with her..." When she had a nurse for the second or third day, it was like gold. Not that night shift continuity isn't important, too, but day shift is when the doctors are rounding and decisions are being made and family is asking questions. There are definitely times I've been able to intervene and advocate for a patient simply because I'd had him or her for the last day or two, and was able to clearly discuss changes with new doctors. It's a lot harder to do that when the nurse is starting from scratch each day.
  14. turtlesRcool

    Surge Pay

    Is the 1.5 for the whole shift, even if you haven't hit the 40-hour mark that would give you 1.5x pay? Because if it is, that's great for someone with 24 or 32 control hours. My hospital sometimes offers incentives of $50 per 4 hours in addition to whatever your pay would be. If you're still in regular pay, that's what you get. If you've crossed into overtime, you get your 1.5x. The $50/4hrs just gets added on top. I have 32 control hours (4 8-hour shifts), but usually work more like 35 now that we have a really time-consuming bedside report process. When I pick up, I try to squeeze 2 shifts into one week rather than 1 shift each for two weeks so more of my picked-up shift is OT.
  15. turtlesRcool

    Using prn staff instead of posting day position

    We have PRN staff who just pick up a few extra shifts, and we have PRN staff who basically work FT. Working PRN gives extra hourly pay and flexibility. It's great for working with a busy lifestyle, and I've seen a lot of new moms transition to PRN. On the flip side, working PRN gives up benefits like health insurance, union protection, PTO, and guaranteed hours. I am tempted to go PRN because I'd love to reduce my weekend and holiday commitment, and I already get my insurance through my husband's employer. But I can't bring myself to to it because if something goes wrong, I want the union behind me. Plus, there are some PRN nurses who get really shafted when they have multiple shifts cancelled during a pay period. As a FT employee, my contract states that I can go in for my control hours, even if the hospital wants to down-staff me. During lower census times, I've seen PRN nurses beg regular staff to call and ask to be down-staffed, in the hopes that the PRNs won't be cancelled again. I agree it stinks that your management has chosen a staffing strategy that prevents you from getting a permanent position on the shift you want. I'd be upset if I were in your place, too. The question is what are you willing to do about it? Would you be willing to give up your guaranteed hours, seniority, PTO, and health insurance to work as a contingency nurse on day shift? It's easy to see the benefits of the contingency nurses, but given the cons and well as the pros, would you be willing to switch places with them?
  16. turtlesRcool

    LPN, Phlebotomy, EKG tech???

    I agree to see what the other positions pay. Phlebotomist seems more promising than EKG tech. Probably not as much money as LPN, but likely more than CNA, and easier on your back. I think you are wise to be thinking about doing something other than CNA work, both because of the financials but also because very few people are able to meet the physical demands of CNA work all the way to retirement age. At 40 you're probably okay, at 50 you'll be slowing down, and by 60 you'll be at great risk for injury, if you make it that long. Is EKG tech an in-demand job? Not being snarky. In my hospital the CNAs all do EKGs. It's really not that hard to learn where to put the 12 leads. The doctor orders an EKG, usually STAT, and the CNA taking care of the patient that day does it. I'm trying to imagine the context in which someone's job would just be to do EKGs, and I'm coming up short. Your child is 6, so I'm assuming s/he is in school, so you should have some time for classes and study. Yes, nursing school (LPN or RN) can be challenging, but that's WHY it's a path to better pay. It it didn't require time or effort, anyone could do it. Since you're 40, you've probably been out of school for a long time. There will likely be a learning curve as you get back into the swing of studying. However, lots of times mature students who go back to school do better than they did when they were younger. By 40 most people have better focus; they are highly motivated to meet their goals, and have better self-knowledge (i.e. they know what they need to do to get things done). If you can get into a reputable LPN school (not super expensive, good NCLEX pass rate), and you make studying a priority, I think becoming an LPN is a good idea.

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