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Nascar nurse ASN, RN

LTC & Hospice
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Nascar nurse has 35 years experience as a ASN, RN and specializes in LTC & Hospice.

CNA to LPN to RN.

Nascar nurse's Latest Activity

  1. Nascar nurse

    Covid-19: The Guilt of the Work From Home Nurse

    I have also worked from home in case management for the past year & half. Prior to that, I’ve spent 30+ years in long term care or hospice. I also asked my employer for some time off to go help my community & was denied. I too felt the guilt that I was secretly so relieved that they told me no. A sweet nurse friend reminded me I had done my time on the front lines & in the process had mentored many young nurses and aides throughout the years. She reminded me that I AM out there, it’s just not my hands doing the work but in the lessons I’ve taught. That’s helped some...but maybe added a new worry if I’ve taught them well enough to save their own lives too. 😢
  2. Previous SNF/LTC Director of nursing and previous hospice nurse here: There’s 2 sides to this financial story that you all may not be familiar with. Example: Pt returns from acute care with orders for hospice (but could possibly meet SNF guidelines as well d/t medical condition). We’ll assume pt meets hospice guidelines as well but not actively passing within the next week or two. -If pt admits under SNF all their needs are included in the lump sum payment the facility gets. This includes ALL meds, room & board, therapy costs. Assuming there’s been no previous SNF days used in past 60 days, this is covered 100% for the first 20 days. -Now assume that hospice provides services upon readmit. The pt/family is now required to pay room and board (usually upfront for a month $5,000-8,000/month). Pt/family has to pay for all non-hospice meds that family might want to continue. In each case, DNR measures are preserved. It’s VERY common that once a family finds they’ll be paying $200-300/ DAY vs nothing they ask to go with as many SNF days as possible. This often leaves the administrator (or DON) saying “Don’t worry we’ll take care of this for you” and thereby making the call to cancel hospice for the meantime (and hence making it look like they’re the bad guy if you don’t know the entire picture). This from a DON/hospice nurse that 100% believes in the hospice philosophy of care but knows are Medicare system is highly flawed when it comes to this.
  3. Nascar nurse

    Can an ADON be an unlicensed Person?

    They could hire a monkey & give it the title of ADON. Anyone could reasonably be in charge of the clerical type work of many ADONS...hiring, attendance monitoring, finding coverage etc. Only a licensed nurse should be directing care practices. Additionally, claiming the title of a nurse if you’re not one is illegal. A note of caution. Make sure you really know someone isn’t licensed before you make an accusation. I’ve come across lots of nurses I can’t get to come up on the nsg board sites until I know the middle initial, a maiden name, etc.
  4. Yes, I’m questioning as this progresses how we’re ever going to isolate so many ppl for 14 days. It’s just not possible to shut down a nation for 2 weeks.
  5. Nascar nurse

    Lab Coat or No

    I like lab coats because my business clothes don’t give me enough pocket space! My favorite was a lab jacket vest. It does appear more casual/shows a willingness to get my hands dirty but still got pocket space. I’ve worn them to about every DON job I’ve had.
  6. I was thinking the miscarriage/not fully miscarried as well, along with Schizo, or thyroid dysfunction? A good mystery is fun, especially since we know already that it all got worked out in the end.
  7. Nascar nurse

    Since when is it okay to be late ?

    CCM - as you know, if someone isn't holding them accountable nothing will change.
  8. Nascar nurse

    Accomadating patients racist request?

    In the long term care world, it is illegal to assign patient care based on patient/resident requested race selection. There have been cases of legal action by the employee against the employer. With that said, I will not accommodate a resident or family request - but I will always notify the employee of the request and allow them to bow out of the assignment in an effort to protect them from mental/emotional abuse as well as potential false allegations.
  9. Nascar nurse

    Medicare regulations

    VFO? I don't believe you are going to find any staffing ratios for hospice care.
  10. Nascar nurse

    LTC nurses...

    Hate to tell you but you don't KNOW they are everywhere and not ALL of them are awful & it's shockingly untrue that NO ONE gets the care they need. I'm an RN and you'll be surprised to find that I actually WANT to work in "one of those places". I'm sorry you've had a bad experience (and Lord knows I've had them too) but it's horribly unfair to paint every RN, every LTC facility and every hospital nurse with the same broad brush.
  11. Nascar nurse

    On Call

    Back in the day when I was a floor nurse for 10 years or so, I would have been lucky to call the DON/on call nurse a total of 3 times max. It was just something one didn't do unless dire emergency. Luckily, in my current position, the nurses I inherited were well trained. I get calls about things I want to know about and rarely get bugged for stupid things. My night nurses have learned I will sleep right thru a text (which they'll send as an FYI, such as an expected death occurred) but also know that they have to call if they need me to respond.
  12. Nascar nurse

    Called off too many times?

    On Thursday you already know you'll be feeling to bad to work Saturday AND Sunday. As a manager - I wouldn't buy that for a minute.
  13. Nascar nurse

    Gloves? Is this acceptable?

    Respectfully, I'm confused. You have ADN, RN next to your user name. This is nursing 101 - surely you've had countless infection control inservices/clinical encounters that would have addressed this?
  14. Nascar nurse

    Sitting out another station

    You are assigned to SNF - you should be on SNF. It's actually very simple and I'm curious why this is a big deal to you rather than just being where you're assigned to be? (Yes, I get it.short distance and all..but this is just not worth ruffling feathers up the chain about)
  15. Nascar nurse

    DON on cart

    Do you work LTC? Besides the cost of an agency nurse, it's a disaster to think any stranger could come in and pass medications to 25-35 residents-all of which are total strangers that likely aren't wearing arm bands to identify them. You're lucky if there is a picture of them that's less than 3 years old. I can't imagine it wouldn't be a huge liability to both the facility as well as the agency nurse.
  16. Agree with all the above comments. Please remember, respect is usually earned not given. That may not be the "right" but it is how the world generally works. You used this line that caught my attention "The manager makes her the leader in the area and totally disregard that we both are LPNs". It's not a big leap here to assume that that LPN has a whole lot more experience than you. As a well seasoned LPN I was often the leader for the shift in LTC. With that said, there really are bad places out there with some really bad leaders that shouldn't be leaders. If this is really is that kinda of place just gracefully get yourself out of there without coming off as an entitled new grad. Good luck