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Nascar nurse ASN, RN

LTC & Hospice
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Nascar nurse has 25 years experience as a ASN, RN and specializes in LTC & Hospice.

CNA to LPN to RN.

Nascar nurse's Latest Activity

  1. 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.
  2. Nascar nurse

    Shift supervisor with zero orientation

    Get a copy of your job description and go from there. It's sad but this happens so frequently. Check in with your direct supervisor and make sure their expectations align with what the job description says.
  3. Nascar nurse

    Advancement

    You are not crazy at all. Years ago I had worked at a facility for nearly 20 years. Was a long time successful MDS coordinator and had advanced up to ADON for a couple years. While ADON, I applied twice for an open MDS regional spot and was turned down both times. Later, in casual conversation with regional people I knew well, it came out subtly that they couldn't advance me out of our building as I was too important to the overall running of the facility. That sealed the deal for me and I left that facility (and the entire company) shortly after for my first DON job. By boxing me in and failing to let me continue to grow, they lost a 20+ year employee.
  4. Nascar nurse

    Christmas Gifts For Residents

    My activities director does an awesome job of coordinating with all the local churches to get enough gifts donated for everyone. Small community and small facility, but awesome participation.
  5. Nascar nurse

    Nasal Irritation From Crushing Medications?

    I've never had a problem with crushed meds but back in the day when I passed multiple doses of Metamucil I finally got to the point I had to take Benadryl. Eventually had to pass it off to other nurses to give.
  6. Nascar nurse

    Issuing a sincere apology...

    Thank you - it takes a big person to own up and right a wrong. Best of luck to your future.
  7. There's your answer in your own words. You have no proof that she did this. There's nothing further you can do
  8. Nascar nurse

    Would I test positive for marijuana if my client smokes it

    Makes me think of my time being in hospice. Went to a home of a patient & their family that I really liked despite the fact they were a little "off". I was running early that day when I knocked on the door. I could hear the panic thru the house that "Nascar is here. Get that out". When they finally let me in, the whole house reeked of pot with a thick cloud of smoke....and at some point that visit the German Shepard also bit my rear. I couldn't help but call the boss on my way back to the office telling her I would be late. Needed to find a bandaid for my butt and a couple of brownies to cure the munchies. The whole office roaring with laughter when I got back in. No drug test required. Told to take my coat back out to my car. :) (and PS - the dog just nipped me, didn't break my skin. Never showed up there early again).
  9. I'm throwing in the towel. Waving the white flag at this DON career. I gave my resignation and told my staff today that the end of the year will be the end of my employment. My current facility has been the best of my entire career but I spend 2 hours every day commuting back and forth and winter is coming (An hour each way on dark snowy country highways - yuck). The dark side you ask? I was recruited by a company that contracts with Medicare Advantage providers. My snowy winter days will now begin in my home office. No weekends, no holidays, no on call, no state surveys, no supervision of others (ie: drama police). I think I'm going to miss it - but probably not very bad.
  10. Nascar nurse

    gentleness wanted for the elderly

    Contact the physician and request an order for routine Tylenol - schedule for an hour prior to am care.
  11. Nascar nurse

    Nurse Imposters

    Was taking coumadin years ago and had the office "nurse" call to report my INR was 32 and just keep taking the medication dose as usual. After a 2-3 minute argument, I had to insist that it was 3.2 and I wasn't actively bleeding from every hole in my body. This "nurse" honestly never did understand her mistake or why knowing the difference would be so critical.
  12. Nascar nurse

    Infection Preventionist

    Unfortunately I've got nothing to help you. Only answering so you don't feel totally ignored - like the government is doing with this fall IP class. :)
  13. Nascar nurse

    Nurse refuses to give me report!!!

    Start documenting - in detail - every day and keeping turning it into the DON (and keep a copy for yourself). If they won't listen, take it to the administrator. I would have another nurse doing the narc count with me when she won't. At least you'd have a witness to exactly what you found when you took over the cart. As a last resort, start looking for a new job.
  14. Nascar nurse

    Taking daily pulse with digoxin - Need help with IDR

    Thanks. I found a great article from the American Journal of Medicine in 2015 on Digoxin. This article stated that the dosage should not be changed based on heart rate alone. My pharmacy consultant also provided me with documentation from one of his sources that stated that a baseline heart rate should be established and then monitored periodically (which happens with our weekly vitals and hers were all in place). I also had the attending, who is also our Medical Director, write a letter to support that there was no need for a daily pulse on any resident taking Digoxin unless ordered by MD. I sent my IDR statement and documents in yesterday. Unfortunately it will take up to 60 days in Indiana before we get a response back. My competitive spirit wants to win this one bad, but in the big picture, I'm just grateful for an awesome survey.
  15. Looking for some help with my state survey POC. We got only 1 nursing tag (yea us) and of course I'm rolling up my sleeves and planning to IDR this and I believe I have a reasonable chance. We're a small facility and had 2 med pass errors which put us just over the threshold for greater than 5% med error rate (F759). One of these "errors" was not taking a pulse prior to giving Digoxin. There was no physician order to monitor pulse, we take pulse weekly with other vitals and pulse always stable, our policy said "take vitals as necessary....". The surveyor cited based on Nursing 2013 drug handbook that indicated administration includes taking a pulse prior. In long term care, this is outdated practice from everything I've heard & most facilities I've been a part of has gone away from all this over monitoring years ago to reduce nursing time during medication pass. We all know patients in their own homes do not take daily pulse with digoxin, blood pressures prior to HTN meds, etc. Problem is - I'm having a lot of difficulty finding credible resources to support my IDR efforts. Anyone with a good resource to support this practice?
  16. Nascar nurse

    An lpn with no desire to work in the hospital.should I get my rn?

    It is always worth getting your RN. You will never be sorry for the opportunity to change what seems like a perfect fit right this moment. Bosses change (sometimes to a really horrible one), companies close, your own lifestyle needs change, or maybe someday you'll wish you were eligible for a promotional opportunity. Getting your RN will likely make your future possibilities much brighter. From an RN who was an LPN for 19 years! :)
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