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vampiregirl BSN, RN

Hospice

Content by vampiregirl

  1. vampiregirl

    Who wants to hire a graduate nurse at 55?

    There are many areas of nursing that may appreciate you, you just may have to look off the beaten path. I would encourage you to think about where your passion lies. What type of environment do you want to work in? What type of people do you enjoy working with? Are there areas of nursing that are of special interest to you? Best of luck to you!
  2. vampiregirl

    How to "calm" down autistic pediatric patient?

    Would it be helpful to start integrating breaks in the iPad use to engage in other activities with your patient instead of using it until the batteries go dead? Maybe consider allowing the iPad to be used during feedings (if they are bolus) or other "quiet times". If all of a sudden you stop using the iPad, I'm guessing the patient won't be very happy! Maybe it would also be helpful to shift your approach from "distracting" your patient to "engaging" your patient. If she is able to focus on the iPad for a length of time, that's great because it means there could be other activities she will be able to engage in. Starting to create a routine with this patient and addressing the environment can be very useful having a more positive-interactive relationship with this patient. If there is a routine during other day shifts, this might be a good place to start. If the child has PT/OT/ST then maybe ask them for ideas for similar activities you could do with your patient. They may also have ideas as to what calms this particular patient when she starts getting wound up. The other children in the residence may be a good source of info for identifying activities your patient enjoys. Keep in mind kids with autism that I've worked may have a short attention span, especially for a new activity. It also may take several attempts for her to be able to enjoy a new activity. It can also be a trick to figure out what she needs/wants and learning to address those needs/wants early. Best of luck with discovering some strategies that work for your patient!!
  3. Thank you for this thought provoking article, well written! I've worked both as an EMT and as a nurse. Sometimes there are so many things stacked against a patient. Wondering if there would have been a different outcome if outside influences (weather, road conditions, delays) had not presented... These are the patients and circumstances we carry with us, those that influence our practice going forward. It can also be even more challenging in circumstances when a patient's decisions contributed to their medical condition. It made my heart smile though by the caring and competence you captured by those involved in this patient's care - from the prehospital providers to the hospital staff.
  4. vampiregirl

    Dry, Cracked Hands

    Ugh. Dry cracked hands are the worst! And I too am not a fan of the infection risk (or being a biohazard risk with bleeding)! In addition to the recommendations of the previous posters, I made the switch to non-antibacterial soaps with not a lot of fragrance in them throughout my home. This was another piece of the puzzle for me. I'm also careful with the hand sanitizers that I use outside of work (vehicle, purse etc). The alcohol content oddly enough doesn't seem to cause issues for me - it's the highly fragranced ones that I've noticed are more irritating to my hands. Good luck!
  5. vampiregirl

    Webcams in Nursing Homes?

    Like several other posters, my concerns lie in ensuring patient dignity (in some cases both the targeted patient and the roommate) and how the video footage would be used/ who has access to it. This is yet another area where technology has progressed faster than regulations and legalities can be addressed/ implemented. So many different aspects - both positive and negative. It will be interesting to see what the future brings in this area.
  6. vampiregirl

    Med/surg to Inpatient hospice empath health job

    An hour for an admission isn't bad at all. When I worked inpatient, I could complete an admission in 2 hours if I didn't have interruptions and I was considered one of the quickest. Where I work now in home hospice, it typically takes 2-4 hours to complete all the tasks associated with an admission depending on the complexity of the patient. Not only the software, but the tasks associated with admissions can make a huge difference in time requirements.
  7. vampiregirl

    Med/surg to Inpatient hospice empath health job

    I've worked both inpatient and home hospice. For me, I love my current job which is hospice case manager for small, local non-profit with a commitment to quality. Both inpatient and home hospice can be great IF you work for a good company. Good leadership and a strong team (Social Work, Spiritual Care and aides) are essential. Learning good self care is also critical. Hospice done right is ensuring that patient's symptoms are well managed and that the caregivers have the education and support they need to care for their loved ones. Hospice can be sad but there is also a lot of joy and satisfaction with hospice nursing. It's a sacred privilege to be present for some of the things I've witnessed. I would be a little cautious about salary. I've not worked a salary position in hospice but have worked salary positions before... and am not sure I would again in the future.
  8. vampiregirl

    Scary commute for work?

    One more consideration is the addition of 2 hours to your day. If typically nurses get out in reasonable time after their scheduled shift, it might not be too bad even when you are scheduled with shifts on consecutive days. Also, how are you with flipping shifts. I know for me an hour drive home after I'd worked a night shift made me a little extra cautious (especially when I had recently worked days).
  9. vampiregirl

    fluid/electrolyte replacement

    We used slightly weak gatorade alternated with water. Electrolyte popsicles and regular popsicles were also offered as needed. We also had lemon-lime soda available in the clinic. Our camp ordered gatorade powder by the case, on super hot days we had it available for all campers at "water stations" around camp. On those days, popsicles were available for everyone and lifeguards had access to electrolyte popsicles. Campers were encouraged to alternate gatorade with water. All campers were required to have a water bottle of some sort. Bottled water was distributed as the beverage for afternoon and evening snacks (8 oz bottles). Counselor training included education about preventing dehydration and early identification of dehydration. These strategies worked, we did not have to send anyone out for further medical care all summer to have dehydration addressed.
  10. vampiregirl

    RN to BSN or straight to BSN??

    This may be true in some areas. And for a while I saw this in the area I live. Now I'm seeing more institutions hiring ASN prepared nurses with a stipulation that they must complete a BSN within so many years (typically 3-5). Typically the hospital offers a tuition reimbursement or tuition assistance. Also, there are a variety of RN to BSN options.
  11. vampiregirl

    RN to BSN or straight to BSN??

    I'm not convinced there is one "right" answer to this question. I graduated with my ASN and worked for several years as an RN. I went back to school to complete my BSN. My work experience made some of the material "more" relevant (because I had experiences to apply it to) and I got so much benefit from interactions with my cohort members. I paid for school as I went along; this route made the most financial sense for me. I know others who got their BSN before they started working in the field. I've talked to several nurses who are glad they did it this way because they could focus on their careers and family without having school thrown into an often complicated equation. I think evaluating one's circumstances and the opportunities available to them would be the best option.
  12. vampiregirl

    Should I try LTC?

    There are some good LTC's but you have to look carefully to find them. I was fortunate enough to work at one as a new grad and gained a strong skill base there. Currently I'm a hospice nurse so I visit several different SNF's. A couple are provide good care to our mutual patients, one downright scary and the rest middle of the road.
  13. That's a lot of changes at one time, the emotions you are expressing are completely normal. Give yourself time to adjust to this huge learning curve. Figure out who are the good resource people on your new floor. Find things that you are already good at and let yourself shine in those areas. Find some positive people on your new unit - and this doesn't have to just be nurses. At several of my previous jobs I've found the most delightful environmental services, unit clerks etc that have cheered me on as I've figured out a new job. Being kind to people can make a world of difference and help you feel better. Several months ago I switched jobs to a small non-profit in the same specialty I been in for several years. This agency is amazing and I'm so thankful that I work there. But the learning curve was rough for me. Hang in there and see where the journey takes you.
  14. vampiregirl

    On Call versus Case manager

    What is the average census for this agency and what geographic distance is the service area? Those would be 2 pieces of information that to me would be significant considerations for this question.
  15. vampiregirl

    Time to step down from management?

    Being the voice of authority didn't specifically bother me. I function best in an environment in which expectations are clear (to both management and employees), rules/ policies are consistently enforced and managers support each other. Unfortunately where I was in management, this was not the environment I was working in and there was no interest from upper management in changing at the time. I wasn't comfortable asking employees to do things I wouldn't do myself (pick up crazy/ unhealthy numbers of hours etc). I didn't feel like we were taking care of our employees and this reflected in the care we were providing. This just sit well with me and eventually I left this position on good terms.
  16. vampiregirl

    Time to step down from management?

    For me the decision to step from a manager role back into a staff role was a combination of several realizations; most importantly that I really enjoyed the hands on/ clinical aspects of nursing. I also realized that my personality is much more suited for non-management roles. I've also held clinical leadership roles (charge nurse), those I enjoy. That's the beauty of nursing though, there are so many different roles available. Currently I'm a hospice case manager which is a great fit for me. Good luck in finding the right role for you!
  17. vampiregirl

    New Camp Nurse

    Camp nursing is a great change of pace! If you haven't discovered it already, the Association of Camp Nursing website has a wealth of info: www.campnurse.org
  18. vampiregirl

    "Green House" model

    I'm journeying back to LTC/ rehab world, but with a twist. I've accepted a position with a company that has successfully opened several Green House model "homes" in my area. I did my research (about the agency and the Green House concept) and think that this job will be a good "fit" for me and my skills set. I'm hearing positive feedback from a current nurse who works there (and I worked with at another agency), a friend who was a patient there and from several professional contacts I have in the local medical community. Curious if anyone else is working in a facility that uses this model of care, I'd love to hear what your thoughts are... All the threads I found were quite "old" and I suspect this model of care has evolved from when it first was being implemented.
  19. vampiregirl

    Wrist watch or a fob watch?

    C. Fobwatch I have mine set-up so it is attached to my name tag but doesn't obstruct view of my pic and name/ credentials. I had trouble with dermatitis under my watchband in the past, no issues now. So much easier for handwashing. Took a little time to get used to it, but I will never go back to a wristwatch.
  20. vampiregirl

    New grad nurse needs help giving report

    Brain sheets are great! Even if there is a brain sheet already made up, figure out a system to document specific info on it that works for you and helps you organize info. I've ended up making up my own template before. Listen carefully to the reports you receive - the good and the not-so-helpful. Base your brain sheet off of this and subsequently your report format. Figure out how to organize info for complicated patients. Ask for feedback when you give report. This is just one more thing that takes time, learning to give a "good" hand-off report.
  21. vampiregirl

    Sick over a mistake I made

    Unfortunately part of being human is that we make mistakes. Part of our growth as nurses is the actions we take when we realize we made/ contributed to a mistake. Accepting responsibility is huge. Making the appropriate notifications and putting appropriate interventions into place are also critical steps. You've already got this in process. Something else you may want to consider is working within your unit to put interventions in place to help prevent this type of oversight in the future. Especially since it doesn't sound like you are the first person that has discharged a patient with staples... this sounds like something that needs to be addressed. This can be as informal as you figuring out some way yourself to prevent this from happening in the future or even making formal recommendations for a process change within your unit.
  22. vampiregirl

    CNA to RN

    I opted to become a CNA to learn more about how to care for patients. I took a 3 week course at a nursing home. From what I understand these days the course typically lasts a month. Some local nursing home offer the course for free with the opportunity for a paid position upon successful completion.
  23. vampiregirl

    Working on weekends!

    What area of nursing are you interested in working in for you NP goal? Have you talked to any NP's who work in that area to find out what experience might be most helpful? Also, is a hospital where you are sure you want to work? There are many other nursing setting which some posters have mentioned. I wouldn't rule out nursing homes - it's hard work but I got some great experience as a new grad working in nursing homes that has served me well as I've continued my nursing career.
  24. vampiregirl

    CNA to RN

    I don't know if becoming a CNA first would make the path to RN any "quicker", but for me there were lots of advantages... I was exposed to a lot of nursing activities and great nurses who loved to help me learn when I was a CNA. My CNA skill set is also very helpful to me as a nurse still to this day. Plus, it's a good income often with some flexibility in scheduling while attending nursing school. I know some places even offer tuition reimbursement or assistance. Being a CNA is hard work but for me I'm really glad I chose that path.
  25. vampiregirl

    New Hospice nurse, all tips welcome!

    Different agencies have different case management expectations and different structures. In addition to your mentor's suggestions, I would recommend talking to other case manager's to find out their tips, tricks and systems. I just started at a new agency, but from previous experience my case management was a combination of ideas "borrowed" from other case managers, tips I've gained from other sources (allnurses) and my own spin on things. The most important thing is figure out a "system" that works for you!
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