Oliver1234

KatieMI I am glad your facility has more people to call in like an ethics committee. I wish we had something like that. But at our place the Dr rules all. It's disgusting.. And situations similar to this has happened before (same dr). I think I need to find another job for multiple reasons!

I thought so too! I mean how can a Dr get away with that? Its unacceptable. Doing some research online before posting here, in my state (ma), a physician has to invoke the HCP when enterting into a facility. So at the previous hospital they clearly had no problem doing that, and at my facility they assigned the one dr that we all knew would ruin this. We have plenty to choose from and by right it should have been someone elses job by the way who covers who at my facility so it almost seems like a big scam thinking they could trick the family into keeping her alive and live a miserable next 3 years as a vegetable. Anyways so the dr used the only thing that he could by not invoking the proxy, and said somthing to the matter of how the pt needs to be evaluated by psych before able to use HcP... But pt was unconscious!!!!!!!! Come on!!!

Hi all, I had a situation at work recently where a patient was transferred to my facility (long term acute care hospital) from an acute care hospital to be terminally weened ..pt was ventilated and ended up having a stroke at the hospital and was no longer mentally there. before the stroke, the pt said she was ready to die to her family and was okay with it. They filled out a health care proxy in previous hospital. they were transferred to my facility thinking it was a hospice place and it was a mess. One of the higher ups and a doctor talked the family into staying and said we would create a hospice environment for them. so they stayed. I took care of this patient the next day when pt was to be terminally weaned off ventilator. Dr came in ( different one than before, and one who never helps anyone die peacefully but instead makes people live with no quality of life...sorry i could go on) anyways this doctor kept prolonging the wean and not allowing us to up the dose of morphine drip. Eventually the Dr said the health care proxy wasn't invoked and decided to completely ignore the families wishes and ordered meds, g tube feed, vitals and d/ced the morphine etc. the family was so upset and ended up calling the hospital they came from and had them acutely transferred. I am honestly sickened by this situation on so many levels. How can a Dr not invoke the health care proxy when the patient is clearly not capable of making their own decisions? the pt wasn't even conscious! the proxy was filled out before hand and we were given a copy. I don't understand how that is even legal and especially ethical! The entire family came to say good bye to the patient....I can't even imagine being that family. I personally said goodbye to both of my grandmothers with the help of Drs, nurses and morphine and if something like that happened I would have been beside myself. I am not sure what ended up happening to the patient at the other hospital but I am praying they are at peace now. Any incite or similar situations out there? Honestly, situations like this make me want to go into hospice nursing. Allowing people to Die with dignity is so important to me.

My supervisor is the one who told me to do it lol. It is prob fine

Ya... It is def weird right ?? I just wrote a note... Hopefully it doesnt come back to bite me!!

Is it illegal to do a med prefill for the week if the patient isn't present?? A family member was, patient was suppose to be... We didn't log it as a visit so the company won't get paid for it by insurance.. But I am still getting paid by the company... As I was leaving the disaster the patient showed up.. But I left regardless. The patient didn't have enough pills set up for the weekend so if it wasn't done today, there was no one to do it tomorrow. Just a big confusing situation.. Just wondering if that is legal to do as a RN? There is no insurance fraud or anything.. but it just seems odd.

Thank you so much for your reply. Cant believe i havent responded this long! =) i ended up going back to my acute care job and i do 4 hour shifts. I am exhausteddddd after and very sore. Then i started a vna position which is not working out and I am leaving soon. So going to take time and rebuild my strength, as i jumped back into work way to fast.

So sorry to hear about you and your mother. I am a cancer survivor myself just after 1 year of working as a rn. I had terrible anxiety about returning to work... And even still dont know if the stress is worth it... It really does effect your health... Maybe try a different avenue of nursing? I went from acute care to visiting nursing but the stress is the same just in other ways..just don't be too hard on yourself. I keep telling myself things will work out the way they are meant to! And I hope the same for you =)

Well.... After my month of stress I gave my 2 weeks notice. They offered me per diem. I said yes, but was just told the pay rate and it is HORRENDOUS. Worse Ive ever heard of. so i will not be working for them at all. Now I am sticking with my per diem acute care job and looking for a per diem vna job that the pay is worth while for me. Hope something comes up because I really do enjoy vna. Although the case management aspect is very stressfyl, thats why per diem will be better for me, no case management! =)

Ya i did say, well im going to need a day off then next week, and they said yes if sun is busy we can figure it out. It didnt end up being that bad on sunday.. But nether the less I am still exhausted. I have today off and thats all... So it ends up being 2 five day work weeks when i am hired for 32/4 days weekly. But thats true about setting boundaries. Its hard to do that when your so new to a company.. I am afraid of being concieved as difficult rather than strong if you know what I mean. Either way, I am going to stick it out and continue to look for jobs closer to my house.. This time i know what questions to ask if I get an interview and job offer... Thanks again all!

Thanks for responding all! When my manager said that she thought i quit it was in a joking manner... But clearly they knew it was too much and no one cared enough to intervien and work the weekend to help. Sad part is., I only went with this company for 2 reasons. 1 being 2 people work for them for 20 years and recommended it. Second one, they have an office close to my home, and said I could transfer in a few months when a position was open, but that office is so slow they are more likely to close down than to actually have another position. A huge part of me did not want to take this job because of the inconvience of driving to the area.. And now add in very long days, busy weekend that you dont get paid any extra for and no day off to make up for busy weekend. Maybe I will start applying to other places, and this time I will know the questions to ask before accepting a new position. They hired me btw without telling me my pay... I had to ask for it and they got back to me days later.. And I knew nothing about the benefits either. Truth is i was feeling desperate after my illness because alot of lies and disaappointment happened trying to get a job. Now i wish i didnt settle. The positives are, the staff are all very nice and dont mind getting asked a million questions. It just seems like they take on too much as a small office and expect the nurses to deal with it.

i have a work phone and the message says to call the office but people don't listen. Im going to make it more specific regarding weekends and after 5 though. I had my phone off too and then turned it on after it finished charging.. No idea why... And saw the voicemail... And in the end I had to see the pt today at 4 pm instead of tues at a decent hour and it turned into a 10 hour day. I am Exhausted!!!!!!! Its almost as bad as hospital work that i did before. Wish I could find the happy medium... I really thoroughly enjoy caring for people in their homes.. Maybe I should find a per diem position so i can choose when i want to work.... Hmmm problem is, i have guilt leaving a job after such a short while. But the supervisors obviously know they put too much on me because today they said ohh we were wondering if you quit after the weekend...Ugh..

Yup. I have only been on my own for 2 weeks. New to homecare too. I was so stressed out.

Hi all. I started working as a visiting nurse a month ago. Havent worked in over 10 months prior d/t illness, and i took on 32 hour position and it is taking over my life. I am thinking about asking to cut down to 24. The problem i am having is they seem to want me to document in the office, until 4:30-5pm. I live 45 min away and would rather document at home, and the other 3 nurses doc at home so I dont get what the problem is.. I figured at first because I am new they want to keep close tabs on me, but they threw me to the wolves my first weekend, 3 soc and 2 visits.. Had only done 2 soc on my own before and they were uncomplicated ones. I was totally stressed out and feel like i hardly knew what i was doing this weekend. Now i am having trouble sleeping.. I had a pts family member call me when I am not on call and I felt obligated to call back...all these things are stressing me out..is this the norm of visiting nurses? Does it get more manageable? The travel to and from office is making it an extra long work week and ive been working 8.5-9 hour days without a break.. Anyone else travel that far to do vna?? Thanks in advance...

Hi everyone! I was offered a visiting nurse position, and they haven't told me the pay rate yet!! I asked and she said she had to ask (whoever) what it would be because they base it on experience etc. I am really nervous they are going to try to low ball me! So when I see them next week, I need an idea of the average pay rate for visiting nurses in MA??? Any help would be appreciated! I have about 1 year acute care RN experience, and 3/4 years of CNA experience. Thanks in advance!