old&improved

I read somewhere recently that the fed was going to make it illegal to charge extra for out of network providers in an emergency type of situation. I don't know if it has come to pass yet.

I am hands on. It is a small facility with around 70 residents. This is assisted living where the residents are able to get around by themselves and take care of their ADLs. There is no lifting, no IVs. It is mostly medication prep and pass and since this is a veteran's facility we deal with psych and addiction issues a lot. It would be boring for most nurses, but I don't need the excitement of acute care anymore.

I'm so glad I left the hospital a year ago. I was looking to get out over a year before that due to the increased pressures of the job. I'm working in assisted living now and am so much happier. Less pay, but less stress and so worth it. I sold my high cost, high maintenance home with the big mortgage and moved to a cheaper state and bought a cheaper, more modest home. I'm in the last years of my career (I am 63 years old) and plan to work for 4 more years.

I work with a CNA who puts a paper chux inside the bedpan. I thought it was strange the first time I saw her do it. But I guess it works. Of course you can't measure the urine (but you also can't if it's spilling over anyway). We also use powder around the edge to keep the pt from sticking to the pan. I'm not sure if hospitals provide powder anymore considering the issue with talc.

These questions are why I won't interview for other jobs any longer. Sitting with a group of 5 or more people asking these questions is intimidating and nerve wracking. I've been to a few where they seemed to understand this and tried to make it less intimidating, but they still asked the idiotic questions, "tell me a time where you.....". Please.... just talk to me about my work experience, ask me clinical questions to test my knowledge, and judge my appearance, comportment and personality, but stop with this crap. It is so obvious that the interviewee has had to write a script and practice and memorize their answers to these questions. How is that beneficial? A lot of good nurses don't interview well under these circumstances. I know nurses who got jobs because the person knew them already, knew what kind of nurse they were (some had done their clinicals and preceptorship there). If you can get a job that way it's much better in my opinion, but unfortunately most don't have that advantage and have to jump through the hoops.

You're right about personality being the driving force. When I was allowed to look up my pts before my shift I did it because it decreased my stress level by being prepared before report and also because I would catch missed things from the day nurse. I'm kind of anal that way and not really laid back. So do what suits your personality.

This would be great if it could be done in 30 minutes on 5 pts. It could be done if we didn't need to do bedside report. But not with pts needing to go to the bathroom or wanting to talk a lot. Yes, we can try to take care of those needs before report, but it rarely works- they still find something to need during report.

Nov 15, 2019 by VivaLasViejas, ASN, RN VivaLasViejas has 20 years experience as a ASN, RN and specializes in LTC, assisted living, med-surg, psych. 1,381 Likes; 8 Followers; 142 Articles; 9,739 Posts; 250,186 Profile Views I was fired from a job essentially for having a chronic mental illness. I'd had to go out on medical LOA for three weeks, then came back with a very brief list of accommodations, signed by my doctor, that I needed to continue in the position. My employer shot down every one systematically; they made it clear that they didn't have to work with me and they weren't going to. End of story. I was let go three days later. I suppose I could have fought it. I probably should have gotten on board with the EEOC and asked for a lawyer to take my case. But I was so beaten down by the circumstances that I didn't have the emotional energy to do battle. Besides, the employer would have had to give me my job back, and who wants to work for a company like that? Now I can't work, I'm on disability and had to give up my nursing license this year because I didn't have any practice hours in 5 years. I still resent that company because I loved that job, but once they knew I was ill, it was like they turned on me and did their best to force me out. The corporate nurse told me that "it's not your fault, it's your brain chemistry." If that isn't discrimination, I don't know what is. May I ask what kind of accommodations were recommended? In many circumstances workplaces can't provide those accommodations due to the patient population, job description, etc. I don't mean to be negative, but I know it can be hard for the employer to accommodate as well.

Are there any nurses reading this forum from northern Wyoming? I live in Arizona and would like to move to Lovell, Cody or Sheridan. I'm 5-7 years from retirement. I have worked with a few travel nurses from Wyoming and Montana and they say the pay and work conditions in WY are poor and many nurses who live there work in Billings, MT where its much better. I'm curious to know what pay for an experienced med-surg RN would be and whether ADN nurses get hired in hospitals. I'm an ADN nurse (29 years) and am close enough to retirement that I am not going to get my BSN. Thanks for any info.

I used to look up my patients 15-20 minutes early, but they put a stop to it saying it was a HIPAA violation. They also used to let us clock in 20 minutes early. Now- only 8 minutes. Admin says its a HIPAA violation to look up your patients before you're on the clock so I assume their legal department has looked into this.

I have known a couple of people who quit our hospital and were not eligible for rehire. One was because she was a new grad who didn't complete the 1 year requirement before leaving for greener pastures and the other didn't give notice. Both later wanted to come back and the hospital would not rehire them. I would consider sticking it out in this new position. Especially since this is a corporate hospital that owns almost every medical facility around you. What if you take the new position and you are unhappy there? You won't know whether this is your dream job until you have been there awhile. What if your lifes circumstances change and you need to work nights or weekends? Unless open positions at this other place are extremely rare or you're fairly certain you will be miserable at your present job I would give your current job at least a year and then possibly reapply at this other place.

I agree with this completely. And the last part about that dreaded interview question, "tell us about a challenge you had" is excellent. This is a perfect example for that question followed up with what you did to ensure it wouldn't happen again. You've got this cjp1994!!

You are not useless and stupid. This facility sounds substandard in not providing the necessary supplies to do your job. Yes- not putting the bed down before going to get a shirt was a mistake, but would he have still fallen out if the bed had been down? Unless his bed is a mattress on the floor you would have needed another staff member there to prevent a fall- extra staff is a rarity at nursing homes. I would look for a job somewhere else where you are not put in such a position. Stand up for yourself and write down all the ways this facility's rules and lack of supplies (and probably staff) is putting patients at risk and use that to defend yourself if you are given a warning or fired. And in future job interviews if this comes up mention these points. Most health facilities know nursing homes are notorious for short staffing, overburdening the staff and putting patients at risk to save money.

I work nightshift and I have not called a family member about restraints unless I was also calling them to help calm down a confused, angry, paranoid patient or to come in to sit with them if they were able. I have found family generally is understanding about restraints because they know it may be needed to keep the patient from pulling medical equipment out and to keep the patient and/or staff safe. If I call them in the middle of the night it's usually to give them the option to come in and sit with the patient if they want or to relieve the confused patients anxiety. If I had to restrain a patient in whom it was completely unexpected (a young, a&o person with no known drug/alcohol use) then I would call family to let them know because it would be a huge and unexpected change in condition.

Ah. OK. I misunderstood what the poster said.