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JohnBearPA

JohnBearPA

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JohnBearPA's Latest Activity

  1. JohnBearPA

    Dangerous nurses

    about the order for KCL not being d/c'd, and kaexalate given at the same time,,,,, doesn't anyone do chart checks in this facility? There's more than one nurse at fault here. it's still terrible that it wasn't caught sooner.
  2. JohnBearPA

    Bummed

    I agree, because most of the CNA's here understand the reasoning behind telling their superior, the Nurse or Charge Nurse, that you're taking a break. If you're playing fast and loose with your staff, I'm just happy you're not at my facility. Believe me, you wouldn't even make it as a CNA. I'm sure sooner or later you'll ends up either understanding, or you'll lose your license for neglect or abandonment. Have a great day!
  3. JohnBearPA

    Bummed

    The pee break is getting blown out of proportion here. The OP said "stepping off the floor" which can be for anything from a pee break to lunch. From your responses, you seem to be just getting a laugh from serious responses explaining why nurses expect to know where their CNA's are, and I'm not going to keep on trying to justify my responses. When you're a nurse long enough, maybe you'll understand. Until then, have a great day.
  4. JohnBearPA

    Bummed

    Most units that I've worked on have staff b/r's on the floor, so no one is leaving the floor to go pee. As for the "MY LICENSE" thing, when you lose yours because of something a subordinate has done or failed to do, you'll understand why most of us feel as we do regarding our licensure.
  5. JohnBearPA

    Bummed

    No, it's NOT kindergarten, it's WORK, and as a supervisor of the CNA's at work, I too expect to be notified of when they leave the floor. I also have the courtesy to let my CNA's and the other nurse know when I leave the floor for break, or whatever else I may have to do in another section. I've been a CNA for years before I was a nurse, and I'm very aware of what their jobs are. That being said, I'M the one directly responsible for everything they do while at work, and I'M the one signing off on the fact that they did, in fact, do everything for their pt's that was expected of them. It's MY license on the line, and I let my CNA's know that, and that they can ask for help with whatever task they require help with, no matter how messy, or gross. I'm just asking the same respect from them that I give them, as I think the OP is also. As for the CNA in question, sounds like insubordination to me, write her or him up, and stick to your guns. CNA's like that don't need to litter the floor, as there are plenty of hard working CNA's that actually like doing their jobs to take their places!
  6. JohnBearPA

    Abuse of Nurses

    The facility tried to get her to retract her statement to police the next day, but it was too late. The resident had been exhibiting this behavior for several MONTHS, and admin was VERY aware. In fact there were several other assaults, such as resident throwing feces, menstrual blood, and urine, as well as resident literally running over a staff nurse with her motorized w/c. Thankfully resident figured out that charges might be pressed against her, and checked out AMA with family the next day. Now she's someone elses problem, unfortunately. As for advocating, I'm a pt advocate AND a staff advocate. How can I expect my staff to give proper care when they're afraid to enter a room to answer a call light?
  7. JohnBearPA

    Abuse of Nurses

    I was charge in my LTC when 3 CNA's came to me reporting an assault by a known combative, A&Ox3 resident. I called my DON and administrator, which were both unavailable, then police upon CNA request. Police responded, resident was made aware of consequences if CNA wanted to press charges, and resident checked out AMA the next day. Admin was furious, but I firmly held my stance that CNA was within her rights, and the powers that be were unavailable, after several calls and voicemails left. They eventually got over it. We have the right to press charges at work just as if we were at home, or on the street. Don't EVER take an assault from a resident and let it go, because Admin will NOT help staff, they're all about pt satisfaction!
  8. JohnBearPA

    Nursing and Spirituality

    I think you'll learn what's expected and your texts will become clearer when they're covered in class. We learned alot of this stuff in school, and had no idea how it would effect our nursing care until we got out and actually worked as nurses. As nurses, we care for the "whole" person, psych, physical, and spiritual needs. You'll realize the relevance when you get out on the floor. I was one of the few Catholics working at a Jewish run facility, and believe me, I learned alot about the Jewish faith. It certainly helped me better address my pt's needs, and I'm certain that it helped me grow as a nurse. No one asked me to convert, but I learned ALOT and it broadened my personal horizons. Just don't get upset yet, until you cover it in class and see how your instructors explain how it will relate to your career. Also, I agree, your spirituality has nothing to do with how good a nurse you are, and don't let anyone tell you otherwise. Best of luck, you'll make a fine nurse soon!
  9. JohnBearPA

    Culture Change In LTC?

    We'll just have to agree to disagree. Again, my sincere wishes for you to have a great day, and be happy in what you do, whatever that may be.
  10. JohnBearPA

    Culture Change In LTC?

    You have a point. but if it wasn't for the facility being open and getting paid for it's residents by your tax dollars, they wouldn't have the money to pay you, creating those tax dollars that you're paying to take care of those residents, now would they? As for culture change, which is what I originally wanted to post on, our place is going thru this now, and it seems a success, except for the fact that overhead paging is no longer allowed. MD's have to wait longer on the phone, but that seems the only drawback so far. Then again, we're VERY early in the change, so it'll be interesting to see where it goes.
  11. JohnBearPA

    Culture Change In LTC?

    If a facility is engaged in illegal activity, it surely needs to be reported to state, but most facilities are NOT engaging in illegal or unethical activity, other than the short-staffing that is prevalent in our profession. The facilities that are engaged in anything illegal are caught by regulatory agencies and closed down, as they should be. I'd be willing to bet that if you polled most nurses on this forum, most would say that their facility works above board. To make a blanket statement is a disservice to the profession, as it makes it seem as the nurses are part of the problem, because they have no choice but to go running to the state surveyors because there are no facilities that are good out there, and we're forced to work in lousy facilities that are working illegally and unethically. That makes us as nurses part of the problem. You did state that there were some management people with scruples, but in the same sentence, you stated that they're soon run off out of the business. I also didn't state that the employee was incorrect to report, just that there are other avenues that carry less of a punch financially to the facility that signs our paychecks. I've been around the block a few times myself, having been in this field one way or another since I was 16 working as an orderly for the summers in a state hospital. I'm well aware there are instances where management turns a blind eye to anything but profits, but believe me, in my experience that's not the norm you are trying to portray. I'm truly sorry for your bad experiences. My loyalties are also to my pt's, as are my DON's, and my administrators. Staff that doesn't feel this way doesn't last long at my place. My loyalty lies in the fact that my facility lets me do my job, advocate for my pts, and pays me well to boot. Have a great day, and may you someday find a facility as pleasant as mine to work at.
  12. JohnBearPA

    Culture Change In LTC?

    Actually, I think you DO owe something to the nursing home, they're the people that give you money for your services, and allow you to live with a roof over your head and eat, pay bills, put your kids thru school, and not be on the street. I agree that some management is just looking out for the bottom line, and may not be AS concerned with pt advocacy as they should be, but I don't by any means feel that they all are like this. I work at a facility that's advocating culture change, and it's a slow process, but believe me when I tell you, our DON is all about pt advocacy, and also defends her nurses as long as they're in the right. There are alot of other agencies that you can go to to blow the whistle other than directly to the state during a survey. That's kinda' like cutting off your nose to spite your face.
  13. JohnBearPA

    Vent, called a "stupid nurse",,, again

    He's not our Medical Director, although that guy is almost as bad sometimes. At first, I just thought this was a "southern" thing, as this NEVER happened to me up north. I just want to figure out a good way NOT to enable this man to do this anymore, to myself and my colleagues. It's out of line, rude, and just plain unacceptable. I need a good idea of how to take away his power to talk to us like this and get away with it. My DON said she'd talk to him, and she has before. She defends her nurses, but she's in a tight spot herself, because she's a nurse, and he seems to disrespect all nurses in general. She suggested documenting his behavior, but I don't feel the pt's chart is the right place for this, and yeah, it'd probably get me fired, so that's not gonna' happen. LOL.
  14. JohnBearPA

    Vent, called a "stupid nurse",,, again

    This may be a bit long, and it's a vent, but I also need advice on how I should handle this so it doesn't happen again. Let's start at the beginning, I'm an LPN at an LTC, and have been in this facility which I absolutely love for several months now. We have a particular MD that's just very rude, sometimes calls the nursing staff names over the phone when he's "disturbed", and can generally be obnoxious. Yesterday, I had an HA1C that was a bit high on a resident. I called this doc, along with several others I had to inform of lab results. Three docs called back at the same time, but I took the rude doc first as to not make him more upset by being kept on hold. I was in a bit of a hurry, as the other docs aren't exactly patient either. Anyway, he asked what meds she's on now for her diabetes, and I told him Metformin and Glipizide, and the dosages of each. He prescribed Glucophage 100 mg, I repeated it back to him, he said "yeah, that's what I said" and he hung up. As I said, I was rushed and didn't immediately realize what he prescribed wasn't manufactured at that dosage, and she was already on it at another dosage. Wrote the order on the lab sheet, and moved on to the other docs. Somehow I just wrote out the order and didn't think it thru. Moving on to today. When I got to work, the nurse I releived informed me laughingly of my error, and I told her I'd call him and have it fixed. I paged doc twice before he responded (like an hour later) and told him of the error, asking him what he would like to change it to. He again repeated metformin 100 mg, at which time I told him that they don't manufacture that drug at that dosage, and she was already on glucophage at another higher dosage, and glucophage and metformin are the same thing. At that time, he said "what, are you that (expletive) stupid? I said 1000 mg. you (expletive) stupid nurse. I no longer want to talk to you, don't ever call me again, have another nurse who knows what they're doing call next time, you're just (expletive) stupid" ( wrote this down immediately after I handed the phone to another nurse at the station so I wouldn't forget. ) I told him I'd be happy to document that, and handed off the phone to a very scared new nurse who heard every word he said across the nurses station because he yelled so loud into the phone. She took an order for glucophage at another dose, and ended the call. I called my DON immediately, and informed her of the situation, which is my second run-in with this doc. I informed her I would NOT be spoken to that way, and something needed to be done about this. I didn't document anything about the call on anything relating to a pt, or on anything belonging to the company, just had the other nurse write the order and sign it, and let it go. I documented the incident privately in a notebook I keep now for just such an issue, so i get the facts straight immediately after an incident. I'm still mad as I type this, and it happened several hours ago. Now I'm not the only nurse he's done this to, and he's always very short with the nurses, often mumbling these things under his breath when he actually gets his butt into the facility to see his pt's. When he does rounds, he expects the nurses to give him their chair, get him coffee, etc. He's not an old doc, but he's not from the US and that may be due to a cultural thing from his country. He also takes the whole chart rack down the hall with him when he does rounds for an hour or so, and gets mad when someone needs to hunt down the chart rack to pull a chart. I realize he treats us like this because we enable him to do so. My question is, how do I NOT enable him, not be rude, and keep my job? I love the facility, residents, staff, and everything else about this place. It's a great fit for me, or I woulda' left already after the first time he called me a "(expletive) stupid nurse". Any suggestions? Thanks in advance ladies and gents! By the way, just a little funny PS. When he's been in the facility during my shift, he avoids me, and stays out of my path. I'm a fairly big guy, not tall, but filled out, and I think I might intimidate him in person because I'm male, and bigger than he is, both taller and wider. LOL
  15. JohnBearPA

    Gay Boomers and nursing attitudes

    :yeahthat::yeahthat::yeahthat::yeahthat::yeahthat: I too have worked with gay seniors in m y facility, and have seen the snickers by staff and other residents. When I see this, I speak up and try to educate the offenders about equal rights and equal care. I also happen to be a gay man, and proud of who i am. At work, I've been told I'm not "obvious" and i "pass" as straight. I in turn tell people that say this that I'm just me, and don't have to "pass" for anything. It should boil down to equal care, no matter what color, nationality, handicap, religion, or sexuality, and I'll settle for nothing less in my facilitgy!
  16. JohnBearPA

    NANDA 2007 RN Dx List

    lol, yeah, me too.