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Idaho_nurse has 18 years experience.

Idaho_nurse's Latest Activity

  1. Idaho_nurse

    Mandatory Hurricane Evacuation - Can I be Forced to Work?

    I dont understand how a hospital, which is rated only a cat 2 be allowed to keep patients in the facility under a mandatory evac order. This is putting the staff and all patients who remain at high risk. I wouldnt mind staying either but not at a hospital not rated to withstand the category hurricane that is due to arrive. My life means something to me and my family and my patients lives mean something as well. I wouldnt think they could be allowed to put people at risk, especially under an evac order.
  2. Idaho_nurse

    Patient abandonment?

    Oh my!!! I completely understand WHY you resigned your job. I dont think I would make it a week with that agency before I told them off. Patient abandonment? are you kidding? wow!!! Like others have said, I would contact a lawyer that specializes in something like this. This is not a reason for termination you want following you around for your career. Sounds like your "boss" would be the sort to ignore the laws associated with references and sabotage you in your future job hunting. I cannot even fathom employers like this. I guess I am very lucky. every job I have ever held have been great, with great employers and very fair directors. I cannot say that every branch we have is wonderful, but MY branch is the BOMB!!! We have a great time, we are left alone to do our jobs (as long as you are giving excellent care), and we are all friends and there has never been any "bashing" of anyone. I am truly blessed to work with such a great home health agency and branch.
  3. Idaho_nurse

    Charting in the home

    For me, it truly depends upon the client and your ability to concentrate. I personally, have been a home health patient before becoming a home health nurse, and it is very awkward to have a nurse just sitting there staring at her device typing away. As a nurse, I have noticed that it makes some of my clients uneasy as well.. when you are charting, unless you are very, VERY good at multi tasking, your not speaking to the client and staring at your computer screen... Some clients I have though, enjoy my presence and I enjoy their's and I have no issues in charting my visits while in the home. This is where, as a home health nurse, your powers of observation and your ability to to be efficient come into play. If you can read the client correctly, it can make everyone's job much easier. I have taken complaints from clients about other nurses before, and the majority of them state that the nurse was "impersonal" and didnt interact much because they were too busy staring at the device or computer. As we all know in Home Health, if we make the client angry or upset about something, it makes everyone else's job much harder and you set yourself up for the client to be "non-compliant" with plans of care. If its an easy visit with no issues, I will usually chart my narrative out in the car immediately after my visit, if there is alot of concerns to be addressed, I may just type a quick note regarding my findings for easy access, and just incomplete it until I can gather my thoughts for charting later, especially if I need to message docs or other clinicians regarding the client and I am needing feedback. While it may be "better" to chart IN a visit, ultimately, the client is the variable. What is best for them at that moment. Being flexible is a key element to be successful as a home health nurse, IMO.
  4. Idaho_nurse

    Any urgent care LPN's?

    I work part time in an Urgent Care setting and part time in Home Health. If you are looking to use your skills, avoid Urgent Care. Basically your duties are that of an MA. Not that they dont work, but compared to your skills in other places, you dont do much more than run labs and do vitals. Your main job will be rooming the patient, getting vs, and then ordering any tests that the doctor or PA wants done. Setting up xrays, collecting urine, maybe blood (but not often in Urgent care), as most patients you see are injuries and colds etc. Occasionally I will do dressings but very rarely. The Urgent Care I work at also has a family practice medical clinic, so we do see more "regular" patients, but they do try to keep general visits and urgent care type visits separate. I work there because it is less than a mile from my home, but if it wasnt for the high skill that I use working in Home Health, it would drive me crazy. Like you, I am very hands on and enjoy using my skills. I get very bored working UC. Hope that helped your question.
  5. Idaho_nurse

    From the other side...nurses as patients.

    The reason I became a nurse 20 years ago was because I was a patient first and really had some BAD nursing care. Since then, I have been a patient many times in some truly bad situations. I've had pretty much everything from basic procedures to massive surgeries. I have also gone AWOL out of hospital because of shotty nursing staff and my mom had to make me come back in. They made me cry when they treated me like **** and made me feel worse mentally than I was physically. I would say I was bullied by some of the staff. The main thing I have to say is.... COMMUNICATE with your patients and listen to them. The staff that made me walk out of the hospital had an attitude of "I know everything, dont tell me how to do my job". While I wasnt telling them how to do their job, they downplayed my pain levels and even went so far to say "You cannot be in that MUCH pain" and then ignored me when I told them that my only good blood draw vein is in my right AC. I told them this because I was a very hard stick and just to get a single line on me, they had to try 8 times before they finally got someone from life flight in to get it done. I saw them rolling their eyes when I would tell them things or ask questions. I saw them "huff" when I would ask them to explain what what going on with my case (we were waiting for the doctor but I didnt know that and they refused to say). It really is basic courtesy and common sense to communicate with your patients. I suspect alot of the issues with patients would go away if nurses would communicate more. I've worked the floor and had some really difficult patients, many of which other co-workers gave me because I didnt mind dealing with the "problem" patients. I have been there and it can be a very difficult and scary time in a person's life when they are in the hospital. Oh, dont get me wrong, there are THOSE patients whom you cannot please no matter what, but 90% of mine? they just wanted to know they were in good and competent hands. If a doctor has not put in an order for the pain medication the patient is wanting? be honest about that. I always keep a patient in the loop regarding everything. In each of my hospital stays, pre nurse and post nurse, I was never a difficult patient (I guess that may be subjective because I am the one judging this, but I never ran the bell unnecessarily, I asked for multiple things while the nurse was in the room to avoid being a pest, and would wait on the nurse, even if she didnt come back like she promised to see if I needed anything, instead of calling the nursing station). I could usually hear the nurses at the nursing station laughing and carrying on, being inappropriate on their cell phones, and talking about their weekend plans rather than doing what they said they would do. so that is my other complaint.. if you say you are going to do something, then do it and remember, patients CAN hear you. you get a patient that is sensitive to things such as this and the animosity is going to start right from the beginning. Also, it is not hard to poke your head in the door of a patients room and let them know that you are just checking on them. Trust me, it will make the patient feel good and have less stress because it makes a statement that you care about them and are thinking of them. I literally went through an entire shift when I was a patient for one of my surgeries and only saw the nurse ONE time... this is not exaggerated. ONE TIME. I didnt use the call bell and literally wanted to see how long it would take them to come into the room. Well... She actually came into the room only because I had an IV antibiotic to be hung and it was at the end of her shift. No assessment, no "I'm so and so and I will be your nurse today" this was the time she changed the white board as well and put her name on it. I actually asked her.. "why bother? your off shift within a half hour" and she ignored me. So while we are NOT cruise directors or maids or waitress's, please make your patients feel like they can trust you. Just being compassionate goes a long way.
  6. Idaho_nurse

    New grad RN, don't think I can do this

    You are being WAY too hard on yourself. While I cant say all of us, I can say MOST of us have been where you are at. Being that you had ONLY 5 days of orientation and then were basically tossed out on your own (due to circumstances), I think you are doing FABULOUS. Be easy on yourself. who hasnt given a med 2 hours late at one time in their career? anyone? anyone? bueller.. bueller.. I promise you that it will get better and better and easier and easier as you gain experience. YOU SURVIVED and that is saying something right there.. AND.. nobody was hurt in the process. Keep on rockin on.
  7. Idaho_nurse

    I'm So Over Nursing. I would rather work at Costco!!

    You have alot of compassion and passion for this job which I honestly feel makes you an asset to specialties and you need to find the right one for you. hanging up your hat, imo, would be an error on your part because of your nature. That being said, I agree with you on most of what you said, but as others have said, you need a different place or facility. I did not read the majority of the pages of responses on this topic, so I am unsure if what I am going to say has been said prior, but here goes anyways. I feel you could be a HUGE asset in home health nursing. not private duty, where you have one patient, but true home health. The reason I say that is because you do care so much about the patients you are assigned to. In the home health agency I work in, its all about the nursing staff and the patient... PERIOD. I run the show and make sure the patient is well cared for, have everything they need, and give them one on one attention, while I am in that visit. My agency gives their nursing staff anything they need to do the job and the physicians are held accountable for their end of things. I have developed some close relationships in the specialty. The difficult part is not crossing the line into "friend" territory. AND, my patients are MY patients. unless I am off on vacation or something, I am the only nurse who see's that patient and coordinates care with their primary care physician. I am the one to catch that "off" patient and correct it before it lands them back in the hospital. I am that one to catch that "off" symptom, that "off" lab value, write the order I need the physician to sign, and complete any treatments needed, from drawing labs, wound care, catheterizations, etc... Just something to think about before completely throwing in the towel on your nursing career. Good luck to you
  8. Idaho_nurse

    Advice on the bridge?

    I just finished my 3rd week in my bridge program and it is seriously accelerated. its 5 days a week, horrendous reading, workbooks, NCLEX style exams, etc... If you can get away with NOT working, I would advise not to work during it. I have to work, and it is seriously difficult. I went back after 9 years of working as an LPN, and I am an older student and a single mother, so balancing all this is NOT easy. DO NOT STOP.. continue with your education now because I have found that I have to retake all my pre-req's because I waited to long. My advice? once you are in, get with others in your class. study groups etc. Good luck to you.
  9. Idaho_nurse

    Is home health that bad?

    right? I have found my niche as well.. I LOVE my job and do have plans to continue my education, get my NP and continue with home health to work my rural territory. There is such a need and many of these patients cannot get the care they need due to their remote locations. Would be an awesome service.. the absolute #1 for me is the one on one. You really develop a relationship with your patients and its something a nurse just doesnt get to do in any other setting. and yes, there stress level is very low.. granted, you do get some higher stress situations.. at least working with my company, but that is only about 1-2/10 and once that is dealt with, the stress is gone again. LOVE HOME HEALTH.
  10. Idaho_nurse

    What skills to brush up on for home to home nursing?

    I see EVERYTHING. I do ALOT of wound care, including wound vac's, foleys (both indwelling and superpubic) and do lots of blood draws. We also do home infusions as well and manage PICC lines. The most important though is critical assessment. You need to be able to assess well and do plans of care. Without good assessment skills, you could miss something major. Education is done daily as well, so know your medications (I use the internet alot), and be able to teach about disease processes. Also, you MUST be an independent thinking and be secure in your skills. there is nobody to help you in home care. its just you and the patient.
  11. Idaho_nurse

    Does it get easier?

    I just started my RN bridge program and working part time. However, I am working in home health, so there is alot of drive time and management with this. I am struggling big time. I am not sure whether it is because I have taken almost 10 years to get back to it (in my mid 40's) or if I just have way to much on my plate with this accelerated course. I have worked just about every specialty minus OB. I was a CNA, MA, Scrub tech, ER tech, etc... I am having issues with clinicals because I am sooo used to working "real world" and in home health especially, things are not always available as they are in a hospital setting or help available. I am questioning things, but having to bite my tongue, which is not a huge deal, but I forget the minor stuff that is included in skills validation. The program is intense reading, homework, etc.. and I am behind because I have zero choice but to work (I am in a single mom and paying rent and supplying food is important). I am really questioning why I am going on, but I know I need to. I LOVE this field, and I want to continue on. I think the hardest thing is that I did wait so long and they didnt accept most of my transfer credits, so I am having to retake all the sciences as well, so its a FULL load. I was a 3.9 GPA student in my LPN class, and I know I wont be doing that here. I am just hoping to get through it. Luckily, I do have a heavy clinical background, and it doesnt take much studying to get through those, but I am worried.
  12. Idaho_nurse

    My phone keeps going off at work...

    I work in a different kind of specialty than a hospital. being in Home health, we use our phones almost constantly, and I dont know how people did it before our current technology of being able to get ahold of patients and doctors on the fly. That being said, I never have time to use my phone for personal reasons. I dont have a problem with nurses using their phones for work purposes but its those that abuse it that drive me nuts. At work is not a time for personal calls, checking social media or playing games. When I worked LTC, I used my phone as well because it was easier to have on you than rushing to grab the desk phone. But it was a smaller unit and we had clearance to forward the main line to our cell so we can be available. This was reserved for Noc shift only though and with a skeleton crew, there was nobody to answer calls should any come in. I also use my phone for research purposes. When in a home, I google things often to make sure that the info I am educating on is correct, especially medications.
  13. Idaho_nurse

    Am I wrong from refusing to help a friend?

    Your "friends" grades are NOT your responsibility. I question this "friendship" because of the one sidedness of the relationship. As a friend, you can sympathize with her, but I doubt anything would have changed her grade had you helped her. Your studies should be more important to you than her's. Sorry if that sounds harsh but if she cannot pass basic Bio, the medical field is not the place for her. Its on her and it sounds like you have tried to give her tips and suggestions for better retention. She needs to find a friend IN that particular class or external tutors to help her. You are not in that class and shouldnt have to learn that material to teach her. Just my thoughts. Dont beat yourself up.
  14. Thank you all for the tips. Although I am not in the market for a new job, I have decided to make a document to highlight both so I have it available should I need to find a new job. This question is always my weakness, lol. It can be hard to state your strengths without sounding cocky. On the flip side, its hard to state your weakness's. for myself, its my interpersonal skills because i have zero tolerance for people not doing their jobs, or not treating their patients as they were most important (in my eyes). So with this I always struggle on how to answer this question. So anybody who has idea's on how to state this would be great. Thank you.
  15. Idaho_nurse

    Contacting patient after discharge

    I also want to add on to what some others have said... I have been told that I am a GREAT nurse and show great compassion and treat others the way I would want to be treated. I care ALOT, probably too much and that is another reason I try not to cross any line when it comes to outside work. I want to know, I want to know they are ok and I want.. very much.. to help them, but I have to think of my own mental health as well. being in this field for almost 20 years has taught me alot about myself and how much I can take without taking away from my own life. In the beginning, I worried about all my patients. At work, outside of work and heck, even dreamed of some, and emotionally, I was drained and my personal life suffered. As a CNA, I worked double shifts often because of lack of staffing and call in's and it literally put me in the hospital and set me up for a lifetime of back issues because I could not handle the thought of MY patient not getting the best care. Though the years, I have learned to back off and prioritize my feelings and have gotten to the point where, once I clock out, I try not to think about work or those I cared for that day. Operative word being TRY. I do not feel I am a less compassionate nurse because of it, I feel I am better because of it because I give all I can while on the clock and nurture my mental health when I am not. I would never not say hello to a past patient, nor do I not care, but I have learned that I cannot be turned on as a caregiver 100% or I would worry myself to an early grave. I cannot say how many times I have cried in my career over a patient or patients to the point where I felt I was on a full blown crisis. The other reason I dont go further outside of work is because sick people usually only want to talk about their illness and being that they know my role, that is what they want to discuss and what I think they should do. It can be a double edged sword.
  16. Idaho_nurse

    Contacting patient after discharge

    From someone who HAS crossed that invisible boundary, DONT DO IT!!! It became a nightmare situation where I was almost stalked to the point of filing police reports, and this was NOT from the patient I treated, but rather from a dysfunctional family member who got my number from his mother. I had given it to her because we "bonded" and I had asked her to call me after treatment to let me know how it went. was not a fun experience. However, having said that, I have ran into old patients occasionally and we do talk "in the moment" and catch up, which I feel is appropriate, because I am not acting in a professional sense or giving medical advise. When we cross over into the friends category, we can set ourselves up. I have had patients who have told me.. "my friend, who was my nurse at one time, told me to...." fill in the blank. or I have gotten "my friend who was my nurse said that I need you to get an order for... " again, fill in the blank. I have had patients ask me if we could keep in touch after their stints in a facility, but I decline.. politely of course, but still decline and say something such as... "I am honored that you consider me a friend, but I need to focus on my work" or home, or whatever, and with a few pushy one's I have said it is against my work contract to have communication outside of work. Thankfully nobody has thought the wiser on it. Protect yourself, as people in this world can become pretty pushy and cross boundaries. It sucks that we live in such a world, but HIPPA is very real and not negotiable. As for the facebook comment, I cannot even imagine being FB friends with past patients. I think the only way I would be is if they were fiends prior to being a patient, but then in this situation, I would probably ask to not be their primary nurse.