txbornnurse

Try 1 to 2300 inmates. I don't think I have ever worked any prison or jail where the ratio of nurses to inmates ever exceeded 4 to a 1000. And that 4 to 1000 was only on the days the docs were there to conduct clinics. Otherwise the max per shift regardless of inmate population size was 2. About 75% of my many years in corrections it was me, myself and I.

43 years as a LVN in a variety of fields and my joints look like I was a pro athlete. Every major joint has repeated injuries, osteoarthritis as a result of the constant stress and trauma plus the emotional stress of the responsibility. Pushing med carts which can easily weigh close to a 100 pounds (or more) loaded up, bending constantly to get in and out of lower drawers, lowering and raising beds by crank if the beds are not motorized, re positioning people in order to give meds, sitting at poorly designed work areas on non ergonomic chairs which leads to shoulder and neck tightness and wrist and finger fatigue. My list could go on and on. Plus add in the brain work and the stress inherent in supervising others and it is still harsh to the body. Nothing about any niche of hands on/direct patient care is non damaging to the body. Doing it for decades is brutal. So remember what you wrote today when you wonder why you still feel like you have been run over by a train at the end of a shift of bedside care. Nursing is not for the faint of heart or the weak of body if doing hands on care.

How you are supposed to handle giving meds if the resident is not in their room? And I echo a previous poster about where oh where is your state licensing/regulatory agency to do that initial survey? You know what is not home-like? Residents getting incorrect meds and infections from lack of proper sanitary supplies.

Check out Taskmaster Pro. It was designed specifically for HCS and related DD programs.

This sort of policy decision is why removing dedicated float pools was a bad idea. I can visualize the bean counters rubbing their hands in glee at the idea of removing all of those "overpaid" float nurses. Silly short sighted twits.

OP correct me if I am wrong but from the way you worded your original post it sounds as if you had worked a swing shift, the facility wanted you to also work the over night shift and you have a day shift job? If that is correct no way in the freaking world would I ever work 24 hours in a row unless it was the zombie apocalypse/apocalypse of choice. As an ADON I was forced to remain in my facility working for almost 30 hours once. On my drive home I fell asleep at stoplights twice. I had to park my car, get my DH out of his job and have him come drive me home before I killed myself and/or others through sheer exhaustion. Never ever again will I work more than 16 hours in a row unless it truly is an emergency situation. Do not give in on this.

Here is my opinion about random UDS. Back in the dark days of yesteryear when I was active duty my husband at the time was over the age of 25 and I was under the age of 25. In its' infinite wisdom the military decided I was at high risk of drug use due to my age and I swear I peed in the cup at least three times a month for several months. Always negative. Meanwhile my over the magic age of 25 husband, also a nurse, was the one diverting from the narc cabinet at his unit in the hospital. He was finally caught with an entire package of Demerol 100 mg Tubex in his uniform pocket when someone noticed an unusual bulge in his tunic top. The moral of my story: no matter what the criteria are for selection of the participants of the random UDS the effectiveness of actually catching a diverting nurse is slim at best. Save the screens for bona fide cause.

Disposable bedpans for the most part.

Metal bedpans, urinals and emesis basins which were gathered up by the night shift and put in the bed pan hopper in the dirty utility room every day. I also remember burning my fingers more than once taking those things out so we could slip the sterilized ones into a paper cover, pile them on a utility cart and trundle them down the hall to the clean utility room or put them back into the bedside tables in the patient rooms. Stock meds on every floor. The metal pill trays which had a hole for the pill cup and a slot for the med cards for that pass. It was sort your med cards pulled from the kardex before each scheduled pass by patient name, check them against the kardex, correct the cards if changes had occurred ( and grumble under my breath that the other shift didn't update the cards), go into the med room and pour the meds for each patient and line them up on the pill tray. Take said tray, put it with water, food if necessary, tongue blades and some paper towels and off down the hall to pass the meds. Yes we carried the tray into each room, put the pill cup into the patient hand, gave them some water and watch them take their meds. Repeat until complete. Then chart said meds on the MAR Using this system I could pass po meds to 25 people in under 45 minutes & the whole prep for said 25 people took me maybe 10-15 minutes max. Using today's system....much slower especially if an automated dispensing system is used.

OP you probably won't like this but be grateful it is not worse. Back when I was active duty nursing I literally worked all three shifts every week as did all the other military nurses. It sucked. At least I was not alone in my misery. Onto the child issue I got very tired of hearing on every single holiday that the nurses with children had to have the holiday off because they were parents. My issue was even single childless folks like to have a major holiday off on occasion. We singles had family too. OP you have been given some good advice about advocating for yourself going forward and please pay heed to not raising the "I have a child" card with your co-workers. Single, married, childless or not we all have family, friends and lives outside of work so no one has a monopoly on scheduling needs.

For the record OP I have a fair number of years in the I/DD field and it is not in any fashion stress free for a nurse. There is the on call aspects which can be exhausting, there are productivity expectations, there is dealing with insurance coverage issues when trying to obtain care for the clients. Try spending hours on the phone and internet finding a specialist who is part of the latest managed care network for Medicaid. There are lengthy and redundant reports and meetings. In addition since there is not shift to shift coverage by the nurses the nurse has global responsibility for health and welfare issues which ties into that on call all the time thing. Granted most of the companies I have worked for do rotate the call on the weekends or have an on call nurse but it can still lead to some very long days. It is not a job for a new grad by any means. Like home health you are assessing things solo quite often with your only nursing resource being on the other end of a phone. You might not do a lot of procedures or hands on care but you need to be sharp in your assessment skills because many clients are non verbal or limited in their ability to describe an issue. If one does this it is because of the hours, the focus being less task driven and, frankly, because of enjoying working with people with disabilities. One last thing unlike a hospital where the patient/family from Hades is only there for a limited time one frequently finds themselves dealing with the family from Hades for years at a time. IMO OP what you are wanting from nursing is not something a new grad is equipped to handle. You need that "stress" and experience to learn how to be the best nurse possible. That is not a justification for poor staffing or unsafe environments but one cannot just sail through the day and learn how to deal with literal life and death issues without stress and being challenged in the mix. And when one can do that then one has, again in my opinion, earned that "low stress, high paying" job.

Any threads by Viva. You are a shining example of keep on trucking no matter what.

Have you considered becoming a licensed chemical dependency counselor? This is one area where you can make a decent living and having the experience of an active addiction plus being in recovery works in your favor instead of barring or limiting you. Just a thought.

I have spent a good chunk of my career in this field and unfortunately this attitude is too prevalent. It is especially pronounced when the supervisor/director is not a nurse. I have been told several times but these folks are like our family and it is a privilege to work with them. It is no more a privilege than any other field of nursing. Plus I have learned to establish boundaries through the years and I do not view these folks as my family. They are my patients period. In my opinion that philosophy leads to a culture of no boundaries and unrealistic work loads and expectations for all employees but especially nurses since we have an obligation to speak up when we know we cannot realistically handle a case load and do a good job. OP you did the right thing. Go pursue your NP and remember in the future that anyone who tries to take advantage of you is not worth you losing any sleep or worry over. Trust me they are not spending any of their precious time worrying about overloading you.

So many things at so many times :). When I was working the intake unit at the county jail one of the screening questions was how much alcohol did you drink tonight. The inevitable answer was "just two beers". Sure buddy that is why the cops found you passed out in a puddle of vomit or you blew 0.2 on the breathalyzer. Man those two beers pack a punch. Good thing you didn't really drink tonight...not. Upon being handed another checklist to complete each shift "It only takes a couple of minutes. Work smarter not harder." One time I couldn't stop myself and fired back the way to work smarter is to have less checklists and forms. One of the silliest was the sister of a I/DD client age aged 50. This client was fairly low functioning and showed the normal changes of aging, had gained some weight, bit of a pot belly and her skin was dry and sagged a little on her face. The sister always showed us a picture of the client when she was 15. The sister was always wanting plastic surgery (tummy tuck, lap band, face lift) so her sister could resemble how she looked at age 15. One day after hearing this "wish" for the hundredth time I said we all want to look like we did when we 15. Not happening for any of us. Sister never showed that photo again. I mean denial is not the word...delusional is more apt.