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LanaBanana

LanaBanana

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  1. LanaBanana

    New job may be eliminated

    Looking for advice. I started a new job 5 weeks ago as a care guidance nurse in a clinic. The job was just created as part of medicare's pilot initiative the Comprehensive Primary Care initiative. My clinic is owned by a larger hospital that has 16 clinics participating in the initiative. However, our clinic is now going to be bought out by another hospital and it seems my program will not transfer to the new hospital because of how it is set up with Medicare funding. We're still waiting to find out if they are going to keep any of the 5 RNs who were just hired for these new positions, of which I'm the supervisor. We've spent the last 5 weeks building our case management program and building relationships without patients, letting them know that we are the ones they should call if they're having problems. We had planned to begin working on protocols with the physicians and I'm to start writing our policies/procedures. But knowing that the whole thing very likely will come crashing to a halt soon, or at the very least will change drastically due to the lack of Medicare funding, is making dread going to work and not want to proceed with all the administrative work. The physicians don't want to work on protocols and policies either until we know something. But without that to work on I don't have much to do throughout the day. They also just hired our 5th nurse who started this week and I'm orienting her. It seems so unfair to have even let her start right now. Up until 2 days ago I was told our jobs were safe, yesterday it was more 'we might be able to keep a couple of RNs but no guarantee, and certainly not 5.' What would you do? I have asked for answers and been told to be patient. Then after I left work last night my boss sent an email for me to come see her Monday. No idea what to expect from that. I feel like we're putting our patients in a bad place if we continue to build these relationships and have them rely on us and then leave suddenly and that if nothing else we should scale back until we know. Or maybe I'll find out next week that its all over. Advice? And yes, I'm keeping my eyes/ears open for other jobs!
  2. LanaBanana

    Too many absences for transfer

    Yes, I am anticipating having to take time off work IF we have an adoption come through. But being that it will be adoption and not me having a baby, I will have no control over when we know about the availability of a baby or when the birth mother goes in to labor. If we know in advance then I will arrange my time off and do FMLA. But as would be the same as any female nurse who goes in to labor, I don't have control over it. Our nursing morale is very bad and we try to trade when possible. But when health problems arise - such as during the IVF when I wasn't expecting allergic reactions to the hormones or a continuous headache requiring 8 hours in the ER to control - we don't always have a chance to switch. Also, we have nurses who are already working a relatively unsafe number of days in a row (up to 8) and aren't able to switch because they're already scheduled and we're short-staffed to start. I don't go in to a schedule planning to call-in and anticipate my call-ins decreasing a lot now that all the hormone stuff is over. No other profession has a limit of 3 sick days per year - heck, most are allowed at least 7-10 plus personal days. When you are working 5 days a week it's really unrealistic to expect only 3 sick or personal days per year. Yes, for some that's not a problem, but when you're exposed to every flu, RSV, gastroenteritis patient you have to expect some nurses to get ill.
  3. LanaBanana

    Too many absences for transfer

    Recently we have had several nurses on our med-surg floor apply for another job within the facility who have been refused an interview due to too many absences. One of those nurses was a 11p-7a charge nurse who was having health problems from her working overnights 5 nights awake and being unable to sleep and also had a parent die as well as her husband having surgery. I just applied for a different job and got a call from HR advising me that I had too many absences to be considered for an interview even though the medical director of the clinic I was applying for asked me to apply. I was told that 3 absences in a year in the maximum. THREE???? Seriously? They also counted days that I was off from a work-related injury. I had in-vitro fertilization this spring and my manager was aware that I was having it. It's not something that you can just schedule on the calendar so I had to call in, but was able to give them a few days notice as we got going with the process. I was just shocked to find out that 3 absences in a year is the max. The lady from HR told me that she might have been able to accept 4-5, but I had 8 plus 2 from a work-related injury. I asked to see a report of those absences because I know of at least 5 other nurses who have been told the same thing. She said it's a big problem with staff from our floor (general medical). Well duh. We have a higher nurse:patient ratio, patients who are sick (and probably more contagious than we know) instead of having a chole or something, and also have peds. Our nurse satisfaction rate is really low so I think that contributes to call-ins. Frustrating thing for me is that I am PRN and have been asked to work 40+ hours frequently. I spent 6 months last year working as 3-11 charge nurse until we could hire and orient a new one - and even oriented the new one! I am willing to pick up shifts when called. But that isn't even considered. So, I think I will go back to actually working PRN hours for a few months - doing my 1 day a week and 1 weekend a month. That should eliminate some of the need for calling in sick (I don't get sick as often when working less). And hopefully get back to an allowed # again. But now we're working on adoption and I'm sure things will come up with that require me to be off work. I'm just wondering what other facilities allow for absences before being allowed to transfer? Or what is considered "acceptable"? And are you usually counseled about those absences or told at the time you try to transfer????
  4. LanaBanana

    Bard Access education manual

    I took the Bard Access course for PICCs online a few months ago and saved the pdf to my computer to use as a reference. And of course, my laptop died and I now have a new one. I'm still doing insertions with supervision and would like to be able to review the pdf because I'm going several weeks in between insertions. Does anybody have the pdf they can forward to me? PM me if you do. According to the Bard website, since I've already completed the course I'd have to re-pay to access it again. Thanks!
  5. LanaBanana

    Education on CHF core measures

    I'm in charge of doing education to all our RN staff on CHF core measures to help improve our core measures ratings. I'm looking for ideas for this education. I'm probably going to use powerpoint handouts. If anybody has suggestions or examples, I'd love to see them! Thanks! Lana
  6. LanaBanana

    RN salary in Tulsa, I am confused!

    This should probably be moved to the Oklahoma forum, but I'll answer it here. I'm currently living in Stillwater but just moved from Tulsa where I was a LPN working at St John and then bridged to RN and continued to work at St John. As a LPN I was making around $13.50 and that increased to around $18.50 when I became a RN. In the hospital setting, that's a pretty standard pay rate. Not sure what you're doing that you make $20/hour, except I know that agency, nursing home, and home health pay more than hospitals. You'll probably find that most hospitals don't count your experience as a LPN towards their career ladders either, and if they do they will count as 2 to 1 (2 years LPN = 1 as RN). Sucks, huh? Sorry. But by the way, if you talk to a nursing recruiter at a hospital, they should be willing to tell you their pay rates. Just tell them you're a new grad and interested in a position - you don't have to follow through.
  7. LanaBanana

    giving, giving, giving...until I'm gone

    I've been a nurse for about 2 1/2 years now. In January of this year I started a new job after getting married and moving. At my previous job I felt like I was always giving so much of myself while at work but my manager and co-workers made it a good place to work and we tried to build each other back up. At my new job, I feel like I'm just giving of myself until I'm empty and no one else seems to care. The response I get if I'm overwhelmed with my patient load or just have an extremely time-consuming or needy patient is "Sorry." I'm the kind of person who wants to go above and beyond in my patient care, but sometimes I just reach this point where when no one else is trying to do the same, I don't either. I hate reaching the "I don't care" stage. I know this isn't all coming from my work life, it's partly from home - afterall, I did just get married and move to a new town and I'm reaching the same point at home. I feel like I'm always the one giving, planning, etc and no one is giving back to me. I guess I'm just venting and wondering if anybody else gets this way? I know that nursing is a 'giving' profession - ask any nursing student why they went into nursing and probably 90% say 'to help people.' But if we give so much - emotionally, physically, and spiritually - at work and then give more at home, what's the solution? I wish the answer was as easy as finding a new job, but we're in a small town with 1 hospital and I check for jobs every day. I start back to school in August (doing RN-BSN) and am thinking about taking a few days to myself and going somewhere. My husband has had several conferences that he's gone to this summer where he's been able to get away and de-stress, but I stayed home and worked. Maybe that's what I need? I want to go somewhere and get a massage and lay by the pool all day and drink martinis. I feel better just thinking about it! But seriously, what do you do about the constant giving until you're tank is empty when at work? We're nurses, we give, so how do you feel up your tank? If you've read through my rambling, thanks!
  8. LanaBanana

    interview next week for school nurse position! Advice?

    Thanks for everyone's replies. I'm super nervous about this, but hopeful. NEOtoKIDS - congrats on the new job! Do you happen to remember anything specifically they asked you about? I'm a good prioritizer, as that's what's required in floor nursing. I also think I specialize in calming people down when their upset (i.e. parents) and communication. I have an associates degree in psychology, so hopefully that will be a plus. I know I use psychology with patient's every day, and elementary kids are no different!
  9. I'm so excited about my interview for the elementary school nurse position next week! However, I'm a little nervous about the interview because I'm sure it will be different than when I've interviewed for other nursing positions. For one, the person interviewing me is an assitant super. She's not from a nursing background and I don't want to go off on my "nursing schpeal." Suggestions on questions that might be asked? Thanks!
  10. LanaBanana

    Edukan Microbiology session 2...anyone????/

    I would recommend it. I feel like I got everything I needed from it. Just remember that he requires 2 trips there for in-person labs. Don't know where you're from, but I drove almost 5 hours for mine I think. If you have someone locally who would cooperate with you and help you do the labs there he will allow that. My local school wouldn't allow that (they wanted my money for taking micro with them.) I don't remember how much time the class actually took me so I can't advise you on when to take it. Good luck with whatever you decide!
  11. LanaBanana

    Did anyone apply to OU's LPN-BSN program for Fall 09

    I'm in the RN-BSN program which is basically identical to the LPN-BSN except LPNs are required to take tests prior to admission and have a couple of extra class meetings during the program. It's not very competetive. I applied well before the deadline but didn't find out until December that I'd been accepted. I finally had to call them about it and they said they'd sent my acceptance letter in November but I NEVER got it. Thankfully I called when I did because the deadline to accept was that week! I would think they would have a better turnaround time for the fall semester since they have all summer but you never know! Good luck! I'm sure you'll be fine!
  12. LanaBanana

    ratio limits in Oklahoma?

    Thanks everyone. I talked to our clinical instructor and manager about this and they say it's being addressed. I would love to leave this position and find something else, but that would mean at least a 45 minute drive since this is the only hospital and we're in a small town. But I'm keeping my eyes open for other options.
  13. LanaBanana

    ratio limits in Oklahoma?

    I've been at a hospital for 4 months now and am working on a general medical floor. Like every facility, there are problems. However, there have been a lot of staffing issues that scare me. I recently had a day when I was assigned 9 patients at the start of shift, with an LPN taking the team with me. However, our facility doesn't allow LPNs to administer any medications through central lines of any kind or ports and 5 of the 9 had this type of access. She also had broken her wrist the night before and was extremely limited in being able to administer medication. They are also not allowed to do assessments, admissions or discharges. Over the course of the day, I had 5 discharges, 2 admissions from ER and an ICU transfer. 3 of my patients got blood tranfusions oredered within about 1 hour of each other and my LPN couldn't do those either. I kept asking for help and was told they couldn't do it. But we had one nurse who had been on-call all day and another that was sent home in the middle of the shift because she had discharged her whole team! The 3 transfusions were insane, along with my other patients who were all very acute (no walky-talky patients here!) I've never had such a situation where I was asking for help and refused because "you have an LPN with you" but she was barely able to function and I made this known. I was NOT safe that day, broke down twice in tears. I can't find any info about ratios in Oklahoma. Does anybody know about patient limits? I've talked to several people who say their facility has limits on the number of blood transfusions that can do at the same time while taking care of other patients. We don't have that. This is not an isolated incident, but is my most recent. I'm taking my concerns to administration but was wondering about other facilities. Sorry this is long, I've just been very upset about the working conditions and staffing lately.
  14. LanaBanana

    Bummed...I think I have MRSA

    I developed a nasty abcess last Friday and had an I&D on Saturday. The Dr was pretty sure it's MRSA but I haven't been able to find out about the culture yet. Since it was done in a clinic on saturday, their stuff doesn't get sent out until Monday afternoon. It should have been back today but nobody called me back. I was told I can work since the abcess was in the groin and to just do good hand hygiene. I've been obsessive about washing, sanitizing, bleaching all my clothes (have probably done 20 loads of laundry since then!) But today in the shower I found a small abcess on my left groin (the first was on the right.) I'm keeping an eye on it and doing heat packs. I'm taking Bactrim and using bactroban in the nares and on the wound so I started using it on the new abcess as well. I'm trying to come to grips with the fact I'm going to have to have another I&D done, probably tomorrow. I'm just not sure what to do. I know that the actually site of the infection is covered and not being exposed to anybody, but I feel like I'm spreading infection everywhere I go and I should be yelling "unclean! unclean!" And I hate the thought that I could accidentally pass this to a patient. Anybody's experiences or advice? I started crying in the shower this morning when I found the second abcess and hate the thought of continually having these!
  15. Okay, first I want to appologize that this is a totally non-nursing related question! I'm traveling to the UK, Scotland, and Ireland next month and we'll be renting a car. This may be a stupid question, but do the cars there have 12V cigarette lighters in the cars? I'm taking Enbrel and need to keep it cool and am thinking that the easiest way may be a small cooler that plugs into the cigarette lighter but I wanted to make sure it would work. TIA! Lana
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