NebbyLPN

I think you were right. I helps to have another person on the staff as a witness though for your protection. I'd run this whole situation by the DON for an opinion too. The resident may be breaking a rule, putting other staff nurses at risk and the DON needs to be aware of it.

I've only been a charge nurse in nursing homes. When I worked in a hospital there were times when we were short staffed that I was sort of a team leader and working with an RN, but she got into trouble for doing it.

I think it would depend on what your work place says you can wear.

Yes, you get paid at your full rate of pay while on orientation. The designation between "orientation" and being a regular staff member is usually one for the accounting people. When you are on orientation you are being educated to the policies and procedures of a facility.

If it's so offensive to hear people using profanity, then it shouldn't be hard for to tell them not to use it when talking to you or just turn and walk away from the conversation. Otherwise, just politely ignore it or tattle on them. That's the way freedom works. To my way of thinking, religion has nothing to do with profanity.

I would think this nurse has such a huge lawsuit she could file against the news media that even if she loses her license she won't need to worry about an income.

My LTC facility usually gives a new charge nurse 3 days with another charge nurse and one day somewhere during their first month where they go through policies and procedures, fire policy, other safety issues, etc. After that 3 days of on the unit orientation you are on your own. You have to be smart enough to ask questions when you need to know something. Most of us will check in with a new charge nurse to see how they are getting along. There's always something they need to know about if we don't take the time to tell them. There was one time when the DON hired someone who went home put on her uniform and came back a couple of hours later and just dug in and started working. She's no longer working here, but she was pretty good. I think she had been working for temporary nursing agencies, so she felt pretty comfortable doing that.

Hide when you see one of the surveyors coming your way!:roll Call in sick. We know they are in the building because in Ohio they post a notice on all the doors of the building stating that they are present and doing a survey. Tell all your aides to keep an eye out for the surveyor and to let you know right away when they see any of them around (gives you time to hide). Get rid of any pre-poured meds anywhere in your med cart. Make sure your orals are separated from any rectal meds. Do a quick check for outdated eye drops and topicals and get rid of them. No treatment medications should be in the medication cart. Today you have to do everything by the book, so sign out meds as you give them. Keep your med cart locked at all times. Same with the treatment cart. Hide the communication book that sits on the nurses station--it's illegal to have one. Make sure you can cite the steps to take in case of fire, tornado, earthquake or hurricane (depending on where you are in the country)Seriously, these surveyors were once nursing instructors or DONs themselves. They know they are intimidating and that people are scared to death of them. Just smile and be pleasant. Mostly, they want you to continue doing your job. My experience has been that they will usually tell you or ask you if they are going to or can they tag along with you. We have been told that they have agendas and specific things they are looking for and asking the nursing staffs when they come into facilities (at least here in Ohio). I was once asked if I knew where the care plans were kept. I was also asked if the surveyor could come and watch me do a dressing change on a resident. She was very nice and even discussed with us the previous treatment that had been done to get the patient's wound healed just as if she were any other nurse. One of our aides was asked what she would do if the fire alarm went off right at that moment. We also had a surveyor who went into patient rooms interviewing patients and ringing call lights to see how fast they got answered. One time a surveyor stood at the nurses station with a couple of the nurses just shooting the breeze about nursing. Most of the time they were with the DON and the medical records people going through charts and other kinds of paperwork.

i like working in ltc because i have the same patients every day. it does change, but not nearly as rapidly as the hospital. i like being able to get to know more about my patients and i can do that over days and weeks. when i know a patient's routine and the way they like to do things i feel a lot better about being able to help them. i can have their morning pills just at the time they would like them and i can do a little treatment for them before they go to their bingo game. many of these older people are forgetful and i can help them with their memory. despite what people might think, i really do spend a lot of time with my patients, but it's important quality time. i am very sad when we lose a patient. if their family can't be with them during their last moments of life, then i will be. i suppose the cons of it would be when we are short staffed. everyone has to work a little harder then. occasionally, our don hires a cna who turns out to be a real jerk, but i don't blame the don. anyone can pull the wool over someone's eyes during an interview. we just have to do what has to be done to run these bad aides out of our work place.

When you are working in LTC you are not just being a nurse who is passing meds, doing treatments and making patients comfortable. You are also a charge nurse, a supervisor. Being a charge nurse does not involve expecting others to do their work, particularly your CNAs. Your responsiblity as a charge nurse is to supervise those aides and make sure they are doing what they are supposed to and not sitting on a sofa watching a game. When your residents complain to you about your staff, you cannot pass the buck and report this during a staff meeting. You have to address it right then and there when it happens and take care of the problem. These are not the kinds of problems to bring up at staff meetings. Talking about it at a staff meeting only makes the CNAs angry at you and makes the DON think poorly of you as a charge nurse and supervisor. Not only that, but discussing someone's bad behavior in front of a group of their peers is a violation of their right to privacy. I would have told the aides that they were not to be watching TV while there were lights and rounds to be made. I would have gone back 15 minutes later and if they were still there I would have shut the TV off and told them to get back to work, there were lights to be answered, etc. When a patient complains to me that a CNA has yelled at them, I take that CNA aside as soon as I see them next. Out of the earshot of the others I tell them what the patient said and give them a chance to explain themself. Then, I tell them that if I ever hear of them yelling at a patient again, or a patient complains to me about it again that I am officially writing them up and reporting it to the DON. If you don't know how to discipline or how far you can go with discipline with the CNAs then you should discuss this with the DON or that lazy RN you work with. I would get a disposable camera and take a couple pictures of this sleeping beauty RN. I'd wake him up and tell him I need him to help with a med pass or treatments. A skilled unit is extremely busy and his help is necessary. If he gives me a hard time, I'd tell him right to his face that I was going to report him to the DON. He's going to have a pretty hard time explaining why he's sleeping on the job. If I have to eventually write him up, one of the pictures would be included with the write up. You are in a real pickle here because you have permitted the CNAs to walk all over you. It's going to take a lot of time and effort on your part to get your CNA crew back in shape. If you don't exert your authority as their charge nurse it is never going to get better and no matter where you go to work you will have these kinds of problems. All that aside, I'd be very suspicious of a place that couldn't get their paychecks out on time. That is usually a number one priority of most employers because the labor board comes down on them hard if they don't pay their help like they are supposed to.

That is the exact same thing I was taught in school. My instructors really stressed getting the needle in quickly like a dart. It works!

my sister clep'd her way through a lot of her pre-requisite classes. she says that the instructions for each clep are right on. there should also be some way to access sample problems to get an idea of what they will be like. she's never done a math one, but if the instructions say no calculators and they are supplying an on line one, then that's what you will use. i believe there's one or two math websites that have on line calculators. if i recall, they appear on the screen exactly like any calculator and you just run your pointer over the specific buttons and click on them as if you were using your finger. here's one i found with a quite search for a virtual calculator. maybe you can practice on it a little before your test. http://www.arachnoid.com/lutusp/calculator.html aren't there a number of different formulas that are used to work out problems in calculus? it's probably a knowledge of those that is going to be what they are testing you on.

If this were about 50 years ago and your son was my brother, my mother would have hauled off and socked him a good one and told him to get out of the house. However, we can't do that kind of stuff these days. What a terribly, nasty thing for a son to say to his mother. What got under his saddle? He sounds like a very disagreeable person. Is he a drinker or taking drugs himself? This is just the kind of argumentative thing an alcoholic would say to someone to get a rise out of them. (I'm sorry I don't mean to insult your son, but I was thinking about an abnoxious cousin of mine who is an alcoholic and says stuff like this around people all the time. It's amazing someone hasn't beaten the crap out of him.) Just ignore him. He doesn't know what he's talking about. Your daughter is right. You won't be turned down from nursing school for the medication you are taking.

The family of a patient in a nursing home gave me a check made out to me for $50 just after he died. He had been quite ill with cancer toward the end. Told me it was to thank me for being so wonderful to him as his nurse. The son who did this was a doctor as well! I told him thank you, but I was going to pass it on to the administrator to put into a fund for some staff educational equipment the facility wanted. The administrator wrote a letter to the son thanking him for the gift and told him how it was going to be used. Gifts of food get put in the nurses lounge or at the desk for everyone to share.

I think that depending how large the company you are going to work for this is happening in some places. The larger the corporation running the hospital the more likely this will happen. Also, I've heard that certain states seem to be kind of gung ho for this. Are you sure the paperwork didn't say they "might" do the checks? I know that where lawsuits, back-owed taxes, bankruptcies, and poor credit histories are concerned, some corporations don't want employees on their payroll involved with those because it puts a big drain on their payroll departments and places them between the courts and the employee. As far as workman's comp histories are concerned, they are looking for people who have cheated the system or have had a history of complaining about specific types of injuries in order to get paid off. It causes an increase in the corporations insurance premiums to the insurance company handing their workman's comp claims. There are a number of investigative companies that have set up business just to provide these background checks for employers. If you haven't had any of these happen to you, you're in the clear. A company can hire anyone they want. Overall, these checks will also show if anyone has lied on their application which is usually a deal breaker when it comes to getting hired. Just how large was the hospital you applied to?