Snowchild

Good afternoon, I have posted here and there, and have received good support from my fellow nurses. I have something new that's bothering me, and I am hoping by putting it in writing and asking for advice, I can get past this. I have worked 3 years in my current role as an intake nurse/marketing specialist for a managed Medicaid long-term program for the elderly. I have successfully brought in many new participants in this time and I have a wonderful, supportive supervisor, plus the few other team-mates in this position (intake/marketing is a very small department) are as well. I consider myself lucky in this regard. A few days ago, however, my manager got a complaining email from the director of site operations for one of the elderly centers. Background: Crunch week for getting new participants enrolled for the following month is the immediate week leading up to the deadline of noon on the 20th, when everything has to be submitted to the county. It can be a busy, stressful time for everyone, but somehow we all pull together to make it happen. One of my jobs is to present my participant on a Microsoft Teams intake and assessment meeting, where the participant's needs are discussed and an initial care plan is developed. I have never heard negative feedback from anyone in all of this time. There were two participants who for one reason or another, were particularly challenging in figuring out a few specifics for their needs. However, we were able to collaborate and it worked out. My manager was in on the Zoom meeting and said I did a good job (she always compliments me). But right after the meeting, an email came in from this director of site operations complaining about me, saying in her email that she didn't feel like I was prepared on the meetings and I didn't know my people well. My manager let me know that she has worked with this person for many years, and doesn't have much regard for her personally, although she is good in her role. She says not to pay attention to this and to know that she thinks the world of me and that I am doing great. I am trying to get past this, but it really stings. I am always aware of things I can do to improve myself and unfortunately sometimes participants are not forthcoming with me, so I am presenting their cases with the best and honest assessment of what I see are their needs, but still. Has anyone had other departments send emails like this to your manager, and how did you respond (if at all)? I feel like it's a really **itty thing to do.

Hello, I have a question for those of you who specialize in neurology and neurosurgery. My 82 year old mother, who had taken a fall this Monday and seen in the ER, was admitted to the hospital and now that all of the tests/scans have been run and analyzed, the neurosurgeon updated me this morning that she has what they first suspected in the ER, a Meningioma, but unfortunately it's a big, nasty aggressive one that covers pretty much the entire frontal lobe of her brain. There are really only two options, and they are bad or worse. The bad is proceeding with surgery to remove the tumor, which they feel confident they can do because of the location, but at best it is iffy and despite of course wishing for the best possible outcome for quality of life, there are the definite risks of infection, bleeding, and left-side weakness (her dominant side is the left). Worse is doing nothing and following the natural progression of end of life. I am devastated to hear this. I had suspected for some time that there was something wrong with my mom, but she absolutely refused to have any testing done. I never would have suspected this. Now my 3 siblings and I are meeting tomorrow by Zoom to discuss everything. I am so conflicted. (Just for more information, I am the HCP and POA). She has told me over and over in the past that she NEVER wants to be in a facility and I am afraid if we proceed with the surgery that this could happen. Also, for more background, I asked the neurosurgeon if my mother has decision-making capabilities, and he let me know he does not think so based on her presentation. I don't know what to do : (

Hello, I'm not sure where else to post this question, but figured general nursing support might be appropriate. A nurse posted a comment on the Facebook group "Nurses with Cards" that she earns a good income from a side hustle. When I (and many others) asked for more information, she shared that she works as an independent life insurance broker. I have looked, and looked, to find out more information on this. The agency is an independent FinTech marketing agency called "The Chosen Agency" based out of Houston, Texas. The only things I came up with investigating the agency is warnings about pyramid schemes, MLM's, etc. Does anyone know of this agency, or have any experience with ladling life insurance as a side hustle?

Fellow nurses, I want to stipulate that I'm not asking for possibilities of diagnoses, just a daughter almost at the end of her rope. Please bear with me as I launch my story: I live with my 80 year old mother. Over the past two years, I have seen very subtle changes with her. As more of a background, just prior to the pandemic, my father who had suffered a stroke two years before that, passed away. I also lost my job of 15 years 4 days before he died. These past 4 years since he had his stroke and subsequently needed long term care in a SNF, have been some of the most challenging and difficult times my family has ever been through. I have siblings, but they have their own lives. I made the choice many years ago to be live with both parents and be a support to them. I sometimes wonder if I'm going crazy, or if my mother is showing signs of dementia. She is fully independent with pretty much everything, including driving and managing her finances and really no memory loss issues what I think are typical of dementia. She sometimes needs help opening up jars or carrying laundry up and down the stairs, but that's about it.She tends to fixate on various topics, and will repeat stories over and over, but she knows she does this. What's wrong is this: She will send odd text messages throughout the day, to me at work, or my siblings, and she seems to love to create tension with her family, "picking" fights, eventually upsetting each of us, then she turns it around and says we're the problem. You can't ever argue with her, but even if you yes her to no end, that backfires as well and she will think something is wrong with that. I am generally the target of her lashing out. It comes out of nowhere, she can be absolutely fine one minute, then the next she is in a rage. It is absolutely unnerving. The latest example is the other night, over a group chat that my sister started, and for some reason she wasn't getting the texts on her phone. I tried to calmly point out that her name was includes, to which she screamed at me to shut up, that I was acting hyper ever since I got home from work(I wasn't), and something was wrong with me. I realize this reaction may stem from her realizing that she is losing some of her mental faculties and this scares her, she really wasn't lashing out at me per se, but I couldn't help in that moment to yell back. I told her she was acting off the wall, that I was going upstairs for the rest of the night, and not to bother me. I went into my bedroom and closed the door. I broke down in tears, I was shaking and feeling so unsettled. I still don't know if it's dementia, though, because her personality hasn't really changed over the years, I have always known her to be suspicious of others, pessimistic, and tendencies to fly off the handle. But there is something about the whole thing that makes me wonder if it is the start of dementia. There is nothing that stands out and tells me, yes, that definitely sounds like dementia. All of my siblings know there is something off, and with the exception of my younger sister, who has 4 small children and works full-time, my other two siblings generally choose to stay away and avoid her. This creates a vicious cycle, where she thinks her other children have abandoned her and she will complain about this to no end. I once tried to encourage her to get a full workup, careful to tell her I didn't think anything was wrong but I was concerned about her, She wouldn't hear of it. I'm reaching out to see if there is anything I can do. I feel so alone right now. : (

Davey Do-“immediate jeopardy”

I was new to home care and just out of orientation. I was driving to my second patient of the day and listening to the local radio news station. They were reporting on the first plane hitting the tower, and my first thought was “an accident.” Then I heard them saying a plane hit the second tower. I remember thinking at the at that time this was a terrorist attack. When I arrived at my patient’s home, he had his TV on and that’s when I saw the smoke and fire coming from the towers. Throughout the visit, I saw both towers collapse in real time. The rest of the day was an unreal blur. A page(I carried a pager at the time) meant for someone at a different agency came over, directing their staff to stay at the clinic for now. I called my family to make sure they were okay, especially my sister who lived in Baltimore, as she was close to D.C. My friend and I had made plans to go out to eat that night to celebrate my birthday, which was 9/6. We went to Tully’s, which has several TV sets. The entire restaurant went silent when the President came on the air to deliver his address from the Oval Office. That night, I got home, threw up, and had nightmares of burning buildings and dying people. ? I can’t believe it’s been 20 years, it really feels like it was yesterday.

Hi everyone, Well, my career has taken some strange twists and turns in the last two years. Quick backstory: I’m an R.N. I worked acute care at the bedside for 8 years in Med/surg, 20 years in Homecare as a case manager(6 years with the same company as a care manager for the MLTC department-managed Medicaid). I tried the nursing home surveyor/complaint investigator position for the state health department for the last year, but my gut instinct told me it wasn’t the right fit for me. I resigned just recently, and now I’m starting a new job in the utilization review department, back in the hospital setting. I am excited, but nervous. Any experienced your nurses have tips/tricks to make the transition easier?

Hi, I don't see this anywhere on the community wide site, so I am posing a question to those of you like me who have "gone to the dark side." As a (not so new but still have a great deal to learn) nursing home state surveyor, do any of you experienced surveyors have tips you've learned along the way that can help me in my journey? I am trying to feel confident each time and put on my brave face each time I go out to a survey, but to be honest I'm still pretty terrified.

Hi, I have been an active member for several years and have posted on here a few times. I am here again because I need to talk. Last week, to this day, I was laid off from my job of 15 years. (Part of a mass lay-off, not anything I did). I was completely blindsided by this and although I am taking steps forward, I am still in shock and processing it. I was a RN care manager for the managed Medicaid long term care insurance division for 5 years, and the ten years prior to that, with the same company, but with the CHHA. Three days later, my father passed away. Although this was expected, it does not take away from my grief. I am trying to stay strong but I am so overwhelmed ?. Any words of advice?

This is literally what happened to me this morning. I work in home care, and had a patient who was in palliative care in a nursing home, and the family called to let me know the patient had passed during the night. This is a patient I had for 3 1/2 years. I find that you can never go wrong with saying” I’m so sorry “.

Hi, I am an RN, and have worked in home health for 18 years and I have never had an incident like this. Has anyone had something like this happen? Here is the story: A few days ago, I stopped at a fast food restaurant to use the bathroom. I got in, did my thing, and left right after. Not more than two hours later, I got a call from my supervisor letting me know of a very bizarre complaint. He told me that someone had called to complain that a woman was yelling at a man with a walking stick in the parking lot, and both got in my car and left. The person who called claimed to work with the traumatic brain injury waiver program and even gave a full name. She took a picture of my car and forwarded it to my company. I was absolutely flabbergasted, to say the least. Not only do I not have a patient with a walking stick, there is NO earthly way I would ever take a patient out in my car, anywhere. The only passengers I ever have in the car are my family(we are allowed to use the company car for personal use) or a trainee. What's really odd is that the picture showed only my car-no yelling people anywhere nearby. The description she gave of the yelling woman was totally off, too. At first I thought maybe she saw these people in the parking lot and it looked like they were heading towards my car, but after thinking about it some more I'm becoming more convinced that the whole thing was made up by someone who had a grudge against our company, saw their car in the parking lot, and saw an opportunity to get back at us. Bottom line is, my supervisor is thinking like I do, and nothing is going to happen, but the fact that I had to even take time out of my day to even talk about this was just really ticking me off big time. How do you protect yourself against these kind of things? Do you have to start recording yourself, wearing a body camera, etc? ?, just being paranoid, I know, but it irked me to no end! I mean, I just had to use the bathroom, for crying out loud!

Hi, I don't have a lot of experience in OB/GYN nursing, other than my clinical in nursing school, and I have a question for my fellow nurses in this specialty. My sister is 8 weeks pregnant with her fourth child. She is 37 years old. Last December she had bronchitis, and she went to see her physician because she thought she was coughing up blood. Obviously her doctor wanted her to go for an MRI to rule out a blood clot, and a very small blood clot was found in the periphery of her lungs. After she was heparinized and her PT/INR was therapeutic, she was discharged on Eliquis for 3 months. She was seen by hematology and screening done showed no risk for blood clots otherwise. They think she developed the clot from her birth control pill, but this was speculation. However, she went off the pill as a precaution and since then she has been fine. When she went to see her OB/GYN yesterday for her first appointment and ultrasound, they discussed her options. Her OB/GYN wants her to start with daily low molecular Lovenox and towards her final weeks be induced. My question is, is this the appropriate protocol? I'm really thinking it is, but she is very worried and thinks that it is overkill.

I was with a patient familiar to our homecare agency, doing her admission. Two hours in and I still hadn't done any assessments as the patient and her friend spent the whole time either complaining about the discharge process, getting the patient set up for lunch, or talking to each other in general basically ignoring me.When I finally got around to taking her BP, the friend turned to me out of nowhere and said, "You girls have no compassion! You don't understand, SHE is the focus, YOU are just overhead!" She asked if I had ever had surgery, which I have(3 times). She then snorted, "What, to have your tonsils out?". I had to step out of the room for a few minutes because she had me in tears. I managed to finish for the day and did the patient a favor by dropping her prescriptions off at the pharmacy at the end of the visit. I was willing to overlook the mean comments to follow up with my patient the next day(but before seeing her did her yet another favor and picked up the patient's medications from the pharmacy-even though they were to be delivered in 2 hours). It was then the weekend, and I planned to see the patient again on Monday. However-I checked my voicemail early that morning and found one from the weekend nurse manager who had tried to reach me on Saturday. The patient apparently was missing her Ambien(none of her prescriptions were for Ambien) and was throwing around accusations that I had stolen it. I was totally freaking out! I went straight to my manager and emphatically told her I was not going back. My manager was completely on my side since I'm well-established with the agency and am known for being highly ethical. She called the patient later on and read her the riot act. The ironic thing was, the patient couldn't understand why I wouldn't go back! Just goes to prove that no good deed ever goes unpunished...