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TwoLayi

TwoLayi ADN, RN

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TwoLayi's Latest Activity

  1. TwoLayi

    Death and Denial. Need Advice

    I am looking for advice on how to respond to a patient who is in denial about their terminal illness. Patient is in an acute care setting and prognosis gives the patient about two weeks to live. MD has communicated all this to the patient and family. Patient has chosen NOT to go on hospice or change code status to DNR. And yes social services has been involved to discuss all this with the patient and family. The problem I am having as a nurse is responding to the patient when they talk about the future and getting better. I know denial is a stage in death and dying, so do I just play along with this fantasy? Usually, when this patient talks about the future, I just smile and nod. I feel like I am almost lying to the patient, but I don’t want to be cruel either. Any advice on what I might say to the patient to help them be more accepting?
  2. TwoLayi

    Cant find work while on probation in Ca

    Oh, I didn't realize that, but it makes sense. I have never been on it myself, but have worked with other coworkers who were.
  3. TwoLayi

    Cant find work while on probation in Ca

    I would look into SNF positions again, specifically MDS positions, which doesn't involve patient care or handling of medications. Also in the bay area, there are home health agencies-not through the hospital system, that have positions that are called "pediatric home health" or "school nurse". It is 1:1 respite care in the home or 1:1 nursing at school. It seems most of these agencies are desperate for nurses because they pay VERY little (for CA) due to federal reimbursement.
  4. TwoLayi

    Nurse vs respiratory

    I did not mean legal as in breaking the law. But say a nurse administers medication and fails to document it right before her lunch break. The relief nurse comes, sees a medication is due, so he administers it and documents administration in the EMAR. And the patient dies from it. Who do you think will be charged with negligence?
  5. TwoLayi

    Nurse vs respiratory

    I don't believe you did anything wrong, RT should have documented the administration of the neb treatment. I see a lot of responses saying that a lot of RT's don't document on time or wait until the end of their shift. This still doesn't make it right or legal! The scope of practice for RN's and RT's are very similar and the responsibility for the patient ultimately falls on the RN. Meaning if you were ever taken to court, saying that RT wasn't available WOULD NOT be a valid defense.
  6. TwoLayi

    Is disclosing a mental health record that awful of a thing to do?

    Nurses can be prescribed controlled medications and a medical review officer does review positive drug tests. Being prescribed a controlled medication does not prevent a person from becoming a nurse or getting a job. I think the real issue is why this nurse was being drug tested in the first place. Did the OP's employer suspect they were working on the job impaired? If the OP was displaying odd behavior or made an error, the employer might have ordered a drug test and reported the findings to the BON. If so, the BON may make the decision that the medication and/or mental health issues pose a danger to patient safety. If it were a pre-employment or random drug test, I don't believe the employer would be reporting this information to the BON, but I could be wrong.
  7. TwoLayi

    Preceptor is SO BAD!

    Playing the Devil's Advocate... Hi All, ICU nurse here with several years of experience. Recently I have been precepting a new grad to our unit. I let her observe at first because I don't really know how much she learned in school and what she feels comfortable with. But I am starting to get worried because she has taken no initiative. She just follows me around, asks zero questions, looks distressed when I do explain things to her and has failed to even introduce herself to our coworkers. And then when I gave her permission do very basic nursing stuff, she went to the bathroom and cried.
  8. TwoLayi

    New To This Area of Specialty

    I once did in home care for a child who had petit mal seizures. In that case, there wasn't alot I did as a nurse, except record and document the time it started and stopped. With the child, they had a particular "tell" that indicated it was occurring, not sure if that happens with everyone. Also keep in mind safety and any meds they are taking for it. In addition, CHADD is an organization that can provide you more info about ADHD. And I would just review normal milestones, because these are healthy children Also keep in mind emotional/psych issues which I think will be most important will this particular population.
  9. TwoLayi

    DON on cart

    I realize this is an old topic but I felt I needed to add my two cents I was a RN floor nurse at an SNF and I really admire all the DON's who said they work the cart. I am not saying it should happen on the regular, but it shows real teamwork. In fact, I just quit my recent job because I was constantly mandated to stay overtime and some weeks I was forced to work 72 hrs, or lose my job. I was stressed, burned out and very unhappy. I could never make plans after work and constantly had to cancel appointments And it really pissed me off when our DON, would come in at 9 am and leave at 4 pm, when I had been there since 7 am and would probably be staying until 9 pm. If my DON had taken the med cart, even if for a few hours, I would've seen her in a different light. I would have felt we were in it together. But she didn't, that is why I am leaving and the other RN's have left. And this facility will lose a star(s)
  10. TwoLayi

    Relocating to California

    I would say this is not very possible....if you have your heart set on acute care and pediatrics. Nowadays, most new graduates get jobs in hospitals via a new grad program, and it is at hospitals they did clinical/preceptorship while in nursing school. And the hospitals in my area DO NOT accept new graduates into specialties like labor/delivery, peds, ICU, OR, ER. You first have to work in med/surg, ortho, neuro for a year and then transfer over or apply for a training program. Southern California has more facilities, but also more competition and lower pay. However, I do see a lot of jobs for a pediatric home health nurse and they train new graduates. However the pay is extremely low, I mean extremely. People in Starbucks probably make more. In my area, they start out at $18/hr, but considering new graduates in a hospital start at $50+, this is nothing. If I were you, I would stay put, gain experience and then come to California. After you have the experience, particularly in a specialty, many hospitals will pay a bonus and sometimes even relocation benefits. Good Luck
  11. TwoLayi

    Frustrated trying to get a hospital job!

    If it were me, I would jump at the chance for a hospital job. I also live in the Pacific Northwest, but I graduated with my ADN in 2015. I am currently working on my BSN and I currently work in a SNF and it does not count as acute-care experience, that the hospitals require. I have applied to over 100 hospital positions, some as far as 2 hours away, without any luck. I not sure if my SNF experience has hurt my chances at a hospital job, but it sure has not helped. I would definitely take this opportunity because it might not come around again.
  12. TwoLayi

    LPN supervising RN?

    I am a RN and work in a SNF, in my facility we usually have an even mix of LPN/RN staff nurses. We have a DON that is a RN, BUT all of the supervisors/managers are LPNs with many years of experience. These supervisors are in charge of admissions/discharges, nursing assignments and patient care issues that come up, especially when the DON is not in the building. I am wondering if this is legal? The NPA for my state says that LPNs work under the direct supervision of RNs, and it goes on to say that RNs have the assumed role of supervisor even if it isn't in their official job title. So I was wondering if I could be held liable if I were the only RN in the building and something happened? Could I get in trouble for inappropriate delegation, even though I am not the one making those decisions.
  13. TwoLayi

    Laundry Bins

    The two faclities I have worked at we have had individual bins on wheels, that were stored together. It could be infection control because people might accidentally put garbage in the laundry. That would happen all the time at my last facility because the laundry bin and trash bin looked almost identical.
  14. After submitting my resume to a company I really want to work for I got an email from a recruiter. We set up a time to talk on the phone. Everything went really well, she asked me a few questions about my background, experience and why I wanted to work for the company. She explained the hiring process and the next steps would be a phone interview with the hiring manager and if that went well an in person interview. So we set up a time for the phone interview and I got an automatic email confirmation. On the day of the phone interview, I got all prepared with my resume and notes in front of me and waited and waited and waited some more. I rechecked my email to make sure I got the date/time correct. After about 45 mins of waiting I sent the recuiter a friendly email asking if the date/time was correct because I hadn't received a call. She responded right away saying she would find out what was happening. About 30 mins later I got a call from the recruiter, she apologized and explained that the hiring manager had a work emergency and it was "totally not like her". I expressed my understanding and we set up an phone interview for the next day (today) and I received another automatic email confirmation. So the same thing happened AGAIN today. She never called. I haven't sent the recruiter an email yet, because I don't really know what to say. I don't have a way to contact the hiring manager because all communication and scheduling has been through the recuiter. I do want to work for this company, but I feel like something else might be going on, like maybe the hiring manager doesn't think I am qualified or already has someone else in mind they want to hire. I don't want to keep wasting my time if the hiring manager isn't interested. So how do I express this in a professional email to the Recuiter? I am hoping there was some mistake, but it just seems odd two days in a row they flake on me. Any advice would be greatly appreciated.
  15. TwoLayi

    Change in condition during report (sort of)

    I think you are approaching it the right way. Is this a new nurse that doesn't know any better or one that is just taking advantage of you? Some nurses will dump stuff on you if you consistently allow them to. It sounds like you are ready to break this pattern. When she gives you a report about a cough, low O2 etc ask her WHAT SHE DID ABOUT IT. If she tries to brush it off as nothing. Ask for more information, such as VS, assessments, interventions she did, if she notified MD etc. Then when she says she hasnt you can say "Well you will take care of that before you leave." If she refuses or asks you to do it, tell her it happened on her shift and it's her responsibility to follow-up and you don't have time because XYZ. Just ignore her huffing and puffing about how she doesn't have time for things...it doesn't sound it is directed towards you anyway, more like her venting out loud. If you stand your ground she will learn to take care of things before you come on shift. If this behavior continues you might need to talk to a supervisor about it.
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