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TheDudeWithTheBigDog ADN, RN

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TheDudeWithTheBigDog's Latest Activity

  1. TheDudeWithTheBigDog

    How can I be a better nursing professor?

    The thing that always makes the biggest difference for me in school is the attitude of the teacher. Don't be one of the ones that your students are expected to pretty much self-teach while you just do a general review. Make sure your lectures are planned out to actually fit presenting the foundation of the information. Give examples when you can. Definitely try to tie the physiology into past things they've learned, and especially tie the treatments back to the fundamentals. The key takeaway is make sure that you spend your job as a teacher actually teaching. As long as you do that, you'll be fine.
  2. TheDudeWithTheBigDog

    Do EHRs Push Nurses to Lie?

    Basically, EHR's don't push nurses to lie, management's obsession with productivity > patient care push nurses to lie.
  3. TheDudeWithTheBigDog

    The Staff RN’s Role in Nursing Homes

    Usually not, because in most cases where LPNs are allowed to be in supervisor roles, they're still working under the supervision of a manager / director either in the building or on-call who is an RN. Because of that, in a lot, probably most states, an LPN can be in charge of an RN. Where the delegation issue is going to come up is when you're working with an LPN on your assignment. If you have one hall and the LPN has a different hall, the expectation is typically only what's realistically reasonable. You're not in charge of that shift, so you have no reason to be looking through patients on the other assignment to see who has an IV, but if you know from the night before that a patient has an IV, you should be volunteering to hang the IV or just take the patient.
  4. TheDudeWithTheBigDog

    Long term care medical director is a jerk!

    First bring this whole issue up with the administrator. Then, make sure your nurses know that if that ever happens again, that he calls back after the call is over and he gave instructions already just to yell at them again for calling him during dinner, have them put him on hold and just never pick back up. If it's ever the first call when they have to notify him to get an order of how he wants it handled, tell them to just let him yell, and when he's done, just calmly ask him about any orders he wants to put in, acting like his little tantrum never happened. If he doesn't give an actual order, put it in the note, that he was notified, and no new orders were given. DO NOT put in any order that wasn't specifically ordered by him. Then call the administrator, and complain about calling him with a patient care issue and he refused to address it. The next time it happens after that, report him to the state for refusing care to his patient that he was responsible for.
  5. TheDudeWithTheBigDog

    Why do RN's avoid LTC positions?

    So then you get revenge, you go public about the conditions you had to work under. Get a story out to the local news. Make the residents' families know about their mother having to lay in her own diarrhea because the only nurse was busy with 58 other patients and the CNA assigned to that room was busy with the call bells going off on his 29 other rooms assigned to him. Actually, do that anyway. Make the public know what their families are dealing with in these facilities. Make Medicare and the insurance companies know that they're basically paying for fraud, that all those RN hours that are reported to them are secretaries and office workers that do not require a nursing license. The reason that a job would hire and train an entire staff at another facility and then replace their entire staff is because there aren't any consequences. And that's because of us. We allow our facilities to hide behind this illusion of an extensive amount of nursing care between the RNs and LPNs. We let them report the staff educator who handles new hire orientations as patient care hours. Me and a lot of other guys, let them make us do the heavy lifting, and the moving beds because we're men so we're stronger, that even if we're the strongest person in the facility, it's still technically sexual harassment since all the women are supposed to be held to the same expectation. And with COVID, how many of our facilities are we watching expose non-covid-unit staff to the COVID unit, and then return to their long term floor, or work on the COVID unit, get exposed, and then work in long term the next day, becoming a ticking timebomb of exposing 30-60 residents. But you know who doesn't know about this? All the people thinking about sending their parents there. All the insurance companies and state agencies that have to cover the costs to the workers when they end up testing positive. All it takes is one anonymous tip sent to a local news station.....
  6. TheDudeWithTheBigDog

    Why do RN's avoid LTC positions?

    The issue is that it doesn't solve the underlying problem. If it's not her it's another nurse who's going to replace her. Until we put an end to this, it's going to be an endless cycle.
  7. TheDudeWithTheBigDog

    Why do RN's avoid LTC positions?

    Nobody should have to look into what they don't want to do. What DESPERATELY needs to happen is that all of us, as an entire industry, stand up and make it clear that we are not OK with this. WE let this happen
  8. TheDudeWithTheBigDog

    A Staffing Perfect Storm

    All the time that these hospitals and nursing homes have been intentionally working with a bare minimum staff... Who could have ever predicted that it would become a mess like this if a major outbreak ever happened? Oh, right, everyone who actually has common sense unlike the majority of hospital and nursing home administration in this country.
  9. TheDudeWithTheBigDog

    Staffing and covid

    Let me guess, 30:1 patient ratio and now you're extremely short staffed when someone is forced to take time off? My idea: learn from this. Make sure you have staff. Fight to make sure that your facility will actually hire nurses.
  10. TheDudeWithTheBigDog

    Memory care-Can you pass meds in the dining room?

    Meanwhile, for most of the patients in these places, they're not getting assessed, their treatments aren't actually getting done, just signed off that they are. The 20-30 patient / nurse ratio forced on everyone should be crime... But hey, at least they're not getting their meds at the table in front of other residents who are also getting their meds.
  11. TheDudeWithTheBigDog

    How long is a typical LTC orientation?

    If you're an RN, when #@$%@#$!@ hits the fan, ALL OF THAT was your responsibility, that shift and every shift. The fluff is your job and your responsiblity. There is no such thing as a "med nurse" when it comes to who the blame gets dropped on. The treatment didn't get done by the treatment and now that patient has an infection? Are you saying that he wasn't your patient that you were responsible for?
  12. TheDudeWithTheBigDog

    My Experience as an Non-political White Male in Nursing / NP School

    There seems to be a massive confusion on what socialism and communism are in the US. To explain: capitalism the internet is privately owned Socialism - we all own equal shares of the internet Communism - the government controls and regulates the internet. The government regulated the research into developing it. The government regulated the funding to the research. The government contracted the people who did the work developing it. The internet was created by communist principles, and still exists on those principles.
  13. TheDudeWithTheBigDog

    Why do RN's avoid LTC positions?

    Trust us, if there were available jobs in our area, you can be really sure that we would not be working in LTC. Unless we do want to be in a management role, 0 of us are OK with the risk we have to take to our license and career to clock in at these places. And the sad part is there's subacute units in these places that would give us the medsurg experience, if we were staffed right. But unfortunately, with 30 patients, you're a glorified pill dispenser and nothing more. You are not a nurse in a LTC / subacute facility. You're just a title for compliance with the state laws. We'd rather be in a hospital and work as the actual nurse that we spent all that time and money to become, while not having to fear that we're going to lose our license or have it suspended before we can move on to a real nursing job, but unfortunately life isn't that perfect and some of us are stuck with this because our landlord doesn't care what we think about our job, it's either pay the rent that we need this job to cover or be homeless and die on the street.
  14. TheDudeWithTheBigDog

    No hands on skill labs?

    The instructors, and that's actually VERY common in schools that aren't directly associated with the hospital. Yeah, I got to use some skills, but 99% of the actual stuff I did, was at a CNA level. Talk to nursing students. You're going to see that it's extremely common in med surg clinicals.
  15. If they're not sick enough for the hospital, but still need a nurse, and have nowhere else to go, it's kind of our job to take them back. I don't know when nursing homes started becoming confused with retirement homes, but there's are key differences between the two, mainly the existence of nursing care. True, it sucks for the other residents, but unfortunately, pandemics aren't supposed to be convenient.
  16. TheDudeWithTheBigDog

    I Got The Call! Now What?!

    As someone that hires for a company I help run, I couldn't disagree with this more. The interview is a sales meeting. I read an advertisement for a person selling a service. In my current case, someone selling their marketing skills. In context of this thread, someone selling their service as a nurse. I reached out, and scheduled an interview. That's our time to question each other, and sell ourselves to each other to reach an agreement for employment. Part of my job is knowing what the pay range is, knowing what benefits there are, knowing the perks. I am the one that's selling this job to the applicant, not HR. If I am not ready with that information, it says A LOT about my company. And what do I see from an applicant that asks me about pay, benefits, and raises? Someone planning on working for me long-term, because those details actually matter to that person. When pay doesn't come up, I see that as the person more likely to only use me as a temporary job until they move on. Every single thing in life that we pay for, the cost is a part of it. Why is this applicant not bringing up what we're going to be paying him to work here? I don't know about you, but I am 100% positive that people work to make money. That SHOULD be a major issue. And then, ask the hard questions. What are the most common complaints that nurses have? What is the retention rate of new hires over the last year? A job interview is an interview for your livlihood. Don't be afraid to ask. There's nothing wrong with caring about where you're going to accept a job.