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I had to explain what the affordable care act was to my co-corkers. Like, no one really even knew about pre-existing condition coverage and were barely aware of the mandate. It was kind of depressing.
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Nov 10, 2012 07:14
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I'm an RN in North Carolina. It looks like roboshit is going to have the CNA duties covered. I can say that while the book stuff is easy to learn, there are clinical requirements for the CNA license that I really doubt you could get satisfied on your own.
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Dec 22, 2012 05:26
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UnhealthyJoe posted:Hrm. I thought I could suffer through a long period of time again. What is killing me is knowing a weekend only overnights in the ED else where pays so so much better but this program as you said is suppose to help retention and being generally a better nurse. Bah. If it's any consolation at my hospital you wouldn't be allowed to work that shift regardless. New nurse are terrible. The new grad programs are supposed to give you some time to improve your skills in a controlled environment and get up to date with what policy is at your hospital. Mine was a mix of totally useless classes that might as well have been in nursing school but taught worse, sim labs that were useful, and awesome classes taught by people with certs that were usually awesome and informative. The real advantage was the preceptorship, I would have drowned and probably caused some major medical errors without it. We're a teaching hospital/ level 1 trauma center in an outlying area of NC though, results may vary depending on staffing and the education program at your place. In other news, I'm being oriented to Charge at a year and a half to help cover holes in the schedule. I'm a right sick oval office and the manager seems to think so too but it's pretty weird. I kind of like getting detailed knowledge of my patients and charge has me watching the whole floor. Going to take some getting used to. awkward_turtle fucked around with this message at 05:14 on Feb 19, 2013 |
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Feb 19, 2013 05:11
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BadSamaritan posted:The waste tube, especially for Chem/BMPs, CBCs, and coags is mainly to make sure the blood is fresh and undiluted. It essentially makes sure that the results accurately portray the patient's blood and helps prevent contamination from anything that may have been put through the line. Heparin, excess saline, glucose, EDTA, and old rbcs/factors can all effect tests. Coag and chem panels are usually the most affected and can get pretty crazy real fast. That makes sense for drawing from lines. At my institution it's standard to draw another of our blue top (liquid heparin) tubes for coags if you're drawing through a needlestick. I was told by a lab tech once it was because the dead space in our butterfly tubing was enough to mess with the results since coags are so precise. I've never tried emperically testing to see if this was true or not. Has anyone in this thread ever done home health or home infusion therapy? I've got a possible side gig lined up to do a few hours a week in my city and the surrounding area. One of the pharmacies does home infusion set ups and their nurse was talking to me about needing a hand. It would mostly be more complicated drugs that some of their nurses don't feel comfortable with/ haven't seen in a while; Things like home inotropes and IV Ig. I've been a nurse for 3 years now in general med surg and step down and I'm fairly competent on my own (pretty regularly complimented by providers for knowing my material and being a step ahead in catching problem. Constantly stop interns from killing my patients.) It's a fairly rural southern town so I'm probably going to be going into some straight poo poo but I'm considering the offer.
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Feb 22, 2014 05:09
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Madame Psychosis posted:You got this djfooboo, just take it easy and always run your answers back through the problem. I was nearly kicked out of nursing school for tearing my ACL, MCL, and lateral meniscus in a wrestling accident. I was on my last day of clinical allowance and did my entire second semester of clinicals in a flex brace and a lot of pain. Partially this was due to the brace and partially to the degree of skeletal muscle damage I'd done at the same time. When the orthopedist operated though it turned out to be a partial ACL tear, not worth repairing, and he only performed a partial meniscectomy. The rehab for a meniscectomy is famously short, I'm not sure what you'd have to go through for an ACL repair. All that said, the ACL is a good thing to have but not technically essential if you're not making frequent strong cutting motions. Your limp isn't from your ACL being torn, it's from the damage you did to the rest of your knee while tearing it, and the swelling in the area. With some PT now, you could wear a good hinge brace, go to work, and figure out how your FMLA, sick leave, vacation time, whatever work, and consult a surgeon to get a better idea of your rehab timeline. I had to be cleared by occupational health first, but that was basically: can you stand from a chair and walk 30 paces. You can get there before you start working. Three years later now I'm back in BJJ, no longer have to work in the ACE bandages and knee sleeves I did when I first started, and dead lifted 350 today. You can do it, you just have to be mindful of your recovery and work hard at it.
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Aug 22, 2014 03:00
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Madame Psychosis posted:I play contact sport on roller skates-- might be time to stop that, eh? Yeah, lacking an ACL makes it significantly more likely you'll tear a meniscus if you do something funny or twist wrong, and funny in this case is a pretty broad range of activities. Ice it a lot and keep trying to work through a full range of motion. Even without having insurance yet it may also be worth it to you to go ahead and pay to see an orthopedic surgeon though, and get started with a treatment timeline. He'll be much better able to tell you your options as well.
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Aug 26, 2014 19:16
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All my managers in my rural but large regional flagship hospital have been BSNs, one had been there a million years and actually got her BSN after already being manager for a few years. We're openly talking about making the nurse managers a business position, with the implication that they wouldn't even be RNs. The effects of such a policy are nightmare fuel to me, go look at the TPS/ office work thread.
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Nov 13, 2014 19:40
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Risky posted:Did anyone else that did a transition program from LPN to RN have paramedics in their program? We have a handful of them in ours and they are constantly bombing tests. They recently integrated them with us LPNs but they have their own teacher. From what I've seen and heard most of them should have failed out by now but we think their teacher tacks on extra points to get them to a 75 to pass the terms. Paramedics or EMTs? I didn't but no paramedic should be failing a nursing test. If they're like, EMT-Bs or something, that I'd understand.
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May 6, 2015 19:01
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My hospital requires all new grads to go through an orientation first, because new nurses are considered to be dangerous retards. Having trained a few, I don't they're not wrong.
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May 11, 2015 12:53
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Nine of Eight posted:Tomorrows my final day of training for Hemodialysis (and final evaluation) and I'm really not sure how I feel about it. In training in a hospital setting, I was mostly on top of my poo poo, and could feel like I was gonna be some good, However, I'm gonna be assigned to an external clinic, and in between the patient ratios (5:1 instead of 4:1), and the lack of LPNs, as well as the fact that I'm evening shift and have a 4 minute margin to catch the bus home, I feel like I'm getting hosed by the clock each day. By the time I've plugged my patients, logged my poo poo in NephroCare, checked labs and contacted the nephrologist with any outstanding findings, it's already time to rush to reinfuse my patient's blood and unplug them so they can rush home, hopefully without being rude to me the whole time. And that's without the need to rush causing me to make a bunch of mistakes that are thankfully caught by my section mate doing the mandated double checks on my stuff. You're gonna miss that bus. You're gonna miss that bus a lot. Is it the last bus, or does it just entail an hour wait for the next one?
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Jul 2, 2015 22:24
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Nothing reeks harder of role insecurity than nursing diagnosis, except maybe DNPs who demand to be called Doctor. Public Health and research are cool though.
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Sep 6, 2015 01:47
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Epic Doctor Fetus posted:The day you leave nursing school is the last day you'll ever have to worry about nursing diagnoses and care plans. And group projects and presentations, for that matter, unless you decide to be part of a special committee on why it is better to use one type of tape over another type of tape. My institution was cited by JHACO because, among many other things, our care plans were frequently incomplete or undone.
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Sep 7, 2015 01:41
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Weebly posted:Do we have any Carolina nurses here? My friend and I are finishing our traveling contract here and are looking to go South. Any god awful places to stay away from? PM me. I've lived here my whole life, work in the east.
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Nov 9, 2016 04:35
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Has anyone in this thread ever had to calculate a drip rate? Is that a think that is actually done in modern medicine? The only time I can imagine doing it is some sort of overseas conflict zone placement.
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Nov 16, 2016 23:36
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My teachers were not terrible happy when I wrote one of my first papers on the lack of strong unconfounded evidence to differentiate ADNs from BSNs.
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Feb 11, 2019 03:13
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A coworker sent me a link to a "Nurses with Cards" facebook group and oh boy, the population that checks off both boxes of the "very on Facebook" and "Nursing" diagrams is CHUD as gently caress. It's like 1000 Fox News grannies rolled into one. Every "diagnose this" thread further destroys any belief I had in giving nurses more autonomy. That's leaving off an EKG reading thread where 1/2 were calling afib a 3rd degree heart block.
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May 23, 2019 18:57
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I moved a year ago to take a clinical supervisor position in a new hospital, in a different state, with my then fiancee. It turned out the unit was in much rougher shape than I was initially given to understand, the office time for what I was sold as a mixed floor/office job in non-existent, and our already terrible staffing got further hosed by COVID hiring freezes. Supposedly they're bringing people on but it's like... 3 experienced nurses and maybe also some travelers, a drop in the bucket to what we need. The last one they oriented lasted a week, before using a car accident as a reason to break her contract. There are no staff left there that have been there longer than me but less than 5 years, and the old heads are all beyond crusty. A 44 bed cardiology/vasc/post surgical/med-surg unit that they want to expand to the 50s and soon want taking LVADS. Highest patient turnover in the hospital, the surgical floor being the only one that even competes. Most nurses routinely at 6 lately, with the post ct surgery 4 to often 5 and its a rare day we don't have 2+ primaries, sometimes no techs at all. Our surgeons are notoriously willing to cut anything so there were 8 post cts deaths last month and even more long term morbid. The last 3 shifts the HOS/ facilitator/ whatever you call them has had me calling my manager at 5 am to come in because float pool can't get me past 8 nurses, a number at which the charge nurse would have a full patient load on top of unsafe staffing. Meanwhile my company just published their quarterly earnings and the company as a whole beat EPS estimates by 300%. I've got this good crew of younger nurses that I can see burning out before my eyes and I feel like a serial abuser. The personal risk doesn't mean much but I could certainly see myself getting named in a medical error lawsuit for supporting this grossly unsafe staffing. I don't really have a question, I just wanted to tell some people who might know how it feels.
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Aug 6, 2020 06:34
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As an aside does anyone else work somewhere with no time clocks? They tore them all out saying that we should be using Kronos on the PCs for clock in, but we don't have enough wows or PCs for day and night shift to be on them at the same time. Imo it's basically wage theft and I'm torn between quitting literally today and staying so that I can look into unionization resources. awkward_turtle fucked around with this message at 14:34 on Aug 6, 2020 |
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Aug 6, 2020 13:54
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White Chocolate posted:How do you note your hours? On paper instead? The "time clock" is entirely digital, you access it from a PC or lately from one of our care connect phones. The removal of the physical clocks is just kind of a head scratcher, it only makes it harder to get your time right.
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Aug 15, 2020 08:52
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rosenritter posted:Does anyone who works as a nurse in Canada (literally ANYWHERE in Canada) know if it's possible to find a hospital job that doesn't have rotating shifts? I've been looking at jobs around the country out of curiosity and it seems like it's impossible to find a part-time or full-time job that has consistent day or night shifts. How does anyone live like this? Talk to someone on the unit, when I was making the schedule the problem was always filling in night shift, not days (until the vacancy rates got really insane anyway) so even if the contract said rotating, someone who wanted straight nights was getting what they wanted. Days, yeah, depending on how short they are for nights, rotating was just what I had to do to have coverage.
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Feb 28, 2021 18:16
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Modules are universally the worst part of starting a new job. Trusted pays better in general than most travel groups but they notably don't pay for prework modules either, so I'm just blasting this out as fast as possible and it makes me want to drill a hole in my head. I was way lazier than I should have been about finding a new place and now I'm 2 weeks out of a new assignment with no housing confirmed, gently caress me.
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Oct 24, 2021 16:44
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Avian Pneumonia posted:I quit my job! Been travelling for a year now so my 2 cents: I like Trusted and their blog has some good advice on it. I worked with a Stability first, had a recruiter I liked, and then had one I barely heard from. I don't particularly see what value a recruiter adds to the whole process. I left them when I realized I was looking at the same contract from 2 different agencies, 1 was 3 days and the other was 4, for essentially the same pay. Contracts are made up out of your hands and offered to you, but negotiation is possible. I have been cut once this year, at Inova Fairfax because they had taken on a ton of travelers for last Januarys COVID surge and it didn't really materialize. A lot of travelers live out of hotels or short term housing only on the days they're working, I prefer to stay in one place for longer stretches, but I also have very little tying me to my tax home beyond what's legally required(ie no kids or spouse and its on the other side of the state.) It's up to you if the additional comfort is worth being trapped in a lease, but furnished finder has a lot of places that will do month to month. Evaluate what you want from a contract. Prestigious, well staffed hospitals and nice locations pay less. Good units (usually) pay less. Do you wanna be more picky and work in your specialty (easy if you're ICU or ED, somewhat harder for others) or do you just wanna pick up the first med-surg tele contract you find? Everybody's short right now, and I've heard even Cali isn't keeping their ratios. You have options though. I just resigned at my current hospital with a different unit I liked more by talking to the manager and getting them to do all the backroom stuff with the travel liaison, because I'd made a good impression with that manager and her staff. Like most subreddits, /r/travelnursing is pure poison and full of people who have wound themselves up on the idea that they absolutely deserve to make 200k+ and have 3 months of vacation a year while turning in substandard work. Rates are likely going to fall, even if there has to be legislation to do so and frankly we are all likely participating in the gutting of american healthcare and a profound transfer of wealth from the aging middle class into the coffers of hedge funds and for-profit systems. The government is by far the largest single payor in healthcare and it is definitely legal and probably obligated for them to exercise some sort of price control. I do not feel good about the ethics of the current situation but I'd also feel foolish to not take advantage of it. I left a terrible job at a for-profit inner city hospital that gave me PTSD, more than doubled my take home pay, and have lived in some cities I probably wouldn't otherwise. Actual, actionable advice: Use a recruiter for your first gig. Aya is one of the biggest agencies and they have the most options. Pick a University hospital, a level 1 trauma or a Magnet, they're at least gonna have enough people to have their poo poo together. Go for a 3x12 if you can like what Lovelyn said. That'll let you test the waters and see if it's for you. If you've been in the same place for 8 years you're gonna be surprised by how much of what you took as gospel is simply convention. Travelling isn't for everyone, you've gotta be flexible and adaptable. You're the first to float, probably to the worst units. Most of the core staff appreciates you, some will resent you for your absurd pay rate. If you're not a social person (and you're a goon soooooo) it can be really hard to make friends in a new place every 3 months. If you have a spouse consider getting on their insurance. Most agencies offer it but it ends as soon as your contract does. Get umbrella insurance, you're working in unfamiliar systems, mistakes will happen and it'll take a weight off your mind. Start a ROTH IRA if you haven't, being mindful that if you go for high level contracts you'll possibly make enough in a year to exceed the income limit. Trusted has a 401(k) with no matching now, most agencies need you to run with them for a year for any kind of retirment account. If you were thinking about buying a house, shelve it, mortage lenders won't even look your way without at least a year of paystubs.
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Feb 12, 2022 18:30
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The HCA hospital I'm working for sent me a letter last week along the lines of "take this 40$ an hour paycut or we're cutting you at the start of May." Nobody else is paying more and it only gave me 2 weeks to find a new position so I decided to stay, but I think I'm the only traveler I've talked to so far who did. The staffing here is already awful, may 1st is gonna suuuuuuck. Even with COVID mostly gone here they're busting at the seams. 7 Med-surg patients is not terribly unusual. They have a union but the union seems to be entirely toothless. The obvious solution? HCA applied to open another hospital.
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Apr 25, 2022 23:32
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Nice and hot piss posted:Jesus. We get time and a half plus $10, or $20 for nights. I'd work myself to the bone for $180 an hour lmao I think it was $170 before the paycut, 1.5 plus a 22/hr extra hour bonus, but I didn't do it as much as I wanted because it sucks and I'd talk myself out of it. Straight nights grinds on you. Nice and hot piss posted:HCA and Ascension are some of the worst private hospital systems you could work for, and it would probably be a better move to apply as a clinic nurse/become homeless than work for those companies. Haven't worked for ascension, but yeah, Mission in Asheville NC, hot garbage. My girlfriend is with Healthtrust and Im desperately trying to get her on Trusted with me. Lol at just 7, I've had 7 on COVID units here, I've heard of nights with 8, and they've started firing travelers on the spot for refusing to float to the med-surg floors with 7. Including 1 who apparently had it written into her contract that she didn't have to take more than 6. Ascension reported a significant profitability loss due largely to labor costs, every system is gonna start putting the screws to travelers this summer.
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May 7, 2022 13:11
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my morning jackass posted:
Golden Chains man. I'm kinda controversial cause I agree, it's managment is exploitative but the work is, frankly, not all that bad for the pay (which is normally much less than I was posting above). Emotionally trying more than physically. I've been in r/Travelnursing some and I'm kinda disgusted by the attitudes there. Sure, hard at times but I'm from a very rural part of the south, and if I had to choose between nursing and laying hot tar in the sun for a state road crew, I choose nursing. I've thought about going back to be an educator though, I love teaching. In other news I'm doing the training for a hospital that uses Meditech right now. We will see how using it feels. It's definitely a loop for someone used to Cerner and Epic style flowsheets but... I kinda like it? Parts of it make so much more sense even if it kinda looks like a windows 3.1 program. Plans of Care look waaaaaay more intuative. My gut is telling me that there's less to modify and therefore hospital admin hasn't been able to make it stupid. I have worked with some very stupid Cerner Millennium flowsheets.
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Jun 30, 2022 02:24
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Nice and hot piss posted:Like that poo poo is rough, I have a massive respect for the nurses here who are getting hosed with 5-6 patients and limited CNA staff. No wonder our Ortho department is chronically short 4 nurses each night and gobbles up our float pool Ortho/trauma and med/surg general are always a mess everywhere I go. The patients are hella sick, need a lot of hands on care, surgeons are a pain int he rear end to deal with, and there's always a big push for movement.
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Oct 10, 2022 02:59
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