First week of hospital orientation

I finished my first week of hospital orientation, which translated into multiple 8-hour days of class, basically. Seriously, I finally got a tour of my unit the last day, AFTER everything else (except restraints) had been covered.

And how was all this class, you wonder?

Pretty cool, for the most part. We're the pilot program of them implementing CNA's at Father Sainty's, so every single one of the CNA's for my floor was hired and trained all together. So it feels like we're a graduating class together after all these days of orientation classes together, which is neat. Dayshift, swing shift, and noc shift all got trained and oriented together for the pre-floor stuff. We learned new things (bladder scans!) and slung each other around using the overhead lifts in the patient rooms. Good times!

Now for the humiliating news: I passed out. Cold. In front of every single other CNA on my floor, two nurse educators, and one of my managers. It was AWFUL. We were in the classroom and I have a needle phobia.

I do okay when someone is actually in front of me bleeding or has an IV inserted or whatever, but that's because I can move around to keep my BP up, and because I know I'm responsible for them and cannot faint. I've cared for someone through a compound fracture and been okay. But when it comes to the classroom setting, when someone verbally starts describing blood draws or the like, I get woozy. Even if I'm listening to a nursing podcast and they get too graphic, I have to change it or I'd be a danger on the road.

So not only do I have a crazy phobia, it's ridiculously specialized; a DESCRIPTION of blood and needles phobia.

So our nurse educator is merrily telling us how to do glucose checks, and going on and on about it, and about how we may not "milk" their fingertips to get more blood, and I was getting woozier by the second. I trying to hang on as long as I could, then I figured I'd better get out in the hallway where I can put my head down without anyone seeing me. So I stood up and started walking towards the door.

Who can guess how that turned out?


Yep, I woke up flat on my back on the floor, with people over me going "Are you okay Polly? Are you okay???".

So. Freaking. Unbelievably. Embarrassing.

So now one of my managers thinks I'm going to do this while working the floor, and the rest seem undecided. All I can do is prove them wrong. And once I do, hopefully this will become a funny story about way back when I first started working at Father Sainty's.

Oy.

Promotion

My facility is fairly small, as assisted living facilities go. We've got just under 70 residents, and usually have 1 charge nurse on shift supervising 6 caregivers/aides who take care of approximately 10 residents per shift. During regular working hours we also have the Director of Nursing and a med-tech.

All told, we've got maybe 2-3 different charge nurses for each shift, and they just take turns, and have 2 med techs. One does M-F, one does Sat-Sunday.

That doesn't leave a lot of wiggle room for call-outs, so sometimes our charge nurses end up having to work a double, and this last weekend our Director of Nursing (DON) had to come in and work a med tech shift, which she didn't like doing since she also had to come be the charge nurse simultaneously. Oops! That means she had to do all the routine med passes, PLUS all the treatements and assessments PLUS all the charting by herself. Ouch.

Med techs/med aides are a fairly new position that mainly work just in nursing homes and assisted living facilities. They can hand out routine meds to people who are able to actually take them independently - meaning that I could hand them a little med cup, say "here's your medicine" and they could then take those pills. If they had to have them crushed and in applesauce, or they weren't able to comprehend that they're taking medication, the nurse has to administer it to them.

Med techs have to be trained, need to have a basic understanding of pharmacology (how drugs interact, what they do, when to give them vs. when to hold them) and be responsible enough to handle narcotics honestly and chart appropriately.

Our DON decided we need another med tech because right now there is no backup if one of our two gets sick or goes on vacation.

Normally she would advertise within the facility to see who might like to apply for it, but this time, at our meeting, she apologized for not doing so but said that she had one person in mind for the job for a while now and was glad that this person accepted the position. She'll be training the new med tech starting this week. The new med tech is ... ME!

That's right, guys, Polly is going to learn a lot of new skills, be paid a little more, get to wear cute scrubs for the first time, and get more responsibility!

This is huge for me. I'm really excited, proud, and nervous.

Med Tech Polly, coming soon!

I Bet on the Wrong Adorable Horse.

Remember how I was trying to decide between the Adorable place and the Well-Known place to work at next? And chose the Adorable one?

Looks like I chose wrong.

Today was the all staff meeting at the Adorable place, where they were introducing the new Executive Director. What I didn't know when I accepted the job is that the new Executive Director has been working there approximately 3 days longer than I have. And what I didn't know until this afternoon is that the nurse manager that hired me is now on a leave of absence after hiring 3 too many noc shift caregivers.

Also in the "things I didn't know" category: this facility has a 20 percent employee retention rate. When you end your shift, there's a decent chance that no one, or only a small portion of, the next shift staff will actually show up to relieve you.

The work itself is fine (if heavy) but not knowing if one can actually leave when you're supposed to? So not fine. I've been leaving anyway, because there's always a med tech on duty and they are charged with more responsibility, which means they cannot leave until they have someone to hand the keys to the med cart off to. I just say I have to go to my other job (whether that's true or not) and leave within 15 minutes of the end of my shift. And then don't answer my phone if they're calling to try to get me to come back.

Ugh.

Lucky for me, I got a call the other day from another dementia facility with a great reputation for an interview. It's also for a full-time, night shift caregiver position. The great reputation place is usually not hiring, but is the first one that people recommended to me when I started my search. I filled out an application, but didn't think much of it because they weren't hiring when I did so. I guess they are now! So I'll call them tomorrow and try to get in there to meet with them. I just really, really want one full time job with benefits that I can stay at long-term. The waitlist for nursing school is a year, and I'm not even on the list yet.

Maybe I should put a personal ad up on Monster:

Nursing Assistant/Caregiver Seeks ...
Assisted Living facility for gainful employment. Management must be willing to provide required training, and understand that gloves are not a luxury. Coworkers can say "ain't" and be trashy, as long as they actually show up for work on time. Facilities where residents have adjustable beds given preference, so this Polly doesn't have to mess up her knees and back trying to change people who sleep on the floor due to falls. If this sounds like you, contact me, Polly! I work hard, show up on time, don't call out sick, and will do extra things for my residents if the basics are already covered.

Alternately, I could stay at the Crapdorable place part time (2 shifts/week) while doing the 3 week CNA course and then reapply at the Skilled Nursing Facility of my dreams. Also a decent option, as long as I can continue to never, never get roped into staying when I'm not supposed to due to the flakiness of others.

Who Manages Nurses? Nurses.

After pumping myself up, studying my nursing assistant flashcards, and getting all dressed up fancy-like, I got to my interview at the Skilled Nursing facility only to find that in fact, they don't even consider candidates who aren't certified. Crap.

Since the facility is affiliated with a hospital, and the hospital is part of a multi-state network, they do all their applications online and have outsourced recruitment to a different company. This means that even though I applied online like I was supposed to, did my phone interview with the recruiter and did it well, it was only today that I actually spoke to anyone who knows about nursing. A nurse, and a nurse manager at that.

Oh well.

This is why nurses manage nurses. You know on TV shows how the doctors are always bossing around the nurses, telling them to do this and that? And sometimes even firing them or threatening to? It doesn't really work that way. Doctors and nurses are paralell professions that work together, but do not supervise one another except to serve as checks and balances against one another. Doctors are responsible for the health of the patients and so are nurses. If one staff does something wrong, it's the other one's job to catch the error and correct it. Sure, doctors make more money and are often more respected, but doctors are not the ones who hire and fire nurses. Nurse managers are.

So what happened today was a good example of why nurses hire other nurses (or nursing assistants): it's a complicated little world, nursing is, with tons of niches and jobs to fill. And non-nurses don't always know or understand all the distinctions between the various certifications.

And in Long Term Care (nursing homes, assisted living facilities, and the like)? You almost never see a doctor on premesis. Sure they come and assess patients occasionally, but for the most part, nurses do that. Nurses fax doctors to get meds and treatments ordered, and then once they get what they asked for back, they administer the treatment or med.

Have you heard the expression "Doctors diagnose, Nurses heal"?

Today it should have been "Human Resources interviews, Nurses hire".

Oh well, I'll be back with certification in hand by January. By the end of this month I'll have worked enough overtime to pay for a private CNA course out of pocket so that I can be finished in just 3 weeks, take the state exam, and get myself certified. Hooray!