I got in to the RN program!

I got a letter in the mail last Saturday. I'm in!

I start August 20th of this year.

The new job as a med tech at the assisted living place is going well. I've got a good reputation there, among the residents as well as the staff. It has been an adjustment, being on my feet all the time, but I'm doing ok with that as well.

I will write more soon. My cat recently used my keyboard as a scratching post and tore off several keys, so the typing is a struggle at the moment, but I do have a lot of new stuff to share.

Kind of disgusted.

I went to my first monthly all staff meeting at the new job. They announced the "employee of the year" (last year's) and I had a feeling I knew who it was going to be, I've heard other people talking about it, but I was hoping not.

See, there's this one girl on staff who has been there a few years now, longer than my current supervisor, and she, although she is a favorite of the managers because she'll always cover a shift or fill in where needed, is a total thorn in my side. And I'm not alone. Even our supervisor has talked about her being rude to the public, and how that's not a good thing. She's the leader of this little click with two other girls, and they always sit around and make fun of the other staff, and many of the residents. She is especially mean when it comes to new people on staff. The last new person before me she (and her click) make fun of for being *too sweet*. Because she works hard and has a good attitude.

One employee told me that she requested never to be put on shift with K because K disrespects her. I personally believe she was messing with my walkie-talkie for the first week and a half of my work there so that I would never hear incoming calls...and when I complained about it to my supervisor, she then made fun of me for complaining at the first opportunity.

Also, because she has been there so long, she does most things by memory rather than looking at charts/etc. And there are two instances in the last week where a med error was made and I know she is to blame. In one, she was on shift on a Saturday, and when a resident who recently returned from the hospital asked about her B12 inhalations and why she wasn't getting one that week, K told her that she's not on that anymore and walked out before any further discussion was possible. This was related to me by the resident. I checked her chart and she *is* still supposed to get the B12 inhalation and she did miss it that Saturday.

The second was more dangerous. Some residents get their blood pressure checked early in the morning, and if it is below a certain value, one of their medications is supposed to be withheld so their pressure doesn't go *too* low. This resident's systolic was already below 100. The LVN on staff who has been mentoring me said I should look through the recent treatment records and see if I saw any trends in blood pressure worth looking into, and when I did I came across that record. The instructions there on the treatment page say to withhold metroprolol if the systolic is below 100. I asked the LVN to look in the MARS (medication assistance/administration record) and according to that documentation, the med hadn't been pulled. She and I went to the resident's room together and checked the woman's BP several times. It was quite low (top number around 85-90), and we both agreed that it didn't look like the med had been pulled as ordered.

Together, we told our supervisor about it. She is young, unused to managing people, and close with the employee who messed up. And there have been 4 documented and reported med errors in the last year, and if there's another one it will come with a hefty fine and perhaps further consequences to the facility. She said, "Oh. Hmm. Well I will check with K and ask if she pulled the metroprolol this morning."

I get it that sometimes if it is busy, it is possible that she followed protocol and just didn't document it. But we both saw that the resident's pressure was too low, even lower than it was earlier that morning pre-medicated.

Since I'm on a rant here about employee behavior, there's another instance that is bothering me. There is a resident who is having an episode of back pain right now and has had trouble getting back and forth to the bathroom. Apparently a few days ago during noc shift, she pressed her pager for help, and it took a while for someone to come. The resident reports that the staff was "mean" to her, saying things like, "I don't know what you expect me to do if you can't tell me what you need!", "You should be in the hospital!", and "You need a bedside commode, there are only two of us on the floor." I wrote down exactly what she said, and told her I was sorry that she had to experience that along with her current episode of back pain. Then, as soon as a chance, to related what she said to my supervisor. She thought through who would have been there that night, and said, "No, I can't see so-and-so ever saying something like that. That resident's perception is a little off right now. I will talk to so-and-so (staff member) and see what happened from her side."

I appreciate that she doesn't jump to conclusions when there is a chance her staff has done wrong, I really do. But when she's getting multiple complaints about one particular employee, she really needs to take action on it, even if that employee is her favorite person that she can always lean on.

What really chaps my hide, so to speak, is that two of the reasons that our supervisor wrote that she should be employee of the year are her record of "mentoring new employees" and "doing things accurately".

Ugh.

Middle Fingers and Generous Spirits

It has been a couple weeks since my first day as a med-tech / caregiver, but there were two stories I wanted to share from that day.

First, I was in the wellness center learning what my role and responsibilities would be as a med-tech. I was there with C, an LVN, and K, another med tech. In walks a frail senior lady. "How can we help you?" someone asks. She looks at us and flips her middle finger.

It turns out that she has a chronic crack on the tip of her middle digit that she regularly comes to the wellness center for to get ointment :-) She either has no idea of the significance of pointing that finger skyward, or is doing it ironically.

Later that day, I was in another residents' room. She had been dizzy and needed help back to her room, and I was alone with her helping her put on some new depends. She's going on about how comfortable this particular brand is, how it doesn't sag or bunch...and then she looks at me and asks, "is this the kind you use? You can have some if you want!" Completely serious face. I thanked her for her generosity but said no, I don't use that kind.

:)

Workout at Work

In my efforts to lose weight and get healthy, I have been wearing a pedometer for the last few months, every day. When I was working a combination of the receptionist job and teaching, I would get from 3-6,000 steps per day, generally. Since I started the med-tech / caregiver position, I get more like 10-12,000. The caregiver work (currently 1 day per week of my job) is more physical. Kneeling to put on ted hose and shoes, serving in the dining room, etc. The med-tech is also very physical but a few less steps in the day.

So far, so good. I've been more aware of my right knee, which has been tender for the last several months since I fell on it in late November. I was worried that my plantar fascitis problems would come back again with the increased activity, but so far, so good. I have been wearing my orthotics every day, as prescribed.

I sweat A LOT at work. Part of it is the physical activity, and being a larger gal. The other factor is that inside the building it is at least 75F at all times, and in the resident's personal rooms it can be much, much warmer, depending on their preference. I have been using residents' kleenex or toilet paper to mop my face when needed, but I should probably start carrying a hankie or something in my pocket. Sometimes when I take off my gloves, sweat splashes out of them and my fingers are pruned. I mentioned the sweat issue to another caregiver I was training with last week and she said she sweat a lot at the beginning too.

At one point, I was riding up in the elevator after serving a meal to the residents, and the woman I was working with that day asked me what was wrong. "Nothing, really!" I kept saying. I then understood that she thought the droplets falling down my cheeks were tears. Just sweat, I promise.

Accepted a new job. RELIEF.

Two days ago I accepted a new job (within the same company) and put in my 2 weeks notice at my current position. My current supervisor at the receptionist job asked if I would be willing to fill in sometimes if needed and I said I'd be glad to.

My new gig will be full time, 40 hours per week, with benefits. I will be spending part of that time as a personal care assistant, and part of it as a medication technician. They are starting me at $11 per hour. I will have benefits after 90 days. Huge. Sigh. Of Relief. If I have to cut down to half time during nursing school (likely) I should be able to at least get back on a COBRA continuation again. Another plus? They provide the uniforms. One less ongoing expense to worry about.

I had two interviews for the job. The first one felt like a hole in one. Totally rocked it. Had no doubt I was going to get an offer. The second was a little rockier but I felt like the decision had already been made on their part by that point. I also talked to the other place I was considering, the paid CNA training program, that day, and there was promise there, but I decided to go with the med tech job for two main reasons:

(1) the paid CNA training gig would have only been $8.70 an hour (vs $11)
(2) if I decide it would be useful to have my CNA license after all, I will be able to apply for that after my first semester of nursing school, which, assuming I get in, is only 11 months away.
(3) I like that I will be spending at least part of my time as a medication technician, which requires some state-mandated training (another thing to add to the ol' resume).

During the interview, the manager said that if I ended up getting into nursing school they would be able to work with me on hours as well. I don't know what kind of course schedule I will have during the first semester of nursing school. I know it won't be a good idea to work full time, even if I am tempted to. Have to wait and see.

I am just a little bit concerned about my pre-employment physical, which is happening next Friday afternoon. I already had one for the receptionist position but because I will be on my feet more and stuff they are having me do another one. I also need to get my TB records together again, and all that jazz. It may be about time to renew my first aid training again as well. They will pay for all that if necessary.

I know that this job will be more physically taxing than my current one, but it should be GREAT preparation for my nursing career. And probably being on my feet all day will help me slim down.

So, again, whew.

to CNA or not to CNA that is the question

So...I have finished my phlebotomy training, but it will be a while before I get my certification all ironed out with the state, and it could even longer before I'm able to nail down a job in that field, if at all.

The local college did not need me to teach any classes this term. They go to the faculty first, the graduate students next and *then* the part time pool by seniority, and between the low course offerings during winter and being the newest of the newbies, no luck for me.

I've still got my retirement home receptionist job, but that is only 19 hours per week, and at $10.50 an hour and no benefits, you do the math. No es bueno. Not getting by. So...

At the end of last week I saw that a caregiving facility I applied to almost a year ago for their in house CNA training program was starting a new training round at the end of January. I managed to get an application in the day after the announcement went out, and I put a lot of energy into my resume, references and cover letter, so I'm hoping I have a good chance there.

Secondly, I also put in an application to be a "medication technician" at a care facility across town from, but owned by the same company that I currently work for. The CEO at my current job found out pretty much immediately, asked me about it, and I explained the situation. It turns out they won't hire a non-CNA for meds passing, not really, but several days later he told me that I should apply to be a caregiver at yet another facility owned by the company. I put that application in tonight. It would be full time, so I would get benefits after 90 days. However, they do not have an in-house CNA program; I would not graduate to certified nursing assistant over time or have the job portability and pay raise that comes with it.

My inclination is that doing the CNA program at the un-related-to-my-current-job place may be the best opportunity long-term. I would have to find out pay rates, etc to be more confident in that statement, but even if I just stayed there 6 months, got my license, and then moved over to the hospital where they make twice as much, it would be totally worth it.

However, if I tell my current employer that I need more hours, they say, alright, here's an opportunity, and then I don't take it, that's a little awkward. Or what if it becomes a timing issue...what if my current employer says, okay, sure, let's start training you in the new job, and then *days* later I get word that I got into the on the job CNA training program?

I should call the on-the-job-CNA place tomorrow and ask if they have had a chance to review my application, and make sure there isn't any contract that mandates 1 year of FT work following training (as some places do), or anything like that. How can I carefully bring that one up, huh?

On-the-job-paid-CNA-training-thingy:
$8.70 per hour (lame)
3 months-ish to get CNA license
benefits, probably after 90 days
my friend who used to work there said the new company cut down on overtime possibilities
the last time I applied, when I met the teacher, I had a positive impression of her
After establishing my CNA license I could move somewhere that pays way more

Caregiver position with my current company
Pay unknown (maybe more than the other since I already have a history with the company?)
Benefits, but after 90 days
they are not set up to train someone who has little experience in caregiving, to my knowledge
No idea what hours they'd want me to work


When it comes down to it, I really don't need the CNA training if I'm going to be an RN in a couple of years anyway, but it might help me stay better afloat financially while in school...maybe....

Doubts...

I've just finished watching the final Harry Potter (weepy) and looking through all of my friends on facebook (lonely) and I'm in a sort of _where is my life headed_ sort of place right now.

Did I make the right decision to move back home and start in an entirely different direction?

I look at old friends' profiles. One that I used to live with is living in Australia now, as a yoga instructor and writer. One that I used to work in a research lab with changed courses several years before I did and is now a nurse practitioner. Another that I went to high school and college with is now a physician's assistant and has a young son. Friends that are professors, and work at nonprofits, and manage or own companies, and have families of their own and children.

And I can't help but compare. I'm 31, still struggling to "find" myself, no partner or prospects, considering applying for a job that would pay lower wages than I've made since I was 19. What if all this that I've been going through is for nothing. What if I am not a good nurse or don't enjoy my work at the end of it all. What if.

I need to get myself out of this downward though spiral.

I've done a remarkable job of holding it all together, juggling obligations, and continuing to move forwards. During the time I have been home, even if I haven't made great strides forward in my career, at least I have managed to form a strong bond with my niece, who I love dearly and with my whole heart. Everyone goes through lost periods, even if not all at once, and at different rates of recovery. It feels like a long time coming, but I *am* moving forward. Soon I am going to hear back from the nursing program and I am most likely going to get in. Even if not right now, there are times when I *do* think that nursing will be an excellent fit. People trust me, and I am a caring and compassionate individual. And I am smart. I should be able to do this. I can do this. A year from now, everything will be completely different. I won't continue in this in-between state forever.