I have been an LPN for two years now. I started in corrections where I had a slew of RNs and Physicians around me. I was good at my job and knew exactly what to do all the time. I am now in LTC in a level III res care setting. I feel that my assessment skills are low and the RNs around me expect me to know a lot more than I do. I manage a unit of only 20 residents who are healthy for the most part, I know that I am a good nurse but I am very afraid that I am going miss something...
Jan 25, '13
my advise find an old brute hard nosed nurse follow her notes (mentally) as far as assessment for me it was simply knowing the pt I had 32 pt 4 CNA's for 16 hrs sometimes, after u get used to them you can tell when something is wrong start with the worst of their Dz processes COPD pay attention to lungs and heart skin color resp pattern ect, for dementia, pain what makes pain worse is it anxiety, pain or over-stimulation, constipation or do they need med intervention did they start on something new is the behavior worse... my assessment is always as follows, what is dx...what do they look like...IS IT NORMAL...how's mentation can they communicate with me... IS IT NORMAL...skin and eyes, head to toe... problems interventions and who i notify,ex:
huh pt is COPD, skin pale circcumoral cyanosis, resp patter shallow but non labored, speech is garbled, noted much situational confusion, O2 set @ 6 L/min... think think... lower O2 give pt support encourage deep forceful breathing clearing lungs each time check O2 sat.... long term intervention, at the end of shift especially if your new, just report to oncoming nurse what happened and what you did and ask her that sound good to you? or idk what do you think? she'll give you her/his opinion, next day pay attention to her documentation se if you see what she did, then next time you know next time trst me with old folks it's going to happen again when the have chronic issuses
Last edit by malenursega on Jan 25, '13
: Reason: missing letters