Latest Comments by LTCangel - page 4

LTCangel 5,292 Views

Joined Nov 8, '05. Posts: 85 (49% Liked) Likes: 138

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  • 2
    TheCommuter and chaos0058 like this.

    I agree with The Commuter! Too many new grads think that the only place to work is in the hospital. If that's your idea, it's just not a valid one anymore. Look ANYWHERE that will give you a chance and that you can begin to hone not only your basic nursing skills but also your critical thinking skills. Anywhere there are patients to be taken care of, this is where you want to be, even if it is LTC/SNF. Most of these residents have multiple medical issues and of course multiple meds, all of which means many many opportunities to learn and to make decisions. LTC has often been looked down upon by RNs but it is a valuable place to learn and take that experience with you as you make other career moves in the future! Good Luck!!!

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    Well as the previous poster said, she learned all of those skills in the first week! So will you. Hospitals don't always give the best orientations either and when they are finished you are also on your own so to speak. My very first job was as an LPN in LTC. I was Charge Nurse. At that time the facility didn't even staff any RNs at night. I learned so much in that 1 1/2 years that I can't even begin to list it all! You will NEVER learn your critical thinking skills if you don't start using them! I would definitely ask for more orientation time but if there are going to be other RNs or experienced LPNs in the building there is nothing that you cannot learn to do! I know jobs are hard to come by right now and you really need to get some experience in order to even go to another job. Sooo... I say go for it!!
    P.S. If it sucks you can always give your notice,

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    nola1202 and handyrn like this.

    Ok, first of all I would like to say that I just finished "orientation" at a local LTC facility and it sucked! I just came from working 14 years in a hospital so my Nursing skills are up to date and I am very confident in them but this facility has failed to show me and make me comfortable with their policies and procedures and especially their paperwork. Oh just little things like, admission paperwork and charting, incident reporting, death papers and the procedures, etc. I got 3 12 hr nights with the RN Supervisor who had me working with her on the skilled unit( a much smaller unit) and then I came back for my next 3 orientation nights and the nurse that was to orient me had had surgery and instead of replacing her they threw me on my own with 40+ residents that I knew nothing about! Now I'm a big girl and I know Nursing can be brutal and I can take a certain amount of beating but I felt this was very unsafe and uncalled for. When I complained to the Nurse Practice Educator( who by the way said I could ask for 2 more weeks of orientation if I needed it), it turns out she was the one who told the scheduler that I was ready to be on my own with Supervision. Only one of these 3 nights included a Supervisor. This was Memorial Day weekend so you can see what happened. They threw mw to the dogs! When I was hired in, the DON(who is new) tld me she was trying to make positive changes. I had a discussion with her and told her I wasn't thinking her positive changes were taking effect! I got 2 more nights od orientation and that's it. I'm on my own. So when you are thinking about orienting someone, start by asking them what they are already comfortable with and see what they feel is important to learn. Also be sure and make them a little packet with examples of all of the paperwork they will need for all of those emergent or serious situations. any seasoned nurse can pass meds and do treatments, it may take longer in LTC but it's a basic skill unless they are a new grad. Make sure they are comfortable with knowing all those things that you take for granted now. I am still trying to decide if i want to look for another job or just stay here for a while and give it a chance. Needless to say, I have a sour taste in my mouth.

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    Chin up likes this.

    At my facility, each unit has a sheet printed out for each hall with room numbers, names, and how they take their meds with space to take notes. since I'm new it's been a life saver and a great time management tool. It is not supposed to leave the facility and i put it on a clip board so I can keep it with me and not lose it. I don't think this should be on your PC though. Maybe you can type up one with room numbers and leave room for names and fill them in at work. Make copies for yourself and leave them there at work so you will have a fresh one each shift.

  • 0

    In the hospital you may still have to work the same type of hours, I know I did for 14 years mostly all nights. I would work 2 off 2 work 2 off 3 work 3 off two or some variation of this. I am now just starting a new job in LTC- floor nursing in the hospital has taken it's toll on my body. My schedule will be work 3 12 hr shifts and off 4. That's actually much better! I am just trying to adjust to LTC polices and procedures versus acute care. Also the 9pm med pass is killer! I am working on my MSN, so unless some dream job comes along that I can't resist, I think I will hanf out where I am until I am finished with school. I hope to become a Nursing Instructor. Even with all of my skills and 15 years of experience I have some trepidation about the new environment I am in. I know it while to feel comfortable. So just relax, it will get better, and if you desire to work in a hospital start looking at ehat's out there.

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    In the hospital that I just left after 14 years, we had a very specific way of flagging and noting charts. It was taught to all the docs and new residents. Whwn they wrote new orders they would fold the page over and lay hte chart by the unit clerk's desk. The unit clerk would then put the orders in the computer, scan every order to pharmacy, then turn the color coded wheel on the chart to green and put it back in the rack. Green signified that the chart had an order that needed to be noted. Sometimes the doc would be too lazy to carry the chart to the unit clerk but they would still fold over the order sheet so we could tell that it had a new order. If I, as the nurse or the Charge nurse picked up the chart and saw that it had orders to be entered into the computer I could do one of 2 things. I would lay it next to the unit clerk or turn the wheel to yellow which meant that orders need to be entered in, or I would enter them myself. If there were stat orders the wheel was turned to red. If it was a discharge order the wheel would be turned to blue. Even more important though, a copy of each new order would be put into the pts slot in the med room so that the floor nurses could check the paper order against the new order that would pop up on their computer screen. If I was in charge, I would also call the nurse on the phone that we all had to carry and let them know that their were new stat orders or orders of high impotance such as giving blood. Orders would not be noted until all of the med orders, etc. were profiled onto the pt's electronic record. Once that was verified, the order would be noted and the wheel was turned to black and put back in the rack. We also did 24hr chart checks on night shift. Was this perfect? NO. Sometimes docs wouldn't fold over the page or they would put the chart back in the rack without letting anyone know they had written a new order, and it might be hours before it was found. As the floor nurse and the charge nurse I tried to scan each chart every so often to make sure no new orders had gotten past me. Most of the time though if a doc had written a stat order they would tell someone whether it was a nurse or the unit clerk. Sometimes though things just happen and you can't always catch everything immediately. You can only do the best you can and try to correct any mistakes that may have occured. I have just started a new job in LTC(it was time for me to leave floor nursing!) and I just beginning to learn the procedures of the facility. But there is only one doc for all of the residents who comes in once a week to do rounds on the residents, unless there has been a new admission or a resident has a change in condition that he needs to assess. The rest of the time he is called for telephone orders. This is def. less confusing than having 20 different doctors in a chart in one day!

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    eriksoln and gonzo1 like this.

    This article highlights the art of Nursing that often we as Nurses don't even understand. We often witness horrible trajedies, deaths, and just the day to day dealings with people who are sometimes experiencing the worst pain and fear in their life and can be difficult to deal woth and understand. Yet, as a Nurse, I have found that as the years went on I knew how to deal with all of this without causing it to change me into a mean person. Instead, I feel it taught me to be a nicer, more compassionate person. One who can deal with difficult patients, dying patients, and family members who all over me take care of their family the best or more than other patients. Thank you for posting this article. I feel it expertly describes the way a really good Nurse functions each and every day!

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    The way things are these days if i were in your shoes, I wouldn't limit myself to ANY job opportunities. If there's anything open in the hospital go for it, eventually you can bid off or you might come to love it. Consider that you may not be able to start off in a hospital. Expand your thinking to LTC, Home Health, Hospice, MD Office....anything to give you that first job experience. A lot of new nurses think they should only work in a hospital but Nursing is sooo much more. Good Luck and God Bless!

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    zephyr9 and VickyRN like this.

    Thanks for this article VickyRN! I want to be a Nursing Instructor. I have my BSN and am about halfway through my MSN-ed. I have applied for several positions just to get my foot in the door even as a Clinical Instructor. They all want experience, which I don't have because I can't get a chance. I just applied again to a local school with an ADN program who want a Clinical Instructor and the job post states only a BSN is required. I'm keeping my fingers crossed and hope to one day develop that hardiness I need to be the best Teacher I can be! I know it won't be easy at first but it really is all I've wanted for several years now. Your post makes me feel excited and hopeful that I CAN and WILL do it one day! Thank you again, Lisa.

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    I believe in the Psych world that's called MANIPULATION!!!

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    Chin up, LMFRN, and LockportRN like this.

    So sorry for your loss SJersygrle. I cannot even imagine it. As a nurse we are taught to do what is best for the patient but we must also be empathetic to the family and what they are having to deal with, and everyone handles it different. the death of a child would be the ultimate loss and as a mother of 3, I admire your strength to let hom go. God Bless You and thank you for sharing. Lisa:heartbeat

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    ticklemenita and Orange Tree like this.

    Best advice I can give is to be positive and let them know that you are willing to help in anyway you can. be a hardworker but don't let anyone dump on you. Let them know that you also want to learn from them cuz you are gonna grow up and be one of them soon. Nurses appreciate extra pairs of hands so they will be glad to see you comin' if they know you are going to be an asset and make their shift go smoother. Good luck, have fun, and learn lots!!

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    I'm not sensitive as far as letting things get to me at work and cause it to ruin my day, but I have always believed in being nice to everyone and sensitive to others' feelings. This always seems to bring about a much happier calmer day as we work together and not against each other. I have been told on evals that when I'm in Charge the unit runs smoother and calmer cuz people feel it from me. I am an optimist and a glass half full type of person. I just think if you treat everyone with kindness and respect most of the time it will be returned. It's worked for me 99.99% of the time in my almost 15 yr career.:hgu:

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    Yes, twice. first time it was a kidney stone. I was working night shift and just kept having left flank pain that worsened to the point of being excrutiating. Our census was low, so we only had 2 nurses and an aide. My coworker said run down and sign yourself in and they'll call when they're ready cuz I really didn't want to leave her alone. I got a CT-kidney stone-script for pain meds and push fluids and went back to finsh the last 4 hrs of my shift. Second time, I was in charge that day and actually was having wonderful morning. We were fully staffed, patients were stable, I felt great and then BAM! extreme pain in my sternal area, nausea, and felt like I was going to pass out. One of the girls pushed me to ER in a W/C and it was a gallbladder attack. I was sent home and the Clinical Coordinator ended up doing Charge. It happens....


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