LTCangel 6,455 Views
Joined: Nov 8, '05;
Posts: 85 (49% Liked)
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When someone is admitted, I ask "would you like to write for this now or at 3AM when I call you?" I believe in being pro-active and having pain, bowel, and sleep meds already ordered - you KNOW you will need them.
Well, after my first new admit at my first RN job (LTC and two month old grad), I cried on my next day off...because the other nurse working on the next hall was NO help at all. I feel like she purposely withheld info and wouldn't tell me diddely quat.....so I get it, it is be a witch to the newby who asks lots of questions..UGH!
I've worked nights for 13 years. In the past I have pulled over someplace safe and napped. My strategy for my 35 minute drive now is chewing ice. My co workers wondered why before I leave, I fill a large cup with ice and I had to explain that all that crunching keeps me awake plus it's cold!
Momnurse6,I wasn't trying to say that you were saying any one group of nurses is better than another and I'm sorry if you took it that way. I understand that you probably work with more LPNs. I think it def sounds like a continuity of care issue and I would hope that as others have said that the DON handled the situation but you just weren't privy to it. If these things keep happening, maybe you can ask the DON for a Nurse's Meeting in which you outline what you expect from them when you get calls for orders and the follow up that you require. Education can go a long way in solving many problems. We have a wonderful NP that has been at our facility for about the same amt of time and I would welcome a meeting in which she outlined her expectations and ways that she wanted us to communicate with her. Fortunately, I don't think she's had the same issues you have. I feel having our NP has taken a lot of burden from our doctor and she is available M-F all day to deal with a myriad of issues that in the past we would have had to call the doc and try to explain the problem but he wasn't available in person to actually assess the resident the way our NP is. Sorry for rambling. Sounds like you are doing a great job and you are very contientous and caring.
A little bit of Mineral oil mixed with Mouthwash and a toothette have work well for me. It moistens and freshens. My LTC also has a product for mouth cleaning made by Biotene.
We got a 25$ Walmart gift card and a t-shirt with the company logo. Also a free Christmas dinner but I work nights so I didn't come in for that. We also got lots of cards and homemade goodies from residents' families and a scarf from family. Last year all we got was the dinner so I was pleasantly surprised since I work LTC and I know money is always an issue. I am appreciative. I need a new watch!
In my facility all staff do answer call lights but that is the extent of it. For instance, if the secretary walks in and answers a call light, she simply comes out and tells the nearest Nurse or CNA what the resident needs/wants. This can happen over and over. One of the reasons I prefer nightshifts,lol!
In my facility all staff do answer call lights but that is the extent of it. For instance, if the secretary walks in and answers a call light, she simply comes out and tells the nearest Nurse or CNA what the resident needs/wants. This can happen over and over. One of the reasons I prefer nightshifts, lol!
My DON likes to say that we are a 24 hour facility and that it's ok to pass some things to the next shift. That resident returning at 10:45 would have been something that I would have passed along. A set of vitals, a note to say they have returned and then passed any new orders and the full assessment on to the next Nurse. Especially, if I had completed all the work for all of those silly Tamiflu orders. You are only one person, sounds to me like you did an awesome job and I'm amazed you were even able to get a break. Kudos to you!!
I have been a Nurse for 16 yrs. Almost half of that was as an LPN. I earned my ADN and then my BSN. I worked a number of years in Acute Care and am now in LTC. I find that I have worked with great and not so great Nurses who have been LPNs and RNs. I can say the same for NPs, PAs, and MDs. I really don't think you can lump all LPNs in one type of category fairly. Good Nurses come with all levels of education. I believe a good Nurse possesses good common sense and good nursing judgement, but the latter comes with time and experience. In the LTC setting, brand new Nurses are often in charge of a large number of residents without much back up and I believe are often set up for failure. If you are having this issue again and again, I believe you need to start with the Management of the place and some education or re education needs to initiated. I gained much of the skills and judgement that I now have while I was an LPN, but I also had the common sense to know when to ask questions and glean whatever knowledge I could from those around me who were more experienced. I still do. I never want to think I know everything because I don't. I learn something new every shift I work. I also try to help younger or less experienced Nurses around me. In my facility, we seem to use a lot of Agency Nurses who come into the building basically to fill the spot with a warm body and many times that's all we get from them. Many times, they are brand new Nurses walking into an unfamiliar building and they know nothing about our residents and don't seem to want to learn. They just want to pass pills and leave. I don't know what the situation in your facility is, but you may want to find out. A lack of permanent staff who are committed to the care and well being of the residents can be a recipe for disaster. I always hate the RNs are better than LPNs debate because I have worked on both sides and even now I will find LPNs who are surprised to find out that I'm an RN because I actually "work", lol! I'm not sure I answered your question but it sounds as if some education is needed here.
I'm glad you've figured that out! I have been a Nurse for 16 years and I started out in LTC as an LPN. Went on to work in the hospital for 14 yrs and some of that in float pool. I ended up on an Ortho/Med-Surg floor and eventually got my RN, BSN. It's a long story as to why I came back to LTC but suffice it to say that I love taking care of our elderly generation. It gives me a great deal of satisfaction to have the time to learn the ins and outs of each of my residents. They make me smile, laugh, cry, mad, and very humble to make their last days here as comfortable and happy as possible. In today's world of Nursing, people are being released from the hospital quicker and sicker. My facility tries to make sure that we have performed all interventions possible before sending a resident out to be admitted to the hospital. It comes down to reimbursement. I do understand this because it's the same type of game all areas of healthcare are playing. LTC needs Nurses who can care for these reside ts. Learn all you can and def keep a running list of all the skills you have mastered. And please don't be ashamed to say you care for this nation's elderly. They deserve our best.
Uhmm...yes you are passing lots of meds, aren't you learning the reasons for these meds? Aren't you assessing your residents while you are in their rooms? You have your own hall, you should be learning the ins and outs of all of your residents and their specific conditions by now. Aren't you seeing their labs? Calling the doc with issues and learning what is ordered? Taking care of foleys, gtubes, trachs, wounds, wound vacs? Our facility also does IV fluids and uses PICC lines, does yours? Are you learning when someone is going downhill and needs sent out to the hospital? All of this and more is teaching you critical thinking skills. Think about it. Aren't you doing care plans on your residents and charting? You are doing everything that a nurse in the hospital is doing, you are learning time management skills. You are learning prioritization, you are learning how to delegate to your CNAs. Look at all you are learning instead of thinking that you are missing out on something.
I started out in LTC as an LPN and then after 1 1/2 years got a job at a hospital. I worked in this hospital for 14 yrs. While there I obtained my RN and then my BSN. I worked on a busy Orthopedic/Med-Surg unit. I ended up leaving that job for reasons I don't want to go into and I got a job at the same LTC facility I started out in. I have to tell you that I have not lost any of the skills I gained in the hospital. LTC residents are much different now than they were 16 yrs ago. There are also many RNs working there now. It used to be only LPNs and an RN who was the DON. The acuity level of these residents is extremely high, they are being discharged from the hospital quicker and sicker. A LTC nurse has to be on their toes and know their stuff or they won't make it. The stigma that LTC nurses are not real nurses needs to end! I am a great nurse, my assessment skills are excellent, and I love my residents as if they are my own family. Yes, it is stressful. Yes, we are understaffed. Yes, we have to care for too many at once. But I did the same things in the hospital. This is just my experienced humble opinion.
I once had a very wise Nurse Manager on my Orthopedic Unit who said during a staff meeting, "Give pain meds when they are due. We will not make them drug addicts in the 3-4 days they are here and we will not cure them if they are already drug addicts." I have always carried this advice in my mind since she gave it because it is true. I know I have encountered true drug addicts in my 16 yrs as a Nurse, but if they are suffering an acute condition then they are going to require MORE pain meds then the average person. It is not my job to judge but it IS my job to be the patient advocate and to give pain meds in a timely manner. Just Sayin'
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