kbrn2002 Pro 25,972 Views
Joined: Jun 18, '01;
Posts: 2,437 (69% Liked)
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RN Supervisor; from
20 year(s) of experience
Yes I can't find anything else but home Care. But as a lpn I feel ltc is my only choice
Good gracious, you are a brave soul. Just the thought of the horribly misnamed GoLytely gives me the chills. I'm not so worried about my eventual colonoscopy procedure, I am frankly terrified at the thought of the bowel prep. Sadly the eventual torture is on the horizon, my doc suggested it my last physical...last year. Yep, procrastination is king!
I see this at work pretty regularly. I work with an elderly population, many of them have dementia to varying degrees. All of the residents that have dementia also have a medical power of attorney giving somebody else the right as well as the obligation to make health care decisions for them. The right to make those health care decisions does not include the right to force the resident to comply. If the resident chooses to refuse a med, treatment or even basic cares it is still their right to do so.
LTC is a very difficult field as you are finding out. Huge patient loads and everything that comes with that. That part can be conquered with some perseverance. What really can't be overcome is a schedule with so many 12 hour shifts. That's way too many hours to regularly work without burning out. I am amazed a facility willingly schedules that much overtime.
You absolutely did the right thing. I would never enter a verbal order passed from nurse to nurse, much less a narc order. It's like a game of telephone, you have no way of knowing if that med/dose are even what the MD said if you didn't hear it yourself.
I couldn't even get a controlled med out of our pyxis unit without the order. Pharmacy won't clear a controlled med without a written Rx for schedule 2's. Schedule 3's require a minimum of a verbal override to dispense from the ordering MD given directly to the pharmacy. Pulling the med from the nurses say-so without a MD signing off on the narc just can't be done.
I never considered that before, but I suppose so. Each state's BON is it's own entity so it's a possibility that any other state you want to practice in could expect you to go through their discipline process before you are able to practice there.
God I am so sorry. How devastating for that family, and how scary for the kiddo's [and adults] that witnessed it and couldn't do anything about it. Hopefully they come through this ok.
Sending you into a home flying blind like that is not ok. That being said, for some reason it's easier to get a job if you have a job so if you can stick it out while you are looking for another job you won't have yet another employment gap to explain during your job hunt.
I am a little surprised that any DON would be OK with staff calling at 1 am to ask about vacation days. I can't say how other facilities handle after hours calls but we don't call the DON after hours unless it's important. An unexpected death, a fall with injury that requires an ER visit or a staff number becoming ill during work hours and even then we'd only call if there's not enough staff in the building to cover if we need to send somebody home.
If you accept the job just make your expectations clear from the get-go what situations require you to be notified regardless of the time and what can wait until business hours.
That's such a frustrating situation to be stuck in. At least since you are in an acute care setting you know that at some point this jackass will leave. We had one like that in LTC. Our administrator finally got so sick of the antics this person was evicted. It's not an easy thing to evict somebody from a SNF, took a month for the eviction process and even then we had to find a place that would take this resident. It took another month after we had the eviction notice to find alternate placement. Believe me there were plenty of times we would have loved to just roll the jerk out the front door and say goodbye. I always wondered how many lies we told the facility that ended up accepting this person. Must have been some whoppers seeing as to how they called us pretty regularly for a while asking for advice on how to handle this person's behaviors. Eventually the calls stopped, which then made me wonder if the person was transferred to yet another facility or if they died. I guarantee the calls didn't stop because the behavior stopped.
If the patient is alert, oriented and responsible for themselves legally you have to respect their wishes. If the patient directs you not to call family, you don't. If the family gets upset about it when they later find out their loved one was at the ED then do what you can to calm them. If they won't accept that you couldn't tell them anything per the patients wishes refer them to management.
Interesting responses. I can mostly tell by the responses which nurses, like myself, work in LTC. Of course I can't speak for all nurses, but for the most part we are more than willing to help where we can. The problem is when we start becoming too helpful with tasks the CNA's need to be doing we can't get our own work done.
I am passing meds, doing dressing changes, managing diabetics, doing respiratory treatments and tube feeds, calling family members and doctors, making appointments, taking and processing orders, etc. Then I still have to do all the charting that goes along with that for 24 residents. The CNA's I work with can do none of these things. Yet I am still expected to add answering call lights, helping residents to the toilet, fetching drinks and snacks, dropping whatever I am doing to help boost a resident to my already overwhelming workload.
I am not at all saying the CNA's aren't pulling their weight. With very few exceptions our aids are wonderful, dedicated and hard working. They run their behinds off the full shift and truly do the best they can to provide excellent care to our residents. It's just that not any of us can be in two places at once and it's sometimes just not possible to meet every residents wants the second they ask. The immediate needs come first, for those less pressing wants it's usually "take a number and wait in line" and we get there when we can.
Thank you. But I am not s traditional new grad. Real nursing to me is not technical skills or med passes or even being anal about organization. It's sitting at the bedside and talking to a patient about a new cancer diagnosis who just wants to give up on life - talking for an hour and in the morning patient decides to try therapy. It's comforting someone who has all these chronic diseases with a new diagnosis of heart failure and making sure you advocate for the plan of care they are to receive. It's listening to their story to understand the patient as a whole- not what their illness is and treating their illness safely or without question. It's defending yourcpatients rights no matter what the cost.?most patients I've encountered in just a limited -year time frame: LISTEN- really LISTEN to them - be mindful of their needs , goals, and preferences.
I admit I could be wrong, but this is what my limited experience has taught me so far.
I think what nurses do on their own time is there business. I have chronic pain and don't sleep it's the only thing that helps unless you want me on opiods at work. I only use it on my days off. Go for it. It's no one's business.
General Question: Is alcohol allowed or ever provided in long term care? I understand there are a handful of diseases where ETOH is contraindicated. But, for your average LOL who needs to spend her final years in a SNF, is a glass of wine (not provided by the nurse) out of the question? Genuinely curious.
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