Spring_Peeper 2,952 Views
Joined: Apr 9, '06;
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Can you find any positive things that go on there? At the facilities I used to work, we had movies with popcorn, ice cream days, and such, which residents loved. Comatose residents with feeding tubes can be depressing to see, but it made me smile when I walk into their rooms and see that the CNA brushed and braided their hair, lips moisturized, and linens nice and crisp.
I got so many comments like, "It must be so depressing working in a nursing home!" Well, it is what it is. But we have the opportunity to make it not such a depressing place by our attitude and all the little things we can do to brighten up the residents' days.
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.
Nursing can be stressful at times. Every often we get a patient that pushes our buttons. We just want to scream and tell them a thing or two. Other days we are overwhelmed with the number of patients we have. Running up and down the halls to do the tasks that we were given. It can be upsetting.
These are the times we need to sit back, relax, and breath. We need to take care of ourselves.
Give yourself a night out with your friends, exercise for an hour, eat a great meal, or just give yourself 10 minutes of pure relaxation in complete silence. These are just a few things that can help you relax.
What do you do to help you relax?
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WOW......just came back to this thread and about a year and a half after posting it.....i can see what a long way i have come. i was right.....that first shift was awful. i only did about 4 or 5 patient's meds before i completely lost it and was crying at the med cart. one of the CNAs was nasty to me as well. luckily, my supervisor ended up coming down and helping me pass a lot of my meds. other nurses from different floors came down and took care of my charting, and did treatments for me. i cannot express how much this helped me when i was brand new and just wanted to walk out of the door and leave nursing forever. now, i'm that nurse who always goes down to check on the newbies and offer my help and advice whenever i can. just hang in there it will be okay. as a newbie always try to get there as early as you can, have the nurse from the shift before you give you whatever information she can to help you! print out a list of all the patients, highlight your diabetics, go through and have her tell you who takes pills crushed/whole/in pudding/in applesauce/with juice/thick liquids. these things seem silly but will really save you so much time and save you from having a patient who is now choking on a pill or has aspirated thin liquids and now needs suctioning. hang in there, it will get better! it took months to finally feel comfortable and there are floors that i still don't feel as comfortable on, and always worry about charting last. i would stay behind for months doing my charting, sometimes for an hour or so after- just to make sure everything was done and anyone who told me it would get better, i really didn't believe them but i have to say everyone was right.
My first nursing job, as a brand new LPN, the day after I got my license in my hand was at a LTC facility. Because they were so short staffed, I had one whole day of orientation and was on my own. Did I cry a lot? Yes I did, but when I put my two weeks notice in one year later, they begged me to stay because according to the DON and Administrator, I was the best nurse they had ever had to walk through those doors. I was determined to not let it defeat me and I worked very hard to become a good nurse.
Hang in there! It WILL get better and you just might find you enjoy the fast pace. I know I do
First of all, best of luck with your daughter. Yes, work is important but family is more important. I hope everything turns out all right for you.
Second, when you're hired for PRN work, that does not mean you are always available to work. It's not like they're paying you to be available. If they need someone, they call you to see if you're interested in working. It does not mean you *have* to work.
My grandmother who had advancing Parkinson's eventually had to move from our house into a
skilled nursing facility. We were fortunate to get her a private room.
Down the hall, lived a very very old Jewish lady who, in her demented state, no longer remembered
any English. She could only manage a few words of German (sometimes) and Yiddish. Mimi would
wander and screamed or called nonstop. Usually, it was garbled and made no sense.
Grandma had been a German professor. She'd call out to Mimi in German, giving her simple directions
to get back "home" (to her room.) Grandma would count the rooms: "Eins...Zwei...Drei...Vier...until
Mimi was at her door. Always, Mimi would call, "Danke!"
Mimi loved to "go to the market" and would usually find treasures in other residents' rooms, which staff
would quietly return.
If Mimi would awaken in the night, she'd call out, "Mary! Mary! We're late to the shops!" If grandma
were awake, she'd answer (in German) "It's all right, Mimi. We have nearly an hour before they open."
Mimi would settle down and sleep.
We have a former DON patient who is a high fall risk, especially overnight ,so the nurses give her a clipboard and she goes along for the med pass. She will make notes about the job the nurses do and also which patients she feels the doctor needs to come see.
When I was a CNA I had an Alzheimer's patient who would wail at the top of her lungs..."ohhhh God!, please help me!"..."ohhh God, just one word from you and I will be able to sleep peacefully..". She would go on and on for hours doing this...didn't matter where she was, and only at night when it was quiet. One night in particular, she was really off the wall..screaming that out, driving her demented room mate into a tizzy. This roommate also had a particular habit of yelling out..."yeeaahhhh, yeahhhh" said in a very thick Southern accent. So you'd hear "ohhhh Lord!".."yeaahhh! yeaaah!" Then those two would set off the whole wing...you know how that goes.
We tried toileting them, giving them a snack and juice, getting them up and putting them in a quiet area, having them sit with us..it was worse when they were OOB, so back to bed they went. The "ohhh God" and "yeah! yeah!" kept on. Finally one of our nurses had had enough and grabbed the call system and clicked on their room. He very calmly, gently, and softly said "Christine**...This is God...go to sleep". She fell silent. We were all amazed..and then we hear "Yeah!". Both of them uttered not a peep after that last "yeah" but the entire nursing station roared with laughs.
It became habit, after Christine went to bed, and would start with her "oh God", someone would pick up the call system and say "Christine, this is God, go to sleep". And she would every time and slept soundly all night. It seemed that she just needed reassurance from Him that it was ok to go to sleep.
(**name changed for privacy)
At least you don't have someone yelling "Blue Cross! Blue Shield! Blue Cross! Blue Shield!" over and
over again. =)
It was a warm fall morning. The alarm clock jarred me from my dreams at 4'oclock. I jump to turn it off so it does not wake my baby who is snoring in her crib. I almost want to pinch my husband in a jealous rage that he is sleeping so peacefully. I sulk off to make a pot of coffee, throw a load of wash on, and scuff off to get in the shower. As the warm water hits my back I am still filled with self-pity, thinking "what the heck have I gotten myself into?" I loathe my situation thinking that I will not be home to relax until 8 that night. I go about the steps of putting on my clinical uniform the stiff , itchy scrub top and scrub bottoms, that seem to be shirking every time I wash it, no way it's me gaining weight!
The one part of waking up early that is enjoyable is sipping my first taste of hot coffee. It does little to wake me up but it warms my spirit. As I finish my cup of coffee I check my emails just in case there are last minute clinical changes. Thankfully there are none. I gather my clinical books, papers, stethoscope, slap on my watch, and make sure my wild curly hair is pulled back neatly. Looking at the clock it mocks me back into a bad mood announcing it is five am. I jump into my car and begin my hour long drive to the assigned hospital.
Usually this early in the morning the bridge that takes me into a new city is pretty clear, however this morning it is full of drivers who have been diverted to my bridge due to a gas main break near their bridge. I curse my luck. Now my heart starts to beat fast, I am going to be late. My clinical instructor is going to hang me out to dry. After my trek across the bridge I just have to tell myself late is better than never, "slow down!" I finally get near the hospital, I miss my turn because of the windshield is splatter with rain making it hard to see my turn. I pound the steering wheel because the next turn is a one way street. I am now just in a bad mood. I finally make it to the employee parking lot that is a mile away from the hospital, or so it seems. I make turn after turn to the very top of the parking garage. Students are forbidden to park any place but the top. Add just one more thing for me to be mad at. I turn my engine off and look around. Fear makes my heart skip a beat, I have made it in time but where are all the other students!
Gathering my backpack I trudge across the dark parking lot. I try to pretend I am not scared but fear has gripped me, horror stories fill my mind. Thanks to my over active imagination I pass on taking the elevator down and high tail it down the stairs. Breaking out my umbrella I step out into a sheet of rain and see the hospital trolley. I make my way to it, as I cross the street still a few yards away the trolley driver closes the door and pulls away. At this point I just know that rest of the day is going to be like the start, just crappy.
I mosey my way to the hospital repealing the rain with my hot pink umbrella. I try to think happy thoughts. After all I am not late. I walk into the lobby and greet my instructor and two other of my fellow students. I am escorted to the Emergency Center. Because of my grades I was one of only two students picked to spend a day at the Pediatric Emergency Center. I am greeted by a staff of about 15. The morning starts off rather slow, so far we have had two teenagers recovering from hangovers, a toddler with an inflamed throat, and a little newborn with vomiting. The emergency room is slow but not a soul says a thing about it. We really do not need a busy emergency room. Who wants to see children in pain, ill, or just suffering?
The morning rolls along, we have sent two patients home and one to surgery. Just as we are about to leave for breakfast the radio dispatch announces they are bring in a 9 month old with a closed head injury and the triage nurse starts filling room after room.
I see moms and dads scared, stress, and on the edge of a nervous breakdown. I have one mother of a tiny 4 month old who has come in with a distended abdomen that is hard as rock just grab me and hang on for dear life. I do the only thing I can think of and hug her back and tell her we are going to do everything we can for her baby. About an hour after the baby has been treated with fluid, pressure removed from his abdomen with an NG tube to suction, and diagnostic test after diagnostic test he starts to act like himself, both his mom and dad are happy that he is starting to act like the baby they have grown to know. He is not well yet and will need surgery for an intestinal obstruction but you can see that just knowing what is wrong the parents have had some weight lifted. We have a young girl come in with a rupture stomach who is rushed off for emergency surgery her parents in blind fear, a baby with chicken pox, a few upper respiratory infections, a young lady with a shunt that is ineffective. Case after case of some of the youngest patients I have ever seen come in and are sent on their way. Some treated and able to go home with a sticker and a smile. Others stabilized and sent upstairs to start a longer road to recovery.
One thing that gripped me was the resilience of these young patients. One after one these children are entrusted to a total stranger who in a matter of hours or a few minutes becomes part of changing a life. Each child without them knowing it gave me a gift. They helped me see that my bad day pales in comparison to many. Each one of those young people gave me something to be thankful for and showed me that life even when dealing with pain and sorrow will show you something that can bring a smile to your face.
Everytime someone comes up with such ideas that tack on more tasks onto already busy med-pass nurses, they should first shadow a med-pass nurse with a stop watch, record the time it takes to do all those tasks they came up with, and calculate how long the med-pass will be for the given number of residents a nurse has, and of course the time it takes to walk from room to room should be added too, not to mention the occasional (errr... frequent) distraction that pops up throughout med pass. And then increase the number of staffing so that all those tasks can be done within the time frame they want. When I worked at LTC, I often thought of timing myself for each med-pass, time it takes me to walk from point A-to-B, doing the cart audits, etc, and show them how inhuman it is to do it all in the allotted time. But what do you know, I never had the time!
Evidence-based practice? Ha! All that research doesn't mean squat if it doesn't follow with practicality!
Sorry for the rant.
I'm prepared to flexible here. If an elderly woman would rather her daughter who is the primary carer put the anitfungal cream on her excoriated groin rather than the guy she's known for 10 minutes I have no problem with that.
Where I work, the DON staggered our med times.
We care for approx 130 people. One half's med times are 7-11-3-7.
The other half is 8-12-4-8.
So you can start your med pass at 6am for the 7am time, then proceed on to the 8am med pass which can start at 7am thru until 9am. It works for us and helps alot as it gives an extra hour.
So maybe some of you on here who are in management could help out your medication nurses by implementing some staggered med times.
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