Latest Comments by chelynn

chelynn 3,115 Views

Joined: Jun 19, '06; Posts: 135 (38% Liked) ; Likes: 145

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  • 1
    Forever Sunshine likes this.

    Things in our treatment books are: Wound care, dressing changes, creams, powders, monitor bruise, skin tear, etc, skin checks, diabetic nail care, podus boots, o2, cath care, cath changes, elevation of extremities, peg tube checks and flushes, remove dressing 4 hours after dialysis, suture removal. I think that about covers it

  • 8
    nola1202, kiszi, ahintonRN, and 5 others like this.

    I often wonder how you can even breathe when you're head is always so far up your butt

  • 3

    Quote from NamasteNurse
    It is a lot, but at my LTC facility, we have sometimes one LPN for 42 residents. The sub-acute floor has two or three LPN's for 43 res. It will be do-able but yes it's very hard and a steep learning curve. Your orientations sounds good. The nurse who wants nights, is looking for an easier shift. Most residents sleep at night and no matter what it's easier than days. The good thing about days is usually you have extra people around to help and the residents are busy with PT/OT, and other activities. Nursing is hard no matter how you slice it. Best of luck.
    How dare you say the nurse wants an "easier shift." I work nights, I have 45 residents and 2 CNAs. You do understand that these confused residents don't know whether it's night of day. They try to get out of bed several times a night and often end up falling. We also have to prepare all paperwork for dr appts the next day, as well as check the Narc ekits and fridge temps. We have to update alert charting list and start the 24 hour book. We have to finish treatments that day nurses "didn't have time to do" as well as doing our own. We have to call on call pharmacy or the on call dr for coumadin orders or abx orders that you "didn't have time" to get to. We have to go through the whole huge med cart once a week and order meds. We also have to note orders and file lots of things in the chart that day nurses leave there because, "Nights can do it they are not busy." When I come in to work at 6 pm there are charts and papers everywhere, when you come in at 6am and everything is neat and pretty you need to know that didn't happen by magic. During the day there is one nurse for each hall, each nurse has 22 residents and 2 CNAs. At night since I have both halls I have 45 residents that means I have double the meds to pass, double the charting to do. I am NOT saying that nights works harder than days but I want you to understand that nights is not EASIER than days by any means. I have had several nurses tell me that they would never work my shift, mainly because of the 45 residents I have for my med passes. Please educate yourself about what night nurses do before you throw around comments like that again. Thank you.

  • 1
    nurse.sandi likes this.

    LOL, lucky you! I have the exact same story about 3 years ago, only the thing shot right into my thumb! The other nurses and the doc I was working with almost wet their pants laughing. Talk about a crazy rush: Legs like jelly, shaking, pulse 135, then my thumb stayed white and cold for a good 24 hours! LOL

  • 2

    Quote from NurseLoveJoy88
    This is NOT insurbordination. Let me tell you why. When ever you ASK the PCA to do anything you leave her the choice of saying YES or NO. Now if you said" I need you to do an EKG" or "Please do an EKG" and she didn't comply then that would be insurbordination. I had attempted to write up a CNA who did not want to help another CNA transfer a heavy patient. I asked him to help her he said NO and I immediately wrote him up for insurbordination. Then I was told my managment that I could not legally do this because I asked him to do something rather than telling him to do it.

    Insubordination definition:

    Willful failure to obey a supervisor's lawful orders. So I learned this the hard way. For now on I don't ask my CNAs do anything but I politely tell them to do. I give clear and direct directions that way if they still insists on no then they can be written up for insubordination.

    I too, have been known to ask, "Can you get me a BP/pulse on so and so?" The reply was, "No, I'm really behind," I simply said, " What I meant was get me a BP/Pulse on so and so, thanks." I don't like sounding like I'm bossing them around, but I want them to know that telling me no is not an option. I had words one night when a CNA came back to me with, "You could say please." I simply told her, no I am not going to ask you please do YOUR job.

  • 9

    That would definately be insubordination. We discuss this at work all the time. Ours are CNAs, ceftified nursing assistants, which means they are at work to assist us. They do need to work with us and do as asked. Definatley write her up. A couple weeks ago before I got off work at 6am I put a resident on the vital board to get orthos. When I came in that night they hadn't been done. I asked the CNA why and she said to me because he can't stand. I said she could do all the rest anyway. She said she didn't have time. I said, "Well why don't you have one less cigarrette today and get my orthos done?" She then slammed her water bottle on the counter and yelled, "Yes Maam" Then she went into a residents room and slammed the door. The two getting off work just stood there stunned. I did not write her up but I did complain to the CNA manager. Then just the other day I was told by another CNA that the insubordant one said, "I told her Yes Maam but I should have said **** you!" Needless to say, I did mention that to my DON and she told me to write her up. I don't act like I'm God but I do deserve some respect and you do too.

  • 0

    For one why has she been getting 2mg when the order stated 4-15mg? Also tell us what you would guess and why and then we are more likely to help you from there.

  • 1
    nurseynursej likes this.

    Quote from TheCommuter
    It greatly helps to place one's self in the shoes of the CNA, especially a LTC CNA. I work at a nursing home, and each one of my CNAs is assigned 12 to 15 patients each. They simply do not have the time to sit with one patient for an extended period of time when there are other call lights that need to be answered in an expedient manner.

    In addition, most LTC facilities suffer from high employee turnover and attrition rates, so the DON usually won't bestow severe punishments upon lazy staff members. The DON is just happy that a warm body has arrived to fill the necessary shift. In addition, there's typically not enough quality time for most LTC nurses and aides to devote to non-emergencies such as panic attacks and screaming. Few, if any, procedures are done by the book in LTC. You'll learn as you spend more time in your new LVN role.
    If you read it the problem isn't that the CNA didn't have time to sit with the resident. The problem is that the nurse gave the CNA the patients meds, MORPHINE and ATIVAN to administer. That to me is grounds for termination for BOTH of them. By the way I am in LTC and I do my job "by the book" thank you very much. There is no excuse to take shortcuts in ANY nursing situation and if you think there is then maybe you need to reconsider your career choice.

  • 1
    IowaKaren likes this.

    I have to say you have it better than I do. I work 1800-0600 with 3 CNAa until 2200 and 2 after that. We have 45 residents. I have the med passes, treatments, tube feedings, TPN, among all the other stuff and then the charting, med orders, dr appointment paperwork and a ton of other stuff. Yes I hate my job, and tell myself I'm lucky to have one. I've been there 7 months and am looking for something else. I came there from the ER and let me tell you a bad day at the ER was nothing compared to what I have on my plate now. But to answer your question, yes it's legal, we always pass our state inspections. Is it dangerous? It can be. I think that is why I am so stressed because I work my butt off to make sure I do everything right.

  • 0

    Our place does 12s, 6-6. I work 3 nocs

  • 0

    How many times are you going to post this? Not to be rude but I swear I read it not long ago

  • 0

    I don't think the drinking was so much the problem as placing an IV was. Why were you doing that?

  • 5

    Tylenol is what I see most, I guess because that's a common drug around the house and the lay person doesn't understand what a slow painful death liver failure is.

  • 0

    Quote from Mikessa

    I think a nurse can lose its job if he or she cant spell or pronounce medical terms.
    You're kidding right? It scares me if you think this is true.

  • 0

    Quote from chelynn
    I look for pysiologic signs such as higher bp and pulse. We also look into the pts old charts and visits. We see if they are under the care of a pcp and if they go their follow ups. Also when you see many FFs you get a sense of the real pts in need.
    I guess I wasn't clear enough in my first post. I never meant to imply that I don't give the meds. As a nurse it is my job to do what the doctor orders. If pain meds are ordered then I give them regardless if I belief the pt or not. The things I listed in my first posting are issues I will bring up with the doc IF he wants my opinion. Hope that clears it up.


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