Latest Comments by CoffeeRTC - page 3

CoffeeRTC, BSN 15,521 Views

Joined Jan 22, '03. CoffeeRTC is a RN LTC. Posts: 3,556 (23% Liked) Likes: 1,564

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    Turns out my teenager has an allergy to tree nuts and now will need to carry the epi pens.
    Of course we've all been watching the news stories and reading the stories on line but I never thought it would happen to me!

    So, call the script in to the pharmacy. We will need 4 I think. Get a call from the pharmacy and they tell me to sit down...with my copay it will come to $1,200 or so.


    Here it is....a friend mentioned she has 4 non expired epi pens that her child doesn't need/ never used. Still capped, in the package 100% untouched. She was looking for a way to get rid of them.


    I've never "shared or borrowed" meds before nor would I in my nursing practice but..???
    Lots of scenarios come to mind. I'm assuming if i go with these meds for home use, i will still need to get a script filled for that would only be $600. I will be looking at the coupons out there, but I have a high deductable plan.

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    BabyFood26 likes this.

    Our school has a nurse in the building once a month. This is common for all the Catholic schools in our area.

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    Clint1076 likes this.

    I work in an extremely busy LTC, often times understaffed. I've been in LTC for 20 years. I'm good at what i do and know what I need to do. Everyday is stressful, some day's I'd like to scream and actually do. I get paid a very comfortable rate. My point....I like what I do. I thrive on the stress and business at work. I manage the stress and probably wouldn't know what do do without it.

    Is that crazy? Probably. I've been at the same place for those 20 years and have worked at other places PT and PRN. I get bored at the "less stressful" places.

    Bottom what you do. At least have a strong like for it!

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    frappuccino1 likes this.

    i'm not sure I will ever get out of LTC or if i do it would be for hospice/ home health setting. Its just different. When I see nurses with a goal of "working in a hospital" I tell them do it, but if you think you will give LTC a serious it too! Realize that it is a "different world".

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    It all depends.

    I'm a LTC nurse and some days I want to run for the hill. Head over to the LTC forum and read some of the posts to give you an idea how LTC has changed. 10 years ago, I would have said that LTC would be a gentle transition back to nursing, but now days, many of the LTCs are understaffed and have higher acuity residents with a high patient to nurse ratio.

    If your goal is to get back into acute care, I think you should look there instead of a LTC. In the hospital setting you will be given and orientation and preceptor to get you back on your feet. LTC..maybe a few days of training if you are luck.

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    Well, that just about covers my facility. Our acuity varies. The CHF patient with fluids and hypocalemia...that would have put me over the top due to the constant need to monitor. This patient should have been sent to the hospital for closer monitoring. Sad, but this it what a good bit of LTCs are looking like.

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    I think in PA, the lpns must have this certification. We recently had our pharmacy IV nurse some in and do a two day in-service. I found it to be a great review and informative. (I never thought i would say that

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    Welcome to LTC!!! A mod might want to move your post to the Geriatric forum.

    Anyone can "lose their license." Being in LTC for the last 20+ years, I haven't seen it due to being a nurse in LTC but more for the nurses actions like stealing/ diverting drugs.

    3-11 is a busy shift. The bulk of the admits occur on 3-11 shift, labs need followed up on and there are generally less staff and less support staff in the building.

    My routine as a staff nurse:
    2:45 arrive at work and get myself ready...pens, census sheet etc
    3pm-3:30...make assignments, report, quick walking rounds and set up my cart, take off orders and look at any labs back pass
    5:30-6:15...assist with dinner, monitor meal pass etc.
    if able, take a lunch after residents have dinner, charting, follow up on order/ labs start treatments
    7:30 start pm med pass and do treatments
    10pm...finish med pass, more charting

    We generally try to have a charge nurse that will work on any admits, md orders and labs......that is a huge help. If not, it is all sqweezed in the above schedule.

    if they don't have a census or cheat sheet, make your own.
    I list the res room #, name, Md, full or no code, an area for quick notes and then a spot for IV/ accu checks. You might want to include their top diagnosis until you get to know your residents.

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    WKShadowRN likes this.

    i work in a much more laid back area of LTC nursing, well sometimes it is LTC and a lot of times it is more short term rehab. For the most part, I love finding out if there is a nurse or someone with a good medical or nursing background in the family. Right now, we have a few nurses as patients and it really makes things easier. I still do all the teaching I would do with a "lay" person, but it is just different.

    In LTC and other home type of settings it is often the nurse who is explaining the procedures, coming up with a nursing diagnosis and then telling the doctors what we need or what they need to look at. Working with the patient or family member with the background makes things flow better. .....well after the initial culture shock of LTC!

    Me....I hide the fact I'm a nurse unless it comes down to being needed. I'm not versed in ICU or critical care and my only experience with L and D comes from having 5 babies and I'm not even going to begin to think I'm up with onocology BUT...I'm always up to be a supportive family member and help my loved one with ADLs etc.

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    AutumnApple likes this.

    This is universal to nursing. I work LTC and have days like this. 3-11 and 11-7 run on much less staff, no support staff either. Accidents happen close to shift change too. Nurses need to give and get report.
    We tried to solve some of these issues by staggering report and having the CNAs get their assignments as soon as they walk in the door and get them moving.

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    Quote from CoffeeRTC
    i love the fact that our new ADM is a nurse!
    Any now she is gone! 7 administrators in the last year.

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    Ahh...I re-read this and when you say " i didn't bother looking" did you mean looking for meds to borrow or for the actual resident in question?

    You are correct in not wasting time looking for the meds from the other residents. Supervisor should have when to your emergency box to get the meds. We are not permitted to borrow meds. Yeah, in the bunch card system we might still do this, but it is wrong.

    Treat any order for controlled substances extra carefully. Always double check if you have a question or the order doesn't seem right. You can never go wrong when you do this.

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    study the above suggestions but also take into consideration the changes in the elderly.

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    NutmeggeRN likes this.

    Wait, is it every time you give the med? or just at shift change?

    Can you ask your pharmacy services about "the reg"?

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    Nurse Leigh likes this.

    ??? Not sure what you are asking. If this is a need for a certain program you are in, ask them for examples or suggestions.