Latest Comments by michelle126

Latest Comments by michelle126

michelle126, BSN 12,181 Views

Joined Jan 22, '03. michelle126 is a RN. Posts: 3,466 (22% Liked) Likes: 1,469

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  • 0

    Make a few phone calls. When was your cert to run out? Do CNAs need recertified?

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    Have you figured out what was causing the mental changes?

    I can't belive I am going to type this BUT...I was watching Dr Oz ( yikes, right?)

    There was a segment about parasites causing menal changes. I did a google search and found a good bit of info on it.

  • 1
    Fishmm likes this.

    Is this an after the fact question?
    I would do my assessments, call MD. A chest X-ray and ekg could take hours. Do they have nitro? Cardiac history? What were vitals like? Did you rule out gastrointestinal? Anxiety? Resp issue?
    If it's a 911 situation, I don't wait for the MD to return the call...5 minutes can make a difference. I'd also get the AED and crash cart ready.

  • 0

    Sounds like a nice bit of training and that they are willing to invest in their employees. Good luck!

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    ShaneTeam likes this.

    Welcome to LTC! First step is realizing how different it will be. A lot of how crazy it will be will depend on what type of facility you will work in. Larger facilities might have more support staff and of course more nurses. Smaller places you might need to wear a few more hats.

    Read thru some of the new grad posts already in the forum. Good tips.

    Even though you have some time in, ask for as long of an orientation as you can get. Will you be more of a supervisor or floor nurse working the cart? Ask to get training in both areas. Keep cheat sheets. Depending on what type of facility, some of the residents will be long term and you won't have many changes. My sheet has room number, name, Dr, code status, top dx (they will have tons of them, but what are we treating them for?) and a spot for IVS/ Accu Checks. How do they take meds? Whole or Crushed? and if they need anything special...thickened liquids, etc.

    In LTC, you will be doing focused assessments. Rarely do you have time to do a full head to toe like med surg.

    Get a cheat sheet for important phone numbers or extensions. Big places can be confusing. In a new place, I find it useful to have drs phone and fax # handy along with the pharmacy's. I also make notes about what drs like certain things. All of our drs are so different.

    My biggest piece of advice.....not be afraid to ask questions!!!

  • 8

    Sounds like Dad w wanted out of work!

  • 0

    What was the biggest hurdle besides actually getting the job?
    How did you manage to get your foot in the door?

    Many of us who have done LTC / skilled nursing and even semi sub acute are very familiar with complex wound care, wound vacs, IV meds, IV starts, blood draws, NG tubes (including inserts) G tubes, Resp treatments, med passes from hell, family issues, dealing with cranky doctors etc.....sooo how does this experience help?

    What do you feel you needed to re-learn?

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    Easy answer...follow your P and P and professional standards. Remember....if it wasn't documented, it wasn't done.

  • 0

    Quote from Rose_Queen
    Unless report is given to someone who accepts the assignment, that is indeed abandonment in many if not all states.

    Yep. If I'm the only nurse on and there is no one to give report to, then I'm still "it." This is mandatory OT. Now, the question is whether or not the OT situation was avoidable? Did the facility purposely staff low, did they make an attempt to call in people?

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    Sounds like a few of my nights!

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    It would be frustrating to follow this nurse especially if you are trying to manage the patient's pain and you are playing catch up. I'm willing to bet this is LTC? It sounds like our system. I'd also bet they are probably not giving other meds. The med passes are overwhelming!
    Ask Leslie what happened.

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    ponymom likes this.

    Think about what would attract you. Good pay/ benefits are the big ones. A good working environment... Good leadership, manageable staffing ratios, etc

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    We also do an investigation as part of the incident. Each person on that shift that may have come into contact will need to do a statement.


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