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dallet6 5,863 Views

Joined: May 13, '08; Posts: 243 (12% Liked) ; Likes: 48

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  • May 6 '13

    Quote from supervisorhatchet
    I do agree with previous post, about cleaning up the MAR. I am working on that now on my med pass. But our medical director is horrible. He is the PCP for 90% or our residents and he won't change anything. He won't d/c meds on a resident that has not put a pill in his mouth in over 4 years! Now isn't that crazy.

    And as far as checking BPs, we have a ton of them at our facility that do have orders to check BP and/or HR prior to, and hold med if ....It is time consuming...

    And when I said, I knew some nurses weren't doing it. I really do know that they are not doing it. During my orientation, one nurse actually had the nerve to say to me "I don't have time for that. Make something up"
    And that is why I always act in a manner that I can sleep with at night, AND can defend in a court of law.

    Just saying....For the original post....

    It will get better, it just takes time. And learning your peeps is part of it.
    Good night all!
    My question is, nurses...and as nurse managers...and DON's, we KNOW nurses aren't doing these things.....yet we do not act on FIXING the problem. If the medical director won't d/c meds, I would have the DON speak to him. IF the MAR is NOT what we are really doing/giving the resident?.....Scary nurse practices. The golden rod is...what would a prudent, reasonable nurse do in any given situation? My second question is...why are we bothering our LTC clients to take B/P twice daily, or pulse twice daily, or supposedly HOLDING meds based on paramaters that we aren't "really using"...when this problem can be easily fixed? The second advocate is the consultant pharmacist, get him/her to put the reccomendations in the pharmacist monthly report, the MD will/should and /or the DON will follow-up for all the unnecessary nursing time used for no quality of life for the resident.

  • May 6 '13

    I pass meds to 22 residents, after passing the same meds to the same residents for a few months, I began to memorize them.. I still look at the MAR but it is just quicker now because I already know what meds I am giving to who. I found that in the beginning most of my time was spent reading the meds and comparing them to the MAR.
    You will get faster too, but remember faster isnt always a good thing, more mistakes can happen if you do not take the time to do your 3 checks.. and many nurses don't.

  • May 6 '13

    By your own admission you verbally abused a resident (with whatever name you called him). That alone is grounds for immediate termination. It sounds like you really had a horrible night but abuse of a resident is a violation of several federal regs & I seriously doubt your DON had any choice.

  • Feb 8 '13

    So should a person with a mental illness not be sent to the ER then,
    because they were seen on the street attacking and accosting every
    person who walks by?

    I used to work at a psych facility; we didn't even have walk-in service.
    The ONLY way someone could be admitted to our facility was by first
    going to the ED downtown.

    That ED had a section reserved specifically for Psych emergencies.

    Before you fuss at me because my LTC doesn't have a unit set aside
    for dealing with agressive residents... well, why doesn't your ER have
    a section set aside for Psych emergencies?

    This problem, the problem that the OP presents.... it's no one's fault.
    If an LTC has a resident that has become a legitimate danger to
    themselves or others, the only safe and logical place for them
    is an ED, UNLESS that LTC does happen to have an area set aside
    for aggressive residents. BECAUSE an LTC is NOT a hospital, but
    is in fact a HOME.. the likelihood is pretty low that that LTC is going
    to have it's own psych unit. I'm sure some LTC's *DO* have areas
    set aside for aggressive residents, but I think it's rare.

    If you have someone in your home who becomes physically out of
    control as a result of a problem inside of their brain... is a danger to
    the rest of your family... what are YOU going to do with them?

    An LTC is a HOME. I think some people who have never worked LTC,
    forget that. It's not a hospital.

  • Feb 18 '12

    It was up earlier this afternoon, but has been down for a couple hours

  • Apr 24 '10

    Start with the different parts of the body and the drugs that work on them. It seemed that in Pharm class we started with the brain and then the heart and worked our way from there on the different systems. You need to UNDERSTAND how the drug works and why and what can result from that more then memorizing anything.

  • Mar 9 '10


    CONGRATULATIONS! That is a huge stepping stone, getting accepted to nursing school!!! The nerves you are feeling are completely normal. Try to relax (easier said than done, I know....) and revel in the moment of hearing the words, "you've been accepted" Yaaaaayyyyy!!!!!!

    I'm waiting right now to see if I get accepted so I'm a bundle of nerves for that reason..... But....I guess another advise I would give you is to try to get your life in order prior to starting school. Just anything that needs to get done that you haven't done already (i.e. file income tax return, organize your closet, visit know what I mean..... )

    CONGRATULATIONS again...... I don't know you, but I'm happy for you!!!!!

  • Mar 9 '10

    Congratulations! I'm terrified too.

  • Mar 9 '10

    That's great news! Being terrified is what I would call a high class problem!

    Here's a hint: write on a list of what terrifies you...doesn't matter what it is or how silly it might be. When you're done, study each item and figure out what you can do to conquer that specific fear. Is it math? Do a little extra studying between now and school. Anatomy--review your notes.

    You'll do great! FYI--I just found out I'm staring nursing school in September. I'm worried about being overwhelmed so betwee now and then I'm taking the non-nurse course, testing out when I can (CLEP tests). Then I can concentrate on the nursing courses.

    Have fun with it.

  • Mar 9 '10

    I got accepted from a waiting list too. It'll be ok! Just relax now and let yourself be excited!! Nursing school takes ALOT of work....but you'll get there!

    You start off with small baby steps so don't worry about being thrown in there.

  • Mar 9 '10

    Everyone is scared at first, i was terrified too! But the good thing is everyone else there will be scared too so you're not alone, plus your teachers are there to walk you through everything. Yes, nursing school is hard but they dont want you to fail. So if you need help with anything just ask them!

  • Mar 9 '10

    Congratulations! To occupy your time, you could start looking for a stethoscope :P

  • Nov 7 '09

    The basics are the same no matter how the client is positioned. So you do the knock, wash, intro/explain, gather supplies, curtain, lock wheels if they're in bed. If your skill is foot care, chances are they'll be in a chair (that's how we were instructed) but if they're in bed, you will have to assist them to a sitting position. With vitals, it's more likely they'll be in bed. Doesn't matter. This is where you have to think "what would i do in the real world". If you have BP, raise the head of the bed. If you have radial pulse, it's unnecessary. If you have respirations/pulse, again, leave them supine. If you have tympanic temperature, it's easier if they're semi Fowlers. If your examiner gives you a scenario where the client must be positioned a certain way, you go with that. Otherwise, take charge and do whatever vitals you get in a way that makes it easiest for you. If you get weight with ambulation just DON'T FORGET to zero out the scale before and after the skill. If you are lucky, like me, and get fluid intake, you just get three containers with pee-colored liquid. Do your best estimate of how much liquid is missing and make sure you record everything on paper. Especially do it before you forget what the numbers were and before moving on to another skill. Oh yeah, and don't forget to give the call button.

    Order of the basic steps isn't critical as long as you remember to do them all. If Headmaster is your testing authority, the only skill with steps required to be in a set order is female perineal care.

    In our state we didn't have to check wristbands. That depends on your testing authority. We were told who the patient was before the skill, and all we had to do was greet them by that name. Don't get too wrapped up in the order of steps. Remember the basics of privacy, safety, dignity and universal precautions and just do the skill without skipping the critical steps or forgetting to wash your hands and glove. You won't be docked for washing too much. I think it's a good idea to wash anytime you remove gloves, even if it's only a simulated wash.

    If you KNOW the skill, your knowledge will kick in and you'll do fine with that boost of adrenaline. I know it sounds ridiculous now, but try to have fun with it. If you feel goofy, joke a little. Your BP will go down, and you'll feel a lot better.

    Quote from dallet6
    I'm hoping I could hear from others what their test was like for a few questions I have. I've been watching skills videos on youtube and practising everyday on my family. I have a couple questions though as I'm not sure how my patient will be positioned in some circumstances.

    On the videos the client is sitting in a chair when the candidate "enters the room" to perform all vitals. Is this how you performed it? Or were they in bed? Also, for foot care were they laying in bed and you assisted them to sit at the edge and performed their foot care on the floor (naturally with nonskid footwear on one foot and towel under basin). Or were they in bed and you had to do footcare with them laying down? Same with hand care. Did you perform it with their hand on the bed and towels under basin, or did you set up on a bedside table and they sat in bed while you did it?

    One other question--did you go to the patient and introduce yourself and check wrist band before the first skill (hand washing)? Or did you go do that and then do the introducing when you performed a skill that was interacting with them?

    These may seem trivial, but it will help me alot if I can study them with advice!


  • Sep 18 '09

    One thing I would like to point out, not just for the OP but for everyone in this situation: When you enter the nursing profession, you are CHOOSING to work with vulnerable populations. Many or most of your patients will be immune-compromised in some way. These vaccinations are required to protect both you and them. They have a purpose.

    For those who cannot or will not get vaccines, they can't be forced when simply a part of the general population. But when you become a nurse or a nursing student, you are signing on voluntarily to work with these people, and thus are accepting the responsibility of protecting them. That includes protecting them by insuring your immunity to certain diseases.

    Going into nursing and refusing basic vaccinations (I'm not talking H1N1 here, folks) is like going to the police academy but wanting a waiver not to carry a gun, because you disagree with the use of firearms. Hopefully the gun will never be necessary, but it's part of the job. If you have objections, you may want to look at another field that does not require any vaccinations.

  • May 11 '09 exciting. Growing up as a kid my sister and I used to climb up on the roof so we could watch the fireworks at night. Times were different back then; nowadays parents letting their children climb up to the roof in the dark would have CPS all over them. But I digress...

    Yeah every school is different regarding their deadline for accepting applications for the following semester. I would imagine it would be towards the end of the semester...depending on when your semester began you may or may not be too late. But don't let me worry you...just call 'em up first thing Monday morning. But if you can, I'd just contact the nursing department them or go down in person. I've had bad experiences with counselors before so that's my thing...I'd rather just go right to the source: the nursing department itself, rather than someone in the counseling department.

    Thing is though, I would imagine that somewhere on the webpage for the nursing department they'd state when their cutoff date for accepting applications would be. There's nothing there?

    My school had a wait list...and when I turned it in I just simply put an application in a special "In Box." No formal meeting/interview with anyone.

    Good luck!!