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sbostonRN 7,398 Views

Joined Jun 22, '08 - from 'Boston metro area'. sbostonRN is a Nurse!. She has '2.5' year(s) of experience and specializes in 'Med/Surg, Rehab'. Posts: 524 (32% Liked) Likes: 336

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  • Mar 1

    Try acute rehab or LTACs. I went from a nursing home to a LTAC hospital and it's very similar to acute care. I plan on working here for a few years before trying to move onto somewhere more acute.

  • Feb 25

    I am a new grad and I've been working on a subacute rehab unit at a LTC facility for 2 months now. I really love it and I'm well supported by my coworkers. On a typical day, my unit has about 36 patients (up to 40), 2 med/treatment nurses, 1 charge nurse and 1 to do admissions and discharges. So I'm typically responsible for the morning med pass for about 18 patients. I'm curious how other med nurses arrange their morning schedule to gain speed. I come in at 7, generally start my pass around 7:30 (after getting count, stocking my cart and getting any blood sugars), and I finish around 10 or 10:30. So it takes me about 3 hours to do a med pass. I've seen others at my facility finishing their med pass at is this possible when each resident takes 10-15 meds?

    Please, if anyone has tips or tricks for time management, it would be much appreciated. Since I'm on a rehab unit, I do have therapists coming at me constantly wanting to take my patients down to therapy, so I would love to start finishing earlier than I have been!

  • Jan 5

    Boston is a great city for nurses and medical professionals. I work outside the city right now, and am getting my BSN so I can work at one of the big Boston hospitals some day. Pay starts around $30/hour for new grads and benefits are good at the major hospitals (Mass General, Brigham & Womens, Beth Israel, Children's, Boston Medical Center). Plus you're working with some of the best doctors and nurses from around the country. Even though cost of living is high in the actual city of Boston, public transportation is great and allow you to live in the neighboring cities.

    I wouldn't live anywhere else!

  • Nov 1 '15

    We have Sigmacare for our EMar and ETar. I am a new nurse so I don't have a ton of experience with Mass DPH surveys but we went through one last summer with Sigmacare and things went great! The surveyors do not have access to Sigmacare except for what we choose to show them on our screen (for one or two particular patients), so they can't see if a med is late unless it's late on the patient you're providing care for at that moment. Also, our computers are attached to the med/tx cart so they rarely go into a patient's room. Sigmacare allows us to change the administration time so it always appears that we are in compliance with timing. Of course it's best to just change the time due to the time you're actually able to get done, which we're encouraged to do with daily meds.

  • Aug 28 '15

    Hello! So happy to see other people interested in this program. I'm an evening/weekend student going into my last semester at LM/RC. I took a semester off because I got married and couldn't handle everything, and I'm getting ready to get back into the school groove again. As others have said, it's a very challenging program. You are expected to learn a lot, know how to apply what you've learned and make connections. however, the teachers and clinical instructors are fantastic. They all want you to succeed even though sometimes it seems like torture. I agree with saving up your pennies - the program costs a LOT more than I originally expected it to. Uniforms, stethoscope, medical supplies, PDA, PDA programs, tons of books, etc etc. Most of the books you buy in the first course are used throughout the program, so you don't get stuck with a huge bill each semester. And if you have an iPod Touch or iPhone already, you will probably be able to use that as your PDA (when I started the program we were all required to buy the same device but that has since changed). I have worked full-time throughout the program. It hasn't always been easy but it's necessary for me. I am very lucky that I have a lot of free time at work and I often study while I'm there. Depending on your job, you may or may not be able to work. Good Luck! I can't wait to be done with the program and be able to call myself a nurse They have a very successful NCLEX pass rate and a very good job placement rate. Many area hospitals love LMH grads!

  • Aug 8 '15

    My patient was new, just arrived last night from the acute care hospital. He was on the young side for our population and clearly not used to being in a hospital. I went in with his medications and breakfast tray this morning and cheerfully introduced myself. He stared off into space, pretending not to hear me. I introduced myself again, said that I was here with his medications which he needed to take because therapy was coming in soon. He continued to look away. Slowly he turned to me and said "I didn't order those and I'm not taking them". I explained what each medication was for, and he replied that he didn't want any medication, that he was going home and he didn't belong here. There was frustration in his voice, a need to be heard.

    I could have gotten frustrated and walked away, written "pt refused all medication" on the MAR. Something told me he needed me.

    I sat down next to his bed and told him that I would stay with him for a few minutes, and if he wanted to talk, that I would be there. After less than a minute, he completely broke down in tears. A recent cancer diagnosis had left him battling embarrassing symptoms, and he was struggling because in the hospital setting, his needs were "exposed" to say the least. I sat with him and listened to his concerns and reassured him. Once I came to terms with the fact that he would get to call the shots today, things went much more smoothly. He agreed to take the medications. Therapy was able to get him out of bed and comfortable. And we worked together to ensure his stay was productive, for however long it is.

    I truly felt like a nurse today. Many days I feel like a glorified waitress but today I felt like a nurse.

  • Jul 31 '15

    I wanted to update this thread with news of my new job! I graduated with my ASN in 2011, and worked on a skilled rehab floor for one year before transitioning to a LTACH (long term acute care hospital). There, I learned so much! Trachs, advanced wound care, dialysis (peritoneal and hemodialysis), tons of meds via every possible route, etc etc. I also learned how to see the big picture, how to manage patient and family demands, learned to have confidence with doctors and communicate and collaborate with the healthcare team. I've been there for a year and three months.

    And yesterday I was offered a position at one of the most well-respected hospitals in my area!! I'll be working on a med-surg unit that specializes in respiratory and cardiac patients, some are on telemetry and some have trachs, but my experience at the LTACH is a great fit for them.

    Don't ever give up and don't be afraid to take a position in a well-run LTACH or SNF! You will learn great time management and innumerable skills. If I had held out for that perfect position as a new grad, I would still be waiting, but I went out and got 2+ years of experience that I'm now able to bring to the table in my new position. And you might even find out that you love being a rehab nurse and that's awesome too!

    Best of luck!

  • Jul 15 '15

    I talked about this program with one of the nurse managers at MGH. They are definitely filling spots, so there is still a lot of demand for the program. I don't think it's right to "take advantage" of desperate new grads, but the hospital is really benefitting from this program. And really, probably all of the people who finish the internship will get hired at the end, so I think it would be worth it as a way in to MGH. I think I'd rather have an intership making a low salary than be jobless making no money at all, wouldn't you?

  • Jun 14 '15

    No they are not the same thing. Subacute rehab floors are generally in LTC (nursing homes). They are shorter stay than the LTC floors, anywhere from a few days to a month. When I worked in one, we cared for mostly geriatric patients who were post-op joint replacement or cardiac surgery with minor complications. Some had severe wounds, some were on dialysis. I didn't personally care for trach patients, but we were able to. Lots of IV meds, G-tubes, neuro checks. LOTS and LOTS of respiratory patients, administering nebulizers, daily weight checks, lung assessments, etc. It's definitely good experience!