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strawberryluv, BSN, RN 5,468 Views

Joined Oct 8, '09 - from 'New Jersey'. Posts: 671 (32% Liked) Likes: 380

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  • Jun 9

    In addition to all the excellent suggestions here (most importantly HIRING ENOUGH STAFF) - I think contracting with a cleaning/ yard service. I would be likely to turn down extra work because I had stuff to do at home. But knowing when I get home my house will be clean and my yard mowed? Watch how fast I take extra work!

  • Jun 7

    I never understand why people/nurses show up to work sick. In all the non-nursing and nursing jobs that I have had nurses would show up to work sick, clock in, take report and then turn around and say i am sick....Administration does not care!!! Because they know they can threaten nurses with abandonment issues, so most will not put in the effort to call for a replacement nurse, most nurses don't want to come in anyway. I personally don't care I start sniffing, coughing, fever, throwing up... I won't come in. I have missed the time frame to call in and have called in sick anyway. Yes I will be reprimanded from the facility but no way in hell would I compromise my license. I tell nurses all the time, you can not be so desperate to not lose your job where it clouds your judgement. And nurses let situations like these cloud their judgement everyday. You can always get another job but the day your license is revoked you are toast. You are on the pavement by yourself. And have to look for a lower paying job until you can pick your self back up. Let's see... that's about 2 yrs to pick yourself back into a different profession versus 2-3 months of looking for a different job.

    I will not be in any profession where I bullied into caring more for anyone else first above myself. How is that helping the patient? How is that helping management be more efficient? Nope I refuse.

    I honestly don't believe they will alert the BON. But I would be ready, just in case, as most people said to have a lawyer look into your case.

    This scenario could have played soo many different ways. Please don't ever compromise your license for anyone...patient included. It's not worth it....the world will continue to run if you are sick, so will the patients, the hospital and the nursing homes.
    Please keep us posted.

  • May 27

    Wow all these immediate jobs are awesome to hear. In California you can get 6 - 12 months out when you finally land in acute care. Of course one can always walk into a SNF LTC and land a job quickly.

  • Apr 19

    I failed a class and had to repeat not just one course, but TWO courses, setting me back a full year from my expected graduation date. Why did I have to rotate back 2 courses? Course content was moved from one semester to a previous semester and I had to follow the moved content. I graduated 2 years ago...

    What I did was very simple. I simply analyzed why I failed and set about correcting that. I went from struggling a bit to basically being a class leader and peer mentor because I'd already "been there" and knew what was coming up. I studied, peer taught, and generally did my best to maintain an OK home, school, and work life. Because I didn't have the amount of time/energy to study as much as I'd have wanted to, I didn't make straight "A" grades throughout school but aside from my course failure, I never got a grade lower than a solid B and the school discounted the F so it doesn't appear in my GPA. It's still on my transcript, of course, and it's a reminder to me that life sometimes takes a curve you never quite expected.

    In a way, I'm proud of my F. Not because I failed, but because I overcame it.

  • Mar 20

    A nursing home job is not a job to be proud of? That is a HUGE insult to the wonderful nurses out there who work LTC. Yes there are some poor facilities out there. But there are wonderful ones too. I think you need some counseling.

  • Dec 28 '15

    I work 11-7 in LTC. We have two nurses on duty at night, each with approx. 60 residents to care for. We most certainly do not have time to get bored, and we never take our "lunch break". We eat at the nurses station while we are charting. Here is a typical night for me:

    11-12 PM - shift change-over, initial rounds, report, narc count, making note of who has to be charted on, flushes on the tube feeders.

    12-2 AM- med pass, syringe and tubing changes for tube feeders, humidification for the 02 concentrators, a couple of bolus feeds, a few of glucose checks, vital signs on those who need them.

    2-4 AM- making rounds, charting on everyone who needs it, can be as few as 6 medicare residents or up to as many as 20 with declining status, falls, etc. Faxing med refills to pharmacy, accucheck controls, refrigerator temps, crash cart checks, restocking.

    4AM flushes on the tube feeders. Taking a couple of feeders down prior to giving dilantin at 5 AM. Any tx/dressing changes that have to be done.

    5-7 AM- med pass, glucose checks, final charting. Any incident reports, any non urgent calls to physician. Outgoing report and narc count.

    Granted, there are not nearly as many meds to pass on graveyard, but don't ever let anyone tell you there are no meds to pass. This simply is not true, in addition to the PRN meds, I have quite a few scheduled meds to give, and we have quite a few tube feeders that require q4h care that is rather time consuming.

    We have several residents who sleep during the day and stay up at night. One requires constant supervision, so on nights when we are short staffed (regularly, LOL) he poses quite a problem for just two nurses.

    All in all, I love my job, and I've filled in on 7-3, and I'd never consider going to day shift permanently. There are days when I feel rushed, but most often, I have a steady pace that allows me to give quality care to my residents. Yet, I still have enough going on with my residents that I'm constantly learning through my assessments.

  • Dec 27 '15

    I've always worked LTC by choice. I may or may not remain in LTC but I am certain that I will continue to work with geriatric patients.

    The acuity in LTC has changed, so you'll learn just about every skill that you would working a medicine floor. Aside from that, you will develop sound assessment, prioritization and delegation skills.

    I was a charge nurse, then unit manager, now educator. I participate in quality initiatives also, and I have two certifications in geriatric nursing. There are many opportunities if you enjoy working with the elderly.

  • Dec 26 '15

    Hemoglobin 2.9. Alive and talking to me.

    Glucose of 1200ish. Also alive and hungry for dinner.

  • Dec 21 '15

    I finished my last nursing class in Dec 2013. I graduated May 2014. I just took my NCLEX RN Nov 2015 and past 1st try.

    My personal advice;
    Review companies - they only go over the highlights - things you already know - but just as a reminder "remember this". You need more details. It's not enough to know that Ca++ is a sedative - you have to know how it applies in different situations. Hypercalcemia is generally not a disease in itself - its part of another process - that process is what you need to know more about, and how the Ca+ comes into play and what to do etc. Review companies don't completely tie it all in, and they leave LOTS of holes - some things they don't even cover at all. My advice - DON't WASTE YOUR MONEY.

    Practice tests and questions - these are valuable tools to help you find out what you don't know- and help remind you of the things you do - you can get just as much info out of these as you can paying for any review so long as you study the rationales.

    #1 thing to do with them - go body system by body system. Go back to your old notes for example on "renal" - read everything you have - look it over in your text book - ADPIE it for notes - know what you do from the time they walk in the door to when they leave. When to start an IV, when to remove the IV etc etc
    #2 - AFTER you have reviewed the system - then go looking for questions in groups, internet, review books, wherever - that focus on that system. If you run across something you can't answer - go back and review it.

    You retain more info if you focus on a subject than if you just jump around and randomly answer questions - like heart, then lungs, then ICP, then CAD - you'll forget the info as fast as you got it.

    SATA questions - these are not "harder" questions - they are given the same weight as any other question on NCLEX. They do not have ANY hidden meaning - you didn't get them because you answered the easy questions right - and now they are giving you harder ones - they are just another type of question. Not everyone gets them - some do, some don't . I had 3-4 out of 75.

    PRIORITY & DELEGATION - this is patient SAFETY as well - there is a lot of this - and they want to make sure you know what to do. KNOW THIS STUFF.
    #1 - the practice tests, and questions you've been doing do not hold a candle to the way NCLEX does it - you will get down to two answers and this is where having taken the time to ADPIE situations will help you. Best advice I got out of all of it before the test is if you get down to two patients -and its not easy to decide - choose the answer that does the least amount of damage. Don't kill anybody.

  • Dec 19 '15

    WOW! That still feels unreal to type I graduated in May 2015, passed NCLEX in July, and started working in August in a LTC facility. I'm still amazed that I managed to make it though nursing school and the NCLEX! I think I checked the nursing board website at least 10 times during the week after passing just to make sure my licence still stated "active" LOL
    Anyway, the majority of my former classmates are now working in hospitals and when I tell them that I took a LTC position they always say, "Just keep'll get a hospital job eventually." My two sister-in-laws work in hospitals as RN's and both of them feel that I'm wasting my time in LTC and that I won't be marketable in the future.
    Here's the thing... I'm perfectly HAPPY working LTC! I was hired in at the same hourly wage as the hospitals near me and I feel that I get plenty of hands-on experience! I am charge nurse of two halls. I currently have 23 residents that I provide care for during my 12 hour shifts. In my four months on the job I've had to insert IV's, foley caths, and suppositories. I've given all types of injections. I've placed several wound vacs, changed dressings on all types of wounds, and removed surgical staples. I've toileted and bathed more residents than I can count. Perform assessments, take vitals, and call physicians on a regular basis. And unfortunately, I've seen 5 resident deaths. This doesn't even include the stacks of paperwork, labs, charting, making appointments and transportation arrangements for residents. Oh yea, and passing medications
    But most importantly, I get to become familiar with my residents. I can walk in the room and notice if something is wrong just by the way my resident looks or speaks...I don't think you can get that in acute care hospitals.
    I am proud to be a LTC nurse. Will I stay in this specialty forever? Who knows. But I won't be disappointed or feel like I short-changed myself if I do.

  • Dec 19 '15

    UWorld updates their questions like crazy to be consistent with evidence-based practice.

    Concerning the difference between the two about this particular disease process: you'll remember the differences about this if you see it on NCLEX... so, just answer to the best of your ability and knowledge. Right now, you have more knowledge about it than most test takers.

    Who's to say that the newer research is "damning" enough for the NCLEX to consider and who's to say there isn't other evidence that's just as recent which suggests the opposite?

    I wouldn't concern myself about specifics like that - remember, NCLEX is looking for minimal competency - the VAST MAJORITY of students would select "avoid nuts and corn" in a question like that.. a GREAT MAJORITY of students end up passing the exam.

    Take a deep breath, and good-luck

  • Dec 10 '15

    The 'my license is at risk' mantra is overinflated. Statistically, nurses lose their licensure for issues involving addiction, impaired practice, theft, diversion of narcotics, and other drug-related charges. A nurse's license is typically not on the line for issues such as sloppy care or failing to administer a medication.

    With that having been said, I've worked in subacute LTC before. The trick is to not spend more than 10 minutes with any particular resident during medication pass. You quickly assess them, change any dressings, medicate them, and move on to the next resident. They're not our friends or anything like that, so there's no reason to spend an inordinate amount of time on any particular person.

    Good luck to you. I wouldn't return to subacute LTC unless I desperately needed the money to avoid becoming homeless.

  • Dec 9 '15
  • Dec 9 '15

    I work in public health as my full time job and have a float RN position for an abortion clinic. I have another side hustle as a semi-professional belly dancer, have taught dance on occasion and have taken custom sewing commissions as that's what I did for a living during nursing school. I don't do the sewing as much anymore because of the time involved in the sorts of projects I took (historical costuming), but I still perform at least once every couple months in the belly dance gigs.

  • Dec 2 '15

    I'm a hardcore introvert. I've adapted to nursing's demands for socialization, but this entails stepping out of my comfort zone.

    Still, I spend much of the shift alone. Meaningless small talk makes me want to cringe. Unless the conversation is substantive, I gracefully disappear.