Finallydidit 3,693 Views
Joined Nov 15, '09.
Posts: 137 (35% Liked)
Anyone willing to expand on LPNs in the Wilmington area, Jobs, Pay, Cost of living in general? 5 yrs exp. LTC & Corrections
Thanks so much
Check with Goodwill Industries in Knox or Morristown...... They both offer classes!
You have helped me narrow it down pretty much!.... Like many of you, I feel there are so MANY issues to choose from that it is really difficult to just pick a few, when I know I could write a freaking book!
Some of my biggest issues are staffing, and the treatment/abuse of staff members, Pt./family education... I too am usually able to make the family understand that Mom's time has come and its time to let her go.... But as a nurse, I feel that families should be educated, informed, and made aware long before I am in spending my "limited" time on why its not a good idea to go with a feeding tube.
But I honestly think my biggest issue that I really noticed starting to increase about a yr ago, is the FIGHT that a nurse has to go through to get a Resident sent to the ER..... I am not talking about the hospice residents.. I am talking about the one that you have been taking care of for months and months that you know like the back of your hand and you know something is not right, and they need to be sent to the ER and the Management wants you to wait 4 days until the NP comes in to evaluate them. It takes me contacting family to come in and insist they be sent and then they are admitted. Then have a supervisor tell you, well if they are not here we are not getting paid for them! #*%&# It really shouldn't take 8 hours to send a sick Res. to the ER!
Anyways thanks again for your input...
Hey Guys........ LPN here taking classes for RN...... Have to write a speech about issues in health care..... Can be any issue.. So as a fellow LTC nurse, I would like to take a poll from here and the top 3 answers will be what I cover in my speech. So please respond with your honest opinions & concerns<br><br>Thanks so much for your input
Hey Guys........ LPN here taking classes for RN...... Have to write a speech about issues in health care..... Can be any issue.. So as a fellow LTC nurse, I would like to take a poll from here and the top 3 answers will be what I cover in my speech. So please respond with your honest opinions & concerns
Thanks so much for your input
If you are looking at the Tri Cities, I would go to the VA Med Ctr.........
First of all...... Take your breaks!! If you don't take care of you, you can't expect to take care of anyone else.. ...
The first thing I would do is get your med times changed... This will be a HUGE help, and it is as simple thing to do.
The first half of my hall is sched for 9am meds and the 2nd half is sched for 10am meds. this turns a 2 hour med pass into 3 hours. Also look at your Med passes and see if anything can be combined and sched it accordingly. It won't work for all of your Residents, but every little bit helps....
My first med pass includes all 30 of my Residents of course, but my 1&2pm passes, are down to less then 10 residents. allowing me time to chart and stock etc.
The Residents that need coaxing, put their meds in food, or a drink that you know that will finish.
Tell your CNAs that unless it is an emergency or high priority, to make notes and tell you the little things all at once and speaking of CNAs, why are they not doing your vital signs?
Staff assignments, they are adults, let them decide among themselves, if they are unable to do this, then tell them you will have to, then put them all where they don't want to be, and it won't take them long to work out their own system.
If you allow family members to run over you they will.... I have been known to put them in their place in a very in a very nice way. If this was your mothers medicine would you want me to ignore giving it to her, so I could discuss a non-emergent matter with another Residents family member? The answer is Always NO!......... Then I say give me about 15-20 minutes and I will be happy to speak with you, They get the hint and it also shows them that I have no favorites and all of my Residents are important to me.
These are just a few of the tidbits that come to mind....... From what I have seen in LTC it takes 4-6 months to find your groove and actually be able to clock out on time!...... hang in there
Have worked for LCC for 2 years, Its like any other facility... its a tough job.... Biggest complaint is always under staffed, they take residents that should be placed in other facilities, and it is nearly impossible to be in compliance with med passes.
The pay isn't great, as a base salary, but there are alot of "perks" that make up for it. 2 wks vacation, 5 paid holidays, 12 sick days per years, bonus days for not using sick days, or calling out....
Most of the staff have been there along time, other then there is a high CNA turnover.
I can so see them continuing to pay the staff that was effected by Katrina I would expect no less from them.. At my facility we have has alot of random tragedies effect several of our staff this year, and it was pretty much like you tell us what you need and we will make it happen. That means alot more then people realize
Have worked for LCC for 2 years LPN charge nurse, they have some great "perks" but the staffing ratios sucks! CNAs most times have 20 residents, LPNs have 30. To be in compliance with my med pass, I have less then 6 minutes per resident, to pull it, check it, pop it, give it, and sign it............ I have had as many as 18 diabetics on my hall. Most shifts I end up doing nursing and cna work, or my cnas would never finish on time.
If you have any specific questions feel free to ask
Okay as a nurse in a LTC facility, I have to respond to this post.
I work wkend baylor 7a-11p, my facility has 120 residents, and a staff of 1 RN, 4 LPNs and 8 CNAs, (however, with it being wkends, there are always call outs and the norm is 6 CNAs. I honestly can't recall when the last time we have been fully staffed for a full wkend... With that being said the LPNs are responsible for 30 Residents each, and the CNAs 20 Residents each.
Company policy is that each resident be changed, turned, cleaned, etc Q2/hrs. That gives the CNA 6 minutes per resident per 2 hours.
Keep in mind that in addition to the changing, turning, and cleaning, the CNAs also have take their residents to dining room, pass and set up meal trays, and feed the majority of their 20 residents. Also 1 of the CNAs has to stay in the main dining room during meal times, and another has to go to the "restorative" dining room and assist the "at risk" residents, this leaves 4 CNAs on the floor passing the trays and feeding residents.
In addition to the above the CNAs also have to pass ice, hydration, and snacks to their 20 residents. and if they are medicare, they also have to get a full set of vitals q8/hrs.
Please keep in mind that this is the wkend and Activities are abundant throughout the day and evenings, with church services both afternoons and evenings on Saturdays, and even an additional one thrown in on Sunday mornings right after breakfast. Yes.. 3 church services on Sunday. PLUS... we get all the FAMILY visits. Did I mention that company policy also states that we can not interrupt our residents during "activities" or "family visits" to do any care for them? It is considered a violation of their rights.
So if Ms Jones who is alert and oriented to name, demented and incontinent, decides to go to the dining room for breakfast, visit with family and stay there until the afternoon church service is over there is absolutely nothing that anyone can do about it. Now a good family member will bring her back and ask that she be changed, but that is not usually the case, as that cuts into their weekly 1 hour visit.
If Mr. Jones decides that he doesn't want to take a bath for a week...... He has a RIGHT TO REFUSE. We can send him to "behavioral" after a couple weeks of refusing, but they will send him back..... and the process starts again.
I could go on forever, but I think you all get the idea.... We at LTC facilities, KNOW that most of the residents are going to have a UTI, they wear briefs all day, and no they don't get changed as often as they should, with state guidelines on adequate staffing being what they are it is IMPOSSIBLE to change all the residents every 2 hours. WE CAN CHECK FOR UTIs at the facility... That is NOT what we are sending them to you for. We are sending the to you because WE KNOW THAT SOMETHING IS WRONG but can't diagnose it. Just because they are 92 doesn't mean for you to check their urine, and send them back to us, only to have them returned to you the next day throwing up blood due to a GI bleed. (happens all the time)
There truly are good LTC nurses and we try to get them to you ASAP, because we do know them so well, and we do know if something isn't right but we can't exactly put our finger on it or we know and can't do anything about it.
I honestly believe that "most" LTC try to be the absolute best that they can do with the staff that they have. The expectations, rules, regulations that are placed on the staff of these places are mind boggling and I often say the only way to make them better is for every one to set a date and just up and quit and open the eyes of the powers that be but we love our residents and that is the only reason most of us work under such conditions.
The answers you see here reflect all of my hours upon hours of research..... Texas seems to be the best place for nurses to live!
Started out as 3-11 charge Its not that bad, until you need an evening off... Chin-up gave a pretty good basic over view.. Hopefully you will have an RN supervisor to help with admissions and dealing with calls to pharmacy and calls from family members. But it is hard to not see the hubby and kids and can get frustrating because you can't be with them
Hosp vs LTC totally diff. In LTC there has to be team effort, there are far too many residents on a unit to otherwise give proper care. As an LPN, I could never do my job without my CNAs nor could my RN supervisor do her job without her LPNs. We count on each other, and we help each other, we question and advise each other. But most important we TRUST and RESPECT each other. It has so little to do with the initials that follow our names and so much to do with the attitude that is in our hearts.
As an RN at a new facility, you should calaborate with your team, they know the facility, the residents, the family members, the Drs etc. learn from them no matter what their title, and allow them to learn from you. Together develop trust and make a plan, then you as the RN lead by example. The other units may continue be in chaos, but you may soon find that your unit runs like a fine tuned engine.
Good luck to you
In LTC we often have to get orders for increased respirations, the drug of choice is usually liquid morphine the order will state "for pain" or "air hunger" even though I called d/t respirations not pain
If resp. are controlled, and no s/s of pain/distress I will hold the dose and monitor q15/min.
If the drug has been ordered for pain control, I would give it ATC just to stay on top of it.
We all agree that it was very unethical that the nurse accepted this gift, however, if the Resident and the POA, are both saying that it is okay for her to accept it.. I don't see where it needs to go any further. How do we know that the admin didn't start an investigation, and was simply told that that they wanted this nurse to have it? Then sat down the the nurse and told her what they had discovered, and then educated her on ethics and told her not to accept any future gifts from residents. If the grand-daughter isn't POA they don't have to discuss any of this with her. Yes shame on the nurse, but we can't judge the facility without knowing for sure if it was investigated, and I'm willing to bet that it was.
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