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MedChica, CNA, LPN 9,206 Views

Joined May 18, '10 - from 'Tampa'. MedChica is a I float everywhere.. She has '3.5' year(s) of experience and specializes in 'Psych, LTC/SNF, Rehab, Corrections'. Posts: 578 (52% Liked) Likes: 1,027

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  • Sep 21

    Quote from ashley2009
    I graduated in May 2012 from an LVN program. I did very well in Clinicals but on test, i ranged from C's and D's. Some B's. My test date is Thursday and i been studying every day, making sure im not over studying also. I have taken several ATI tests and im getting 63%-70%. Its really discouraging. I'm also studying from the Saunders Book and doing flash cards. Since I'm doing bad on ATI test, will I do bad on NCLEX?
    I don't understand the problem. How are you doing so 'poorly', in your opinion?

    For the quizzes, 60% denotes 'content mastery'. Coach might have you take more tests and assign some homework, but you'll move on to other modules.
    ATI demands a 95% chance of passing for the 'greenlight'.
    My school? We had to have a 90% chance of passing...and that's about a 60% on the Predictor, I think.
    If you're getting 63-70% on your tests, it still represents a high pass-rate percentage.

    From my ATI page:
    Criterion-Referenced Measure -
    Probability of Passing NCLEX-PN«:
    The following expectancy table was developed by
    comparing PN Comprehensive Predictor« scores
    to NCLEX-PN« performance for a sample of PN
    students. As can be seen from the table, higher
    Predictor scores tend to indicate a higher
    probability of passing the NCLEX-PN«. However,
    students should use caution when interpreting
    the table because numerous factors can influence
    performance on both the Predictor and the
    NCLEX-PN«.
    For example, note that a student with a score of
    57.3% correct would be expected to have a 90%
    chance of passing the NCLEX-PN« on the first
    attempt. Although this is a high probability of success,
    it is not a guarantee. For every 100 students with this
    score, 90 are predicted to pass and 10 are predicted
    to fail.


    PN Comprehensive Predictor« VATI Individual Score
    Predicted Probability of Passing the
    NCLEX-PN«
    74.0% - 100.0% 95%
    66.7% - 73.3% 94%
    62.7% - 66.0% 93%
    58.0% - 62.0% 91% - 92%

    54.7% - 57.3% 89% - 90%
    50.0% - 54.0% 85% - 88%
    44.7% - 49.3% 79% - 84%
    38.0% - 44.0% 65% - 77%
    30.0% - 37.3% 41% - 62%
    20.7% - 29.3% 11% - 38%
    0.0% - 20.0% <10%

    I found the NCLEX to be way less comprehensive than ATI. Everything was dialed back. Even the SATA, though there were a lot of them on my exam, weren't that bad. Actually, I'll be even more honest -- and I usually don't like saying it like this b/c so many people on this board seem to have such difficult with that exam, BUT: I thought NCLEX was easy. There, I said it. LOL
    There was a degree of difficulty, but I - a wee little black woman of average intelligence - thought it 'easy'.
    I knew that I'd passed halfway through the exam and when I walked out of there.
    ...and that's something else to consider.
    Wouldn't you rather that your test prep be harder than the actual exam?

    Either way, there are no guarantees which is great for those who need to improve.

    The only thing that ATI does is test knowledge content, application and comprehension.
    Either you know it or you don't.
    Yet, 'comprehension' is a something that can be improved. Nothing's set in stone.
    So, you're not cranking out 80's and 90's on your quizzes? So what?

    You can do poorly on ATI, but you can STUDY and still pass NCLEX.
    Conversely, you can do excellent on ATI. Take a break. Schedule the exam 4 months later. Not review and bomb it.
    ...like a certain valedictorian that I know, exactly 3 cohorts ahead of mine, who shall remain forever nameless. It happens like that, I'm telling you.
    The valedictorian failed NCLEX. How embarrassing...and not because she 'failed'. Rather, because it really made no sense for her TO fail.

    How can you forget it, I wonder? NCLEX questions are pretty basic. It truly is just ensuring that the nurse has enough competancy to not kill anyone.
    So, someone who pulls A's out of their butt for every test from Fundamentals to Pharm to Leadership should retain enough info to pass NCLEX, the first time.

    Oh, yeah - I'm judging it! LOL Make no mistake about it.
    Like a year's worth of schooling just leaks out of your brain? Maybe GVNs/GN's should start packing their ears with cotton and duct-tape their ears before they go to sleep at night.

    How can you forget? It's not like you stop studying once you land yourself a job. Heck, I STILL research and study things. Every night.
    When you apply for jobs - with staffing and homehealth, especially - you still have to take competancy tests. It's not like some of these employers are going to take your word for it.
    "Oh, yeah...I graduated with a 4.0 on a 4.0 scale..."

    "Uh, yeah...here. Can you prove it?" LOL
    I've an interview tomorrow (why am I still up on ALLNURSES? LOL) and I had to take 4 tests (with time limits) for those people.
    - HIPAA. 15 questions
    - Infection Control. 15 questions
    - Nursing Comprehensive. 50 questions.
    - LVN test. 30 questions.

    For another job that I wanted but didn't get, I had to take a dos cal/pharm test and a matching Pharm exam. 'Match the disorder with the med that treats it'.
    Like, 20 questions a piece. The math was simple, though. 'Desired/Have'. It's not like I was calculating gtt rates.

  • Sep 16

    Someone turned on the 'Way Back' machine. LOL

    Requisitions were composed on a typewriter.
    I had one of those as a kid! I'm glad for computers. You know how many bottles of white-out I went through trying to type a page? Error after error. Back then, most who typed actually HAD to look at your fingers.

    IV pumps were used only in Peds and ICU. Nurses had to calculate the drip rate using the second hand on their watch and a roller clamp to regulate the flow.
    I still try to retain this skill. Actually. Why?
    Anything could happen. My former occupation, radiology, has gone digital...but it's still important for techs to know how to shoot on regular film, calculate time 'techniques' by hand, process film, duplicate film without a CD and operate/troubleshoot the processer.
    The system went down twice and the techs were having to do everything manually and there's a whole mess of xray techs out there who can't change processor chemicals or shoot with their own 'techniques' unless the computer's helping them out. The technology is great. Saves time and money, but it actually does tend to produce techs who are less skilled. In my opinion.
    I've no idea why we were ever paid as much as we were. Not that I'm trying to be the barrier to anyone's cashflow, but...seriously. A robot could do it. A fair amt of xray techs get paid $23+/hr to robotically do their jobs to begin. That's why, to those whom I suspect of only entering nursing for the money/stability? I tell them to go straight to radiology. I'm serious.
    You're not the quarterback. The nurses are. LOL Unless it's on the table, housekeeping cleans it up. You don't have to 'tap-dance' for the rude pts.
    I don't see that nursing has been revolutionized to such an extent (where everyone's literally and completely dependant on technology) as xray techs, but it's something to think about.
    Stay up on the old skills. You never know when they might come in handy.

    "State boards were 2 grueling days of exams that were completed with number 2 pencils. No computerized tests in those days."
    LOL I had to explain to one of my aunts about the process. She was kind of confused when I told her that 'the machine shut off at 85 questions'. Her brow furrowed. 'Well, when I took boards, I had 200+ questions. Ya'll do it by computers now? Hmm..."

    Nurses notes and vital signs were recorded using pen with 4 colors of ink as different colors of ink were used on different shifts. Actually only 3 were used since there were 3 shifts.
    Now, this I remember. Those in my family who are nurses used to always have these.

    "Patients were called Mr. or Mrs."
    I still do this and this still goes on. I feel weird about calling someone 20 years my senior by their first name. It just shows a complete lack of home-training (manners), in my opinion.
    Nurses wore uniforms which consisted of white dresses, white hose, white lace up oxford shoes, and, of course..........white nursing caps!
    I actually like 'whites'. I've always thought it very professional looking, in my opinion. I thought this way even before I became a nurse. I'm prior svc military and dress/appearance are pretty important in my eyes. 'Whites'... just scream 'authority'. Position. Nurses in whites look...'important'.
    Its kind of like with medical doctors or NPs. You can tell who they are because they're always running around with a clipboard and a lab-coat over their casual professional attire... looking 'important'.
    I'm just not sure how realistic it is to wear. Personally? I could imagine myself fussing (primping) with it all day...and don't let them give me a swing cape! LOL
    I would be forced to 'don'... The Cape...every single day. I'd be whooshing and swinging all over the hall.
    You know how I know? Again - ex-military. Sometimes, we'd have to wear our service (dress-up) uniforms. Worked in the hospital. Still...it was hard to not be conscious of your clothes with every movement. Doesn't matter what you're doing. When you're in a service dress uniform and not up to par, everyone will clock it. It was no thing to see someone within the dept stop a coworker to fix their slightly askew necktab. Crisis averted. Actually, even when it came to the old BDU's (the battle green).
    "What? No creases...?" *rolls eyes in disgust*
    Military folk do fuss with their uniforms. It's just done in a very serious and 'manly' way. LOL
    Or, they 'did'. The new uniforms don't require much. It's actually pretty difficult to look a mess in them, but some do the impossible and manage to pull it off.

    Then, there's the subject of dirt. I wore a white top and 2 hours into my shift, I had:
    - blood on the back (from where a resident grabbed to alert me that they'd scratched themselves)
    - chocolate pudding down the front. I was trying to lift a resident and got it all over my shirt. (it was pudding, FYI. Not pooh...although that's happened, too)
    - dots of Prostat and depakene on the bottom of the shirt. I just said 'the hell with it' and wiped my hands on my shirt/pants. It was already DIRTY!

  • Sep 6

    Quote from pumpkinfuturelpn
    I am getting a lot of negative feed back from my fellow CNA co-workers. They congratulated me on getting accepted into the program but they are making comments like you think you better than us now. And certain ones are saying dont forget where you came from and I dont want to be a nurse! I hate to get into a argument with them but its getting on my nerves, I worked hard to get accepted into the program. I REALLY need some feedback as to how to handle the situation! I DIDNT EXPECT ALL OF THIS NEGATIVITY!!
    I've never encountered this and if I have? I probably never noticed. I study quietly on breaks and I come to work to pick up my checks in my school uniform.
    That's how folks knew that I was in school. People will ask questions and cheer me on and say how they'd 'wanted to go to nursing school, too'.
    Of course, my response was always, "Well, what's stopping you? You're smart. You can do this. Just study. The 'health science' discipline is difficult. It's just that there's so much info thrown at you in a short period of time..."
    The answer is always some variation of being too dumb, too old, etc...

    But with some people? The success of others allows them to reflect on what they're not doing/unable to accomplish.
    So -- if you're happy? Be happy.
    If I'm nursing school? I just am.
    If I made a good grade on a test? I just did. Unlike this type, I compete with no one but myself.
    You shouldn't have to hide that you're in nursing school or hush up about this, that and the other in order to make everyone in the free world feel better about themselves.
    I'll give support and encouragement, but if you're asking me take your issues into my self...like it's MY fault that my success gets you down?
    Sorry.
    It must really suck to go through life feeling so inadequate around (what you perceive to be) your 'betters'. But...that's a 'personal problem, babe. It's nothing to do with me.
    LOL

    As far as work is concerned? Please...
    I don't sweat people at work. Work is professional; not personal. I do my work and go home. My coworkers are not my friends. They're just people that I work with in that place that holds my paycheck hostage.

  • Sep 6

    Quote from RNperdiem
    CNA experience is more than "dirty work". You are gaining experience in patient interaction in a healthcare setting. The skills you are doing are the basic skills.
    Some settings do not use CNA's; it is the RN's who perform all the care.
    My brother was once a CNA and said it was very helpful when he started med school clinicals. He had gained specific people skills that many of his classmates lacked.
    ...and this is EXACTLY why I'm getting my CNA certification.
    Plus, I didn't want to take a year off from my BSN to do my LPN. It's been a while since I've worked in the hospital setting and this is a great way to get 're-acclimated' to the environment.

    The way I think about: LPN's do the same as CNA's...and more. RN's do the same as LPN's...and more.
    It's experience, either way. Even if it is the basics...it's stuff that I need to know. After all, I'm going to be able to observe and indirectly shadow the LPN/RN's as well.
    I think the experience will make me a better RN. Get to see how things work.

    More than that, I just don't want to go on that floor as an RN being totally green about things. Y'know...?
    'Book knowledge' is one thing; 'Hands on' experience is another.
    ...and, honestly, it's the same -- no matter where you work in the hospital.

  • Sep 1

    Quote from Rntr
    Employers have a right to ask for a certain dress code and this includes hair, tattoes, inappropriate or overdone jewelry, perfume (totally out of place in the workplace). To ask you to show up on time and not abuse the "sick" benefit... there could be more and this should all be in a policy. It's upfront, not hidden and.....

    You have a right to not work there.

    I personally am glad there are certain standards that apply to everyone. Get over it and quit making such noise out of nothing.
    We're talking about judging someone for something that CANNOT be controlled. It's a problem when you tell a group of people that what is natural about them is wrong -- that they should change a natural feature to fit.
    No, they shouldn't be told to 'get over it'.
    They don't have the problem. You do.

    ...but this isn't an issue that affects you so, of course, you'd be all obtuse and "dismissive" about it. Who cares, right?

    Ugh. Does this site have an "ignore" feature?

  • Sep 1

    Is this a troll thread or something?

    I have an armpit length kinky/curly fro. I rec'v compliments from everyone.
    Even I didn't - I doubledog dare anyone to look me in my eyeballs and call it 'unprofessional' -- suggesting that I "do something about it".

    No. Braids, dreds, sisterlocks, fro's, etc... are not fads. They're black hair styles. It's deeply cultural.
    As for my curls -- this is how my hair naturally grows from my frickin' scalp. Hell, yeah - it's BIG! LOL I don't need to 'do something' about it. OUR hair doesn't need to be 'fixed'.
    I'm not going to alter the very structure of my hair shaft to fit some idiot interviewer's WARPED beauty ideal.
    Should I change my skin color,too? Maybe, get the fat sucked out of my lips...or butt ( could be lucrative considering all of these 'boxy'-looking pancake *expletive* females getting butt augmentation these days). LOL
    I've enough to spare!

  • Aug 19

    I was burned out of my previous career field (rad tech/ct/management/military). I can understand.
    I just quit cold turkey. Was I scared? Not really.
    Do I advise the same?
    Nope. It was hard. I never did regret leaving. Maybe...the way I went about it. LOL I didn't keep my license current. I did the whole 'take this job and shove it' schpeal with middle fingers blazing (ok, maybe I don't regret THAT. LOL It's been 6 years later and they can all still kiss my a--!).
    I was done. 'Over it'. In fact, I couldn't have been more 'over it' if I were standing 10 ft in front of it. I could've been folding t-shirts at The Gap and been completely content with life.
    That was my 'American Beauty' moment.

    I never did regret leaving and seeking better, however. I went back to school and didn't return to work for 2 years. When I did finally rejoin he workforce? I got a job at UPS. I didn't have to think. I wasn't in charge of anyone or anything. Someone was always telling me what to do.
    I was just a straight up 'worker bee'.
    It was great.
    That's nothing. I used to work with a rad doc who told me that he wanted to be a used car salesman. LOL We'd sit around and trade stories all the time. He never left, though.
    But, of course, he wouldn't. The man earned about $245,000/per year. It's not easy for most people to just pick up and leave that kind of security. Plus, his daughter was at Harvard, so he def couldn't. It's nice to dream, though.

    Nursing? Meh. I 'love' nursing (at the moment) because it's new...AND because I know myself well enough (thanks to my last burnout meltdown) to know the signs and how best to manage such things.
    I work weekends and nights, with good reason. The politics of nursing would drive me insane - would kill my spirit - if I worked 9-5, mon-fri. It's the only way that I can maintain my dewy eyed 'Pollyanna' outlook where nursing is concerned. LOL
    ...and I know what goes on during the week because I occasionally pick up shifts during the day and it's nothing but hellraising, drama and ******* contests.
    Of course, everyone compliments my diligence and focus. I'm 'the hardworker'.
    Some of it's just how I work. But, honestly? I just put my head down and concentrate on my tasks+pt's+aides because I don't want to be bothered with it or any of those crazy a--s women.
    Last week, we lost 6 aides. GOOD aides, too. I mean, what are they doing to these guys to make them quit?! SMH

    Anyway - I see nothing on my regular shifts. I hear nothing, because the unconventional shifts are never kept in the loop. Nights and weekends are the last to know everything...and that's how I like it: Blissfully oblivious.

    Ignorance is bliss. LOL

    So, IMO? You spend a lot of time and energy - a great deal of your life - at work and that's entirely too much spent not doing work that makes you happy.
    Seek a more fulfilling path, I say. Just cover your bets and keep that nurse license current.

  • Jul 1

    I don't see how you'd be doing this alone. You're not in that facility all by yourself.
    When the facility alarms go off, everyone (CNA, Nurse, Housekeeping, Maintenance, etc...)should be making a beeline for the exits to recapture the pt.
    Yes, running. You can't work psych in cute Koi clogs, I'm sorry.

    Someone should already be on the phone with the A/DON. Yes, you must FOLLOW the pt and coerce them back. Call the daughter on your cell if that helps. If not, call the police and state the cause. Get a cop out there. You cannot lose your pt.
    We've pulled residents off city buses. It can be done.
    Is the neighborhood attentive? If you've got watchful homeowners nearby, they WILL alert you to a resident trying to escape.

    Your pt doesn't seem all that aggressive. How exactly are you 'distracting' the pt? Why not give them something to do?
    Reality orientation doesn't work when someone's mind is completely broken. It could actually create aggression.
    Sometimes, you've gotta run with the delusions. I don't mind talking to residents for hours on end. Psych pts are funny. Characters. They're hilarious. I let them follow me around, too. It doesn't bother me. I'd rather them follow me around, a bug in my ear, than trying to break out. The discussion will be weird but fun.
    "How do I get to giant eagle?"
    I'd say something like, "I dunno. What's a giant eagle?"

    Interesting dialogue will be had. If it's a destination (like, where they used to live before coming there. Home), lead the convo off on a tangent.

    -- "How do I get out of here?"
    Give them direction. Just don't provide the right ones. I just keep sending them to dead ends. They'll just walk to the other end, get distracted, come back around 30 minutes later and ask again. Good exercise.

    Do they have friends in the facility? Sometimes, I put two talkative pts together and let them yack the other's ear off. If you eavesdrop, the discussion will be utter gibberish but they like it. Everyone needs to socialize.

    -- "I'm trying to get home."
    "Where do you live?" Then, redirect the discussion to something more interesting.
    "Why?"
    "It's dark outside/too much traffic, papa. Stay here with us until the traffic thins out/tonight and you can leave tomorrow."

    I used to have a resident who wandered (sundown) and tried to elope every other day. He either had to pick up a car or go to work or was looking for an item for work or was waiting on a vehicle to pick him, etc...
    -- "Papa, the car is in the shop. It won't be ready until tomorrow. Just wait here with us."
    -- "Papa, you don't work today. It's --" ...nighttime/Saturday/Sunday/the weekend/the holiday, etc... " You're off. Why do you want to work on ____? You should be resting. I wish I was off. "
    -- "Papa, it's night time. Why do you want to be running around at night - it's dangerous? Let's wait to leave until tomorrow when you can see? They'll pick you up tomorrow.
    -- "Well, you should eat before you leave. You're gonna get hungry. C'mon - they're making --"
    -- "...you can wait here for the night. We have a room for you with a tv in it and everything else. You don't have to pay for it or anything. Stay with us and leave tomorrow."

    It's okay to phrase statements in an asking tone but you don't redirect a pt with questions. That gives them opportunity to shoot down whatever you're offering which shuts the dialogue down. "Is that something you'd like to do?" ; "Are you hungry?"
    Ask questions when you're probing for info. You don't redirect a pt with a question.
    You suggest. You make statements.
    "Let's do --"

    Food helps. I used to settle a pt with pudding every time he made a run for the exit. Talked him down; then, "I have some chocolate pudding...?"

    EDIT:
    I never worked ALF. I was just geripsych. So, pardon my confusion.

  • Jun 15

    - Make sure the cart is stocked BEFORE you start. Rule #1.

    - Make sure you've got mixed thicken liquid. It's a pain in the booty to have to stop and hunt down powder.

    - Make sure you've got ensure and formula on the cart.

    - Disoriented/Sundowning/Dementia pts? Go with the fantasy. Don't get frustrated with exit seekers. Be creative in your redirecting. "Let's wait for breakfast. Then you can go to work after you eat." ; "It's dark outside and everyone's asleep. Let's wait until sunup." ; "We've got a nice room for you over here with a tv in it. All paid for and everything. Let's come this way so I can show you where it is. They'll bring your breakfast to you."

    - I like to manually flush but, in the world of auto-flush buttons, there's no excuse to not have well hydrated PEG pt's.

    - During report, figure out your blood sugars and your crush/whole people. Also, make note of who needs BP/P and O2 Sat.

    - Leapfrogging with the CNA helps create a buffer for the pt who likes to talk about everything under the sun.

    - Get in the habit of using paper towels when you deal with PEGs.

    - Give PRNs with the med pass if you know the pt will request it.

    - When you pop a narc flip the card backwards & return it to its spot. When it's time to review the count, just go to the narcs that are flipped backwards. I never sign as I pop narcs. Slows me down. I pop and flip. When I've finished everything? I open the cart, search for flipped narc cards & refer to my notes to record the times of admin.

    - Keep gloves in your 'clean' pocket.

    - Skin tears happen. Keep some TAO & island/bandaids on the med cart or in your 'dirty' pocket.

    - Temporal thermometers are quicker.

    - Use pulse oximeter for pulse.

    - Keep your wrist cuff and pulse oximeter within reach. Steth, too, but it can stay on the side of the cart if yours has a carrier. At one facility, we're told to record manually. No one does. I certainly won't get on here and lie as if I do.
    Whatever. You're not going to be doing manuals for routine BID/TID vitals unless the numbers are out of range or change of status. Other than that, you'll have to take more scheduled BP/Ps than you will listen for bowel and lung sounds.

    - Recognize a potential situation and head it off:
    a. Skim through the blood sugars. 0630 b/s (recorded at 0400, most likely, and it's a lazy nurse so they don't think to give the pt anything to maintain glucose levels) of 70. It's 0700. Think you should go look over the pt or recheck the blood sugar? B/S of 210 recorded at 2445. 0200 B/S recorded @ 97. S/S begins at 200 so they didn't rec'v much insulin. Think they're dropping to quickly? Think you might want to keep an eye on them? Think a little glucatrol...or OJ or a shake or sandwhich and milk might help?
    b. Alarm going off? Answer it. You can keep a lot of people off the floor that way.
    c. Family member that you've never met comes in & everyone's talking about how they're such a huge pain in the booty. Don't duck and dodge them. Remain cheerful and available. You've gotta make a good first impression or they'll sit and nitpick and create problems for you the entire shift. I've seen it. With "problem" visitors, being proactive always works for me. That family member may not be what others say they are anyway. Could've had a bad day. Could've dealt with rude nurses/aides. You never know. I
    d. Fall risk/wandering/elopement with combative tendencies on 1x1 presently seeking an exit to "go to work" dragging the CNA up all over the facility. Potentially combative pt looking especially volatile this morning with raised voice and pressured speech and all the distracting/redirecting in the world isn't working. As soon as you get on the cart pop those PRNS. Ativan, Geodon, xanax, apap, etc....
    Anyway, behaviors escalate with time. Redirection doesn't always help.
    Medicate "now" and you won't have a situation to contend with "later".
    Medicate "now" and you don't have to scrape them off the floor "later".
    It's about keeping them calm and safe...and uninjured (and out of handcuffs for assaulting staff)...and in their home. Too many incidences and they'll eventually be put out of the facility. If yours is one of the few geripsych places available, where will they end up? Jail, maybe.
    No joke. This happened to a former pt of mine. The facility didn't 'put him out'. His stupid ass daughter took him away from us and put this 63 year old low-impulse control having occassionally psychotic man (who couldn't even watch the news at times because it gave him homicidal ideas. Seriously. He came to me contemplating murder/assault of another because of something happening on tv. Had to talk him down,buy him a soda and pop some ativan.) in an ALF. Well, he set it ablaze one night according to the local news. Now, he's in jail.
    The aides and nurses where I worked were just like, "Well, what the hell was he doing in an ALF in the first place?"
    Of course, he should be taken to task for breaking the law and endangering lives. He just doesn't belong in jail. He's (mentally) ill and, literally, "knows not" what he does, at times.

    - Don't memorize unless you're writing every order.

    This is what I call 'thin line' corner cutting that is typically done in real world:
    - Start medpass earlier. Hit the PEGs and trachs early.
    - Lots of bolus feeds/PEGs and you're running late? Push it. Same goes for combative (MR, disoriented) pt's on PEGs. Push it. Clamp the tube, draw up two syringes of water and push them through. They're fed, medicated, hydrated & the line is patent. Win-Win for the shift. I wouldn't let an Ax0x1 or disoriented and deluded pt lay in filth or refuse to bathe so I won't have them refusing anti-HTNs, ABTs, anti-anxiety and psych meds. If they have a psych dx, you already know that redirecting has it's limits & continuous refusals of important meds only hurts the pt in the longrun.
    - Med noncompliance. They're AXOx2 or manic/schizo/disoriented and getting loopier by the day? Crush up important meds (throw in any ordered sedatives), add a bit of water. Put in microwave for 5-10 sec. Mix in coffee, juice or shake and serve.
    - Always add crushed meds to HOT food and salads with creamy dressing.
    - Throw the albuterol in the nebulizers. The pt will get to them. Just remind them.
    - I'll check PEG placement once a shift. Good enough.
    - A/Ox3 to 4 residents may be happy to have you place their meds at the bed side. Especially, if they don't like to be awakened or bothered. Just check to ensure that they've taken them. Warning: Don't leave meds unattended in the room.
    - Do 0630 accuchecks at 0400. Just don't give the insulin unless longacting. You don't want them crashing out on morning shift.
    - Pass creams/groin/abd fold powders to the aides. Just be aware that these are medications and technically a CNA can't administer. Do I use them to administer, anyway? Heck, yeah. They can throw on nystatin when they're changing them.
    - Jevity 1.2 (for instance) out for continuous feed? Crack open some cans and pour it in the bag. No one has time to be doing bolus feeds on 6 residents.
    - Heavy number of PEGs/Bolus w/hordes of meds BID/TID/QID? I will give every OTC (and once a day med) that I can on the first feeding/administration. You really can't bypass most OTCs. They need their iron and vit d. They need their protonix, lactulose & pro/uri stat. They need their eye-drops. They need their neb txts. Gotta give it.
    - Sometimes, benadryl helps...

  • Jun 5

    Quote from Rntr
    Employers have a right to ask for a certain dress code and this includes hair, tattoes, inappropriate or overdone jewelry, perfume (totally out of place in the workplace). To ask you to show up on time and not abuse the "sick" benefit... there could be more and this should all be in a policy. It's upfront, not hidden and.....

    You have a right to not work there.

    I personally am glad there are certain standards that apply to everyone. Get over it and quit making such noise out of nothing.
    We're talking about judging someone for something that CANNOT be controlled. It's a problem when you tell a group of people that what is natural about them is wrong -- that they should change a natural feature to fit.
    No, they shouldn't be told to 'get over it'.
    They don't have the problem. You do.

    ...but this isn't an issue that affects you so, of course, you'd be all obtuse and "dismissive" about it. Who cares, right?

    Ugh. Does this site have an "ignore" feature?

  • Jun 5

    Is this a troll thread or something?

    I have an armpit length kinky/curly fro. I rec'v compliments from everyone.
    Even I didn't - I doubledog dare anyone to look me in my eyeballs and call it 'unprofessional' -- suggesting that I "do something about it".

    No. Braids, dreds, sisterlocks, fro's, etc... are not fads. They're black hair styles. It's deeply cultural.
    As for my curls -- this is how my hair naturally grows from my frickin' scalp. Hell, yeah - it's BIG! LOL I don't need to 'do something' about it. OUR hair doesn't need to be 'fixed'.
    I'm not going to alter the very structure of my hair shaft to fit some idiot interviewer's WARPED beauty ideal.
    Should I change my skin color,too? Maybe, get the fat sucked out of my lips...or butt ( could be lucrative considering all of these 'boxy'-looking pancake *expletive* females getting butt augmentation these days). LOL
    I've enough to spare!

  • Apr 14

    Honestly, you're supposed to do count whenever you take the cart. Is the RN not counting with you? That's a problem.

    Corrections is odd. Where I work, some used to flip the cards upside down. The supv found out because another whined to her about it and blamed the new staff. I came in once and the supv gave me a talking to about it. I was like: ??? "I just got here. The cart is always 'like that when I get here'. I dont flip cards." Most of us came from the nursing home. Flipping cards upside down isnt a bad habit learned ... from the nursing home.

    Your supervisor is completely useless, by the way. I never ran across so many lazy mini managers until I did that specialty.

  • Apr 4

    Quote from roser13
    Nursing school only teaches a fraction of the necessary knowledge. Experience teaches the rest.

    Practicing nursing under an administrator with no on the ground experience is most nurses' nightmares.
    Requoted for emphasis. Thank you, madame.

  • Apr 1

    Attaching the '-shame' suffix to everything. I never hear it in person. Only online. It just makes me hostile.

    'Bully'.

    What's a 'sontimeter'? (centimeter)

    Coochie. When I did xray(ivp), had a little girl who kept referring to her vagina as her coochie. "Mommy - my coochie!" ; "Mommy, my coochie hurts." Eww. She just kept saying it.. When I have 'workmares', this is what I dream of.

    "Dude -- !" My coworker taught me that this is a question, exclamation and a response. I used to think it was funny. Now. I found myself using it all the time

    "...and I was all -" ; "...and she was like -" ; "...and we were all like --" I have a coworker who talks like this. Cracks me up. Now, I talk like this, too!

    "Super"...because nothing is just cute. It is SUPER cute. Awesome can't just be awesome. It must be SUPER awesome. One of my coworkers talks like this. Often. I like the feelgood motive behind it. I mean, have you ever had someone call you 'super awesome'? I have.
    I was like, "Yes!" *pumps fist*

    "Moist" is only gross sounding because people drop their pitch and enunciate every vowel and consonant. MmmmoooiiiiSSSSSST. See? That's just gross.

    When elders use the word 'pet' for fondle or canoodling with a partner. It's like using the word "having relations" instead of "having sex". I tend to use the latter often, though. It just less dirty and more proper to say that someone's 'havin' r'lations'.

    Canoodling.

    "Lou-wheeze-e-an-uh". (Lousianna) I never heard it pronounced that way (uh, correctly? Lol) until I encountered nonsoutherners and floridians. Screw Webster! I don't care what the vowels dictate. It's "Lou's'anna". .or "Louey'sanna" (slur it!). It's "N'awlins:...or "Na'orlins". It's "tEx-is", not "Tec-sis".

    I actually didnt screw up orient and orientate until I became a nurse.

  • Apr 1

    Attaching the '-shame' suffix to everything. I never hear it in person. Only online. It just makes me hostile.

    'Bully'.

    What's a 'sontimeter'? (centimeter)

    Coochie. When I did xray(ivp), had a little girl who kept referring to her vagina as her coochie. "Mommy - my coochie!" ; "Mommy, my coochie hurts." Eww. She just kept saying it.. When I have 'workmares', this is what I dream of.

    "Dude -- !" My coworker taught me that this is a question, exclamation and a response. I used to think it was funny. Now. I found myself using it all the time

    "...and I was all -" ; "...and she was like -" ; "...and we were all like --" I have a coworker who talks like this. Cracks me up. Now, I talk like this, too!

    "Super"...because nothing is just cute. It is SUPER cute. Awesome can't just be awesome. It must be SUPER awesome. One of my coworkers talks like this. Often. I like the feelgood motive behind it. I mean, have you ever had someone call you 'super awesome'? I have.
    I was like, "Yes!" *pumps fist*

    "Moist" is only gross sounding because people drop their pitch and enunciate every vowel and consonant. MmmmoooiiiiSSSSSST. See? That's just gross.

    When elders use the word 'pet' for fondle or canoodling with a partner. It's like using the word "having relations" instead of "having sex". I tend to use the latter often, though. It just less dirty and more proper to say that someone's 'havin' r'lations'.

    Canoodling.

    "Lou-wheeze-e-an-uh". (Lousianna) I never heard it pronounced that way (uh, correctly? Lol) until I encountered nonsoutherners and floridians. Screw Webster! I don't care what the vowels dictate. It's "Lou's'anna". .or "Louey'sanna" (slur it!). It's "N'awlins:...or "Na'orlins". It's "tEx-is", not "Tec-sis".

    I actually didnt screw up orient and orientate until I became a nurse.


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