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Joined Aug 3, '11 - from 'Disco Hogwarts'. libran1984 is a Registered Nurse. He has '4' year(s) of experience and specializes in 'Emergency Nursing'. Posts: 590 (37% Liked) Likes: 672

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  • Jan 29

    Every sing person who applied to the Lawrence campus got in during my transition from 2013-2014. During that year's time, two other LPN-ASN classes were admitted and there was actually a shortage of LPN-ASN student applicants, so EVERYONE got accepted and then they were thrown into the medic-ASN program b/c the Medic - ASN program had so many holes too.

    So essentially, you will absolutely get in (based on the above cited evidence). When I applied in 2013, I applied to 6 different regions (13 different schools), of which included Richmond, who only takes 6 transition students / year, and I was accepted to every single program.

    Also, as a sidenote the Graduating class of 2013 (ie: the class that ended just as mine began) received a 100% NCLEX pass rate for their ASNs and PNs that year at Lawrence (indianapolis).

    Oh, and another thing... I graduated on a Saturday, I had my authorization to test on Tuesday, I took my NCLEX on Thursday, I received my RN license # on Friday.

    A lot of students complained of the lack of Ivy Tech's planning and organizational skills r/t scheduling. I promise you, I precept several student externs at a local hospital, and the students even in the BSN programs like Marion and IUPUI have the EXACT same problems. So, I beseech you, when you get into the transition program, please try to foster an atmosphere of understanding for the school b/c the grass is NOT greener on the other side. It is all the same problems a student would face at any other (accredited) college. You can't beat the price of $121.15 / credit hour and then immediate NCLEX testing dates - my BSN friends graduated with me or a week or two before me, and they're still waiting for their auth to test!

  • Sep 16 '16

    I'm an LPN in both a LTC and hospital setting.

    To compare, the paperwork in the hospital is incredibly minimal. They use EPIC, most everything is point and click. The pharmacy and patient files are connected. The doctors are connected to Epic. Everything is connected! Not to mention, at most you're only charting on an average of 3-7 patients any given day!! There is so much patient contact that the nurse can do so much and still find time to chart novels when they get hyped up.

    My first and last bit of PRN work at a LTC rehab facility last just 3 weeks. They said they were using computer charting- that accounts for <10% of the charting. There is a book for accuchecks, a book for dr appointments, a book for PT/INRs, a book for treatments, and half of the MARS are barely legible due to the nurse not pressing hard enough to carbon copy the damn thing!

    Now let's talk about the amount of redundancy that is done... A verbal order confuses me to no end. I know that it must be placed in three different boxes (a white, pink, and green copy). It must be faxed to pharmacy. It must copied again and put in the hard chart, and should be documented in the computer (which it never is).

    The morning vitals are charted on the nurse's cheat sheet (bc bedside charting does not exist at the facility), charted in the MAR, and charted in the computer (which it never is). The accuchecks are charted in the MAR, the accucheck book, in the computer(which it never is), and in the nurse's cheat sheet. There are 16 patients everyday, and everyday of the week is designated a specific kind of assessment day such as cardio-pulmonary monday or skin check Wednesday, etc. of course if your pt is there for cardiopulmonary issues, every day is a cardiopulmonary assessment in addition to whatever other assessment is designated to the given day of the week. This assessment is charted as a bunch of check boxes in the MAR. In addition, it is to be free-typed as a progress note in the computer (which it never is).

    The computer is not linked to any other discipline so the doctor and the pharmacy has little to no access. There are no known rehabilitation goals. The med pass is in excess of 2 hours. Treatments, new orders, and new dr appointments are frequently missed due to the lack of time to review all 5 books and the insane patient load for such high acuity patient load. Every day 4-6 patients are receiving IV vancomycin!! This too needs to be charted in the MAR and in the computer.

    I can't do it. I thought being an ER nurse I could handle anything. But this paperwork is too much. My final day was Monday. There were two ladies by the same name and similar last names with similar problems. The nurse who admitted them mixed up the pt mars like a deck of shuffled cards and then cut the deck putting the top half as Jane Doe A and then Jane Doe B. there were no patient identifiers like birthday. Only allergies were listed. The names were very faded as that they were carbon copies done with very light pressure.

    Omg. The MARs... Everytime a new pt is admitted - everyday, the admission paperwork is insane!

    Presuming you can get just the daily paperwork done and charted in your 8 hour there is no more time to chart the unexpected!!

    Example: 8 hours in a given work day

    med pass takes at least 4 hours

    Treatments take 2 hours.

    Mandatory lunch is 30 minutes.

    You now have left 1.5 hours left.

    30 minutes are spent scribbling illegible scratches on the daily assessment log which were all half assed. Did you really strip your full 16 residents down to his/her birthday suit to search for skin breakdown? No you did not. You presume your aids will tell you if so. You know that those that are immobile will be at a higher risk so you may check their bottoms in a rush but forget to check heels! What about the 4-5 cardiopulmonary people? Did you put your stethoscope to their chest and listen? Did you touch all extremities looking for edema? Have you been getting proper daily weights? No no no. You asked the 16 patients during med pass how they feel, if they have a new cough, and eyeball their extremities. You have 16 patients and every single one of them has an unanswered call light going off at all times during the day!

    1 hour left in your day... Did you get any new admissions? How long did it take to receive or give report? Did the doctor give any new orders? Did you have a day where pain levels were abnormally high. Did your daily supply of medications come in and did you actually count and verify all meds that came in? Btw that is a fair amount of paper work! Did your faxes to pharmacy go through? Did a lot of family members come through that day to occupy your time?

    This facility is in the top 200 in the nation for its kind. What do the more squandered or lower ranking facilities look like?

    The hospital is the best place I have ever worked and I will never, ever work LTC ever again. I would quit nursing before I do that again.

  • Aug 30 '16

    One should probably get consider if they have yet to become NLN accredited, or even if hospitals will hire them.

    I would consider the price. Why pay the price if a bachelors degree only to receive an Assc degree?

    Also, it stands to question, if the admissions are so competitive why do u think you would get in there over the local community college?

  • Aug 30 '16

    I work with an LPN who is certified to administer botox for her primary job outside of the ED. She loves her other job and her work with the Doc. I wish you much luck. Don't get discouraged by what others say. A certified LPN working in the field may know more than some NPs outside of aesthetics nursing with regards on proper botox administration.


    edit: example of Specialty LPNs performing better than an NP... I was doing ACLS with an FNP who works primarily fast in/out clinics. She kept trying to shock an unshockable rhythm and wonder why the mega-code kept deteriorating. LOL.

    To each his/her own. People go around toting a vast amount of certs behind their name and say this is an example of my education and experience. However, others often over look or don't take the certified individual seriously if he/she don't have an RN somewhere in the title or in some cases, a BSN or higher- then you are pretty much just... well... out in the dust for qualifications, despite your... despite your qualifications!

  • Aug 4 '16

    RNsRWe: preach the truth sistah!!!

  • Jul 11 '16

    HA! I was working fast track and read some of the fast track patient assessments by one of the RNs.....

    Pt 1:

    A/Ox3. Hx of Cdiff. Recent blood noted in stool x8 hours.


    Pt 2:

    Fell yesterday in ED. Presents today with hip and knee pain bilaterally.


    Pt 3:

    Believes she may be pregnant due to multiple positive UPT's


    Those were examples of our RN assessments today in Fast Track.



    Our hospital also makes all RN assessments simple check boxes for different body systems. Click Click Click Assessment complete.

    When you're running around like a chicken with your head cut off, you could write out a very detailed assessment in the flow-sheet, or you could get to doing orders and use the check boxes. /sigh.... somedays, i feel assessment skills fly out the window

    ---------

    I get mad props on my assessment skills in my ED and I moved into my second year of ER nursing. A good generalized written flow sheet assessment could even go like this.....

    "Pt presents to ED with c/o..... (why pt is here) x (how long s/s persisted).
    Pt ranks discomfort / pain a (#/10).

    (Insert focused assessment- ie: use your head to toe assessment skills learned in school but focus only on that one system)

    Pt Hx includes....

    Bowel and bladder question
    Pregnancy question


    Call light in reach. Pt voices understanding of current plan of care. Family at bedside.


    -----------


    So to make one up off the top of my head....

    Pt presents to ED with c/o worsening RUQ abominal pain x 3 days. Pt state pain is "consistent & sharp, like it never goes away" pain ranking 9/10. Pt denies previous Hx of current c/o.

    Bowel sounds are normo-active x4. Abdomen is soft and non-distended. Tenderness upon palpation per pt in RUQ.

    Medic line 20G LAC. 150 mL NS successfully infused by medics. Infusion discontinued upon arrival to ED. Pt seen at St. Jane Doe ED last night for similar s/s. Pt Dx'd with bladder infection.

    Pt denies dysuria, urinary frequency, hesitancy, anuria, or pain upon urination. Pt denies fever, chills. Pt professes to outstanding hx of ovarian cysts, commonly treated with Norco Rx. Last menstruation stated to be approximately 1 week ago and WNL per pt.

    Pt states BMs are WNL and denies dark tarry stools or bright red blood.
    Denies chance of pregnancy.

    Call light in reach. Family at bedside. Pt voices understanding of current plan of care.


    ------

    The assessment included

    1. primary complaint (HOW LONG and complete with a SUBJECTIVE DESCRIPTION as well as if this c/o is something NEW or OLD.)
    2. Nursing assessment (notice its similar to your GI assessment in your head-to-toe assessment)
    3. Hx leading directly up to current ED visit.
    4. Previous medical Hx for pt
    5. always ask about urinary and BM outputs because they factor into almost every system in one way or another.
    6. Pregnancy does F-ed up things to the body, so might as well ask, particularly if u suspect a CT or Xray.
    7 Call light in reach. Family at bedside. Pt voices understanding of current plan of care

    --------


    Good luck.

  • Jun 26 '16

    We've identified a problem... How can we make employees value us?

  • Jun 26 '16

    I live and work in Indianapolis, IN. I graduated nursing school in Oct 2010 and began work for 9 - 10 months as a corrections nurse in prison. After being fed to the wolves in prison I managed to persevere by continuing on with good nursing assessment skills and encountered all kinds of trauma and ER situations that I managed to land a highly coveted LPN position in a local ER. The LPN is being phased out in many hospitals that are attempting or are Magnet status but I have found the non-magnet hospitals still use us in one form or another. The Best part is that I'm NOT a tech. I'm a real nurse with my own patient load ranging from ear aches, appendicitis, to pneumonia. I only need an RN to do the initial assessment or agree with my assessment and to do the discharge should pt not be a candidate for admittence to the hospital.

  • Jun 26 '16

    Love this post.... Right now as an LPN in the ER, I'm sitting here in the Triage playing on the computer waiting for the patients to arrive. By the end of this shift I will have achieved 29 hours of overtime, and 33 hours of Critical bonus. I'm making $38/hr rt now!! WOOT! I love my job and I love working for OT/CB

  • Mar 13 '16

    That's the problem tho... we all want to and strive to provide quality care, Lb321. However, in so many places it is just not possible, ie see above libran1984 posts!

  • Mar 13 '16

    The best way to avoid the worst nursing homes is to get your RN.

    otherwise you can try asking these...

    Ask what sort of acuity levels you will be working with.

    Ask what the nurse to patient ratio is? (don't worry tho, you'll have TONS of help the management will say. Also add 2 more patietns minimum on to what ever number they give you) I truly feel anything over 10 patients per nurse is ludicrous unless the patients are TRUE assisted living classes- however, most assisted living facilities i'm familiar with still hold residents who need complete and total assistance and no way should they be in assisted living.

    Its all about the money, man. That's why LPNs work in these places because they know we are the "low paid nurses" and they can get away with paying less than they would for an RN.

    ugh....

    just steer clear. Otherwise next thing you know you'll be forced to put an NG tube down a guy with esophageal verices and you'll cause excessive bleeding and he'll expire. Then the DoN will blame it all on you because you should have known he had the esophageal verices, but the patient was non-verbal so how were you to have known? His chart is all paper and its not even mentioned on his Dx's except for 300 pages into the chart where it was inexplicably left out in more recet Dx's....

    Then the medicare charting is terribad. Computerized charting, you say.... no no no... ugh.

    I honestly don't know what to tell you Jasmine other than I can imagine no worse job than being in LTC.

    One guy I dealt with had a terrible MRSA infection in his leg and was at the rehab center to help heal it up. I asked my supervisor why the pt was unable to move his upper extremities and why is Level of consciousness was down the toilet. The nurse responded, "I think he had a stroke sometime". Upon further investigation, the hospital discharge assessment made him out to be A/Ox3 with full RoM except for his affected lower extremity. Because there was no charting EVER in regards to the computer and all the MAR assessments had been put into a storage box no one was able to tell when the pt became the way he is now. So what happened to him? It obviously happened while in rehab!

    My first nursing job was ~$14/hr. That's like 2-3 dollars more than most CNA's and in many cases less.... if these LTC centers could just pay all the LPNs $14/hr and staff extra nurses, then patient safety and satisfaction would go up, and nursing retention would increase (as long as year raises of up to 4% were provided to allow financial growth) because it would offer valuable skills in a safe environment because let's face it, most of us got into nursing to help people.

    I'd always heard how terrible the nursing pay was and then I became an LPN so I wasn't overly surprised when I began making $14/hr.

    /sigh....


    Jasmine, I'll be coming back to this post to see if anyone else has better advice to offer you. I'm sure I'm just scaring you. I apologize, but I've been scarred by the LTC experience as well as most other LPN jobs I've ever had. I love being an ER nurse but I'm not often referred to as a nurse by my co-workers but rather a "non-RN" and that just grates me. At the LTC centers where I am considered a nurse, I feel that I actually harm the patients through neglect since I can't assess them or offer them the emotional support they frequently need.

    Find a clinic job, girl! Find a clinic job!!!!

  • Mar 13 '16

    Oh and vintagemother had another point.... The call lights never EVER stopped. NEVER!!!!

    I worked in fast food during my teens and early twenties and heard less beeping at the drive thru than I did with the incessant call lights.

    I'm getting so worked up and angry over all of this..... Phew.... Just breathe....

    I hate LTC

    Edit:: heaven forbid someone uses their call light for resp distress, choking, or CP... They might not survive the 20-40 minutes it takes to respond!!

  • Mar 13 '16

    I hate LTC. I hate it with an undying passion. I truly feel if it were my only resort I'd just leave nursing altogether.

    In my experience, my patients were not "stable".

    I never had proper supplies let alone hand sanitizers.

    Orientation was pointless ( 2 eight hour shifts and ur on ur own)

    The charting was redundant to the point of sheer ludicrous.

    Everything was on paper and then expected to be transcribed to the computer.

    Hours were watched like a hawk for fear u go over.

    You never left the med cart.

    The MARs are illegible.

    The meds are disorganized and u are encouraged to steal from other resident's supply to fill an empty med slot for another resident.

    Med pass should be but a medium chunk of the day, not all of it. If I were actually at my computer and not in my iPhone I would write very precisely every thing, in detail, that is wrong with many LTC settings.

    The environment is toxic and leads to... No, encourages poor nursing care.

    On a side note, this has only been my overall impression of LTC from observation and experience.

    I look at LTC centers where LPNs are few to none and the staffing seems much better. Get this.... In a pediatric LTC center for rehab (and some hospice) there were no LPNs, but instead an all RN staff and QMA's who passed meds. The RN approved PRN meds for the QMA, she did all the charting, VS's, assessments, and treatments. The RN never had more than 8 patients at a time.

    Now why are the RNs making more and doing less? Why are her patient ratios so much smaller? Why does she have someone dedicated to med pass so she can do the appropriate work required of her position.

    I, an LPN, had to deal with brand new strokes straight from the hospital who were total care pts. Ppl in recovery for post op open heart, ppl who would regularly be placed on bipap (srsly), and ppl with god awful infections of varying kinds and at least half are on IV vanc and merripenem (!!!) thru their PICC lines. How am I supposed to deal with meds, new admits, treatments, ADLs, blood draws, daily weights, accuchecks, more meds, and spontaneous colostomy seepage when I, an LPN am responsible for 16 patients and btw, WHERE is the foresaken handwashing station!!!!!????

    That's not even that bad. My friend went to a diff LTC center for her LPN to RN critical care clinicals and some dude was on Levophed- and he was awake!!! Seriously, the same "levophed leave 'em dead" stuff. This is the kind of stuff LPNs have to deal with in LTC.

    Yes yes- someone is going to say that isn't the typical LTC experience. That is correct. Many LTC facilities hold are not SNF's, or rehab, etc. it's just an elderly, frail, person who needs a little guidance and reminder to take all their meds- but that has not been my experience.

    And working in the ER, when I get report from a LTC nurse, it generally results in a lot of eye rolling. Seriously who continues to give Norco's for a fever to a dialysis pt and then wonder why she's become lethargic. /facepalm


    I hate LTC. I feel very strongly on this subject and believe "hate" is sufficient to convey the amount of contempt I have for LTC.

    God bless all the nurses who work there because I cannot.

    Sorry this tangent kept going on and on



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