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libran1984 6,604 Views

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: 671

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  • Sep 8 '14

    I hope this serves as motivation for nursing students and pre-nursing students. A little background about me. I'm a Paramedic. During Medic school I worked in a busy Chicago ED as a tech. I'm obtaining my BS in nursing. I will become a flight medic and flight RN in the future.

    Nursing isn't any easy field. Long hours, fatigue, stress, rude patients and rude co-workers. If you're looking for constant praise from patients, this isn't the field for you. If you feel that you are more of a servant, this field isn't for you. If you are planning to make lots of money, this field isn't for you.

    This field will challenge and test you everyday. If you think the learning process stops or gets easier once school is done, it doesn't. You will be always tested and challenged. Never stop learning. Embrace that. Knowledge will help your patients.

    Laziness and complacency is the enemy. If you are trained to do it, DO IT. CNAs and Techs will help you when you need it. They are not there to help you when you are too lazy to do it. They work just as hard as you do and they get less pay. Don't complain or whine about petty things. Everyone has rough days and plenty of people push past it.

    If your co-workers are rude and talk smack about you, don't put up with that. Call them out on it. Most of them will shut up after that. If you have a rude patient just remember that's just the way some people are. You still have to do your job and give 100%.

    If you are nice and pleasant with patients, they will be nice and say thank you. However, don't be upset when they don't say thank you. Why do you need to be praised when THOUSANDS of RNs around the world do the same job? What makes you so special?

    Cleaning a patient is part of the job. So is getting them something to eat. So is changing the bed. It's the little things that matter to the patient. Some people require more attention than others. So what? How hard is it to get a patient water or a blanket or adjust the pillow? Get the attitude of "They are demanding" out of your head. If you are always complaining about patients, you need to do an attitude check.

    Talk to your patients. Find out what hobbies they have, what they do for a living. You will meet some of the most interesting people if you just talk to them.

    I LOVE the feeling of being tired at the end of a shift and so should you. It means you worked hard and accomplished your goals. One way to combat fatigue is to exercise. Running before work helps. Train for endurance. I can't stress that enough. It will help you.

    If you work for a hospital that treats its employees like crap, it's time to move on. Don't be afraid to move to a new hospital or another area of nursing. Sometimes it takes a long search to find a employer who you like.

    I would suggest to current students and pre nursing students to become a tech to see what this field is like. If you don't like being a tech or a CNA, you probably won't like being an RN.

  • Jun 5 '14

    I have been hired for a jr high school nurse 2014-2015 and I'm excited but very scared.. I just keep hearing and reading how horrible this position is! I am wondering if anyone has any tips such as ideas for organization of medications/paperwork, what supplies work best for you, what would you do in certain/common emergencies(sports injuries etc.) This will be a completely different field for me so any information would be great!!!!

  • Feb 26 '14

    In my humble opinion, failure can be turned into a positive aspect if the person learns a lesson or two from it. The deprivation of failure can build character, instill perseverance, and teach a person to dust oneself off and try again, but this happens only if the individual consciously chooses to evaluate what went wrong.

    Some people totally give up after failing. Others address the root causes of their failures, learn from the experience, and eventually succeed.

  • Jan 3 '14

    I work in a state that elected to provide medicaid expansion as part of the ACA. We were closed yesterday for New Year's, so today was when "obamacare" implementation really took effect for my clinic.

    Instead of seeing <5% patients with insurance, more than half the patients I saw today had medicaid.

    My schedule for the next 3 weeks is booked entirely with established patients who need new referrals placed to the medicaid system. I am trying to clear a 2-year backlog of orders for echo's, ultrasounds, CTs, MRIs, physical therapy, and any specialty referral to rheumatology, urology, sports medicine, orthopedics, pain management, etc.

    .... Yes, our patients previously waited, on average, more than 12 months for any of the above referrals. Without insurance we can only refer to the horrendously overbooked safety net county system. It was hopeless. Usually they never got any appointment at all. The alternative is a 24+ hour ER wait which rarely gets them the evaluation needed (an angry resident once returned a patient to me with WE DONT DO MRIs IN THE ER scrawled on the referral I gave her.)

    I was finally able to order diabetic shoes and a wheelchair. Tomorrow I will see 2 asthmatics who need prescriptions for neb machines.

    I will complete prior auth's for cellcept (SLE) and rebif (MS). Both patients are currently off meds due to cost and not doing well.

    For patients with no insurance we have a very small dispensary with limited stock of meds. With medicaid coverage, I can now prescribe:

    combined BP pills, januvia, finasteride, flomax, epipens, advair, imitrex, fioricet, insulin pens, namenda, aricept, lexapro, lipitor, lovenox, verapamil, zyrtec, olmesartan, atropine nasal, levaquin, and valtrex to name a few. I have missed lexapro and verapamil the most.

    My experience with obamacare is that it has made me feel like SUPER NP!!! because I can finally deliver care to high-risk patients. These are not bad people, or freeloaders, or "welfare queens." The majority of my patients are the working poor, who put in more hours/week than I do, feed more mouths, have more chronic diseases, and make a fraction of my salary. They keep my city running.

    Has anyone else seen a dramatic change in their practice with ACA implementation?

  • Dec 23 '13

    Worked every Christmas between the ages of 25 and 60.

  • Dec 16 '13

    In the nursing profession, LPN is a commonly utilized acronym that stands for licensed practical nurse. According to the Merriam Webster dictionary, a licensed practical nurse is defined as a person who has undergone training and obtained a license to provide routine care to the sick. 48 states in the union and virtually all of the Canadian provinces utilize the LPN title. The two most populous states in the union, California and Texas, employ the acronym LVN, which stands for licensed vocational nurse. The Canadian province of Ontario identifies practical nurses as RPNs, which is short form for registered practical nurse. In spite of the somewhat dissimilar titles, LPNs, LVNs and RPNs are terms that basically refer to the same type of nurse.

    Duties / Responsibilities

    In the US, LPNs practice nursing under the supervision of a registered nurse (RN) or physician; however, in many cases LPNs are the only licensed nurses physically present in numerous facilities during certain work shifts. As a general rule, LPNs in all states execute basic nursing care such as medication administration, finger stick blood glucose testing with glucometer machines, data collection, observing and reporting changes in condition, vital sign checks, dressing changes, wound care, blood draws, specimen collection, indwelling urinary catheter insertion and care, removal of sutures and surgical staples, tracheostomy care, care of artificially ventilated patients, incentive spirometry, ostomy site care and maintenance, recording intake and output, and cardiopulmonary resuscitation. LPNs also chart and document nursing care in accordance with facility policies and procedures. LPNs may supervise and direct certified nursing assistants in specific types of healthcare settings.

    The duties of an LPN are very much subject to the regulations of the American state or Canadian province in which he / she practices nursing. Various state boards of nursing, such as the ones located in Oklahoma and Texas, exercise particularly wide scopes of practice that permit LPNs to do practically anything that facility policies and procedures will permit. The LPNs who practice in states with the widest scopes of practice can perform many of the same skills that their RN counterparts carry out, such as starting IV lines, administering medications via IV push, central line care and site maintenance, and so on. Other state boards of nursing, such as the ones found in New York and California, make use of rather restricted scopes of practice that especially limit the skills and tasks that LPNs are permitted to perform.

    Work Environment

    LPNs normally work in climate-controlled settings such as nursing homes, residential care facilities, inpatient hospice houses, home health, private duty cases, jails, psychiatric hospitals, prisons, rehabilitation facilities, community health centers, group homes, clinics, research trials, doctors' offices, assisted living facilities, agencies, private residences, extended care facilities, and schools. LPNs also secure employment in acute care hospitals, but LPN opportunities in this type of setting are on the decline in many regions in the US as a result of issues that revolve around limited scopes of practice. The vast majority of these workplace settings demand 24-hour patient care, so many LPNs work days, evenings, nights, weekends and holidays. Contact with blood, urine, feces and other bodily material might occur; however, any risks can be diminished through proper use of personal protective equipment when providing the types of direct care that are likely to result in exposure.

    Educational Requirements

    People who want to become LPNs may select from two distinct educational paths. Certificate / diploma programs and associate degree programs are the primary ways in which one may become an LPN. The first method requires attendance of a state-approved program that results in a certificate or diploma upon completion. Most LPNs in the United States received their training at the certificate / diploma level. These programs are offered at community colleges, vocational schools, technical colleges, adult education centers, and private for-profit entities. Graduates of certificate / diploma programs will need to pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN), the exam that results in state licensing as a practical nurse. The second avenue to an LPN career is graduation from a state-approved program that awards an associate of applied science (AAS) degree in practical nursing. Associate degree programs are offered at community colleges, state universities and technical colleges. Graduates of associate degree programs also need to pass the NCLEX-PN to attain a nursing license.

    Salary

    According to the Bureau of Labor Statistics, the median annual pay of licensed practical and vocational nurses was $40,380 in 2010. The median hourly pay rate in 2010 was $19.42 per hour. Pay rates can be influenced by factors such as cost of living, specialty, company, geographic region, and experiential level.

    Resources

    http://www.bls.gov/ooh/Healthcare/Li...nal-nurses.htm
    http://napnes.org/drupal-7.4/
    http://www.nflpn.org/about.html

  • Nov 13 '13

    Thanks BrandonLPN because you understood my situation exactly. There were no grimaces, groans or guarding to indicate pain. All vitals were WNL. I had been on shift for 4 hours before she came on and had been closely monitoring these patients. She walked in the door and stopped at nurses desk and started demanding that the patients receive Morphine without even entering their rooms. These patients have not been receiving Morphine previously, but it is on the cart if needed. I have since talked to the DON and she agreed with me and said she would not have given it either in that situation.

  • Nov 7 '13

    This morning we had a code blue on our nursing floor. A peds pt was just admitted from the ED with fever and emesis. MD ordered IV Rocephin/Ceftriaxone. Pt was alert, oriented, playing but as soon as the Cef was done infusing she dropped back in her bed, non responsive, pale pale pale, diaphoretic, fever 38.2, tachycardic, pulses thready, hypotensive, and unverifiable O2 sat bc the monitor couldn't pick anything up (occasionally, it would pick up and show >90%). Pt was ventilated with ambubag with good aeration in lungs. It didn't look like an anaphylactic reaction.

    I overheard the MDs saying likely septic shock, and some interaction between the Cef and gram neg rods causing her reaction...? Pt was not given any abx down in the ED. Another nurse said they usu give them IV abx in ED and wait 45 mins to see if pts react to it, if they do then off to PICU, if not then to the nursing floor.

    Does this sound familiar to anyone? Any idea what happened or can explain to me the pathophysiology?

    Thanks!

  • Nov 7 '13

    I believe it has to do with toxins released when the cells lyse after antibiotic administration. I've seen this happen with hem/onc kids before.

  • Oct 29 '13

    I am currently in Purdue's RN to BS program. I'm about halfway into it. Its 15 months long, with 5 week courses. You get one week off between courses.

    I like that everything is online. Basically each class you have to do discussion boards each week, and write a paper or two. Its not too bad.

    If you're good at writing papers, it should be easier for you. I hate writing so the writing assignments take up more of my time.

    Its 325 a credit hour... Overall about 12-13 thousand... Depending on how many non-nursing courses you need

  • Oct 16 '13

    Quote from BSNINTHEWORKS
    There was a new grad RN who was placed with an LPN on one of our med/surg units at a facility that I once worked for. This LPN oriented me when I started at the facility, as well as any other newcomer to the hospital. She was and still is the best nurse I have ever seen. Anyway, little Miss New Grad went running home to her RN mommy, mommy placed a call to the hospital, and this Super Nurse was no longer able to precept another RN. That new grad does not know just how much of a learning opportunity she threw away. This LPN had been at this facility since the foundation was laid (not really) and she absolutely knew the policies and procedures in and out and the physicians REALLY respected her opinions moreso than any of the RNs there. She did not mix words; she told it to you just like it was; and she was a warrior for her patients. If we had an IV team, she would be the leader of it since she was the go-to person for IV starts all over the hospital.

    Anyway, when management did this to her, her reaction was the 'typical' her. She said, "No skin off my *** because I know how to be a nurse; this newbie don't know ****; she needs somebody to show her how to get to where I was before she was even born". Then, our nurse went down the hall to care for her patients.We could not do anything but applaud. Even the doctors sitting around stood up and started clapping. Score one for the LPNs!!! This happened earlier this summer. It is so unfortunate that some of these brand new nurses rode up out of nursing school on a white horse. It's gonna be very embarrassing for them when they ride up off the job on a donkey.
    Do we work together?! Hence why I chose to leave acute care.

  • Sep 25 '13

    But you all forget, the reason for the move to MAs is just that. They don't want thinkers. They just want "staff" to complete the list of tasks given.

    I see movement to off floor management centers full of telemetry and live feed images from each patient room. Generalists probably NP/PA hospitalists will be responsible for managing the day to day. MAs will complete tasks given and talk to the camera on the wall as THEY perform assessments and med passes (No thinking, just doing, charting and reporting findings).

    NP/PAs will supervise and will report back to a MD in a glassed-in central area within the management center (He's eating cheetos and watching SportsCenter and plotting fantasy football). He's there in case he's needed... better not bug him...

    I don't see RNs in this mix, once it's all established.

  • Sep 25 '13

    If anything Inthink nursing school should focus a lot more on patho and pharmacology. Bed making, fluff nursing theory, WASTE of time. the longer i go as a nurse the more I understand why many instructors said not to worry about skills so much. And the more I resent the implication and demands that RNs waste their time on stupid tasks a robot can do. It is the dumbing down of the profession. But in reality not THAT long ago only a MD could place an IV or take a blood pressure...... who knows. why even have rns if an ma can do the job? why have an MD if a pa or np could do it.......

  • Sep 25 '13

    I tend to keep my finger on the pulse of new(er) trends.

    This subject is something I've alluded to before, yet now I am even more convinced it may become reality.

    My state--a west coast state--recently (last year) redefined the scope of practice for MA's to include much of what RN's are responsible for, based on a new tiered level of education and certifications. Colleges have jumped on the bandwagon to develop intense MA programs to fill the need.

    At one time, MA's were relegated mostly to Dr.'s offices (which used to be the domain of RN's). That may not be the case much longer, if the trending continues.

    I was just speaking with a fellow student from a math class, who is pursuing her MA. One of our college's nursing program professors is apparently steering potential nursing candidates (friends of hers) away from the nursing program on the QT. She stated, "Now that the scope of practice for MA's has been legally expanded, the hospital is looking to integrate MA's to fill the floors, instead of the more costly RN's."

    Just sayin'. Research on your own, and draw your own conclusions.

  • Sep 13 '13

    Hi, I'm new here and I just wanted to get your imput on my situation. I'm a cma, or med-aid. If you've never had the pleasure of working with one of us before I'll give you a quick rundown on what most med-aids do. We generally pass medication, do treatments, check blood-sugars and all those other little time suckers. Generally we try and make a nurses life easier.
    I work in a very small facility with 5 full time residents and up to 7 respite patients. As you might imagine our turnover rate is a nightmare, and I'm responsible for the paperwork and everything that comes with it on up to 7 addmissions and discharges a week, and I work nights! We only have 3 Nurses on staff and those aren't going to be replaced when they leave.
    Essentially the managment is attempting to run a nursing home without actually having any nurses, now we do have access to nurses from another building on site, but actually getting ahold of one to come over is very hit and miss.
    any thoughts or suggestions?


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