Latest Likes For tnmarie

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tnmarie, LPN 6,653 Views

Joined Aug 23, '12 - from 'Tennessee'. tnmarie is a Agency/PDN. She has '10 in medical field' year(s) of experience and specializes in 'geriatrics, hospice, private duty'. Posts: 283 (44% Liked) Likes: 256

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  • Apr 21

    Quote from WildflowerRN
    I'm all for diversity in learning and alternatives to traditional learning, but you'll miss the comradery of nursing school. And that comradery gets you through some pretty crappy stuff that you've never seen and prepares you for dealing with the stuff we, as nurses have to deal with daily.
    Are you kidding? My LPN class was FULL of drama, back-biting, and backstabbing. Not having to deal with that again was a HUGE plus of this program! Didn't have the time or money for brick-and-mortar anyway, so it all worked out. :-)

  • Apr 16

    Quote from WildflowerRN
    I'm all for diversity in learning and alternatives to traditional learning, but you'll miss the comradery of nursing school. And that comradery gets you through some pretty crappy stuff that you've never seen and prepares you for dealing with the stuff we, as nurses have to deal with daily.
    Are you kidding? My LPN class was FULL of drama, back-biting, and backstabbing. Not having to deal with that again was a HUGE plus of this program! Didn't have the time or money for brick-and-mortar anyway, so it all worked out. :-)

  • Apr 7

    Quote from WildflowerRN
    I'm all for diversity in learning and alternatives to traditional learning, but you'll miss the comradery of nursing school. And that comradery gets you through some pretty crappy stuff that you've never seen and prepares you for dealing with the stuff we, as nurses have to deal with daily.
    Are you kidding? My LPN class was FULL of drama, back-biting, and backstabbing. Not having to deal with that again was a HUGE plus of this program! Didn't have the time or money for brick-and-mortar anyway, so it all worked out. :-)

  • Mar 18

    I used the recommended reading as well and I'm glad I did. A lot of people have success with SG 101 but I didn't really find the few I purchased that helpful. I usually cast them aside pretty quickly. I've actually outlined most of the chapters from the recommended reading. If you want a copy of my outlines, PM me and I'll send you a link to where I posted them.

    And do use the study guide. I can't imagine taking a test without it. They are the most valuable study resource, IMO.

    Good luck!

  • Dec 27 '15

    What medications absolutely must be given daily?

    All medication MUST be given as ordered. Unless it is PRN, it must be given daily as scheduled. If it is not given, it is a med error. "Borrowing" from another resident is technically insurance/medicare fraud and hence a big no-no. Your facility should have e-kits (warfarin is almost certainly in the e-kit). If a med isn't in the e-kit, you can call pharmacy and get meds from emergency back up. If there is no way to get the med there to be given as scheduled, then you must call the MD and let them know. They will usually order to hold it and/or give a one time dose of something that is available in the e-kit. TL/DR: if a med isn't on the cart: 1. check the e-kit. 2. Call the pharmacy. 3. Call the doc if med unavailable through e-kit or pharmacy.

    What should I be looking for before I send a patient to the ER?
    Too many specific scenarios to list! Basically any change of condition from the patient's baseline should be reported to the MD and the MD will decide if they want an ER visit. So you will call the doctor, notify them of the change in condition and they will order the ER transfer (or they may opt for labs, xrays, meds ect.). If the patient is unresponsive, coding, or in a life threatening situation, our policy is to call 911, get them out, and then call the doc after the fact. On the other hand, if the change in condition is minor, we wait until morning to call the doctor. TL;DR: In most cases except the most emergent, the MD will be letting you know who and when to send to ER (though you pretty well know who will be going out based on s/s).

    What would you include in a good progress note?
    Depends on what is going on with that particular resident. I use my head to toe assessment cheat sheet as a guide:

    http://allnurses.com/attachment.php?...7&d=1360684094

    There is also a great tool floating around on all nurses that deals with charting on specific issues called "daily skilled documentation guidelines" that I also use but can't find a link to at the moment.

    Basically if there is anything going on with a resident (UTI, URI, ABT, PEG, FOLEY, TRACH etc) you will want to chart about it.

    Good luck!

  • Sep 24 '15

    You know those places that everyone tells you not to go to unless you are desperate? To get that first year of experience, most people have to go to those places and work a year there. There are also usually places known for not requiring experience (though I'm sure that list is a lot shortner now). Just keep applying and trying, that's all you can do!

  • Sep 22 '15

    My mom left (retired early) because of the physical toll; after 25 years of LTC nursing she literally physically couldn't do it any more.

    My sis left because she was summarily fired by a local LTC after putting in her two weeks notice. She has since been blackballed and been unable to find other work (She has almost a decade of LTC experience). She is currently working at a fast food place.

    I'm looking at leaving nursing myself and getting into HIM or something.

  • Jul 18 '15

    I recommend buying the flash cards from the school; they include all the critical elements for all areas of care and all your labs. I wrote my pneumonics on them as well. Very portable and only $10. Turned out to be one of my greatest study assets.

    I studied for labs and care plans simultaneously. I went through my labs every day (takes a little under one hour) and also started submitting care plans to Sheri Taylor right away. Those were my two weakest areas, so I wanted to go at both of them ASAP to have plenty of time to practice.

    I'll give you the advice given to me: buy the wound. It is the exact wound used at the CPNE. $40 is a small price to pay compared to $2,100 (cost of retake). The swim noodle is still great for practicing your injection station and IV push station.

    Good luck!

  • Jul 18 '15

    Definitely get the guide printed and bound and read through it cover-to-cover first thing. Don't try to memorize it yet, just read it to get familiar with it. It helped me to keep Unit V in a separate binder and tab it off further (dividers between Section A, B, C etc.).

    I broke the CPNE down in to four areas:

    Labs + PIE (Planning, Interventions, Evaluation)

    I set up a lab immediately and went through all my lab stations every day. You will fumble through them at first. Don't get discouraged. You will get better.

    I knew that planning was my weakest area and intervention was my strongest, so I started with Planning and focused on it, all the while practicing my labs and studying the study guide. I tried to read the guide at least once a month every month.

    I also highly recommend keeping a notebook and jotting down questions. You can submit your questions through the message center. I would read the study guide at least twice before starting to submit questions though, because most of your questions will be answered in the study guide.

    Youtube is also a great resource for brushing up on basic nursing skills; just keep your critical elements in mind while watching the videos.

    I also found the flash cards that the school sells to be invaluable! Just not the audio ones, lol.

    Someone here suggested a small dry erase board to practice writing your grids and they were spot on....

    But first, read the study guide

    Good luck!

  • Jun 28 '15

    I certainly wouldn't say you are doomed. Hospice is a whole other animal. I'm not saying that having med surg experience wouldn't offer some advantages, but I know it is not mandatory in order to be a great hospice nurse. Congrats on your new hospice job :-).

  • Jun 22 '15

    In theory it is a time where either one of you can terminate your employment without notice or reason. However, if you leave your probationary period without notice, good luck getting your next job. Naturally, they can kick your butt to the curb without reason or notice and without repercussions.

    Also be aware that quitting your first job with less six months to one year there raises red flags to future employers and may make it harder to get a job later on. Your best bet is generally to hang on for a year and then move if you are miserable. They don't call it earning your stripes for nuthin!



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