advice for a new l.v.n working in a long term care facility!!!!

[princess007]

I am a new L.V.N, just started working, ..so can i get some advice on some situations that are very common in the long term care facility which you think is good to know about and if some thing like that happens what i should do instead of freaking out...because i am going to start working by myself and they put me on call and the first time i am gona be working is going to be at night and i m going to be one and only licensed nurse in the facility at that time so if i have a question i cant really ask anyone at that time...so please tell me some of your stories or situations that you were in and what did you do????anything pleaseeeee......godd bless!!!!

[Ms.RN]

I see alot of patients wheezing and coughing becuase many of geriatric patients have CHF or COPD. check their vitals including pulse ox and more likely doc is going to put patient on breathing treatments or lasix. A slight change in mental status means they have some kind of infection. when you are working tell your CENAs that you dont want any falls. Because of state regulation most of nursing homes are restraint free and they cannot take any anti anxiety medications so I see alot of them just walking in the hallway and many end up falling and hurt themselves. I have really dependable cenas and i rarely have any falls which is a blessing. :yelclap:. I also work with patient with behavior problems due to dementia. Skin breakdown is a problem if patients are not being turned and needs aggressive treatments. Most of my patients are very fragile who cannot speak up for themselves so be a patient advocate. I hope this helps.

[princess007]

I see alot of patients wheezing and coughing becuase many of geriatric patients have CHF or COPD. check their vitals including pulse ox and more likely doc is going to put patient on breathing treatments or lasix. A slight change in mental status means they have some kind of infection. when you are working tell your CENAs that you dont want any falls. Because of state regulation most of nursing homes are restraint free and they cannot take any anti anxiety medications so I see alot of them just walking in the hallway and many end up falling and hurt themselves. I have really dependable cenas and i rarely have any falls which is a blessing. :yelclap:. I also work with patient with behavior problems due to dementia. Skin breakdown is a problem if patients are not being turned and needs aggressive treatments. Most of my patients are very fragile who cannot speak up for themselves so be a patient advocate. I hope this helps.

Thank You!!!!

[+one]

Make sure you know your facility's protocol when sending out a resident.

Make rounds before, during and after your shift just to be sure.

I onced worked every shift and each shift is different from each other.

Know the unstable residents and make sure you monitor them.

You will feel better and get your own pace after several days of work.

[Hospice Nurse LPN, BSN, RN]

I used to always make rounds before counting with the nurse going out. I had just got my first job as a new nurse working 11-7 and didn't make rounds until after counting and accepting the keys. I was almost to the end of the hall when I noticed that one of my residents had expired. Poor thing had been gone for several hours. After that, I always rounded before accepting the keys.

Hope that helps.

[Nurse_Tricia, LPN]

because I am new as well, I noticed early on that falls happen and I was worried about what to do and when to send out.. There is the thread "What to do when a patient falls" and it has great advice that I had to use a couple days after it posted.