Angry LPN

People can get hooked on Ultram? I wondered why they started to keep them under lock and key and count them.

Jees, not so loud. If the state visits this place, you will give them ideas. I just posted about the last nursing home I worked at. The central air to my unit broke and the owners refuse to fix it. There was one wall fan in the middle of the hallway that I parked my cart under and walked my meds up and down the hallway, because it would get stifling in the summer time. All the management parasites had big window units in their offices, the rest of us that actually did real work were left to suffer. I have never heard of such a thing, but I wouldn't put anything past the government. The more they mingle in healthcare, the more they ruin it. It would be just like them to mandate that the med carts have some traking device that transmits some signal to some lazy state monitors to make sure those carts are moved. If not, they will accuse us of "sub standard" nursing care (like I am told they like to do if you are not a great paperwork person and place your priorities where they should be, doing hands on care) and their agents will come out and steal money from the place in the form of fines, fees, penalties, etc etc. Sounds like your DON, like most of them, is trying to rule by manipulation and intimidation.

By all means, take that management job. You don't have to work the floors anymore. The last nursing home I worked at, the AC broke down on the units but all the lazy people in management got huge window units in their clean offices where they curled up to watch TV, surf the internet, talk on their cell phones while they would come out and threaten as floor slaves as our scrubs would be drenched with sweat from the heat and humidity if they thought we might be watching something on someone's television, or if we used the computer and made a quick call home to check on a situation. Only people in management can do that. It felt like walking into an igloo when you were being threatened, intimidated, or being told to worker harder from someone who doesn't really do any work at all. I over heard one say after she refused to come in and help one nurse take on 200 patients because one from the pool called in and the other didn't show on the midnight shift "If I do that once, they will expect me to all the time". Yes, wouldn't that be terrible. Actually do something to help these people who rely on us to meet their needs. Nobody sawed the good folks in management fingers off nor did they break their legs when they got that management job. Then you get to go out and stress the floor nurse's out, ask them to do things you know you couldn't do yourself. Yes, take that management job, by all means.

People with dry skin would be well advised to keep a jar of moisturizer with them. I would worry more about ruining your back or losing your mind before your hands. I could qualify for a disability with my back, sometimes it takes me 45 minutes to get out of bed.

Another thing to keep in mind is burning too many bridges. When these nursing homes were profitable many of the independently owned ones are concentrating in the hands of a few large for profit corporations. Some of them have a hit list of do not hires. I was at this one place where I worked on the midnight shift and this sweet, little old lady would want to get up around 3am and have a cigarette outside. I was quite fond of that lady, should would tell about her life, the Great Depression, etc while I sat out there with her for like 5 minutes. Not a problem. Then this mean spirited social worker there took it upon herself to establish smoking times, with the cut off being like 7pm. Now they drill it into us that this place is their home, respect their rights, etc and I always have. The employees, including some of the nurses can go out and smoke as often as they want. So I figured chuck it I am not going to pay that any attention. The day crew there. Talk about a seething cauldron of witches, they would make nurse Ratchett look like an angel. They would bring in their boxes of doughnuts and coffee and sit down for an entire hour cursing and complaining about all the other shifts over their caffeine and sugar orgies. I was always by myself on the MN shift and never got to sit down. Here I am writing out their schedule for them and all this other stuff they dumped on the MN shift so they could come in and sit down. This one particular nurse who was very vile and nasty assumed the role of the manager although neither the DON or the admin gave her that position. She would take it upon herself to ask me anyone took my friend out for a cigarette last night. What I wanted to say is what business is that of yours, you are not the administrator here so don't ask me again. Get this. They kept the nice ladies cigs locked up in the med room and this vile witch was taking it upon herself to actually count the ladie's cigarettes. I will admit I hated the day crew there, and I didn't have the heart to tell my friend that she couldn't have her nicotine at night, one of the few things she had left. So between that and my hatred of the day crew there I just couldn't bring myself to go back. It was a PT job anyways. So wouldn't you know, they went out of their way to put me on the hit list. All of their facilities are horrible, they pay way less than other companies, so are always hiring. I went to apply at 3 places, the DON acted like she wanted me to start the next day, and then the silent treatment. Call the receptionist up, "may I ask whose calling", then you get the voice mail (you know she is standing right there screening her calls). Leave a message and they don't call back. 3 places owned by this cheap company where I could have ran circles around the best nurses but apparently I made the hit list. Just as well, but don't burn too many bridges

Yes, my specialty is taking care on patient's with trachs or that are on vents in the homecare setting. It is almost stress free. I don't know how I survived in nursing homes as long as I did but I am fortunate enough to have the specialty of also being an RT so I got away from those horrible places and it was the best thing I ever did. If I had to do it all over again, I would have went for physical therapy but too late at my age to start going back to school

The blood sugars are not "unusual" but get a hand full of brittle diabetics who either had their food tray stolen or the CNAs didn't feed them from the shift before (a frequent occurrence) and protocol calls for you to call the physician, break the instant glucose out of the people proof med box, administer it, fill out the forms so they pharmacy can charge for it, put the tags back on the people proof med box that was like trying to steal gold from Fort Knox trying to get into, and you used up probably 20 minutes of your time. Then the G-tubes. Meds have to be crushed, and some dimwitted physician always writes out some order to give some elderly patient that has had osteoporosis for decades those bunk, lunky green calcium pills that never fully crush and plug up the G-tube and doesn't do anything to reverse the osteoporosis. Then you are being almost constantly called off the floor, family members wanting to know about their loved ones during your med pass, lab results, the pharmacy wanting to clarify orders, and physicians that can't write legibly get pissed off when you call them because you can't read their hieroglyphics, etc All that eats away at your time. Toss in a few fall risks and a new admit or two and you have the makings of a long and stressful day

I try to be forgiving and reserve judgment, but how despicable that is to take away someone's pain meds when they in severe pain or dying. Prosecuted, yes, but not persecuted. Give them the option of seeking rehab. I used to like to drink a few dozen beers when I got off work, never drove or came into work under the influence. When I realized that it was a habit and not particularly good for a type II diabetic I just simply quit and haven't had a drop in 5 years now. People can reform themselves without having their careers and thus their lives ruined.

Be very careful with facebook. I have one account for the guys, so to speak, and the privacy is set to friends only. Then I have another G rated account for family only. I am told more and more employers think they have the right to snoop at your facebook account, which is why I deactivate mine if I am job searching. People have been terminated over something they said on facebook or twitter, it's like people don't have a right to privacy anymore or freedom to express an opinion without retribution from your employer. Residents as friends on FB? Not a good idea, especially if they are trouble makers. Also, that might even be crossing into the HIPPA or whatever that nonsense is that they like to torture us with. I wouldn't go there if I were you. People can turn on you real fast

It has been my experience that everyone is too tired after 10-12 hours (supposed to be an 8 hour shift but no mortal person can get all that work done in 8 hours). Also, at least 3/4 of the staff were stressed out, angry, and always trying to dump their new admits, labs. treatments, physician's orders, etc off on someone else or the next shift. There was a lot of discontent, back stabbing, even hatefulness amongst the staff. When the facility hosted an x-mas party, they wanted everyone who was not on duty to attend so they could pretend they were being nice to us. We weren't joking when we said they'd likely write us up for something we did at the party when not on duty. I sure as hell didn't want to go into that torture chamber of a place on my free time and tried to stay away from the gossip, the in fighting, the constant stress and tension.

In my state the department of nursing thinks your employer is God, so when the work you to death, always threaten you, and those lazy managers that like to sit in the cozy offices and watch TV or tinker on the computer rather than help the floor nurses out when you are short and refuse to help you, when you reach a point where your back is so sore from running up and down hard floors and staying over for hours to get that never ending paperwork done and you quit because you can't take it anymore without giving the slave drivers notice, they will get even with you by giving you a bad reference. I think my state has a standard for hiring where you have to have 2 positive letters of reference, which means they are actively siding with management over labor and should be taken to court over it. No matter how badly they treat you, harass you. discriminate against you, you had better smile and take it or give them the 2 weeks notice. 20 years of busting my backside off and the nursing homes are all the same. Constant threats and intimidation, people who get those office or management jobs once worked the floor and dread the idea that they might actually have to do some work, then they come out and threaten you. If you miss your break (which you never get to take), we'll write you up. If you get 3 write ups, suspended or terminated. Then the government seems to be on a mission to make our jobs even more impossible. More regulations, paperwork this is totally unnecessary and then the dreaded state inspections that prompts the facility to start cleaning the floors and carpets, painting the walls, etc. Used to be you had a pretty good idea of when they were coming, and they always came on the day shift. Now they zig zag across the state, come in at 2am or these odd hours trying to sneak attack the place so they can steal money from these petty "infractions" to get revenue for the budgets that are broken all over the country. The owners lose money and get pissed off, they jump on the administrator and he gets mad, so he pounces on the DON and she gets stressed out, so she goes after the unit managers and the tortured floor nurses. We are supposed to pick on the CNAs but I refused to do that. When they were short, a took a set, gave them showers, helped them to the bathroom, fed them, etc That left me with a hernia and a severely damaged back. I am so glad I got into homecare. Give them 2 weeks notice and try homecare. It's one on one, minimal management, no government inspectors, etc

If you mean respiratory therapist by RT, that is how I started out. There was a 2 year waiting list to get into the local LPN school and I didn't want to be a substitute teacher another day (42 bucks a day after taxes, no benefits, and because I didn't know somebody and the schools here prcactice raampant nepotism, my 4 years of slaving away, writing azzling research papers, getting good grades was all for nothing and te thousands of dollars i saved up working in a warehouse and as a guard were wasted). I completed my associate's in resiratory therapy and then went right into LPN school. I can tell you this for a fact. There is no way nurses will ever phase out respiratory therapists and there are 2 main reasons why. First and foremost, the nurses already have too much work to do, they are too overwhelmed to start doing oxygen rounds, breathing treatments, drawing ABGs, and most importantly, ventilator checks and maintenance. Which brings me to my second point. The subject matter I had to learn in respiratory school was way more complicated than anything in nursing school. It was way more scientific. Gas laws, pressures, tidal volume. PEEP rates, etc. A person that has a shallow tube that puts oxygen in their lungs through a narrow opening in their throat from a mechanical ventilator had been have somebody well trained and experienced taking care of them and monitoring them closely. Because of this insane, broken, greedy healthcare system, the government and insurance companies of course don't want to pay and so create a mountain of frivolous. redundant, and in my opinion, totally unnecessary paperwork because the boneheads think they can measure the quality of care through more paperwork. Just when you think they can't possibly come up with more paperwork, they manage to. That's why you see well intended nurses who would rather be on the floor doing what really helps the patients, hands on care. Instead, their hands are tied clippety clipping all this never ending charting on the computer. Because they are overwhelmed with red tape, they will never have time to do the job of the respiratory department and they lack the training to do their work. So no, they will never phase out RT. Some hospitals may try and dump off some of their work on already tortured and over burdened nurses so they can save money by not hiring as many RTs, but over time the turn over rate and having to train new nurses as the other ones get burned out and quit after months or years of constant stress, never getting to go on a break, having to stay over hours off the clock to get the work done. The sadists that run these for profit places will realize it's cost effective to keep their RTs and not dump their work off on overwhelmed nurses. That is my take, I am an RRT and an LPN.