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Newgurl17

Newgurl17 CNA, LPN

LTC
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Newgurl17 has 2 years experience as a CNA, LPN and specializes in LTC.

Newgurl17's Latest Activity

  1. Newgurl17

    Scheduled and PRN Doses

    Hello!!! I'm wondering if anyone can please answer this question I have about scheduled and PRN doses... But first I will give some background: We had a lady who had been pacing.. Like really pacing... Around the unit. This lady is on scheduled hydromorphone. The other nurse working with this lady gave her the scheduled hydromorphone along with her scheduled medications to help her sleep. Shortly after, I could hear from the other side of the unit a lady calling out for help... Sure enough, it was the lady who had been apparently been pacing. So this lady usually has no problems with her scheduled night meds. Had always received them and never fell until tonight. When she was on the floor, she was still restless and wanting to get off the floor. So we get her up off the floor and got her to sit in a wheelchair and at this point, still restless. She wants to get up. So she gets up and we take her to her room. Other nurse is trying to check her BP and she's wanting to get up after we sit her down on the bed. Before this last had her fall, she was apparently pushing another resident around in their wheelchair. I take her to my side of the unit. While we're walking, I ask her if she has any pain and she confirms that she does. Once we're there, the CNAs get her to sit down for a glass of juice and a sandwich. At this point, I decide in addition to her scheduled dose of hydromorphone, I give her a PRN dose as she was complaining of pain post fall. Shortly after the CNAs give this lady a glass of juice and a sandwich, she starts pushing her table towards the unit entrance doors. Only has a few sips of juice. Too restless to eat. The CNAs manage to sit her down once more and spend some time talking with her, then decide to take her to her room. The talking was effective for time until the lady wanted to get up again. I tell the other nurse that I gave the lady a PRN dose of hydromorphone due to complaints of pain post fall. So my question is, should I not have given the extra PRN dose if the lady already had a scheduled dose before her fall? She was VERY restless before her fall and I honestly didn't think that her other scheduled dose was cutting it. I just thought that giving a PRN dose post fall would help to settle this resident?
  2. Newgurl17

    Holding HS Meds

    Yes, RN was notified. Resident was agitated this morning during AM care but not hs care this evening. More alert this evening than she was yesterday evening.
  3. Newgurl17

    Holding HS Meds

    Usually we let the RN know what's going on, they give us direction, we continue to monitor, then notify the physician via fax, unless the resident's condition is more urgent, then the RN gives the on-call physician a call. In other instances, the nurse lead (an LPN or RN usually) may have us trial holding medications, like risperidone, if a resident is too sedated, then we fax the physician of the trial was effective to discontinue the order
  4. Newgurl17

    Holding HS Meds

    Meds were scheduled
  5. Newgurl17

    Length of Time it Takes to be a Good Nurse...?

    Yes, as of this year amd things have gotten better for me! A few CNA's and an RN have told me that I was a good nurse!
  6. Newgurl17

    Holding HS Meds

    Hey all, I'm still working in a special care unit. So I was working this evening with a lady who gets a scheduled Seroquel 25mg tab and a 50mg (I think) tab of a sleeping medication (trazadone). This lady was sleeping in her wheelchair after supper, had little intake at supper as per CNA. In report it said that she was slowly declining. She was able to wake up for me for a while. I decided that I would hold off on giving the seroquel and trazadone, as she was already so sleepy. Another tine she was with a volunteer who stated that she was tired at 1830 so the cnas put her to bed early. I didn't have a chance to give her her medications because she was sleeping. When she didn't have her medications, she was up at 0200 but she was helped back to bed again with no issues. If I was on another unit (not special care) in the facility, I would have held the antipsychotic and sleeping medication and that's what myself and other nurses were instructed to do? I only the held the meds tonight because I was afraid that this lady would be over-sedated?? Should I have given the medications?
  7. Newgurl17

    Tips/Advice on Orientation?

    Hello fellow longterm care nurses, I got a temproary part time position this year and my time has finally come to show new hires the ropes.... The thing is, I've only been a nurse since March of last year... I was telling my co-lpn that maybe the new hires would be better off with a more experienced nurse to do their orientation and she told me to just show them the routine and to believe in myself:) Well anyway, I was on orientation with a nurse for the first time and to be quite honest, I didn't like it I didn't like it because I wasn't able to just go with my own flow with my routine. Anyone have any advice to provide a successful orientation to a newly hired nurse (woth and wothout experience)? It's been a while since the time I was first oriented
  8. Newgurl17

    Self Doubt

    I am a little over a year into my nursing career and have been working in long term care. In the time that I've been a nurse, I've experienced 2 choking emergencies.... And I've frozen up both times. The second time made me feel doubtful of whether or not I should really continue being a nurse. Have you ever frozen up in emergency situations? Thinking back, did that make you doubt your career choice? Or is it just me?
  9. Newgurl17

    Length of Time it Takes to be a Good Nurse...?

    So you were working in a SNF for 2 years?
  10. Newgurl17

    Nursing School

    Hello, It has officially been a year and a month or two since I first started working as a nurse and I have been feeling a little down lately thinking about what we were taught in nursing school. My program was only a a year and a half long and half the time was spent not being hands-on. My transition into the workplace had and still remains a struggle because nursing school didn't prepare me for my job in ltc. If there was any way that you could change how future nurses are taught in school, how would you change it? How would you develop a program that will better prepare nurses for the workplace? What would you teach future nurses?
  11. Newgurl17

    Need Help! Want to Switch Specialties!

    Does it go without saying that you never know if you're going to be good for a specialty until you try it out?
  12. Newgurl17

    How to Handle New Admissions?

    Unfortunately 4 hours is the new standard at this facility due to the new admission paperwork the the company created which is 100 pages long. The floor nurse has to go through ALL the paperwork, assess the resident, and put the adl's together. A lot of the paperwork is repetitive, and there are chechlists for checklists. Usually an extra nurse is called in for the four hours that the other nurse has to do the admit but this isn't always the case. So in total, there are 2 or 3 nurses working the floor. When I was admitting my resident, all my DON did was hand me MORE paperwork amd left on time for the evening.
  13. Newgurl17

    How to Handle New Admissions?

    i just did her vitals and pain assessment. the rest of the info I got from the daughter. Of course I spoke with the resident herself and did my head to toe. The company I'm working for created all this paperwork for the nurses to complete which was quite repetitive. I was told on the day of the admission that we would be getting a new admission so I felt like I wasn't prepared. The admission package wasn't even double sided. Collected health history, completed adl's, pain assessment, diet, falls risk assessment, braden scale. Ended up staying til 9pm because of everything I had to do on top of the admission.
  14. Newgurl17

    How to Handle New Admissions?

    Hello, Had to admit a new resident for the first time a couple of days ago and had 3 packages of paperwork to complete. My shift starts at 0800 and ends at 1830. I started the interview with the family at 1300 as the resident herself was going to arrive an hour later and had a dx of cognitive impairment. Wasn't finished until 4. How do you handle new admissions while also having to take care of the rest of your 23 residents?
  15. Newgurl17

    Extra Certification for Wound Care?

    Hello my fellow Canadians, So I work in BC and want some extra certification in wound care. Curently I'm an LPN. Does anyone know where I can get extra certification that would be recognized by CLBNBC and my employer? I don't know where I can get extra certifcation that would be recognized... Anyone else an LPN interested in extra certification for anything? Where did everyone go for their certificates?
  16. Newgurl17

    Dealing with an Unexpected Death

    Yeah, i was reassured by the fact that he had apparently been decling since admission and that he was already 98 years old. I spoke about this with an rn at work though and yes, I do feel like his life could have been saved unfortunately. She talked to me about suctioning and now that I think of it, I think it's important to always know where the suction machine machine is at your facility. When we were talking about it, the rn said that we had it DOWNSTAIRS but resident's room was UPSTAIRS. Do you think that maybe facilities should have suctioning machines on all floors? Oh, and I've never suctioned anyone before. Talked about suction ing in class, but never actually practiced it, not even on a mannequin. The RN said that the cause of the resident's death could have been heart related. He couldn't tell me what he wanted because I noticed that working with him, it just takes him a little time to explain himself because he has to catch his breath. Even when he wasnt short of breath it would still take him a while for him to tell you what he wanted.
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