withasmilelpn

withasmilelpn

Rehab, LTC, Peds, Hospice

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All Content by withasmilelpn

  1. No longer a nurse?

    withasmilelpn replied to withasmilelpn's topic in General Nursing

    Thank you for all your replies. I just feel so sad and angry about this and was wondering if I was overreacting. I'm proud of being a nurse (though I also often say I have a love/hate relationship...

  2. ER nurses not calling report anymore...

    withasmilelpn replied to plinytheRN's topic in Patient Safety Issues

    Have been through numerous surveys through 17 years of Nursing and 6 as a CNA, by JCAHO, CHAP, ACHC, CARF-CCAC, PA dept of Health...numerous ABC regulatory agencies depending on what nursing job I...

  3. Weekly Weights

    withasmilelpn replied to CapeCodMermaid's topic in LTC: Directors, Assistant

    Honestly, the worst thing about being a long term nurse is being responsible for 'others' work when you have such a hard time getting 'your' work done. It is possible to be buried alive in your...

  4. Fentanyl patches

    withasmilelpn replied to CapeCodMermaid's topic in Geriatric, LTC

    I was told not to use transparent dressings either by our

  5. Carb counting and insulin in LTC

    withasmilelpn replied to cactusj's topic in Geriatric, LTC

    Wow - would not want to so that on my unit. Very few CNAs I could trust with that. Our dining room is far off the unit and Residents don't return timely for meals. However, we are under construction...

  6. D.O.N. tells me NOT to describe wound???

    withasmilelpn replied to nervousnurse's topic in Geriatric, LTC

    Pain management is 50/50 where I work now. Docs are very cautious, a lot of our nurses are fairly new and one supervisor always characterizes people on narcotics as 'addicts. ' It can be pretty...

  7. Bruise or ecchymosis?

    withasmilelpn replied to SneakySnake's topic in Geriatric, LTC

    From http://www.medscape.org/viewarticle/578859_2 Of note, Sheridan reminds us that nurses sometimes use the word "ecchymosis" erroneously in place of "bruising." Ecchymosis is not a synonym for...

  8. ADON/LPN Fired after 13 years of service!! Your thoughts?

    withasmilelpn replied to downsouthlaff's topic in Geriatric, LTC

    Well there is such a thing as smart business practice - and I'm questioning how smart they are. 8 DONs? That is some pretty high turn over and speaks to some likely problems. Long term care is highly...

  9. HELP! LTC RN VS LPN!

    withasmilelpn replied to ricksy's topic in Geriatric, LTC

    I have to say to the others saying you should've checked the orders - I actually don't understand why it would be your job to go behind him and check what he faxed? Licensed nurses are responsible...

  10. Bruise or ecchymosis?

    withasmilelpn replied to SneakySnake's topic in Geriatric, LTC

    Contusion: Another name for a bruise. What is a bruise ? A bruise, or contusion, is caused when blood vessels are damaged or broken as the result of a blow to the skin (be it bumping against something...

  11. Bruise or ecchymosis?

    withasmilelpn replied to SneakySnake's topic in Geriatric, LTC

    Sometimes it's best to stick to "discoloration" when you are not sure - we have had instances of documentation of 'bruising' when it was actually 'staining' from venous insufficiency.

  12. HELP! LTC RN VS LPN!

    withasmilelpn replied to ricksy's topic in Geriatric, LTC

    Actually - I can't believe the LPN didn't know those were not the orders - and there would be no way to for her know what he faxed either. He said he faxed them - a nurse with 12 years experience?...

  13. 1/2 ns vs. 0.9% ns

    withasmilelpn replied to Lev's topic in Patient Medications

    There's no one ideal fluid for every situation. For resuscitation, crystalloids allow rapid repletion of volume. 0.9% sodium chloride is slightly hypertonic compared to plasma (308 mOsm/L vs 290)....

  14. Being the "only RN" in the building.

    withasmilelpn replied to Spikey9001's topic in Geriatric, LTC

    I worked as a weekend supervisor in a LTC/Rehab as an LPN - because I had tons of experience , worked there 6 years and knew their policies forwards, backwards and blindfolded. We did have an RN that...

  15. Hostile work environment - considering breaking contract - any thoughts?

    withasmilelpn replied to knitnurse72's topic in Patient, Colleague Relations

    It is not unusual to have a DON not do patient care, or not know patients, I've worked plenty of places unfortunately where I had to redress wounds because 'someone' wanted to see - DON, unit...

  16. Problems at the SNF

    withasmilelpn replied to richnurse828's topic in Geriatric, LTC

    While I seriously have issues with the behavior of this poster - this is ANNOYING. There are absolutely places where lunch breaks don't happen because the work load is impossible and the nurses are...

  17. help

    withasmilelpn replied to RNfuzzy's topic in LTC: Directors, Assistant

    Testing won't prove anything except that she takes a prescription. It won't show she is impaired and unsafe to practice. On performance reviews you can address behaviors, and suggest a medical leave...

  18. ltc desk/treatment nurse newbie

    withasmilelpn replied to malicexmirage's topic in Geriatric, LTC

    Why? Explain exactly how it is better? Not disagreeing altogether, but most of the nurses in LTC are frustrated that I know, because they have 'tasks' they must get done and way too many distractions...

  19. Please help! Questions I haven't read here yet....so curious!!!

    withasmilelpn replied to nervousnurse's topic in Geriatric, LTC

    Ok - I've been fortunate to bounce around a bit over the years and have seen how different facilities handle admissions. The best, hands down smoothest ones were facilities with an 'admission nurse'...

  20. Does your LTC get mad when you send patients do the ER?

    withasmilelpn replied to Blackcat99's topic in Geriatric, LTC

    I reread this - and realized I read your post wrong. Sorry - don't think what I said applies after all to your post.

  21. Does your LTC get mad when you send patients do the ER?

    withasmilelpn replied to Blackcat99's topic in Geriatric, LTC

    No offense Brandon, but as the patient advocate you can and should persuade the doctor if you feel strongly they should go to the hospital or whatever else you feel will benefit your patient. Doctors...

  22. Nurses HELP ME pls

    withasmilelpn replied to BelleNurseRN's topic in Geriatric, LTC

    Get a new job first though before you quit or call the labor

  23. LTC-What is meant by "The skilled nursing area of LTC"

    withasmilelpn replied to Blackcat99's topic in Geriatric, LTC

    The business is indeed changing. I've been a nurse for 17 years now (jeesh) and 6 years a CNA before. LTC was what assisted living is now - but even that is changing with CNAs becoming med techs,...

  24. VENT!!!

    withasmilelpn replied to WldChrry's topic in Geriatric, LTC

    Yuck / not a good

  25. Nurses HELP ME pls

    withasmilelpn replied to BelleNurseRN's topic in Geriatric, LTC

    She is violating the law. Period. And they owe you all the $ they didn't pay you. Approved or not - you were working and they owe you money. Their only recourse is to discipline or fire you for not...