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It's rough a lot of days. It doesn't seem like it would be as fast as acute care, but it is. You are right, the patient/nurse ratios are much higher; you are much more dependent upon UAP due to the sheer volume of patient care. In my area, one nurse is typically in charge of 20-30 residents as well as the UAPs taking care of them. You need to be on top of your game in a different way than in a hospital - you don't have the resources or personnel available in most hospitals when you work at a nursing home. Sometimes the pace can become incredibly frenetic. Pros: yes, you do get to know your residents over time compared to the in-and-out care of a hospital. Also, you're much more autonomous. The physician is generally only available by phone and comes in 1x a week for a few hours. And if you're an RN, you probably have a better shot at supervisory/administrative positions at a NH than at a hospital; even ADNs have a fair chance at DON jobs, depending on experience and what the competition has to offer.

I broke down and got unlimited texting. I do wish that cell phone companies would make texting optional instead of an always-active feature that cannot be turned off or refused though. The 15c/message deal is a racket.

In most jobs, breaks, let alone meals, were a luxury. If I did sit down for a meal, 9 times out of ten an admin nurse or a CNA would be dragging me back to the floor. We weren't allowed to leave for lunch. The same admin nurses would routinely leave for hour-long lunches at good restaurants. I regularly got the old "time management" spiel when I protested. I live and work in a Right-to-Work state which is one of the most union-hostile in the United States. In my current job, which is not in a hospital or LTC, we're mandated to take breaks and will get in trouble if we don't take them, partly due to the fact that overtime is a big no-no here.

Any of my professors (I'm working on my B.A. in English) who caught a student texting in class would have a cow - "See me after class" with a threat that if it happens again, the student will be flunked for the semester. A lot of colleges are banning notebook computers in class because students use them to check their Facebook or MySpace pages. I used to use my notebook to take notes in MS Word. Plus, in Thailand and a few other countries in Asia, it is illegal to use cell phones to cheat on exams. It's prosecuted as computer fraud. Several students went to jail at a Thai university some years back for setting up an elaborate system to cheat on exams via cell phone. I took 10-stroke typing in junior high years ago, and it stuck with me. I can type 50 wpm blind.

Given the horrible limitations of the cell-phone keypad, I can understand why people who text use "texting language." What I never got was the appeal of texting itself. I'm an old dinosaur and need the full QWERTY keyboard to express myself on screen. Plus, the whole 15 cents a message to send AND receive a text message, whether you want it or not, kind of killed any enthusiasm I had for texting... especially after my wife's 15 y/o daughter ran up a $650 cell-phone bill for texting.

Ah, but anyone can spell anything correctly nowadays by Googling it... provided it's something professionally written. I double-checked it. Bragging on it and then spelling it wrong would make me look quite the fool... Although, I must confess - I was a spelling bee champion in the halcyon days of yore....

Heh... my medical director was impressed because I was the first person he'd ever seen that wasn't a physician who was able to correctly pronounce "Creutzfeldt-Jakob". "Dulcolax", oddly, is frequently mispronounced around here.

Generally, CNA and CMA certification mandate x number of minimum hours of training at a state-approved CNA/CMA training program. As far as I know, no state allows a person to become certified until they are documented to have completed all the required training, under any circumstances. Getting a CNA/CMA may give you an idea of some of the fundamentals of patient care, and may help you decide whether you want to continue on in becoming a licensed nurse. However, CNAs are very limited in scope of practice. They are oriented towards basic patient care tasks such as feeding, hygiene, and vital signs. They are not allowed to act on situations that require nursing judgement, and MUST report these situations to the charge nurse for follow-up. That said, an observant CNA can be an real asset to a nurse. Notably, certain nursing programs may count your experience as an Army medic towards your nursing program, or at the very least, your experience may improve your chances of being admitted into a program.

In the history books, this was called "indentured servitude" and "bonded" employment (hence the term "bondage"), and amounted to slavery, since the wages indentured workers earned were always insufficient to pay back whatever loan or "bond" the employer held. These foreign workers are being exploited as well. Henry Ford understood that putting Americans to work would create a built-in customer base for products. Once Americans stop buying products, who will buy them instead? Ther

My own contribution to this is: I live in the lower Midwest. We don't have blizzards here, very rarely does snow get more than an inch when it does fall, because the climate is too warm for blizzards. Our climate is too warm for full blizzards, but instead it causes ice storms consisting of freezing rain, which forms a casing of ice on anything it hits - the roads, trees, power lines, etc, and turns the roads into black ice, making any expedition dangerous. Cross-country skiing is not an option here. Nurses are expected to literally risk getting themselves killed on the roads or getting their cars totalled to get to work.

this kind of stuff is why i'm glad i got out of hospital/nursing home care. it's nice to go back to work in a job that closes during ugly weather.

"Only" a month? The only job where I spent more than a WEEK in training was my current job at a plasma center, where you have to do every task in the view of a trainer x number of times and jump through all kinds of hoops. In regular jobs, three days, tops, and you were on your own.

In the US, you're lucky if you get paid leave at all. The FMLA only protects you from getting fired for taking maternity leave. Most employers here would prefer for women to squat in the bathroom, have their baby, send them home with a relative, then go right back to work...

Bottles of those "pills" Hallmark sells (really jelly beans.) Flinstones Chewable Morphine....

They could like this site to Digg and have people rate comments that way....:chuckle:chuckle

You did aggressive follow-up with both the resident and his physician. Your actions were appropriate. As long as you documented your interventions and the Physician's responses, all should be good. No reasonable nurse should object to what you did. We all know how hard it is to keep some diabetic residents regulated. I would have done exactly what you would have done. The resident may benefit from your actions in the long run with titrated insulin orders. Granted, there are a large number of unreasonable people out there, which is why you document what you did.

Unfortunately, Oklahoma, with the blessing of our then-governor, passed the right-to-work law in a landslide. The governor proclaimed, "Oklahoma is OPEN FOR BUSINESS!" Yeah, maybe for minimum-wage jobs like Wal-Mart associate. Whatever. This is also one of the reddest of the Red States.

I wonder how this journalist would feel about the idea of "protecting their jobs" if the L.A. Times falls victim, as so many print publications have, to the ready, if somewhat questionable, supply of information that the Internet provides? Will he gracefully give up his job if the public decides it no longer needs a paper version of the L.A. Times? Teachers are replaceable too: Calvert School in Baltimore, MD, will provide you with everything you need to educate a child in grades 1-8 to the standards of any state in the country, all in a box shipped via UPS. The right nut job in the right position of power could cause an ugly "revolution" by replacing teachers with minimally trained "teaching techs" under the license of one single masters'-prepared teacher. That kind of system would make for crappy education, of course... but it would save the state billions, so who cares?! Just like our hospital system! But teaching is about more than just reading lesson plans... just like nursing is supposed to be about more than reading a sheet of physician orders. You have to know something about WHY you're doing what you're doing. That way, if an unforeseen complication arises, you're not stuck helplessly wringing your hands wondering what to do, because the book didn't mention this!

A-MEN! No California nurse would accept the working conditions common in Oklahoma facilities!

Ugh... used to constantly dig food scraps, even whole food out of several morbidly obese, elderly NH patients' crevices and bedding who had habits of hoarding snacks. Another gross patient I had was a 91-year-old lady who dipped snuff and spat or drooled the juice all over her clothing and bedding. Reee-pulsive.

I've taken the Hep B series once, and have refused it at all subsequent hire-ons. I only accepted one flu vaccine, and I was so ill for 3 days (and wasn't allowed to be off work) that I absolutely refuse to take another flu shot.

In my area, LPNs have generally worked in LTC; they are a rarity in hospitals. This has been the case for years, and is not particular to the current economic recession. I haven't heard anything about nurses being laid off here, whether LPN or RN. In fact, nursing homes constantly run ads for LPNs with nice, if not great, sign-on bonuses after 6 months of employment. Even in this recession, nursing staff hires on and quits in waves in a nursing home, and if you can handle the work, you can probably get a NH job with few problems.

I don't know how secure the jobs are, given the recent hospital and unit closings in certain cities, and in some areas, such as many Northeastern cities, there's a glut of nurses who can't find jobs already. In more stressful areas of nursing, like some med-surg units with high nurse/patient ratios, as well as in poorer regions of the country like the South and Midwest, there may continue to be a shortage, however. We still need staff at my own workplace due to high turnover, coupled with huge demand for our services.

"Boys and their boobs..." You know, you just put some rather disturbing mental pictures in my head with those 4 words.

Honestly... I think some of you ladies are too hard on yourselves. There are beautiful features to be found in ANY woman. Besides, I know I'm no Brad Pitt myself.