lilblue

Are you looking to do skilled visits or private duty shifts? Have you looked for nursing groups local to your area on facebook that are for job postings? Do you live in an area that is perhaps over-saturated with nurses in home health? I haven't ever really had an issue finding private duty jobs, it's been more difficult to just find the hours and type of patient/home environment I'm looking for but my area has a huge need for nurses, especially in private duty and home health visits. For instance in my area most of the job postings are for high acuity patients during weekend (or night hours for PDN jobs). When you said you've been rejected many times, is it that you're not hearing back from employers or is it that they are actually calling/emailing you back to let you know you weren't chosen for the position? Are you getting interviews? Do you call each employer after submitting applications online? When you have been rejected, have you tried to ask them why? How is your resume? I haven't worked in assisted living, but is it perhaps that you don't have much experience with the type of skills needed for home health like wound care, Foleys or g-tube/trachs? If this is the case, I would suggest before trying home health that you perhaps try working in an LTC/nursing home environment to get more skill experience.

When I was in school to become an LVN, I did not get as much clinical experience as I would like, partially for some of the same reasons you mentioned, especially the feeling of being forced upon nurses who didn't sign up to have a student with them. I understand you want to work in the OR as well. However, in order to have other nurses willing to let you do things, perhaps try from the start of your clinical shift once you meet whichever nurse you're going to be with, to let them know that you're happy to help make their load lighter by perhaps doing all of their vital signs, or other tasks. If they see that you won't slow them down during their day, they may become friendlier with you and let you more. For instance if you're on a med-surg unit, you can go and check on all the patients and see if there's anything you can bring them so that their nurse doesn't have to deal with the "non-nursing" specific tasks like bringing them blankets or cups of water (make sure they aren't NPO!) or what have you. You can also ask the charge nurse where extra gloves or PPE are kept and restock each area of the unit that needs more gloves or masks etc. I did most of my clinical experience in the ER (which is not at all where I've ended up so far!) so I went around helping to clean and set up rooms (remove sheets, wipe down beds and pulse ox cables, restock any supplies each room needed, etc.) Just by being someone who made things easier for whichever nurse was "stuck with a student," I made them more likely to let me do skills like place IVs or give injections etc. I also saw students from other programs and schools and the ones that annoyed the other nurses the most were students that just stood there and didn't offer to do anything. There were BSN students all huddled in a group basically hiding near the elevator in a corner so they could get out of doing anything. Some of my own classmates either refused to do a skill (there was a stroke code and a classmate was asked to place an NG tube and she said no!) or were not prepared (didn't have a pen light or stethoscope). Our instructors explained during our first semester that we must be willing to do tasks that don't seem like a nurse would do them (like help to change a brief or get a patient onto a bedpan, which too many RN students think is beneath them) and then some nurses are more likely to see you actually want to help and will often give you assignments, or teach you new things. Anyway, I would try to make the best of it, even if you aren't training in the specialty you'd like, the skills you learn in clinical can help you even in other areas like the OR. Be willing to help out with anything. Even if it doesn't help you get nurses to want you to follow them (most are overworked, tired, and the last thing they want is a student hovering around), you will be seen as a team player and at the very least, you can network with other staff members or learn something new. I hope that helps and good luck!

I worked in a nursing home as a new grad and I'm still a fairly new nurse so I don't know if an SNF is the same thing as a nursing home but I did work nights there so this is what I remember doing (although I did block out a lot of memories of 2020 for obvious reasons): 1800- receive report, grab a cordless phone because there was no receptionist on nights or weekends, do narcotics count with outgoing nurse and start med pass after going down the hall first to briefly check on everyone. I had 45 residents although not all of them needed meds or treatments. I did have 9 g-tubes and 3 trachs though so they took up most of my night. I shared 3 CNAs with another nurse who had about 24 residents on his side of the hall. I would answer the phone in between residents when I could, usually family members asking how the resident had been that day. If I had time I would wheel residents back to their room when they were still allowed out of their rooms for dinner but later they all had to stay in their rooms all day. 2200- Start the next med pass which was much smaller and was mostly the last neb treatments or an insulin and one g-tube bolus feed. Usually around then the phone didn't ring as much or the other nurse had more down time and could answer it. 2300-- If anyone needed their Foley changed, I'd do it after the second med pass. I'd try to do some of the TARS (I've forgotten what that stands for but it was time consuming and involved a lot of clicking). 0000-- About 3 people had meds/treatments at this point, it might have been all the trach pts needing nebs, I don't remember but it took very little time. 0030-- 8 g-tubes needed their milks and pump tubing changed. This took a bit of time because I would lay out all the different milks, need to label each formula bottle with pt info and then the pump tubing also needed to be labeled. Some residents had their formula in cans, so these had to be poured into bags that attached to the pumps. While there I would also change the g-tube split gauze and again label it with my initials, the date and time and some also needed zinc or A+D cream. Every 3 nights at my nursing home was "neb night" which means they needed new tubing and masks for their nebulizers (for those that had one whether PRN or daily). Anyone receiving oxygen also needed a new mask, nasal cannula or trach collar mask and/or new "water" for the O2 condenser or air compressor. Those also had to be labeled with the time, date, my initials, the pt's initials and their room number. 0100-0400-- Documenting. I took my time and was pretty thorough but some nights if I didn't finish during this time I would stay after my shift like if there had been any emergencies or new admits or any of that that threw me off timewise. If I finished documenting early, I was reordering meds at this time (we could click to reorder with our software or if I needed to I would fax info to the pharmacy and if it was urgent, I would have to call the nights/weekends number.) If I had downtime I'd do all my skin assessments for the week, if not I only did the assigned one I had for the night. During this time the night CNAs would come to me and ask if I needed vitals on anyone (evening CNAs would refuse to do this) so I'd grab the list of residents and highlight anyone I didn't get to who I didn't see during med passes. If they were a new CNA and the vitals looked wonky I'd ask some follow up questions or I'd go take the vitals myself. 0500-- I'd go to central supply and bring back anything I or the other nurse needed or that we were running low on. Then I'd go to our unit's supply room and restock what was needed there and then restock my cart. That included med cups, water cups, little wooden stirrer things, sleeves for crushing meds, flushes if anyone had IVs, etc. Later into my working there a couple of people had early morning meds I needed to give but it didn't take long. Right before the end of shift I'd dump the old water from my pitcher and put fresh water and label the pitcher. 0600-- Give report to the day nurse and count narcotics with them and usually finish any documentation. Sorry it's super long but that's what I remember doing. Of course this would vary if anyone fell or any emergency happened but you get the idea. Good luck!

I'm not an RN, but I don't recommend private duty if you're a new grad RN. (I don't know if you're a new grad or already have some experience.) You would want to be using your skills as much as possible in your first job and most private duty jobs (at least in my experience) don't use a lot of skills. I do trach suctioning and I straight cath once or twice a shift but mostly I diaper and feed PO and monitor their sleeping O2 levels. Some pts are higher tech but there is still a limit to the skills you will be using. I did LTC for a few months first as an LVN and I'm glad I at least did that because I have done some other skills. However, if you already have hospital or LTC experience then if you want to do PDN on the side or just to take a break from a facility, then it's a good job depending on the agency and the pt/home. For me doing nights it's often quite slow and it's what I would want to do if I was ever to go back to school because there is a lot of downtime to study. Days can be quite a bit busier including doctor's appointments and getting your pt to have labs done etc. I do enjoy what I do as a PDN but I don't know that I'd want to do this for the rest of my career. Hope that helps!

I did LTC as a new grad LVN and it definitely was not easy at all. I did get more training than 2 shifts but I had 45 residents and what made it even more difficult was a lot of them were wanderers who constantly tried to escape the building or fall. I only lasted 5 and a half months before I left to do private duty because it was 2020 and that year was bad enough on it's own. If there's anyone higher up like a DON you can speak to, I would definitely do so because as someone else said, you are putting your license at risk but it could be doable if you want to give it a try.

I try not to swing back and forth (I don't have kids) but there are occasions when I need to. When I get home from my last shift (I work 4 12s) I go to bed right away but when I wake up to go to the bathroom as is often the case, I stay up. Usually my husband is watching something interesting on tv or he wants to go out so I stay up with him at whatever time I wake up until he goes to bed and I do as well. Basically I only have a small nap after my last night shift and stay up until he goes to bed then I let myself sleep but wake up early like 5 am or so. As far as what I take: I take melatonin only when I sleep during the day. My room is totally dark because the windows are actually painted over (it's my in-law's house). Some days I can't sleep at all so if I'm still awake by 9 am I will take a benadryl but I don't really recommend because when I wake up I'm incredibly groggy and feel more tired than if I slept less. But you're asking what you can take to stay awake during the day? Caffeine works for me. Actually I drink it whenever I need to be awake, whether at night or during the day. I found coffee even with tons of cream still bothered my acid reflux so now I squirt a little Mio Energy into water or juice and it bothers me less. Be careful with that one though, I believe one squeeze/half teaspoon is like 60 mg of caffeine. I've been on nights for about a year and a half but I do switch back and forth with my sleep schedule lately when I'm off just so I can have some social life. Hope that helps!

Pediatric patients aren't always a good fit for everyone. I felt incredibly nervous when I found out my first private duty patient was a baby! I knew I would be working with kids but I guess I thought my patient would be like school age or so. Nope! But in my case it has gone very well and I really enjoy it. I did use to babysit toddlers when I was younger. I don't consider myself naturally good with kids but I do like them and usually can get them to laugh or smile a bit. I'm actually quite introverted and quiet most of the time but I manage well. I would say if you want to give it a try, go ahead and see if you like it. Hopefully in your area there are a lot of other jobs in case it isn't a good fit. But you may be surprised and find you like it.

It would depend on your school's dress code policy. When I was in nursing school we couldn't even wear headbands or anything. The rule was hair in a bun or cut above the shoulders and hair could not be in our face/eyes so small hair clips that blended in with our hair color were the only accessory allowed. I wear very wide headbands to work in private duty to keep the frizzies at bay so I feel you. With the pandemic, schools may be more lenient in that regard.

I have not worked in an ER, only a nursing home and now that I'm 2 years into being an LVN I wish I had. I ended up leaving the nursing home for private duty and I feel that although it is way lower stress it was a mistake because now I have very little experience. I personally would recommend the ER.

I'm brand new here so I'm not sure of the rules yet as far as mentioning specific study materials but there are a couple of HESI study guide books out there, one has a yellow cover that I used. I also Googled HESI exam practice questions for that section. If you've taken A&P already that will really help. I remember it mainly being material from A&P 1. Basically do practice questions and for every one you get wrong read the rationale and write it down until you score at least an 80% or better on a consistent basis. If you did well in A&P classes you will most likely do well on the HESI as long as the information is still fresh in mind.

I've only ever worked in South TX. In my experience there are no ratio limits as a rule like there is in CA but each facility may have it's own ratio. In Texas it's usually high. I previously worked in a nursing home with 45 residents of my own but I've heard of worse in other nursing homes here. My mother in law had 65 residents at her facility. In my area I believe it's about 6-8 patients in med surg but not sure about other areas because most of the nurses I know in hospitals are RNs. Maybe someone with more experience can tell you more. Good luck and stay safe!

I just did a lot of practice questions. There are a few HESI test prep books out there you can do practice questions with or there are websites with practice questions. For any you get wrong go back and look up the information. Are there any sections you feel you may not do so well in? For instance I scored the lowest on the math. In retrospect I should have memorized metric vs US measurements and personally I feel I should have learned dimensional analysis (you can look on Youtube for videos if you're unfamiliar with it). I scored the highest on anatomy and physiology because I had just taken those classes (1 & 2) so it was still fresh in my mind. Good luck and hope that helps!

Before the lecture (preferably the day before or earlier) I would go to the end of the chapter questions and try to answer those by skim-reading until I found them and write the answers down. The power points were given to us so I would read those and only write what I thought was important down or that might get asked. The power points also had questions every few slides so I would try to answer those. I also was in a group with my classmates so we would quiz each other. If I had time I also tried to read as much of the chapter beforehand as I could but in my program I was also taking several other classes at the same time so for me I had to set priorities based on which exam was soonest or was worth the most points. Hope that helps!