kstec LPN

kstec has 1 years experience as a LPN and specializes in Geriatrics/Family Practice.

kstec's Latest Activity

1. 

   50 yr old LPN in LTC

   kstec replied to Lutie's topic in LPN/LVN

   30 residents is a lot. Where I work the limit for true LTC residents is 25, that is with no medicare charting at all. We have a wound care nurse, but we still have to do dressing on PM's. There is a lot of falls (incident reports), lots of behaviors (Alzheimers and dementia) and a lot and I mean a lot of meds to give. Most are probably not necessary but you obviously still have to give them. I do work with some 50 + year old nurses but along with the younger than 50, we are darn tired at the end of the shift. It's like working in an adult daycare except your residents act like new walking 1 year olds (falling) and have behaviors like 2 year olds. When I get done working that unit I'm emotionally, physically and mentally drained. I do make great money, but I work for every penny of it and then some. I worked in a family practice office and the work is like night and day, along with the pay. I would definitely shadow, especially because not all LTC facilities are created equal. Understaffing, poor quality of care, lazy coworkers, etc. If the facility is promdominately medicaid, definitely beware. I told you the above all from my personal experiences.
2. 

   Help!!! I Cant get hired anywhere!

   kstec replied to RL1883's topic in LPN/LVN

   Is the area your in just wanting a year experience for LPN's, or for RN's also?
3. 

   A couple questions about med injections

   kstec replied to mnnurse29's topic in Nursing

   I was given phenergan IM in my deltoid during a surgery by the nurse anesthetist (sp). No I did not have any nausea post surgery, but my arm hurt for 3 weeks post-op. I actually asked the surgeon at my follow up appt. if the darn needle had broken off in my arm because it hurt so bad for so long. Eventually the pain did go away, but I am here to say "Do not give phenergan IM in the deltoid." My common practice in family practice re: injection amount is 1cc can be given in the deltoid except for infants and children older than 5 or 6 years old, they are given in the VL. Any injection more than 3cc is to be seperated into two syringes.
4. 

   Grounds for termination

   kstec replied to kstec's topic in Nursing

   I was the original poster of this and I have come to find out that certain types of disciplinary action are taken according to the residents cognitive ability. Have you ever heard of that? Both of the residents that I was cussed at in front what you would consider dementia residents but not so far gone that they don't know what cussing is. This event happened over a month ago and since then I've worked appx. 6 shifts to avoid working with her. I'm prn and fortunately I have that choice. Finally, today since I really do want to work I contacted administration to see if I'm overreacting re: this situation or should I let it go. My heart and gut tell me that this is not something to let go. If I wasn't still feeling that this was unacceptable from the get go I would of probably let it go by now. I just think that no matter whether you're demented, with it, or in a coma you have standards of behavior that you (healthcare professionals) need to abide by and when that is thrown to the way side than I guess it becomes a free for all and the the ones with the biggest b_lls stay and the rest of us leave with our tails tucked wishing that being a patient advocate was supposed to be a good thing. It's sad to think that I'm sitting her day in and day out due to the fact that I won't work with her and she has stated she will not work with me. I refuse to work with her in that it is walking into an uncomfortable situation. What if I asked her to do something? Her actions from a month ago could be her nice way of being unprofessional. I don't condone that behavior and I refuse to work with it. I did fill out three applications today. I know that the grass isn't always greener on the other side, but because administration did not back the fact that this was grounds for termination and back me in what I felt was appropriate discipline, I feel that it could happen again with little or no repercussion (sp). I think that she has been there a long time and due to this she has probably done many of things that have been ignored and with that comes more courage to be disrespectful and do what you want when you want because nothing is going to happen. Sorry so long... Any further input would be greatly appreciated.
5. 

   Grounds for termination

   kstec replied to kstec's topic in Nursing

   The reason that I'm fearful is that she is known to be a CNA you don't mess with and is already walking on thin ice due to her attitude. When she was brought into my bosses office all she could do was demand to speak to me face to face and I guess her state of mind was so irrational that my boss said absolutely not. That is why I'm fearful. She's seems like someone who doesn't play by the rules which in turn makes me fearful of her setting me up at work, being a bully or whatever else. It is mutual that we do not work together per my bosses okay. But how sad, when the whole thing was over me asking her one to many times if she had so and so, and that if she did please let me know so I can come help her with the HS care and do my tx. whether it be a cream, oint, powder or dressing change. It's a lot easier doing it that way than asking her to go back to each room after she's done with them when we could of "killed two birds with one stone". But she took it as I was rushing her and riding her all night, which was not the case. I did not tell her to do anything. I asked her to tell me when and I would come in the room then. I even said if she wanted to she could turn on the light and I would come with my medications (oints, creams, drssgs, etc). Does that sound like I needed to be cussed at in front of two residents?
6. 

   Grounds for termination

   kstec replied to kstec's topic in Nursing

   We as floor nurses are not allowed to write up anyone. If we had that type of authority, I would of sent her home that night. She is still employed there and her story is the same as mine, except due to her being so mad at me when written up she was allowed to go home the day of the supposed write up. Yes, I'm fearful she will retaliate, but I don't want to have to look for another job at this moment. I figure I'll just play it out and if something happens physically, 911 will be my new best friend and administration will be sorry they just didn't terminate her from the get go. Back to the original thread: She did this in front of two dementia patients, but my facility also has a rehab facility with perfectly coherent patients like you and I. What if she would of done it and had the patient go to administration? She got lucky on her part that the residents can't verify what she said. Well thanks for all the input. I'm glad that the majority of you agree with what I think should of happened. I guess with the nursing shortage all the way around it takes a lot to be fired d/t having noone to replace them.
7. 

   Grounds for termination

   kstec posted a topic in Nursing

   If a CNA cusses at you (the nurse) in front of two residents, do you think that is ground for immediate termination? I think so, but instead I have to continue to work with this CNA. Not that I'm trying to save face but I didn't do anything wrong to deserve the cussing and the CNA just misunderstood something somewhere along our shift. She admitted to the DON that she did this and wanted to confront me in the DON's office, which she (DON )did not allow d/t the CNA being irrate when confronted from management. I refuse to work with her and she says she refuses to work with me. I do have to say I'm probably one of the most easy going, eager to help nurse that anyone including CNA's could possibly work with. I worked as a CNA and I know the hard work they do so I'm always willing to help if time allows. What would you guys do? Am I wrong to think this is ground for immediate termination and am I wrong to be in fear of retaliation, because this CNA was beyond ticked off when she got into trouble. Any advice? Oh and by the way I apologized numerous times to the CNA for her misunderstanding me and causing her to cuss at me. I do not like confrontation, so I tried to smooth it over, even though me reporting kind of made my apology null and void. Help, I'm worried she may do something, what I don't know......
8. 

   peg care protocol

   kstec posted a topic in Nursing

   Could someone give me a website re: nursing care re: checking for placement, how much residual, how much H2O to flush with between meds, how much to flush with before and after meds. This information only needs to pertain to the nursing protocol of peg tubes only. Any information would be greatly appreciated. State coming in for routine review and our facility has no written policy for me to review. Thanks in advance.....
9. 

   Protocol re: peg tubes

   kstec posted a topic in Gastroenterology

   State is coming in for our routine survey and we were told to make sure that we know everything about peg tubes re: checking for placement and residual. If I remember correctly you put in 30 cc of air and listen. As far as checking residual its over 100cc that is bad,correct. Always put back in residual, correct? How much do you flush with prior to administer meds? I've read several different amounts, I do 30cc. We are allowed to give all meds together unless contraindicated. If anyone can give me a website with any information that would be wonderful. We do not have a standard policy re: peg tubes. I want to be prepared. I know there is the school way and then the real way and some ways in between. Any information would be greatly appreciated. Some of these questions may make me sound like an idiot, but actually I'm not, I'm just wanting some clarification. Thanks in advance.....
10. 

    nurses with anxiety and depression

    kstec replied to Akercat's topic in Nursing

    You will find that a mass majority of nurses suffer from depression and anxiety. It's not just a nursing thing but a societal thing. Through my own personal experiences and work experiences, I've found that the "normal" people are the minority and a then there is the rest of us. If this is a personal issue with you, you'll do fine as long as you take care of yourself, just like a diabetic would have to. It's a disease and has to be treated as so.
11. 

    fired

    kstec replied to cccc's topic in Geriatric

    I'm guessing you worked LTC. If so, if anyone wanted to find a reason for any nurse to get canned they could. When you take care of way to many patients you learn to cut "safe" corners. If LTC nurses did it by the book, noone would get their am meds until noon and their noon meds till mid after noon, etc. We as LTC nurse do our best and bless the rest because I've come to terms with I'm am only one person and if someone can show me how to do it by the book in an 8-10 hour shift with 25-30 residents, 1-2 admissions, discharges, sending people out to ER, triaging the residents who are ill, wound care, tubefeeding, medicare charting, accucheck, administering insulin with complete accuracy, writing up fall reports, neuro checks when they hit their head, infection control reports for all the residents on antibiotics, doing blood draws, collecting urine and of course helping to bathe and toilet d/t shortage of CNA's, than please do.......That's why I'm going back to school to get my RN, hoping that the grass is greener when the options are broader.
12. 

    How long did it take you to feel comfortable in LTC?

    kstec replied to vanilmil's topic in LPN/LVN

    Long Term Care, a.k.a: nursing home
13. 

    Are LPN/LVNs a dying breed?

    kstec replied to Trophywife81's topic in LPN/LVN

    Long Term Care, aka: nursing home
14. 

    75 residents/3 nurses

    kstec replied to TrickieTam's topic in Geriatric

    In two out of the last 3 facilities I've worked at we shared a cart. I thought it was pretty much common practice since you always work short in LTC. Where I'm at now we have 4 med carts but usually only have 3 nurses so there are 2 nurses getting into one cart throughout the shift. LTC is one of those places where a good show is put on for state but the reality is much different. Sad but true.
15. 

    75 residents/3 nurses

    kstec replied to TrickieTam's topic in Geriatric

    Supervisors are added into the daily staffing? How can that be when they don't provide patient care? So in that case my facility we are over staffed everyday, due to having to many chiefs and not enough indians. Interesting......
16. 

    Are you content at LVN level?

    kstec replied to 53Kalypso's topic in LPN/LVN

    I've recently decided to go back and get my RN. Why, because I've been told one to many times that I can't do this or that as a LPN. I want to do this and that. I'm going back in January and the thought of it nauseates(sp) me. It's a love/hate relationship with school. I hate the commitment, but love the rewards. So no I'm not content with my LPN level. I want more. At first I was content, but two years into being a LPN, I'm not. Our scope of practice is narrowing by the year and I have to always ask an RN to help with situations that I'm not allowed to do. I know that I will always have to ask for help or information to continue learning, but to do it for more is very depressing to me. I just hope I'm up to the challenge of school again. I'm scared and excited. If you don't mind being limited in your job, then being a LPN is great, but if you want a broader job description with more tasks that you can perform, RN is the way to go.