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  1. ejsmom

    About TB

    My mantoux was positive, took myself to an ID doctor and are going to be starting Rifampin for 4 months. I'm devasted. I was vaccinated w BCG in my country of origin where TB IS NOT of concern, but the vaccine is part of childhood immunizations. I've tested positive in the past but was told it was a false-positive and had cxrs that were negative. I wish eveybody was on the same page w this info. Not one nurse @ work that I questioned knows tx is need. I just hope that I don't have significant side effects from tx since the meds are toxic. Wish me luck I guess, I have no other choice.
  2. ejsmom


    ok so now I'm more confused.... if you were vaccinated and test positive )5mm or more induraton) w/ the antigen how do u really know that u have a latent infection? And also, now you go months being treated w/ INH or Rifampin (which is the second line treatment of choice) how r u safe from re-exposure? After tx shouldn't ur ppd still be positive if you had the antigen? my head is spinning:uhoh3:
  3. ejsmom


    No. I just had a general question. Our infection control dept informed us that even w/ BCG vaccine pts should be treated for 9mos if they have a positive ppd. I was never aware of this. I was under the impression that if a pt was vaccinated, a positive ppd meant immunity not exposure. Just a bit confused.
  4. ejsmom


    Good morning to all! Have any of you had positive ppd, neg cxr and treated for TB? Thanks in advance.
  5. ejsmom

    VERY frustrated...

    Thanks to everyone on your great advice! I've charted on every interaction that I have w/ this pt, I also always make sure that there's someone w/ me when I'm performing care. I have not had anymore interactions w/ the family. They pop in from time and watch me as I do my work @ which point the unit coordinator always come out to speak to them, ask if the need help, etc. The family does not speak to me at all and I have not heard any further complaints from up above. Ironically, the pt all of a sudden is super friendly w/ me. Which makes me wonder if she is using me as pawn to get attention from her family...she has a looong psych hx....
  6. ejsmom

    VERY frustrated...

    Hey everyone! I work in LTC, pretty good place w/ a good rep. We have a problem family whose loved one has been in the facility for 10 years now. I say "problem" because they are very unrealistic w/ their aspectations of how the unit should be run and how care is rendered. They have called the ombudsman and the board of health numerous times because the aide assigned to their family member didn't toilet her as quickly as the family wanted. Aides and nurses have been fired because of this woman's family and now she has been transferred to my unit. The family has already complained about me and asked for disciplinary action because I asked one of them not to follow her mother's aide in to a bathroom while the aide was rendering care to another patient. I do not want to take care of this person any longer. I feel as though I should just hand my license over to the family when they come in and let them decide wether or not to destroy it, that's what they're doing anyway as far as I'm concerned. I asked that I be transferred to another unit, and I was told no, I asked for the patient to be removed from my assignment, again I was told no. Legally if I feel that my livelihood is threatened must I care for this person? MY DON tells me not to bother w/ them at all..hello!! I'm the one taking care of their mom...how do I not talk to them?! What would you do?
  7. ejsmom

    Talking to MDs

    Hello everyone! I'm a new LPN working LTC for about 4 months now...love it!! I have 10 years experience in Healthcare as a medical assistant and phlebotomist. I'm having a very hard time speaking to physicians (never happened before). Most of the time if there is an issue and I make a call I usually get "well, what do u want to do/give". How do I answer this?? He's the doctor....right? I get very flustered when I get a call back, even for the easiest things like labs! I ran a coumadin clinic for years and never had a problem speaking w/ any MDs, all of a sudden I forget how to speak!! How can I get over this!!!
  8. ejsmom

    Lantus given wrong time

    Lantus was essentially made to be given @ HS b/c it doesn't have a peak time and it is used to level out glucose levels over an extended time period. You did the right thing reporting it anyway.
  9. ejsmom

    Are LPN/LVNs a dying breed?

    I've heard that for the last 10 years and its funny that both the LPN and RN programs around my area have 2 year waiting lists. In jersey, LPNs will most likely not get hired in a hospital and that really has to do w/ scope of practice and malpractice insurance issues. I know LPNs that have been so for 20+years. Just today I had 20 LPN nursing students at our facility.A dying breed? Yeah right
  10. ejsmom


    Hello everyone! Is it "legal" to take a med order via fax? There is an MD at my facility that will not under any circumstances give us a telephone order, and we hardly see him for a verbal one. To keep the peace, management is going along w/ him for now. I would hate this to be a new trend. Thoughts?
  11. ejsmom

    What is it with the nurses in LTC?

    I've been in your shoes. I didn't come across one nice/decent nurse during my clinicals, so when students come to our facility I leap the extra mile for them. With that being said, I have run into students that think that they know it all, spend hours behind the nurse's station, don't want to get involved w/ anything hands on, and do not give very good care. We also have students that come in and are wonderful, both LPN,RN and even resp techs. I have 31 resis to pass meds to, do treatments, review labs, call mds, take orders, reassure family members, and thats before noon, on a full bladder and an empty stomach.... yeah sometimes I get testy and I'm pretty nice. Just go in and do the best that you can do and be a sponge! Ask questions and offer your help because there is always something that you can help with while learning at the same time! Hang in there!!!
  12. ejsmom

    Put off by LTC

    WOW... thanks everyone. I have two offers on the table that I'm considering...very carefully. Great idea about an exit interview. I have already started to write down a list and can't wait to hand it in w/ my letter of resignation...w/ a smile on my face from ear to ear.:roll Thanks again everyone.
  13. ejsmom

    Put off by LTC

    Well, I decided that the facility where I am is def. not for me. I work 11-7 on a pretty busy floor, trachs, Gtubes, etc. 3-11 leaves me all of their work and 7-3 blames me for everything that they can. Med times are changed at random daily so that they have to be given on my shift, even if the res has been on it for months.The aides are terrible. They don't want to be asked to do anything and disappear off of the floor for hours at a time. They are known to tell the nurses to "do it yourself you make more money". The problem is that this is my first job in LTC and even though I have gotten job offers recently I don't want to this anymore. I'm totally disgusted w/ the way that the aides' work, with how the res are treated and how the shifts spend more time fighting over who does what than actually working. I went back to nursing school to help people not sit in my car on they way home and get upset because I was accused of sleeping all night because someone left a sheet on a chair. I'm nervous to take another position in LTC, but as an LPN there is nothing out there. Everyone wants RNs and I can't afford to back at this point, I just graduated and wanted at least one year experience before going back, instead I'm bailing after 5 months. I'm very upset over this. Any advice?
  14. ejsmom

    careone facilities

    Hi everyone! Just wondering if anyone out there has worked/ is working for a careone facility. There's about a trillion in NJ.:roll I decided that the facility that I currently work in is not the place for me, however I have only been there 4 months and just graduated in June '06. Without going into details management is terrible and the environment is not conducive to learning/safe work practices. There is a facility near me, and I applied and have gotten a call back for an interview but I'm a little nervous b/c I really haven't heard anything about their rep. Thanks in advance!!
  15. ejsmom

    nursing assistants

    Hello to everybody! I am a new nurse working LTC for 3 months, and I find that the aides are very rude. I work nights, but when I cover for someone on the day shift, it is horrible. We have 4-5 aides on 7-3 for 31 residents, which I think is reasonable considering half of the residents are self- care. Call lights go unanswered for 20 minutes, sometimes more. When I ask for help w/ the slightest thing I either get ignored or get attitudes. Half of the day the aides are gone off the floor w/out letting me know. There's only one nurse on my floor which is tough enough, but on top of med pass, treatments, MD calls, phones (we don't have a unit secretary) new orders, families, and making sure that each res is safe I don't have time to chase after each aide! I decided that I will not work another day shift on that unit again, but in the meantime, does anyone else have problems w/ their aides??