paprika88

Don't be scared. Find a good resource nurse who has worked there for a while and pick her/his brain every chance you can get--they will be happy to teach you the ropes as it empowers them to feel so highly regarded. They will help you will all the tricks of the trade (so-to-speak). Ortho is definately a love it or hate it unit. My first 5 yrs as a nurse I worked Med-Surg, then for the last 17 years I have worked Ortho/Neuro. I LOVE, LOVE, LOVE the ortho part. Why? Generally, they are NOT sick, they are simply there to recover from their surgery...they get well and go home and don't linger for months on end and for the most part, dont die. Of course, you will get the older person who has fallen and is ill, but thats not the norm. There is ALWAYS help when you need it. The comrads in arms, I call them, who will help transfer a patient without question. Always use a gait belt and use good common sense along with good back precautions and you should be just fine. Finding your own routine along with a good report sheet will be your strongest asset toward success. Just like every unit, it has its drawbacks. There are many pitiful stories from every single nursing department, bar -none . Give it a try and then sit down and ask yourself if you want to keep going. If not, transfer. Its not the end of the world....many nurses move around to be well-rounded nurses, and that's perfectly okay. Then, there are nurses like me who could never imagine doing anything else. When I first got out of school I thought I wanted to do cardiac care, then after 5 years, I KNEW what my professional destiny was. Then after 12 years I got introduced to the neuro part, and its okay (easier), but my one true love is the spines and total joint patients. Best of luck and let us know how it is working out for you.

Beth, Did you get moved to Wyoming? Just wondering...if so, how's it going? where did you end up?

Just wondering where the majority of LPN's are working in the Portland area. I recently transferred my LPN from Wyoming and am now searching for a job before I start the RN program this fall....I have been accepted at PCC but also have application at Mt. Hood pending. I have over 19 years experience in acute care (hospital only) and cannot imagine only having to work in a nursing home or home care as neither are my thing. God Bless those of you who do, I tip my hat to you. You inspire me to be a better nurse! I applied for a position at the VA today. Anyone working there and care to comment on how they like it? Are there jobs available for an LPN to teach....like for a CNA program? Thanks in advance for all the input!

I got into PCC from the lottery draw today. Its not my first choice, but at least I know I am in somewhere and the anxiety of it all is over. Thank goodness. I still have to wait for Mt. Hood, and hoping that all goes well.

We currently have a flow sheet we use for upper/lower extremity strengths for our spine surgery patients. However, it does not cover all spine levels, does anyone have one that covers all of them? Is there such a thing? What we use is pretty handy as it has pictures on the back as reference on how to do the check for our novice and float nursing staff. But, I think we can do better. The only other thing on the neuro spine assessments we chart is numbness/tingling (for all spine surgeries) and speech/swallowing (for c-spine's). Any help would be greatly appreciated.

Thank you both so much. I found a few more jobs that I am going to inquire about. I am going out to visit the week after next, so hopefully I can get an interview and job soon. I appreciate all the help.

I am planning to move to Portland/Salem area the beginning of June. I have been searching online for a LPN job that is NOT in a nursing home, but have only found one part-time job available. I am starting to get worried that I will be unemployed if I don't find something tangible soon. Have been a LPN for 19 years. Any hints/suggestion from anyone on where to work out in that area? Doesn't seem like there are any job openings for LPN's in the hospitals. Thanks for the help.

Yes, wisconsinortho, we have a preop joint class. We are moving towards a total joint camp therapy approach as well. Our class is 2 hrs long which we offer every other week. We try to get all the info in about the surgery and routines of our unit. The patients' do much better if they attend. We have the class on powerpoint with a video and now have the ability to send our class to almost every rural medical center in our large geographical state via the satellite. (I teach this class if the regular instructor is gone). We also use the re-infuse for our TKA, but not for the THA. Pain mgmt is so individualized...some do great, others not so great. In the class we have a pain pharmacist talk and they (two for our unit) see the THA/TKA patients once a day and are on call 24/7 for us if we need them, it is a GREAT protocol as they help us manage the side effects too (ie post op puritis from the intrathecals). We turn off the PCA's POD #1, but we have one doc who has us try oral analgesics first and forego the PCA if we can. His patient's seem to do just as well as the rest. We use CPM's, but only for a couple of docs who like them. We rarely use epidurals any more, too many patients with "jello-legs" that we cannot get OOB. Length of stay is 3-4 days fro TKA/THA.

Wow, did this question bring back a memory from many years ago. I was caring for a terminal patient who was dying from ovarian cancer. Doc ordered 8-10mg Morphine. Her respirations were 8-12. As a new nurse, I felt so uncomfortable giving that much. In the late 80's there wasn't a lot of meds like the new ones for pain, nor near all the info about pain mgmt. She got the 10 of Morphine, but not from me. I was really scared to "push her over the endge" too. Her respirations went from 8-12 to 4-6 and she passed away shortly thereafter. Since then, I have realized that she did not expire from the Morphine, but from the cancer. If she had a more peaceful, painless death then she was better off getting the Morphine than not. What I have also come to realize that IF this had been someone I knew and loved, I would not hesitate to give them the Morphine in addition to anything else we can now give. Don't we all want death with dignity and as painless as we can? The recent shift in patient care is WONDERFUL as far as pain management goes. When I first started nursing over 18 years ago, we didn't have much emphasis on a patients' pain management. I think it took one of us or one we love to be in pain to make these changes. Giving the Morphine may have made her respirations decrease, but wouldn't you want a nurse to have enough empathy for you and your pain at death the give you the relief from your misery? Hope this helps. Good Luck.

i am planning to move to mov to or in june. i want to go back to school when i get there. hubby is working in woodburn and hopefully can find a place to live nearby. i have been a lpn for almost 19 years. i have worked mostly ortho/neuro and i have taught a preop spine class for the last 2 years, as we do about 400 spine surgeries a year where i work now. i also work on the ortho/neuro unit fulltime. how do the rn programs work in or? is it difficult to be accepted? are there programs for lpn to bridge to rn? seems like quite a few posts talk about how hard it is to get into a program....here, you just sign up and go! wow, what a concept to be denied acceptance into a program when we are (as always) in a nursing shortage. any good leads for a job when i get there? feeling real uneasy about this move as i have a good job with a fabulous boss right here. thanks in advance for any help i can get.