*Pepper*

Wow! I had a second interview today for a job in --nursing informatics--. I never even heard of this in nursing school!!! As a fresh LPN sitting on 26 years as a software engineer, this job would great! No pill passes, no ordering chucks, no working off the clock to finish up...... .......is this heaven ??????????? Fingers crossed....

Careful! I might come back to Taxachusetts just to work for you! Eat some fried clams for me!:nuke: If only I was a democrat..

I share everyones frustrations about med pass, the one hour rule, high acuity in LTC, the push to be fast by those above. I REFUSE to answer the phone in the office during my med pass and REFUSE to leave the cart for diddly poop. What worries me is not just getting it done, but not having the time to do it the way I was taught in school. Five rights, documentation, having all the drugs to administer. It is alot of liability to be doing it with short cuts that are pushed on you by management. We are not fixing cars here..

Congratulations! I have been doing meds for 35 residents, and today I am down to 2.5 hours per pass. The first day was a 6 hour pass. FIRST: Run, do not walk to Amazon and buy the book Mosby's Surefire Documentation. This book may save your butt. SECOND: Remember to give every patient their five rights of medication! Try to last at least three days before you pre pour and do more that one patient at a time. THREE: Do it like they taught you in school, BP before some, recheck pain after one half hour, stay while the patient takes the drug. FOUR: Do not hate yourself after two weeks when you find yourself skipping 1 thru 3. FIVE: REMEMBER you are a nurse first, a patient advocate second and a employee third. Good luck!

I know I am in the right field but am not sure I am on the right bus line. I find myself passing pills, ordering med supplies, and taking phone calls as I can. I hardly have time to do any hands on patient care as all of that is farmed out to a HHA. If I am not there, the pills are passed by med techs. Overtime for pill passing goes to med techs. I get no overtime and if I 'mismanage my time" I am told to punch out and then finish my work. This is my first job after licensure. I would like to get into a environment that demands skill and offers growth. Do I need to to stay 3 or 6 or 12 months so I don't look like a job jumper? Frustrated in San Francisco....

We used to have a guy who watched 'Girls Gone Wild' ads every --early morning--....at least we knew where to find the aides LOL....

Thanks so much for the information. In clinicals it was all document by exception on computers. Most checks and x's. Reality is now using the trusty black pen, first to note to remember that you have to document it, and then documenting it. This I was never taught. I think when a BS is low, I need to document it in four places, what I did because of it, how the patient was feeling, and how the patient was afterwards. CYA, document, document, and when the time is left, take care of the patient....glad I love this job!

If anyone has written a book about LTC documentation, I sure would like to buy it! Guidelines, phrases, outlines would also suffice. Late entry guidelines Thanks in advance!!

Thanks everyone for the useful advice. I am implementing many of your suggestions! My residents thank you.

The most critical assessment skill in LTC appears to be responding to either a patient on the floor or a patient feeling sick. I sure would love feedback from experience LPN nurses to help in making that type of assessment. Please explain 'don't pick up the patient off the floor' and at the same time time 'send them out if they can't bear weight'. What do you say when the EMT says "their strip is syncope want us to still take them", and then the pt is admitted. Well you can't say anything I guess because the EMT is long gone but who made them so smart? Oh, and who does the med pass when you are photocopying medsheets to go with the patient???? AAAARRRRgghhh!! One more patient on the floor and I am going to send myself out!!!!!!!!

Oh no, I am sorry I gave you that impression. As I was a CNA for two years, I treat the CNA's tht work with me with the outmost respect. They hardly care what I wear, more how I talk to them and ask them to do stuff. I still remember being told what to do as a CNA with a stinging attitude. Alot of my interaction is with families, other nurses, and other professionals who come in. Personally I like the 'white' appearance of a traditional nurse and I just don't look good in scrubs with goofy or mickey. If this is a hangup on my part, I accept it. While making a list please also add that I hate having a stethoscope around my neck (never allowed in nursing school). I also hate crocs. Oh, and don't forget NY giant football players and fans.:cheers:

They do tend to be a bit more expensive than plain/unisex scrubs, but they are heavy-duty/bulletproof and will last a long time. Bulletproof might come in handy! Thanks!

I hate scrub tops. As a LPN in a LTC, I am looking for something more indicative of my leadership role and professional licensure/training/responsibility. We do not have color guidelines. I also hate scrubs shirts as it makes me remember my 'CNA days'. I have settled into scrub pants (dark) and a white golf shirt with 'LPN' on the chest. There are many on cafepress.com, but would like something perhaps embroidered, while at the same economical Any thoughts/mail orders suggested. Thanks!

You might want to go to the FLBON and check out the historical NCLEX pass rates for the schools you are considering. Just a thought. Good luck!

Stop beating yourself up. First, now the next time you take it, you will know what to expect. The whole atmosphere of the test process is not going to effect you. Right there, alot of junk is off you shoulders! Remember, the test is not a information retrieval test, but a test of your clinical thinking. Concentrate on answering questions that test you as a Nclex Nurse. I found the Kaplan very helpful, but do what system makes you think like a Nclex Nurse. REMEMBER -- When you are at someones side to help them, there is not a sign on your forehead that says 'I passed after two tries'. Your compassion, touch, and self assurance is what the patient will feel and be comforted by. Advocate for your future patients, dig deep and slay the dragon! Your patients are going to need a good nurse, and you're it. Best..

You might also consider hospice nursing. As a RN you could do independant Case Management as part of a service team, get to know the patient, family, and significant others.

There is no forum for independant Home Health but I would like to ask if anyone is doing this, to provide start up ideas. How do you like independant LPN work? How busy are you? How do you find clients? How much do you make? What do you end up doing? Paperwork? Insurance? Insurance? Are you a licensed provider? State or Federal? Are you paid by families, lawyers, insurance companies? That should be a good start :-)......

Would there be a need to be licensed as a HHA agency to provide this type of service. I expect it would be smart to have liability insurance. Thanks.

Wow, thanks so much for your two replies. I especially like the idea of patients sensing you not being happy. I was up ALL NIGHT thinking and looking at Home Health on the computer so I think that is something I am going to pursue. And hospice, ..... I have been doing crisis care as a CNA for about a year and yes, that to me is what I want so bad. Unfortunately to go to a LPN spot I need to have a years clinical experience. I need to look into other Hospice providers. I guess I should advocate for myself as well as I do for patients and not jump into the soup just to be in a LPN slot if I know it is not going to be right. Again thanks for being there.

Opportunities for the type of nursing I want to do are not open to me as a new LPN graduate as most slots require 12 months clinical experience. I did not like my hospital rotations as RNs seemed to need to do 45 minutes data entry for every 3 minutes of patient contact. I did not like Nursing Homes -- working as a CNA -- watching nurses pass meds for thirty patients seemed reckless to me. Hey I had the 'five' rights battered into me, and there she was lining up all the meds on top of the cart for the pass! At the nursing home I was the 'silly student' finding sick patients and pestering until they were sent to the hospital (heart attacks, stroke, dead et al.....) BUT hey I graduated so here I am going to interview at a LTC (feeling like a cow walking to slaughter) and then a interview at the prison (hello, what am I thinking....) Is the only way 'to protect my license' is to work at McDonalds or cut grass? I love patient care--maybe I should just wipe and swipe for the rest of life...... What was I thinking going to Nursing School???? Why did I pass NCLEX ?????? Help I want a preceptor!!!!!!!!

Please allow me to comment, from my experience. First, the process of dealing with the Exam Center was not as stressful as I thought. Sure they fingerprinted you and took your picture, but the staff were friendly and accomodating. As far as review books: Think you should consider books as being in two categories. First there are subject review books. Books like Saunders that review what hopefully was in your program syllabus. Second there are books that tell you how to take and work the exam. From my experience, the review book I used was Saunders, although honestly I did not review the whole thing. The other book I used was Kaplan which concentrated on how to read the question, discard wrong answers and then pick that correct answer (even if you did not know the subject!). Truly, as they say, the NCLEX is not a recall exam, it is based on application. I read the Kaplan book at least six times, and did the 145 questions in the book and passed at 109 questions (two hours, no breaks). ABC, and Maslow are your best friends. Hope this helps. JB, LPN, formerly known as JB PN STUDENT.

What would motivate you and help improve customer service? I'll start with two suggestions; Happy Smile Awards: gift certificates to McD's given out by mgt supervisors to any CNA they see being friendly/kind to residents. Attendance Awards: Free (monogramed with facility name) shirt for perfect 30 day attendance. Any more ideas (more money is a given)..... Jeff.

Addison, TX is great.

Hmmm...customer service or nursing. I do not think anyone can tell you what is right for you, although information about programs are helpful. I have worked, and enjoyed both. Alot of the attributes in CS are used in nursing May I suggest that prior to making a decision , you run down to Blockbuster and get a movie called 'WIT'. It is a HBO movie whose story line originally was a play. It may help you in your decision. Best-- j.

Sarasota County Technical Institute (SCTI) Sarasota, FL