Mabel 29

When my children were babies I had one of those carriers that you wore over your shoulders and the baby hung in a pack on the front of you. It was called Sarah's Ride Carrier. This item had a tag sewed to it that read "do not use over open flame". Ok...so was someone dumb enough to have tried that for a warning to have been attached? And if they were that dumb, what makes the manufacturer so sure that they can read the warning tag?

One or two days a week I work in LTC and do the med pass, the rest of the week I ride a little yellow bus with my pediatric clients....I prefer the bus!!

I remember a similar situation to the above post. The fellow was young and lived home with his spouse. He was admitted to the LTC facility /Rehabilitation Center for ABX IV therapy. He used to sign himself out and have his wife pick him up. He would go home and return five minutes prior to his scheduled therapy. Once the therapy was finished, he would leave again. A home health nurse would have been so much more cost effective.

i'm a lpn working in ltc in pa. just went for iv therapy certification last week. the facility is taking more iv, midline and picc patients.

I've taken many classes on line - Algebra, Statistics, Chemistry of Life, Sociology.... This month I start A & P II online. I like not having to drive to the college at a scheduled time. I can read the book and do the assignments whenever it fits into my schedule. I also like that you don't have to sit in a classroom with a bunch of students who may ask the same questions over and over, when it's a concept that I may not have to dwell on. I agree that you have to be self motivated. Without that drive to push yourself you will fall behind and never get caught up.

I had a toddler in home care with a JG Tube which was placed by Interventional Radiology. Feeds went into the J, the G was for meds only. We were told not to aspirate the J because the tube would have a tendency to dislodge and necesitate a return trip to IR to be checked / replaced. We were told to keep pump running as long as there was no leaking or reflux of feeds.

How about comparing treatment with a wound vac and treatment with another type of dressing? Or maybe compare a venous stasis ulcer treated with a Unna's Boot to treatment with silvasorb gel and a dry dressing. I have been amazed at outcomes with both wound vacs and Unna's Boots in the LTC facility that I have worked at.

I had a MD prescribe nasal spray to me one time and he said to aim out and away from the septum, because the sprays can dry out the septum and cause damage. I have read cases of holes in the septum from overuse of decongestant nasal sprays.

In some states LVN (licensed vocational nurse, I believe) is used instead of LPN (licensed practical nurse), but they are the same.

The child was not really being cared for by the hospital. We sat in an exam room for 6 hours, seen for 5 minutes by NP and then 3 minutes by Chief of Surgery. Other than that, no care given by hospital staff. Surgeon trying to "figure out what to do" with another surgeon in Interventional Radiology, who was on a lenghty case herself. As far as riding with them and then reporting off, I'm two hours from home with no car, and agency surely will not come for me. I thought of calling Greyhound, which is what I would have done if the child had been admitted. Personally I would have much rather been somewhere besides the hospital for my entire evening, as I had plans with my family, but I thought once I left with them, I was obligated to follow through.

Hi all. I'm new to pediatric private duty and I work for an agency, 7a - 3p. My current case is a child who is a patient at a Children's Hospital two hours away from the home. Recently the child had an emergency, and the hospital told the mom to bring the client right in for treatment. It was during the first hour of my shift, and mom said pack up and lets go. I cared for the child in the car on the way to the hospital while mom drove, and cared for the child during the entire 9.5 hours that we sat at the hospital. The treatment receivced at 7pm only took 25 minutes! The agency was kept informed of the progress along the way, but seemed upset that I went. (This was not my first trip to the hospital with the child.) Now they say that I should have come home and let mom go by herself. I did not return to the child's home until 9:30 pm, which was 6.5 hours after my shift ended. I didn't dream that we'd be gone that long. Now I'm told that I may not get paid for the time. What is the policy of your agency in a situation like this?

I'm a LPN and I worked LTC / Rehab for a couple of years, and then I left to take a fulltime private duty position, BUT.... I keep going back to the LTC facility. I take a shift about once a week or so. I just CAN'T leave my "old" friends. They need me. We've bonded. I just love them. :heartbeat They're friendly and sensitive. (for the most part!!) They love to talk and feel wanted. :heartbeat Even when I can't pick up a shift, I stop by as a friend just to check on them and make sure they're being taken care of!! I guess in a way when I'm with them I feel needed.

The issue with the feeding tube - NG or G - may be aspiration precautions. This may validate the need for night nursing.

I thought of tegaderm, but isn't that porous? I'm also cautious because of her sensitivity to adhesives. I could use the film from a would vac, but again, it may irritate her skin. The plastic part of the Hollister sticks out about 3/4 of an inch and it's about an inch long, so it's not the easiest thing to cover. We're heading to CHOP soon, so I will ask the professionals for their ideas. Thanks for brainstorming!!:loveya:

Hi All. I'm calling on all of you creative, been there/done that type of people. I previously posted this in the pediatric forum, but received no posts, so I thought I try it here. I'm currently working with a 1 year old girl who has, among other things, a G-tube and a J-tube. She is also sensitive to most adhesives. This child is becoming increasing more mobile / independant, and I can't keep her still! The J is held in place with a Hollister tube attachment appliance, which adheres with a microporous adhesive. I put her in a bathtub with about 2 inches of water, and she loves it..but only briefly because if the Hollister becomes wet, the adhesive becomes gummy and the appliance must be replaced. (these are not cheap!) This child becomes overheated easily and with summer coming I need to find a way to cool her down while keeping her happy. Mom bought a small baby swimming pool for her to enjoy with her sister. I need to come up with a way to keep her abdomen area dry while she splashed in the pool. I'm imagining a stretchy, waterproof fabric that I can wrap around her and will remain in place while she plays. It can't be too bulky or constricting, as she needs to bend and move. Has anyone seen or made such an animal? Perhaps they make this item, but I am new to this area of nursing and can't find it anywhere.

Hi All. I'm calling on all of you creative, been there/done that type of people. I'm currently working with a 1 year old girl who has, among other things, a G-tube and a J-tube. This child is becoming increasing more mobile / independant, and I can't keep her still! The J is held in place with a Hollister tube attachment appliance, which adheres with a microporous adhesive. I put her in a bathtub with about 2 inches of water, and she loves it..but only briefly because if the Hollister becomes wet, the adhesive becomes gummy and the appliance must be replaced. (these are not cheap!) This child becomes overheated easily and with summer coming I need to find a way to cool her down while keeping her happy. Mom bought a small baby swimming pool for her to enjoy with her sister. I need to come up with a way to keep her abdomen area dry while she splashed in the pool. I'm imagining a stretchy, waterproof fabric that I can wrap around her and will remain in place while she plays. It can't be too bulky or constricting, as she needs to bend and move. Has anyone seen or made such an animal?

And this is why I recently resigned my full time LTC position and accepted a much more quiet position caring for 1 child... on her couch... without 63 other screaming patients chasing me....AND with Barney and Sesame Street to keep me company! As an added bonus I get a set schedule, more pay, no more aching feet, and I keep my sanity (what little I have left!) I find that I get along with Big Bird and Elmo much better than I got along with most of my co-workers in LTC. My only regret is that I miss "my residents" and I think about them often. :redbeathe

Hi All. I recently left LTC for Pediatric Home Health. No experience at all in this new field, but I felt that I needed a change. So...any advice that would calm my nerves at this point? My first client is a beautiful one year old little girl:redbeathe. I have been reading anything that I can find and trying to educate myself quickly. Any advice or learning experiences that you could share with me would be much appreciated. Thanks. :bowingpur

Any place has to be better than St. Louis. Just drop a coin on a map and go where it lands!!! I've visited St. Louis and surrounding areas twice, and I'll never go back. I can't think of anything really great about the area, although the engineering of the Arch is pretty amazing.

How about joining the skin team and doing wound care. I pushed a med cart for a year or so until I got really bored with it. After that I had an opportunity to do the weekly wound assessments and care. I found that I liked it much better because I got to spend a little more time with the residents and could better assess their conditions. I worked closely with the staff podiatrist and learned a lot from him. I wouldn't say that it was a promotion, but it was a pretty good experience and a different view on LTC.

I turned in my resignation yesterday. I gave them 2 - 1/2 weeks notice. I've been at a LTC facility for 18 months, my first job as a new LPN grad. Yes, turnover is high. At this time, they can't even buy new CNA's!! No one applies. And the quality of the new nurses that they have been hiring has been questionable. I can't stand the backtalk from the CNA's and the talking about everyone behind their backs. Management has been staffing a unit that NEEDS 7 aides with only 5. I was called today (my day off) and asked if I would come in the 3 - 11 shift. (My normal shift is 7 - 3). I felt bad for them and said yes, I'd come in for a few hours. The administrator said thank you very much, and by the way, you'll be working the floor as a aide. Good Bye! I feel tricked and don't even want to show up. I can't wait until my time is up. I am soooo outta there!!!

I have seen Silvasorb packing used with positive outcome on wound similar to this. The antimicrobial properties keeps the bioburden down and promotes healing. The dressing should be changed daily.

I had a patient in LTC who wheeled herself up to my medcart and asked me if I had a permit to pedal drugs on her street? I replied that I had a license, and she seemed happy with that and went on her way up the hall.

I was an administrative assistant for a civil engineer for eight years prior to nursing school. Sometimes I miss being able to go to the bathroom when the need arises, and being able to come and go as I please. I've also worked in a bank for twelve years and in a daycare for one year. Nursing was always my dream, and here I am.

I experience the same complaints from the aides at the LTC where I work. It gets so bad that I have contemplated working in home care so that I don't have to listen to them anymore. I think I heard the best one this week. An aide told me I need to do something about "Resident X" because it's not fair to the aides that she has loose stools so often!!! I get so tired of listening to them complain that I do some of their work by myself instead of asking them to do it just so I don't have to listen to them complain. I already have 32 residents to take care of, and doing their work puts me way behind. At the end of the shift, the aides leave and I'm left to finish my work.