jude11142

I am an lpn, who just sent in applications to a technical college and one to a private college. Both offer a "bridge course", so you basically don't have to do the first yr of nsg school. I know several co-workers who went this route and they were happy to do so. As an lpn,first, we do have more experience than an RN right out of school. Whichever you choose, you'll be fine. You have to find the right way for you, and you will. I was enrolled with Excelsior, but I just wasn't disciplined enough. I felt terrible that I couldn't complete it,but I had to accept that it wasn't for me. Good luck in whichever you choose. JUDE :Melody:

i i would hope that the charge nurse would be available to you at all times. you should never feel that you are alone. As for night shift, I agree with others, make sure you restock, area is neat,and unless you were swamped, all of your tx's are done, etc...As a nurse who works 2nd and 3rd shifts, we are often left with work that days should of addressed(taking orders,updating md/fam, ordering meds). What makes it difficult, is that days seems to think that nights have it easy. Not so, how many times does a pt go downhill on nights ,or a pt falls etc...? that's all it takes for a bad night. We don't have all the staff days has. Each shift should take responsibility for such.You should always have somebody that you can go to for help. JUDE

I have no problem reporting any incident that is abusive, neglectful, illegal, inhumane, dangerous or potentionally dangerous and so on. As nurses ,we are the patients advocate and mandated to report any abuse. As a human being, I believe that we should report the same. What I have a problem with is when a coworker tells you about such an incident and you ask what happened and they tell you that they didn't do anything about it. Now what? This has happened to me several times and thankfully nobody was seriousely hurt, but.............I just didn't feel right. One time, I told our supervisor about an incident with one of our pts and a cna............what was I told?? :angryfire Did I see this for myself? No, I did not, but so and so told me. Ended up with the person who told me this being mad at me and with the sup doing nothing. I did tell my coworker that if they didn't report the incident that I was going to, so therefore, I could care less that she got mad at me. Other than making it a somewhat hostile atmosphere for a while, she got over it. She actually ended up leaving the facility for another job. Another coworker told me that I shouldn't of gotten involved with that situation but I feel that if somebody knows of abuse/neglect etc...and does nothing then they are just as guilty as the person who commited the abuse. What do others think about this? Have you ever been in such a situation and if so, how did you handle it?? JUDE :Melody:

Our facility recently changed the hrs of bowel regimen. Now, days gives out the MOM, evenings next with the supp. and night shift is to give the fleets enema if no results. It's crazy to wake up a resident in the middle of the night for this! Sometimes, I have 6 pts on the list. You can't wait until near the end of shift to do them because you don't have the time. Too busy with med pass, finger sticks, charting etc.....So, you really have to give the fleets around 4am............... We also have a good amt of treatments on night shift. Also, with the weekly body checks..........we already do a body check on their shower day but once a week on nights we do "foot checks"...aren't feet part of body check??? Makes no sense. We also had passed on to night shift more and more paperwork. Monthly summaries have been put on nights, ofcourse all the lab reqs are for nights to fill out, all st. caths done on nights......I say that when a nurse gets the order for labs, they should fill out the lab req. Seems like we are doing more and more labs......some nights just on one unit of 30pts, we'll have 15 labs!!! Nights is not a piece of cake to work. We all hear the stories where others think those who work nights sit on their behind all night and don't do much unless something happens. Yeah right!! OK, sorry this it turning into a rant,lol..........so I will sign off now,lol JUDE :Melody:

I don't know if this is an option for you but, what I do is I take a 10 minute break and go outside in our courtyard. I walk around and the fresh air gives me my second wind. I know that not everyone can just get off the floor let alone off the unit to outside, but I am lucky enough that I can do so. I work 3pm-7am twice a week and can relate to what you say. I have gained over 20lbs since taking this shift!! We would order pizza at 1am, hit the snack machines at 3am etc.....At first, I would try and bring some healthy snacks, lol, but I ended up taking them back home. Who wanted that when you could order pizza, nachos etc...... No matter what, working the night shifts throws your whole body into chaos. At times, when I got home in the morning, I'd take my shower and hit the fridge and think nothing of heating up a bowl of pasta. Then, I'd go to sleep!! No wonder, I gained weight. I am still struggling with this extra weight, but slowly it's coming off. I agree with the others about keeping busy. Clean out the med cart/room........order supplies etc.......It gets you going and before you know it, it's time to start that med pass, lol. JUDE :Melody:

i think that everyone feels nervous at first.....as for being grossed out, i worked in the o.r. as a scrub tech, so blood and guts don't bother me..............what does gross me out is vomit, lol.....if you weren't nervous, i would be worry....it is normal to be nervous.....as you get more experience, you will become confident in what you do. it's amazing, because i was soooo nervous at first, and now? i no longer feel that way and i love nursing!! remember, that as a nurse, you are always learning new things,it never ends. that's one of the things i love, learning......ask questions if you aren't sure of something and remember that there are no stupid questions only stupid answers, lol...... jude :melody:

we had a good amt of rules when i went to school. yes, we had to have our hair pulled back/up. the only earrings we could wear were studs or small hoops. the only rings allowed was a wedding band. minimal make-up..........absolutely no perfume! even down to the underwear, lol, no thongs, lol....(not something i had to worry about, lol). the rest was basic, ya know, clean uniform, white shoes with no scuff marks,,,,,,,,,,oh yeah, we were reminded to wear deodorant. lol, they said that the previous yr they had several incidents where some students had body odor. then there were the childish rules, lol, no gum chewing, no cheating, no talking during class, raise your hand etc.....that's about it. jude :melody:

i was just past my 40th birthday, when i was accepted into the lpn program. i too, thought that i'd be the oldest student, but there were others who were even in their fifties!! i always wanted to be a nurse :melody: but the time was never right. ya know, raising children, having to work etc.....then all the sudden, i was like, "this is it", i'm gonna do it. i have never looked back, as a matter of fact, i am going for rn....so, go for it!!! you will not regret it. jude :melody:

We have a 156 room facility. On night shift, we have 4 licensed staff. We have 5 units and our supervisor(RN)takes one unit. The other 4 are covered with either lpn or rn, many times it's lpns. One of the nurses has to work a "double unit"(60pts)and the other 2 work a 30 pt unit. I'm not quite sure how they determined to have one nurse for 60 except for the fact that those rooms are blended??? Anyways, that is how the night shift is divided up where I work. JUDE

I work in a LTCF and have to say that we seem to have the same employees calling out time after time. Doesn't really matter if they are nurses, cna's, dietary etc...If it's a weekend that they call out on, then they have to work the next one. I often wonder why nobody gets fired?? I don't understand it esp since we have many applicants that would love to come here to work?? Makes no sense?? JUDE

Very dangerous, I feel. I would never work in a place where there are medication aides. No way!! Med pass is not just doling out pills(as we all know)...what about side effects, allergic reactions, monitoring effects and so on??? This is nothing but asking for trouble. JUDE :Melody:

I think that every nurse has at one time or another has made a med error. The main thing is to learn from it. You realized how serious of an error you made, so now you need to learn from it. When I first started working in a long-term facility, I was petrified of the med pass. But, I got over that fear and became more focused and confident as time went on. You need to stay focused during your med pass and try to concentrate only on that. I don't know if you are getting distracted or if you are feeling rushed?? Like others have said, "Check, double check and check again"!!! Don't let this experience kill your dream of nursing. Next job, make sure that you get a good orientation. I would make that one of my priorities when job searching. Never hide the fact that you made an error. I am always very leary working with a nurse who says, "I never made a mistake" or one that is always finished with her med pass when it takes everyone else 2-3hrs or with somebody who "knows it all"...............Admitting that you made an error is not something any of likes to do but.............it's the right thing to do and it is how we learn. So try not to look at it as a mistake but as a learning experience. Hang in there, JUDE

I 100% agree with you. I have seen this happen and it makes me sick!! All patients should be treated equally. Yeah, some may need more attention than others but that's something totally different. It upsets me also when a coworker will say "so and so is my best friends mother, make sure she is treated extra nice"..WHAT??? Extra nice?? LOL, I happen to be a nice person first of all, second, I like to think that I treat all of my patients well. We are there to care for them, not to make them like us etc... If anyone tried to tell me that somebody is VIP and to take extra care with them, I would tell them how I feel. I'm also not going to kiss anyones you know what. JUDE

I work in a LTCF and got a sign-on bonus of 2500.00. 1000.00@6 months and the rest @ 1 yr. 2500.00 seems to be the avg sign-on bonus around here for LPN's. JUDE :Melody:

Hi, I was enrolled about a yr ago with Excelsior and had found it hard to make the time to study. At that time, I had alot going on in my life, with hubby in hospital etc...Now................I am ready for it!!! I have my work schedule pretty much to the point where I can have time to devote to studying and most of all, I want it! So, here I go again, lol. How did you find the exams? Were the study guides enough? I did purchase several books last yr, so I can probably use them too. Any suggestions? I appreciate any input. This time, I am going to follow through and do it. I will check out the section on distant learning and see what information and/or support I can find. Bye for now and good luck on your future tests. JUDE :Melody:

I have to agree, I would rather be off the floor and have a relaxing meal but.....most days, you have no choice. Either you eat at the desk and yes, answer call lights, phones inbetween each bite. Not very healthy. If you don't, then chances are you won't be eating. Just the other day, I came in for my shift at 3pm and the nurse I was relieving, still had her lunch that she ordered sitting at the desk. She had a bad day and couldn't even eat sitting at the desk. They wonder why we get burnt out, lol. I think that it's like this for most nurses, we just can't get off that floor for anything. JUDE

Who doesn't? LOL, yep unfortunately there are always people like that no matter where you work. Atleast, you know what you are dealing with and what the story is with this person. It's the ones that pretend to like you and then go behind your back that I'd worry about. I always think that when I hear somebody talking about another person but when in front of that person they act buddy buddy, this kind of person probably does the same thing to me. I tend to not say anything and walk away because I don't want to get caught up in all the bull. Just be careful of what you say in front of this person since people like that tend to take a completely innocent conversation and turn in around, then the drama begins. JUDE

Hello and welcome to the nursing field. When you were hired were you given a job description? What are their expectations? One thing, always remember to stay within the scope of practice for an LPN. If unsure, you can look it up and see what your particular state allows an lpn to do. Also, if your facility is new at hiring lpn's I would hope that they are aware of what you can legally do and cannot do. When I first became an lpn, there were several situations where I was expected to perform certain duties that were not within the scope of practice for an lpn. Being new, I was nervous, very nervous and since it was an RN who happened to be supervising in this particular situation, I assumed it was ok to do. You know what they say about assuming things right? The result: nobody was injured in any way and I did do the procedure right. BUT........Number one, I was not legally allowed to do it. I could of lost my license(one that I worked very hard for). It was my you know what on the line. So, always cover it. Never feel pressured to do something just because you are told to. Know what your allowed to do, know the nurse practice act for lpn and the difference between the lpn and rn. I hope that I am not coming across as negative. It's not my intention. I just don't want somebody else to make the mistake I did. As time goes by, you will gain more confidence. Being a new graduate, you are nervous, that's expected. Remember that you worked way so hard to become a nurse, so never take it lightly or jeopardize your license. Never be afraid to ask questions as there is no such thing as a stupid question(only stupid answers, lol). Especially, in the medical field, we are always learning, it never stops. Good Luck and enjoy being a nurse . A difficult job, but very rewarding. JUDE

Yeah, you have a point there. It is a long shift and sometimes knowing that you have 2 double shifts to get through gets to ya. It's alot different than being asked to pull a double now and then. The other thing that is burning me out, is that at night the assignment they always put me on is one which you have 2 units(60pts). The other 3 assignments are 30 pts each. Why is this one 60?? It is the unit that shares a nsg station and splits off into 2 units. Other than that, there is no difference. It is not an "easier assignment", as all units have the same type of pts etc... During day and evening shift, each unit has a nurse with 30 pts, then on the 11-7a shift, the "middle" gets the 60 pts. Several of us have complained over and over again that we need 2 nurses at night and we get the same answer, "it's not in the budget"....To make matters worse, they are giving night shift more and more duties. Most of which we just don't have the time to do. Just lastnight, I had 3 residents who were climbing out of bed, 4 pts with diarrhea, 2 falls from previous shift who are on neuros, 4 with g-tubes and 3 who are comfort care. Oh yeah, then there's the one who can ambulate and is always trying to get out. And the one who atleast once a night pulls off her colostomy bag off. It is also drug-pull night, lab night and wander-guard checks. On thursdays, we have to defrost medication fridge out. Then we have our charting to do, plus medicare charting, signing off on the cna books. The lab slips have to be filled in everytime with pt name, dob, ss#, insurance#'s, diagnosis, codes. Some places have pre-printed labels, not us. You can count on a few UA C&S's to obtain. Now, they are having nights do the monthly summaries. I didn't do them, I just didn't have the time. Before ya know it, it's time to do your med pass, blood sugars. We were told that nights now has to check each room with a printed checklist for each pt. I can't even understand how this falls under nursing. Shouldn't housekeeping be doing this??? We don't have a DON right now, the ADON has her hands full right now, so what can we do? I am seriousely thinking of telling them that I refuse to take those 2 units at night because I don't feel it's safe and I am not going to risk not only my patients well-being but my license too. Sorry so long, but this is why I'm burning out along with doing these doubles. I need to make a decision about my hours or I need to stop complaining. LOL, I still think that with 2 nurses, it wouldn't be too bad. JUDE

I also find it humiliating and frustrating but I can tell you that the RN's where I work aren't too happy about it either. I don't blame them. Just think, we take the MD order, write it in as one and then an RN has to sign it. What if we wrote it up wrong? Wrong med, wrong dose, wrong pt????? I, in no way am trying to say that we as LPN's aren't capable of taking an order, I am saying that I would never want to sign off on it unless I was the nurse talking to the doctor. Doesn't matter to me if it's an lpn or rn. It is demeaning to us as lpn's to have to do this. I have to wonder what will be next? JUDE

I have to agree with what others have said. I have no problem doing anything that benefits our residents and/or helps out a coworker, but there are times when you are just too busy and can't drop everything unless it is a true emergency. Assisting ambulating a pt is not one, it can wait. You have to make your med pass a priority and shouldn't be interrupted during it. You need to stay focused to prevent making a med error, plus you don't have a big window of time to finish it. With experience you will learn when you need to lock up the cart and attend to a resident. The bottom line, I have found that you need to be able to delegate and be confident about it. When I first started, rumor went around that "I love working with her(me), she's so easy"....Not quite a compliment, I had a hard time when it came to say, vital signs, all the other nurses had theirs by a certain time and me, well, let's say that 30minutes before end of shift, I'd be running around getting them. One cna would say, I'm sorry I forgot, and I'd be like that's ok. Dinner breaks, some would be gone for over an hr and I would say nothing...Not anymore. We are all adults and we all know what is expected of us. I have become more assertive and firm in my decisions regarding assignments/breaks etc....Now, serveral yrs later, those who are still there enjoy working with me, not because "I'm easy" but because they respect me, I am fair, not afraid to help out. Big difference. There are those who will try and take advantage of you and it is not limited to the cna's. I have had another nurse who works days, who always left the MD callboard full, treatments that should of been done that weren't etc....why? Because she knew that I would take care of it. Thank God, she is no longer there. I always pull my weight and try to make sure that at the end of my shift I completed what needed to be done. Ofcourse, sometimes you have to leave something because you had an extremely busy day, a death, a fall, somebody going to hosp etc...that is understanding. It's really about mutual respect. That goes for everyone, doesn't matter if it's a nurse, cna, housekeeper, laundry, dietary and so on. You have to give respect to earn it. Always remember that the CNA, are your eyes and ears. They often can tell you when something is just not right with Mr. Jones. The care that they give to pts allows them to notice any changes esp physically. Come on, when's the last time say, you saw Mr. Jones bottom? If your pt can't tell you, it's your cna that will come to you and say, "his bottom is starting to get reddened"......The cna's that I work with are regularlly assigned to the unit I work and let me tell you they have great skills and often have caught something early on with the pts. I don't remember every saying, "no" to anyone at work,(take that back, I have said "NO" when asked to work 10 days in a row, lol"). You know the old saying, "one hand washes the other"........so true. It's all in how you approach others too. All of this you will learn with experience, as there is no way you can learn this in school. JUDE

I too, see the advantage of having the same staff on each unit, but......for me, I have been going through this and I am getting burnt out being on the same unit. One particular night, I had it. I went to supervisor and begged her to please not put me on that unit the next day. I work 16 hrs shifts, several times a week and after a while, I feel that I just need a break. They are pretty good about switching assignments but sometimes we have those who will not give up "their unit" and they refuse to work on another unit. That means that we have to work where assigned if others won't work elsewhere. Right now, we have a nsg shortage and are using alot of agency. That is when we can ask for certain assignments. With our Cna's, most have regular assignments and I think that is good for our residents since most have dementia/alzh. The families really are happy to see the same faces everyday, it makes them feel better. That is all and well, but what about us nurses? Bottom line, when a nurse feels that she is becoming burnt out, they should have the facilities support and be rotated for a while. JUDE

Hi Lara, I went to a vocational school for the LPN program. The total cost was about 1,500.00. My daughter is enrolled at one of the "private" schools in an LPN program and the tuition is an astonishing 17,000.00!!! Do you get a better education because of the cost of a program? I don't think so. As a matter of fact when I graduated and went on job interviews several of the facilities stated that they have always hired nurses who graduated from this particular school and they've never been sorry. The reason why my daughter is going to another school other than the one I went to is for several reasons: 1. There is no waiting list 2. You don't have to wait to schedule exam 3. You also don't have to wait months until the exams are scheduled and then wait to see if you passed 4. The day that you apply, you take a test(nothing like the exam for vocational program) and find out if you are accepted 5. There are several lpn programs running, so you don't have to wait until next yrs program 6. Private school offers evening classes too. 7. This last reason is more of a personal decision, where I went out of the 5 instructors, 3 were downright verbally abusive, demeaning, unapproachable. I would never recommend somebody to go there, regardless of their reputation. I went there as an adult(41yrs old)and could not believe the way people were treated. If they didn't "like you", you were in for a hell of a time. Bottom line, it isn't the cost of ones education but how good of an education you get. And that is mostly up to you. It's an intense program but well worth it. Good luck with whichever one you choose. JUDE

I work nights(11p-7a) and have the same concerns. I have 3 residents on the unit that I normally work on that are assigned tylenol(Q6h ATC)and are scheduled at 2am. Ridiculous. I suppose that getting the order changed to "while awake" would solve this. But, maybe not because these pts are A&O and there have been times, when I, along with other nurses chose to circle it and write on the back "pt sleeping". Guess what happened next? 2 of those residents complained the next day stating, "I didn't get my tylenol lastnight".....What gets me with esp. these three pts, is that they all get Ambien HS and all request it at 10pm...And they want to be awakened between 1-2am for tylenol??? Our facility also started changes the times on Synthroids/Prevacid to 6am. Forget that too, because almost all are on Prevacid and may on Syntroid, and most have trouble taking their meds when awake, never mind trying to get them to take it after being awoken from a sound sleep. This was recommended per pharm also. They nixed that pretty quick because many pts either spit them out or started choking, not swallowing etc.....Breakfast comes usually between 8:15-9-15, so days has time to give them starting at 7am. Another stupid order for nights is that our aides must do foot audits every Tues 11am-7am. Are we not supposed to be checking the residents everyday during personal care??? Or why not doing these weekly foot audits on their shower days? They think that nights has it easy, so they keep piling new things for both the nurses and aides. I don't know about other facilities but the amount of paperwork that has been designated for nights to do is crazy. Lastweek alone, 2 days I left late. One day at 8:30 and the other at 9:45am....and they are complaining about OT!!! I say too bad. We have 5 units of 30-32 pts each wing. At nights, one nurse works the middle(which is 2 units and 60-64pts)....So, that is double the work. The other units are supposed to come and help with the paperwork, like helping on consults/labs for one side but it still ends up being alot of work. Between the paperwork, g-tubes/meds/charting etc..., it's still too much for one nurse. My point? Night shift gets dumped on, everything that the other shifts don't get to, don't worry, nights can finish it............I know this first hand because I work 2 doubles a week going in at 3pm and working until 7am(16hrs)or later in am. I have seen some nurses/aides say, "leave it, nights can do it"...................Bull!!!! And what happens when a problem arises? Somebody falls, goes in distress, add that to your work. I had 3 pts up the other night, because they kept trying to climb out of bed. So, they were at nsg station in their wheelchairs with hopefully a lapbuddy or sr belt. Ya know because they are trying to cut down on restraint use. Let people like them fall out of wc or bed, the state tells us, "It's the patients right to fall"...Yeah right.... Well that about sums it up for my facility, how about yours? JUDE

the date our facility went to No Smoking Facility. I don't think that is fair. For instance, we had woman who smokes and was admitted to this facility 2 days after the facility decided to become a no smoking and she was being forced to abide by that decision. She is A&O, and made a fuss about this and was able to smoke outside where we have a smoking allowed section. But now, the facility now makes it clear at the beginning of admission process that there is absolutely no smoking allowed on the grounds. They are asked to sign an official document that states they will abide by this rule. I know that many will disagree with this, but it's not fair to a human being who smokes to be denied that right when there is a smoking section. So, if a resident wants to come to this facility, there are forced to sign that part of the contract. Now, say this resident goes outside and she is sitting/socializing with other residents who were "grandfathered" in and are allowed to smoke. Sorry but that is wrong. Well, that's my opinion on this topic. JUDE