geniann

Well I talked to some of the other nurses in the office and one jokingly said something to doc- He said " yeah I know"- he didn't leave any behind since. Thank you ladies for your insight. Where I work all the nurses including the medical assistants write AND call in orders all the time. My doctor sees ALOT of elderly people and they can sometimes be on 10-20 different meds including the holistic meds he orders. If he would have to write them all out it would take forever, so when the nurse rooms the patient she also writes the scripts and puts them on the chart for the doc to sign. If he doesn't wish to sign them, he just rips them up and thows them away.The electronic thing sounds great but I don't see it happening with us anytime soon. I just wish there was a way for the pharmacy to detect forged scripts. I know they can when it is obvious but what about the little ones- or even non narcotic ones. I have heard my doc give scripts for non patients- like other docs- and sometimes for narcotics. We don't get our scripts back ,or at least I don't see them, so I am just gonna have to hope noone has forged any. I am sure I am jus stressing. I was just reading a post about young addicts and we see alot of kids- you know how sneaky they can be. Ok I will relax now- it is out of my hands. Thanks to you all for your help.

I work for a VERY busy family practice. My doctor is great but he is WAY to trusting. I walk into rooms all the time and find his script pad on the desk- I am afraid to leave them around for fear a patient would swipe it. How would the doctor know? The bad thing too is that his signature is VERY easy to duplicate. I grab the pads up as soon as I see them but I am afraid to say anything to him- afterall HE is the doctor. With the vast amount of patients we see, how would we know if the pharmacy filled a forged script? I write out alot of scripts(then he signs them), and I worry I would get in trouble. Anyone know how to handle this or should I check with the pharmacies- or am I just worrying for nothing? Thanks!

Just when I think I have heard it all!! I can't believe some of these stories- How on earth do some of these nurses sleep at night!!! I always thought nursing was just that "NURSING"- caring and taking care of others- What a sad world it is becoming when a nurse will see things like this and WALK OUT!! God help me when I get old!!

I am one of the most passive people around. I am usually proud of it but at work I had to be the "boss" and that is NOT fun. I had to tell women who are old enough to be my mother to do something- not tell at first, but ASK. I would ask and then I HAD to tell them- especially if it were really important. MOST of the older ladies had no problem with it but MOST of the younger ones did- and they let me know it. Just take it one step at a time- take a deep breath and say what you NEED to say. You will be fine!

I had this same problem when I began at a local LTC facility. I was WAY too nice and they took advantage of me. Finally I had to write some of them up and I also had my supervisor, the DON and myself talk with all the aides to find out just exactly what the problem was. The main thing is that your supervisor and your DON stand behind you and they let the aides know it. Whenever I had another problem with them I would get my supervisor and we took care of it together. It was harder for them to jump on me when there were 2 or us. After a while they learned that I was a good, helpful nurse and they became friendly with me. They would see that I would take someone to the bathroom or change a patient and not make a big deal of it- IF I had time. They helped me and I help them- I think in time you will have the same thing happen. Best of luck to you and just keep doing what is right- you will get through it!

Besides just pulling a resident off the floor and putting them back in bed after they have fallen, then acting like nothing happened because they didn't want to do the paperwork:nono:- a few other things come to mind. While in nursing school, a "future nurse" :smackingf was "taking" a blood pressure with NO stethescope. I asked her what she was doing and she said "I just watch the needle jump and when it starts I get my top number and the last jump is my bottom number":no: I almost died! ( and perhaps her patients will too with that genious taking care of them!) She didn't even say "diastolic and systolic" pressure. I have also seen 2 nurses give IV atibiotics 6 hours late and knew it and did nothing to rectify it- the one said "I was too tired" and the other said "I couldn't read the MAR". What is wrong with people nowadays!!

L5/S1 herniation and severe degeneration with cervical scoliosis here! Been living in pain for 2 years- I agree with PT- it helped me so much. I was completley off narcotic pain meds while I went for PT. If I could afford it now, I would be going 5 days a week. I know it will help me but I just can't afford it,plus I don't have the time. I know alot of people who had great success with surgery but that is very drastic and I guess it is a last resort. Even though I have low back injuries, I have ALOT of neck pain. I have not had a MRI of my neck yet and wonder what it would find. Hugs and prayers for you- it is so tiring living with chronic pain. Please address your depression as it will also make your pain more prevalent. PM me if you would like.

Thanks mamason- I did try that site but that info is not on there. I hope someone else replies- I am trying to find it but can't. I also wonder if I need to subscribe for a nursing mag- I recieved it automatically back in PA but not here in FL. Wonder why?

The Commuter did an excellent job of answering your question for double shifts- I work 12 hour shifts and do a few things differntly. I don't prepour my meds and I have 31 residents. I also am not required to monitor the dining room(which is great!). After the initial am routine (getting report,counting narcs, and stocking my cart) and then passing my 9am meds, which take from 8-10, I then look over my labs/x-rays and if the ARNP is not there I call the doc with any abnormals. I also answer the phone a million times and call pharmacy because there is always something someone is out of. After my 1100 accuchecks, I do any 12-1300 meds and then I do my treatments. I spend quite a bit of time talking with family either on the phone or in person. I try to squeeze my lunch in there but miss it quite often. After my 1600 accuchecks I pass my 1700 meds, which take me until about 1745. I then clean off my cart, wipe it down, empty the trash and stock it for the next nurse. Then I begin the tedious chore of charting.UGH:lol_hittiThen I pass on the madness to the next nurse!!

Since it has been a couple weeks since your original post, how are things going? Are you working for the agency? I worked for agency right out of nursing school and worked 11-7 at hospitals and LTC's. It was ok and I learned ALOT and made good money. I worked ONE 7-3 at a LTC and went home early- it was TOO much!! If you haven't don'e 1st or 2nd shift yet, DON'T! I went home crying that day and I will never forget it. I am glad I worked agency but it is just too unreliable. I learned SO much- even though I have only been a nurse 3 years I feel like I have been one 10! And I know as much as some nurses that have worked twice as long as me. Keep us posted!

I loved my old Rockers but after reading all the posts about Crocs, I must buy a pair. I have back problems and my Rockers were the best- then they wore out and I could not find another pair like them, so I went with NurseMates. They are good but I still have to try these Crocs- I know there are knock off's but where to buy the good ones? I normally don't care for clogs but don't these have a strap on the back? What are the price ranges?

Yes, yes and Yes. I think I felt most unappreciated when I worked in the hospital. There are always the great RN's, but the horrible ones sure stick out in my mind- thank goodness there were only a couple. Since we are unable to give pushes, I had to ask the RN's to- one in particular made such a big deal out of it. She would sigh and make comments like "LPN's should be eliminated all together!" How rude! She was the type who would come out of a patients room and find a cna to empty a urinal!! Again, I must say that the majority of RN's were great- But for those who are not- Please remember that we are NOT beneath you- we are BESIDE you and some of us know MORE than you whether we can legally do it or not.

I was wondering if there is a site to view healthcare professionals disciplinary actions? I know when I lived in PA, I recieved a newsletter every 6 months that listed various nursing information and EVERYONE who had ANY type of disciplinary actions against them. It was very detailed- told the nurses full name, address and action taken against them. I was just wondering if there is a site that gives this information, since I live here in Florida I don' recieve any newsletter. :)

I haven't had any patients tell me of their NDE but I myslef had one. July 7,2004, I went in for a hysterectomy. The doc wanted to do it lady partslly but found the 3 1/2 pound tumor too large- Duh! Anyway, she did a partial hyst and left my tubes and ovaries (thank goodness, no HRT). I lost alot of blood and required 2 units. About 20 minutes into my second unit, I began to feel "funny"- the next thing I know I feel all my muscles tighten and hit my call light. Thank God my DH was there- he ran up to the nurses station and told the nurse. By the time she got back to me, I was siezing. I remember bits and pieces- I remember them calling a code and ALOT of people coming into my room. I couldn't breathe and the pain was awful. I felt myself "floating away". I saw my husband's face and everything around it was dark. I DID see a "light"- I was being pulled backward into the "light"- It was very calming and peaceful. The next thing I know I was waking up in ICU with a NRB mask on and a ton of wires and lines. I used to be afraid to die- not anymore. Not in the traditional sense. Noone wants to die,but I now truly feel I am going to a good place. It has been 2 years and I remember it like it was yesterday. My severe back and neck pain are constant reminders of that day too- :angryfire I know working where I do would be the perfect place for these stories- I guess if I start asking, I will hear alot of them.

Sorry nd_mom- My bad- I misunderstood your question- I must have been half asleep when I read it. Hope things are going well for you:nurse:

I agree with everything Nurset1981 said- those are great ideas. A good report sheet can save ALOT of time and mental stress. I always check for odd timed meds a the beginning of the shift- I would write a little 1p or 2p by there name- some nurses flag the MAR. Then when I get done with my initial pass, I go thru the TAR and write the treatments on the back of my report sheet. That way when I go in to do the treatment, I don't have to lug the whole TAR in and flip through the pages- especially in LTC because so many of them will have Dc'd orders and wind up with alot of pages you must go through. I worked agency right out of nursing school and I learned alot just because I had NO orientation. Even though pre-pouring is frowed upon, I have done it if I have had a really hectic day and am running behind. I just write the room no. or the residents last name inside the paper souffle cup. Unlike Nurset1981, I work 7a-7p so I do have 2 major med passes that are both in the middle of the already crazy day. If a resident is declining when you get report make sure to know their code status- one less worry if they do stop breathing. Also if Ms.X ONLY gets a MVI and an aspirin, make sure they have them to be given together - why have to chase someone down at 9a when they can take both at 5p. Most of all- STOCK YOUR MED CART WELL! This will save your poor feet a few extra miles throughout the day- and don't forget the insulin needles and tube feeding. Just my If you want you can PM for more help- I have a ton of little tricks that may help you. Best of luck and remember to pee- I can't tell you how many days at 2 or 3pm, I realize I have not went to the bathroom all day.

Air mattresses, Float heels on pillows, skin prep to boney prominences and tips of toes, massages (especially to back and buttocks) with lotion to incease circulation, proper incontinent care followed by generous application of zinc oxide, and obviously, proper hydration and protein rich nutrition (if diet allows). Hope that helps:nurse:

Like the Commuter said, you have that 2 hour window for the med pass. Another thing is to be prepared ahead of time. As soon as you get report and count your narcs, go thru the MAR and TAR. Stock your cart and have everything ready by 7:45am (for the 9 am pass, for example). By looking over the MAR you can see your accuchecks and know who will need BP or pulses- therefore you will need yor stethescope and cuff- You will also see if anyone needs meds before they go to the dining room for breakfast and who can wait until after they eat. Some nurses flag thier MARs- and some hightlight their report sheets. You will find your niche. What shift will you be working? How acute is the setting? This can help with prep too- I am here to help. :nurse:Also by looking over the TAR you may be able to knock out some of the quick treatments with your med pass. Have fun!

I agree with the others regarding the CNA's. One other thing is to remember is to not only listen to them, but make sure they understand YOU are THEIR supervisor. Most cna's will not take advantage but the ones who do will become your worst nightmare. LTC can be very hectic especially during the normally long med pass times- and during these times if you cannot find your cna's, you will wind up putting people on the toilet/bedpan, feeding them, or getting glasses of water. Of course, I do these things and don't mind, but once your start your med pass, you should not be interrupted. It can be dangerous. Let the cna's know that you will work with them, but they need to do thier work. Oneof the other nurses said something about not trusting everything you get in report- this is true. Especially if you deal with agency nurses. Do your own mini- assessments and take your own vitals. I had a resident who was on BP meds- for a week the other nurses were charting his BP as 160/80. I took my own and got 100/60. This is a big difference and was cause to hold his med. I don't know if the nurses or the cna's were taking the vitals but they were way off. Since he was a big man, I kinda think they thought that seemed right for him- I know some cna's would assume certain vitals were right- Yes ASSUME. I guess the best advice I can give, is CHART, CHART,CHART. This will save your butt even when you really don't think you should. I had a CNA turn me into department of children and families JUST because she didn't like me!! She never even worked with me- NEVER. Thank God my charting saved me. Best of luck and just remember- they will live if you give them thier meds REALLY late. Have fun and let us know how it is going- Geni:nurse:

I too know what it is like to not be believed. It is beyond frustrating- and of course we must deal with the pain. kk2000, I had almost the same situation. Then I see an ortho doc and he tells me "I know nurses know what to say to get drugs and they know how to act". I was shocked and apalled- I told him "I have NO insurance- If all I want are the pills I can buy them off the street cheaper than coming to you. I spend $200-$300 dollars to see you plus the cost of the scripts. I want a professional to help me so I get the best treatment. Yes I am in pain and I do need narcotic meds but I want them to help me- NOT rule my life! Needless to say that doc later changed his tune, but the words still hurt. Another poster said "wear a suit,have insurance and be articulate"- a drug addict can be as well dressed and well spoken as anyone and still be a DRUG ADDICT- and the doctors will see past all this- They have probably seen it ALL before- and they DON'T fall for fancy clothes or good insurance.

The LTC facilty I am working at did the same thing- new grads making more than me! So frustrating- especially on nights. They are paying weekend night nurses $25/hr even with no experience! When I approached them about this, I was told "you are not supposed to discuss payscales. Don't beleive everything you are told". I told them I saw thier paychecks and I know they make that money and I want to know why. I was also told they would get back to me. So I am leaving- I don't think it is fair to give new hires better pay and weekends off. Yeah they also told me when I started that EVERYONE had to work every other weekend- not the new hires. Some work no weekends at all! Some only work 1 a month. Not fair. If you can't get equality then move on- you deserve it.

I did not go to school in NC but in PA- my LPN cost $5500 and that included books and IV course. It was a Tech school. Good luck to you!

LTC is not for everyone. I am not saying that to discourage you. Just being honest. LTC can get very hectic- there will be several days with no lunch and no breaks. I work 12 hour shifts and end alot of days without getting everything done. I take care of 28-31 residents and the hardest part is just getting to know them. That is something that only time will help. Once you get to know how Ms. X likes her pills and that Mr. G likes tap water and not iced water, you will be fine. Don't be afraid to ask questions- there truly are no stupid questions. Don't let anyone intimidate you and most of all, BE FIRM with the Cna's right from the start. I made the mistake of being a pushover and they took advantage of it. I do the "you scratch my back, I'll scratch yours" and it worked out much better. Your cna's are your eyes and ears- they can be your best assests or your worst nightmares. I always wondered about the clinical part of lpn school- they know alot of us will work in LTC but do no training with us there. Interesting huh? Well best of luck to you- You will be fine!

I faxed my resume to a local doctors office and just got a call for an interview in the morning. I am so nervous! I don't know what to expect. I have never worked in an office setting before and I hope I am not jumping out of the frying pan into the fire! I have worked long term care for so long that it is all I know. I am looking forward to not working weekends and holidays but I have poor organizational skills. I have my own system but it usually doesn't work well for others. I really want to work in a surgery setting- which is what this job is looking for- but have no experience. Any LPN's out there working in a doctors office? How is it for you? Does getting up 5 days a week get old? I love my days off. Since I work 12 hour shifts I have quite a few days off during the week. I would like to get home at a descent hour thought. I am kinda confused. Must be nerves!!!

Never heard of it. Can you give me more info on this? I too am interested in getting an Rn a little faster- Wonder how accredited it would be? Hope someone relpies!