Loving.Very.Nice

I have worked as an LVN and RN in LTC for five years and always wondered why there was no true licensed nursing staff to patient ratios. I am very aware of the PPD (patient per day) and I've even had to do the calculations for the facility administrator. What happens when these patients go out to a hospital, come back and receive PT/OT/ST and are as critical as a Med surg patient? How does a licensed nurse give good care to 30-40 Rehab and LTC patients on one shift? I wish there was a combined LVN/LPN/RN LTC/SNF/Rehab/subacute union to tackle patient ratios.

When I was just starting as an LVN, I had a schizophrenic patient. Every day I would introduce myself as her nurse fir the shift. And, every day she would say "when I was a little girl my mom would say RN stands for real nice." I would ask her what LVN stands for. She would think for a while and get distracted and then start rhyming. Unfortunatly, she couldn't focus to answer my question. My sign on is my answer for her. I'm now an RN, but I still love my signon b/c it reminds me of that patient.

The good news is: patient is still alive and breathing and is not in any pain. The bad news: the patient still has an ambiguous code status and a "spontaneous fracture." My heart started racing went I was notified of this just happening from no cause. The doctor was called from a previous shift and the patient was x-rayed. I called the doctor with the xray results, patients pain under control, and details of the unsigned DNR POLST. The MD was like"ya,ya it's ok. We'll just have PT splint it." no concern over the unsigned DNR by the state conservator. This patient is State conserved, but the family came out of the woodwork this last week. The family is allowed to have medical info, per the conservator, but can't make medical decisions. They want the patient to be comfortable & are ok with the patient being a DNR. The higher up's are walking on egg shells like there is a law suit in the works. Today is Monday, so maybe the DNR will get signed.

I will go in in one hour.

My problem is that SSD (Social Services department) does have a social worker and they have tried all week long to get the state appointed conservator to sign. My other problem: is that my DON knows that the POLST is not signed and has put one nurse on suspension for questioning this patients CODE status.

I work at a Rehab SNF. We have this patient that was recently diagnosed with end stage cancer. The patient is conserved and was previously a full CODE ( or may still be one.) My question is: Is the patient a full code if you have a signed DNR POLST by the doctor but no signature of the conservator? According to SSD notes, the conservator has been Faxed the POLST many times, voicemails have been left for the conservator and one SSD note states that the conservator needs to get a supervisor to sign the POLST. If this patient codes what do I do? My DON has been telling the nurses that she is legally a DNR because we have a doctors order. All meds for this patient's HTN and other conditions have been stopped and all we have to give is Roxanol. Should the meds have been stopped before we had a signed POLST? I'm very concerned for my license.

I went to the WCC LVN-RN program in Sac and it is 8 months long. The prereq's have a 7 year experation. My prereq's were close to 5 years old when I entered the program. As far as the program being "easy", it's not, it's challenging. The good thing, though, is that I was able to take the boards and pass with no problems.

The pre-req are the same as Community colleges: Anatomy, Physiology, Micro, Human growth and Developement, Psychology, Nutrition, English, Math and I think Chem. As far as being employed: I was working as an LVN Treatment Nurse at a SNF and now I'm a Charge Nurse at an Alz. SNF that doesn't have any tubes. I needed a job and my old place couldn't afford an RN. I am making $7 more an hour and apply to hospitals, subacute SNFs and clinic jobs EVERY day. I either get polity declined or no responce. One of my classmates is working for Mercy Urgent Care as an RN, but she was their before she started the program. One of my classmates worked for Kaiser on the Med Surg floor for 9 years, had some of her education paid for by Kaiser and she is working for them as an LVN (they won't let her use her RN license b/c they don't hire new grads.) I think my RN education was excellent and think that LVNs should consider WCC if it is possible, but all of the 2008 RN grads are going to apply to hospitals when the hiring freeze is over. We will probably have to do some type of new grad program b/c we were at SNFs. Do you think that there will be a "back log" of applicants? If being an RN is a life long dream of yours and you don't mind a small pay increase and having the same job as you have now, then go for it. Reach for the stars. Good luck!

Once you have your pre-reqs, WCC in Sac. is about $35-37K. I paid $35K for the eight month program. It was quick, there is usually two admit times a year and hardly, if any waiting list. I applied and was accepted with in six months. You are paying for the short duration of the program and not having to wait. BUT, hospitals are not hiring new grad RN's in California.

news channel 13 finally reported on the difficulties of sacramento new grad rn's having a tough time getting a job. i'm glad to see some truth in the news, instead of journalists reporting nursing as being recession proof. here is the link: http://cbs13.com/local/nursing.jobs.becoming.2.934391.html

which program did you think sounded "like a nice program"?

Nursing is not recession proof. I'm a California new RN grad, previously an LVN (LPN), and am having a very hard time getting a job. I just got rejected for a LTC position and I worked in LTC for 2 years. I can not imagine what other professions are going through, if this is what I'm facing.

The program was overall good. Don't let the cheezy "You can do it" commercials fool you. It is a tough, thorough program. My classmates are passing the NCLEX, so that's what counts. Right?!:monkeydance:

My classmates and I graduated from WCC's LVN-RN program in Sac on Oct. 17, 2008. We continue to get rejection letters even though our graduating class has a total of 80 yrs of LVN experience (from LTC to Med/Surg). I guess we need to go back to LTC, again, b/c the hospitals have phased out our old positions. :deadhorse

I did my finnished all of my prereq's at Solono Community College to get on their waiting list in 2004, but they said it would take about 2-3 years to START their program. So, I went to Western Career College's LVN program and graduated Nov. 2005. (I worked and was pregnant.) Then I worked as an LVN for 1 1/2 years. I went back to WCC for their LVN-RN program this year and graduated Oct. 2008. I've passed my boards and am now a RN. I probably would have saved some money, but I'm a new grad with experience. :yelclap: