dotherightthing

First, if this is occasional, I'd encourage the teacher to speak with the child to find out what's up. And then go from there-to talking with the parent and maybe social services Second, if this is a frequent thing and if the kid is not rousing to his/her normal LOC...being drowsy, disoriented or with unstable gait...those kinds of things, the parent should be notified immediately so they can transport the child to a physician for work-up. If the parent refuses to get the child, I'd consider calling 911. Something is wrong and you probably can't figure that out at school. Third, if this is a frequent thing and if the kid can be roused to his usual LOC, (It shouldn't be dumped on the school nurse), the teacher should report it to the parents-it may be a chronic home/social/discipline issue. How late is the kid is staying up, doing what? What else in going on in that kid's life, etc. If it isn't that and assuming the parents are on their job, they should take the kid for primary a care work-up. If it continues, something is going on but it's iffy whether its a social or medical issue. If they refuse to pick up the kid, I'd encourage the teacher (and help her) to flood the parents with calls and notes while documenting it all to cover myself and the school. The child can't learn much is he's asleep in class, I'd involve the social service people and the principal as well. Lots of unaddressed social kind of issues come up in school nursing....lice, unwashed bodies, dirty clothes, hungry children. It becomes a medical issue when it's longer term, chronic kind of stuff (a couple of weeks of dirty clothes, not washing, etc., is chronic to me). Otherwise, on a daily basis, my job is acute care and diagnosed 504 type care issues, self-medication oversight, health education, etc.

I've heard that it happens at heritage woods of chicago, from someone who lived there once. Don't know for sure though.

first of all, you won't know until you know. it may not have gone as badly as it feels. you'll know when you know. 2nd, many rns fail the exam the first time taking it. i've known at least 20 nurses who admitted it. so imagine how many i may have met who just didn't mention it. i've known rns who took the exam 3 times before passing, this is to say you're not alone, if it is the case. everyone is not a good test-taker. for some people, in general, the stress of test-taking works against them. re-group, study and take it again, as many times as you can or have to. no employer asks if you passed the first time or how many times you've taken the exam. this may not be exactly what you want to hear but in the real world, you have a second or even third chance. if this is your mission, go for it.

as an rn and having an open mind and one who has worked with some experienced but terrible rns, i say give that giving the lpn a chance may not be all that unreasonable. the nurse manager must have some reasons for not wanting to give the position to the rn besides not liking her. as you guys are on opposite sides, she may not feel comfortable sharing those reasons with you. lpns are often painted with a broad stroke, the type of paper received (not a aa or bsn or whatever) being something that is used constantly and the lpn as a group has lots less support (to do pr) than the rn. the one ltc facility that i've worked at and liked the most was headed by an lpn so go figure. (the distance was the problem). so, let her give it a shot, if it doesn't work out, it'll be as evident as any other nurse.

It may not get done, which is why I left LTC, you're still held accountable even though overtime is not acceptable. And even though, facilities are staffed for 24 hours, leaving something for the next shift is also unacceptable. It's very wierd.

i'm an lpn also, i tried ltc because the money is good but the facilities are a mess in the inner city and nearby suburbs. in ltc, it's all about billing it seems, and throwing pills at people really fast - not about health care. i don't want to be too negative because i know some really like it but it's not for me. i've tried but it didn't work out. the facility where i worked had a large population of filipino nurses and the language issues are difficult not only for the patients but for the other staff as well. the culture there is very interesting, they've very honestly shared that they don't allow their elderly to go to places like that. i get the feeling that they don't really respect the patients that are there or the families of the patients. this was my only real experienc with a facility that was straight ltc. i've worked part-time at facilities that had sub-acute care and assisted living and the culture was definitely different. i'm trying to find my way back to ambulatory care or school nursing with a part-time weekend job in supportive living or assisted living. i like to see a positive result through good care and education, that's a rarity in ltc. so, hang for a minute or use your cna to hold you while you find your niche. the job market for lpns is really limited these days so it's tough. i'm still trying to find my spot too.

the assisted living facility where i work operates more like a nursing home and it shouldn't, so i can't really give you much practical advice except: help the residents maintain the adls that they can do. remember not to "assist" them too much. you'll assist them right into a nursing home. try to work as a team with the cnas or front line staff. every staff member is important to the care of the resident. there's probably more but after an exhausting day with a crazy don, i'm done for.

at a school where i worked, the kid - an extremely unstable diabetic, ran out of glucose test strips. we had to go out and buy some, at the school's expense, and try to get the parents to pay the school back. this child really needed to do her bg a minimun of 3 times a day on a good day. on a bad day, we'd get a bg 5 times which should really be overkill. but diabetics really don't die of high blood glucose itself, complications yeah. the parents who seemed to understand the disease process would not supply a reliable glucose source - this kid would be 380 in the morning, she ate choco-something cereal and then 37 after lunch, because she ate only junk food. at 37, she was barely symptomatic and that was really scary. i went out and bought a couple of bags of smarties - a very cheap, empty, reliable, rapid acting carb source - about 6 gms per roll. i didn't always know about smarties. but, i found that about 2.5 packs, 15 or so grams, would knock her bg up really quickly. so, i know this is really bad but think about it, diabetics usually don't really die of high blood sugar, it's the low bgs. and 37 would have me cold and clammy. and the child had an automatic insulin pump so this was happening with the insulin on board. did i say extremely unstable? but the child was otherwise, well cared for. and very manipulative - children with chronic illnesses often are. so not a pretty story at all but there it is.

i agree that she did not do much more than recount conversations. she was not specific about his ongoing treatment at all. i really don't see that as a violation. the insomnia that she did mention was well known and she did not reveal any specific treatment. she was not disclosing anything that was not public knowledge. it seemed that he saw some of the drugs as sleep aids, this type of drug seeking is common, many patients feel this way. we commonly use diphenhydramine as a sleep aid - not it's original intent. i also believe that she probably spoke out as well because of the allegations that are being tossed about in regard to his health care providers and advisers - i'm sure she realized that having worked with him, some of those carelessly tossed about allegations could hit her. she was making it known that she was not a prescriber. not such a bad idea really. in any case, as i've stated before, i'd rather have a hippa violation than a murder charge.

the thrill of taking care of michael jackson went completely sour when he died of questionable causes. though certainly a violation of confidentiality, this np is probably trying to cover her bottom half, as she was involved to some degree in michael's care. if diprivan was found in his home, someone, possibly a healthcare provider, was really out of pocket. i'm sure she wants to make it known that she was not involved in providing any inappropriate medications. i'd rather cop to a hippa violation rather than a murder beef.

male nurses are very common and not necessarily gay. some are gay of course but then some doctors are gay as well. lab, radiology, or techs are gay, too. look at all healthcare providers, some are some aren't. i've not heard of instances where patients take some stand on whether to receive care from whom. i'd bet it's one of those non issues.

If I'm just checking on things, making sure she's properly connected to whatever, stay in the room as long as the patient's privacy is being honored, ask me the questions when I've finished, I love patient and family education. And if I'm doing stuff, larger tasks like repositioning, dressing etc., and you can't/won't help-it's fine, you're not obligated. But since most rooms or areas are only so big...STEP AWAY FROM THE PATIENT. and BE CAREFUL, hospitals, LTC, IN-Patient Substance abuse, in-patient facilities in general are loaded with viruses and bacteria. So tell the visitors about that very serious infection (that's surely somewhere, so you're not lying) and they will probably STEP AWAY FROM THE PATIENT.

If you're starting the liberal arts portion of your studies, the usual stuff for school. If you're starting the clinical areas: be sure to protect your feet and legs. I mean like wearing good shoes with good inserts, support hose, etc. Have about three pairs of shoes to rotate so that the bones in your feet remain flexible, the inserts help with arch support and the support hose help support the muscles, veins, bones, ligaments etc in your legs. Nursing is a lot of walking and worse, sometimes a lot of standing. You'll need and want your legs and feet to be useful for years to come. If you're not absolutely great at math, look into Dimensional Analysis for medication administration; calculating IV drip rates etc. Calculating medication in the form of pills and/or injectables is pretty straight forward. IV infusion rates, X amount of fluid per kg/day at what ever rate with the piggybacks, etc., can get a little sticky and DA can come in very handy. Your clinical facility will probably have pumps, etc., but if they are scarce...Dimensional Analysis. A recorder for lectures, I would say that a laptop would be quite useful for research anywhere but probably not essential, same with a PDA - I happen to work a bit better with both. Mechanical pencils with good erasers. Organizational stuff like index cards. A flu shot as soon as available. A really good grip on the policies of your school and the facilities in which you'll be training. It pays to know where you are. It's a really exciting time in your life. I'm excited for you. Enjoy learning to be a wonderful nurse.

i've commented about health insurance. so, i'll respond to your comment about nurses working together. nurses, all combined, make one of the largest worker populations in the us. there are more nurses than all medical areas of practice. fact of the matter, we work in all areas of practice. i think there are more nurses than lawyers (we are lawyers, too) and many other professions. if we were together, we could contol the healthcare arena, based on sheer numbers alone. we wouldn't do that, just for control's sake but if we stuck together and quit the in-fighting, we could be a major participant in determining standards of care. sure, we participate but somehow though we know the numbers that are good for the patient, his care and safety, we don't seem to control that. we, like physicians, work in every area of healthcare, not just on the hospital floors but in radiology, research, pharmacology...all of the specialities...you name it...even the insurance companies...except there are more of us. our numbers should control healthcare, we should be hospital administrators, along side the physicians. we should write policy along with the physcian. we should be up there with the docs, drug sellers, researchers and insurance companies, we're there to some degree, but we should be equals. healthcare would not the wreck that it is now if that were so. i may sound like an ego maniac but we're the ones who touch the patients with our hands and our hearts...

i feel you but canandian nurses are working in the us for more than the money and definitely not the healthcare. it's that it's the us...immigrants come here everyday for various reasons but if that canandian nurse got sick, if she could make it back home, she'd get the same care that everyone there receives and would only pay that minimal amount. notice that these folks who are citizens elsewhere usually only receive the basics here and go back home for serious health issues (that's when they'd be eaten alive in the us) where treatment is really low or no cost. if they're gone from their country for some extended period of time, they usually have to pay a little more, typically equal to a couple of hundred dollars per year. ask someone.