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nursegoodguy

nursegoodguy

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  1. nursegoodguy

    Question for those of you who work in a LTC?!

    So you just got this job... Give yourself some time! You've got a lot of patients there also... my load is 30 max but have worked in facilities where I had 45 average and in another facility they'd work us short and sometimes would have over 50 to 60 patients! The more experience you get as an LTC LPN the easier it becomes to see when you are being taken avantage of. Okay so how do you organize your med pass... Well to begin with get report from off going nurse, count, give your techs report get your med pass started as soon as you possibly can! You'll figure out where everyone eats, how they want to take their meds etc as you gain experience. Try not to spend a lot of time chatting with them just get it done! Don't take short cuts with med pass, you'll make a mistake! Just do it the way you were taught and know that as you get more experience it will go smoother... takes a good couple of months to really feel comfortable and that's if they put you on a unit and leave you there!
  2. Happy Birthday! Don't worry... You'll be okay!
  3. Happy Birthday! Don't worry... You'll be okay!
  4. nursegoodguy

    I'm writing up the CNA at my LTC facility

    I work in LTC and I know the way I run the unit when "i'm on duty" is a little different than the way the other nurses run it when they are on duty... I would say that vitals by midnight is a good idea that way the patient can get the most uninterupted sleep possible. Also it is good for the nurse to be able to get some of the charting out of the way and to know if anything is going on with a patient early in the shift! I prefer for any shift I'm working to get vitals as soon as possible because if something is going on I want to be able to get the patient the care they need as soon as possible! Maybe if you do talk to the CNA you could explain the rationale for early vitals and make it more of a learining experience as maybe they think it's more of a power trip for the nurse? I would say if the other nurse talked to you and asked you to intervene I would still probably encourage them to try to take care of it themselves if they could but if they had a hard time doing it then I'd probably talk to the CNA for the nurse. Just keep in mind that maybe the other nurse is telling you one thing but not telling the CNA the same thing? I am not a big advocate of Write-Up's! To me the only time to use it is if you have a really bad employee who needs not to be taking care of patients and you need a paper trail to get rid of them! I've been fortunate I guess because for the most part most of the CNA's I've worked with have done a pretty good job! I can count on one hand how many times I've had to write anyone up. It's not that I won't do a write-up but it's got to be something pretty severe to get me to that point and that is probably going to be working with a person who truly does not care about the patient and needs to be outta there! As I said I guess I am pretty fortunate because I work with many wonderful people who do care! I've found that a more effective way for me to work with the Nursing Assistants is to talk to them and work with them especially when there's a problem... We start out our day with a brief report of what's new then work together as much as possible the rest of the day. Things just seem to go better when we have a caring attitude for all the people we come in contact with regardless of if it's a patient, visitor or coworker and a good attitude can become contagious and make just for a better work place for us and better patient care! Try talking before writing...
  5. nursegoodguy

    I'm writing up the CNA at my LTC facility

    I work in LTC and I know the way I run the unit when "i'm on duty" is a little different than the way the other nurses run it when they are on duty... I would say that vitals by midnight is a good idea that way the patient can get the most uninterupted sleep possible. Also it is good for the nurse to be able to get some of the charting out of the way and to know if anything is going on with a patient early in the shift! I prefer for any shift I'm working to get vitals as soon as possible because if something is going on I want to be able to get the patient the care they need as soon as possible! Maybe if you do talk to the CNA you could explain the rationale for early vitals and make it more of a learining experience as maybe they think it's more of a power trip for the nurse? I would say if the other nurse talked to you and asked you to intervene I would still probably encourage them to try to take care of it themselves if they could but if they had a hard time doing it then I'd probably talk to the CNA for the nurse. Just keep in mind that maybe the other nurse is telling you one thing but not telling the CNA the same thing? I am not a big advocate of Write-Up's! To me the only time to use it is if you have a really bad employee who needs not to be taking care of patients and you need a paper trail to get rid of them! I've been fortunate I guess because for the most part most of the CNA's I've worked with have done a pretty good job! I can count on one hand how many times I've had to write anyone up. It's not that I won't do a write-up but it's got to be something pretty severe to get me to that point and that is probably going to be working with a person who truly does not care about the patient and needs to be outta there! As I said I guess I am pretty fortunate because I work with many wonderful people who do care! I've found that a more effective way for me to work with the Nursing Assistants is to talk to them and work with them especially when there's a problem... We start out our day with a brief report of what's new then work together as much as possible the rest of the day. Things just seem to go better when we have a caring attitude for all the people we come in contact with regardless of if it's a patient, visitor or coworker and a good attitude can become contagious and make just for a better work place for us and better patient care! Try talking before writing...
  6. nursegoodguy

    Outrageous Tuition for CNA Classes

    Some of those specialty schools that teach tech programs really do take advantage of people and most of the time they will try to get grant money or student loans to pay for the training. To become certified a person just needs to be eligble for hire at a nursing home and they will train you and get you certified. Where I work there's no difference in pay regardless of how you got your certification whether it was on the job or in a specialty school. They really just want to make some bucks on you!
  7. nursegoodguy

    A message to new grads: NEVER....

    Never chart you'll notify the next shift to notify the doc! If you note a problem take the extra steps and assess it fully and call the doc yourself.
  8. nursegoodguy

    Nurses wearing white

    Okay first of all I must be in a mood today... I don't want to quote anyone but, why do some people still refer to the nurse as "she" and the patient as "he"? You know that's getting about as old as the history of white uniforms and it is really condescending! So... Just how many people who think white is so great have actually been told by their employer, "by the way the beginning of next month all the nurses MUST wear white or a lab coat over their scrubs! Thank you, Management" Do the nurses have a right to complain? Uhh I would say YES! (not that it will do any good but it's nice to be able to vent!) One nurse I work with makes all her uniforms. Her patients all Love the variety and they each had a favorite scrub top! This nurse has so many scrubs that she has made that she can wear a different one every day for probably a year, most hand made! She dry cleans all her uniforms and always looks the epitome of a caring professional regardless of if she has frogs, chile peppers, or John Deere tractors on her scrub top! (and yes I have my eye on that John Deere scrub top!) Incidentally I have never had a problem with a patient not being able to distinguish that I was the nurse regardless of what color I wore. Maybe it's because when I have a new patient I go and introduce myself to them and spend as much time as I have with them. My techs also introduce themselves. Everyone in my facility answers call lights. If it's something they need a nurse for they come and tell me and I go to the room and take care of it. Even if the patient "thought" the housekeeper was a nurse in scrubs the housekeeper is not going to bring them a pain pill, I am! Nurse-Pill, Shots, Tx's Housekeeper-Cleans the room (and does a heck of a job at it)! I have a lot of patients with mild dementia and they still know the difference! It's really not that difficult for them to figure out! Oh yeah I did mention before that I have to wear white or a lab coat right?
  9. nursegoodguy

    Nurse Bully?

    Usually a few of us other nurses take their name tag out back and burn it! They usually get fired not long afterwards... LOL Okay really has anyone tried talking to this person about their attitude? You always have to be above reproach when dealing with someone like this. I have worked with Nurses like this in the past and they've always pushed just as far as I would let them push... Yea I complained to admin but it didn't seem to go anywhere? I think the best way to deal with these people is to first try to talk to them about what is going on. You never know if they have some problem at home they are unknowingly bringing to work with them. You have to take the first step and it might be more helpful "if" there is another nurse who will talk to the offending nurse with you! You just have to have the right attitude when you do it and that is the attitude of concern and helpfulness otherwise they will get defensive and you'll have even bigger problems with that person! Anyway that's how I would handle it... or you can always bring matches and burn her name tag on the patio! LOL
  10. nursegoodguy

    I'm at a loss...4-year-old on nectar thick fluids

    I do apologize if I sounded condescending... I really didn't mean to. I know for myself I have a lot of people at work who almost on a daily basis have some medical thing with a child going on. I don't work with children so I usually am quick to tell them to go see the doctor! One girls baby had a fever and rash and one nurse was telling her to use hydrocortisone cream... I told her to take her kid to the doctor, it could be scarlet fever! I do apologize for imposing my overly cautious attitude. It's truly wonderful that you've taken an interest in these people and their child. After all we are all here to watch out for each other...
  11. nursegoodguy

    Nurses wearing white

    We have to wear white or if we wear anything else we have to have a lab coat on and CAN'T take it off until we are through with our shift! I don't really care what color I wear, if it's all white then it's a pretty easy choice of what I'll wear today! However, white is not the most practical color choice for all the reasons that have been previously mentioned and having to wear a lab coat is not practical either as you are running into an emergency situation or just "running" all day in a hot lab coat! I think the biggest reason the suits decide to make us wear white is that it "looks professional"... I'm sorry but I really have a hard time with people just wanting you to "look the part"! That's like saying, "just ACT like you know what you are doing"! It takes a whole heck of a lot more that a white uniform to make a good nurse! And YES I do think that if you come in contact with patients your facility should take care of the uniforms and the laundry! C'mon folks it's not like we're stocking shelves! We are coming in contact with a whole lot of bad stuff that we can take home to our loved ones! It would be perfect to have a locker room with showers and uniforms! So with all that said, I need to find white boxers with Big Red Hearts to wear under those white pants and for Valentines day! Not really! I'll get socks with hearts! LOL
  12. nursegoodguy

    I'm at a loss...4-year-old on nectar thick fluids

    If you google thickit you'll find online medical suppliers and what I saw was definitely not as expensive as what you quoted!
  13. nursegoodguy

    I'm at a loss...4-year-old on nectar thick fluids

    That poor baby! As you already know be careful when giving advice and encourage them to seek out a better health care provider who will explain what is going on and can give them medical advice they need. Aspiration is a life threatening condition. There has to be a problem causing the kid to aspirate. They need to take him to another pediatrition and if they aren't satisfied take him to another still til they find out what is wrong. Is there a childrens hospital where they are? Are there any organizations who will help with the cost of thickener for his fluids? If he's aspirating on thin liquids then he's got to have it thickened. When I was a kid we couldn't afford glasses and I think it was the lions club or shriners that bought my first pair of glasses. Maybe there is a group like that where your friends are? Be sure to mention with thickeners you can't just have a recipe that works in every type of fluid. Different fluids, consistencies, temperatures all thicken differently and sometimes they get thicker as they sit. You really have to go by the consistency as you mix. So you mentioned Speech Therapist, is he getting therapy? Do they know why the kid is aspirating? Are the parents trying to monitor "how" the kid is drinking? They need to monitor every sip he takes and if it were my kid I would monitor him, encourage him to take small sips and tuck his chin down then swallow. I hope they get this worked out for the poor baby... It's emotionally hard enough sometimes to work in geriatrics I Know I could never do pediatrics! A big Thank You to the Nurses who do!
  14. nursegoodguy

    How many places do you document an order?

    Anyplace I worked that had a computer system meant you had to do all your hard copies plus extra stuff on the computer!
  15. nursegoodguy

    How many places do you document an order?

    I'm just sort of venting here and curious as to if anyone can add to this list. Okay suppose it is an order for routine pain med: So there's your initial assessment A call to the doc The T.O. MAR with notation of pain med given and effectiveness on pain scale Pain Scale in chart Pharm Fax Nurses Note when med given and follow up note Pain Assessment Care Plan Call to Family to notify of new order If you have a change of condition form E Kit for med, counting the E kit documenting med taken Shift to Shift Report Then you are thinking "now I know I forgot to document it somewhere?" Oh yea the new MAR for the upcoming month! If it's an antibiotic there's even another form! So how many places do you have to chart a new order?
  16. nursegoodguy

    Body Hair

    We "should" all strive for a professional image in how we present ourselves... Just follow your facilities dress code and if it states that all hairy men should wear an undershirt then I would definitely call my Lawyer! Why not be more concerned about his nursing abilities and less about his chest hair? People come in all shapes, sizes, colors, flavors and degrees of hairiness! What's on the inside, is much more important than if they have a hairy body that is visible above their scrub top! Is it wrong to think this hairy guy should wear a t-shirt... what do you think... and when someone notices some physical thing about you that makes them "cringe" would it be wrong for them to point it out and ask you to cover it up? Let's concentrate on what's on the inside!
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