DF-LPN

I loved working nights! Can't wait to go back. When I was on nights I kept my same schedule even on my days off. I treated working nights like ppl who worked days. I would get home and do my housework, errands, ect then go to bed around 2-3pm sleep to 9pm when I worked 8hrs. With 12hrs I would go to bed at 10-11am I'm good with 6 or 7 hrs of sleep. I didn't have kids or a husband so it was easy for me.

I have seen this before, looks like a hot dog that exploded in the microwave.

When someone act surprised about lack of staff, supplies, or any of the thousands of c/0 everyone mutters, I always ask, What, are you new here? I can be quite sarcastic at times, lol

We all suffer from anal darkness every now and then! Some more then others 😉

The 1:4 or 1:5 really doesn't matter because they find ways around it. I worked for a facility that literally broke it down to seconds. It was nothing to go into work and there would only be 2 nurses and 3 cena's for about 115 residents, I had 4 hallways. I would have to count up our hrs, 8 for nurse, 7.5 for cena, take that sum and check the chart for how many hrs need to be covered for a particular number of res. Subtract to see how many hrs needed to be covered. But don't forget the 4 floor nurses that start at 06:30, that's another 2 hrs. Well lookie there I'm only short a 1/2 hr, so I would/could only mandate a cena to stay 30 min......at my least busiest time of the shift! Bottom line....health care is a business, and like any business, it's there to make money.

In MI for midnights in LTC is 1:15, but it doesn't differentiate btwn Nurse and CENA.

This year I gave my cenas those fuzzy aloe infused footies, a couple of ink pens, and these lg marshmallows to put in hot coco. Got it all from Wally world. Wal-Mart has these mini cast iron pan with a chocolate chip cookie dough that you mix up and bake in the oven, costs $5 plus they get a real cast iron pan thats big enough to cook an egg or 2 in. Bought them for my fellow nurses and my nurse manager.....even got myself one lol

This happened to one of my cena's: I had a res that was constantly putting her hands on and in her hoohaa every time staff changed her brief. So cena was talking to the res while changing the brief, res went to town scratching away and then promptly stuck her fingers in cena's mouth. Cena came running up to the desk gagging , went into clean utility, grabbed tooth brush, toothpaste, mouth wash, and peroxide and scrubbed, rinsed, garggled and repeated mult x's. Being nurses, we all about died laughing . Poor cena now was doing the above cleaning interspersed with cussing us out!

First and foremost that is your license, and like so many of us, sacrificed time away from families, your sanity, and possibly your liver from all the Tylenol you took. Spent hard earned money that you most likely didn't have. Cried buckets of tears because you just knew you failed your midterms. Ate tums like candy because someday you'll have ppls lives in your hands. All joking aside, we are educated to take care of ppls medical issues and in a court of law that is how you will be treated, you can't say, "because the Dr ordered it" If that was the case, nursing schools would only teach fundamentals, there would be no CENA, LPN, RN, Bachelor or Masters degree's or any of the other degrees. Bottom line, It's Your License, protect it!

Maybe not a mistake? When I was an aide I was orienting a new girl and I sent her to get vitals on a res and she came back and said she couldn't hear her BP, said sometimes she has a hard time hearing them and asked if I could get it for her. I walked into the res rm and told the orientee to get the nurse immediately. While I was waiting, the res took her last breath, back then we didn't do CPR, there was no such thing as code status in LTC. Anyways, the girl came back with the nurse, saw that the res was dead, looked at the nurse and said, "She was alive when I left!" I just stood there, I'm sure with a look of ***** on my face. Since then I go get the nurse, that is until I became the nurse, but I still look back and laugh about it.

Keep Calm and Poop! It's actually on a button pin that I have pinned on my purse. I get alot of comments on it, lol

This may be a little long but please bare with me. I have worked LTC for 25+ years as both a NA and a Nurse. I'm not condoning any of the neglect you mention, nor attacking you in anyway. I'm just trying to give a small insight into LTC operations. We all are aware of the Patients B.O.R's. I beleive that is the same in NH's as well as hosp. I'm sure there are others out there who beleive that its a very fine line between protecting their right to ref cares and preventing them from harming themselfs with those refsuals. One thing you need to know is that LTC operates under a whole diff set of rules then a hosp. In the hosp you are allowed to restrain pateints, either physically or chemically, if they are presenting a harm to themselfs or others. I can not do that until I first try to distract/redirect them with: BRP's, food, massages, changing their environment, playing calming music, having someone do 1 on 1 with them, chart all this and its success/failure. Then check to see if the behavior is caused by either pain or a UTI, cart this info. Then I need to notify social services and administration and ask them for sugestions and permission for a restraint. Chart all of this. If I get a green light then I have to notify the Dr and then the POA/Gaurdian, chart all this. I'm not gonna get into trying to get the Dr to call the pharm in the middle of the night (shutter). I don't know what staffing guidelines are in a hosp but ours are as follows: 1) [7-3] 8 patients to 1 nursing staff. 2) [3-11] 12 patients to 1 nursing staff. 3) [11-7] 15 patients to 1 nursing staff. That does not differentiate between nurse or cena, which I beleive they should. It should be so many pt's to 1 direct care staff. In NH's nurses usually do not do direct care. Thats a whole other thread (LOL). Now where I work we never work short, per admin! We have 159 residents and the least amt of cens we can work with is 14 with 5 nurses, thats an 8.4 ratio. Excellent staffing right? Well here is the problem. Those 159 res are split into 5 diff units in a 3 floor building. So if we are to be down 1 cena on my floor, which we rotate between units, that means I have 37 res to 2 cenas and 1 nurse. Now I can do cena work to help them out but they can not do nurse work to help me out and I have all 37 res's I'm responsable for, meds, charting and tx's. Now if my cens took their 15 res's like the guidelines say then who is responsable for the other 7 res's? I can't do that plus my work because nothing would get done. Its unlogical to pull a few cenas from other units. 1 they can't hear call lights from my unit an others have to watch their res while on my unit. So even though the numbers show we have excellent staffing, we are actually short staffed. Which we are no longer allowed to use that phrase. Looks and sounds frustrating doesn't it? It's more so when your in the middle of it. Hmmmm, I feel like I am so off the subject of the original post, but there ya go. Nothing is black and white, there are almost always other factors in play here. And lets face it, we are dealing with humans who do not feel well to begin with, who can be really fickle, and not on their best behavior, either angry or depressed about being sick. Angry that they are in a NH and trying to make their family feel quilty and take them home. The one thing I love about my job is that fact that I know my residents. I know their moods, their habits, and all their idiosyncrasies. I take care of my residents 8 hrs/day, 40hrs/wk for wks or months and even years. Unfortunatly hosp nurses don't get that oppertunity. So siad your gentelman is AAO and a sweet nice old man, but is that his normal dispostion? I could tell you stories after stories where res who are indep have with held info from us on their health. Now after all that, here is my big ol 180 degree turn!!! I'm glad you notified the authorities of your concerns. Yeah it's a pain in our backsides when state comes in for investigations, but it shows your morals and your heart and your concerns for your patients. And to be that makes for 1 hell of a nurse, and your patients are lucky to have an advocte such as yourself in their cornor. Once again I appoligize for the length but I hope this gives some insight or education into the 2 diff styles of nursing. Thanks, Dee

Not a "Where babies come from" but pretty darn close. My ADON was telling us that when she was pregnent with her 2nd, I think. She was due anyday and her husband had to go scout a game and he was worried. She said she was fine, to go ahead and go. Husband heads out and she heads upstairs and her water breaks. She yells at her son who was 7 or 8 or 9, to hurry and try to catch his dad and tell him her water broke. Son runs off and catches dad pulling out then run back up stairs.........With a pipe wrench I about fell off my chair laughing so hard. Dee

From staff when they tell me I'm no fun and this one I have said LOL See my paycheck stub it show payment for: NURSING/Staff and NURSING/Charge......no where does it show payment for: NURSING/Being fun!!!!!! Never been at my best when I first wake up and thats where this one comes from LOL Other: Why don't you talk to me when you come in? Me: 1) Umm I just woke up 2) I don't know you yet and not sure I even like you!

Part 1 I've been a nurse for over 20yrs in LTC and I agree with all the other "experienced" (ummm euphemism for old?) patients are sicker, they're stay in the hosp is shorter also. When I started as an NA in "86" about 90% of our admits were ltc placements. We didn't do CPR. I don't think we even had advance directives back then. Now, that 90% has dropped down to, (this is just a guess) maybe 20%. Acuity of care is much higher, requiring more skilled nursing. I've taken care of res with eviscerated chest wounds from by-pass surgery, a 3rd day post-op triple A repair, even a 2nd day post-op breast augmentation Nursing itself has changed. When I first started as a nurse, we didn't have pulse ox machines, ppl got O2 if they were SOB or kinda blue around the lips. Hell we didn't even have O2 concentrators, we were useing the big H tanks. Heres something that will blow you new nurses minds.....when I started as a nursing assistant ( you did need to be certified back then) we didn't have gloves!!! The only place you needed gloves was in the dirty utility room to rinse out soiled linens. What we had were finger cots( think condom downsized to fit a finger ) we had glass thermometers, you put the blue tip ones in one pocket and the red tip in the other and about every 2 weeks a memo would go out for ppl to please return the thermometers because it never failed you always went home with some. Part 2 I always tell new nurses....." There isn't enough money in the world to make me be a new grad again!" I believe your 1st year as a nurse will be the hardest thing you do in your career, harder then even school was. Yes, you have all this book knowledge, but now you have to apply it to your patients and that can be very hard to do. The one thing you can never be taught and probably the one skill you will need the most is experience. I never felt more stupid, more incompetent, i never cried more or doubted myself more then I did that 1st year. And yes some of us more experienced nurses can be a major PITA to new nurses. But it doesn't help when you get a new grad who comes in tooting their own horn because they graduated in the top 5 or 10 in their class, or being told " We never were shown that!" I hear that one alot and its on basic nursing skills like giving a supp. There has been a time or two when we thought we should call the college and give them some feedback on how well we think they are preparing the students. Or have them come off of 6 wks daytime orientation and be unwilling to give report untill the've seen you do it. I mean come on, report is report no matter what shift it is. I'm not saying that new nurses should let us walk all over them, but don't sit there like a bump on a log either. This is an age old debate that will most likely never be resolved untill they day comes when all of us realize that we need each other. Sorry if i rambled and i hope i made as much sense in writing as i do in my head LOL Dee