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  1. Flynurse

    The Line Up... In The Hallway?

    I am absolutely certian sundowners exsists. Maybe this admin. person doesn't know what it is? As it was said, most of the residents we make comfy in their rooms and they come right back out to the hall because they are too restless. Our residents lie down after they return from lunch and most don't get back up until 3 or 4pm (depending on activity at 3pm). I have even done 1:1 time with some of these residents despite my busy sched. However, we have been told to "fix it!" Documentation might have been the reason these nurses got in trouble when giving the antianxiety meds. As nurses, we'll just have to make sure all avenues of interventions for these behaviors are tried before we give the med. Then, be thorough in documenting the behaviors and interventions. I really don't think there is a solution that will make everyone happy. I'll just keep brainstorming!
  2. Flynurse

    Want to hear your pet peeves in LTC nursing

    The Line Up... in the hallway. The "that's not my job" or "I didn't know I wasn't suppose to do that" CNA. A charge nurse that just can't get it together and then piles it all on the other nurse at the end of the shift.
  3. Flynurse

    The Line Up... In The Hallway?

    here's an ongoing problem at our facility, and needs to be fixed for the dignity of our residents (and because i don't like stepping in poo that has rolled downhill ). after evening meal our residents tend to get lined up in the hallway along the wall across from the nurse's station. a majority of these residents are there for safety reasons. some of them are there because they don't want to be alone in their rooms. recently someone from admin. was at the facility during these evening hours and was in dismay about the difference from literally night and day...or evening in this case and then reported this to the don. my concern is not with her because, quite frankly, i agree with her. hallways are littered with residents in their w/c's. some of them who constantly try to stand without help or bend over nearly falling out of the chair, others who scream at the top of their lungs, some who plain are just left there. then there are those who roam the halls doing all three behaviors! the question is: why are all of these behaviors occurring on the evening shift when they so plainly do not happen on the day shift? quite simply, my answer is this: there is less staff after 6pm. yes, even on the weekend. i include all departments in this simple answer. there is no social services staff, no admin staff, no restorative or pt/ot/st to stop and say hello or occupy their time. there is not one life enrichment/activities staff member there after 6pm to do an activity or sit and visit. no volunteers come in to chat or play cards or simply sit and hold a hand. these are not solely my excuses but i think it would be a quite obvious reason for the loudness and the line up!!! so what do we do? well, firstly, those who can be in their rooms, who want to just lay down, who would like to sit in their recliners after meal should be escorted first to their rooms. while other cna's pass out snacks, give them something to do, etc. as a nurse i realize this requires the direction and teamwork of nurses and cna's. but.... here's the "situation" when we have meet the immediate needs of these residents (i.e. toileting) and tried many interventions including pain management, but the yelling and other behaviors what are we to do when these residents are so obviously just plain aggitated or sundowners? some of the nurses have administered prn antianxiety meds but then the next thing they know they are being pulled into "the office" for doing so when it was not appropriate. give me your input...please!
  4. Flynurse

    Charge Nurse did CNA work. Learned A LOT.

    At the begining of the shift I make my expectations known and update my CNA's on resident changes and the DON's concerns. I end this brief meeting with "Excellent care makes HAPPY residents and happy residents use call lights less." Nothing is a greater motivator than not having to listen to call lights :) Second, our facility requires "compliance rounds." This can be and started out as, checking everything they are suppose to do by the end of the shift from mouth cares to positioning devices to low beds, etc. Now, since they know what we are looking for, we do a "focus compliance round" (i.e. call lights in place, mouth cares completed). However, it is best they don't know what the focus will be. We fill out a worksheet with all of the things that need to be corrected (and in which room, bed) before they leave shift, and sign what they corrected. Again, great motivator because no one wants to go back and do what should have been done. Yes, it is TIME consuming for you but believe me it worked when we began and continues to remind everyone what needs to be done. You will find less and less wrong and by the time it becomes routine it will take but 5 minutes or so because almost everything is RIGHT! A "Great Job!" and "Thank You for your help!" are in order at the end of the night when all is well. I think we all forget how simple phrases can make people feel needed, esp. at their jobs. As a whole, our facility also has a couple rewards systems. 1) A "Star Performance" board which is based on our facility's mission statements. If someone writes you a note for something POSITIVE you did and posts it on the board you get a treat with your note at the end of the month meeting. 2) Laminated cards for a job well done. If you collect 3 you can go to HR to get a treat of your choice (pop, candy, popcorn,etc.) Who doesn't love FREE stuff!?
  5. Working in a hospice house we continuously experience these situations first hand. I have so many stories in the back of my mind it's amazing. I never knew these events were called Near Death Awareness, but how appropriately named. I have two favorite stories. The first involves a patient who saw a famous person in his room. Had a lovely conversation with him. Then told the nurse who he had just spoken with and that the man would visit with him again soon. The nurse smiled and talked with him about it. Afterwards, she went to the office and there sitting on the counter was a magazine with this famous man on the cover. He'd just died the day before. What's more amazing? The patient had grown up in the same small town as this famous person. A week later he went to have that visit. The second is my favorite. We had a very young man who had died in one of our rooms. The next patient in that room was an elderly lady. There were many times in which she would ask about the lost boy that was in her room. Or say, "[Young Man's Name] wants to know where he should go." She would very often talk about this young man by name. None of this lady's family had any idea who this young man was. They knew no one of that name. It was such a common name too. She too died. No one since has mentioned this lost boy by name. Finally, one day the nurses put two and two together. They like to believe that when this young man died his spirit didn't know where to go and stayed in that room. So, when the lady came to the room he was there, waiting for guidance. And when she died herself she took him with her. I get chills down my spine just thinking about it. I believe this is a wonderful phenomenon the dying experience. Nothing to be afraid of. Nothing to disregard. My most precious memory. An elderly woman barely able to speak. Many children of her own. One day, days before she died, spoke clear as day, "I'll take care of the children." We all assumed she meant her child who died very young. A week after her death, both myself and another nurse found out we were pregnant. How my heart is full of happiness and sadness at this thought. Healthy children will not fear life if their elders have integrity enough not to fear death. ~Erik H. Erikson
  6. OH, BTW if you look young, then you look young. Don't try to "hide" it. You'll just run into more problems about not being yourself. However, I do recommend being conservative in dress and grooming. And above all be professional in all that you do at work.
  7. Though I am 27 (looking quite like 17) I hear these comments over and over. I've been a nurse for 5 years now. All along I have taken it with a smile and say "Yes, I'm old enough to be a nurse. Otherwise, they would have never given me a license." I had a CNA say to me just the other day, "Are you old enough to be a nurse? You can't have been one very long." I still smiled and replied. All that is fine and dandy, right. All but one incident I had and was severely insulted. Especially given my background as a nurse: 8 years total in the medical field, 1 of those years as a Medication Aide, 5 of those years as an LPN. I am a small town girl who ventured out to Long Island, New York (I don't know what you think, but that's a scary situation for a small town girl) I worked in a large hospital there for 2 1/2 years before returning home to Nebraska. Now... the "situation" ... I had a confrontation with an older nurse at work. And wouldn't you know it she went to the "higher ups" with it. Of course I was called to the Medical Director of Nursing's office (an RN with credentials) and it came down to this, the older nurse was right because she was "SEASONED" and I was NOT. The nerve! I told her that woman had never worked a day outside a nursing home and how could she sit there and say I was not qualified to do my job! I don't care how long the other nurse had been doing it (I tell you it wasn't much longer than I). That doesn't make the older nurse right. But all in all, I was still in the wrong. Que sera, sera! I suppose. I'm glad I believe in karma.:thankya:
  8. i just wanted to take a moment to say, "hey! hi! hello! i'm part of the team!" it has been 6 months since i began working in hospice. it has been 10 months since i spoke the words, "i will never work as a nurse again." yes, nearly a year ago i had worked in enough nursing positions and had been in enough unnerving situations to make me feel burned out from nursing after only 3 years as an lpn. i never wanted to go back to the profession. i left new york with a bad taste in my mouth i called, "nursing" and moved back home to nebraska to "start over" again. after trying out a couple other jobs and not succeeding in financially getting back on my feet i was forced to return to the nursing career. i returned to the last place i was employed in nebraska 4 years before i had moved east. ...a unique retirement community ranging from independent living to long term care. i was hired on the spot! yay me!:yelclap: the catch? there was only one position open... night shift at a freestanding facility, miles away from the community itself... a hospice house that had opened only 2 years ago. i thought, "oh great. night shift? hospice? this spells disaster for me." never had i ever been so wrong about anything in my entire life. never! i am not certified as a hospice nurse. what do i do? i am a nurse who works closely with my coworkers and hospice providers and their hospice nurses to fulfill our mission statement. i have truly found my niche. to be able to give the bedside care i hold most precious. to be able to provide comfort to those who need it in an unrushed environment. to be able to be ... a nurse. there certainly are not enough words to describe my relief and gratitude for the wonderful opportunity a higher power and my employers (whom i have a strong regard for going strong 5 years) had given me to be a nurse again. those words were spoken frankly and with tears during a conference held at our facility provided by one of the many hospice providers we work with and attended by many of my coworkers, my mentor/coworker and my employers. i could go on and on about this wonderful place. i could go on and on about my employers/supervisors. however, there just aren't enough words; only the warm feeling i get in my heart everytime i put on my nametag. this...is my saving grace! :angel2:
  9. Flynurse

    What kind of first aid kit do you have?

    The last place I worked handed out first aide kits to the nursing staff last year. For what reason I don't know. They may have been some part of a promotion package with Johnson and Johnson since they use to buy alot of stuff from them. It was a pretty decent one too. Bandages, tape, scissors, tweezers, ointments for cuts and burns, acetaminophen, ibuprofen, ASA, gloves, uh... let's just say it was loaded all inside a tin case. I also keep a CPR mask in my truck. I keep meaning to get a plastic container to put my blanket, my flashlight, a knife to cut open a seat (for the foam insulation, just in case I'm in the middle of no where and have to wait a LONG LONG time) and some water and crackers in my truck as well. Mostly because I don't wanna be caught in a bliazzard with nothing while I wait for help. Call me overcautious, but I'm not gonna die freezing You never know.
  10. Flynurse

    Dr. Phil made nice...

    Something is better than nothing. That's how I see it.:wink2:
  11. Flynurse

    My name is Chim-Chim Apple Hiney

    Boobie Apple-lips? :imbar Uh.... no comment. My corrupted mind went wondering again:rolleyes: :chuckle
  12. Flynurse

    eye edema/puffiness post crying

    *sigh* This reminds me of something one of the Directors of Nursing I use to work for told me once, "There's no crying in nursing." He was a donkey's patoot however. I didn't stay there much longer after that. I say there is crying in nursing, just a right place and time for it, otherwise I wouldn't feel human. :) Cold compress and a nice sigh of relief is best, hon. Hope you're feeling better.
  13. Flynurse

    asking for help to purchase Boys Town shirt

    You are so very welcome. It was no trouble at all. Hope everything works out for you!
  14. Flynurse

    What Tree Did You Fall From?

    yum! i'm hazelnut. i always did like the smell of that flavor coffee. i'm extraordinary! yay!!!! :dance:
  15. Flynurse

    asking for help to purchase Boys Town shirt

    I did a little research, but I'm not sure if you are comfortable buying things over the internet. I found the website to the catalog for Girls and Boys Town and searched under apparel. This is what I found: https://www.girlsandboystown.org/store/products.asp?dept=14&title=Apparel If you would like further assistance I would be more than happy to try and help you out.