PralineLPN

What's so wrong with being 20 and a BSN?? Are you jealous or something? I finished a BS in chemistry 2 years out of high school. I could be done with med school and halfway through residency by 25 if I wanted, is that OK by your standards?? PMD

What is reporting them to the State Board of Nursing going to do, exactly? Are they breaking any laws?

What?? Sounds like you're making life a little too complex.

I don't know if you are kiddding about these mistakes or not. If you are being serious, this thread makes me nervous. I handle narcotics with utmost care. I stop and clear my mind, breath for a second or two, do 3-4 checks on my narcotics, then check my narc documents twice, I don't care how busy I am. Leaving a Tums in a pts room is one thing, but 2 vials of Dilaudid left in the room is not good.Not knowing the generic name for Dilaudid is hydromorphone, as the other nurse pointed out is scary in itself. These powerful narcotics will literally kill a person if you mess up the doses and names. You'll lose you license over that kind of carelessness. Pick up a drug book. Don't take this personally, but just stop and think about what you do first.

These devices are very simple to operate-don't be worried about them. The o2 tanks have a knob that controls flow (rated in Liters/min), usually set around 2-3, no more than 4. Be careful with the tubing, when you move the tank or the pt, make sure you have enough slack, or you'll wind up with a strangled pt. I wouldn't recommend taking it off, check with nurse first, as some pts sats drop -suprisingly- rapidly. Don't adjust o2 levels unless specifically instructed to do so. Also in use are o2 concentrators, look like a box on wheels with a tube coming out of it. Same concept as tanks, but don't need to be refilled. Most have a water bubbler that humidifiesbthe o2. Pevents nasal drying. Nebulizers-the machine just has a tube coming out of it, with a resevoir that liquid medicine is poured into. A face mask or "pipe" is then attached. The nebulizer mists the medication, and the pt inhales it. You can see the mist when it is functioning. If there is no liquid in the chamber and no mist, it's done, you can turn it off. If there is liquid and no mist, the machine is malfunctioning, tell the nurse. CPAP/BiPAP- for sleep apena and other respiratory disorders, forces air into the lungs-just put the mask on the pt and turn it on. some units have a water resevoir that humidifies the o2. It should be set properly, but check with the nurse or resp therapist first. Check with your nurse before doing anything if you are not sure. You'll get used to the stuff in a month or so.

If your facility has in-house laundering for the residents, you could check their "orphan" clothes box for some that fit. Tight fitting clothes, espically shoes, are an issue for some patients, skin tears and breakdown are more likely to occur, good job for noticing! Paul

This is what we do, too-Works fine, sometimes the sounds are a little diminished, but just turn off the TV and listen really hard. Paul

This is entirely false. There is only a re-distribution of the labor and skill sets. I don't know where this rumor started, or why, for that matter. The facts are-LPN/LVN usually work in LTC/rehab/dementia/nursing homes. RN/BSN's do the hospitals and management. There are exceptions, of course, but this is generally true. Do you have any idea of how many LPN's there are? Do you know how hard it would be the phase us out? I hate to say it, but is LTC going to pay for several RN's (say, at $30/hour), when they can have a few LPNs (around $24/hour in my area),a few med techs and a few GNA's handle the entire floor?? I don't think I have the skill set necessary for a very acute floor. I could do a med-surg floor, but ICU, no way. That is why there is the division of labor. Why pay for a skill set you don't need? Anyways, I do not believe LPNs will be phased out. If you are in school to be a LPN, get used to the fact LTC and rehab is pretty much your only option. Believe me, as a LPN on a transitional care unit, or acute rehab, you will have your hands full, be using every skill you learned, and then some. Paul

I had this same exact thing happen to me in Dec 2006. I woke up feeling like the room was spinning, threw up several hours later, it lessened over 10 hours, then resolved. Scared the double-hades out of me, whatever it was. Some weird flu or something. What geographic location are you? I'm Baltimore, Maryland. Paul

Make sure you eat. I don't care how busy you are, bring a sandwich or something to keep your sugars at a decent level. Yesterday, I had 8 thousand things to do, and I went to lunch anyways. Still got done by 3pm, some of my treatments had to wait a while, but it wasn't critical. Paul

All I can say, is that being a CNA/GNA (geriatric NA) was horrible and a hard, no-thanks, low paying, crappy (literally) job. But it payed off in dividends while in school. Also, as a LPN, I am easily able to transfer pts, and I learned a lot about talking to folks as a CNA. At school the non-cna's had an obviously harder time than the cna's with at least a few months experience. Just do it for a couple of months, you'll be glad you did. It also made me appreciate my cna's and treat them right. And furthermore, I think being a LPN will definately ease my transition to BSN/MS degrees. What with knowing procedures, sterile technique, Dx, meds etc. Paul

I would like to do LPN-BSN online, but I am very leery. I would like concrete evidence I can work in Maryland as a BSN with a degree from Indiana State U. I don't know, I think I'll just stick with brick and mortar for the actual nursing portion of the program, and take pre-reqs on-line. I haven't called MDBON yet, but Indiana State says they are accepted here. Make me nervous, still. Paul

I've worked with European (Poland, Germany, Czech, etc) as well as African nurses before, and I have absolutely no problem with it. I find other cultures fascination, and I'm always willing to teach as long as you're willing to learn! Paul PS- about the speaking same lanuage thing, It's a facility thing. Ours doesn't care what you speak to each other, as long as you can communicate in English with the Patient. We have spanish, french, and a few other languages being spoken amongst our co-workers. I agree it would be discrimination. After all, It's a free country!

Report it. The anti-biotic issue alone needs to be taken care of. This is why we have lovely strains of MRSA, VRE and who knows what else brewing. As I'm sure you all know.

I don't like the fact I don't get the "hand-on" aspect of autos. I like to feel my pulses and hear my sounds, I also get a chance to check skin moisture and temp. Autos are kind of dehumanizing, I think. I've also had pts complain of pain from the cuff squeezing too tight, I never get that doing it manually. The OR is different, it's not reasonable to take vitals q10min. And their machines are calibrated (hopefully) and the operators should be skilled in their use.

Litigation in America-the first and only answer for everything! Yesterday a Pt hurt my feelings, and there was too much paperwork, I think I'll sue for emotional distress. Seriously, the time and money (good lawyers are NOT cheap) invested in bringing a lawsuit will be better used finishing at another school. Also, the ATI case may not be applied to this one. Oranges and apples. Paul

It takes a while, but focus on the things you HAVE learned and accomplished. I can guarantee, the knowledge you have accrued is not insignificant. Everything will fall into place. Ask for help and guidance. Pick one weak area per shift, and try to improve your skill with it. Hope this helps. Paul

I have. A cleaning lady was mouthing off to residents and cursing in the halls. This woman was a total disgrace. I'm glad she was fired. DON and the Admin actually thanked me for writing it up. It was the last straw. I also had a problem with a med tech not giving me the keys when I asked for them. I had a pt in resp distress who needed nebs and another in severe pain. She pulls that again, I'll write that up, too. I don't deal with BS too well.

Yes, she should have at least told someone she was leaving.

Can you clarify what you mean by you "want you manager to know you are serious"? It sounds like you've already made up your mind about quitting. In that case, write a letter of resignation, and state your last day of work in it. It's that simple. Is she trying to talk you into staying? If so, the words "I'm sorry, but this is simply not working for me" work pretty good. Don't give in to offers if she makes any. Cause if you take them, you become obligated again.

Here's a few- Coumadin-Check your PT/INRS Heparin Narcotics (Morphine, Oxycodone, Hydrocodone, Fentanyl, Dilaudid) Just be aware of last time given, use the least amt needed for relief, IE don't give oxyIR when 2 Tylenol will suffice. If you find yourself pushing limits with a Pt (hip/knee pts seem to go through a lot- espically before psychical therapy), the MD needs to be consulted. The patients pain is whatever he/she says it is. Don't judge, Let the MD decide what to prescribe. Non-Narcotic Pain meds-APAP, Motrin, Naproxin Heart meds-Digoxin, B-Blockers, Check your HR and BP's Diruetics-Lasix, HCTZ-try to give early as possible, else pt is up all night peeing. ACE-Inhibitors, again HR/BP Various psych meds-Prozac, etc, anxiolytics-benzodiazapine class, Sleeping pills (ambien, lunesta), rarely a few anti-psychotics Phenobarb, Dilantin, Depakote (need levels for all these), neurontin seems to be a biggie for neuropathic pain nowadays, as well as seizure control. Don't forget your bowel drugs, -especially- if pt on narcs-sennakot, MOM, psyllium, other laxatives and bulk-formers. Anti-Nausea drugs-compazine, phenergan, reglan, (also biggies with narc pts) Probably a few other common ones, but you'll definately see these a lot. When in doubt, check your drug book, don't be too proud or afraid to take a extra minute to look something up or call pharmacy-Don't forget to check ROUTE, IV instead of IM seems to be big error point. Also, some orders may be written for 600mg and say nothing about the # of tabs- and pharmacy sends 200 or 300mg tabs. Just take your time and do your checks.

I know LPN's in MD can make around $24/hour + differentials if you look around. I'm sure RN's can do similar or better on a med-surg floor. Ask for $25/hour, seems reasonable.

New Balance. Durable, white, comfortable and $50 on sale. A pair last me about a year.

I had a med tech question me about what I needed the keys for. I told her there was a pt in respiratory distress and I needed nebs immediately. Finally I got the keys after convincing her it was an emergency. What is it with these people? And before that, she told me to wait for narc keys. All she had to do was reach in her pocket and give them to me, but she makes a big deal of it. I would have given the meds, but she had some issue with that, so I left a list for her. I'm going to the manager if she pulls this crap again. First of all I shouldn't have to explain myself to a med tech, second of all, if there's an emergency, I do not have time to grovel before her to get keys. Then she has the audacity to say the state will be eyeballing me because I'm new on the unit??? The state will eyeball everyone equally. Some people are so ignorant it makes my BP go up 20 points. Are med techs even considered "licensed" staff?

I understand, I see where you are coming from now. Basically, the supervisor ordered the nurse to take drugs. Interesting ethical and legal questions...I wonder what would have happened if the nurse still still refused to some to work. Paul