CrazyFLBean

So here it is. I have an upcoming interview for a detox center which seems VERY interesting. It is ONLY a detox center/ not hospital. I'm a new RN and would hope to start this job in the next few weeks. My husband and I have been planning on a baby and my husband seems concerned about this type of work environment if/when I do get pregnant. Is there a lot of violence in detox facilities? What is the general day/night like as a nurse? Job duties? Do they have security? I'd prefer to hear about all the RISK factors associated with this line of work (higher chance of Hep B or HIV, assault, ect..). Thanks.

Once the nurse super found the resident at 7am like this, she called for backup and a crash cart and told someone to call 911.. everyone ran down with her so I ran the other way to call~ I was the only one who ran to call and no one asked if 911 was called for about 5 min into the whole ordeal. As I was getting the vitals from down the hall to tell the operator, they were saying his BP was 195/136 (of course they used a digital wrist cuff) and his pulse was 126- again from a battery operated wrist cuff.. the respirations were something like 30+ and temp was a normal range but I don't remember. I remember the BP because I was surprised at the number.. I know things can change fast. 3 hrs earlier, he was 134/90 with a 96 pulse rate and normal resp. In the whole ordeal, I heard the super go he has an o2 sat of TWO. I thought what? 2? The the other super from the other hall said "2? He's a goner." I have no idea since I wasn't in the room. Could drowning in his own secretions cause such a low 02 sat? Of course as I was on the phone with EMS, someone from the other side of the building was like "why was it never announced over the PA". I mean seriously. I know the have a protocol but there were literally 4 nurses, 1 nurse super, 3 CNA's and 2 experienced nurse orientees in the room. If I get questioned about that I'll tell them that no one else came the nurses station to make calls- only me and I thought 911 was more impt knowing enough staff was in there. Argh! I go back to work tonight so I'm going to feel like a sheep. This situation made me realize I do not know the paperwork needed to send someone else for this facility. I guess I'd better ask as each place is different.

Thanks for the replies! He is on hospice support which is just he;ping stay comfortable but he remained a full code (although they were attempting to get a DNR.) I just feel like a fool and now that I look back, I should have done more and I think "duh" why didn't I think of that? I sure hope I'm not the joke around there :-/

that you lived through and still kept your license? Last night was horrible. I work the 11-7 shift and I'm a fairly new nurse (about a year of full time work) Anyway, I brushed off a patients symptoms as "normal" for his dying/disease process and that is apparently the WRONG thing to do. He had an order for suctioning PRN and had been gurgling for many days now~ it was my first time on that hall and my 2nd day back at this facility after originally quitting for other reasons. I know the nurse the previous night had to suction him and was nervous because the daughter was in the room. Last night, I didn't think anything of the gurgling. I suctioned but he fought so I stopped, I attemped a neb but he took off the mask. I sat him up higher and turned down the air and he almost yanks out his g-tube. He is/was on hospice support but was not a DNR. I didn't think his condition was any worse really so I didn't act on it. The patient went from groaning and combative early in the night and trying to yank out his g-tube (all common things for him) with stable VS to respiratiory distress by the end of the shift and an O2 sat of 2.. yes 2. The nursing superv walked in to find him and called for a crash cart because he had so much discharge coming from his mouth. I had just finished a crazy med pass that I started at 5 but had only taken a 7 minute lunch because the rest of the night was filled with pt drama. I didn't check on him during my medpass and that's when it got even worse. *** He had orders for everything from anxiety to restlessness to sleeping to excess secretions ect*** I feel useless and like a failure for letting the facility and my peers down as well at this man and his family (that I couldn't get a hold because both numbers were disconnected). I feel like I'll be the "talk" of the facility for the next few weeks and there will always be those who lie or make themselves appear better to make me seem 100% incompetent. I don't want to show my face there again but I have 3 more days this week. I don't want to lose my nursing license and I don't want the CNA's to lose trust in me as a nurse. I'm really beating myself up over this but you can bet I'd never make that same mistake again. Who knows if the hospital can save him now? I sure don't. Any words of wisdom or stories to share so I don't feel alone in my lack of nursing experience?

Alright so here it is.. about 8 years ago I tried something bad ONE TIME as a dumb drunk decision- never bought or sold. Anyway my application had very specific questions about selling, possession or buying drugs and they said it would be backed up by a polygraph so I didn't lie. Anyway, I'm wondering if this will affect my application- a dumb choice 8 years ago and again it was ONE time. I don't even smoke or drink now so this is ironic in a way.

Good luck! You will do great!

How can I find this out online? I have been searching all morning and all I can come up with is how many hours are needed per pt in a 24 hr period. I know there has to be some sort of regulation so that facilities don't take advantage of it. I'm a LPN in FL and we need 0.6 nurs hours per pt per 24 hrs. If they have 10 nurses on the day and evening shift and only 3 at night with 1 lpn taking 60 pt's how is that allowed? Anyone have any links or insight? Thanks

Oh my goodness that made me bust out laughing.. thanks for the laugh!

After 1 year of nursing, I can honestly say I still hate where I'm at in all this. I am a LPN (the RN wait list was too long so I did this first to bridge over but then had a baby inbetween so plans got delayed!) Anyway, I live about 1.5 hrs outside of a major city so the job opportunites by me are NOT great. I have my choice of nursing homes basically and the local hospitals do not hire LPN's. I want to be in maternity and eventually in NICU so you can imagine that LTC is NOT what I had in mind. Over the past few months, I have cried and cried about my job. I love being a nurse but I don't like the facilities that overwork people. I have to work nights to avoid daycare (can't afford it actually) and with that, I have 60 patients all to myself! I have tried 3 other facilities and it seems they get worse and worse the more I move jobs. I am miserable and have abiout a year left until I am a RN. I seriously don't know if I can last a year! I hate to be so negative but I really can't help it. It is taking a toll on my life and my attitude and I'm bringing down others around me. Sorry for the vent, I just needed to get this off my chest since no one else listens to me!

So I just because IV certified but I never practiced on a PICC line before. I had a few questions. When the order calls for you to flush the PICC line, do you aspirate to see if you get blood return or are you flushing it just flush it to keep the line open? Any tips on what to avoid or look for? I know learning things on the floor is so much different than in a classroom setting. I am not afraid to ask for help so have no fear, I just wanted to clarify on here.

Oh let me clarify my typo.. it's $25-30 a visit NOT per hour.. I didn't catch that when I originally posted!

Alrighty, I got hired on with an agency BUT I don't know how to tell if I'm getting ripped off with my pay. I live in FL and the pay here is ridiculous. I was told per visit, as a LPN, I'll make $25-30/hr (I can't wait to be an RN). Anyway, how long do "low" tech visits take compared to "high" tech? If I can get in 6 pt's a day, then I'm good. Also, I asked about shift work and they said it depends on the hours and days and would avg 16/hr. I make $21/hr at a LTC facility now working nights and I'm afraid of the pay cut. I DON'T get paid for mileage and they sound very skeptical over how many vists they have available- I'm thinking they don't have enough visits for me to be full time and that's not cool. I'm giving this company a shot because they are giving me a shot. I want to see if I like home health before getting into another company that specializes in HH. The other one I called wants me to pay for my background check- is this normal? I don't think I should be paying an employer anything to get hired on :-/

I'm coming straight out of LPN school with about a year of experience- never before was I in healthcare. I worked in a skilled nursing facility but always had CNA's that took care of dressing, cleaning and bathing the pt. Is this required of HH nurses? I'm not saying I mind doing these things but I'm imagining that it can get very time consuming to do this for 6 pt's a day on top of everything else. Do I have the wrong impression of HH?

11-7 shift here. So I called a doctor at 3am and left message for call back because a pt had hematuria (bladder ca and history of hematuria) Anyway, he only accepts calls after 7 am so he called back as I was on my way out the door. I told him a brief summary of the night, he asked if he was on blood thinners and I said yes and told him which ones. Well, he said hold the ASA, get a pro time and that's where I stop the story. When he said pro time, I could have sworn up and down he said fro teen (I didn't put 2 and 2 together after he asked about blood thinners AND I have only had doctors say PT INR to me so yeah it's my newbie error)... ANYWAY... I asked if he could repeat himself and he did- this time it sounded like 'protein'. To avoid confusion I asked him to spell it out and he went off. Told me anyone who doesn't know what a pro time is should not be a nurse, the pt needs a proper assessment because he doubts I could do it and since he's medical director of the place, he is telling the DON. I simply said "okay" then he asked to speak to someone who knows what a pro time is so I passed him over to my relief. So now I'm the joke of the day and to top it off, I've been hating my job the past 3 months so this didn't help much. *sigh* I can't stand those who forget what it's like to be new...

Here I am, I just paid to take it without applying to EC. I made a deal with myself that if I passed this 1st test, then I would do this program (and I know I can do it with disciplining myself to study). I have yet to pick a date and I feel SO unprepared. The material doesn't seem complicated but for some reason, I got a 64% on a practice test I found online. How long do you wait to re-take it if you fail?

I know diseases can come from anyone, anywhere and at any time. Around my area, it SEEMS that I see more diseases in kids because they SEEM to be exposed to more things (because of school and immune system). I can't help but be worried about my 8 month old. Sometimes I feel like if I go into peds then I'm setting him up for ALL the childhood diseases Tell me to get over it or that your babies survived just fine :-)

My facility does not have a RN at night. Thanks for your help, I wish the people I work with could be as helpful as you all!!!!!!!! I feel so useless sometimes and keep telling myself that one day I will know what to do :-/

My son is 5 months old. I really want to see his chart the next time I'm at the pedi's office. Can I just ask to see it or is that something you usually request in advance? What reasoning should I give if they ask "why"? I want to see what they say about a certain issue we dediced against (that happens to be very controversial and I'm not getting into on here) They make me feel like I'm a bad parent because of our decision and they ask the same question at every visit.

"I'm having chest pain" and you work the night shift at a LTC facility!??!! I'm new, still have MANY things to learn. If a patient says this you have him sit down or elevate the bed, ask him about the pain (intensity, location, when it began and what makes it worse), take vitals, search for nitro or aspirin then do what??????? Do you wait to see if the chest pain goes away with nitro or aspirin? Do you go ahead and call the doc anyway? Do you send him out? What if someone is vomiting and has no order for any anti-nausea meds? Vitals, again question them when it started ect.. do you call the doc or wait until morning if it's "normal" looking?

The pt is fine and the pain went away before the end of my shift. He is recovering from a lobectomy so that explains a lot. You're right, I won't be making that mistake again!

I was reading another post were it was more of a vent about "stupid" nurses. Well, I feel stupid because I don't know what I'm doing and no one at my work cares to explain things to me. I had a "questionable" patient claming he was having a heart attack last night and just looked like a deer in headlights not knowing how/what to assess. The day before, I had a 94 yr old lady fall on her way to the bathroom and again, didn't know what to look for (aside from the obvious bleeding, skin tears ect)... Can someone list some impt things to ask and look for that I can print out and put in my pocket for emergencies like this? I'm trying to better myself so I don't seem like a fool. Our supervisor doesn't get called over. We are the ones who make the decision to send them out.

I'm so frustrated.. I'm mad and embarassed that I don't know what to do in certain situations. Thing is, I SHOULD know what to do! FYI I work in a skilled nursing facility 11-7 shift Here's the story. Last night at work was my first night off orientation. Nothing dramatic happened for the 8 weeks I was on orientation so I didn't get to see what they do ect.. so what happens last night? A male pt walks up to the nurses station and says "I tink I'm having a heart attack" Mind you, this pt has had 2 heart attacks so far during his life. I stand up and tell the CNA's to sit him down and get his vitals while I check the MARS for nitro.. does he have nitro? Nope! So I come back out of the med room to hear his pulse and b/p are fine. His temp was elevated to 101 and his resperations were 38/min. I go back into the med room and see he has a PRN order for percocet or tylenol. Since he had some mild pain and a fever, I choose to give the tylenol.. why? Because I thought tylenol is better to help reduce the temp:uhoh3:. Ugh.. Anyway, after I gave him the tylenol, they took him back to his room and I checked on him every 5 min. The nurse on working the opposite wing said to get him oxygen at 2 liters (Don't you need an order for that??) so the CNA's set that up while I called the doc. The doc gave me an order for Nitro and of course he asked me questions about this patient that I knew NOTHING of (I'm a floater at work and that was my 1st night on that wing- no excuse I know) so I looked like an idiot to him:o. Then I didn't know who to call to schedule an EKG- it's like top secret who they use for services. I didn't know the phone number to the facility I work with (not on the phone or anything) so I looked real smart then too. Plus, I'm not sure what standing orders there are.. I know I should know and will find out later today. This is my first job and first time in the medical field~ I wish this place was more organized. Anyway, I didn't know what to do.. didn't know what questions to ask the pt, I was in so much of a panic! So now, the CNA's probably know I know NOTHING and probably are laughing at me behind my back. *sigh* I feel dumb and know I need to be educated more.

I went to college from age 18-21 but never got my BS or BA in anything because I couldn't figure out what I wanted to do with my life. I ended up leaving college to try different jobs to see if any sparked my interest. At age 25, I went to school to get my LPN. How long can I use my old college credits? Does anyone know? Do they expire? I have ALL the prereq's done from my studies earlier on in life.. I am praying it's not too late so I can at least use them towards my BSN or ADN program. Thanks!

or just that portion that you failed? What about the fee? Do you have to pay the entire fee over again or just a part? Is the wait to retest just as long as long as the first time? Just trying to look at the worse case senario before I decide on which college I go to.. thanks! **Of course- we will ALL pass so there really is no worry right?! :-)**

Yeah it would be nice. I think they should text message your phone or e-mail you the result 30 minutes after the test so you are out of the testing area when you get the good/bad news. I know when I pass, I will yell and scream down the street for a good 5 minutes. I would hate to see what I'd do if I failed >:-/