AimeeJo RN

Don't be so tough on yourself. I feel your pain, that really sucks. I still have nightmares about waking up late and missing the NCLEX or failing. And I passed it almost 2 years ago. It is just stressfull.

I have to say congratulations for thinking things through before making such an important decision. I would say that LTC is a good way to start to get familiar with Geriatrics which is a large part of the population in Med/Surg. It helps to learn time management and basic old people meds and conditions. However, you could start in Med/Surg many new grads do well there. I would not compare it to school/clinicals, it is much different when you are on the job. I learned so much during Orientation. I felt that orientation on the job is where I learned all the things I wish I had learned in school.

I have seen this happen before. It is very hard to believe, though it happens. Before you know it she will be back to working with medications. Has anyone mentioned the fact that the patients may have been recieving no pain relief when given what the nurses believed to be Morphine for all those years. Diversion is bad enough but when it comes at the suffering of those who trust us, IT IS NOT A VICTIMLESS CRIME. That breaks my heart.

Don't get me wrong, I take the same great care of all of my patients regardless of their diagnosis and social habits, and I know this thread was meant to be humorous. That being said I have to say that the most disgusting thing encountered at work is the damage done by drugs and alcohol. When the same patients are admitted several times for various illnesses and injuries related to intoxication and years of self-neglect. Infections from IVDA, hepatic encephalopathy. And the unfortunate families that hold vigil at their bedside time after time.

I agree with the previous posts that recommend years of experience first. It is great to work with travelers because of their experience. We have had several travelers at my hospital and many of them were male. They are a great asset to the team.

prosthetic eyes, removing or inserting them gives me the willys. and colostomies

Don't feel so bad. It is not your fault if you are busy with other tasks. You cannot be there every time a resident is cleaned up or toileted, what are you supposed to do apply the creams in the dining room or hallway or wherever they may be 90% of the time. Long term care nurses have responsibililties and tasks piling up constantly you can't do everything just because you are supposed to.

Thanks for the info. I have a suggestion as well. At my last job we had a patient who ended up with peritonitis and sepsis, when his suprapubic catheter was changed 4 times in less than 2 days, the nurses were having trouble with the catheter and each shift decided to replace the catheter. Finally after the fourth change when the nurse noticed the catheter flushes weren't coming out into the drainage bag the MD was notified. Somewhere along the way the catheter was in the wrong place.

Baldwin for chemistry, he is awesome. Ferguson for A&P. Elauria for Micro.

I have heard some nurses especially new ones have a difficult time getting hired. It seems like Franciscan hospitals hire quite a few new nurses. Residencies are a great way to get started if you can find one. PM me if you want details.

I almost took a job with an agency. They wanted extensive personal health information. Even with pediatric patients who will not be a challenge to transfer or lift, they want to make absolutely sure you can do the job and no issues will get in the way. The process was way more involved than I had imagined.

Washington state. LTC, New grad, 22.87 hr plus 1.50 eve/night differential, and 3/hr weekend shift diff. Looking into hospital residency starts 25.50/hr with 3/hr shift diff. No guarantees about the weather, though I am not complaining.

I had a patient a couple days ago tell me all about how alfalfa tea would keep you from getting grey hair. She says I am 65 and have no grey hair. Nevermind the fact that I am looking at a completely grey haired 85 year old. I just smiled and told her how nice she looks.

I work in long term care. This evening I found one of my residents almost unresponsive. He was blue, O2 sat of 59, pulse of about 130. Needless to say he had a pulse, turned out to be new onset afib, and he was breathing. Anyway, I called for help from some of the staff members, sent one aide to call 911, and while I am setting up the O2 tank I turn around and one of the aides is doing chest compressions. I stopped her immediately because he did not need CPR, she just panicked. I told the supervisor, tomorrow we will be having an inservice about CPR. UGGGHHH. I sure hope this resident doesn't remember this part later, that would be terrifying, especially since he has ALS and will probably actually need CPR in the not too distant future.

I don't have advice, just hugs and prayers. I am sorry to hear about your dad.

That doesn't sound safe. The tegaderm could be removed accidentally or on purpose. And do we even know if the patch would have an even concentration/distribution of medication throughout the patch. You could not be sure of the dose your patient recieves.

Nclex books are a good resource. I once read an article called the ABC's of ABG's it had questions at the end, for continuing education. I don't think I have it anymore. I have a screaming toddler on my lap or I would look up some things for you.

Try looking up previous threads or articles from nursing journals. medscape is a good website. You could look up acid base balance, electrolytes or other contributors to abg disturbance, if you learn the pathophysiology behind the changes in pH, co2, bicarb and so on you may remember it better.

Thanks for the advice everyone. Today when I went into work they finally had me sign something for the RN postition. I think they had just set my papers aside and forgot about them. There is not much of a difference between LPN and RN job description where I work. Just a bit of extra paperwork which I have been doing. I am probably not going to stay there much longer I need to get some acute care experience.

My RN license is active. They all knew I wouldn't be an LPN for long when I was hired, I was waiting to take the nclex. Everyone knew when I passed the test, people I barely knew were congratulating me. The pay increase will probably not be that great but every bit helps. I am trying to figure out if I should look for another job, waiting to find out the pay before I decide.

possibly serum creatinine, renal patients are at risk for electrolyte imbalances

I am beginning to wonder how much longer it is going to take my facility to switch my pay. I have been waiting patiently, and I still don't know what my hourly wage will be whenever they make the switch. I was an LPN, got my RN a month ago. I wouldn't complain if they gave me some kind of answers or updates. HR has failed to return my calls twice and the DNS just says the paperwork is in the works. Has anyone had a similar experience? How long should it take? :typing

It's worth a try. Education is important, maybe they will work with you maybe not. Congrats on your educational ambition, and good luck.

That is Bull. Funny how we are not supposed to come to work sick and infect others, yet they leave us no choice. I have a similar complaint at my job, there is no such thing as a 15 minute break and usually no time for lunch either. They send out memo's saying it is mandatory to take our breaks, S#@T we are lucky to use the restroom and scarf down a snack.

It depends. I am trying to get into a residency program where I live. It doesn't require any more schooling, than my RN degree. The residency program (if you don't know), is usually a few months of on the job training and classes at the hospital, along with working with a preceptor until I am ready to work on my own. There are some classes required that the hospital may offer, such as ACLS, Advanced Cardiac Life Support (usually a 2 day class for a couple hundred dollars). I believe you can get your CCRN certification, (Critical Care) but it is not usually required. Hope this helps, I am no expert, just begining to work my way into ICU.