Anne36 LPN

The cheapest family plan where I work is $660 a month. (that is 25% of my take home per month) The deductible is $3000 , 80/20 PPO, $40-60 co pay for office visits. I cant afford it right now so I am without insurance. I am probably going to shop in the marketplace.

I only call the Doctor for emergencies on third shift. If there is no standing order than I write a communication to the Doctor for the request or I pass it on to the next shift. If I am unsure about a dressing, I do what I think is best at the time (without writing an order up) and leave a message for the care manager and a communication for the Doctor.

I have been an LPN for over 3 years now and I get the same comments and questions. I have no intention of going back to school for my RN. I do not want to work in a hospital setting or take on more responsibility than I have now. In fact I have thought of exploring other career paths to improve my income that do not include nursing at all.

I took the nclex 3 months after graduating. I studied for about 4-6 weeks before taking the test and passed the first time.

On midnights I start by doing midnight meds, stock carts, treatments such as bandage changes, skin assessments (they want all of these done on midnights if possbible), some residents get up at night, mostly the ones with behaviors. Last night I got hit over the head with a clipboard as one snuck up behind me at the nursing station. Charting, careplans, pharmacy. Depending on the night, anything that goes on during dayshift, patient care, calling the Doctor if needed, etc. In the morning we start morning med pass until the day shift shows up, this means a mad rush the last 2 hours of the shift. In other words we have plenty of work to do on midnights, Ive missed breaks many times.

The Long Term Care that I work for does not pay shift differential ( I work Midnights), but they do pay holiday pay. This is my third year and I am still not getting a week of vacation time yet. First year, no vacation, second year was 3.5 days. I would take vacation time upaid and have had a few of those days but last time I got someone to cover my shift for me so I could take a day off, they wouldnt allow it. I have had almost no vacation in the last 3 years and Im very burned out.

I was told at work today to not ever chart that I called the Doctor or that I informed the Doctor via the Log book (Nurse to Dr communication) about a problem with a resident. Wouldnt it look like I did not share information or follow up on a problem?

I understand how you feel, we really dont have anyone to fill in when there is a call off or even if someone takes a vacation day. I was just sitting here contemplating calling the DON to complain or vent about the current situation. For the last several months we have been working with only 2 nurses on midnights about once a week. In the past week it has happened 3 times! I had a terrible morning, and to top it off the day nurse actually had the nerve to ask me who I passed morning meds on. I did my job and did not have time to start in on the morning med pass. Me and 2 other midnight nurses are seriously considering looking for other jobs. I think it would be great if we all turned in our resignation on the same day. I think it might be worth your while to look for another job to at least see what is out there.

We can get into the central supply closet but I probably worked there for 6 months before I found out the code to get in. At one point they were making us sign out wipes and most recently they have taken away the medical grade nitrile gloves, now they are only reserved for people with allergies to latex. The other cheap poor fitting gloves are terrible for giving suppositories or for wound care, they dont fit as well and stick like crazy to tape or any other dressing that is sticky.

I would be glad to participate in this discussion. Today I clocked out late at 0730, but I actually stayed charting until about 0820. I was so mad by the time I left. I rarely stay to chart late, but it was unavoidable as I had a resident fall during my med pass which my shift happens to run out on so I could not stop med pass and chart and then catch up later. I had to try and do my assessment and carry on with med pass at the same time. I am not very fast at that type of charting and it is lengthy documentation both in the computer and then done again on paper. I feel that the Incident report and charting in the residents private chart are redundant . I decided to clock out early because I was already racking up overtime which is basically forbidden. I do see a few nurses who regualarly clock out and then come back to chart. I dont do that anymore unless it is something involving an incident report. Too bad I dont work nights, because I hate to be seen sitting at the nursing station after 8 am when the DON and Administrator walk in. I wished I was invisible at that point because I know all they are thinking is what is she doing here and how much overtime is she getting. The fact is that there is not enough time to take care of tasks and real nursing care or assessments because we have too many residents.

Staff gets verbally and physically abused everyday where I work. Not everyone can be redirected. and we have a lot of psych residents along with our combative dementia residents. Recently another Nurse related to me that a corporate suit was in recently and commented to her that they do not care if staff is hit , etc. Welcome to long term care. This is one of the reasons why I want to find another profession eventually.

I feel the same way where I work. The midnight shift is treated as if we have nothing to do so all the busy work is pushed off on our shift, like stocking, etc. We are very busy with midnight meds, a full a.m. med pass that starts at 4 or earlier to get done in time for 6:30 shift report,they want ALL the skin assessments done on midnights and now orthostatic blood pressures of all things! Can you imagine being woken up at 1 am to get an assessment and then sit up to get your blood pressure taken for the second time? Also, we are supposed to do as many if not all dressing changes and treatments. I think its criminal to wake these people up by 6 am. We usually have at least 14 people up on the hall by 6:30 am. The day shift treats us like ugly step-sisters who are there to make shift a piece of cake.There is only time to do the bare minimum nursing care, God forbid anyone gets sick or needs extra attention.

I wish violent/agitated behaviors were as easy to solve as being diagnosed with a UTI. Sorry, I get tired of hearing that one, especially when these people are already diagnosed with psych disorders and are on medication. I have not really seen changing medicaiton help, and I have only once seen a resident get sent out. I have had a Doctor recommend it in one case, but no way in heck are they going to send anyone out from our facility, not even after a resident has shown to be a danger to themselves or others. Many of these peolple do belong in geri-psych but they are now just getting mixed in with regular nursing home populations. I cant tell you how many times I have had a resident yelling to get so and so out of their room. With very limited options, all we can do is stand by and make sure they dont hurt themselves or someone else, (restraint free) too bad we are not staffed for that type of care.

Ive been working in LTC for the last 6 months. The longer I am here the more I feel that I am just working in a psych ward. It seems like 80% of our new admits since I have been working here are geri-psych. They are medicated for their psychosis but it does not seem to touch them. I had to call the other day to get an injectable ordered for a resident who refuses her oral meds. By the time I got the med ordered she had scratched, kicked, hit, and thrown objects at all of the staff, some of us were left with scratch marks and bruises. These people monopolize the nursing staff time to the point where all we have time to do is watch the psych patients and pass out meds. I feel that I have to run my entire shift around these residents. Its not fair to the rest of the people who need my time and attention. I work midnights and have a hall with 36 residents and 2 aids. Most nights the psych residents are up, and need 1:1 care. I dont know how to make my nights manegable when these people wont stay in their seats and constantly set their alarms off trying to get up or scream the house down all night, medication or not. Some of these people are 2 person assist when they get up because they are combative and large fall risks. Any advice would be appreciated, I am so frustrated.

I have been told that it takes most new grads at least 6 months before they start to feel comfortable. Ive been working for about 6 months now and still have tons of questions and not always certain of what to do, I often ask another Nurses opinion and call the Dr if in doubt. I dont get nervous before I go to work anymore but I do get a little wigged out when a resident goes downhill or I am faced with a new situation. One of my biggest problems right now is trying to leave my work behind when I get home so that I can get sleep. I rethink my night over and over again, and worry that I forgot something, etc. Give yourself some time , it will get better.