Luv4LTC

I agree. I am an LPN, and senior semester RN student. My advice is be proactive! Talk to your instructors first off. Mine were not very helpful as far as study advice, but I did find that mine mostly "only mentioned what is important to know". So do whatever you need to to pay attention. Some even repeat things 2-3 times. If it is highlighted, bolded, in a box, or written on the board, you better know it. Next, find out who DID do well and ask them their secret. (Make friends with the smart kids;) Talk to the class ahead of you, find out how your instructors test. In Fundamentals, your book probably has free study questions on it's publisher's site. Go there and create a log in to find them. There are probably also test bank questions you can purchase of your Fundamentals from a couple editions back which have rationals. These have been life savers for me! Google it! Pharmacology, I found to be a lot of memorization. I used index cards and kept them on me. I used them at work, while driving, in the tub...you get the picture. Also, when it comes to the math, do extra calculations. Practice, practice, practice! Lastly, people study differently. Find YOUR best way quick! Mine is perfectly quiet without distractions, hours at the time, no phone, no music, no television. I study at home IF no one is there to bother me. Sometimes I go outside for a bit (we live in the country), or I go to the back of the library facing a wall. Some people like study groups, I do not. I find there is a lot of time wasted. If I am extremely tired, or distracted, I stop. I ONLY read sections that I am struggling with, and things in boxes. Don't just read to say you did. It's too much! Hope this helps, hang in there!

I have been in LTC for many years, in GA and CO. Unfortunately, it seems, these issues are the same in facilities everywhere. I agree that once you get to know your residents and staff, it will get better. However, that is the scary time when I think there is a greater chance for errors. All you can do is be extra careful and vigilant (which is your personal best). I also agree that unless you make friendly with the CNAs you are doomed. Some will never do what they are supposed to do, but most really do want to be good CNAs. The best way to accomplish this is to make an effort to learn their names, genuinely compliment them for handing vitals in on time, answering a light on time, ...anything you see or can think of. Then, always try to thank them as they head out. (Since we usually don't get to clock out together. Nurses are trying to finish our work:/) The massive amount of pills I don't think will ever change, it may get worse. I have left 2 facilities, in my career, within my probationary 90 days because they were so bad. Both had an extremely good hourly pay rate, and bad state ratings. The pay IS NOT worth it! These days, I am choosey. I work in smaller facilities where I will have less than 30 residents. (Even that is too many.) I always start with the mentality that If I can't get up to speed, and feeling comfortable in a couple weeks, I'm outta there! Chances are, if you aren't feeling right; something IS wrong there. Oh, and I'm working mostly day-shifts when there is a charge nurse to take off orders, a wound care nurse for treatments, activities to keep the residents busy, and I'm not required to go to the dining room to feed. Best wishes to you!

you know that's such an important point. if you really like the people you work with, then it's worth it to stay put.

sometimes if you get into an interview with a certain nurse manager, they will try to work it out for you. for instance, if there is someone who wants to do the alternate 7 days. at least, i was told that quite awhile back. it might be worth a try?

:smackingf oops! sorry i posted x2. don't know how to delete.

i'd say more than just helpful. as a brand new nurse in ga i was cross training in l&d one night. ems called to say they were bringing in an active labor who spoke no english, and they got no hx. we called our spanish translator who wasn't in house, but lived nearby. when they finally got there, i checked the pt, and found her crowning. i was unable to understand that she was a g4, and her water had broken some time ago. the pt was histerical, had no iv, the charge nurse was on dinner break, no ob in the house = baby in the bed. [color=#00bfff]here, in co i have several bilingual residents, work with 2 bilingual cnas, and another cna who barely speaks or understands english. ya gotta be able to communicate with pts and staff!!! [color=#00bfff]the health dept., schools, state run programs, etc. (jobs with great fringe)are always advertising here "bilingual only apply".

i'm a newbi too, and this is another thread that shows how everyone has a different opinion. that's a good thing 'cause we can learn from others. unfortunately, everyday as nurses we have to make these kinds of judgement calls. usually i feel alone. like someone said if you don't call you get slapped. i hate calling the docs because i have been driven to tears so many times - for calling and not calling!?! (yes, i'm a crybaby.) so, i'll do almost anything to get around it, which isn't good. i too have worked where we had to "clear" calls with the house super. before we "bothered" the docs. that is ridiculous! our patient's best interest is what's important. if the patient is lying there worried or agitated then they aren't healing! did anyone see patch adams? i'd love to shadow him for awhile. hope to visit his facility some day. [color=#00bfff]thankfully, in our ltcf we deal with nps, and hospice a lot - much kinder.

I've been a "coumadin cinic" nurse at a large cardiology practice, and loved it. (the pay was crap... but I digress.) Anticoag therapy is challenging, especially for patients. I agree with the info you've been given. There is a mind boggling amount of info out there concerning this topic. our clinic was governed under the guidelines of the American College of Chest Physicians as far as target ranges and coumadin titration are concerned. Which is really pretty simple once you get the hang of it. -Managing your INR however is not. you can check out the ACCP website @ http://www.coumadin.bmscustomerconnect.com/ has interesting info.

in my ltcf we take tos everyday from the dr.s nurses. we rarly ever get to actually talk to the dr. (or should i say, have to talk to the dr.) we relay info back and forth via a "remote" nurse and messaging system.

breaks?!? what's a break??? i need a break!

so, who do you think you are - "nurse sunshine" or something? seriously, it sounds like your coworker has issues that really have nothing to do with you. no one has ever been too kind. maybe she needs some psyc meds. scarry to think people like her work with our loved ones, and i do see some of that where i work. you sure made me check myself. hum, who do i want to grow up to be like? ?

you know, i was also told by a recruiter that u of p does not offer lpn to rn, only rn to bsn. maybe that's because i'm in the springs not denver? it sounds too pricey for me anyway.

i'm another who is totally exasperated with the lack of choice. we moved to co from ga 2yrs ago. co is much less accepting of lpns. i do love ltc, but sometimes i need a break! i think there is a conspiracy. in the last few years i've noticed a trend, first off, pn and rn programs have added more classes (= more $$$) required for graduation. they no longer accept previous college credits past certain time limits, and those limits are narrowing (= more $$$ to retake classes). in co you must be "iv certified" for certain jobs (= a several week course and more $$$). certain states do not recognize on-line degrees forcing us to go to pricier campuses (= more $$$). someone is getting rich at our expense! there is such a shortage in this state, and they are shutting out lpns?!? is there anyone in authority anywhere who cares about any of this?!? i want my rn so bad!!! does anyone know if there is financial aide for on-line? i'm pretty sure co recognizes on-line, but i just can't afford it right now.

thanks nurse hobbit for reminding me to check out the site. my brother is ***, i think he's in rehab now. flex would get old eventually, i guess. by the way, i think i remember meeting you. i did 3-11 and 11-7.

hi lilypad, wow, looks like you got slammed with responses to this one! sure am sorry you've had such a bad experience so far. i've been in lots of "health care" settings in my 20+ years, and it can be (and is) tough all over. (i say "health care" tongue-in-cheek, because nursing has become so much other than caring for people and their health.)so, brace yourself and hang on for a wild ride - or bail before there is too much invested. i fought myself for years to get out of nursing, but i was born for this. were you? hopefully it won't take you 2 decades to be able to state that and really believe it.