MisMatch

The issue isn’t operating the lift. The challenge is getting the client safely in/ out of the sling 4 times during the HS routine without risking injury to myself. “Safe body mechanics” are not possible given the equipment, tubes, supply shelves, client’s furniture placement, ect. Thank you.

Thank you all for your responses. As the night shift nurse, I was only getting this client to bed once a week which was not often enough for me to become proficient. The solution was to tweak the schedule so I am not getting them in bed! MisMatch

I am new to home health after working in LTC. My client has ALS, weighs ~200 lbs, no muscle control. They are transferred via hoyer lift from recliner chair to shower chair; after shower from shower chair to bed. Sling must come on & off each time & doesn’t go in shower. I am expected to do this by myself and am not comfortable with this. I have always had 2 people for a hoyer transfer. I appreciate any thoughts, feedback or suggestions Thank you.

Thank you for your imput. Yes, if I was exposed it would have been earlier this year. I have talked to several people who had the typical symptoms (cough, fever, SOB) of Covid-19 before it was declared a pandemic. In my heart I want to be there for the elderly people that I love taking care of but don't want to risk transmitting a fatal virus to them. I want to be part of the solution, not exacerbate the problem. I feel more comfortable pursuing the work I love now.

I am an LPN who worked in LTC. I was terminated 01/20/2020, political/administrative games in an at-will employment state. I have been abiding by the "Stay At Home" orders but need to get back to work. I may have been exposed to Covid-19 but never showed symptoms. I've always had a strong immune system. My concern is whether I could be an asymptomatic carrier or immune. I would not want to start working if there is the possibility I could be a carrier. I would like to be tested but not available yet. Any suggestions/input appreciated! I realize there are no definitive answers to this quandary yet. Thank you!

I am ADHD and think you are likely experiencing new nurse struggles complicated by the challenges of ADD. I have found nursing to be a field that attracts a lot of people with ADHD/ADD so you are apt to find others around with the same challenges. Are coworkers aware of your ADD? Do you have mentors you are working with? Ask others what they do to overcome the challenges. As a new nurse, a lot of it takes time and perseverance! Are you under medical/psychological/psychiatric care for ADD? I was diagnosed in my late 30's and spent years working with various clinicians learning various coping techniques. There are many support groups online for us and they are a great resource to help you with your particular challenges. Since you mentioned inattention, 2 things that have helped me. 1: My watch has an hourly chime to remind me of the passage of time. It also has a stopwatch and countdown timer to cue me. 2: Write it down! Find a way that works for you, a pen & pad of paper, a patient list, something you keep with you AT ALL TIMES to jot notes, assessments, imperative information. I also use color coding with pens and highlighters to cue me for times, red flags, ect. that helps me. Keep in mind the positive aspects of ADD! We can be very creative, innovative, compassionate, empathetic and more...once we overcome the challenges! Best of luck to you!

I have worked at a county run, 300+ bed LTC facility for over 5 years and do not recall any resident ever being "evicted". The facility has a locked dementia unit and a respiratory unit to accommodate trachs/vents. Over the years, I have experienced and witnessed staff being intimidated, harassed and abused by alert & oriented residents who know they can do as they please without ramifications. Many residents are unable to control their behavior due to their disease process. Others are well aware that their behavior is inappropriate/abusive and equally aware that there are no consequences for their behavior other than an occasional "counseling" by management or a doctor. There are several residents who, IMHO, should be evicted but never will because as a county facility we are obligated to care for them. There is nowhere else for them to go.

Venting is good! I was in your shoes 4 years ago, wondering how I would ever develop proficiency in getting everything done each shift. It has been a long journey, taking 1 day at a time (sometimes 1 minute at a time). There are good days and bad days (sometimes good weeks & bad weeks). It took at least 3 months for me to no longer feel like a fumbling idiot then another 3 months before I had any sense of proficiency. At the 1 year mark, I sighed, relieved that I believed I could handle it. Now, I still have times of exasperation alternating with proficiency. Find good support "mentor" nurses. I went to mine a lot for the first 3 months. Mine weren't assigned by the facility, I sought out those experienced nurses that I respected who were willing to nurture (not eat) their young. They knew I was a willing learner, hard worker and able to do the job. They also knew I needed lots of guidance. Watch other nurses, ask them questions, ask for suggestions, observe "tricks of the trade" that work. You will eventually develop a plan that works for you. Give yourself time. You sound like a wonderful conscientious nurse. It does get better!

What type of abuse - elder, domestic, child? There are agencies that work specifically with each group, and they can all give you information for screening. I'm sure there's plenty of information on the internet from the various abuse support groups outlining what to look for and/or what to ask which will vary according to group/type. Once you gather the information, you will be able to piece it together to come up with a template to suite your particular situation.

The best orientation I got at my facility (LTC) was by agency nurses. As a new nurse, the 2 mentors I looked up to most were both agency. Many of the regular staff seemed to like throwing the new nurse in the deep end of shark infested waters to sink or swim. If not for my agency mentors, I'd have been ripped to shreads and drowned.

:redpinkhe THANK YOU so much from another night shifter :redpinkhe I am a night shifter by choice and love the challenges of night shift. I wouldn't work as well with the politics, drama and administrators looking over my shoulder of day shift. At the same time, I get tired of the day shift attitude of "night shift doesn't do anything" and the belief that all the patients sleep all night. It's nice to be recognized and appreciated for what we do!

I graduated at the age of 52; am now 55. My age did not hinder my ability to find employment. One of the biggest challenges comming into a new facility though was people expected me to be much more experienced than I was. I simply explained that I was a new grad. 40 is still young!

This is a timely topic for me. I have a drs appt in the AM for the same problem described here, sleep a lot, always tired, lethargic, no energy...and yes I work night shift, have since I started working in LTC 5+ years ago. Thing is, I LIKE night shift, have always been a night owl and enjoy so much about it. The chaos, egos, politics, administrators, ect. keep me from wanting to work days. I have worked all 3 shifts but prefer my night shift. This is all definately "food for thought". Hope more is served up!

At the community college I attended, entry to clinicals is very competitive based on a point system, ie: GPA is worth 4 points; A&P classes A=4pts; B=3points; C=2 points. Total possible points is 50 for LPN and 100 for RN; admission starts there and descends until all spots are filled. You usually need 43-45 points for LPN and 92-95 points for RN to get into clinicals. Despite that, of 24 admitted to our LPN class, 9 graduated.

I attended a community college LPN program. There were prereqs and getting into clinicals was very competitive. Despite that, of 24 that started the year long (3 semester) clinical part only 9 graduated. Most were lost in the first semester; 2 were flunked out Many were unable to keep up with the enormous workload, especially those with families and/or working. The school bragged about their 100% pass rate for the NCLEX. It was said that those the school didn't think would pass the NCLEX wouldn't get through the program. Grading is both objective (written tests) and subjective (grading the clinical work). There was definately favoritism when it came to subjective grading.

We have pictures in the MAR; most have their name and photo outside their door. Some pictures predate their admission, so it's not really a good idetifier. The pictures do sufice as an identifier, along with the wristband to appease the surveyors. What I like about LTC is that I know my residents, including the ones with dementia. I only use the identifiers when being audited or surveyed!

If we had that kind of staffing, we might actually be able to give adequate patient care! The floor I work on has 3 LPN's and 3-4 CNA's for 70+ patients! Of those 70+, 12+ are vents/trachs, 20+ are tube feeds, several challanging psyc patients (including 2 who exercise their "right" to refuse their psyc meds and create havoc) and numerous dementia patients. There is no way we can adequately complete our assignment. We do the best we can with what we have - and we have a hard-working, caring crew!

I went through nursing school and have worked at 2 facilities while taking Adderall. When I went for the physical/drug testing, I needed to show that I was prescribed it when being drug tested. Nursing school required a letter from my doctor detailing why, how long I'd been on it, ect. There have been no issues for me. Adderall is one of the many tools in my ADD "tool box" that helps me focus, stay on task and get through the mounds of paperwork efficiently. Doing a med pass in LTC with all the meds to pass, tx, interruptions would be quite a challenge without it!

The LTC facility I work in has precautions for C-diff, MRSA & VRE. Gloves and gowns are stocked on the door of the room with that patient. Gloves and hand sanitizer are everywhere. Personally, I wear gloves for checking blood glucose and antibiotic eye drops for those with eye infections, but not for routine eye drops and nose sprays. Protocol is to sanitize hands between each patient, soap & water handwashing after three patients. As for scheduling, nip this one in the bud! Let them know what you were hired for, and demand that they schedule you no more than that. They will push you to work as much as possible. If they told you 1-2, already are scheduling you 2-3, guarantee they will be nagging you to pick up 3-4 and calling you to work on your days off.

Thank you all for your responses. This is a government run facility and has many residents that no one else will take. Yes, some of these residents have mental illnesses. They have medications but have and exercise their right to refuse. There have been psyc consults and social services interventions to no avail. If they become a threat to other residents they can be sent to a psyc hospital. Some know how to play the game to keep from crossing the line. For now, I have as little contact with these challenges as possible while continuing to learn how to deal with it.

How does your LTC facility deal with alert & oriented residents who are abusive to staff? I have been a nurse for 2 years now, and still struggle with this. I have no problem with the dementia residents who are unaware of their actions and language (which can get quite colorful!). There are ways I have found to work with this and I am not bothered by the words that come out of their mouths. I do have a problem with alert & oriented residents who regularly verbally and physically abuse staff with no repercussions. They will yell, curse, hit, kick, bite, spit, ect. and the most we can do is assure they are safe, walk away and chart. I asked the supervisors and was told basically that "it is what it is" and that I should have known it was like this when I got into nursing. They also say it is their illness (ie: CVA, mental illnesses) Is this the norm? How do you deal with this?

Let me start by saying I don't like the way scheduling is done at all, especially since I work night shift, FT, five 8 hour shifts a week. We get every other weekend off, which is the only time we have 2 nights off together. The rest of the schedule will be 2-4 nights on, 1 off. There is no method to the madness, schedule is computer generated, no "regular" time off. I am a true night shifter, have no desire to work days but the way they schedule is a challenge. I would love to work 12 hour shifts!

They recognize us by writing us up for any & every error we make. They reward us with a pay check every 2 weeks. They motivate us by reminding us how lucky we are to have a job. Twice a year, they serve us a meal (Christmas & summer) and give us a gift. Last gift was an umbrella they told us not to use in windy conditions or it would break.

Our weekend for nights is Friday & Saturday nights. Our place (LTC) pays time and a half for them, plus the regular $.60 night differential.

You mean there are LTC facilities that are appropriately staffed? Where?