sixes

I work in LTC as the charge Nurse it is frustrating when I need to call for an ambulance. You must remember that most of our residence have some form of dementia and can't always tell us what is wrong . We know our residence and we must us our nursing skills and usual habits of our residence. Nothing burns me more then when a paramedic walks in and says. Well what did you call us for.Resident is DNR. Well just because they are old and demented doesn't mean they have to suffer. One of our residents goes into CHF often we have orders. Asprin 81mg chewable. Nitro patch o.6mg; Im lasix 40mg; repeat Lasix if not resolved. Call ambulance if not resolved in 20min. Paramedics arrive on scene and say why did you call us? Just because our resident has dementia doesn't mean they have no quality of life When she is well she attends the hairdresser, church crafts etc. Just because they don't know where they are or what year it is doesn't mean they deserve to suffer Sorry for the rant My point is that my job is to make sure they have optimal care. In a long term facility we are limited in what we can do and the eqiupment we have. Please don't look at me like I'm a complete idiot. I get that enough from the ER docs. I even had one DOC who sent a Psycotic resident back to me with an order to only give him plastice utensils. Couldn't understand the problem of sending him back to a secured alzhemiers floor. He said "it's a secured unti isnt it" A secrue unit in LTC isn't a secured unit at a psych. Didn't seem to understand that i had 37 other dememted people walking around and that he posed a risk. P>S> the paramedics called for police escort so why would we be able to handle him??? Please advocate on behalf of these people. Believe you me I wouldn't call for you if Our facility was equipped to deal with the problem at hand Most of you are great to work with and I appreciate the hard work you do

I'm lucky Chantal's mom makes all my uniforms. She has the unusual nack to make every thing fit perfect. I am short 5 feet and have no waist . She even makes us little scrunchies to put in our hair Life is sooooo good

I was doing my preceptorship on a geriatric ward. This very pleasant huge lady 350+ lbs was admitted to our unit. She had a very funny smell. I was assigned to do her admission bath. We decided to do a bed bath as I felt it unsafe to do a tub transfer. she had 3 large abd. folds when i reached the 3rd one I lefted it to clean There were little white bugs running hither and skither. There was a hugh open wound, I didn't know what to make of it so I called my preceptor. Gross they were maggots. Called the Dr. Who was a wound specialist. His orders were to clean the wound but to try and leave the maggots as they were debriding the area, gross

At our facility you get 1 day shift 2 evening shifts and 2 night shifts. Evenings is the biggy as you have meds coming in and are responsible for the building Nights is not bad although you have the building things are usually quiet (haha) If you feel you require more orientation them what is offer ask for more all they can say is no Rely on the staff the first couple of shifts they are a great resource the HCA's know the residents and seldom will they lead you astray then of course you must assess and implement. Good luck I love long term care in the past 18 months i have adanced from part time RN working mostly nights and evenings to my new position as full time charge nurse/unit manager I love it

I also work in Canada Ontario to be more specific. We have 3 RN (unit managers) on day shift weekdays with 3 LPN's on Evenings we have 1 RN supervisor with 3 LPN's and on Nights we have 1 RN supervisor with 1 LPN the rest of the staff are made up of HCA. The HCA are the best you could find and we rely on them immensely with out them life would be HE**. Our LPN's are responsible for the medication passes and general assessments. As a Unit Manager I am responsible to ensure the residents have all there needs met and I chip in and do anything that needs to be done at the time as well as deal with family members and paperwork Doctors etc. Our system is great and it works. On my floor we work as a great team and in reality that is the most important. You need a good team leader regardless of the title.

I hope you don't mind but I printed this to take to work. This is the best one I've read yet Thanks for starting my day with a laugh PS I have 6 children aged 15-27 amd 1 grandchild I think I'll re print this on some fancy paper and includ it with the kids Xmas cards

Comfort measures at our LTC means they don't get sent to hospital only comfort measures this is Advance Directive #1 Advance directive #2 Comfort measures with the addition of antibiotics Advance Directive #3 To hospital for assessment and treatment No CPR no Intensive Care Unit We follow this strictly we always discuss each new finding with the family or resident as everyone has the right to change their mind Hat s off to those who advocate on behave of their clients who can't do this for themselves anymore

undefinedundefined just a little history first. i was a health care aid and then became a registered nurse assistant then a registered nurse. last year i took a job in ltc as a supervisor, now i am a charge nurse. i have the greatest respect for anyone working on my floor regardless of their personal title. the hca's work their fingers to the bone, they never hestitate to do something if i ask and the lpn's/rna's are very hard working. i seldom need to give them direction. when they ccome to me for direction they are informative and have all the information gathered for me to make an informed decision. rarely they have misjudged something. i personally love having rpn's. at out facility the only things lpn's can't do are the following. injections, cathetars unless they have been certified. g-tube feedings. i love my lpn's they are intellegent and dedicated if you want hands on in ltc lpn is the way to go if you want to push a lot of paper then rn is the way to go it is all a very personal choice good luck in whatever you do

I don't nknow what LVN stands for sorry in Ontario we have RN, LPN, & hca/PSW. When I am on as a Supervisor I Have 157 residents & staff (evening shift) I also have 3 RNA's who do the med pass and 1 RPN from 1600-2000 who does treatments, vitals etc. I have 4 HCA per floor (3). On Nights (3) floors I have 1 RPN & HCA on 3rd and 2 HCa on 2nd and 2 HCA on 1. On weekend days it's the same as evenings. If we are short a RPN I have to do meds on that floor ( doesn't happen often) I have recently been promoted to a temporary Charge Nurse stricktly days and every other weekend. I find this harder then when I supervise. I have only 57 residents on my floor but with the paper work, families, Doctor's and all the care plans etc. I find I don't even have time to change my mind never mind anything else. My DON believes this is because I spend too much time doing other people's work Ie toileting, feeding, Lifts& Transfers etc. I like the hands on. I especially like being in the dining room at meals and doing the treatments. I usually have to stay 1.5hours after my shift to do paper work and this weekend I went in on my own time to do care planning. I'll eventually get organized and learn to prioritize but until then I guess I will feel constantly behind the 8 ball. I get great reviews from my staff as well as the DON, for my enthusiasum and dedication. I love my job and all the the staff a very dedicateted including management which is rare You'll do fine. If you are feeling overwhelmed. Ask your supervisor for direction. Good Luck

I was a supervisore at the LTC where I work. I have recently taken the temporary position of a charge nurse. The above statements are disgusting. this would never happen in the LTC where I work. If a residents needs attention they get it. No residnet is allowed to sit wet or for 12 hours at a time. If our DON came to the floor which she does frequently through out every shift. Also our cooperate head office make spot checks on every shift 2 times weekly. And try as you might you cannot predict when tis will be. Everyone and I mean everyone on the floor would be fired. This is bad get out of where you work and report it to the College of nurses. the CCAC and your government officials for LTC and if all else fails call the media. No one should live under these conditions

Remember it's ok to cry I know work in LTC and losing someone never gets easier The worst for me was when I lost 2 very wonderful people in a two week time frame I was doing home care then the first was a 45 year old man wiht CA to the esophagus. I had spent every night at his side for 5 weeks. The next was a beautiful 13 year old who had eving's sarcoma. I had been her primary care giver for 6 months. My son was the same age and they went to school together. We had many good times and made it through some very rough ones Just days before they were told by the speaclist that the tumor was gone, he failed to mention the spread to her brain I was so devastated that I had to leave nursing for awhile Her Mom and I are still best friends and if it wasn't for her I would not have returned to nursing She instilled in me that I can't save the world and I can't always stop the pain but that I can be there to make their lives as full as possible and assist them to the end with all the love and compassion and dignity that GOD instilled in my heart The families will always remember the kindness that their loved one recieved Remember to always be kind, caring and compassionate in every thing you do

I just love this one mind if I copy it for work???? Have a great day

I work in LTC and I am the supervisor for the entire 3 floors 157 residents I work with the team of course I have too do my job first and for most but I never walk by a call bell and yes I still toilet change beds feed residents what ever is needed I do. If I have too of course I can rely on the wonderful staff I am very lucky because I hve wonderful RPN's and hard working wonderful PSW's

I moved to North Bay 1 year ago It is a beautiful City Not to big and situated on Lake Nipissing Lots to do here Camping swimming shopping everything you could want and more

I was a HCA now PSW then I took the RNA know LPN then I took my RN. The experience is great. I find because I took all areas of Nursing it makes me a better RN. As I've been there and done that I have contemplated taking the BSN but at this time in my life I am happy whrer I am I work in a long term Care facility and love it Good Luck in what ever you decide to do

You don't show up in June with skis and wonder where the snow is... You know that people in the north don't all live in igloos and drive dog sleds... You don't think it is cold at -40 When winter starts in October and continues through to June There is actually snow at Christmas ( thank goodness, I'd hate a green one) When hot means it's 80' F

undefined I have only runn into this once. I had an RPN screaming at me in the dining room how unprofessional I was. It started because I said so-so outside call on line one She was shrieking that I should never say outside call ( where else would the call be coming from?) Instead of getting into it I simply wolked away.I mad a mental note to myself to speak to the DON about this outburst in the dining room It was the weekend and then I was off Mon. When I returned for my evening shift Tues the DON asked me to come into the office at my earliest convince I did The conversation started with DON"I have had 6 staff and several residents in here today" " would you like to tell me what happened this weekend?"They had all gone in on my behalf as they didn't think I would stick up for myself I explained what had happened and told her I just walked away that I would not in any situation give anyone screaming at me the satisfaction of a rebutal or response After work the RPN approached me outside after work I was prepared for it as the DON gave me a heads up She asked me what my problem was and what had she done to offend me I calmly told her that I would not be spoken too in that manner and that she should think before she shreaked We are good friends now Believe it or not she didn't realize that she spoke to people this way no one had ever approached her about it My advice walk away take a deep breath and put a smile on your face You can't have a bad day unless you let yourself have one My favorite quote at woek and it is catchy is " I refuse to have a bad day life is to short, bad moments yes bad days never"

I could be wrong but I believe it has something to do with the Potassium Vit K People on coumadin should not have bananas either

I realize that abuse does take place in some LTC facilitities. I also know that the public needs to be informed. Where I work abuse is not tolerated in any way shape or form If there is a complaint about you, you are automatically suspended You never recieve the benefit of doubt. Of course you get to have your day in the office to be heard, then you may perhaps get your job back With all this in the forfront of the news my question is Why are they also not showing the good side of LTC I believe that along with the negative they should also be airing the thousands of good loving caring health care providers doing the work that we love to do. Not all of us are monsters

Where I work we have a secured unit. The doors all have codes The door leading to outside goes to a secured area. We seldom use restraints as we find this just makes the resident more resistive to care or more aggressive. I have been there for one year and have only use a chemical restraint once and that was for the safety of staff and the resident herself We believe in gentle care and we try very hard to follow the residents routine and not ours. I hope this helps you alittle

As the above stated. You get to know your residents, You feel their pain share their laughter and most of all you get to share their knowledge. Even though they may have lost their short term memories they have their long term. Most have lived amazing lives. I look forward to going to work. Even though they all have their little control issues, you learn what they are and you play into them. 8 hour shifts are great, sometimes you leave exhausted. I just couldn't imagine doing a 12 hour shift. Before I worked at long term care I worked home care lots of travel, bad weather bad roads. In the Nursing home I get to do the same sort of work ( with the exception of hicc lines CV lines cadd pumps parental nutrition, parteonal dialysis well yo get the drift) and I only have to get to work and home. At 43 years old life is great thanks to the great bunch of residents and the staff Also have a great DON

Just a thought Has a nose swab been taken? Could be staph C We have a resident that went through the same thing. And yes I thought the Doc had lost his mind when he ordered a nose swab for prsistant itching Guess what it came back positive Polysporin in the nose times 6 weeks bid and no more scrathing

You will get organized. And yes it is your responsibility. On days Mon-Fri. we have 3 charge nurses on and 3 RPN's On Sat and Sun we have 1 RN with 3 RPN's On evenings we have 1 RN and 3 RPN's On Nights we have ! RN and 1 RPN for PSW's on Days 14 for the building Evenings 13 for the building Nights 5 for the building As the RN I am responsible to make sure everyone is doing there job which includes the staff in housekeeping, kitchen and general help We have 157 residents that I am also responsible for Honest you may feel overwhelmed right know but once you get to know your staff and residents it will come together. If you find someone is always neglegent in their assignments report them. They might not like you very much but the other staff are probably as frustrated as you with there laziness as they have to compensate Good luck and hang tight

I'm the luckiest Rn in the world my first 9 years I spent in home Nursing I loved it . One to ONe Nursing. Needed a change after I lost a very young 14 year old from ewings sarcoma. Shatter my life. I know work at a wonderful nursing home the admin is great and the DON is the best in the whole world. You can approach her about anything. When I 'm at work I am charge nurse for 157 residents and staff. The residents are great. The HCA on the other hand have wome social pysch problems I'm sure. The rumors and backstabbing among them is awful. They are all dedicated to thier jobs but god forbid if one of them gets an extra shift All in All I look forward to going to work on a daily basis and often short shift or take mutuals just to be there :)

Bless your Heart. May you have a Merry Xmas and may God bless your home What you have done is wonderful My husband and I (a few years back) took in his 3 nephews Chuck is now 19 and autistic. tony and willy are 15 and 13 We took over chuck's care when his Grandmother died ( his mother was unable to care for him) and We took inn the other 2 when their father went to jail. I had 3 of my own from a previous marriage My husband has helped raise 5 boys ( the daughter was on her own) We just treated all of them the same. same rules etc. One never got more or less. Treat her like your own. With X-mas just a few short days away Santa can give her some extras and then like the above posts take her shopping let her know the budget and make a pact that when she starts her first part time job or finishs school that she will pay you back slowly. This will boost herself esteem and give her some confidence in her future. Tony and Willy's dad has been living with us for the past 8 months. He is getting his life together and will soon move into a management postion with a local food chain. They will be getting there own place in the New Year. Even though there Dad is here the still come to my husband and I for guidance and always ask our permission to do things. The other day Tony won 2 hockey passes he came home very excited and he said " Uncle Wayne look what I won will you come to the game with me?" We had to gently remind him that perhaps he should ask his Dad if he'd like to enjoy the special time with him. I feel bad for his Dad but proud that they think so much of us. To make a long story short do for her like you would your own. Lots of hugs kisses and most of all let her know that she belongs. Sounds like a great teen with a rough past glad there is someone out there to look out for her MERRY CHRISTMAS :kiss :kiss