LaLaEm4

I go one at a time...at my old job I would maybe do two at a time, but it was a day setting so I would pour two, label them, and then cross the building to give to clients. Each was only on one med, so it wasn't as risky as I could differentiate b/w meds just by looking at the pill. But honestly, I still rarely did that. In this setting now, I personally wouldn't pass three at a time...I just wouldn't feel comfortable because I hardly know them and they're on a bunch of different meds. I have 36:1 at this setting, and I'm planning on taking my time and not sweating the window, I'd rather be safe...and luckily that's the philosophy of the DON (she wants us to be timely, but she's been very honest and understanding about the high number and the time it takes to learn the residents and the pass)...prioritizing my diabetics, pain meds, my residents w/ parkinsons, my residents w/ parameters for BP meds, etc. Are you popping meds out of a card or do you have that baggie system from the pharmacy all nicely labelled? (I don't know the right name for the little tear baggies, I'm new to it, but it definitely saves time during my checks) Good luck, would love to hear how you're doing!

You will get faster, I'm about to be in the same boat because when you aren't familiar with your residents, you're slow and that's ok. It will get better. Make a brain sheet with everyone's name and preferences, details, etc to help yourself. How many residents are you passing to?

Hi Vintage, I'm curious about your experience in ALF...I interviewed today and asked to do an unpaid shadow day (tomorrow), because I'm concerned about the 36:1 nurse ratio they told me about. I have worked in LTC, passed meds to 20, so this number seems daunting to me. Are the residents MAR's as heavy as those in LTC? I really want this to work out but I'm not willing to stress over my license while taking care of a number that seems way too high...no med aides, either. Thanks! Em

Oh my goodness, thank you so much for this reply! The facility I'm interviewing with also takes patients across the lifespan, sounds very similar. I'm glad to hear that you say it's the best job you've ever had. I've heard of nurses only having 2-3 on inpatient hospice, and my concern with hearing 5-7 was that my bedside time would be limited. I know this organization offers IV certification and lots of training to new hires, so I'm looking forward to that. I will definitely message you, and again- thank you so much!

I currently work in a day program for adults with developmental disabilities, and have been there for a year. Looking for more of a challenge and change of scenery, and since I've always felt a pull towards hospice, I finally applied and got called in for an interview. It's an inpatient hospice facility (not for profit, highly reputable), and the manager explained that the absolute max I would have would be 6-7 pt/ for one nurse/one aide each evening, with an average being around 4 pt/evening . I have briefly worked per diem at a poorly organized LTC, and while the acuity at hospice seems to be greater, am I right in thinking that the better ratio at hospice makes it slightly more manageable than the 20 residents/night at LTC? I'm very nervous and am shadowing another LPN next week. The hiring manager also expressed concern over my lack of clinical skills, but said that if I were willing to learn/put in the time (which I absolutely am!), they have plenty of tools/resources/support to offer during orientation and beyond. I'm very excited but am trying not to get my hopes too high. This is something I really want to do, and do well- and am willing to put in the time after work to further my skills and learning...are these ratios doable? Can anyone point me to any resources that might be beneficial to a nurse new to hospice? Can anyone tell me what their evenings look like? ANY advice is appreciated. Thank you in advance!

Hi all, The (sort of) short story: I'm considering looking into going back to work at a LTC facility. I really struggled (badly) with my first experience, and felt like I could never go back. I feel incompetent in this area and want to give myself another shot at a different facility. Does anyone have any reading suggestions? Like LTC nursing for dummies? (Kidding, sort of. I wish there were such a guide for someone like me) A guide of sorts, or just anything that might help me to hone my organization/time management/LTC knowledge and assessment skills? I want to 'do' this area of nursing and do it well before I say it wasn't for me. I really miss this population. Advice? Help! The longer story/background: I graduated in 2012 and started my nursing career as a LPN at a LTC facility per diem as my first choice since I really enjoy and love working with older folks. After the standard 7 day orientation, I lasted four months taking random shifts on the floors/wings I felt most comfortable. Aside from the crippling stress I felt, (weight loss, not sleeping, constantly thinking about residents and dreaming about them, etc...despite my best self care attempts to stay sane with yoga, exercise, melatonin, diet, etc.) the hours/consistency wasn't enough, and I decided to look for more regular hours. I ended up accepting a part time (plus pick up/coverage) position at a day hab center for adults with developmental disabilities and acquired brain injuries. I am one of two nurses overseeing 50+ clients (plus another program we are not directly responsible for, but help with first aid, emergencies, etc.) and I've really been able to put my assessment skills to practice, learn about psych meds, lots of g-tubes, etc...- and just be the nurse I want to be in that I am able to really spend time interacting with my clients communicating and helping with their basic needs.It is a rather independent position, as we are the only two medical people on site. I am currently working on finishing my pre-reqs for my ASN/BSN, and I am getting the itch to jump back into a more challenging environment. So looking for something different felt like the smartest decision, any helpful advice? Thanks for your help!

Hi there, I am a LPN and graduated in June and began PRN work at a (for profit- never thought that this would make a difference) LTC in September. The last true shift I worked was Christmas Eve where I stayed late to help out as an aide. My orientation was about 10 days total, scattered over a few weeks. Not nearly enough for a new grad, but I'm told this is normal. However, I have two friends from my class who found jobs with significantly longer orientations (7-8 weeks...heaven)- so I'm holding out hope to find work at a facility like that. Although they feel safer, better oriented, and more comfortable with their workplace- they list all of the same stressful things that I did- so I feel like it is the reality of LTC, unfortunately. And I HAVE cried in front of the DON- so embarrassing. Luckily it was in private in a charting room, but I couldn't stop it, I was talking normally and the tears just fell from the exhaustion/feeling of being overwhelmed/stressed. While I felt like I should have stayed longer (I'm still technically on the per diem list, but I explained I wanted to focus on finding a different job/volunteering for the time being), I also felt like walking into work feeling like I was about to lose my license wasn't worth it/wasn't good for the residents that I cared so deeply about. Like you, I really enjoy and love working with the elderly. I was recently offered a part time job working with individuals with developmental disabilities- which is a total change of environment for me, but I'm looking forward to it. I still want to get back into LTC, but I'm doing a lot of research this time looking for a place that is more ''new grad'' friendly. I realize that many LTC's are short staffed, there seems to be never enough time, way too many meds, etc...but I really do love the elderly and I just hope to find a better fit for this stage in my career. Best of luck to you, I'd love to hear what you decide to do!

I work with a wonderful nurse who has been such an exemplary unofficial mentor and I'm wondering if I'm reading her words. Well said. You responded to one of my panic stricken, flightier sounding posts earlier this week, and I was grateful for the experienced tone that brought me back down to earth. Though I'm new, I've never found this belief to be true. For those who complain, I'll direct them this way. And for the days when I'm starting to feel the slightest bit twitchy, I'll remember Mr. Emerson's wise words. Thanks, GrnTea. I'll be keeping an eye out for more posts.

I appreciate this. I know it seems panic-y but I'm sure with a few more years under my belt, it'll simmer down . Regardless, thanks for your reply, it was helpful to me.

Thank you both, I'll be calling the BON today and seeing if my liability insurance is sufficient. I won't be using any nursing skills, but I know that a license is a license, and I want to protect that. Thank you both again!

Posted this in volunteer nursing, probably not the best spot- I really could use some help and I'm very appreciative....thanks all: Hi all, I am a relatively new grad- June 2012- and have worked per diem at a SNF. I've recently been asked to help/volunteer at a local senior center looking to start an adult day program. It seems It will not be an adult day health program as there is no facility available for bathing, but one to mainly provide the social and respite benefits of such a program. Currently, it's a 'club' run by other unlicensed volunteers- lasting about three hours three times a week...and there are about four people who come three times a week. Obviously it's very small and whatnot, but I'm weary to say yes (even though it is my dream to work at an adult day health program- so difficult to secure a position), as it is in it's infant stages and not a licensed facility. I would not be performing ANY nursing skills/duties whatsoever, but I'm still nervous as I am still VERY new to the nursing profession and I know how sticky legal issues can be. If something were to happen, I know that regardless of volunteer status, my license is on the line. Can someone give me some seasoned nursing advice? I want to be involved and like I said, it is my dream to work in ADH- but I don't want to risk anything. I appreciate any help I can get. Thanks in advance :)

This is really good advice, and it is part of the reason I personally took the PN route. As of right now, I have no plans of ever being a hospital nurse. I love working with the elderly, and my goal is to get experience in LTC - go to school part time for the RN- and then head into home care. It's really important that you recognize the limitations/opportunities for LPN's in our area. The truth is that while you may find luck in an outpatient facility associated w/ a hospital- you're not going to be in the hospital. I worked as an aide prior to going to school for practical nursing, and I knew that I loved the elderly population and wasn't a fan of acute care at all. (Even though a lot of SNF are pretty darn acute) I'm just not a hospital nurse, it's not me. Which is why nursing is great- there's something for everyone. But here I go blabbering on- but to the OP- take the advice by de2013 and do your best to kind of figure out where you want to be working as a nurse. **sorry for the double post...it won't let me delete the first one**

This is really good advice, and it is part of the reason I personally took the PN route. As of right now, I have no plans of ever being a hospital nurse. I love working with the elderly, and my goal is to get experience in LTC - go to school part time for the RN- and then head into home care. It's really important that you recognize the limitations/opportunities for LPN's in our area. The truth is that while you may find luck in an outpatient facility associated w/ a hospital- you're not going to be in the hospital. I worked as an aide prior to going to school for practical nursing, and I knew that I loved the elderly population and wasn't a fan of acute care at all. (Even though a lot of SNF are pretty darn acute) I'm just not a hospital nurse, it's not me. Which is why nursing is great- there's something for everyone. But here I go blabbering on- but to the OP- take the advice by de2013 and do your best to kind of figure out where you want to be working as a nurse.

I graduated from NSCC this past June. Passed the boards on July 28th, currently job hunting! I loved the program, it was thorough and well organized and the clinical affiliations are wonderful. I am planning on going back to complete an associates degree in nursing to get my RN, and the reason I chose the PN program at NSCC was because I wanted to take my time. I know a lot of people want to get it done as quickly as possible, but I like that I'm not jumping right back in, it's what works for me. Anyway- it's a great program. 10 months, intense- you really have no life, but the 10 months do fly by. If there's anything in particular you're wanting to know, let me know.

Hi all! As a part of a group presentation for my vocational trends class, I am looking to get some input from some actual LPNs currently working. -Where do YOU work? What does your role entail? -Where have you worked in the past? -What do you enjoy most about your role as a licensed practical nurse? -Do you wish you had gone to school to become a registered nurse, or are you happy with your choice? -Do you feel that there are any advantages to being a LPN over a RN? -Where do you see yourself in five years in regards to your nursing career? Any input is so, so, so appreciated! Thank you!!!

Hi all! As a part of a group presentation for my vocational trends class, I am looking to get some input from some actual LPNs currently working. -Where do YOU work? What does your role entail? -Where have you worked in the past? -What do you enjoy most about your role as a licensed practical nurse? -Do you wish you had gone to school to become a registered nurse, or are you happy with your choice? -Do you feel that there are any advantages to being a LPN over a RN? -Where do you see yourself in five years in regards to your nursing career? Any input is so, so, so appreciated! Thank you!!!

Congratulations!!!! So exciting!!

Congratulations! I'm taking the LPN route there this fall (kicking myself for not applying to the RN program...oh well!), and I'm hoping to do the bridge a year afterwards. It's so exciting getting the letter, well done! :heartbeat

Thanks, Erin!!! How is everything going with you??

I got in...phew. My acceptance package seems to be missing a bunch of stuff, though. Did anyone hear back?

I'm not sure whether it's different or not at different schools, but the TEAS that I took had no essay questions...mine was at North Shore Community College. If it's version V, I would get the study guide book...that helped a lot and I did quite well on the test-thanks to reviewing all of the chapters. Good luck!

Thanks, lcann! I appreciate it...I'm constantly checking the mail. How did you like the program? Did you have trouble finding a job afterwards? Erin, if you go to http://www.northshore.edu/cms/file/academics/programs/pnr/admission_requirements_and_application_packet/Practical%20Nursing%202011%20Application%20Packet.pdf, there's a list of info session dates near the end of the packet. I couldn't open it on the old laptop that I'm using, but that's where the dates are. You should apply, it's worth a shot. I debated applying to Rivier's BSN, and to community RN programs, but decided I didn't want to wait around on a list or spend close to 30k a year. Also, Salem State has a really good LPN to BSN program that I'm planning on applying to once (if) I finish the LPN program. So I guess that's something to think about if you're considering taking the LPN route. Good luck!! :)

I know, it's wonderful that it's only 10 months. Can't wait to hear back...anything...I'm so anxious!

NSCC only gaurantees application consideration if it is in by the close of business 2/25/11. They will accept applications after that, but only if there is still space in program/waitlist. I got mine in on the last day, and I'm hoping to hear back before April. We'll see! Make sure you check out their application checklist/packet. TEAS scores (test must be taken at NS) and an information session are required to submit the application. Let me know if I can answer any more questions for you...I just about memorized all of the requirements because I was so paranoid that I would forget something. Best of luck! :) Emma

Hi, I applied for the Fall 2011 LPN program and was looking to see if anyone else on the board has also also applied. Also, for those who have gone through the program or are currently in it, how soon did you hear whether or not you were accepted? I'd love to hear thoughts about the program! Thanks!