behensley

While things are pretty hectic at the beginning of your shift, getting your assessments done, chem stix, dealing with family and the pt needs, etc... Usually after midnight, on a good night when the ED is slow, things calm down and you get to catch up on all the stuff that you need to do. Also, working nights you get more cleaning assignments to do, but not so much that it is undoable if you have a good nurse mgr. Things usually begin to pick up again around 5 am, then it is time to give report. I enjoy it, you don't have all the administration to deal with. Just be sure it is an absolute necessity before you call the Dr. in the middle of the night and have all the information that the Dr. will want. :)

She isn't signing out the medication, passing a juice as a placebo and the DON is turning her head???? By all means you need to report to the governing bodies. Just because you have previous knowledge of a persons past doesn't mean that it is a current situation. If she was worried about abusing the morphine, IF there was a non-narcotic alternative that was available she could have tried that first to see if there was any effect. If not, then certainly go on and issue the medication. Doing this addresses the issue of pain the pt is complaining about. I have always tried to start small and work my way up with pain medications, (unless it is after a serious trauma). But never is it acceptable to lie to a patient. :)

If you are working in an LPN position and want to continue working at the same location, you may have to wait for a open RN position to come available. But be aware, some places when you change from LPN to RN you loose your seniority and your benefit packages changes. (Sometimes for the better, but not always!)

I have ADD and haven't had any problems so far. As long as you stay on your meds and keep your condition in control, follow up with your care provider, and don't assume that you are "OK now, I will make an appt with my doc when I need to...", you'll be fine. I agree, check with your state board of nursing about their requirements. And as has been mentioned, you are protected by the ADA, use it if you need to.

L -- Low P -- Paid N -- Nurse :chuckle really though; Honest, dependable, respectful

At the hospital I work at, we all bring things for us to share and eat when I work night shift because there is no where to buy lunch other than the vending machines! We set it up so that when we get a moment to run in to the breakroom, we can shove something in our mouths and keep on going. We don't get to lounge around and eat a meal; its just shove and run.:)

I agree with you whole heartedly!!! I work swing shift and when I'm on the medical floor I hear how night shift is lacking in one way or another. On the other hand, night shift feels that with all the support staff day shift has they should have it easy. Once days and nights have to do the others job, a lot of misconceptions are cleared up.

The only time that myglasses have gotten in the way is recently, and that is only because I need to go and get my eyes checked. I think I need bifocals! Other than having to take them off to see things close up now, they really haven' given me any trouble. :)

I work in KY and here we are just as in demand as the RN title. While there are differences, we are held accountable for our own actions and are directly supervised by the nsg. mgr for the floors that we work. I don't think that we will be phased out anytime soon, all they do is train us, expand our practice and off we go. If LPNs are phased out, I believe that the nursing shortage that is nationwide will help us find a safe niche.:nuke:

Just to add my thoughts on the subject... I have worked in the psych department/ward in the hospital that I work for a year now. I sometimes get pulled to other parts of the hospital and that is where I get the assurance that I won't have to worry about loosing any skills because I use them regularly, (starting IVs, hanging blood, ATBs, NGTs, foleys, etc.) I agree that when we work on the mental health side of nursing, we have to be sharp with all of our skill, especially the knowledge of medication side effects, lab work, and discerning whether the pts psychosis or out side influences are at work throughout the day. If you like this line of nursing, by all means do it -- it can be very rewarding! I Love it!!! :wink2:

I have been working in psych for a year and we have only had a few aggressive acts or attacks while I have been there. Every one on staff in the unit has to have training prior to taking the floor on how to handle various situations. I agree that if you listen to your patients you can usually, (not always) diffuse a situation before it escalates to an attack. A way that our unit deals with it is that we always have a male staff member on each shift. While i realize this may sound sexist, it gives a stronger sense of authority and for some reason less aggression. Also, there is never one person in an area with a patient alone at anytime. If one of the staff is attacked there is always a person to assist and call the code. Then the person with the best repore for that patient (who is hopefully working at the time) goes and helps talk the patient down out of their aggression. The patients are informed upon admission and at various times during their time on the unit that if a code is called, those not involved are to go to their room since the unit will be flooded with every working male at that time to assist the staff member with the aggression. Never is it allowed to injure a patient, only immobilize them until they are calmed.:wink2:

What is the best color or type of dress that is best received in psych units? I have been working in this unit and we have suggested teal blue or even tan slacks with a white polo type shirt. So far she is too head strong to listen and I need to present an alternative with some solid backing to take to the administrator so that I don't sound disgruntled! :)

To be honest, she came from an icu background. Her rational is that it "looks good" on us and is slimming!

i agree with the fact that all of us are trained at the various levels, but please let us not eat our young! as an lpn i have had to train rns to do their jobs so that they can be paid as much as 75% more than me. i don't begrudge them that initial orientation time that all nurses should have when beginning their career or new job.

I work in a psych unit and our nurse mgr decided that we needed to wear black uniforms. I have had negative responses from pts as well as other people that I have come in contact with about this color. One pt refused to take medications because I was in black, calling me an "angel of death". When I broke policy the next day and wore white, the same pt referred to me as an "angel of mercy"! After relating to my mgr this information, the mgr smiled and pollitely went about their business. What are colors that have been used in other psych units and pt reactions?

I have also received RN training, and while I do understand that the level of theory is more involved with that training, right now I choose to work as an LPN. In the hospital that I work at, if I were to get my RN at this point, I would be transferred into a different department of the hostpital and I enjoy the area that I am working in. That being said, with the scope of practice that is ever expanding in the LPN/LVN license, there are becoming less and less practice differences in my state between the RN and LPN. As our practice expands, we are becoming more and more independent. I work along side my RN collegues and have a few problems with respect from them when I show that I do have the skill, insight, and ability to perform an equal performance. The main respect issue is usually not from RNs, but from the layman off the street, or the patient who is unfamiliar with the quality of care that they receive. After they have received quality care, they usually change their tune. I don't think that LPNs/LVNs are going to be phased out at this point. With the nursing shortage as it is and is predicted, LPNs/LVNs will continue to be a large part of the health care team. Do I think that RNs, wether ADN or BSN, or even MSN deserve higher pay?? Of course, the increase in study, blood, sweat, and tears to get to that point deffinitly shows that they have earned it. But should LPNs/LVNs be paid better and closer to the RN-ADN salary range, yes. As LPN/LVN scope of practice expands and we take on more responsiblity so should the pay increase as well. I don't think that it is so bad to be an LPN... I just think that the community as a whole needs to be shown and informed that we are nurses as well. We are nurses ... we just got here in a different way.:nuke:

Hang in there and don't let anyone get you down. I graduated in 2003 as an LPN and have found it to be very rewarding in my almost 5 year carreer. I have been called everything fro a "licensed pretend nurse", "low profile nurse", and (the one that I agree with) "low paid nurse". I have worked in a nursing home atmosphere, med/surg floor and psychiatric floor. I have found that when the chips are down the LPN is the one that is called on to save the ship and get everyone out of the bind that the unit is in. Patients usually only ask about the difference once, and then they watch and see that I AM a nurse. My patients are comfortable asking my questions and trusting my replies. They know that if I don't know the answer, I will get them information on what they want to know.... Most of the time the RN is so busy with the paperwork that the LPN is the one that has to try and keep things balanced. The RN has a place that is irreplaceable, but so does the LPN and our position is just as rewarding as theirs, if not more so.