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Hi I am an Resident Service Director/Manager at an Assisted Living Facility and was hired 4 months ago. I have found that there were many system issues with this facility, as well as compliance issues with state and staff. As I have gone through organizing and bringing the facility up to compliance, I have also terminated 1 staff who was employeed there for several years. She was not following Doctors orders and undermining my authority with other staff and residence. While training a new employee, by having her oreintate with another existing employee, the existing employee told the new employee "When the manager (me) or the administrator is here you follow the rules, when they (me or my adminstrator) are not here you dont have to follow the rules" as she was talking about locking the medication cart and leaving the MARs open - which is one of the issues I have made a point to correct everyone on. After the first day of orientation the new employee came to me practicall in tears that she practically wanted to quit seeing allot of non-compliance. When she told me this it has made me very mad, but I am pausing to think about what is the best action for the existing old employee - who I feel is part of the "old clan" of not doing the right things, even though I have really been trying to improve compliance, audits, education, even terminating an employee.... So ANY suggestions, would be welcome!

Posting an update for ME! EC CPNR 11/09 EC grad 1/10 RN NCLEX 4/10 BSN Grand Canyon Uni. 9/2011 Current position: Director Regency Pacific Summit Place Assisted Living nearby milestones to accomplish - soon to be an RND which is a Registered Nurse Deligator by WA state, and become certified in Geritology Nursing. THANK YOU EC! :yeah:Without EC, I would not be were I am TODAY!! gail Gail Buce, RN, BSN

Congrats! Great post! It took me some time to recover from PASSING, and had to type out a very lengthy post about my experience, trying to GET it outta my system. I never thought of it as PTSD, but, I think you were right on track. Good luck with your new future! Gail RN BSN CPNE 11/09

I went to Excelsiors workshop, it was in Reno and flights to Reno are cheap. I am glad I went, I also got the skills kit to practice. My friend went to one in California (not EC), and she benifited as well. GOOD LUCK!! Gail Gail Buce RN, BSN, CCRC, AE-C CPNE 11/09 - one time!

BSN through Grand Canyon Univeristy - on line fast tract program. Started 1 week after I passed my RN NCLEX. Crasy thing to do but it worked! gail

CPNE 11/09, EC grad. 01/10, RN NCLEX 4/10 (LPN NCLEX 8/00), BSN 09/10, live and work Washington state. Currently - Charge nurse/week end supervisor for 100 bed skilled long term care facility and I really love this job! Past - pulmonary/Asthma/Allergy and research nursing Hurdles - can not get hired on to local hospital, interviews with RN managers drilled me about my clinical experiences during school. Have applied for appx. 50 RN jobs at local hospital. EC? Awsome, I could not have done it any other way. THANK YOU EXCELSIOR! Gail Gail Buce, RN, BSN, CCRC, AE-C

Planning, planning your time, planning your studying strategy. Organization, organizing critical elements, organizing skills. Working, work it out, working towards your goal. Evolve, evolve into the CPNE study machine. Realization, realize you can do it! You have the POWER! Great luck! Gail Gail Buce, RN, BSN CPNE 11/09 - one time only!

Washington state does, however YOU are suppose to do 200 clinical hours preceptorship (I believe this is if you are not an LPN already). Oregon state works wonderfully with EC! Gail Gail Buce RN, BSN, CCRC, AE-C EC CPNE 11/09

EC was a great program for me, a full time working mom of 3. It takes dedication and self decipline. I did not due RUE or college net work help for the course work. I bought the books and read and learned. I did attend a CPNE workshop and bought the skills supply bag. EC is a Great place to earn an nursing degree! Gail RN BSN CCRC AE-C One time only CPNE Nov 2009

Yes, I would say most if not ALL BSN requirements need you to have your RN lic. in hand and faxed to the school, before entry into the BSN program. Or at least Grand Canyon Uni. did. Gail RN BSN

Well, as LPN for 10 years, and fairly new RN/BSN, I was hired at a long term care facility as a charge nurse. There is a lot to think about in this issue: Most New employees dont cost as must as employees who have been on the payroll for some time, including insurance for the employee. An experience RN, may not be in the means of the facility budget. Depending on how many LPNs vs RN ratio, the facility may need an RN and their own RNs may not meet the leadership qualification the facility needs. IF there was an opening for a charge nurse, and it was posted...then those that applied should know why they were not hired. While an LPN/LVN is not a degree, the RN and beyond has forefilled the educational requirements which includeds courses on deligation - leadership etc... While the LPN/LVN may have exceptional nursing skills, a new grad RN has the education and degree. I am very neutral on this and see both sides! As I said I am an fairly new RN/BSN with 10 years of experience as an LPN in office nursing. Everything is so individualized and there are many unknown about your new grad. Any leadership role in their past may have been the key and then of course the education degree. Gail RN BSN CCRC AE-C

Thank you soo much. I knew what I was taught but then I questioned the nurse I was watching..she just threw me for a loop by her reply back to me...like questioning her access through the "exit port" was stupid... Spiking the bag port is the exit port - that is great! AS adding any additional vitamins etc...in through the injection port!!!! SO THANK YOU! :) Gail

you know I just overheard that kind of statement from 2 of my fellow co-workers (LPN nurses) last week and wondered if they were talking about me... I am new at this extended care facility and just think that, as an RN, we need to know how to do the simple tasks (CNA) to working within our scope of practice, however when staffing cuts happen (low census etc..), when I heard a call light that has not been answered or an buddy alarm going off....I am going to answer and take care of the situation, so it is really tuff to not jump in when needed at that moment. gail

Hi OK so tell me fellow nurses, when you have a patient on TPN, and you are hanging a new bag - which you need to add a vial of vitamins to the TPN bag, my question is: Which port do you inject the vitamins into - a separate "medication port" on the TPN bag OR the port on the TPN bag which you spike with the IV drip line? I was shown how to do it and I remember told to use the medication port by one nurse, then.... I wanted to see how this other nurse hung the TPN, and she told me NO and preceeded to inject the vial of vitamins into the port in which you spike the TPN bag with. I have not had time to clarify this with the facility or pharmacy yet, but am interested in what others have to say about this. gail

Hi there, Well me too...I am a somewhat new 52 year old RN. I have been an LPN for 10 years though. Believe me...it will get better, however....your health always comes first...keep that in mind. My story is that I worked at a fairly large medical office group as an LPN, then we were bought out by a multi state hospital group, shortly after that time I became an RN. 6 months or so went by and then I did not want to renew my LPN, since I was an RN - which I kept my managers aware of my progress. One afternoon the new management, called me into the office and shocked me by giving me 2 weeks to inactive my RN - go back to being an LPN, or go on unpaid leave. I burst into tears and left the room. I attempted to fight this and see if I could get on as an RN, but to no avail...after being told just because you are an RN now with the company doesnt me we have a job for you.....ulitimatly I quit, after finding an RN job at an nursing home. THere was NO way I was going to inactive my RN! As an Rn at this particular nursing home, I didnt like many aspect about that job/management...so after 3 months quit. I got a job as an Research nurse (which I have done before), but found myself in a office sitting at a desk, in a building all by myself which is something I did not want to do..so I quit again and found a part time job at another nursing home, which I have just been offered full time work as charge nurse. I am happy now, and for someone who has had a very stable line of employement for many years, switching around from 3 jobs since March 2010...really took its toll on my life and my families life. I was begining to think getting my RN was a bad thing...but as I have just completed my BSN, time will tell. As nursing is my second career - first one was retail sales for 20 odd years, nursing is what I have a will and passion for....even though I have had some bumps along the way, I can say I am a darn good nurse and proud of it and keep my head held high and regain my inner soul. Gail Gail Buce, RN BSN