margaretofcastello

I just started a job at a LTC facility. My last night of orientation ended up being my first night on the floor, because the nurse didn't show up. This article expresses exactly how I felt. Another nurse had to do my treatments and charting because all I did was pass meds. Last night, I had a new admit, and that is all I was able to do. Oh, and his roommate decided to meet a friend to smoke and they had vodka. How the aide who is supposed to be watching the smokers let that happen, I have no idea. (We are one of the rare LTCs that allows smoking, if you can believe it). Thank you for your article. I sent it to my family to try to explain what I feel like at work. Stephani

Thank you, everyone, for your good input. We took a test in our first semester, and the teacher we had at the time prepared us well for it. Most of us passed on the first try, no problem. This test seemed to have content on it that is more for RNs than LPNs (which we are) so we haven't had that in class yet. They did recommend a book, and I have done most of it without any problems at all. I am actually pretty good at math in general; I got a 30 on the ACT, so I didn't think I would have this much trouble with it. It isn't the calculations, actually, it is the rules (rounding rules, peds rules, etc.) and we have had one or two teachers who couldn't remember the rules or did it their own way, so we have been really messed with in a way. The two problems I remember having trouble with with regarding IVs. In one problem, the doctor said blood should run for three hours. The nurse started the hydration at 2 1/2 hours. I didn't know if we were supposed to assume that the blood went fast, or that the nurse didn't give all the blood. The second one I had trouble with was an IVPB. Do you count the D5W together with an IVPB or does only one run at a time? I didn't think LPNs were allowed to do IVs, we have never done them in clinicals, and never did the math in class for them. So I was stumped.

Yesterday our class took a math test (dosage calculations) that we are supposed to pass in order to graduate in four weeks. No one passed. There were things on the test that we never saw before. I don't know why we were not prepared for this, and why they have waited so close to graduation to test us. Does every nursing school do this and how do people get through it? We have two more chances to take it, but I just don't understand why they didn't prepare us for it better. Don't they want us to pass it?

I have a new patient. He had a stroke in 2005 and has had convulsions since then. His right leg was amputated below the knee in 2006. I had trouble today assessing PERRLA because he doesn't open his eyes very much at all. He has tingling in his left foot and has lost those toes, I think due to his diabetes. He has edema in that foot. He also has diminished respirations. He spends all day in his room in bed. He stated that he wishes he could go back to doing what he used to do. He is only 55 years old. I need to make 4 diagnoses. I did poorly on my last paperwork for this, as it was my first time, and I want to do better this time, but I don't really know how to do that. Any suggestions? Some ideas I have are either altered mobility or risk for falls, risk for impaired peripheral tissue perfusion, adjustment problems due to loss of a limb, change in lifestyle, or losing independence.