mama_bird

I punched out an hour over the other day. There had been three interruptions before dinner (someone was bleeding, someone else coughed during suctioning and blew snot all over my arms, and someone else's machine would not cooperate). When I went up to feed in the dining room we were short some CNA's and I had to go between two tables and feed four people! I spent an hour up there, thus went to lunch late, took only twenty min., and started my 8pm med pass/treatments at 7 but the charge nurse had been on since 7am so it was me and the other nurse to man the desk, 60 patients, and the front door buzzer/alarm plus answer patient calls and do extra paperwork. By the time I finished meds/treatments it was 10:45 and it took me until 11:45 to write report, give report, type report into computer, put narcs away, count with the oncoming nurse, sign the treatment book and sign the sheets the desk nurse usually does, AND give info to my oncoming replacemtn who was from an agency and had only been there once and needed to know who was a crush, whose extra stuff was where, etc. I was exactly one hour over. It was the end of my third week. I know that the Coordinator told me that it happens more often than not, and not to worry about getting in trouble for being late, because interruptions happen, but I used to work for places that made you punch out and keep working (of course, it wasn't a nursing home, but in home care they expected me to take total care of a paralyzed person in two hours and sign off and not get overtime). Also, I am new at this but I can't help feeling that the nurses who have been there for a long time are thinking "She needs to be faster." Well, I must be pretty frigging fast because I've lost 8 pounds in three weeks! I am getting better every night and these interruptions and the loss of a desk nurse were unexpected. I have a routine down now and was not behind at all the day before. Is this common? Do I have to worry about getting written up? My total overtime for the week probably added up to a total of 2.5 hours, but still...:imbar I love this job and I adore my patients. I do not mind the physical activity, but I don't want to live in fear of being pressured to always get done exactly on time. Sometimes I think the ones getting done early are either letting the aides put the creams on (not supposed to) or they are giving 8pm meds with the 4pms so they can skip those people! HELP!!

I just posted in the Geriatric and LTC forum. I wanted to be in a SNF because I am a passionate genealogist and I knew that if I ever went back to nursing, I would have to be with The Greatest Generation (Although some day they will be gone and I will have the Baby Boomers, etc.) I have 30 patients on each side of the floor. I was hired FT 3-11 and will end up on the desk in charge eventually but I wanted to pass meds to refresh myself, get to know the people, knew equipment, protocols, and lose the 40 pounds I gained working at a desk. On the first day I thought "I don't know if I can do this." Last night was my 13th shift. I count narcs, pass meds, including 2 g-tubes, do the dining room, take lunch, pass meds, do treatments/dressings, house report, charting, computer charting, clean the cart up, restock, count narcs again, give report, and last night I actually did it all, alone, and left on time. I also have a little time when doing treatments to chat with the residents about their life history which is why I wanted this job. I had to take a medication test for the job. There were 100 questions, T/F, multiple choice, fill in the blank, matching, and I got 95 right. Everyone has told me from the third day on I was doing fine, that I just needed confidence. Two weeks ago I wondered what the hell I was doing, now I am glad I made the decision to treat my RA with Enbrel and get my life back. Good luck. It can be done without a refresher course if you were textbook smart in school. I went to college from 1993-1997 and I felt like a new grad all over again!

Well, as you can see, I haven't posted in a while and that is because I just finished my 13th shift yesterday at a LTC facility (the job I wanted) :loveya:I start at 2:45 and work until 10:45. The first day I watched. The second day I watched in the am and was shadowed in the pm. The third and fourth day I was shadowed/helped with popping and passing. The fifth day I had help near the end. The sixth, seventh and eighth day the nurse didn't shadow me at all but was there to help with treatments toward the end if I needed it. On the ninth and tenth day (Sat and Sun) I was on my own (from there on) and got out at 11:25 pm. Monday I finished at 11:05pm, Tuesday I finished at 10:52 pm and last night (my 13th shift), I finished on time, did house report, charted in the computer, counted narcs and punched out at 10:50! I have 30 patients. Two have g-tubes and alot of meds. Two have dressings for sacral wounds and one has diarrhea all the time and sometimes needs more than one change. About 12 people are a crush. I get in about 1/2 hr early, fill out my sheet, etc, so I am ready to push the cart at 3. At 5:15 I have to go to the dining room and feed/supervise with another nurse until 6. I come back, do a few treatments, go to lunch, come back and start pushing 8pm meds at 7 and try to integrate the treatments. Now I can pretty much get done by 10:15 and that leaves me a half hour to chart, enter it into the computer, put narcs away, fill out house report, and sign the treatment book plus clean up my cart, etc. Any advice would be appreciated. I was out of clinical nursing for 9 years. I did have to take a medication test (100 questions) and I scored a 95 so needless to say, that God I am just a smart cookie. All of that crap pounded in my head from 1993-1997 really did come back to me. Thanks for the help!!!

I was offered a job at the SNF I wanted to work at (2 miles from home!) with the hours I wanted. This is strictly skilled care and custodial/personal care, no ventilators, etc. Some people may be on IV antibiotics. Most seemed to be in wheelchairs, very clean and in a very nice facility (all carpeted, new, etc). I was very honest about my situation (no bedside care other than family members for several years) and stated that I wanted to ease in with precepting and LPN duties (because I want to pass meds, etc), with the goal of being the charge RN 6 mos or so down the road. I told her I do not want to jeopardize the integrity of the patients or my unmarred license. They agreed to do it that way and my home care cases of three paralyzed clients will come in handy. Anyhow, this is the ratio: Shifts are 7-3, 3-11, 11-7. They tried 12 hr. and said it was too much for most people. 60 patients to a floor, 2 floors, currently all beds full (good sign, the other place was down 30 beds). There are three distinct wings on each floor branching off of the central station. Each wing is 20 beds (private rooms on one side of the hall, semi-private on the other side) One RN per shift in charge of the 60 patients. This is mainly a paperwork job and she said I would be at a desk all day once I feel comfortable taking this on evenings and or nights. There is a total of 6 RN's because there are 3 shifts and two floors. I would always have another RN on the other floor. 3 LPN's per shift, 20 patients each. Each LPN has one wing of 20 people and does the meds/etc. for just his/her 20 which the DON said is about all they do because it takes a long time to do 20 people. 6 CNA's per shift, 2 assigned to each wing. One CNA per ten people. DON said that they are the only ones who sometimes come and go. The DON has been there for 14 years. The other RN's and LPN's have all been there close to or over 10 years. I asked about the turnover because if other people are unhappy and constantly leave, I don't want to find myself unhappy. Monday I am going to orientation (general for all new hires). Tue and Wed I will work 7-3 to follow the LPN and RN and learn the ropes (since that shift has the most activity...they bring the doctor's to a room there instead of taking the patients out of the building because it can be stressful.) After that I should be going on my evenings/nights but not alone as charge until I feel ready. The last person I changed a dressing on was myself when I got bit by a spider last year and had three puncture holes and a staph infection on my stomach LOL. I am not looking to leave after a year and go to a hospital. This place is near my house, 8 hr. shifts, beautiful facility, and I have a friend who was a CNA for there for four years and said it is a very nice place to work and few workers ever leave. I know once I am in charge I will be sitting doing paperwork (which is all computerized now) so I am not worried about stressing my body too much as I get older. The pay is excellent for this area, ($23/hr.$24/hr when in charge), good benefits, certainly more than the other interviews I went to. I realize it is A LOT of work to be an LPN with 20 patients or an RN with 60 patients and having to delegate to staff, but I have been building my stamina with a lot of physical activity all day from pretty much 7am to 10pm for weeks now. I'm excited and I can't wait to get back in. Most of the people I volunteer with are elderly and I love talking to them about their decades of experience. I have been reading the threads here to learn the good, the bad and the ugly. Can anyone recommend a good geriatric text? My books are ten years old and I have a good clinical companion for fundamentals but I would like another book. I thank everyone for their help and input! If you have ANY advice, please give it.

I cannot take a refresher course until the fall. I have been out clinically for 9 years. prior to that I worked in an OB/GYN office for 2 years. I am thinking of applying at a nursing home as an LPN and easing my way in. MY RN license is valid and always has been. I have not been "just a housewife" for 9 years. Far from it. I have so much to offer and yet I fear my applications are getting tossed. Here's a chopped-down (no descriptions) version of my resume; contact details eliminated. Critics, advice, please. BTW, I worked FT before college but it was in a bakery and non-relevant: EDUCATION/PROFESSIONAL LICENSURE 8/1993 - 8/1998 D'Youville College, Buffalo, NY B.S. Nursing, Cum Laude. 3.59 GPA. 22 cr. towards M.S. Nursing. 3.33 GPA. Licensure: NYS R.N. License No: 49%$#^. PROFESSIONAL EXPERIENCE Health-Related: 6/1998 - 8/1999 Planned Parenthood of Buffalo & ErieCounty Community Educator/Registered Nurse 8/1997 - 6/1998 Planned Parenthood of Buffalo & ErieCounty Clinical Specialist/Registered Nurse 12/1996 - 8/1997 AllCare Family Services, Buffalo, NY Home Healthcare Assistant Managerial & Administrative: 8/1999 - Present The Edwardian Book Cellar - Owner & Sole Operator 9/1991 - Present Researcher/Editor/Typist 2/2003 - 6/2005 Piciulo & Associates - Administrative Assistant OTHER EXPERIENCE OF INTEREST 4/2008 -Present Historical Society of the Tonawandas Volunteer/Researcher 1983 - Present Genealogical Researcher References Available Upon Request