lots2care4

I have given Bath and Body Works lotion ... they all loved that. This year I bought my 'regulars' the Frost Guard for their cars in an effort to save them time and gas. Pretty soft throws for the others ... got a great deal at JCPenney on these! MERRY CHRISTMAS!!

Thank you ladies so much for your words of advice. This resident is in a LTC facility and is on Hospice; however, she continues with all her regularly scheduled meds along with the prns. I was not comfortable giving what she was asking for and I believe she is in pain but, she wanted them all at once and wanted to argue about it. Numerous attempts I made to have the resident understand my concerns went unnoticed; I notified her PCP who wrote an order for parameters and distinct orders, 'do not give prn morphine with fioricet, oxycodone or gabapentin'. This has helped immensely. I agree she should discuss her concerns with the Hospice RN and go off a lot of the 'non-essential' meds and stick to bringing her pain under control. I have worked for Hospice and love the concept. Again, I thank you ladies greatly! Have a great holiday!

0I have a question for ya ... been struggling with this for a bit... While working in a SNF, I have a patient who receives scheduled pain medications as follows: oxycodone 15mg q 4 hrs, gabapentin 300mg QID .. she also has a fentanyl patch 75mcg/hr. She is requesting the following prn meds to be given to her at the same time as the scheduled meds -- morphine sulfate liquid 10mg for chronic pain and fioricet for migraine. She tells me the 'squirt' medicine is to be given with the fioricet so as to give it a 'boost' to help make it work. Any PDR I've referenced advises not to give together as each one can cause respiratory depression. I'm concerned with giving them all together..."do no harm". This pt is also on hospice. I've notified the resident's PCP, asking for parameters and/or recommendations as regards the above. Have any of you nurses run across this type of issue and/or what are your thoughts? I appreciate your input greatly ... I have talked with my supervisor and she has given me direction as well. Thanks so much! UPDATE: we received parameters from this patient's PCP ... all is good.

I have a question for ya ... been struggling with this for a bit... While working in a SNF, I have a patient who receives scheduled pain medications as follows: oxycodone 15mg q 4 hrs, gabapentin 300mg QID .. she also has a fentanyl patch 75mcg/hr. She is requesting the following prn meds to be given to her at the same time as the scheduled meds -- morphine sulfate liquid 10mg for chronic pain and fioricet for migraine. She tells me the 'squirt' medicine is to be given with the fioricet so as to give it a 'boost' to help make it work. Any PDR I've referenced advises not to give together as each one can cause respiratory depression. I'm concerned with giving them all together..."do no harm". This pt is also on hospice. I've notified the resident's PCP, asking for parameters and/or recommendations as regards the above. Have any of you nurses run across this type of issue and/or what are your thoughts? I appreciate your input greatly ... I have talked with my supervisor and she has given me direction as well. Thanks so much!

Hello ladies/gents ... I just interviewed for a LPN position with an allergist/immunologist. One interesting aspect to this position was the need to learn how to mix allergen drops ... I questioned whether that would be within my scope of practice (New York state) and he replied, 'yes'. I, however, find that suspect. Does anyone on this forum know otherwise? Thanks in advance.

I am currently working as a private duty LVN. I make decent money but no benefits, vacay, sick time, etc. I am 35 and burnt out on nursing in general. At my age I just need to go back to school and get my RN and so on. I hate hospital nursing with a passion and I really don't have the burning desire inside to be a nurse anymore. WELL...I was just offered an opportunity to go to work with a top healthcare recruiting company here in Dallas. My neighbor referred me and I was able to get my foot in the door. I would be working as a medical recruiter with a base pay but with commission the average 1st year is about 50,000 - 60,000. My neighbor is in her 2nd year and makes 70,000. I am totally thinking a career change to this field would be good for me. I could very well be making 6 figures in 5 years from now. This is a big decision for me and would just love some input from you other nurses out there! OK ... dear lady ... what are you waiting for???

hello, ladies ... :yeah:i applaud all nurses ... i am just 2 weeks into float orientation on a ltc unit and a relatively new lpn grad. we have 4, 5, 6, 8 and 9 o'clock passes, neb txs and other wound/eye txs on one floor. i've just finished 3 days doing 20 pts and feel like i'll never get it ... i have to increase my speed to do the entire floor of 38 + pts. i asked my preceptor 'how and what can i do to get this right?' i combine the 4/5 meds, do the 6 pm nebs, eye drops and then combine 8/9 pm meds; some whole, some crush, some with applesauce or pudding, ntf, ptf, tube feeders, take orders off, etc. there has to be a way to increase my speed with med admin. and stay in the hour limitation. medications with parameters to include apical pulse/blood pressure take time. after 5 days passing meds, i have my moments of frustration but i do not give up. any ideas would help greatly and be much appreciated. i love nursing! wish i had taken this route 20 yrs ago!

:yelclap: your words of encouragement are awesome! i will be starting a new job in ltc and, while being a bit anxious about the staffing to resident ratio, i am excited to get back into it. absolutely love the 'shortcuts' you've mentioned and the idea to get your staff to work together as a team .... it's all great! especially the neck/shoulder massage! :thankya: i thankyou in advance and will keep you all updated on my findings!

Currently working in a Continuing Care Retirement Community ... in the Adult Home aspect of such. Management requests we wear 'casual attire', khakis, no jeans, no spandex, put together well with blouses/tops, but nothing provocative; we can wear scrubs but no whites. I prefer to be comfortable and wear scrubs most of the time -- solid bottoms with print tops, usually blues, aquatic and/or nature prints. The residents love the tops I wear .... it's a great way to get the communication going and I love to see their smiles! We do have to purchase our own scrubs and do not receive a uniform allowance either. We are asked to remove the 'name brand tag' if it is displayed on the outside of the scrubs ...

yay! my thought process goes right along your lines! what if you had not called? you did the right thing; there would be no way you would have known she would come around. :redbeathe better safe than sorry! :)

Hello fellow nurses! :) I work in an adult home where cnas are employed as med techs. Our facility works off the 'point' system...you make a medication error, you receive points based on the error, type of med, etc. When an error is made, it really irritates me to hear, "I got 4 points!", or, "suppose you heard I got a med error...5 points!" Not once have I heard anyone remark as regards how that error may have effected the resident! Shouldn't that be their first concern? It just baffles me to know there are people out there who do not put their patients' well-being as the priority. I know we are not perfect...mistakes happen. But... As a new LPN the pharmacology training I received in school was no where's near enough...I am presently taking a refresher course online. Medications are tough and changing all the time. When hired at my place of employment, we had a "medication review and test" we had to take. As regards meds and administration of such, CNAs go through the same training and orientation as a LPN. It's basic...if you can read, you can pass meds. So, if you are matching the blister pack label to the MAR before popping the pill, how can you give the wrong med? And yet, it's done... I don't know what the answer is as to how we can improve in this area...there has to be something besides 'rewarding' someone for doing what they should have done in the first place. Suggestions would be appreciated. Thanks so much...for listening to me vent!

Thanks so much for the wonderful synopsis of your first year...as I wipe the tears from my eyes, I understand all you've written. Continue on, my dear...you will do well! :heartbeat

kudos to all nurses out there who love their job...it shows! i just love this website and sit for hours reading all the varying degrees of commitment. :heartbeat having passed my state boards in september of 2007, i am new to the nursing field and so, found ltc in a nursing home to be unsatisfactory to me for what i wanted out of nursing. i felt all i did was push pills...there was no time to interact with the residents unless they had a need for an extensive dressing change. i always left at end of shift feeling like something was missing. i thank god for the internet and providing the means for me to find my position i now hold. i've been working at the finest assisted living facility i know of and love it! it is situated in a retirement community where residents buy into a health care plan while they are still very much independent; some continue to work a full time job. this retirement community provides full-life care...from independent living to assisted living to skilled nursing needs. the assisted living unit consists of approximately 36- 40 residents with varying degrees of independence. some are permanent placement, others recouperating from various illnesses and/or surgeries until they are well enough to go back to their apartment or cottage. we have a few residents who 'self-medicate'. most of them are assisted with their medications by nursing staff -- one licensed practical nurse and two medication aides on day shift (0600 - 1430), the same for evenings (1400 - 2230), the night shift employs only medication aides, usually two. we also are required to assist with adl to varying degrees based on each individual's needs. the only thing i do not like about my position is the great amount of paperwork involved with everything and anything associated with the resident, their care, etc., etc...in this day and age of computers, we still do just about everything with paper! ugghh! it did not take me long to realize this was the career for me...i regret having taken so long to figure that out. i've been told it's never too late and so, i continue on. every day is an opportunity for me to make a difference in the lives of those i care for. i go home at night with a sense of satisfaction...it is great! ...just my two

]Hi there all. First of all, I am new to this website and thankful to have "come into your world!" I am a new nurse, graduated LPN school last June and took a position a month ago in a retirement community in the ALF. (Just now do I realize the "alf-ie" acronym!) Anyway, I am new in a lot of areas involving all of this and will be on this site frequently for as much advice I can find. As far as I can see, I am going to love my position -- Charge LPN - evening shift - I absolutely enjoy taking care of people and those at my facility seem to "embrace my caring nature" saying I remind them of the nurses from days back. I will take that as a compliment. The "charge" part will be the challenge for me but, I will do my best -- the residents deserve that. I just want to let you all know I am so thankful for this website and always get caught up in an hour or two when I am here. Thanks to whomever got this started! Education and communication are key to survival! All take care...Terry :loveya: