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Staff Ratios at Nursing Homes
Our ratio is 32-36 per nurse and 12-14 per aid on AM shift...I had 30 residents for two days due to low census and was astonished at how much of a difference that made as far as spending quality time with the residents/how smooth the day went...my case manager simply said "Ha don't get used to it". I agree that even complaints from family members don't seem to make a difference. I just do the best I can with what I have each day but I'm afraid of burnout under the stress of the circumstances.
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Any runners???
I'm just getting back into it, too...I recommend the couch to 5K plan (c25k.com)--there is corresponding music on iTunes for each week of program...so you alternate walking/running and build up to running the 5K. I have trouble finding motivation at times, too, but feel great once the workout is over.
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medication strip packs
I have only worked at one facility that did this; actually utilized CNAs to assist with putting meds in the correct order per MAR (by patient with different sections for AM, NOON, PM, HS, NOC). At my current facility everyone dreads refill day because pharmacy stocks the drawers and they are never in order by name, time, etc. and med pass takes much longer (they inevitably forget a container and we're running to contingency throughout med pass, putting meds in order, calling pharmacy with corrections, trading meds between halls because even though a resident switched rooms a month ago they're still being stocked in the other cart, etc.). Maybe the dual nurse check is overkill for normal meds (not a bad idea for narcs) but I would definitely appreciate it if they were in some semblance of order at the start of shift.
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Giving notice.
The facility I work for expects one month notice ("professional courtesy") per P&P and "reserves the right to hold any accrued PTO and provide negative feedback with future job references if employees do not comply with policy". Of course now management is suspicious anytime we use a chunk of PTO...
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Felt like part of the team...
That's awesome--I'll bet you will gain so much experience with this group. Best of luck!
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CPR Certification
Thanks for the advice. I think I will go ahead and take it on my own--the only bonus taking it at the facility was no out of pocket expense on my part plus my time was paid for...but in the long run my own peace of mind is worth more than that. Thanks again!
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CPR Certification
I am a new LPN and my CPR certification expired October 17, 2008...my facility sent me a notice in Sept to sign up for one of their in-house training sessions which I did...when I showed up, found out that the instructor had cancelled. I immediately went to the Nurse Manager (freaking out) and asked if I should go the Red Cross for recert and she advised me not to worry about it--that I could actually go 30 days over my expiration date and still be able to take the recertification as opposed to the entire eight hour training. I was scheduled for another class earlier this month and they called me the day before and advised that the class had been cancelled and they would let me know when the next class is available "but don't worry we'll get you in class soon". My question is this...they KNOW that I am not currently CPR certified and of course it's a requirement for all nursing staff so I do have some concerns about getting fired for being out of compliance but my real concern is whether I'm required by the BON to have current CPR cert? I am in Wisconsin and checked their website but didn't see reference to this. If anyone knows I would really appreciate your input!! Thanks!
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1 year! I made it!
Congratulations!!! It's great to hear the success stories!! I've been working now for two months and while I don't yet feel like "the nurse" I am getting more comfortable and look forward to going in and learning new things each day. Congrats again on your success and thanks for sharing.
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Needs Help With Studying
Hi Blaze, My school also used that grading scale--80% was a B- and anything below that was failing...and we used Potter & Perry Fundamentals first semester...I would recommend using the NCLEX questions at the end of the chapters to ensure understanding of the material as well as the CD that comes with the text. I would also suggest getting in the habit now of knowing WHY and not just memorizing facts because the test questions are geared to the hows and whys vs. easy multiple choice (and second semester is more difficult with alterations, etc.). In Fundamentals and Skills I made up index cards with the "expected outcomes" for each chapter on index cards with the answer, diagram, etc. on the reverse side and kept them handy for studying. Meeting with the professor to help focus your studying might also help (I never used NCLEX guides until I was preparing for boards--because I too thought that was way too much information). Lastly (sorry this has been so long) I strongly recommend study groups--talking through anatomy, physiology, etc. helped things stick a little better than just reading text, powerpoints, etc. over and over. Best of luck as you work through your first semester--it's tough but it's so worth it!!
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Working Full-Time while going to school?
I worked full-time in an office while earning my LPN (one semester for generals and two semesters nursing core)...I didn't have a choice financially...31 with two teens and a husband that traveled the majority of the time...no vacation or time to myself for that matter because all flex time went toward missing work for clinicals and exams. If you do it, my advice is to resolve to not stress over perfection--there was no way possible to maintain a 4.0 and it took me awhile to come to terms with that. Best of luck with whatever route you choose!!
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Vans slip ons
I'm a Vans and Converse All Stars girl myself, but I do not wear them to work--prefer something a little more substantial for the random fluid issues/spills and with more support for those long hours...I definitely understand financial limitations but these are your feet--and if you don't find something comfortable you will be absolutely miserable during your shift...for my clinicals I found all white leather Nikes in the boys department so they were a bit cheaper but once I started my first job I splurged on Asics running shoes and I LOVE them with a passion...12 hour shifts and feel like I'm walking (sometimes running) on the clouds. Best of luck as you start clinicals!
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To much focus on care plans for students
Also agree with OP...our clinicals were for six hours twice a week for six weeks and we had the same patient for the first three weeks and the same two patients for the last three weeks...I did CNA work which was fine because that's what got me interested in nursing in the first place but practically zero procedures--besides basic med pass got to give one insulin shot...I was totally upfront about this when I interviewed and with all of my trainers but sometimes they look at me with such disbelief or irritation to have to show me things. I don't know about anyone else, but it seemed to depend on the professor...some were known to go to the facility prior to clinical and communicate with the nursing staff about procedures that needed to be done so that students could practice skills where other professors had to be tracked down just so that meds could be administered let alone doing anything extra. I do agree with others, though--procedures are picked up quickly when you get to practice them daily on the job. When I have never done a procedure, I ask that another nurse come to the room and walk me through it--that way I don't have to keep saying "I'm sorry but I have never done that"--and they know that I WANT to/am willing to jump in and do it myself. It's also a nice confidence booster and sense of accomplishment--when I did my first catheter I was over the moon!!!
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First year almost over, yet somehow . . .
Sound, I, too, experience this...I started the same time as several others (all of us brand new LPNs) and they are completely at ease with the supervisors and other staff--laughing and joking with similar interests, etc. Because I haven't made these connections I think that it makes even asking work-related questions difficult. I've always been quiet but adjusted at previous jobs--I guess I've never felt at this much of a disadvantage/unsupported before. Sorry I don't have any suggestions...at this point I just try to smile at everyone and be polite (when I'm not totally engrossed in a situation in which case I've been told I look mad ). Good luck--I hope others have some ideas!!!
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New Grad RN, and I don't like it!
Thanks for everyone's responses--it's really easy to lose perspective and confidence--and it's wonderful to hear from others who have been through the same thing...thanks for the reassurance that things will get better!!
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1st year NSG!
Hi Ready, Unfortunately no advice but just wanted to let you know that you're not alone (I could have written this post having myself just posted a msg about feeling like a sham and know nothing nurse at LTC). After reading others' posts I believe that maybe it will get better (or on the flip side I will realize that LTC is not for me) but I'm going to stick it out to find out. I just keep thinking that if I had 20 residents instead of 30 I would be fine you know? Best of luck and feel free to vent anytime!!