WVStarFish

I don't work in a hospital, the MI pts I see live in the community and walk in to our center, kind of like a doctors office. Or we use our vehicles to transport them ourselves. Our pts are the same small group, so we know them very well. For the most part. I'm wondering if any workplace has a policy for when pts inappropriately touch staff, or even threaten to violently assault staff. I understand the pts are mentally ill, and our site deals with the severely MI, but are we expected to overlook the assault just because the person is MI? Is there any kind of protection for bmed staff, like if staff refuse to be alone (totally alone in the office, or in the car) with pts who have a history of assaulting or intimidating of that staff? Surely, there must be some kind of protection for us, esp in the event of a pt with a history with certain staff. What does everyone else do? As you can tell, I'm just a little upset over this. I came here to post this question first before trying to "make waves" with my employer. I really like my job, except for the couple of "touchy" pts, and I'm hoping I have something to back me up on this.

After sitting for almost an hour using a sharpie to black out names on pharmacy bottles, I'm wondering if there is a better way to dispose of patients medicine bottles with their names on them. Where I work, I only deal with their bottles, and the labels with names are tightly bound to the bottles. What else can I do besides spend valuable time coloring? There is no company policy and this is how the previous nurse did it. Every day, I have tons of them to dispose of and I need a better way! I used to work in a nursing home and I remember just throwing out the packages meds came in, not bothering to black out names. That's how they did it there, but here is no policy. HELP!!! and thanks! :)

I was wondering what area of nursing tends to have the happiest nurses? Surely there's been a study on it? And in contrast, I wonder what area of nursing tends to hold the most unhappy nurses? I know that all areas will have each kind of nurse, but in general, I just wonder.

Well, the person who hired me actually IS the person doing the urine collecting. I don't know why I'm embarrased, I guess because it's proof I'm not as awesome as I appear to be. hahaha But I really AM worried that the person hiring me/collecting the urine, might change their mind. So, do I tell them when they collect the urine, or do I wait until the test comes back? Take in the actual bottles, right?

I am assuming I was just offered a job, pending background check and drug screening. That's what a background and urine usually mean, I hear. Both checks will be fine, but two of the meds I take are going to show up on my drug screen. I am prescribed Adderall QAM and Klonopin QHS, as it shows on my prescription bottles. I'm also embarrased to have to show them my "weaknesses". What I'm worried about is, what if when they see that I take those medications, they call me and say they don't need me after all? I really want this job, so should I tell the lady collecting my urine that I take those meds? How do I go about that? It's being collected at the place of employment, I dont know if it's sent out or what. But mostly, can they just decide not to hire me afterall, because I take Adderall and Klonopin??? I was excited over this job until I thought of that......

I've only been a nurse a couple of months and took a job in LTC, hence I'm a "charge nurse". My nursing school was excellent but we werent taught ANY leadership skills. I'm not assertive, and I'm being taken advantage of. My orientation, uh, there was NO orientation. I watched some videos and then went out to push a cart. I have only learned how to do something when the issue arises. And the answer all depends on who I ask, nothing is consistant. I'm finding out that half the CNA's are walking all over me, and I had no idea!!! Anyway, there has got to be a way to learn some leadership. I took it upon myself to look at the company policy and it's written with such broad terms, it is useless to me. I've talked to two in the DON office, and neither time was I told what to do, how to handle it, what I should do, nothing. The ED is a good person but spineless, so that's a dead end, too. The other nurses, calloused and fed up. I dont want to have to become calloused and jaded to be a good nurse.

In short, I'm a new nurse and just had to stay up all night to work. Anytime in my life, staying up all night or not getting more than a few hours sleep, I am so sick and it takes the whole next day to recoup. I am sweating, my heart pounds out of my chest, nauseous, shaking, dizzy....why am I SO affected by losing sleep. There are other people I know who stay up all night and dont feel "good" but none of them are so affected. I'm generally a healthy person, no problems. But going without sleep makes me SOOOO sick. I hate the pounding tachycardia most of all.

I have talked to two different people in the DONS. Ya think anything has happened? Nope. And I had no idea we could write up CNA's. Now, I just need to "grow some" and do it. Oh, I finished the shift w/o sleep and everyone survived. I'm still not recovered, and going off for another shift feeling like I'm hungover. Thank you for the comments, too. No one really talks at work.

The thing with calling off, every single day for the past few weeks, SOMEONE is mandated on a shift. Then they call off or quit. Hence, a cycle. Because the call off isnt in due time, agency doesnt get called in. We've lost three nurses in two weeks, two CNA's. One day, there were only 3 nurses and 6 CNA's for 90-some patients. I've been mandated (along with everyone else) one day the past three weeks, but never an all nighter and come back w/o sleep. And ya know what? The day I ended up mandated and having to work the midnight.....it was my day off, I volunteered to cover. Jokes on me, huh.

Just wanted to add that I have done doubles and such before w/o any difficulty, I can work sun up to sun down and be just fine ....but forcing myself to stay awake all night when my body is used to a midnight bedtime...it's really messing with me.

my biggest problem is how do I tell a crazy lazy psycho CNA that she needs to prioritize, she cant be leaving the floor all the time, she needs to not up the O2, she ... oh hell, I jsut dont know how to tell this one very experienced CNA that she needs to do Simple things like, if a fall risk wants back in bed, dont' let the resident yell about it for an hour while you are calmly and sluggishly changing a wet brief!! I mean, someone who is KNOWN to get up and fall ALOT ..they SHOULD be a priority over a wet brief, right??? It was just a regular wet brief, no wounds, no outings planned, just a wet brief!!! and this resident DID fall.....she kept asking to go back to bed, her bed is ALWAYS to be in lowest position but was raised high to "deter" her from getting in bed....AND IT WAS WELL PAST HER BEDTIME ANYWAY!!! and yes, she got very banged up when she fell. Because of things llike this, I'm still doing insulin at almost midnight. I DO NOT have this problem, or ANY problem, with any other CNA. With the other CNA's, I actually do get to help them out and cut them a break when I'm able to do things like get my own temps. I actually LIKE helping them change or clean someone so I can see the skin, or learn a better way to do anything that the CNA has found helpful for that resident! And yes, I have told management. Everyone knows about the CNA, they all know that she is taking advantage of my inexperience......I don't want to leave my job, but I really feel that because of this CNA, I have found the answer to my own post about "how can one's job make them lose their license. " Which brings me to my next major cause of freaking out..... Sorry for rambling...after the mandated all nighter double, I have been home six hours and only slept for three. And now I have to go back to work, I don't feel like I am thinking straight from lack of sleep, I feel exhausted, I feel sick, and I don't know how in the world I am expected to even be a half-assed nurse. At the end of tonights shift, I will have worked 25 hours within 32 hours. By law, I had my 8 hour off time, but 25 hours work hours within 32 hour, thats three shifts out of four on NO SLEEP...I'm just so exhausted.

I get along great with them, I'm just not used to being "in charge" of anything. And I have no idea what to expect from them. But as for getting to know everyone, we all get along great for the most part.

I have only been a nurse a couple of months and work in a LTC home. I've had basicly no training there, but hey, I can pass meds like crazy. I absolutely dont know what I am to expect from the CNA's. And the one time I did ask a CNA to do something, she backtalked me and refused to take the pt back to his room. So, what do I expect from them? And how do I "delegate" without being a bitch? Being the new nurse, the CNA's who've been around longer are taking long smoke breaks, not getting vitals...one CNA I don't lay eyes on from 4 to 6:30 Please help, because in the LTC, with all the needs my residents have, I need help on the floor, I can't do it all alone!!!! One of the absolute worst, most unsafe and laziest CNA's has been there almost ten years, so I feel the facility really doesn't even care.

I'm a brand new nurse and I keep reading and hearing things like "I'm not going to work in a place that's going to make me lose my license" Also, how can what the CNA's do affect my license? I've been told that if they mess up badly, it's on me??? I work in a nursing home, and have about 25 residents to myself. I'm not understanding how your work environment can jepordize that. Stupid question, I know, but I work at a crazy place and I hear it alot from my coworkers about being afraid of losing licenses because of the workplace. Can someone explain? I thought you lost your license over things like med errors, abuse, fraud.....how can a job cause that? Thanks a bunch!:loveya:

I'm new too, and working at a LTC home. My "orientation" consisted of taking on the med pass for whatever nurse I was with that day. A few days before I was put out on my own, another nurse did show me how to get into the computer and do some charting. Where I am, we have a sheet for our med pass with each residents name, code and room number, in order. At report, at shift change, I ask the previous nurse things like who is crushed, who gets grouchy if their meds aren't on time, who "routinely" gets PRN meds (that saves me lots of time)... I make those little notes on the paper and keep it on my med cart. When I have all the notes for a hall, I use it the next time. One thing I've noticed...we had an agency nurse come in one day and she finished up her med pass in lightening speed even though she had never been to our facility before. While we all had raised eyebrows, it seemed to be a silent understanding that "at least we have staff". Sad, I know. The nurses I work with have told me that I am going to feel like quitting and I am going to feel overwhelmed and then I'll eventually develop my own routine and it will get somewhat easier. I'm relying on that heavily, because I am very, very unhappy and overwhelmed at my job. I also keep telling myself that there are problems every where you go, reminding myself of the bonus I'm "supposed" to get and how close to home my job is located. I know what you mean about the nurses not knowing what to tell you or them being so busy themselves. The ONLY way I've learned anything at all is when I HAD to do something, knda like learning to swim by being thrown in the water all at once. Just yesterday I posted a question about how to get through med pass with such talkative residents. It seems my whole shift is med pass, and I work 3-11. I've completely forgot what the topic was here but I hope some of the things I said will help you.

I do know that the dx of MRSA is recent, as in the day before coming to our facility. As for being colonized...I didn't check or know how to check on that. I got all the discharge papers from the hospital and the lab work, but never saw anything to let me know one way or another. Now that I think of it, when I went to my admin with the MRSA concern, it would have been nice of that person to let me know if it was colonized or what

I know that MRSA in the sputum is a contact or droplet precaution. Either way, here is my problem. In this LTC facility, we admitted someone who is + sputum for MRSA. There are no precautions being taken other than the pt is to wear a mask when not in their room. OK, shouldn't the CNA's be wearing gowns when doing hygiene and ADL'S? Shouldn't staff be wearing masks when within 3 feet? The pt was initially placed in a room with a healthy dementia resident.The pt is VERY HOH, so you have to get right down in the face to talk to the pt. And the pt is very congested. I was the nurse to admit the person, wasn't told by my admin of the sputum (cultured two days prior), only found out after transport told me. Admin was indeed aware of it beforehand, I spoke to them about moving to a private room right away. I know I have a shift coming up that has that pt and I don't want to "make waves" and (heaven forbid) use the precautions and ask the CNA to use them. Is this just a really bad place I work at? Or does this seem to happen at even "good" places? WHY NOT just use the precautions? Maybe I'm confused ...

i wasn't able to handle work and school because i don't have family to rely on to help with the kids, so i was able to get help from the state. it was a *****, and it felt like i was going insane with being broke all the time, but it's worth it now. even at that, i was wore out tired most of the time and still felt like a neglectful mother. but i kept reminding myself of the benefits in the long term. there were very few who worked and had kids, and they had lots of support from family. even then ,they felt like terrible moms and got down about not seeing their kids very much. i kept encouraging them by reminding them of the reward, and that it's better they are getting this over with while the kids are smaller. (mine are teenagers) if you decide to work and go to school, be prepared for a tough time. i only say that not to discourage you, but if you go into it knowing that it's going to be rough, you might deal better. either way, keep your eye on the prize for your future and your childrens future. a year or two of sacrifice will be so worth it, and that is what you have to keep in the forefront of your mind! focus on the long term, and you can do it! best wishes!!!

Thank you for the really helpful replies. I am such a "nice" person who never wants to hurt anyones feelings, so it really is going to be a challenge for me to kinda cut someone off...I just have to practice! On one hall that I work on, most of the residents are talkers so I think when I work that hall, I just have to make up my mind to go in with the "Hi Mrs. So and so, I have to give this med and get back out here but I'll check back in with you in a little bit" right off the bat! Thanks again!

I absolutely do not mean to sound cold, but I have just started working in LTC and most of it is a very long med pass. While doing the med pass, I have found that alot of time is "wasted" (I really don't mean to sound mean) by the residents who want to talk, or complain, or whatever. I swear I'm not being cold, I love my residents, but I can't ever get to do treatments too if I spend all my time on the med pass. How do you guys past that without being uncaring? I really want to say to them, "I just don't have time to stand here and listen to you tell me about the day you met Elvis back in the 60's" Ya know?

After taking the NCLEX PN, I was positive i failed. Nothing on there made sense to me, I felt as if the questions were written in Greek. Thank you to everyone who encouraged me! It really helped during the whole 24 hours it took to find out that I passed. Now, I can pass along some of the encouragement to my fellow classmates as they prepare to take their NCLEX!

My ATI predictor said a 99% chance too! And the test you described sounds exactly like what mine was like!! Everything you mentioned in your post, I think that was ALL of my test and nothing else. Let me know how you did, okay? I find out about 3 tomorrow.

first let me say that i have always been very good at test taking and school work. i made it through a tough lpn program here and rarely had to study. so, of course i felt ready for the nclex today. the test shut off at 85 but what is crazy is that the questions seemed to be nothing like what we learned in school. all of the hard material i learned in school, none of it was there. and the way the questions were worded, i felt so dumb. and those questions that ask you to select all that apply!!!! it was nothing like i expected, and i am so downhearted. i feel ripped off somehow. i felt so prepared and now i think a monkey could have sat for me and i would have just the same chances. honestly, i don't see how 85% pass the first time. i felt totally lost. and it's not because i'm not smart, i did great in school, i've done great on the tests prior to this. oh gosh, i am so disappointed.

Im new and have not worked in a hospital, but at the risk of sounding really, really stupid... what does it mean to code someone for so long? I always thought that the paddles were used and after a few tries, you stop. No?

As a new nurse in LTC, I've come across several residents who get bouts of crying and feeling down and alone and helpless. Some have dementia, some are just physically disabled and mostly realize their situation. It breaks my heart to see them so depressed and crying, and usually I'm passing meds and can't stop and take the time that I would like to, because I do love these residents and care about them, even if tomorrow some will not remember that they cried all day the day before. I'm not really good with words, so does anyone have some suggestions of what I can say or do to comfort them, even briefly, and let them know that I still care even though I'm on the med cart? Alot of times, they don't even know why they are sad and crying, or they want to go home (when really they no longer have a home), or a stroke survivor who is crying because they can't communicate anymore, or someone who is obsessing, or one who feels neglected and unloved. What can I do to comfort them, dementia or not? Thank you!