LMoonRN

Principle of double effect: You are giving the morphine to treat pain and/or dyspnea and as a consequence the morphine may hasten death. Hastening death however is not the original intention. To treat pain,dyspnea, and reduce suffering is and should be the intention. The morphine is not killing the patient, the underlying disease or condition is.

It is a tough situation but you couldn't help it. It's not as if you purposefully fell asleep and wanted to neglect the client's needs. Maybe in the future you could try to get the agency to not schedule you for doubles. As a previous reader suggested you could set an alarm on your phone or watch to go off every hour. I worked a lot of doubles as an aide/patient sitter. When I was working as a 1:1 sitter for patients from 11p-7a the patients would often be sleeping. I would only need to take them to the restroom or clean them up and take vitals if all else was well. I found it helpful to have the TV on in the room with mute on or have it very low. Even the light from the TV gave me something to look at and keep me awake. I would make sure I got a break sometime in the night to make a cup of tea with some crackers just to keep me going. Also, if it is allowed by the the agency/client maybe you could bring a portable DVD player or watch videos on an iPod with headphones. Just some suggestions. I would sincerely apologize to the father. If it was reported to the agency, you will have to fess up to it and promise not to do it again. I'm sure this is not the first time this has ever happened as proven by posts here. Best of luck! Let us know what happened!

I got the job!!!! It will be on a subacute floor on days. This kind of scares me but I need to swallow that fear and dive in deep! I have a few weeks off before I start. It is only about 20 minutes from me.

I will keep everyone updated if I do or don't get the position. I was recently reading something on the "Eden Alternative". It is basically a training/certification for nursing homes/ltc facilities by this company whose motto is to see ltc/snf as "places created for the care of human beings" rather than a place to dump the ill and elderly. Not many nursing homes have been through this program. I don't know if it is because of the cost or because it might not be well known. I found Eden Alternative's website a breath of fresh air. NJFek-I am hesitant to work with 30+ patients as well. It makes me very nervous knowing that I can't really be assessing patients because I am so busy and preoccupied with doing med pass and a million other things that aides typically do in the hospital (CBG, VS etc). Like you, I was caring for four patients during my preceptorship my last semester of school independently and this kept me very busy for the whole shift (8/12 hours). I feel like getting to know the system is half the battle. I define "getting to know the system" as knowing when things happen, where things are, how to document, getting to know the residents etc. I am so nervous about this job that I am not even sure I want it but will be forced to take it. I do not mean to complain but I feel like I am in a desperate situation. I have been so anxious about being an unemployed new grad that I haven't slept well in months. I keep praying. I know God has a plan. As the Good Book says "He who has begun a good work in you will bring it to fulfillment." :redbeathe

Congrats NJFek! It is a start. I hope it works out for you. I had an interview this morning at the rehab/snf that called me. I could not believe how many questions they asked me! I was interviewed by the hr manager then the nurse manager. It was one of the most intense interviews I've ever had. I gave it my best shot. If I get the job I will be happy but if I don't I will move on to greener pastures and keep applying. I am somewhat nervous to begin my career in a ltc facility as I have read so many negative things on the geriatric/ltc forum on this site but I know everyone's experiences are different. Even the nurse manager in the interview made it seem like most nurses who work in ltc want to pull their hair out due to the extensive med passes involved along with the repetitious documenting and this must be something I must learn to handle. There must be some nurses out there who enjoy ltc nursing. Sometimes the negativity on this website gets me down but I have to believe that people are just venting in a safe place. I don't know anymore, nursing seems to become more and more of a mystery everyday.

sarahsmile, Please do not be completely disheartened. This forum is a wonderful place for nurses, students, and CNA's. We must remember that the forum is also used as a safe place to vent. As someone who just graduated from a BSN program, I can give you a little insight into what school was like for me. This is only my experience. I really enjoyed school. I went to Catholic school and lived in the dorms. I made a lot of great friends with both other students and professors. These are people I will keep in contact with for a lifetime. As far as the academic part goes, it was very hard. You have to have a lot of drive and stamina to make it through nursing school. However, it is not impossible!! I found the hardest part being that I had to study a lot which I was not used to doing in high school. In high school. I could make the honor roll with the bare minimum amount of study. The hardest things for me were anatomy ( a full year course at my school), theology (taught by people with degrees from Harvard Divinity School), philosophy, and critical care and med surg nursing (there are massive amounts of information). As a student it is sometimes hard initially to translate textbook knowledge into reality. I can read about a bedbath or an IV pump all I want but until I see it and do it , it doesn't sink. The same goes for dealing with family and patients. As much as you are taught what might be some appropriate things to say at end of life for example, when the time comes and you are with a dying patient it is like having cotton mouth. I think these skills will come in time though. In addition, my school had a 200 hour preceptorship which was completed the last semester of senior year. This preceptorship allowed us to become more autonomous in our transition from student nurse to graduate nurse. I did mine on the CVSU. I really enjoyed it and I was up to four patients almost completely by myself near the end. Check into programs that have a similar type program senior year. Now I am looking to put my education to work and hopefully I will find a job soon!! Nursing school although it had it's ups and downs, was thoroughly enjoyable for me. I feel I got a great nursing and liberal arts education. I think you should pursue your dreams. Best of luck for a bright future.

Congrats! That's awesome. I would say all the above plus I found scrub pants that have cargo pockets helpful. It is good to use a "brain" or "cheat" sheet for patient info or come up with your own. I found a small sharpie helpful that I connect to my badge with a loop ring for labeling stuff. Will you have to read rhythms on your floor? If so a pair of calipers is always helpful since the unit's always seem to disappear. This is just from my preceptor experience in a CVSU (Cardiovascular Surgical). Congrats again and best of luck!

I would most definitely apply to any jobs that say experience preferred. As previously mentioned, my motto as a new grad is to apply to any jobs that say experience preferred but I don't apply to any that says experience necessary.

Thanks for all your replies! I'll definitely consider the pros and cons of what you have all said. I'm not sure I have the money at this time but hopefully by the time the Fall comes I can swing it and in the mean time be studying. I have a hard time with the heart blocks. Any tips?

KMC-RN-BSN: Thanks for your kind words. You seem very dedicated and self motivated when it comes to the job search. The mere fact you have already had several interviews means someone out there is impressed with you. Good luck on your upcoming interview!! Keep plugging away. I know how hard it is to put all the time, effort, and money into nursing school and then be hit with this desperate economic situation. As they say all things will pass. You really have to open the flood gates to get a nursing job nowadays as a new grad. I have applied to every and any place that has nursing positions and will continue to until I am hired somewhere. Someone posted a good link to a Johns Hopkins interview preparation website. I'd like to repost it here. I am going to definitely go through the questions under "Interview Guide" before my interview. Johns Hopkins University School of Nursing | Resources | Career Good Luck to All!

Hello to All, I just graduated nursing school in May with a BSN and am currently licensed as an RN. I was wondering how beneficial it would be for me to take ACLS. I do not have a job that requires it yet. (I've only gotten one interview at a SNF next Wed.) I was thinking it would be helpful for future applications and interviews for jobs at a hospital. How hard is the course? I am somewhat familiar with rhythm strips from my critical care rotation and my internship on a cardiovascular surgical unit but I definitely would need some review if the class expects me to recognize all the rhythms right off the bat. From what I understand there is a practical and a written exam. I found a course at a hospital near me in MA for $220. Is this a good price?

Kelsey clog by Dansko. It has a wider heel and better arch support. I can not walk in regular Dansko clogs but I love these. They come in black, white, and brown. I got them at the Walking Company for like 110. I love em!!!

Got an interview offer from a rehab/snf place! Finally something. I am desperate at this point. I will let you know how it goes.

Thank you for your input. May I ask why you say working at a SNF is rough? I am just curious. I have an interview at one on Wednesday (I am thankful for anything at this point.). I worked at one as a CNA at a SNF one summer and then I was a CNA on Med-Surg and I did notice a drastic difference even between the roles of the CNA in those two environments.

I am not employed yet but when I am I hope to start paying off student loans and credit cards and getting a car and apt. when the time comes. I live in the Boston area. I made almost $18 on nights as an aide and most nurses even in nursing homes get paid at least $28 an hour in my area. I am looking forward to seeing the difference in pay. I will certainly be praising the Lord for His goodness when I do get my first check as an RN. I know He has a plan so keep your chin up everyone who is still unemployed! GirtenBT-No I do not think 50, 000 is an outrageous amount. It is a lot however. I owe roughly 65, 000. Guess that's what I get for going to a private Catholic school. lol the tuition was close to 50, 000 a year so I'm not complaining if that's all I owe for a four year education.

NJFek, I feel your pain! I just graduated with a BSN in May and got licensed in Massachusetts in June. I have sent in numerous applications to hospitals, nursing homes, rehabs, assisted living facilities, and clinics. I have not gotten one call or email in response. I just get emails verifying that they received my info and that they will contact me if I meet the qualifications for the job posting. I get the same response when I call HR departments to follow up. I don't know what to do anymore. I am signed up for every job website out there to get job alerts through email. I realize I do not have experience an actual RN but I think some of what I did in my four years should count as experience. I did a 200 hour preceptorship senior year on a Cardiovascular Surgical Unit where I was handling four patients almost completely autonomously. Additionally, I did clinicals in Med-Surg, Pedi, Maternity, Psych, Community Health , and ICU. I have been an aide in a nursing home and on Med-Surg. I was involved in many activities and community service on and off my college campus. I am so disheartened. I am about to cry. How much more can I sell myself? I need money. I can't survive on nothing. I am really going to have to sign up for unemployment. I can no longer work as an aide since I got my nursing license so I have no income.

Dunkin Donuts iced coffee with cream and sugar instead of skim milk and splenda, organic chocolate, Barnes and Noble (Could spend hours here!), a new album on iTunes, renting a movie, a steak dinner

Hello All! I was wondering if you could post questions that you think could be asked during a job interview for an RN position. I am a new grad with a BSN, RN and am still job hunting. I just want to be prepared for any interviews that I will have. Thanks so much! If this topic has already been addressed, I am sorry. (If this is the case, could you link me to those threads?) Thanks again! :)

"Greater things are yet to come and greater things are still to be done." "Lord let these hands be healing hands. Let everyone I come in contact with today, especially my patients, see You in me and let me see Your face in them. Take away any doubt, fear, or anxiety."

May I ask what state you work in? I was a CNA this summer in a LTC and I am also an RN student. I live in Massachusetts but go to school in New Hampshire and no hospital I have ever been in would ever think about letting an LNA pull a foley out or a saline lock.

I like Neutrogena hand cream. The heels of my feet and my legs usually get very dry in the winter. For this I use a product called "Heel Rescue" that I got at Target.

Regardless of how I may personally feel about the ethical/legal issues of nursing and addiction, I just wanted to send out a message of hope for everyone struggling with this issue. Someone very close to me is also struggling with addiction and it is very painful and confusing to watch and understand. There is HOPE FOR THE HOPELESS. Please don't give up. The Lord loves you and all His children are the apple of His eye. Keep fighting the good fight. God love you all and I will pray for you!

Do not give up hope! Where there is a will, there is a way. I'm praying for you. Hugs

I am disgusted by the idea of medication aides. I will never work with them! I do not believe unskilled aides should be dispensing meds withe life-threatening adverse effects. I will also never take medication from a medication aide if I am a patient and know who they are.

When I first started nursing, I worried about gagging around feces since I have a really bad gag reflex when it comes to smells. I worked at a LTC this summer and encountered enough feces to last me a lifetime. I surprised myself. I really didn't mind the changing of adult diapers/soiled bedding etc. Sure, some of it did smell really bad and some of it was in all varieties of shapes and sizes. However, my motto was to get the job done as quickly as possible while trying to be as gentle as possible. It is a lot easier to change a pt. with another aide because it goes so much quicker. Make sure to have everything you need with you when you go into the pts room such as periwash, wet and dry wipes, any neccesary bedding, pads, and chucks etc. I did not gag once on the smell of poop where I worked and I had to deal with everything from a colostomy bag exploding and going all over my pt. to a 300+ lb women with an XXL diaper filled with diarrhea. For me, I thought of it as a another task that needed to be done. Quite honestly, some of the patients stunk more of BO than feces. I did gag on one woman's BO almost everytime I went into her room. This woman really had a really bad stench to her. She was on hospice and I think it was just her body decaying. When I would wash or change her I would have to try to not breath. The woman was completely out of it but when I did have to gag I would go behind the curtain or into her bathroom to wet a washcloth or something , just to catch my breath. I think the problem of poop is just something you will get over with more and more exposure. I don't even think twice about having to change an adult diaper filled with feces. I just do it and get it over with. Best of Luck!!