BowlerRN

I work PRN in a nursing home where I'm responsible for approx. 40 residents. (including their meds, tx's, assessments and charting) Our policy is to preset our meds, we have little med cards that we set up with each person's meds. This makes breakfast go by much smoother since everyone seems to get 10 different meds! We've never had a problem with this when the state surveyors come. The aids always do the vital signs and pass am snacks. I usually find a little time to help take a couple people to the bathroom and walk people to and from lunch during my shift also. I guess I don't have an abundance of treatments to do and don't usually have to worry about being short-staffed of aids.

Hello everyone, just wondered if anyone knows about the effects of Depo after stopping it or if anyone had a similar situation. I got the Depo-Provera birth control shot for two years, about a year ago I had my last shot, I did not have a period the whole time I was on it, I realize that's normal, In May I had my first one since stopping the shot, it was a very light period, The middle of June I thought I was going to have another one, but since about the 15th I've been having just spotting everday. I do have a doctor's appt. tommorow, but I wasn't sure how concerned I should be about this, I kept thinking it was just cause my hormones weren't back to normal yet, but it's been about a month.

It is Roxanol 20mg/ml, we have three bottles for different residents that are the exact same strength that came from the same pharmacy and the same drug company. Two of them are red and one is yellow.

Just wondering if other places have to do as much checking on orders as the rural hospital I work at. Every time any order is written, the nurse notes it, then another nurse has to check over it and co-note it, then the night nurses have to go through all the orders making sure everything is done properly and note that the chart was checked. I can understand the reasons for doing all this, but just wondered if anywhere else they had to do all this.

At the nursing home I work at we have a resident receiving hospice care, he has COPD and was ordered PRN Roxanol for air hunger. The hospice nurse had taken care of getting the order from the physician and getting it from the pharmacy. The resident doesn't take it very often, but I have given it to him twice, I remember the first time I gave it I noticed it wasn't Red like I've always seen it, but didn't think much of it. The other day our assistant DON asked the pharmacy consultant about it since we have 2 bottles from the same company of the same strength of Roxanol but one is yellow. The ADON is going to investigate it further, the pharmacy consultant said he would definitely question someone taking it and altering, but they did at one time have Roxanol that was orange. We are a very small place with few nurses and there's not anyone that we would suspect of this. Has anyone ever seen Roxanol that was yellow in color?

I definitely would write up an incident report that included your actions in calling to question the order and the doctor's reacton. Did the doctor change the order to 10mg again the next day. That is a very high dose for Ativan.

Hi, I work in 44 bed LTC facility, I work 2p-10p I am the only nurse in the building with 2 aids and an extra aid from 4-7 just to watch the alzheimers patients. I do all the meds/tx's/charting/medicare assessments/etc. It helps alot that I have worked there as an aid and an Lpn so i know the res. and the routine. I don't usually have a problem with getting all this done, unless there is extra dressing changes or treatments than usual. But if I get a little bit off track from my routine it can be a very hectic night. Good luck!

Thanks everyone for all of your support. I just needed some time to cool off and relax and get it off my chest. I'm feeling much better now, of course It's been a week since I worked there now, and I have to work with the nurse I don't care for tomorrow night and she's in charge. Unfortunately the nurses who goof off are all in their 40's at least. The only one I've had the problem with is the one that gets to be charge nurse and is in her 20's. The nights I work with her are the only nights I wish I wasn't working night shift. I am working 2 night shifts a week from 4p-4a, and also two evenings from 2-10pm at the nursing home. I really do prefer getting off work at 4am rather than crawling out of bed at 3am, (I have a hard time making myself go to bed early at night.) In May there may be part time day shift position available due to a nurse retiring. I know I'm probably not first in line to get it, but I don't think a whole lot of the night nurses really want to go to dayshift. So I'll just keep telling myself that it's only 5 months and I might get to go to days. Nichole

I started working at a small rural hospital the end of November, and was orientating on Day shift, I loved it, I got to do a lot of things I hadn't done since graduation 6 months ago and alot of new things, also I loved the nurses I worked with they were great at helping me. Tonight was my 3rd Night Shift, The first night, I didn't know what to think, I worked with a bunch of very immature nurses who goofed off and made noise all night, it got pretty annoying, I was worried about getting in trouble that night:chair: The last two nights I've worked with other nurses, and the one who has been in charge is only a few years older than me, but she talks to me like I'm stupid and acts like she knows everything, I'm afraid to make any suggestions or comments, cause I don't wanna listen to her go on and on about how I'm wrong. (Sorry I'm rambling) Anyways this morning when I got off work and saw the day shift nurses I almost cried (I'm not sure why, maybe b/c I was relieved to go home, but wished I could work with them instead) Then again it could be totally unrelated and it's just cause my hormones are all out of wack right now. On the way home from work I was mad and depressed and wanted to cry and felt so wired that I don't know if I'll ever be able to sleep! I seriously thought about quitting, but I know that I just need to give it a little time, but I don't know if I can stand another night.

I understand shaving the patient for better hygiene, but I do understand the daughter being upset to some extent, although it sounds like she overreacted. If a patient has had a mustache for years, then it is obvious this is something want and should be respected, It seems more like a dignity issue to me. Any nursing home resident has already lost a lot, including their home, ability care for self, privacy, etc. And as an alzheimer's patient he has lost his ability to remember and probably to recognize other people and had a cognitive decline. It may not seem like a big deal, but to someone who has already lost so much, a mustache probably is a big deal.

I've always worked in a Medicare skilled facility, we have a flow sheet for all Medicare patients, which is basically a head-to-toe assessment: LOC/Orientation Skin Color/Temp Skin Turgor IV Site Heart Rate/Rhythm Respirations Lung Sounds Cough/Sputum Pulses (palpable, weak/strong/thready etc.) Abdomen (soft/nondistended etc.) Bowel Sounds Urine Color Voiding Difficulty Edema Homan's Sign Pain/Med given/Relief This little checklist doesn't take long to do once ya get used to it, hope I didn't forget anything. We are also required to chart every shift. The aids get VS every shift. In my actual Nurses notes I usually include any of the above that are out of the ordinary any work I've seen the res. doing with PT or anything they've reported to me, if on O2 and sats. I also include amount of assist needed with ADL's. It's really not that bad once ya get used to it. I work in a 44 bed LTC facility, on the 2-10 shift there's one Nurse, 2 CNA's and from 4-7 an unlicensed employee who keeps track of the Alzheimer's res. (This is extremely helpful and has decreased our # of falls.) We currently have 2 skilled resident.

I know that most women are able to get pregnant within 1 year of being on Depo, I just stopped getting it after 2years, Just wondered if there's a certain period of time I need to wait to try to conceive, to prevent any complications due to the depo?

After so much time, I think about 2 hours, the computer will ask if you want to take your break and you have to raise your hand to be escorted. You can also raise your hand at any time to go to the bathroom, but any breaks you take do count against your time.

Hi, I was just wondering if anyone wore crocs to work? I've heard some controversy about insurance companies not allowing them to danger of tripping. I admit that I have 2 pairs although I think they are really ugly (due to the holes). They are really comfy, my feet feel just fine after a 12 hour day, but I also have noticed that I do tend to almost trip in them often. Anyone else have any opinions.

hi i recently retook the nclex and passed with 265 questions. remember: 1.) take a deep breath before you start and relax and whenever you start to get nervous 2.) read the questions carefully and take your time 3.) remind yourself you made it through nursing school, you can do this! 4.) take the break you are offered, let your mind rest for just a few minutes this board is a great place for support and suggestions! it helped me alot! good luck!

http://www.diabetes.org/for-parents-and-kids/diabetes-care/administration.jsp

http://www.uniformcity.com

My license came in the mail on Friday!!! No more stressing about the NCLEX! I'm so glad it's over and I can finally enjoy my life without feeling guilty about needing to study! Good Luck to everyone, I'll keep praying for you.

well, took my test today had all 265 questions!!! I know it doesn't mean anything but it still has me scared. I didn't have any lab questions and only 1 calc which was extremely easy. I had a lot of questions on TB meds, prioritizing and assigning pt. care. I also had at least 3 different questions related to autonomic dysreflexia. Good Luck to everyone!!!!!!

I have read that Vit B12 can be given as IM or SubQ, I don't know if there is any difference between deep subQ and any other subq injection.

Thanks so much for the encouragement!

Hi, I will definitely keep you in my prayers, I am having the same problems remembering different lab values. I take my test at 9am tomorrow Sept. 7, so keep me in your prayers as well!!!

I failed my boards and am retaking them tomorrow!!! I feel sick to my stomach. The thing that annoyed me the most was before I got my results everyone kept saying "Oh you passed." Then after I got my results and didn't pass everyone kept telling me I would pass the second time (because I had to much stress the first time, wedding,buying a house, etc.) My DON and Administrator both told me that they both had to retake their state tests a second time. I felt a lot better after hearing my DON's story, (got married, failed nclex, lost her job, found out she was pregnant, had a miscarriage, took a review class and passed the second time, and this was all in a 3month time span!) When I first found out all I wanted to do is cry, I couldn't hardly talk to anyone, the worst part was though when I got to work and had to tell them there, I felt like such a failure and thought I was stupid, but I have very supportive coworkers who have more faith in me than I have myself and I never felt as if they thought different of me because i failed.

I completely agree with you! In the state of Kansas as soon as you are aware that you failed the NCLEX you are no longer allowed to practice as a GN, I failed the NCLEX and had my LPN to fall back on instead of CNA. I don't see anything wrong with having the GN or CNA follow the RN and be oriented as long as they are not practicing like an RN. I would definitely refuse to sign off treatments that were performed by the CNA. It doesn't matter if he's a good nurse or not, the law is the law and I wouldn't put my own license in jeopardy.

I work in a facility with 44 residents and the one day shift nurse comes in at 6am and passess all these res. their meds at breakfast and it is not a problem. Unfortunately some of our night shift employees get up people at 4am, but usually there are 2 or 3 alzheimer's res. that are already up wandering who get dressed first. Then they get up the rest of the people who are confused and not aware of the time, many of these people also go to bed between 7and8pm also so they are still getting 8 hours of sleep, although interrupted a couple times, then they take naps after breakfast and lunch. When I first became an LPN I worked many night shifts as a CNA, and I really loved it because it was like getting a really long orientation, I felt a lot more comfortable having another nurse there and not being the only nurse in the building. (we staff one nurse and 1 CNA on night shift.) since graduating from RN school, I haven't worked many nights at all and only twice as an aid, some nights I prefer to be the aid and have less responsiblity.