michiganmark_rn

synthroid, calcium, prilosec, metoprolol, amlodipine, 81mg asa, colace, norco, fentanyl patches, acetaminophen, lisinopril, simvastatin, sinemet, metformin, amaryl, senna, miralax, namenda, aricept, MOM, dulcolax suppositories, albuterol, ipratropium, spiriva, advair, lasix, klor con, detrol la, flomax, oxybutynin, iron, multivit, levaquin, bactrim ds, keflex, acidophilus, keppra, bumex.

As a nurse, my one and only concern is that my unit manager be able to properly manage the unit, treat their staff fairly and get the job done. If they can do that with an lpn license, I'll happily accept their supervision. If they are not capable of doing that, I could care less if they have their lpn, rn, bsn, masters, doctorate or have been personally vouched for and blessed by the pope. Show me some professionalism and ability and concern for the welfare of the unit and I'll love ya forever.

My unit prints us census sheets organized by med cart with resident names on the left by room number and space for report/notes to the right. Equipment info is already included so body alarms, low beds, fall mats are already included. I put one slash through the room number first pass, two when I finish second pass. My CNAs have 9 residents each typically and are the hardest working and most compassionate men and women you'll ever meet. I have between 25 and 30 residents if I do a set that has both ltc and rehab or 30 if it's strictly ltc. The things I've learned is besides the DON, YOU are the busiest person in the building. Don't wait around for people or charts, use your resources and calmly move forward. There is no magic number to managable amount as we all know one extremely disruptive resident can throw your day off. I know when I first started 30 residents KILLED me and I finished late, was frustrated and stressed and just not enjoying life.

Depends on how many admissions/discharges I get but typically I'm done on time but it's taken me a year of building and refining my organizational skills enough. I work the 7-3 shift, I usually arrive about 10 minutes early and gather up the paperwork stuff I'm going to need (blank vital sheet for my cna's, skin assessments for the day, census sheet, cna assignment) and unpack my supplies. I keep a wrist bp cuff, thermometer, pulse ox, steth, scut monkey and davis drug guide on my med cart. From 7-7:30 I get shift to shift report, write out my vital list and check the bowel book looking for residents that'll need a prn dose of MOM. I then quickly sort the stock meds so they're easy to find, get fresh apple sauce and water and at 8am I hit the hallway rolling working on my 9am pass. I don't stop, I don't chase residents - if they are in the room, they get meds and one slash across their name, if they don't, they don't earn a slash. Those few residents that only have one med pass time earn two slashes and are "done" with meds except prns. The ones that don't 'earn their slash' I'm going to catch as they leave the dining room before they go off to activities or rehab or whatever. I usually have enough time after my first cruise down the two hallways to flag my treatment book for later. As they leave the dining room, the ones without their first slash get their am meds and earn their first slash and my 9am med pass is usually finished by 9:45 or so. My next meds are a mix of 12noons and 2pms so I now have time for skin assessments and treatments. I do as many as I can before 11am when I do noon meds. 11:30 or so is a luxurious 1/2 hour lunch and then an hour of charting, phone calls and tasks. 1pm I start 2pm meds whether all my charting is done or not (usually not). I finish meds, finish up treatments and then retire to the desk to finish up charting. Most time I have charting done by 2:45pm so I lounge around the med cart, emptying my trash, restocking, wiping it down. To me, med pass is what killed my speed for a long time, especially looking up meds with the big drug books. Scut monkey has the info I need most of the time and after a year, very few patients are on meds I haven't seen before. I've tried many, many shortcuts - none of them work. I've tried flagging my MAR before pass and unflagging as I go, I've tried flagging my 2nd med pass if they have meds when I do first, I've tried labeling med cups - slashes are the quickest and have been foolproof for me. My charting speed has also increased with time and there is a rhythm to it that insures you write down everything you wish to convey. I don't go searching for charts that are out of the rack until all my other charting is done. Most of the time the dietitian or mds or whomever will have it returned before I finish the other charting. Don't ever chart when your stressed, it's a time waster and what you write is in there forever. When I started, I would be stuck charting for sometimes 2 hours after my shift and would leave flustered and feeling like I wasn't very effective. A year later, it's much better and I love LTC and am glad I chose this over hospital nursing.

Not everyone can handle the emotional stress of hospice. If your heart is leading you to hospice work your back end needs to follow. Best of luck in your future job - while I believe I'm competent enough to do that job, I'm not sure I could emotionally handle it. A good hospice nurse is SUCH a blessing to both their patients and the families. I work LTC, I'm at the tail end of my first year as an RN and I'm constantly at awe of just how wonderful and valuable a good hospice nurse is.

I hired in full time, days. I'm looking to switch and get 16 hour shifts instead of 8s but I'm at a facility that appreciates their nurses and works well as a team.

Word of advise from someone who is in the program, you can save your money and skip buying the dosing calculations book. The math is quite easy, your instructor gives you practice problems and the book is a waste of money. Use that extra $$ for something useful like a nice stethoscope or anti-anxiety meds :)

Yeah, your anxiety and paranoia is a precursor to a life changing experience. The parts of foundations I remember being difficult was getting through your baseline assessment checkoff without running out of time and doing your very first care plan. The one bit of advice I'd give is to NOT buy the crappy stethoscope they recommend. It'll be fine for doing your vitals for checkoffs but during clinicals you'll love having a better scope for bowel/lung sounds. You CAN hear everything with the cheapo, but it's a lot easier with a moderately priced scope. As far as care plans go, use the search function here and seek out advice from the user daytonite. She's probably gotten literally hundreds of students through their care plans and seeing how she rationalizes through gets you thinking with your 'nursing brain'. Also, take the time in pharm to keep well-organized notes. You probably won't need it so much to get through the class but you will refer to the material again....and again...and again.

Fart jokes and inappropriate scratching would be a welcome change of pace compared to some of the conversations I've had now that the female nursing students are comfortable around me. While men tend to be crass more often, female nurses and nursing students take it to a whole other level! I wouldn't trade the experience for anything in the world!

I made note cards all through my prereqs but just do NOT have the time to do it while in the program. I skim the chapters before lecture. My lecture instructor does power point presentations, which I print out before class and add notes to the slides as she presents. This goes with me for review during breaks at work and at least once a day for about 20-30 minutes. When your reviewing your notes, read them outloud and explain them to someone (even if that someone is imaginary). When I have time, I try to go through the related textbook chapters and "flesh" out my notes with info from the text book. Usually a couple of days before the exam I work the questions at the end of the chapters to see where I'm still weak and I'll reread those sections in the text again. I used to also type up the objectives at the beginning of the chapter with info from the chapter but time hasn't allowed it lately due to the evils of care plans. Nursing exams (at least in the fundamentals/foundations level) seems to revolve around applying the nursing process and a lot of common sense. Another thing I now conscientiously do is start my exams with positive self-talk, set my pencil down for 30 seconds after each page is finished and tell myself how it's just another test, I'll do just fine and it really doesn't matter. Another test trick I do now is I NEVER change an answer unless I can explain why my original is wrong, and the new answer is right. By taking time and focusing on relaxing during the exam, the answers come easier. Another thing ro remember is the cone of learning: you will remember 10% of what you read 20% of what you hear 30% of what you see 50% of what we hear and see 70% of what we say 90% of what we say and do Considering the above, if you only have an hour to study, what do you think would be the best usage of that hour? Good luck!!

This is exactly what I just posted I was looking for, how come I couldn't find this thread before I posted?! DAYTONITE YOU ROCK!!!! THANK YOU THANK YOU THANK YOU THANK YOU THANK YOU THANK YOU!!!! :bow::bow::bow::bow::bow::bow::bow::bow:

I've read through the posts where people have posted their patient's assessment for care plan help, but I would like to get some practice BEFORE I get into clinicals. I can almost guarantee what I'm looking for is out there, but I'm not finding it. I would like a site that lists the abnormal assessment info, along with plan of care so I can take that assessment and create my own plan of care to see how I match up with the experts. I need this to match up with NIC, NOC and NANDA as much as possible. This has to exist but so far, I've only found sample care plans and care plan software. Anyone have a resource for me? For those of you struggling with careplans and think I'm crazy, realize, in 2 short weeks I'll need to assess during my clinical on one day and submit a finished careplan the next day, giving me enough time to go crazy from stress, but not enough to really seek out assistance. (just because I have rationale for my action doesn't mean I'm not crazy though) :)

I've just started but I can tell you I definitely get the shaky voice on checkoffs. My checkoff instructor has watched us practicing and knows we know what we're doing, and I've very comfortable trial running the procedures with her watching but when it's "for real" I'm a nervous wreck. I did stop during my last checkoff and said something like "we're going to take a 10 second break now, due to my abnormally high blood pressure and pulse". It broke the icyness and allowed me to refocus on the task at hand.

I just started the RN program and so far, I've been pretty happy with the instructors so far. There is a lot of confusion/disorganization involved in the lab for 1410 with so many instructors and none of them seem to be on the same page, but you get the same instructor each time for skill checkoffs so just learn it her way and you'll be fine. At first I thought there was a lot of negativity with the instructors, but after quietly watching them struggle to keep the same people quiet all the time, I think I understand. They're also more relaxed than they were the first week. The coursework can be overwhelming if you look at each and everything you have to do instead of planning your time, but it's not difficult work (yet). Although I'm sure as time goes on, things will change but for now, I'd say they've been the best instructors I've had at OCC. Top things you can do to insure that they single you out and give you lots of grief: show up late, let your phone ring during class, bring drinks into lab. Avoid those three things and you'll be just fine. Hope this helps.

My school pairs up the guys together automatically for us since they assign us partners. While it would be no big deal either way, it is nice to be partnered up with other guys. As the only male CNA in my facility and one of the 5% of male nursing students, I'm grateful for the comradery of a little testosterone.