calypte

I don't know what to do anymore. Background... graduated in October as an LPN/LVN. Finished a preceptorship in med/surg, decided it wasn't really for me. I've been working on call in LTC since January (there are no permanent positions for new grads in my area) - I'm the charge nurse when I work a 12 hr shift, with 3-5 care aides for 30 residents (depends on time of day), and it has been fine so far. I am not overly stressed about the work - Nothing that seems out of proportion. My coworkers are great, everyone works more or less well together, very little 'ego' issues... my nurse manager is a lovely person, and always supports me in my work and in my requests for more/less staffing if need be, and I certainly enjoy the residents at the facility where I work. So why am I so unhappy? I dread hearing the phone ring. I feel hunted. In nursing school I hung my scrubs in the closet in their own little section, all freshly pressed. Now they are in a drawer. I don't even want to see them. I was excited to take some post-LPN/LVN courses/workshops, and my instructors in school thought I'd do well as an RN. I graduated at the top of my class. I just looked again at the college I planned on attending (more advanced wound care stuff was what I was going to take) and NOTHING interested me. I just don't really seem to care. There was no emotion or excitement at all. I do a good job when I am working - I am present and thorough. But the work in uninteresting to me. I am not energized by it. The thought of continuing on to be an RN makes me feel sick. I feel grateful that I have work, and I know there are many for whom nursing is a dream... What should I do? Even if I were to quit eventually, how do I cope in the meantime? I feel like I was once passionate and excited about this, and I feel very cheated. Can I ever become interested again? How can I get some joy back in my life? The negative feelings are starting to extend everywhere and I feel paralyzed at every turn. I want to enjoy this work. The best case scenario is that I can be excited about it... but I don't know how to get that feeling back. I don't want to just 'wait and see' anymore. I think I've already been doing this for months... Is this normal?

Thank you for this thread. I had an awful day today. I got chewed out by an older RN for missing something that I shouldn't have missed (with no tragic consequences, by the way, but still, something i should have been on top of). I told her "yes, i should have performed such and such an intervention after making such and such an observation" (to make a long story short) and that I was embarrassed that I'd overlooked something that seemed so obvious later! She said "you should be embarrassed". And continued on to make sure I felt ashamed. I can't stop thinking about the shift now. She really rattled me (this was midshift) and now I'm not sure if I got everything done or passed on what I missed to the next shift... I know that anything I missed was minor/not life-threatening. For example, I know that as I was leaving I remembered at the very last minute that I had meant to put Mr. so-and-so in a fresh brief before I left. I talked with his daughter on the way out and told her that if she wanted she could help him, (the family has been very involved in care) but I didn't let the oncoming shift know... Such a minor thing, that probably got done by the daughter. But I'm terrified of getting there tomorrow and having someone basically say "you didn't do a good job". All I want is to leave feeling that I did the best I could for my patients, and I felt like I really failed today. I got some great support from a couple of staff members, who informed me that the older nurse had a particular personality that leant itself to criticism like that. But I still cried so much when I came home, and I don't want to go back... I feel sometimes like this is just too much, I don't want to have to come home every day and question myself and analyze whether or not I did a good job

lol I think the ladies can have beer if they'd like! I've not seen the ladies club get together yet while I'm on, but I assume there might be an option? There are a few ladies that have a glass of vino with dinner which I think is lovely :) It is odd about the folks that change their own briefs isn't it? I recall one E. European gentleman in particular (97 y/o!) still mobile w/walker and will toilet himself throughout the day... but still wears briefs and requires assistance w/am care (he's rather wobbly upon waking, though we try to get him vertical in stages). Ideally he is not to toilet himself, but he is fiercely independent to the best of his ability and he's quite annoyed if he's prompted to use the toilet or if someone follow him! (To quote "I am an old man, not a baby" was his reply to one of the aides...) It would be interesting to find out about the folks that do seem to have the briefs available as a choice. I've noticed in my limited experience in LTC that there are many odd things that go on in the facilities I've been at... (one bizarre and sad example... one of the nurses @ another facility told me that on her wing a resident is given prozac in her coffee w/o her knowledge! The family (one of whom has decision-making power for the resident) consented and the rationale is that it keeps her quiet!) --- I agree mermaid that I'm going to need some special TLC if I'm ever at a facility... I'm looking forward to seeing how LTC will evolve in the next 10-20 years, as I suspect people who are beginning to enter older adulthood will NOT put up with many of the practices still in place! (I could NOT imagine my father w/o wireless internet...)

I'm a student and I've been doing a practicum in a really wonderful LTC facility that bases its philosophy in part on the Eden Alternative. A few things that really stood out for me: - as has been mentioned previously, residents are allowed to wake and eat on their own time. For most people this is between 0800 and 0900, so it's not as demanding in terms of shifts in the dining room as one might expect. For the few that like to wake early or sleep in, it seems to significantly enhance comfort, and makes the dining room overall less chaotic - instead of a set menu, residents in the dining room are offered a selection of food choices in steam trays that rotates through the dining room on a cart. There is a fruit and beverage cart that makes rounds as well... I think the moving bev cart is a great idea because I've often found those items on carts in the first place! For many residents, visual choice is easier to comprehend than a list of options, and people are not forced to eat overly large portions or foods they don't enjoy. I have found so far that residents are more likely to choose beverages other than or in addition to coffee/tea if they see the choices. The fruit is display with a cutting board, so that people can choose just a little fruit instead of "the whole thing"... for some tiny ladies this is more appropriate and ensures that they actually have some fruit :) - residents have a locked glass display case outside their rooms to display photos, precious objects, medals, etc... i think this is wonderful because one is reminded immediately that there is a complex person behind every door, one who is very unique... I've seen variations of this with a photo display on doors as well. Many people have photos of themselves as young adults which is really fascinating... - instead of storing small pieces of medical equipment or supplies in obvious places in resident's rooms, things are placed in cupboards or left on the linen carts. For example, briefs/incontinence pads etc. are not stored in one's bathroom in an obvious way, but are left on the linen carts. Night shift will put out pads/briefs for the resident for the day on the bedside table @ their last round of checks for the am shift to use for the resident before breakfast. People who change their own briefs have them in small cupboards usually brought in by family. - staff are encouraged to contribute to the home-like environment through their unique talents. One person plays the piano for the residents if they have some downtime (and since the staffing ratio is very appropriate given the residents needs, this is certainly possible). Others have contributed artwork, people bring in fruit + flowers from gardens etc. etc... - there is a "men's club" and a "ladies club" once a week for residents to socialize in common area... the men who are allowed get a small glass of beer!

That definitely helps, thank you SO much!

Thank you so much!

that would be amazing! Thank you so much :)

Question from Canadian student... repost from Nursing Students forum: I need some info on gliclazide (sold as diamicron in canada). Can't find it in prentice hall 2009 + davis 2008 (i think) drug guides... likely due to the fact that this drug is not available in the US (and I think I have 2 american publications) I know the drug is a 2nd gen. sulfonylurea antidiabetic agent. I need some information on important nursing interventions to include in a nursing process outline for administering this med. Here is the original thread w/discussion so far: https://allnurses.com/nursing-student-assistance/gliclazide-listed-your-407449.html#post3741454 I have a NIDDM pt. (w/ chronic renal failure, HTN, CHF) taking 80mg PO bid... according to drugs.com this usual dose is 80mg QD or 160-320mg in two divided doses with meals for tx of type II diabetes Will the nursing considerations for this medications differ greatly from other meds in its class? My guess is 'not', but I'd rather not be guessing here. Please help! Thanks in advance

yes I'm in canada... I know the drug isn't available in the states. I suppose this is why my drug guides don't list it...

Maybe... glipizide is listed in prentice hall with the trade names "glucotrol" and "glucotrol XL". The availability is in 5mg and 10 mg tablets or SR tablets... in the MAR I'm using for this pt, it states "one tablet" under the listing for gliclazide, 80mg... *sigh* This is the link I was looking at: http://www.drugs.com/cons/gliclazide.html I'm sure that the drug are really, really similar, which is why I'm sure the ns. considerations for any in that class are also really, really similar...

I need some info on gliclazide (sold as diamicron in canada). Can't find it in prentice hall 2009 + davis 2008 (i think) drug guides... This drug is a 2nd gen. sulfonylurea antidiabetic agent. I need some information on important nursing interventions to include in a nursing process outline for administering this med. I have a NIDDM pt. (w/ chronic renal failure, HTN, CHF) taking 80mg PO bid... according to drugs.com this usual dose is 80mg QD or 160-320mg in two divided doses with meals for tx of type II diabetes Will the nursing considerations for this medications differ greatly from other meds in its class? My guess is 'not', but I'd rather not be guessing here. Please help! Thanks in advance :)

in my area we are "nursing students" as here the term "nurse" is a legal title identifying Registered Nurses and Licensed Practical Nurses. Our nametags say "NS" after our names. (Or "PNS" for practical nursing) There was some kind of 'executive decision' made at some point I suppose... Not sure how it all works, apparently they just changed it recently...

Just to clarify my question... I've been poking around on the forums for more posts about doulas and nurses involved in the same birth, and I guess what I'm most interested in is your opinion on if/how a doula can fit in to a hospital birthing environment, and what experiences you've had to lead you to those opinions :) dancingdoula i'm curious what it was the doc didn't like about your advocating for your client? was it in the sense that they didn't like ANYONE advocating or??

As the title says... what do you think of doulas? Do you have any experience with doulas present @ a birth? Thanks in advance for sharing