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Rehabilitation; LTC; Med-Surg
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ZanatuBelmont specializes in Rehabilitation; LTC; Med-Surg.


ZanatuBelmont's Latest Activity

  1. Hi everyone, this post comes with great humility. I just need to vent in a forum where I know people can understand and, possibly, offer me some wisdom. I was licensed August 15, 2009, as an LVN in the state of Texas. I began my nursing career at a nursing and "rehabilitation" nursing home. Everything was excellent, until I began using my "book smarts" to guide me. Then, slowly but surely, I became less and less liked by staff, especially aides, whom I expected to NOT lounge around in a resident's room for "breaks." Come December, ALL PRN (that was my title, but I began as FT) were laid off. THE HUMILIATING PART -- I began work at a well established national rehabilitation hospital. Here I loved what I did: the hours, salary, staff, and patients. At its core, rehabilitation was "my calling." After six weeks of floor orientation, I was "let loose." Not even three weeks into my freedom I was placed back on orientation. I administered six doses of 10/325 hydrocodone within a six-hour period. This brought to question my knowledge about medication administration. Fast-forward another month. My 90-day review comes up. I was ranked "does not meet expectations of this position." I was placed on a probationary 90-day review, where I'd spend most, if not all, of my time under the direct supervision of another nurse. The CNO even stated, "Although you are spending the longest time compared to others on orientation, consider it a learning experience." OK, fine. I can do that. So today - the day after this 90-day review (first day on my probationary period), I made several mistakes. First, I forgot to sign off a medication I gave. "If you were to disappear and we went through your MAR for a med pass, we would end up giving the medication twice because you neglected to sign it off." That was the CNO's example. Point taken. Then I told my preceptor I had not collected the three blood sugars I needed to check before lunch. I then told him, "Don't worry, though - the policy and procedure guidelines state if in this case check the BS either one hour after (with an expected result And finally, here's the kicker. I gave a blood pressure medicine to a patient with a BP of 101/58 and a pulse of 70. The parameter states, "Hold if systolic So essentially I was told, "I can't fire you, I'll have to speak with HR on Monday." I of course cried, pleaded the many frustrations with my entire situation, and called my stay with this facility "hopeless at this point." So I was fired in a round about way, but I was not actually fired - I resigned immediately. Even if given a "second chance," how could I function in a place that would now microanalyze me so closely, that neglecting to cross a T or dot an I would probably result in termination?! So, I quit. I just feel so pitiful right now. I always wanted to go to Med-Surg, but now I have second thoughts. If I can't even function safely in a REHAB hospital, why would I even THINK about a hospital? I'm going back to nursing homes until at least August (that will be my one-year experience) to work on my med. admin skills. Sigh.. I don't know what to think. To do. To say. I just feel so hopeless with this career now. Everything I was taught in nursing school is for the birds. Most of it does not apply. And you're damned if you do, damned if you don't in this wonderful profession. On a side note, I've NEVER had a patient complaint. In fact the CNO said my customer service skills often exceed expectatons, so at least I've mastered that. But anyone can do that. If only I were a REAL nurse. :(
  2. ZanatuBelmont

    LVN writing orders?

    Hi guys and gals, I've been employed as a nurse since August (I graduated at the end of July). The other day we decided it best to D/C the liquid Hydrocodone/Codeine we had for a resident that can now take tabs PO. "Sure, no problem," says I. So I write the order, which read, "D/C Liq. Hydrocodone/Codeine and replace with PO tablets." Then I charted "New order for PO tab Hydrocodone/Codeine - void order if not signed by appropriate authority within 24 hours." The next day my ADON jumps all over me. "Honey, in LTC, we don't get orders signed within 24 hours. That rule only applies to the hospital. Sometimes we won't even see a doctor for a month." So my question is this. I thought the "must be signed within 24 hours" rules was UNIVERSAL? Or is there something in the Nurse Practice Act which allows a LTC LVN to write an order and it not matter if it's signed for 30 days? I feel like this LTC care facility is the EASIEST way to lose a license... ugh. I just want clarification about my ability to "write an order" that isn't signed from a doctor within 24 hours.
  3. ZanatuBelmont

    Taking NCLEX-PN this Wednesday!

    Hi all, I am taking my NCLEX-PN Wednesday for the first time. I am concerned because I have been using "exam mode" on the Saunders CD (2008 version) and I keep getting 40s and 50s on Pedi/OB and eyes/ears. Is there anyone here that used Saunders, made those low scores on the exam practice, but still passed the NCLEX-PN? My strengths are (score of 80 and above): Cardiopulmonary, immune, endocrine, neuro, musculoskeletal and integumentary. I would hate for the "child part" to kill me!
  4. ZanatuBelmont

    How Important is Accreditation?

    Interesting question. I can't imagine your nursing license being "legit" without completing an accredited program. Check out the California Board of Vocational Nursing website and search for your question there.
  5. ZanatuBelmont

    How do you balance work and school.

    Many students in my program borrowed the full amount in stafford student loans to pay for their living expenses. If you are in a 12-month program at a community college, you should be able to swing $350/month on basic needs, and just work part-time @ 16-20 hours per week to make up the difference. If you are a single mother without much outside family support, you may have to tough it out and work 40 or more hours per week. It is possible, as many in my program did it. You have to sit down and organize your time on paper and then stick to it. There is no other way; only option is to be organized. If not, you'll fail out.
  6. ZanatuBelmont

    How to prepare for LVN/LPN school

    Do not get in the habit of depending on a buddy to help you out. You will pair up with someone, eventually, in the program. It will be tempting to ask them "Hey, do you know the rationale for this?" Find it yourself. You are, after all, in nursing school. Take time to look up answers to your own questions. That's the best way to learn.
  7. ZanatuBelmont


    I recently landed a job in the OR but had to respectfully decline. Two reasons: They wanted me to put my RN pursuit on hold so I could work into their schedule. Second, it was just too damn far! A shame, too - because as I interview more and more, I find it rather difficult to land a job as a new grad. Many look at me and speak as if I did not even master a "real" nursing program. It makes me feel somewhat humiliated and I'm explain what I can to make myself as marketable as possible: the skills I've learned in school, the six months of patient care, clinical experience, etc. But... nobody seems impressed. They always want someone with more experience, which makes me feel even more incompetent. I imagine, though, that we'll be OK - we have to hang in there and remain focused. There is a place for us, and we are not incompetent - we simply need more hands-on training which, from what I've heard, is typical of new grads be them RN or LVN.
  8. ZanatuBelmont

    Massavie amount of info to study...How?

    You need to focus primarily on the nursing interventions, lab values, diagnostic procedures, typical medical management, and have a basic understanding of the pathophysiology relating to the issue discussed. If you have 50 pages to study and only five days to do it, you need to study 10 pages per day and then spend 10 minutes reviewing what you learned before going to bed. Also, with powerpoint notes - you must remember those are "Skeletons." If the projector discusses a topic and lists one or two important facts, you need to go into your book and learn more about that topic.
  9. ZanatuBelmont

    Who's most at risk for developing HTN?

    That's not the point. Yes, all those options were risk factors - but the question is asking you to identify the person with the highest risk. I choose option C because he has a known family history of HTN whereas with the others it's a guessing game.
  10. ZanatuBelmont

    Who's most at risk for developing HTN?

    From my understanding African-American women, not men, are at highest risk for developing HTN.
  11. Daytonite, that was an excellent response. I never looked at it that way. I've been asked many times what nursing "means to me." I always replied with the typical "compassionate care" reply, but looking at it from a scientific perspective makes more sense and, to be honest, changes my view of nursing into a more professional one. I wish my instructors would have put it as you have. There are times I feel like I've learned more from this forum than I have in class and studying the books. I don't know if that's good or bad.
  12. ZanatuBelmont

    What I head during my BLS Training (true story)

    I don't even know what an IUD is.
  13. Why is living in purity and helping the doctor a "girlie" thing?
  14. I think during NS we are built up to believe we have to be a superhero and make no mistakes our first six months working, but that's just not how it is. There are times I hear people discussing something (an illness, for instance) and what they intend to "do" about it. All of the sudden I have a "click" inside and I start going through these different priorities for care, comfort, and health maintenance in my mind. I imagine it will be similar on the floor as a nurse - you know, having that "click." Unfortunately for all we learn in NS we know very little, but we are more prepared when we think. The information you have learned is in there, somewhere, in a dusty filing cabinet. I imagine when you're on the floor you'll naturally "go" the right direction and instinctively ask for a second opinion from another nurse, worried more about your patient rather than your image as a "competent nurse." Try not to beat yourself up. You have two semesters and all you can do is learn the most you can. You'll never be "ready" for the floor, but one step at a time you will become confident. And remember, if you've taken nothing out of nursing school besides ABC's and how to maintain a patent airway, then you're already ahead of the game.
  15. ZanatuBelmont

    Working with mostly women. Heaven or Hell?

    Yes you will mostly find males in acute areas.
  16. ZanatuBelmont

    I'm 39 and want to become a nurse.

    You're not too old. I actually think employers discriminate more against young nurses (under age 24) than they do older graduates. And no, you are not too old - there are at least 30 people in my program of 150 who are over age 40. You're not old yet, but a lot of people find it beneficial long-term to get their BSN so they can work in management when they are in their 50s and 60s to balance their physical aging related to physical workload. What do I wish I knew before I started NS? I wish I had used Saunders from day one. I started using it as a companion study guide at the end of my second semester, resulting in an entire letter grade increase on exams. I also wish I had focused less on the anatomy and physiology of the diseases and more on nursing interventions. It's great to know what cells are responsible for in the body, but the doctor isn't going to ask you for their cellular makeup history! The only subject area I suggest knowing inside and out (including the A&P of it) is the cardiovascular, respiratory and neurological systems. Without those three systems functioning properly nothing else works how it should. So you should know those areas well.