SweetRevelation

Do make yourself a 'cheat sheet' or sorts about the patients -- how they get their meds, any special diets or restrictions, allergies, code/no code status, how well they can communicate, any hearing/visual limitations, any special devices, etc. This will help you get to know them quicker. When I first started in LTC, it took me months to learn the names and faces -- that was the hardest part for me. I don't know how many patients you'll have, but don't hesitate to ask a co-worker if you have any questions about anyone. LTC is stressful and you'll want to keep yourself as organized as possible and before you know it, you'll work out your own time frame and system of getting what you need done on time. Load up your med cart with everything you need to prevent extra miles on the feet during your shift. Also, carry extra pens, gloves, a pen light and your steth which will come in handy before the administration of certain meds.

Bx_RN2B wrote: "On a 3-11 shift I typically have to hang 3-7 feedings....do 5-12 fingersticks (with coverage)...pass all the meds...TXs....suction and do trach care...closely monitor my psych patients....closely monitor my sun downing alzheimers patients....do an admission or two...put a knee replacement on a CPM machine....I do all the nebulizer treatments....chart...do the 24 hour report...make the CNA assignments....do dining room duty 1 day a week...hand out PRN pain meds (we have so many people on narcotics it takes 30 minutes to count them all at beginning/end of shift) run down the CNAs and make sure they do their jobs...get b*tched out by family members because I only have 3 aids for 40 residents and their loved needs to go to bed like right now! Or they are missing a sock and they want to string me up for it....I could go on forever and ever." ^^You just described a typical shift perfectly... and then some! To MedicalLPN: First off, if you choose to go to LTC, I applaud you and wish you the best at the same time. LTC is a crazy kind of stress and it's not for everyone and believe me, I've been ready to pull my hair out on more occasions than I care to admit while working LTC. I realize you wish to change the type of stress you have, but sometimes change isn't always for the better. I'd be torn on this decision, too... but again whatever you choose, good luck!

I'm like you... I cannot sit on my bum and be completely caught up and see another nurse buried up to his or her eyeballs and do nothing. Even if I only have a few minutes, I will go and ask the other nurse if there's anything I can do and I'm more than willing to do it. I work with some nurses that, no matter what, will NOT help out whatsoever. I've been buried with admissions and paperwork, IVs, etc. and the other nurse will be sitting at the desk reading the newspaper. It's very frustrating! When something is said, the excuse is that they're 'on break' or they just needed a quick 'breather' because they're loaded with work too when I know that's not the case. At any rate, I'm all for working together if possible even though I know each nurse has his/her own responsibilities. Things just go smoother when you're willing to extend a hand. Everyone benefits.

I've kinda had the same thing happen to me, although not on an evaluation. I was told that even though I'm a good nurse and that the families and patients give me high praises, they (the admins) feel I'm not managing my time wisely enough when I don't get out until way past clock out time. I happen to manage my time very well I think because it's something I'm not only persistent about, but something I have to do with as many patients as I have at one time (35 in a shift). Spending that extra bit of time communicating with your patients makes me feel secure that I'm taking the best care I can of them in the time I have and also comforts the patient, which is also what nursing is about. It's not just about the meds and labs and paperwork -- they're people and they need us. I never regret spending extra time with patients or families. If I can help them in any way, no matter how big or small, then I walk away a better person and they feel better, also. If and when I do get such a thing said to me on an eval, I'm sure gonna let 'em know what I think.

I do home care daily for a guy that has an indwelling and when I first took over the position of caring for him, upon learning of his enlarged prostate, I immediately started ordering Coude catheters. I replace it q2 weeks and the curved tip makes insertion much easier than regular foleys. If ya have a patient that has enlarged prostate probs, Coude is the way to go.

That's exactly what I do, especially since half the time, locating the actual clamp is quite impossible where I work. Works perfectly.

I'll never forget back when I was in nursing school, my instructor always used to tell us something to this effect -- When you're out on your own, don't ever get too comfortable. You want to be on top of things and that little bit of nervousness keeps you sharp and focused. Personally, I still feel a bit nervous even after doing what I've done for this many years. You never know what's going to happen and you definitely want to be on your toes and ready.

Currently, I work in LTC and our CNAs do personal care, baths, ostomy care, general help with ADL's, I&O, and feeding. They're not permitted to do finger sticks or any other care that's considered 'invasive'. They can do minor dressing changes, if supervised by a nurse, though.

I work in LTC and we have certified med aides occasionally that do our med runs for us. They are already CNAs or GNAs (and have been for at least a year) and go through a special college program that teaches them to administer meds. Ours don't do finger sticks, shots, PEG tubes or anything like that and are not supposed to do narcs. Do I feel it's unsafe? Sure, it is. But I agree with what ac123 said about how it's cheaper to hire a med aide than another nurse. Personally speaking, where I work, the med runs are painfully long (well over the acceptable guidelines for what's legal) and we nurses never have enough time in the shift to get what we need to get done, let alone any extra things that may come up. Some days, it's nice to have a med aide that'll take care of the meds so that you're not having to stay over 4 or 5 hours to complete your work that should have been done. This all goes back to the nursing shortage and trying to make nurses do more for less. I won't get on that rant, though. Bottom line is, I don't think it's safe to have med aides but I don't think it's safe to have overworked nurses either.

Where I work, there's supposed to be a 'dress code' also, meaning no drab colors or whatnot (brights make people cheery or something) but I've found that the dress code isn't enforced much at all. I've seen more nurses and nursing personnel wearing black than ever before and it works for them. I guess it's just a personal preference. Two of my fave scrub sets include one black pair of pants and one brown pair. I do brights, too... variety is the spice, so they say. :)