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El Dorado County. Thanks. T

Not anymore? I recently started working for them (within the past year). I like my job, but it seems so disorganized. I'd like to learn more if you're into a confidential conversation...my email is [email protected]. I thought that CFMG had the Placer contract. Please drop me a line if you don't mind. Thanks, T

CFMG? If ya don't mind my asking;)

Hey Sierra Nurse...I'm in Northern CA too. What county are you in, if ya don't mind me asking. T

Thanks for your replies! I'm starting to become more assertive with the CO's. There are only a few that make my blood boil. One in particular...a young buff, arrogant, cock butthead. For example, last night after med pass there were a couple of IM's that I had to assess. One has HTN, c/o a severe HA and the other had c/o chest pain earlier in the day (his EKG was a little questiobale, but he was not having a heart attack). Anyway, I called these IM's up to assess them and this CO said, if you have anyone else to see do it RIGHT NOW! I want them all here RIGHT NOW! I said, "hey, the night nurse needs to call a few up for meds they missed on med pass when they are out of church, visits etc. If you don't want to stand by, find someone else to do it or I'll just document that you refused to stand by. He huffed and puffed and yelled some more." There is a real "us vs them" attitude right now because we are questioning how a psychotic IM ended up in a restraint chair. I told them NOT to put her in the shower, and they did it anyway. Long story. I really kind of like this job, I just need not to take the Co's attitude personally and be very, very assertive. Does anyone know of any classes/inservices that I could sign up for specifically centered around physical assessment in a correctional setting? Thanks again, T

Hi, I'm an LVN in California. I accepted a position at my local county jail (300 inmates) about 6 weeks ago. I'm a recent grad and my first job was in LTC. I really like correctional nursing. I feel like I'm doing well, but sometimes the volume of work is overwhelming. We've been without management for several months, so everything is pretty disorganized right now. We have a new manager starting next week. To top it off our regular medical officer is out on medical leave so misc CO's are randomly assigned, sometimes to their dismay. My biggest challenge is the custody staff. Most are nice and supportive, but others are very passive resistant--ie, when I go out to find an officer to assist me, they all suddenly get busy, pick up the phone, turn toward a computer screen. One young woman, my son's age treats me like an inmate. This disrespect makes my blood boil. In addition, I meet major resistance if I decide to send an inmate out for a "fit for"...I'm pretty strong and manage to stand my ground, but it sure is hard to work in a unsupportive environment. Advise? Otherwise, this job is a trip. I've learned so much, and my 12 hour days fly by. Thanks, T

Hi, I graduated last December. My first job was in LTC, I learned a lot there and even filled in for the supervisor on several occasions. I was there 4 months when I decided to apply for a job as correctional nurse at my local county jail. Whoa! Correctional nursing is a cross between the ER and a psych facility. Never a dull moment and a TON of responsibility. I work 12 hour days, $21 per hour for the first 8 hours and time-and-a-half for the final 4. Good pay, good benefits and fantastic experience, especially in terms of assessment skills. The full moon made for an especially crazy day yesterday! Good luck to all. T

I just started a new job in correctional nursing in CA. I'm a relatively new grad LVN. This job is a total trip! I make over $20 per hour---great benefits. I want to get more involved in conversations on this site. I'm on a pretty high learning curve, but I'm getting some pretty positive feed back from management so far. I struggle with the chronic detoxers...the CO's want to release 'em, but they are obviously in bad shape. My orientation hasn't been great, but I'm pretty good at figuring stuff out on my own. When do ya keep 'em and when do ya let 'em go out and find a drink?? Advise?

Hmm, I didn't mean to sound all worked up over anything, I just wrote a post describing what my job is like. The only thing wearing me out is trying to provide adequate care for 33 residents. LTC is a tough, but I find many aspects of my job rewarding.

i work in ca and i have been trained to be the on-call supervisor in my facility. the rn's don't seem to mind and treat me with respect, which is nice because i often go to them asking for advise about things that i am uncertain about. i work several days every month as nurse supervisor in my facility. thank goodness the rn's there are kind and supportive. we don't have the rn vs lvn battle going on where i work.

Hi All, Things are going well. I'm working full time, hoping for a permanent part time kind of schedule sometime soon. I'm learning a lot about every aspect of the LTC "business" as well as how to manage 33 residents. It sometimes feels very overwhelming, but I get a lot of positive feed back from everybody. I can't say that I actually enjoy the job yet, but I can say that the work environment is very good. The time that they are taking to mentor me is a great learning opportunity. I spend a lot of mental energy even on my days off worrying about this-and-that, but I'm sure that will get better as I become more comfortable with my role. Right now, I'd just like 2 days in a row off! Thanks for all the advice and support! I'll keep in touch.

Canada must have some different policies. LVN stans for "licensed vocational nurse" which is the same as "licensed practical nurse." For some reason TX and CA call us LVN. I like the nurse supercisor role because I get to communicate with physicians, personally assess the residents and do stat procedures, which utilizes my skills. I help out where ever I can. But paperwork is the biggest issue....I was highly trained to do assessment and careplan in my nursing program, so I'm happy to have an opportunity to keep my skills. As a new grad this is all very intimidating and the state is coming next week ..YIKES. My facility has a very low turn-over for nurses and not bad for CNA's. They treat everyone pretty well and right now they treat me like a queen. I'm having some difficulty directing the CNA's. Some try to manipulate me because I'm new. Not many. They are the hardest working people in LTC by far. I believe in mutual respect, but I also need to be strong enough to make sure they do their jobs adequately for the sake of the residents. It is very hard to be a new grad, a new employee and be handed so much responsibility. So far, so good. But, inside, I'm terrified! I'm using my nursing skills though, and gaining confidence. Too much too soon....?

The same thing is happening in my area. Sacramento CA hospitals aren't hiring LVN's. And, like you they were actively recruiting us in 1st semester. I'm currently working in LTC. I hope the tides change because the few hospitals which do hire us require at least 1 year acute experience and the 1100 hours of clinical that I had at school doesn't count. I'm managing LTC ok, but it is more work than is humanly possible!

Just a quick update...I'M DOING IT! I'm working with a great group of people (I'm staying out of the gossip circle). I've heard through the grapevine that the DON thinks that I'm doing such a great job that they want to train me to do some supervisory stuff. The nurse supervisor goes on vacation next month and I'm scheduled to orient with her next week. As a new grad I really don't think I'm ready for that and don't want to rock boats with long term nursing staff. Already, they are refusing to pay the regular staff double time for OT because I've been hired. Anyway, today I'm feeling like I can manage LTC and hopefully become really good at my job there. My biggest frustration is not having enough time to spend with the residents and assess them properly. I appreciated all of your words of encouragement, because I really questioned whether or not to even hang in after the first few days. Thanks.

Bless you. You ARE an angel! I just started as a new grad in LTC, my RN preceptor is full of praise and tells me that I don't belong in LTC. Unfortunately in my area I don't have a choice right now. I am very medically knowledgable and it was such a pleasure to get such kudos from an RN. There are "good and bad" nurses. The initials behind the name don't tell the story....the proof is in the pudding. Mutual respect is so very important. We don't have time to do battle, we all have people to care for!

Well, today I went in to continue orientation to find out that my preceptor AND the assistant DON had called in sick. I was on my own. YIKES! I managed the med pass and treatments. To top it off it was wound day, which is not generally taken very seriously, but since the sate is coming the DON flagged them in the tx carts. I do take wounds very seriously and made certain that the paperwork was done. The CNA's are (for the most part) great and the DON and administrator expressed great appreciation and praised my every move. The DON told me that she was going to keep me on orientation status for an extended period so that I can be guaranteed 3-4 days of work per week. Currently I am considered "on call." There are a few days they want me to go it alone toward the end of the month, but I'm sure that days like todaywill happen. LTC is tough, sepecially for a new grad. Just when I reach the point where I'm thinking "I CAN'T DO THIS!" I do; and it gives me a little boost. I have already learned a lot. But I feel old and tired and guilty because I have no energy left for my family. This was day 5. I didn't sit down for the entire shift. I figure that I need to become really familiar with the workings of this facility, and I need to get the job done. Hopefully, someday I'll be able to take breaks. There is ALWAYS somebody interrupting my med pass. Hospice, PT, OT, ST...families, staff, emergencies. Jeeze, it feels impossible. We need a desk nurse and a treatment nurse. 33 residents might be managable if we had just another nurse or 2. Darn it!

Interesting you should sat that. I am pretty methodical about my med passes. I had a different preceptor today and I could tell that I was making her fall behind because she was trying to do the med pass "right." There are 66 residents in my facility and not all have armbands and/or photographs, so I'm anxious to just be able to put a name to their faces. This is not my dream job, but I want to give it my best. I'm just going to try my best to set my priorities. Insulin needs to be on time, for example. I sure wish we had a treatment nurse. In fact, I'd like to be it. I just got off work, so I'm feeling pretty overwhelmed. I start evenings later this week, so that will be another new experience, with a new preceptor. GROAN. I just heard that Sutter and Kaiser are starting to hire new grad LVN's again in my area, so at least I'll have a little hope for employment if this doesn't turn out well. I have oodles of notes so my med pass tomarrow should go ok. Thanks y'all!

I've been told that I'll be able to page the DON when needed....another number I don't yet have. I think the biggest problem is that the nurses who are orienting me are so busy that they really don't have time to go over the detail stuff with me. I think that I'll get copies of all the paperwork involved...careplans, incident report forms, staffing sheets etc. just so I can look them over at home. I'm a worrier and a tinksy bit obsessive, so I'm probably putting myself through more stress than is necessary. Thanks for your advice. I'll probably have more questions for you as the days go by.

Thanks for the advice Deb. My preceptor gave me the same advice. I think that I'm doing pretty well for a newby, but I really need to become very familiar with the residents and know "what to do if....this happens" ya know what I mean? I'll have a pow wow with the DON this week. Thanks

Thanks again for your replies. I'm concentrating hard on the med pass routine right now and trying to make a "cheat sheet" re: who can swallow, who needs their meds crushed etc. What a massive task! I still need to learn all about interfacility transfers, when to call 911, family members Docs etc. So much to do. Then of-course there are CNA assignments which is a challenge since I don't even know their names yet. I'm thinking that I'll go for continuity of care and let them tell me where they want to go until I learn more about the them and the residents. We'll see. I have a sneaky hunch that the DON is going to want to end my "orientation" as soon as possible. I've only been there 3 days and I think that I'll ask for at least a couple of more weeks to orient. What do you guys think is a reasonable time line to ask for. Remember I'm just out of school..... I just don't want a patient to aspirate meds or some other awful thing like that. To top it off, the state is expected to show up any minute for the anual review. Ugh! Tell me about what THAT is like!

Thanks for your replies. I started work Weds and "they" say I'm doing very well. My preceptor told me that I'm the best nurse she's ever trained, new grad or not. Why then do I feel Sooo overwhelmed. I managed to do the med pass, and treatments for 33 people...not on time I might add. I haven't started charting yet and there are so many, many things that I don't know how to do. They want me to work evenings...only one other LVN in the building. Do you all find that evenings are slower paced. Fewer tx and meds? There is a big issue about OT in this facility....meaning one is not allowed to work OT. So what should I do? Stay on my own time, or not get all of my work done. I suppose they could "write me up" either way... Suggestions? It is not humanly possible to get everything done in 8 hours and I refuse to cut corners or otherwise fake it by signing out on something that I didn't actually do. I suppose it'll get easier as time goes on...do ya think?

Yup, I'm "real." In CA vitals are taken Q4h on med/surg floors. Even at night. For a patient with a GI bleed or some other condition putting them at risk for shock, vitals are often ordered evey hour. If I read the original post correctly there was an RN, LVN and CNA on board. Isn't it a reasonable expectaion to at least look at the patient every hour? A patient on the floor long dead seems pretty inexusable to me. I stand by my original opinion. The LVN is responsible. I'm an LVN, BTW.

I agree comletely. If the LVN was hired by the facility she/he must have been considered competent. LVN's want to be respected and considered "real" nurses. We need to be responsible for our own actions. The RN should not be fired. On a med/surg floor vitals are suppose to be taken q4. Gimme a break...the LVN and CNA were in the break room or something. How hard is it to peer into a patients room? A patient on the floor really should have been noticed. At least if he were in bed one could argue that he appeared to be sleeping peacefully.

I'd love to read your article whether it's published or not. If I give you my email address, will you send it to me? As a student, I felt like I was being chewed up and spit out most days. I had some pretty unpleasant clinical interactions...or lack thereof. Some of my classmates were booted of the program for petty stuff because of the "tattle-tale" mentality of some of the staff nurses. One was either disliked or hated, fortunately I was only disliked. A major complication was the fact that our clinical practice took place at 3 hospitals that were in the process of phasing out LVN's. The attitude was "what the h-ll are VN STUDENTS doing in OUR hospital." I did work with a few wonderful RN's who great teachers. Nurse practitioners were the kindest and most patient teachers. Bless them. The RN's were always more than happy to delegate wounds, NG's, accuchecks, caths and the like to us, so we all got lots of clinical experience. The back-stabbing that I witnessed during my tenure as a student was sometimes shocking. Some floors were great and I attribute it to good management and an atmosphere of respect and team work. My instructors generally put me on "difficult" floors because they thought that I "could handle it." I did. Barely.

I go tomarrow for pre-employment drug testing (urine). I have an Rx for Xanax 0.25 q6h prn for anxiety. I rarely take this med and probably haven't taken any for at least 2 weeks, though I took it as precribed when I was stressing over the Nclex. I've read where it is detectable in the urine for up to 6 weeks. I intend to list this Rx...question: Do you think this can affect my employment? Can I be denied the position because of this Rx?? Hope not!