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  1. cleo777

    How many residents is too many for one nurse?

    I find it interesting that a DON and the facility don't understand the pressure and the stress, that is put on Nurses in LTC, and everyday you feel that you may be putting your license on the line. Does the facility care? or the DON care? Probably not, everybody pretty much is too busy covering their own ass's!!! If DON knows what nurses are up against, then do something about it!!! What I know is I love LTC and I went into nursing to care for people, not spend a whole five minutes with each resident, to pass the meds, and try to assess I feel their is no patient nurse relationship (professional), it is really like hurding cattle!!! I had 8 hrs of training, told them I needed more, but each day the facility I worked for had a excuse why they couldn't get more training, basically NO STAFF, so here I am 8 hrs of training, with thirty patients, I have the station closest to the nurses station, so basically everybody is a fall risk, oh and by the way, I had to basically learn the paperwork all by myself through trial and error!!!
  2. cleo777

    animal research

    Have you ever seen video's on utube, and I know you can't believe everything you see. But they had to make the video's somewhere, it is absolutely horrifying, I don't know how these experiment teams sleep at night. These poor animals really, we are literally torchering them. Why don't we experience on all the sex offenders sitting in our jails soaking up our taxpayers money!!! Oh yeah that's right they have more rights then the poor animal we want to suffer!!! Karma is a *****!!! You won't catch me ever doing research!!!
  3. cleo777

    LTC and med orders

    Thanks for your input, can I come work with you !!! LOL I wish the nurses I worked with...were just like you..I feel they think I should know all of this!!! After two month!!! You give me hope and also some good words of advice!!! Thanks a bunch!!!
  4. cleo777

    let go 6 wks into 10 wks orientation...is it fair?

    I am very sorry to hear this and as I read all the posts, I can't believe how this profession is so unprofessional. I am also a new grad and took a job in LTC I love being a nurse, but I truly believe there is something wrong with the facility I work in. I just want to run from it. Let's see this was my orientation/training, I was told I would have five days, I had about 8 hrs. I worked 1/2 a day with one nurse during her med pass, not even the patient's I would be taking care of, and then the next day, four hours with a nurse on the patient's I would have. It consisted of her telling me how each of them took their meds. And since then I have been on my own. It has been the worst experience ever, but I just keep thinking I am going to get through it, and since nursing jobs are hard to come buy I really hate to leave at this point, and then I have to consider how it will look on my resume. Nobody has gone through the paperwork with me, I am learning as I go, and I have 25 patients, so I can barely get the med pass done never mind, assessments, stacks of doctors orders, any treatments needed, dressing changes, you name it we do it. I have been there two months now, I am on day shift I always go in 1/2 early, which I dont get paid for punching in early, and I can barely get my work done in the 8 hour shift, and if you stay passed 8 hrs, that is frowned upon. I was allowed to stay as long as I needed for the first two weeks, and then it came down from the big boss, no more overtime for anybody. I dont get any breaks, and my work is sloppy because I am in a hurry and I know the afternoon nurses are ready to kill me because I end up leaving a big mess, not getting doctor's orders done, not documentating clearly, it goes on and on. I have told my RCM I feel like I am drowning and she continues to tell me that "you should see what are work load was like when I started" comments like this are not needed when you are drowning. And on top of that my first week on my own I had two patient's pass away, it was expected. There was a huge error on my day off and I ended up taking a med error, because the doctor's came in on my day off, nobody noted it and nobody knew the doctor was in, it was a decrease in a pain med, and I ended up giving it for five days after the doctor wrote in chart. I had no reason to look at that chart when I came back to work, patient doesn't have much going on and you don't get to look at every chart every day...It was only noticed by me because the pharmacy had called me about a yearly renewal needed, and when I looked at the doctor orders there was this new order, nothing done with it. I had to take the med error for five days, talk about feeling like an ass, and I am so glad no harm to the patient, could you imagine if something was going on with that patient and I continued to give it. I couldn't believe it!!!!! Oh yeah to top it off, every employee there is on probation, we actually have nurses that don't show up for their shifts and then call a few hours later!!! I have anxiety about going to work, never had it before. I feel everybody is thinking "that I am the idiot" as a new nurse. I know I am not a idiot and if you ever speak to any one of my other employees prior to my career change they would gladly have me back in a minute, but I wanted this career change. I feel like **** rolls down hill and because I am the new nurse it all rolls towards me, I am trying believe me but I feel like I am also on the chopping block, because I can't do what they are expecting of me without a chance. Sorry this is so long but you are not the only one out there being railroaded and I can't believe it!!!!
  5. cleo777

    LTC and med orders

    Good advice, thank you, I am a new nurse and working for only 2 months, with very little training in LTC, about 8 hrs, if that. I am trying to keep my head above water right now, without running and screaming from the facility!!!
  6. cleo777

    LTC and med orders

    Thanks for the suggestions, helped alot!!!
  7. cleo777

    LTC and med orders

    Lots of controversary over shampoo, it was only one example I came across that I could think about in the moment. The point is I am having difficulty with the statement other nurses tell me, that I can't ask for a medication, and when making a request I need to write it more like a MD order because when they are faxed to the MD office they read and sign. I had a gentlemen who was prescribed a prn of vicoden every 6 hrs for pain, and we were giving it every six hours, would you make a request for the MD to make this a routine medication and if so how would you make the request, without asking?
  8. cleo777

    LTC and med orders

    We pretty much need a order for everything, I was actually told by my supervisor to get a order for the shampoo, because that was my first thought, and was told ...fax the doctor first!!!
  9. cleo777

    LTC and med orders

    I work in LTC, and I am having difficulty writing requests for medications or treatments. I am told that I can not ask for a medication or a treatment? I am told I have to watch my wording??? And should be writing the request like a doctor order's. I had a pt who had dry and itchy scalp. Faxed Md "pt has dry and itchy scalp" suggestions? MD wrote back " moisturizing shampoo" I had to get it clarified because, it didnt say how often? I was told I should of included that in my first request. I was told I should of written "pt has dry itichy scalp, suggestions, as PRN? Any suggestions on exactly what is meant by I cannot ask for something???? Confused!!!
  10. cleo777

    Where are all the jobs!!!

    I am a new graduate working in LTC, I have heard that it is hard to get a job once you started in LTC. I really didn't have much of a option because there is not alot of jobs at hospitals for new graduates!!! And the ones that have come up, I have applied but have not had any luck, yet!!! But I needed to start nursing somewhere!!! Is it true the longer I work in LTC the harder it may be for me to get a hospital job? And what happened to the shortage in nursing? They is very few jobs for new nurses where I am living in WA and it isn't in a remote area but just no jobs!!! Where are all the nursing jobs????????????????????
  11. cleo777

    Need Help

    I am a student writing a paper on the ratio of staffing in nursing home...patient to nurse. I am having difficulty finding out information. Is there any practice guidelines or laws on how many nurses compared to patients.
  12. cleo777

    first nursing diagnosis

    You are absolutely correct, I don't know if it is muscle weakness, but when doing the assessment, and documenting, the nurse I was working with told me to document as Lower extemeties, equally weak? Due to the fact that when we transfer him from the bed to the wheelchair, we can stand with, but need two people to do this, and the only movement he is making is pivoting his feet, it is the only thing we can get him to do? Or is it the fact that he is not processing what we are telling him to do and cannot make that movement, dypraxia? He has no paralysis, he is a fall risk and has to be watched, one on one, because he gets out of bed in the middle of the night and falls but when we try to interact with him any other time he is almost comatose, and when he decides to speak it is with no no no no or yes yes yes, nothing else other than that..I was not sure whether it really was muscle weakness or not but now I understand what you are saying....He cannot do anything for himself at this point, no feeding, no dressing, no toileting...is this caused by dyspraxia, inability to do a purposeful movement, or is it that he has now some cognitive issues, memory issues, or is it caused by the dyspraxia? What is the underlying issue that he cannot do any of these ADL's for himself?
  13. cleo777

    first nursing diagnosis

    Okay I have CVA patient in rehabillation, and I am looking at the pathophysiology, of the stroke. As of yesterday, assessing him he cannot stand or at all on his own, he is a two person assist, he can pivot with his legs. He cannot feed himself, but he can move his arms, he has dysphagia, aphasia(speaks very little), dypraxia. So my question as I am looking at different nursing diagnosis, the related to factor in his immobility...is it really due to muscle weakness, or is it due to neuromuscular involvement. He does have sensation in all four extrememties. So as I look at my nursing diagnosis the related to factors, how do I determine whether is it muscle weakness, neuromuscular involvement, I can't talk with the client, because of his speech inability. This stroke happen approx 2 weeks ago, this is a big healthy guy, would his muscles start to become that weak that he cannot stand?
  14. cleo777

    Please someone help

    I have a patient with a TBI and his memory, cognitive abilities, a behavior has changed also, in my assessment he is very forgetful, can't remember if i gave him meds, cant remember the year it is, forget's why he is going to the dining room? and his wife also said before he was admitted he lost the ability to do simple math, and I understand the occupational therapy is now working with him. His wife told me he became very irritable and moody... so my question is on nursing diagnosis...of course... can i use impaired cognition r/t head trauma m/b memory deficiets impaired behavior r/t head trauma m/b patient's family states he becomes irritable Impaired copying r/t head trauma m/b the patient's fear he may may never beab le to return to the only work he knows how to do Needing some help if you have time
  15. cleo777

    help please...deperate for OB nursing diagnosis

    This goes with post 9.....she is also constipated...and I wanted to use Constipation r/t pregnancy......can I write the diagnosis this way? These nursing diagnosis are killing me!!!!!!!!!!!!!