StarNurse2006

Yes, we receive a month's worth of meds at a time, except for Medicare meds, which come in 14 day supplies and have to be reordered as needed. At any given time, only about 10% of my patients are on th 14 day cards. I cannot imagine having to reorder as needed for everyone...to much room for error, since there seems to be weeks where the pharmacy is SO SLOW in delivering!

I have done something similar...if the patient is their own responsible party, their request to go 911 trumps MD's refusal to give an order!

The facility I work in is currently on a "the resident has the right to fall" kick. State surveyors were very restraint-focused this year, so we are implementing a new fall-risk program. The staff as a whole is VERY resistant to it. However, I am pleasantly surprised to find that it is actually working out OK. I have only had one my residents fall, but better that she fell off the bed (trying to get up) as opposed to off the bed from another 12 inches up, going over the siderail. LOL The hardest part is getting used to seeing my residents in bed with both siderails down and stopping myself from running frantically into the room and pulling rails up!

Loves: My residents, of course. They are who keep me coming to work every day. The autonomy, as someone else mentioned. The busy pace. Hate: The people I work with who feel that you can walk into LTC, be lazy, and then pretend to know everything. Dealing with difficult families. Lack of communication between departments. Overall, I know this is where I belong, as an LVN. When I complete my RN, I'll run screaming! (And probably be back the next day to say hi to everyone! LOL)

Our facility has a pharmcy rep come in on the first of the month with all of the meds in large cardboard filing-type boxes. The rep checks against the MARs to make sure all the meds are there, and then the boxes get locked up in the med room... Until the third of the month, when each charge nurse changes out all the cycle cards for whatever med pass they are responsible for. (For example, I do all the 9AM and 2PM cards because I work 7-3. That way, the nurse who is responsible for those meds puts them away, in room order. PRNs/Narcs (even routine ones) are ordered/come in as we run out, and we receive 3 deliveries a day. It's not a perfect system, but it sounds a bit easier than some others have it!

I would also love to hear more from those who have taken the exam! I have been looking into this myself and bought the text recommended by NAPNES. The website stated that the exam was based off of this particular text. I bought the older addition for 88 cents on half.com! The name escapes me at the moment! At any rate, please share if you have taken the exam for the curious!

Sorry I wasn't more specific! I was referring to registry in a hospital setting. 33 patients in LTC is MUCH more hectic! I was rather bored with 6-8 patients. It made for a long day! :)

Every morning I have a quick meeting with the CNAs assigned to my residents. I give them any report pertinent to their assignments, confirm what showers they have assigned, let them know if a (combative, agitated, etc) resident has or will be medicated, tell them my expectations (vital signs in by 10 AM, let me know when you are leaving the floor, etc) and ask them if they have any issues they need assistance with. It takes less than 3 minutes, and it makes for a fantastic day. I believe it makes them feel that we are a team and they can come to me with issues, and it also makes them aware that I DO watch to make sure things are done correctly and that I appreciate them. If a CNA does not meet my expectations I set out, I counsel them, in person or with a written warning. That is usually sufficient to prevent a second occurance. We call these the morning "Come to Jesus meetings." LOL :rotfl:

I work in a LTC in Southern CA. We have a 99 bed facility, with 3 charge nurses each taking 33 beds (regardless of census, but it usually evens out) I work 7-3, so I have 3 CNAs, the other 2 nurses have 4 CNAs. Honestly, on a typical day it is not at all unmanagable. Yes, I'm busy, but I have the DON/ADON on weekdays as well as other department managers who are nurses, when the need for advice/assistance arises. We have a TX nurse 7 days a week as well. On the weekends, we have an RN supervisor. I started at this facility as a new grad, and after working some registry shifts with myself and an RN for 6-8 patients, I find I thrive on my busy LTC day!

Just curious about this... I think everyone has heard stories about women who had no idea they were pregnant and then suddenly delivered. I had heard a story like this about a friend of my Mom's, thought "yeah right, whatever," and forgot about it. However, my MIL was one of these women. With her second child she said that she had no idea she was pregnant, because she was overweight, on the pill, and had a period every month during her pregnancy. While on vacation in Las Vegas (we live in Southern California) she felt ill (abdominal pain and vomiting), and her husband drove her to Sunrise Hospital. You can imagine his surprise 30 minutes later (there is a family history of extremely short labors) when a nurse came out and informed him "It's a Girl!" It probably didn't help that he'd been drinking all night. LOL :rotfl: Ever since, my sister-in-law has been know as the "Sunrise Surprise." People absolutely do not believe me when I tell them this story, but I believe her! After all, she had one child before and knew what pregnancy was like. I admit I wouldn't be rushing to take a pregnancy test if I was on the pill and having my period each month. It's harder to explain away the kicking and movement of the baby (thought I was going to die with #2 because my daughter was trying to come out my bellybutton!) but still...anyone have any experience/stories with this? Jennee