Peeker19

When I worked at a SNF we had the most lovely LTC resident. It was her birthday and her son made reservations to take her to dinner. He got it approved by the DON and that was literally all she spoke about for WEEKS before he took her. The night of her birthday he comes and picks her up and takes her to dinner. About 3 hours later we got a call from the restaurant he took her too asking that we come and pick her up. The BASTARD was SOOOO cheap that he couldn't pay for the meal so he told her he was going to the bathroom and left her at the restaurant. Some kind soul at the table next to her paid the bill and our driver came in at 9 PM and took the facility van to pick her up. That A-hole was banned from the facility for months was never allowed to take her anywhere ever again..... it still drags on my heart because she cried everyday at dinner for a month after that. PEOPLE SUCK!

Ok here is my instructions..... First I want you to take a deep breath out like this (show them)...Put your mouth around it (again show them without actually putting your mouth on it LOL) and take a slow deep breath in and hold it like your sucking on a straw.... The goal is for you to make this white thing get to at least 2500 if you can... Go ahead and do this a couple of times... not in a row we dont want you hyperventilating!! Do it at least 10 times an hour while your awake. Works everytime... usually dont have to show them more than once :) Hope that helps!

I have worked float pool now for 2 years full time. Started in float pool as essentially a new grad... only had 10 months of SNF experience. Do I recommend starting as a new grad? NO.... there were a lot of tears for several months :) BUT BUT BUT do I love float pool now? YES YES YES You HAVE to and I repeat HAVE to be flexible... period... if you cannot change gears quickly than float pool is not for you. I work nights and there are times where I get my assignment at 7 and meet my patientes and by 10 PM I'm floated to a different unit. There have been times where I have float three times in one shift, which can be trying. Yes sometimes you feel like an idiot because lets face it you can't know everything about every unit or every disease and you do have to ask questions, now and then. Yes you occasionally you get the poopy assignment because that pt has been on the floor for months and the regular staff is sick of them. Yes you will be the only nurse with the isolation patients sometimes. For me this beats out the floor drama anyday. If I have a hard shift with needy patients??? Guess what I know that most likely I won't be back to that floor tomorrow and have low chance of having to work with them again. You get a vast knowledge base and I feel like I can take care of any patient that walks through the door. The only places that I do not work is ICU/ Mom baby and L&D, which is just my choice. Hope that helps!!!!

What is your hospital policy regarding precautions for a pt with known bed bugs? Do you maintain contact for the entire length of stay? What about belongings? Can they stay in the room double bagged or do they need to be sent home? What is the process for cleaning the room after discharge? Just curious as our hospital does not seem to have a clear written down policy and I am concerned because ID has said that as long as their stuff has been bagged and they have been showered there is no need for precautions. Thanks for your responses!!!

OH yes I will be teaching all new grads and students for SURE! We all have our stories that we pass on to the next generation of nurses and this is one of mine that I will hope that everyone will learn from and never happens to anyone else....I even told the patient about swelling at the IV site and she said she never felt it so don't be fooled that they will complain of pain or discomfort with an infiltration, cause it is just not true and does not always happen.

I just need a few hugs, my pt's forearm PIV seriously infiltrated last night...it was really bad. There was blistering and leaking of the fluid out of the sq tissue, it was NS. The patient complained of NO PAIN absolutely nonesaid she felt a little swollen but not terrible. The pt was a bigger lady 250+ and it was difficult to visualize the change in size until you touched it and then it was clearly HUGE I feel terrible and incompetent....I should have ,could have, would have the whole ride home this morning HUGE aligator tears the whole way home...i just feel terrible Im trying not to let this ruin my day because it is my wedding anniversary today and I am trying to let this go but I am having trouble I have been a nurse over two years and this is my first ever infiltrate, I just cannot believe it.... Thanks for listening

My first RN job in a hospital was as a float and I still work in that position. Best advice is to try not to be too overwhelmed and ASK QUESTIONS!!! Every unit will be different just take it one day at time. Yes there will be tears but you will survive....we all dom Good LUCK!

That was how I got my hospital job was my LTC and SNF experience. Many people think that the LTC SNF jobs are the bung hole of nursing, yes at times they are BUT you gain valuable experience there in regards to time mgmt and prioritizing. You learn a lot about wound care. You learn a lot about the geriatric population in general. So I would take the position something is better than nothing. :cheers:

Thanks everyone for responding after some sleep I am feeling much better about itKelRN- The nurse that I was referring too said that because he was somewhat weak that I should not have gotten him to the bathroom and because he had a previous history of seizures and the dilatin and hyponatremia it was a bad call to get him up and walk him to the bathroom. I should have gotten him a BSC. So that is where that came from. But it would not have mattered whether he was in the bathroom or using the BSC, yes it would have been easier to get him back to bed but did I know he was going to have a seizure on me? NO or obviously I would have planned better. I am with you that they need to get up just like everyone else and use the bathroom whether they have a seizure disorder or not. I just wanted to clairfy that is where that comment came from.I am alot more clear headed today and feeling better so thanks again everyone for your input and support! I love this site! It makes me feel safe to ask questions that I do not feel safe bouncing off of fellow co-workers!

Let me tell you I have had one HELL of a night!!! I'm seriously contemplating not coming to work tomorrow. First off I had a pt that gets like 30 NPH at night, this AM his BG was 54. They made him NPO at 1800 and I gave 30 units of NPH tonight. Just as I finished pushing on the plunger it hit me. So I called the doc and have been checking BG frequently, pt has been ok. No need to rag on me I know that it was wrong and I need to think more, I made a mistake we are all human and it happens. Thank god the pt was ok. Then my other pt has some crazy electrolytes stuff going on Na 123 after two serial NA's, fluids (then no fluids, then fluid restrict etc )low dilantin ( gave 300 mg PO at 2100), high K etc etc. Pt has been a little confused since I came on. Needed to get up to use bathroom. A little unsteady on feet but moves with one assist. Goes to bathroom (something told me not to leave) pt was yelling at me to give them privacy and I just stood there. Got up from bathroom bobbed and weaved leaned against door jam and went non-responsive. I screamed for help and when the other nurse got there pt had a 3 second seizure. I yelled to call a rapid response. Got him in a wc and back to bed. By the time the calvery showed up pt was alert and oriented, does not remember the seizure but ok. So I have a nurse that is mad that I called the rapid response. She was the other one in the room and she told me it was unecessary to call. Oh and he has not had any seziure activity in ten years so it was not like I should not have got them up because of previous seizures. Am I wrong? Did I do the wrong thing? I have had two RRT calls this week and they were my first two EVER! I'm over it seriously. Then I also feel stupid because they asked me what kind of seizure and the only thing I could think of saying at the time it that he was "shaking" IDIOT!!! Guess it is time to brush up on my types of seizures. Thoughts?

Sort of a rant but for whatever reason at my facility we are being told there is a shortage of IV compazine, zofran, reglan and now we are running short on IV phenergan and most patients have it set up as IM phenergan. REALLY!!!! How are we so short on all of these drugs! I just do not get it....must be another debacle of the healthcare system So I have to tell my nauseated uncomfortable rectal cancer pt that not only do we not have much to give them BUT all we have is an IM injection.... let me tell you the response I got "I would rather be nauseated and puke than have another injection" can you blame them???? Oh and not to mention the 5000 Unit SQ heparin shortage that we are now required to pull from the 10,000 unit vial and get a cosign....talk about waste of time and energy. Thanks for listening

I am a float pool nurse who obviously has to get a long with anyone and everyone. I like that I am not apart of ANY DRAMA!!! That is why float pool ROCKS! I go and I do my three shifts and go home. There are no politics in float pool. I work nights to avoid managment (which honestly I have not even seen my manager sinve NOVEMBER 2011). There are some floors where I am very social and there are others where I say nothing. Depends on who is working with me. I leave work at work and home at home. I do not have a single co-worker as a FB friend although many have asked LOL. My life is my life and when at work it is always best to just do your job and SHUT UP!!!

OK OK OK I will have to chime in....OK so on the topic of foley's. I had a pt that was a littler elderly man who had fallen and broken his hip had not had any previous medical problems and he was 80! I had to start the foley and I walked into the room in my usual hustle hurry up task mode. I whipped the covers back and he was shall we say a little "firm". So I turned around and gave him a minute to get it under control. I go to put it in and I cannot get it around this mans gigantic prostate. So i got another pair of hands to help and smaller fr and it went in. So at the end of the shift when we I wished him well with surgery that day he says to me " I want you to know that was the first time I have ever been intimate with a female nurse" BBBBAAAHHHHH I think my face was so red it was purple and I just told him that he was an excellent patient and I left. Makes me laugh just thinking about it :)

3 days in the SNF setting Then we I moved to a hospital 10 months later I got 6 weeks. But I signed on as float pool so it was different floor each night and a different person they "dumped" me with each night. SO unfair and horrible, I thought I had made the wrong decision but now I LOVE IT! So glad I stuck it out.

My habit that I am still trying to break it saying I'm sorry for Everything! It is just a nervous habit and I say it to everything!!! I'm sure it is very annoying! Example: I'm sitting at a rolling computer and someone reaches over me for something. In stead of saying am I in your way.... I say sorry im in your way....they all look at me like I am crazy. I have gotten better and I do catch myself doing it and stop immediatley. :)