Hi everyone! Im hoping i can get some advice and guidence about nursing school. Ive been a lpn for 19 yrs, prior to that i was a cna for 10 yrs. Ive been researching lpn to rn bridge programs and im completely OVERWHELMED!!! I have no current college...
Ok, i need some assistance from all you knowledgable nurses out there. Just a little background. I have an elderly lady in the advanced stage of dementia. Diabetic,not very well controlled d/t her noncompliance with diet and meds. She can be behavori...
Nurse_Pauline replied to Lfransis's topic in Geriatric
"Working night shift hard to "reorient" patients with dementia. One night has women singing gospel songs and crying out for God as "Sunday at church"...attempted reality orientation, talking in soothing tones and telling her it was night time, she w...
Nurse_Pauline replied to Lfransis's topic in Geriatric
"Try having as your most vocal patient a woman who ran an illicit brothel for several years during the 50's "... Oh would that be a riot! I bet she was great the stories she could tell!! And I still firmly believe that if lying makes my resident fee...
Nurse_Pauline replied to Lfransis's topic in Geriatric
I have a 27 yr history with dementia residents, both as a cna and a LPN. Currently Im involved in a 60 bed long term care dementia unit,and managing that is quite a challange. My father in law also had Alzheimers Disease when he passed, so I have had...
Nurse_Pauline replied to purplesdk's topic in Geriatric
I have to say, the types of jobs that the mds co. and the adns are, the responsabilities they encompass, i cant imagine them being together. Im not sure of the amount of beds at the facility, if they have subacute or ltc? If there is a case manager? ...
Nurse_Pauline replied to CapeCodMermaid's topic in Geriatric
I know at our facility we report falls with injuries, trips to the er from a fall, (whether they were treated or not, dont agree, but hey), resident to resident altercations,including sexual ones. I run a 60 bed dementia unit, so ive seen alot of tho...
Nurse_Pauline replied to banditrn's topic in Geriatric
Personally, I dont care what time it is, if I have a resident that has a problem,I call the doc,24/7. Of course,you try to use your best judgement in these types of situations. A lab thats a little off? No, I wouldnt call. Temp of 102, not responding...
Nurse_Pauline replied to txspadequeenRN's topic in Geriatric
This is an awfully complicated issue, isnt it? Which is why my own wishes are very well known. If this man can carry on a conversation, is he competent enough to make his wishes known? Has anyone actually asked the resident how he feels about it? His...
Nurse_Pauline replied to MrsStraty's topic in Geriatric
Congrates on your new job. Ive been a nurse manager of three different units over the last 12-13 yrs. Its a difficult and very rewarding job. The main thing is to stay organized. Know when reports are due. When your careplanning days are. I do all my...
Nurse_Pauline replied to mickeypat's topic in Geriatric
I think the reg in my state is vital signs shiftly for the first 72 hours, then daily, but at the facility i work at we continue to obtain vitals shiftly. We also use a skilled nursing flow sheet for our medicare pts which is like a checklist instead...
Nurse_Pauline replied to dinkymouse's topic in Geriatric
At our facility it also is a hippa violation to post info in residents rooms or outside the rooms. We have red spine name tags on the charts for a dnr and white for full codes. And we use a red nameband for dnr and a clear one for full codes. But, an...
Nurse_Pauline replied to Gaylord_Focker's topic in Geriatric
Briggs forms are very good for flow sheets. As for coumadin flow sheets, i know there was a posting on that not to long ago. We also keep the cbs on the med sheets with the insulin orders, we dont use seperate flow sheets for those. The 24hr I&O'...
Nurse_Pauline replied to trudy88's topic in Geriatric
I think it would depend on the state you are in. I know here in mass most paperwork is kept for 7 yrs. As a manager of a unit, i keep the current year of pharmacy receits,cna assignments,glucometer checks refrig checks ect on the unit in seperate not...
Nurse_Pauline replied to BowlerRN's topic in General Nursing
I work in long term care, and the night shift does a 24 hour check of each chatrs doctor orders to ensure all orders are transcribed properly and nothing was missed.
Nurse_Pauline replied to CapeCodMermaid's topic in Geriatric
I find this issue very difficult for many nurses to deal with. No one wants to give the "last dose"of Morphine and hold the med because of a low resp. rate or because they "looked" comfortable. Personally, i would never hold Morphine, despite the rr,...
Nurse_Pauline replied to IloveSnoopy's topic in General Nursing
As a nurse manager, i can tell you, it can be awfully tough sometimes to deal with the multiple complaints you recieve in any given day. Between other staff members, other discaplines, family members, doctors ect, it can get very overwhelming. And at...
Nurse_Pauline replied to johnson0424's topic in Geriatric
Also have had deficincies on wgt losses. On my unit (60 beds, lots of hoyer lifts) 7-3 obtains the weekly wtgs (pts that have hx of wgt losses, g-tube pts, new admissions for 4 weeks) 3-11 obtains the monthly wgts. It works out about half and half ,w...
Nurse_Pauline replied to CapeCodMermaid's topic in Geriatric
You have my sympathy CC. Recently survived joint commision,wasnt too bad for me. I run a dementia unit and they stayed away. I know they are big on Patient Saftey and the timelyness of MD's seeing Pts after admission. Beyond that our survey was prett...
Nurse_Pauline replied to Couture_Honey's topic in LPN/LVN
Im in Mass. Management position in LTC. With the same company for 14 yrs. Currently making a bit over 25.00 an hour. I believe that LPN's are starting at our facility for 16-17 depending on experience.