Anise1

If a nursing program would accept the online class, then I would have absolutely no problems taking it that way. I just had awful visions of going through it and then having nobody accept it.

Maybe I have some kind of strange sleeping disorder, but I've always had a hard time understanding why anyone would even WANT to sleep on the night shift. I feel so alert and awake working nights, never tired, and I don't think I could sleep at work if I tried. (Now, getting up at 4 a.m. for the DAY shift felt horribly unnatural...) People who have a lot of trouble staying awake at night are probably the ones who are going to have the most health problems from that schedule anyway, so it could be a sign that y'all should change shifts ASAP!!

I've thought quite a bit about making a transition to nursing (from social work), but I absolutely would only want to do psychiatric nursing. I really would have no interest, talent, related experience, passion, or ability for any other specialty (geriatric psych comorbid with dementia/Alzheimer's would be the ideal.) Honestly, I would have no business trying to do anything else related to nursing, because I know I just wouldn't have much to offer. So my question is, what have people found the work situation to be these days? Is there ANYTHING in this area now? Is it better or worse than other specialties? All advice appreciated. :)

The only A&P I class available at the local community college (which is the only option for taking it now) is the online one (yes, with an online lab, God only knows exactly how this works). I am NOT happy with this, but there are just no other options. I'm going to try to find out *exactly* what they even mean by "online lab" tomorrow, but I don't have a very good feeling about it. Would any program accept this type of class to fulfill a prerequisite, or is it just better to not even waste my time? All advice appreciated.

I have TLE, and I am actually trying to get on the night shift because of a foot sprain that will NEVER get better with the amount of running around that we have to do on the day shift (I'm a CNA btw, not a nurse!) Are problems really so inevitable, or is it more because people don't tend to get enough sleep when they work the night shift? I never have any trouble getting to sleep or staying awake exactly when I need to, no matter what weird hours I have to keep. I don't see any problem with getting a full 8 hours every day. Also, the day shift hours have always felt so unnatural, and I think I really might do better being up all night (I've worked night shifts before.)

It's hard, because in some LTC places and situations, it is an OBJECTIVE, VERIFIABLE fact that the night shift simply does less work for more money. The night shift does not do what they are supposed to do where I am, and this is a provable fact. Now, the night shift nurses really DO have as much work and they do it, but the CNA's... no. Just no. They're supposed to take all vital signs, and we on the day shift end up having to do it; they're supposed to put everyone to bed, and we are constantly told to do it, they're supposed to get a certain number of people up, and I count every single morning, and they never do it... these are facts. No, this isn't true everywhere, but it is true where I work. (Oh, yeah, and we've found pillows and blankets in the back-- and it's totally against the rules for the night shift to sleep on duty!!) They're supposed to do a certain number of night showers, and they don't do them.... it's listed in the book, and we can see that they aren't doing them... this is a fact too... I am sick and tired of getting stuck with their work AND the work of my lazy day coworker. Where you are, this may not be happening at all. But if day shift people have worked in places like this, the resentment might unfairly carry over. I have been trying and trying to get on night shift ever since I started at my work, and there has never been an opening. I would be SO happy to work those hours and to have that schedule, I would trade in a heartbeat. Management should offer that shift first to people who actually want it-- but that's not what happens where I work! Sorry about the venting... but sometimes it just has to happen....

If this is true, then what should we do? Should nobody even think about bothering with one of these direct entry NP programs? Or will things change at least to some degree when the job market is not as horrendous as it is now?

A very dear friend of mine just dropped out of medical school with the EXACT same amount of debt he would have had if he'd finished the entire program. I just feel that in retrospect it was SO obvious that he wasn't cut out to be a doctor (and his grades, test scores, etc., had nothing to do with it; they were great.) If only he'd really sat down with someone who knew the field and had a long, honest talk, maybe this fiasco would never have happened. Sometimes I think I should have just asked him the really hard questions, even if it made him furious with me ("Do you honestly want to work with patients? Do you really think you're going to be able to handle the hours? What about the pressure? have you thought about x,y,z...?") So, yes. I think that maybe asking people "So, why do you want to be a nurse?" or "Why is this important to you?" could be a good way to go about it without being inappropriate. Grades and test scores are not the real issue and should not be focused on. Motivation, dedication and a desire to work with people have got to be there and can't be manufactured. Personally, I would give a lot if only there had been someone who had asked these types of questions and made me think about what I really wanted to do at the turning points of my life.

I'm at home right now with kidney stones... awful awful... tons of Lortab and about to go to sleep! With the sit to stand, I got the undershirt and shirt on him but couldn't pull them down, pulled pants up as much as possible, put on socks and shoes. While I would push from behind and the other person got his feet up on the lift, I would pull down his shirt some more. Then we'd get him on the lift, change out his diaper, pull up the pants and button them, and put him in the chair. We would both lean him forward and pull his shirt down in back. Pulling on the draw sheet... I'm not so sure see how that would help with turning him is the thing. It would be great if I just had to get a wedge or pillows under him, but this would be turning from side to side to change and put on clothes. But I will try. Roomier clothes wouldn't make any difference; that's not the problem, and fastenings being in the front is actually a whole lot better than if they were in the back. I've decided that I will never EVER try to put him on the Hoyer by myself, ever. I honestly don't know if I could roll him by myself (it seems so impossible, but I will at least try.) During the week, I will definitely never use that sit to stand lift to transfer, but what the care plan note said was to use the Hoyer lift for TRANSFERS only (not for getting him up and down and lying on the bed and turning and taking God-only-knows how long just to change him.) I talked to the other lady I work with on the hall and she said we would just have to use teamwork when the students aren't around (we're finally starting to get students again.) If I can JUST turn him by myself, using the Hoyer lift will be manageable. The other thing was that I found out why the order was changed. A new PRN CNA complained that she thought it was too hard to use the sit to stand lift with this resident. (!!!!!!!!!!) So now we're stuck with the Hoyer, which is about a million times HARDER with him, and this CNA comes in once in a blue moon and doesn't have to deal with daily consequences. The change had NOTHING to do with patient safety. I am sorry, maybe this is an awful way to think, and I don't mean to be mean, but I can't help thinking that this person really caused problems for the rest of us.

ETA: The main thing I have to do is to dress and change him while turning him, and also get him on the Hoyer sling. It isn't just turning him to repostion him-- I don't think that would be so difficult.

This resident is completely stiff all of the time (I think maybe it's part of the advanced Alzheimer's?) That never changes. He's never combative with me but has been to some degree with others (and I think they've put him on Ativan fairly recently to lessen that, actually). (Just for an example, I have a 300 lb lady who uses a Hoyer lift, and I have to turn her by myself, but she's no problem even though she really can't move much at all. She is flexible and she can also grab onto the side rails.) At this facility, we have to get everyone up every day, for the entire day, so the day shift (that would be me) doesn't really do the repositioning. I guess I have to TRY turning him by myself tomorrow, because I know we won't have enough help for that; if I have all 4 bedrails up at least he won't roll off onto the floor! If I absolutely can't do it, then that's that. But I'm very strong (no problems with the 300 lb lady!) I will NOT try to put him on that Hoyer lift by myself though because that's just asking for trouble. Wish me luck... And any suggestions, please post them!!

There is no help to be had. This is not a situation where I need help for 2 minutes to spot me on a lift. I need help for the full amount of time it takes to get this person up because he cannot be rolled from side to side by one person unless they are basically able to benchpress 225 lbs. There is nobody available for this amount of time in this severely understaffed situation. I hate being put in this position because it is unsafe for everyone involved.

Bumping an old topic... if anyone wants to reply, please do! My brother is moving to Portland, and I may relocate too (well, if he actually stays there!) I have experience in long-term care and dementia.

One of the residents on my assignment is a sweet man but INCREDIBLY DIFFICULT to work with. He weighs 225 lbs, is 6'2, and has advanced Alzheimer's. He is extremely good with me, which means he's completely rigid and dead weight to move (instead of being combative as he is with most CNA's.) Officially, the policy at our LTC is that we're supposed to always have two people on any lift. Unofficially, we all do lifts solo all the time because we are understaffed. He was using a sit to stand lift and is very difficult to do alone that way, but at least possible. Lo and behold I came back from the weekend to find out that the DON had written a note on his chart saying that all transfers were now supposed to be with a Hoyer lift. So not only do I supposedly have to get him on and off with the Hoyer, he also has to be turned from side to side now. I'm very strong, but... This is literally, physically NOT POSSIBLE for one person to do by themselves unless they're Mr. Universe. If I try, he will roll off of the bed and onto the floor. It is difficult for *two* people to do-- one can NOT!!! do it. The charge nurse told me privately that if I can't find someone else to help me, then I can use the sit to stand lift. The thing is that it won't be enough to just have someone to spot me, the way it is with other people who have the Hoyer lift used on them-- I'd have to have someone with me the entire time I'm turning him, getting him dressed, etc. This is IMPOSSIBLE at this understaffed facility. So the basic reality is that I will usually have to use the old lift. I just feel really uncomfortable with this even though the charge nurse told me I could do it. The official statement from the DON is that I'm supposed to be using the Hoyer, but there is no possible way in this world unless they hire more people. I'll do it whenever I can, but most of the time, it will be totally impossible. The resident's condition hasn't changed, he's doing the same physically as he was before, and he doesn't like the Hoyer at all, so nobody seems to know why the order was changed in the first place. I know that the person who has him on the other rotation sure isn't using the Hoyer lift. But what if the DON somehow walked in (very unlikely)? It just seems really unfair that the CNA's should be put in this position. I don't know... what does everybody else think?

Some really ridiculous things happen in health care settings, without a doubt. But the most successful tactic I have ever learned is to just do everything you can to get along with everybody and even ingratiate yourself with everyone. Smile, be pleasant even to those you don't like, go the extra mile, volunteer to help whenever possible, sympathize when others complain, try not to complain yourself even when you KNOW it's more than justified, and you can make it work in any situation. I ended up in a CNA job that is basically nothing but politics, cliques, backstabbing, unfair assignments, and half the people involved not doing the jobs while the rest have to pick up the slack, but I just keep telling myself, "I'm here to get the experience at the start of a second career, and I love the residents." I get along just fine with all of the nurses and all of my coworkers except one (the self-appointed "supervisor" who has no actual authority but who has been there for years,) and that's because there's no way to get along with the people from Clique A (who I have to work with daily) and also with her. On the other hand, there are times when I think you run into things/people/pre-existing situations that are just too nuts for anyone to handle well no matter what they do or how hard they try.