WorkinMama

So I'm sort of nervous about state coming, it's my first survey as a nurse. I know there is protocol for everything almost but it's the real life situations I still wonder about. I'm curious if anyone can help me with some questions I have. When you crush your resident's medications can you crush them all at once or in different baggies? Does the same rule apply for peg tube administration? I know that each med needs to be crushed and dissolved separately. What if the pill falls on top of the cart, do you have to throw it away? Even if you have a barrier there? When state comes is it just better to use gloves while prepping meds in order to avoid citation?

So I was wondering if anyone else out there has issues with delegation in LTC setting. I need advice on how to work with some CENAs who don't follow through on basic delegation (vitals or can you get water for so and so while I'm in the middle of passing meds). I know I could write everyone up technically but some of this is so gray for me. Granted I am a new to this type of work and I'm learning a lot daily. And yes I do appreciate and respect CENA's for all they do. I appreciate all the direct care they provide and need them to communicate with me. However that comes back to my issue I have CENAs getting attitude with me and I can't put my finger on it but yeah you probably know what I mean.

Clarification: So if there are routine meds every 4 hours and the patient is 1/2 out from the beginning of the window normally allowed you would....

Update... There is Hope! Thank You Jesus! I got into a long term care facility where they know I'm new and are working with me. Everyday I work I get to learn new things. It's a bit scary but there are great people I can ask questions to. I'm still going through with the refresher and trying to apply it to work.

So I'm thinking my story is like others here. Got through nursing school, struggled but passed NCLEX (thank GOD!), life happens-time passes and here I am. Right now I feel that I'm my the brink of giving up hope I'm in a refresher course but it takes at least 9months to complete. I've been looking for a job, made sure I have my BLS cert updated and like I said I'm in the refresher but still no job. I've had plenty of interviews- I'm getting really good at explaining the gaps. I just wonder if it's all worth it. Would love to hear from others who have gone on to get positions they love. (Oh did I mention during this time I also got married, moved 5 times, had twins and now am pregnant again.I just don't know how much more I can take.)