NoahscoopsRN

I'm a new RN licensed in Rhode Island but would also like to be licensed in Massachusetts however I'm not sure how to go about doing this? Has anyone else done this? Do I just go to the state board of nursing's web site? Thank you!

@ Dixie, I couldn't agree more! I would probably be swinging at someone if they tried to shower me at 5:30 in the morning too! I just don't see the sense in it. This facility is like nothing I have seen before (perhaps im a bit naive), they just don't seem to care. The facility is big on trazadone (BIG, that's all you see in the med carts) I just don't see the sense in medicating someone if they are not doing anything wrong or are not out of control. And i've said this to other staff, "don't you get hungry in the middle of the night?" "aren't there nights where you just can't sleep?" It's the same for them.

Suz, there are a few patients that they get up in the morning, no they don't shower them in the middle of the night. I would have a serious problem with that.

I'm in the same boat as you with your job (sortve miserable), I say, if you're able to withstand the pay cut go for it. Do what makes you happy!

Thank you for making me feel like I'm not crazy! I knew I was right but actually hearing it from another nurse is so helpful. When it comes to the showers I say to myself enough is enough, it's not worth it, if I get spoken to about it, so be it. One of the day shift nurses had said (not to me) that if we don't shower them it's "neglect" which I think is such a crock, it's not that these aides don't WANT to shower them it's when they attempt to they freak out obviously because they are scared and don't know what's going on. To continue to shower them when they are that upset, in my opinion, is abuse if nothing else.

I'm a new RN working in LTC 11-7, 4 nights per week I work Alzh unit (weekend rotation) and 2 nights a week I work Medical/Psych with a lot of skilled pt's. (Rotating schedule). My question is in regards to Nurses working with Alz patients. When is it appropriate to medicate a pt with a PRN (for example, resistive to care, wandering etc)? I ask this because I have been told (and have refused in certain instances) to "just give them something" when they get out of hand or are up in the middle of the night. Usually if they are resitive to care (and in this unit a majority of them can be) I usually tell the aides to leave them be, and try again in about 30 min. If it is their shower day and I am hearing them scream in the shower (and I mean SCREAM) or become combative or say continuously "no!" I have, in the past, told the aides to just stop, change them if necassary, and put them back to bed. I have gotten strange looks from the day nurse when I tell them, so and so didn't get their shower because they were screaming, worked up and combative and I just rather not put them (the pt) through that. Am I wrong? When is enough enough? Or if someone is up wandering in the middle of the night like the case I had the other evening. This woman was simply walking around the unit. No behavior issues whatsoever, she was pleasant, I gave her a snack and something to drink etc. I did end up giving her something about 2:45am just because I did want her to get some sleep however, I know other nurses (with this same pt) that the minute she begins wandering they medicate her with trazadone. Is it just me? I don't see the need for it, she isn't doing anything wrong. I try to think to myself, can she simply just not be tired? Don't people wake up in the middle of the night? hungry? thirsty? Why do they need to be medicated. Maybe I'm crazy, I just don't get it! Don't get me wrong, if someone is out of control and is a danger to themself or staff I will and have medicated, but for simple everyday things like being up in the middle of the night I just don't see the need for it. Advice please? I appreciate it.

I'm in a similar situation as you are. I'm brand new (as of Oct 2011) i'm in a busy LTC and like you, bounce from unit to unit. On my weekends on I am on the Alzh unit (4 nights) then one night a week a Medical/Psych unit and another night just a Medical unit. Feeding tubes, IV's, everything. I found it VERY overwhelming (and still do at times) getting to know the PT's and how the system works. I'm just now starting to get used to everything and it's March. However, my orientation was 2 weeks and could have been more if I felt the need for it. At the beginning of my hiring process I had told them that I had been out of a clinical setting for 2 years and felt a bit unsure of my skills etc and asked if I needed more orientation would I be able to have it and they said yes, we want you to be comfortable before you're on your own. Luckily I felt ok, and I have nurses on the other units that I call if I have questions or concerns. If I'm unsure about something, I ask, I don't care how stupid I look or sound, it's my license and I worked hard for it! My advice to you is to talk to your supervisors and explain your situation and that you feel as though you needed more time to orient. Time management is always difficult but when I feel as though I'm behind I just try to tell myself to relax and reassure myself that I'll get through it. You're not superwoman! If you need help ask, if you have questions ask. Good luck!

I'm experiencing a sort of similar situation as you are. I'm 28 yo and a new nurse, some of the aides I work with (i'm 11-7) are, and I'm trying to be polite as possible, LAZY. I myself worked as an aide for 6 1/2 years prior to becoming a nurse (the 3-11 shift) and I know first hand how hard and demanding it can be, however, they chose their job and they just have to manage! (or leave). I do not view myself as any better than anyone else on my units, degree or not, I try to be as fair as possible...to an extent. You can't allow people to walk all over you, that being said, you can be firm with the aides without seeming as though you are going through a power trip. Make it be known at the beginning of your shift what your expectations are of each one of them and make sure they follow through with their assignments. Yes their license is on the line, however, so is yours, and your supervisors will be on your butt a lot quicker than theirs because technically we are supposed to oversee what they do (or don't do). I remember when I first started at this job, I had a pt who was actively passing, family was not with her (which is fine) so I had told each aide (there are 3 per unit for 11-7 at this facility) after your first rounds, I want each of you to take turns sitting with her, I don't care if you rotate 20-30 min per person, it is unacceptable (in my opinion) for a pt to pass alone if I can help it. They didn't really respond when I told them that, no, "ok fine" nothing. So, I gave them the benefit of the doubt went about my business, and noticed after their rounds they were all sitting around doing nothing while I ran around like a fool. So I said to one of them, "Are you done with rounds?" she replied (rather b*tchy), "of course I'm done with rounds." So I responded (rather b*itchy), "well I asked you to go sit with that woman and you're not, you're just sitting around." She got annoyed and ended up slowly walking to the pt's room. She probably stayed there no longer than 15 min. Another aide asked to go on break (I said not yet) etc..the point is they did not care. I said, "What would you do if that was your mother in there? or grandmother?" They didn't see the comparison. So I being the better person went and sat with the pt and she passed peacefully about 15 min later. Those aides were later reported and reprimanded for not doing what I had asked them to do. I wasn't asking for the world, I was asking for compassion for a dying woman, something that they just did not have. I'm not sure if it is because I'm young or new, but they just don't listen to me. I'm not there to be friends with them, I'm there to do my job and make sure each pt is cared for properly. Just stand your ground! It's not worth losing your license over! Good luck.

@ Dixie, perhaps at the facilities you have been around there were standing orders for straight caths, however at this facility, there are none. I'm not calling a doctor at 2am for just a routine urine spec, unless its a stat order, it can wait unti the morning. In regards to feeling comfortable and doing my job, I do do my job and I do it to the best of my ability every night that I am on. I am not an irresponsible person, so just "leaving" my job because I'm unhappy without something to fall back on would not be the right move. Not only that, but I am getting married in less than 3 months, it would not be in my best interest to do that obviously. I posted on this forum simply for some feedback and advice from other nurses who have possibly experienced similiar situations. Isn't that what we are all here for? Thanks for your response......

@Viva, I really think you are right, I mean I literally was sobbing one night before going in because I just did not want to be there, my fiancee said, "It's not worth it." I need to go to a job where I have fulfilled, and this place is just not doing it for me.

I absolutely do not do anything without an order and I don't care about the odd looks I get in the morning, but to me, it's common sense, Don't - do - without - an - order. But to these people, it's FOREIGN. For example, say we have an incontinent patient whom the doctor asks for a urine spec on, the first question I ask is, "Do they have a straight cath order?" most don't, so then I say, "well I'm not going to do it without an order and I'm not calling a doctor at 2am for that.." man does that go up their butt sideways. I have already spoke with the director of nursing about this and she is behind me 100%. Other things that I've run into are like the other evening, a PT had come back after having a stent replaced (kidney), had clear blood in his urine and at first denied pain but as the night went on complained of it. So I went to to check his MAR and the only thing he had ordered was oxycodone 8a and 1p, his oxy PRN order was dc'd, now did anyone else think to ask the doctor, hmm, I see nothing PRN for this pt can we get something on board? Of course not. So I spent a majority of the shift calling and calling the doctor (who did not return my call until 6:55 am 5 min before I'm supposed to leave) thankfully this PT's pain must not have been that bad because I checked him several times and he had been sleeping, otherwise I would have sent him out. The point is, this is common sense things and it is just swept under the table here, I have never seen anything like it before in my life. It is awful.

I am a new nurse working in a busy LTC facility. This was not my first choice to begin my career, however I had been out of college for 2 years prior to my passing NCLEX (due to unforseen circumstances) and I did not feel confident enough to begin in a hospital, so I decided to start out a bit, "slower" to advance my skills. I applied to several facilities and hospitals and this was one of the call backs I recieved. I am working full time on the 11-7 shift and I have to say...I absolutely hate it. There is nothing worse than going to work every day feeling absolutely miserable, however I know millions of people do it everyday, I just don't want to be one of them! Some of the CNA and Nursing staff are great, however a majority, are not so great. I see things I do not want to see (use your imagination) staffs attitudes are very poor and negative, and I get the "you've got 10 heads" look when I give report the next morning to the nurse and she's upset with me because I refused to do a certain task without an order from the physician. "Just do it" I've been told. Just do it? Really? I understand I have to stick this out because I do not want it to look poor on a resume to see I've only worked at a certain job for a few months, however, I absolutely dred going in every night and feel it may not be worth it. I'm not naive, I do realize that there is bad practice out there but I did not realize it would be this bad, some things that go on in this facility are enough to have ones license taken away. No exaggeration, it is that bad. The only thing I can say is that I am learning along the way, it is everything else involved that is making it very difficult for me to have a good experience. So my question is this: Has anyone else experienced a similiar situation starting out? If so how did you manage and how long did you remain there? I appreciate any responses!

I'm a newly licensed RN starting out in LTC, I also was an aide in a very busy LTC facility for 6 years also and let me tell you it is HARD work and VERY VERY busy. Im lucky if I have time to go to the bathroom once per shift (HELLO uti!!!). I applied to several hospitals after I was licensed with no call backs due to the fact that a lot of them were asking for prior med surg experience. Was I sad about not starting out in a hospital? sure, but am I also happy with my experience thus far in my LTC facility? YES, I have seen a LOT of things and it is a good way (at least I think) to start out. I definitely won't be there forever, but until I get more comfortable with skills, I don't have an issue with it.

I'm a brand new nurse starting out in LTC, I'm still orienting and have done so on 7-3 numerous times and last night being my first 11-7 shift which I will be working. The question I have is on assessments..some people do it some people don't...AT ALL. I know it's easier on 7-3 and 3-11 but still, on 11-7 it has to be done! I'm currently working with another nurse, so I'm not on my own until next week, but this particular nurse did not do a full assessment. Anyone out there on 11-7 can give on advise on best practice? What type of assessments do you do on 11-7? I want these people to be able to sleep but at the same time I absolutely don't want to miss anything!

I currently work at an "Assisted Living" facility and I use quotations for a reason..90 percent of our residents should be in nursing homes, period. We have a paraplegic, lots of Alzheimer's/wandering issues and numerous residents with hoyer & other mechanical lifts. I've been told, "the face of assisted living is changing" and that is why they are accepting who they are accepting. It is RIDICULOUS. We have about 80 residents by the way, I'd love to have just 30!