grateful2010

Congrats to you!

Thank you! In choosing a nursing home is it better to work for a large Nursing home or a small one? Since I have no experience working in a Nursing Home I really don't want a large patient load. (About 20 is good for me, No higher than that).

Which is a better choice and why? I have no LTC experience.

I have no intentions on being there much longer. My agency doesn't care about me nor my license, I have to care. Most likely this will be my last week working with these clients. I'm learning a lot but I know having been in home care for less than a year isn't enough to handle these situations. For myself and for my client I won't be retuning after this week. I already have a job this was just extra money, I realized I can do without it.

Thank You both for your response.:) Keep the suggestions coming, I need all the advice I can get! Although I feel taking on these clients may be over my head (especially with limited experience) I'm grateful for the opportunity to learn. The medications they are on (a total of 30 combined) has definitely been a learning experience for me. I have studied the normals of all the vitals, so I won't have to call the doctor (which by the way wasn't my clients' primary doctor, he was a fill in..) Your post has boost my confidence. I will NOT allow a doctor to scream at me like that again. As a matter of fact I dismissed him and he kept on going on with his rant of never calling him for vitals within normal parameters. At that point I had no choice but to hang up on him..

I'm an inexperienced nurse. My agency recently sent me on a case where I am taking vitals and arranging medications for a couple: The female has CHF along with other medical issues and her spouse has Parkinsons with a history of heart problems (coronary bypass surgery a few years back). Although I am there to ONLY take vitals and prepare their meds (as the agency would put it), as a nurse I know better-it's not that cut and dry. When I enter the clients home I am there to assess and implement. If something goes wrong, it's clearly on me. I've been reading up on all their meds and conditions since I have to be there weekly. I don't want my inexperience to cause harm to these patients. The other day I called the doctor because my clients' Blood pressure was 110/50 and he had an irregular heart beat. The doctor SCREAMED at me and said NEVER to call him again with a reading as such, because it's a normal BP.... I wanted to know if I should hold his next dose of BP meds (safety first) instead I got an earful.....oh well, that won't stop me from calling whenever I'm not sure about something, so, here's to you doc My question is, what advise can you give me to provide the best care for my patient?? I already brushed up on my CPR, and read the S/S to look for regarding there conditions. Anything else I should be doing (besides the obvious, leaving the case ). I'm in a bind. Help!

$20 for an RN is on the low side. Homecare RN's should get paid about $25-$28 an hour. Your agency is probably getting paid $50 an hour to have you there and since it's a buisness you're getting what they feel is appropriate for you. At this point the money shouldn't be a concern as much as the experience. Yet, I wouldn't suggest you accept a case where you aren't properly-your patient and license is on the line, tread cautiously. Best of luck.

I think you should think this through before quitting. Unfortunately, you may deal with this type of behavoir wherever you go, whether big or small. Some people are just plain 'ole cruel and bitter. What matters most is how YOU are able to deal with the situation; you can't keep running. Your introverted personality may bring out insecurity in others, although it shouldn't it probably does. Those who aren't social are either perceived as "stuck up' or "strange". Neither may be true but a little small talk here and there (not necessarily about your personal life) will show that you are relateable/approachable.

CONNNNGRAAAATTTSSSS!!!!!

I don't think you should move to NYC until you have at least 2 years of experience working as an RN in a hospital. Make sure to get a few reference letters to boot.

did you land the job??

Take the job-get as much training as possible. Know emergency contact numbers, if possible get the number of the 24 hour nurse hotline (where a nurse is available to answer any questions you may have at any time during the day). Call the doctor WHENEVER you deem necessary. In the process Look for a job at a hospital. Most importantly pray ever day that you deliver the best care to your patient. Best of luck.

Orientation may be longer (if requested), which I'm definately opting for!

I say take the job! Ask a lot of questions and do the best you can....hopefully you get oriented to your job, at the minimal a few days to a couple of weeks. One thing they never tell you is that the one year requirement is usually exempt for the RIGHT candidate. If you show competency, passion, willingness to learn, optimism, great personality, along with who you know, I'm sure you will land a job in an acute care setting. If you're going to sit around waiting for that hospital job, you might be waiting for a loong time. In the meantime -get SOME form of experience every chance you get! Who knows you may end up liking agency work.

I truly believe that positive attitude and perception has a lot to do in landing a job. At this point you sound very discouraged, which is understandable, but you must be optimistic! Believe that you will land a nursing Job soon( any Nursing job at this point) and later more doors will open. If you focus on landing a job instead of "I can't find a job" your situation will change, believe in it. Good luck.

I've been a home health registered nurse for six months. Recently I've been hired by an agency to work at an LTC facility (temporary). Although it isn't where I want to be, I truly need some form of experience than what I am currently getting at my workplace. My question is, what is the role of a new RN in LTC? What should I brush up on prior to orientation (common geriatric meds, time management tips..etc)? I get about 10 days of orientation, more if need be. I'm actually excited to start orientation despite all the horror stories..go figure. *BTW, I graduated Nursing school in December 2004, never practiced nursing 'til 6 months ago (home health and flu shots only) and has yet to take a refresher course*

thank you!

What is it like working in this type of setting? What are you duties? From my understanding, Assisted Living is different that working at a nursing home? How so?

I'm sorry this happened to you...*hugs*

What is the reason behind your nerves? Usually when we have difficulty explaining ourselves to others is because we aren't clear on the topic. If you are clear on a topic i'm sure you'll be confident in expressing yourself. I have great interpersonal skills. It comes natural. As for someone trying to build interpersonal skills, I would say to be kind, caring and truly listen to others and respond accordingly. I don't think you need a speech class. People skills are built by interacting with people-go out and be social, it will all work out in the end.

I understand delegating certain tasks to unlicensed professionals but in my state, it isn't allowed to delegate prescribed medications. I'm doing the best I can to be informed because at the end of the day it's my butt on the line! :uhoh3:

In my state as well!

I'm trying to leave this situation as fast as I can but I'm not able to find any other form of employment at this time. I don't feel comfortable giving the aide's instructions on medication since I know it isn't their role to administer. I'm praying each and every day to get a better position, but at this point I'm trying to protect myself while there. Any advise on how I can CYA (cover your ass?)? Also this agency is giving me assessment cases beginning next week. I'm a new nurse. Is there any rules and regulation I should know of, anyone??

I'm a private duty home health nurse employed by an agency. I work a couple of hours a day with my patient, then the aide comes in and completes the remainder of the shift (8hrs). My patient receives meds all day. She isn't competent to take her own pills due to dementia. The agency has the aide give the meds throughout the day but I am there only a couple of hours in the morning to administer the morning meds; when the aide arrives I leave. I know the law states aides are not supposed to give meds. What I would like to know is, how do I protect myself (my license) in this kind of situation? Is it legal that I give the aide instruction on how to give the meds? I don't want to be involved in the "she told me to do.." How about documentation? What do I document..? The way I see it is, I should only care what happens when I'm on my shift but it's kinda like the aides are under my license, if they make a mistake is it still on me? I'm so confused, under traineded and in need of answers..plz help:uhoh3:

great advice ladies! I'm taking notes.