Heather27

*Singing* I'm so glad I'm a Canadian nurse...........LOL!

Hi Stefani...EXCELLENT field to get into..I love geriatrics. Can I give you a word of advice? Don't go into your clinical all brushed up on "disorders" alone... Take a look at the residents from a non-nursing perspective for a minute...from a non-student one. These people have seen and lived through more than ANY of us ever will. The average geriatric patient has LIKELY lived through at least two wars, the Depression, women getting "the vote",the first movies with AND without sound, wringer washers, homesteading out West, the steam engine's demise, the changeover from streetcars to motor cars/buses, the Civil Rights movement, JFK's assassination, the Hippie era...shall I go on? Point is...these people have much to offer YOU. Even the ones who appear limited by Alzheimer's have, by times, AMAZING long term memory. Don't take away clinical experience from the LTC facility you choose..take away life experience.

We have run the gamut of napkins, "bibs", whatever you want to call them. We have found that it is most cost effective AND most practical to use the terry-cloth tie-on ones. We tried the rubber-backed plaid ones from Aveda, but they didn't last long enough once bleached. We tried cloth napkins, both facility-made and ordered...cotton, poly/cotton, straight poly...none lasted or were the right size or shape. Hope this helps!!

I graduated in '92 from Grace General Hospital School of Nursing as an RN. Did I feel prepared to practice? Are you kidding? I was INVINCIBLE!!!! Then I got out into the real world!! Like the previous poster said, I had all the head knowledge I could need, but wasn't really TOTALLY prepared for all the little "extras" you need to know about caring for people. We had TONS of clinical time, but I think that we were so focused on seeing the medical need, and how to "fix" it, we lost out in seeing the PERSON suffering from the malady. I guess what I am saying is that it takes more than SCHOOLING to become a good NURSE. And what you need can only be gained thru experience. Who can "teach" you to sit at a bedside of a dying person, or comfort that family after the patient's passing? Who can "teach" you to deal with those dang doctors that think they are God's gift?? Who can "teach" you those "shortcuts" we all use and love??? I plan to keep learning and experiencing right up until I retire!! Heather

I can see how it would make you question the whole "DNR" thing...That is why we have made the move toward very specific health care directives. I would have probably done the same thing you did, in fact. What are you supposed to do? Have a team meeting on DNR specifics while the patient chokes?? I personally think that the staff could have been found negligent in their care if you HAD left the patient to die, as much as if you had walked in and found the call bell cord wrapped around their neck and ignored it!! DNR, I think, should have the reserved meaning of a spontaneous respiratory failure, cardiac failure, etc...not one caused by an outside stimulus. Makes ya think, though, about how specific policies NEED to be in place!!

Our facility has changed it's policies recently, in keeping with current regs, I guess...We now have "No CPR" policies, and then "Levels of Intervention"... i.e.: NO treatment if a condition is irreversible (Incl. IV fluids, antibiotics, etc...) and so on. DNR meant that if a person arrested, then we did not initiate CPR. It certainly did NOT mean that a person was left to choke to death, whether by food, liquid, or secretions! Suctioning is not really considered a life-saving intervention, but more of a comfort measure.

Hi... I HATE having to "babysit" my staff!! And that is what signing off THEIR work amounts to, in my opinion. Admin. needs to realize that they are hiring incompetent caregivers and NOT make you responsible for whatever they might screw up or omit! (pet peeve, can you tell??) If you have to, use anecdotal notes or document somewhere what was and wasn't done, and make SURE you have input into these people's performance appraisals. You are professionally responsible for how your staff cares for your patients, but NOT to cover for them by signing off "good work" sheets when it isn't done well or completely. If enough of you are consistent, then the CNA's will HAVE to pull up their socks, and do their work. Document document document. At the same time, you need to have consistent "rules" about the care that is given. The people that are in charge when you aren't around can't let them "get away" with things, or it just makes you look like an ogre. Nursing is supposed to be a team thing, and if you approach it in that spirit, and not in a threatening "Do it my way" manner, it SHOULD work out okay!! Good luck, anyway!! Heather