nursingcares

My phobia I had to get over was kinda different..I was afraid of talking to people..Like at all. I had to get over it quick! Even the first year of school I would get so anxious when I had to talk to people in my clinical group or my instructors. My voice would be so soft and sometimes I wouldn't get the words out and even if I did they couldn't hear what I said. Eventually I was able to talk to people with out my voice cracking or my face turning blood red. I worked my way up from there and now working as a nurse it's not as big of a deal any more. I have to talk to patients, doctors, families, coworkers..I think the whole phobia stemmed from just never being exposed to much socialization during my life.

Yes I had the same ones for clinicals and loved them! Lasted so much longer than the nurse mates I just threw in the trash..

Bought nurse mates..after about a month they were wearing out and started getting holes in the sides and the bottom started coming off and tripping me! Will not buy them again..

I was precepted by a nurse like this at a LTC facility! He was PRN as well which made me question why in the world he was precepting me! It was really frustrating and I had a lot of those "Really??? I'm brand new and know better than that!" moments. Most shifts I just told him to go do menial things and I handled it myself!

I think it also depends on the patient. I had one that if I had given it for a bp of 110 sbp he would have bottomed out quickly.

Where I'm at the facility has to give you a death pronouncing class before you can pronounce!! I wouldn't have done it if I were you- I would have told the supervisor they needed to call in someone who was qualified. Let them figure it out it's not your responsibility! I work LTC and it gets better..I'm still trying to get a medsurg job and I'm nervous as all get out that I will have forgotten many things since LTC is so different.

NM $28/hr

^^^^ Originally Posted by diane227 I don't even bother to call a doctor for this. I check to see if the patient has had recent cultures, if not I order blood cultures x2, CXR, urine culture then give some tylenol. I then call the doctor to let them know what I did. If I have a patient with chest pain that I assess to be a valid complaint I get a stat EKG, Chest Xray, first set of cardiac enzymes and a BNP. Place oxygen on the patient and give then either morphine or Ntg if they have it. Once I get the EKG I call the doctor with results. "Please excuse my ignorance here, but I'm new and was just wondering about whether or not doing these things is outside of the scope of practice for a registered nurse? Could you somehow get into trouble for ordering tests, EKGs, and labs and giving oxygen without an order (I know it's OK with standing orders, but I mean if you do not have them)? I am very concerned about the legal aspects of care and want to cover my butt as much as possible!" I'm wondering the same!!!!

I work in an area that has several Indian reservations and I have several Navajo coworkers. If anyone passes away the Navajo cannot help in preparing the body because they cannot touch the dead. Also thought it was interesting when one of my friends was pregnant she had several rules during the pregnancy: she couldn't watch or see violence (it could cause some type of deformity), couldn't play with strings or anything like it (belief that the cord will wrap around the baby's head), and other rules of the like which I can't remember off-hand at the moment.

You are describing where I work!!!! Exactly! The part that drives me the most crazy is the vital signs equipment..I don't believe any of the vital signs for our residents are correct! Half the time it doesn't even work. Our facility is remodeling right now as in new flooring and paint and such...But I think they need to get some decent equipment, beds, and staffing!

Yeah I thought these were a little old and outdated! I'd like to gather some research to present to my supervisor. Just to bring the topic up. I'm sure it's been brought up before but I really can't stand it any longer! I may have to start squatting as well haha. I'm in America...New Mexico to be precise =). We are under new ownership and they are planning to remodel the facility but I think new beds would be a much better start! I bet it is expensive though especially since our facility has 369 beds.

Do the beds in your facility go up and down? Ours only raise the head or the feel (with a crank type thing at the foot of the bed). My back kills me from trying to lean over doing dressing changes or whatever else! Just wondering if many places have beds like this..

Wow did I make a mistake! I was supposed to be off tonight but I decided to pick up a shift. So I went to a skilled unit I've never been on (I'm usually on a Psych/Alzheimer's unit). I should have asked to shadow or orient on the unit before I picked up a shift! The med pass was CRAZY, I had Gtubes, these residents are alert and so had many many requests, a million zillion treatments...Geez! I mean I got everything done but I had to stay an hour after my shift just to finish charting! Needless to say it left me feeling accomplished for finishing everything but I'm so afraid I'm going to get a call tomorrow that I charted something wrong or entered orders into the computer wrong. This unit has sooo many narcs my heart was literally pounding while doing count! I feel so nervous being responsible for SO much. But then again..I'm the one who signed on for it. I felt sooo much more comfortable with the patients I had in the hospital on cardiac care during my preceptorship where by the end I was taking full care of 5 patients who were much more acute than these residents. I will say that the residents were soooo much nicer and more pleasant than what I'm used to. And thank God the other nurse working was willing to answer all my questions! This shift left me feeling like I can handle the stress of a skilled unit and that I just need to refine a lot of things like organization and prioritization. LTC is not for wimps!

I'm on my 3rd week of orietation in LTC on an Alzheimer's/Psych locked unit. Although I don't have much hospital experience I, too, was shocked at how little assessment we actually do in LTC. Basically I assess anyone who has any issues (recent falls, ABX, or new s/sx) and we have a list of monthly nursing assessments we do. It's definitely a BIG change. Also, I noticed a lot of things other nurses in my facility do that is totally wrong and I will be doing things the RIGHT way on my shifts. I have also found it very confusing to find out what to do with labs or who is the on-call doc. Everything seems so unorganized on my unit! They just recently switched to computerized charting so even the nurses I'm orienting with don't really know what they are doing as far as charting is concerned. I've also oriented with a couple nurses who I feel so unsafe working with! But I'm not going to leave- I can develop my own way of nursing practice and maybe (just maybe) others will notice and follow suit. If they don't- then it's their license and up to the facility to decide what nurses they hire. I think the reason the standards are so much lower is because the workload is so heavy and because a lot of nurses see LTC as "less glamorous". I've noticed a lot of nurses I work with either work there just for the money (my facility pays well) or prn to supplement their income. Which isn't necessarily bad because we all need to make a living, but I think I work with one nurse who actually cares about the residents. She was my nurse when I worked there as a CNA and she is an amazing nurse (she's been an LPN for years and years). To me, I think it's selfish to totally discount LTC because it's working with the elderly and "just passing meds". I can't tell you how many times I heard classmates say, "I don't want to just pass meds." when referring to LTC. It is SO much more than that! And when you do things the right way and raise your individual standards of care- it can be extremely humbling and rewarding. I'm getting a lot of psych experience on the unit I'm on now but not very many skills. I only have one resident who is skilled and she is skilled for behaviors and psych meds/consult. However I can choose to pick up shifts on other units that have tons of skills! For now, I love working with my residents. I find it can be either a very relaxing day or an extremely busy one.

Thanks everyone so much for your response! This helps a lot. Maybe I will stay in LTC but if I decide not to at least now I know I will be able to get a hospital position. Thank you!