MySonIsAdorable

With every doctor and every patient the orders are different. Sometimes you will use your nursing judgement, say a person who has a sliding scale and routine insulin and the pt has 68mg/dL the sliding scale certainly wouldn't prompt for the insulin administration so I would hold the the routine regular/fast acting insulin. Give some milk & graham crackers or something like that. In my facility we are to call the lab & notify the PCP if the bs is 400. We have an amount of insulin to give at 400 usually per sliding scale but we also have rapid acting insulin for community use that we can use if the PCP so orders when we call. However we have no standing order for a certain amount. This is one of the most dangerous drugs we give and a lot of nurse I have met do not take it seriously enough. A nurse told a coworker the other day that she would not bother to give 2 units of regular insulin if so ordered by sliding scale. This is nuts! Most nurses I work with would rather the persons BS be high than low because being his is corrected, however being high is very dangerous also. My best advice is to learn all that you can about DM, insulin, and hypoglycemia because its very common and something you will be dealing with often. best of luck

I was where you are about 3 weeks ago, I got 2 days of orientation, that were at the very best weak 2 days. The nurse had no pleasure in showing me the ropes lol. I busted my butt*, did everything that I could & ask questions, listen in where I can now and I was told that I am doing a fantastic job & they wouldn't guess I was a new nurse. When it comes to skills, you can always read over them, restudy them ect. You should be fine. If you are scared, then ask someone for help. It's not going to be the end of the world.

Texas, $17/hr but I know some that got started elsewhere at $20/hr, some as low as $15/hr.

Also you probably need to know about the PRNs, the most common PRN in my SNF unit is ativan, restoril, and morphine. With the antipsychotic, antidepressants, ect there are many scary side effects & will need to be monitored. Make sure that you check for new orders daily, find out where all the paper work is, find out about post fall procedures, and for that matter know where the policy manual is located. Know who to call when something happens and where their numbers are. If you will be alone this will help. The hardest thing will be getting to know where everything is, and getting to know your residents. If you happen to have any spare time read their charts. Use your aides, the will be your best help! For real, treat them with respect & show them that you aren't above them by helping them, turn, transfer, whatever you have time to help with. But make sure they know you are their supervisor because after all you are delegating to them under your license. Good luck!

Just now reading this because my son has the chicken pox. And yes he was vaccinated. His pediatrician told me that (which is what I assumed after researching it before I decided to call it in for an appt.) when a child actually gets the chicken pox after being vaccinated they are likely to only have around 40 lesions...and they aren't really even blistered usually until a day or two after being spotted. Because they do have some immunity its not likely that a child who has be vaccinated to have full blown chicken pox. However they are still just as contagious. When my son's father called me last night to tell me that out of no where my son had a rash & said "I think its chicken pox" I thought, yeah right...well turns out that the Dr said without a doubt he Dx as varicella! He said that its more likely in his case that he was in contact with someone who has shingles. Because there haven't been any reported cases of chicken pox in our area recently.

I am an LVN who is going for her BSN in the near future. All I have ever wanted is to work on the floor! I want to be there, helping people hands on for the rest of my career. Sure I have thought of specialties like pedi oncology for tops, and any critical care area. And sure I have thought about advancing to NP but I would much rather just make a stable living doing what I dream of. So I think that the future could be in RN's who were LVNs for awhile that all they wanted to do was be in acute care and know what its like to have a hard days work. There is a BSN program in my city. I have spent A LOT of time with their students in clinicals, and the hospitals we shared were open that they preferred us to them because all they want to do is sit there while we assisted with ADLs and they waited to assist with more complex procedures. One said "I'm not going to RN school to wipe butts" and the ICU nurse said "I am a BSN, RN and I wipe butts, shave, shower, change linens on a daily basis." I think its sad that these new RNs everywhere we were thought they were above us, maybe they were but all I can say is, in 1st semester we learned a variety of skills that they on their 3rd year didn't know how to do. In the end of the year they watched us perform these skills as they watched because all they could do was tell us how to do it.

Think you made the right choice, you know you can find apartments that are pretty nice for around $800 per month, which you will be able to afford on that salary. I am an LVN trying to move to the area, going for my RN and let me tell you, that's all the jobs there are RN jobs. I would love to move home but can't if I don't have work! Take in all the free shows in the live music capital (just remember just because its the live capital doesn't mean its always the best music!) Temple is great, scott & white its great and its only what 45 min from Austin...plus they have other hosp in that area Round Rock for instance that you could transfer to later if you ever consider it again. Best wishes! Check out 2222 and 360 for places to live, that was my favorite neighborhood to live in. You will spend more but its very nice and comfy in that area.

Okay I have decided to take the LTC care job. I worked yesterday and although it was clear that the CNA's are in a bad habit of not listening...I have been told that I can write them up and they have plenty of applications to go through if they continue to act they way they are. I told her I couldn't work on the days that I would have to have someone outside of the family to watch my son & they said "NO PROBLEM!!! we will switch these to your days off right now!" And I tried to apologize because I knew it was a pain but she said "No we want you here I will do what I can to make you happy" and told me that in a couple months I will be able to move to morning shift because two of the nurses are leaving due to they are graduating RN school and have different jobs. They have all computerized charting so this will be good experience as well.

Thank you! Now I just have two companies to decided from. :yelclap:

I know I am a little nervous and want to dot all my I's and cross my T's. I did find some others that I have actually seen before! So I did a bit of oh man I should have done that first sorry! Where are the go to stickies I seem to be skipping over them somehow?

I don't think you should move first unless you have another reason for moving. Because you don't know which state you will choose yet and what city either. Texas for instance is where I live and its HUGE and the bigger cities are pretty far apart from each other. I don't have any experience in this but my Mother has moved from state to state, hospital to hospital several times and every time she did phone interviews first and then traveled to a 2nd interview if her hiring was likely. Then we would move if she was hired (for sure hired, start date and all) Usually jobs know people need to give at least two weeks notice so that gives you some time to decided & at least secure a hotel that you can stay for a week or two until you find a place you will be staying long term. Hope this helps.

I am a new LVN. No experience who's long term goal is to be an NP with trauma in mind. I am in a decently rural area with only small hospitals within 60 miles. I would like to work at one of those hospitals in the future but nothing is open right now & certainly not for a new grad LVN. I have taken two jobs out of the picture because of travel time & pay that relates to the travel not making it "worth it" at the moment. I have a 3 year old boy, I am pretty much a single Mom who has a great Mom who will watch my kiddo when she isn't working. Job #1 is in LTC, nursing home, it pays more by 3 dollars an hour 36-40 hr/wk. Has the possibility of benefits. It's 30 miles away. Shift would mean that I would take my son to pre k at 8 am and not see him until the next morning on the days that I work. I don't have a schedule yet but I am starting tomorrow...The pro's for this job for me is the experience that is broader than Addictions and the pay would help my little family a lot. Job #2 is in addictions nursing at a rehab facility 15 miles away. Pays the 3 dollars an hour less. 32 hours a week on the weekends & one day during the week. I have an interview but not the job yet but I have decided to go anyway she said she just wants to see my face & get my signature for a background check and UA. The pro's for this job would be, being around my son more & having free time to take classes next semester and possibly pick up some PRN work in LTC...if I can find it w/o experience. Please help me pick! I don't know what to do and if I get a chance to pick I would love some of your opinions to consider. Thank you in advance for any response even just a vote!

Yeah I have run into this. I am actually trying to quit just passed my nclex so I know I need to quit now, excuse after excuse I give myself, nursing school, nclex, what next? a new job...gotta do it soon. I went to 2 nursing homes that wont allow smokers, makes sense even though it wasn't fun for me! They don't want to supply health benefits for someone who smokes, that makes sense. They don't want to have their employees smoking, smelling like smoke...that makes sense too. I guess they are just trying to protect themselves from extra expenses.

GOOD LUCK! I took mine last Monday and I passed! I was very nervous, I thought I would continue to be mildly anxious but the morning of (I tested at 8 am) I threw up, and diarrhea and just felt terrible. I told myself I am in God's hands, he will take care of me if I can just calm down and think positive thoughts I will be okay. The best things I can suggest will be: *If you haven't yet download the tutorial (pearsonvue.com/nclex) that you will see when you start your nclex go over it until you feel comfortable that way you can skip it easily when it comes so it wont count against your time! *Be positive say "I WILL PASS" *Take your time and focus on the first 85 questions. *If you get frustrated and find yourself looking at one question and reading it over and over and over, then close your eyes and say "I will pass" take deep breaths and reattempt. *Take a break after say an hour or 50 questions or if you decide you cannot do it anymore. Get up go to the bathroom, wash hands, drink some water and go back in. That took me 4 minutes and didn't hurt my time much at all and gave me confidence and focus. *If you get to the 2 hour break TAKE IT! I was close to my 85 and I still took it I went to the bathroom as the first break. *When you get stuck, remind yourself of what you know about the subject or the subjects of the answers and answer the best you can based on what you see and what you know. DON'T fret about the question when its gone! If you get to 85 and you need to answer more questions don't panic just tell yourself "this is my chance to show them I am safe and I am going to do just that" Again good luck and YOU WILL PASS! Good luck! Get sleep, eat a good breakfast, lunch whatever you have to eat before you go and be positive.

It is certainly important to maintain sterile technique you know those nurses who for instance say "do as I say not as I do" yeah they are out there. BUT that doesn't mean you have to be one of them. My favorite nursing instructor says "If you make a habit of doing things right then you wont have to be worried when someone is watching you." Get as many sterile gloves as you can and practice putting them on its not the easiest thing to do but certainly isn't hard after practice my best tip could be to have your hands completely dry if possible. I am sure you have read about HAI's, Nosocomial infections...these things are real and the hospital or LTC facility isn't going to get paid by the insurance if its their fault the infection is there. They keep track of who, when, how many times you have possibly caused this and there can be consequences. These infection control procedures are not just to protect the nurse and other healthcare workers its to protect the patients from harm as well. So do you part in preventing HAI's by following the guidelines, they are all there and are all important for a reason. Good luck, I know the models are sometimes hard to work on, just don't attempt one alone and if you break sterile field go back & start over don't feel bad if you have to waste a cath. I saw a nurse drop one on the floor and then wash it off with some tap water once, and use it! I also have seen a nurse insert into the lady parts and then go ahead and use the same cath for the urinary meatus. I was in school and so we were told to let our instructors handle stuff like that but in the real world you need to do your #1 job which is being a patient advocate, after all that's why there are strict rules for us to follow and why we go through so much to be a nurse because its important to one's safety and well being. Good luck & sorry for the lecture.