georgianurse89

I've been a nurse for 3 months. 3 MONTHS! and i have already reinvented myself 100X over. I was also the quiet type until i began nursing as a licensed professional. I LOVE what i do and even with only three months under my belt i don't have a problem talking with doctors or family. I love to talk and teach residents/patients. I enjoy being a team leader and a go-to gal. If you were called to do this work, everything comes so natural: the watchful eye, the pindrop hearing, the intuition/gut feelings. The biggest advice i can offer is to ALWAYS ASK QUESTIONS! I am constantly learning because i am constantly looking information up or asking a more experienced nurse. And believe it or not, my co-workers have been more accepting of me because they see my passion for this profession! which further boosts my confidence (and eagerness) as a competent nurse. but you're feelings are very normal. and good luck with boards and your first job!

I know what you mean...but try working in a LTC facility with drug seekers! It's much, much worse! At least at the ER you can treat and street. That's not an option here. I have a pt that came to us for anorexia/bulimia and b/c of her admitting dx she has lost almost all control of her life so to speak (we monitor her food, we monitor her trips to the BR, we go through her things once a week,...) so now she is turning to her pain meds to have some control. Although she receives Tylenol #4 regularly, she complains constantly that that is all she gets, shes on the call light constantly for us to call the doc to get a stronger med or to get another dose or that says "im gonna die if i dont get my pain med" But 5 min after telling us how unbearable and excruciating the pain is, she's asleep and snoring! How can you be in such pain and be asleep. With that said, I'm a firm believer in pain control!! But, there are certain things us nurses notice that totally disprove your claims of pain. That's when I have a problem dealing out narcotic pain pills like m&ms.

And as for orientation...I followed a nurse one night and the next night i was on my own with over 20 pts. Oh and i graduated in June. So i definitely hope you get more orientation than i did!

I'm a new grad too and I work nights. And all of my orientation was at night. The only time i had to go in during the day was when I had to go in and fill out all those papers you have to fill out at a new job (insurance, tax stuff, acknowledgements,...) and watch a bunch of videos that tells me everything that I already know. Other than that everything else has been at nights. And it's been great!

I deal with CNA's like this daily!! I've learned that all you can do is DOCUMENT and take care of your residents/patients. I take care of about 50 residents on some nights and about 30 on others (depending on what halls I'm assigned to) and my cnas (all of which have been there longer than ten years) don't ever do there job. But it doesn't come out in the wash until DAYS later. For example: i had a pt tell me he had a doctor's appt. in the morning and he hasn't had a bath in a week! and he is totally lucid and AAO at all times so i believe him. Another example: I was taking a pt's VS because she wasn't acting just right, she told me that this is the first time someone has taken her VS since she got here (SIX WEEKS EARLIER) again pt is totally with it and it's the CNA's job to obtain those. so basically all of the VS turned over to me are made up by the cnas. Another example: I had a pt fall and break her nose while a cna was in the room. come to find out before i started working there, this same cna has had several incidents where her pts fall while shes in the room and did nothing to protect them. I DOCUMENT EVERYTHING and quote why the cna duties aren't completed. I'd understand if they were busy like nurses are but at night they have a total of 10 baths (between 3 cnas) and brief changes. that's it. And at night for the most part, I answer call lights! then when i tell the cna that a resident needs changing or to get to a BSC or bedpan, they don't move. It takes them at least 15 minutes to get up from their nap and get to the resident. But I document every incident and every time it takes longer than necessary to answer call lights! And I'm sure to verbalize my concerns with the DON almost daily. These are my residents and it's my responsibility as their nurse to ensure their safety and to speak up for them.

At our facility, we have a resident that has an MD order for ETOH (Mr. Boston's Vodka to be specific), I never question giving it. I mean, if you have alcohol induced dementia then there is a serious addiction and if the ETOH is withheld then you are increasing the possibilities of something bad to happen. The MD only has ordered enough to maintain a level of ETOH in the blood to keep away withdrawal symptoms/DT's, not enough to get them drunk or keep them drunk.

I am also a new nurse i graduated in June, started my job at the beginning of August at an LC facility.. I have never thought of the "journal to self-assess" that is a fantastic idea! I've already been doing that in my head but if it's written i can truly compare each shift. I have almost 50 pt. (2 gtubes, about 6 diabetics, ALL WOMEN [so UTI's and moods run rampant] In the short amount of time I've been nursing I've already learned how to maximize efficiency like during report make a note of all the supplies you need to stock for your shift and get it all in one trip so you prepared for the next 12 hours! then group pts together that you know are just "pill-takers" and the ones you know require attention and explanation and talking to. Things you'll pick up quickly. As for med pass it still takes me about 30-45 minutes longer than everyone else (we only pass at 9pm and 6am) but i know EVERYTHING is done by the book. so if Joint commission comes in or the executives of the organization comes in, all my ducks are in a row everytime. It's different to cut corners when you are going on a road trip but to me nursing is NO PLACE FOR SHORTCUTS! especially when you're dealing with fragile elderly people who sometimes can't stand up for themselves. THAT'S OUR JOB!

I've been an LPN for only a few months now and I have heard MANY, MANY times that doctor's prefer to work with LPN's turned RN than straight RN's. We learn everything hands on. I suggest to everyone to consider LPN to RN. In Ga, there is no obviously written scope that I have found, but I was taught in school that the only thing RN's can do the LPN's can't is blood infusions and the first 15 minute assessment. (so if someone can correct me, please do!) But my day consists of (with 47 pts) collecting VS, passing meds, physical and skin assessments, charting, talking with MD's and families, drawing labs, dressing changes (until we got a full time Wound-Care Nurse) things like that.

dajulieness...sorry!! i copied yours to answer for myself and accidently hit enter and it posted! I edited it but apparently the edit didn't go through. sorry about that!

1) What kind of facility do you work for? (Hospital, Nursing Home, Assisted Living, Home Health Agency) Nursing Home 2) How often do you come into contact with bed alarms? we have bed and wheel chair alarms with SEVERAL residents 3) On a scale from 0 to 5 (0 being not effective at all, 5 being completely effective), how would you rate the effectiveness of bed alarms? I think this all depends on your assisting staff and nurses. If you and your have staff responds quickly then it can be very effective but if it takes you and your staff longer than a few seconds then the scale dwindles. At my facility every time I work I have to get my assisting staff together and stress and stress and stress the importance of answering call lights and alarms quickly!!! When I first started, I would be in a resident room giving med or a treatment and I'd hear an alarm or call bell and 1 minute later I was still hearing the alarm!! This in unacceptable and dangerous!! 4) On a scale from 0 to 5 (0 being always, 5 being never), how often do you find dead batteries in bed alarms to go undetected in your facility? At our facility our are the kind alarms you lay on or it on. Not the one that clip on, so every time the residents is turned or up to the BSC or BR or any thing like that then its "tested" and if an assisting staff member doesn't hear the alarm when the resident is up with assistance then a nurse is informed and the battery is changed. So i give this a 4.85 (very,very,very rare) 5) On a scale from 0 to 5 (0 being always, 5 being never), how often do bed alarms sound without being heard in your facility? To me, if you have residents on bed alarms then someone should consciously stay in the area to hear the bed alarm. and be able to get their within seconds. And our alarms are sooooo loud you can hear them on the porch of our facility. Ive never heard of an alarm going off without being heard. 6) On a scale from 0 to 5 (0 being always, 5 being never), how often is it difficult to locate a sounding alarm in your facility? Again, at our facility, as a whole we know our residents, we all know which residents have alarms. where their rooms are. what the residents habits are (do they try to get up alot, will the continue to get up even with the alarm sounding, do they never get up...) so locating the alarms is rarely an issue. 7) On a scale from 0 to 5 (0 being always, 5 being never), how often are bed alarms left disconnected in your facility? NEVER! 8) On a scale from 0 to 5 (0 being always, 5 being never), how often do bed alarms malfunction with no apparent reason in your facility? Ive never encountered an alarm that malfunctioned for no reason. If they are weight bearing alarms, then they may go of as the resident turns in bed, but i hardly classify this as a malfunction. Id rather it go off too much then not enough. 9) What other problems do you encounter with bed alarms? None really. Again, since we have weight bearing alarms, the residents cant "turn them off" or unclip them or any thing like that. 10) In your opinion, what percentage of falls do you believe are prevented by bed alarms now? LOTS! since our staff knows to respond quickly, when i work at least, falls have decreased dramatically with those with alarms in place. this also depends on the responsiveness of the staff! 11) In your opinion, if the issues discussed in Question #'s 4, 5, 6, 7, 8, and 9 were resolved, what percentage of falls do you believe could be prevented by bed alarms? IT'S ALL ABOUT RESPONDING TO THE ALARM! Luckily, we have enough staff to respond quickly. And in the little time I've been at this facility if the resident had an alarm, they've not fallen. 12) Comments?

BOTH ARE DEF NOT OVERKILL! I am also a new pn as of about a month ago. I always go to possible job interviews in professional attire with a resume on cotton resume paper and a resume envelope. I fill out the application (i always bring a black pen and have a small clipboard to write on) at the site while trying to make small talk with some of the employees. making sure that i spell things correctly and neat writing and that everything is the same as the resume (at another non-nursing job i had, if you had a resume and an app with different dates and stuff like that it was an automatic no with us) then give the app & resume directly to the one in charge of hiring. I NEVER LEFT MY RESUME AND APP WITH A RECEPTIONIST OR ANOTHER NURSE! Then make a quick statement about how you'd love to be a part of their team, a quick education synopsis, and the hours or rotations you'd like to work. I've done this on every interview (for nursing and prior to nursing) and I have always gotten the job I interviewed for. I got my first nursing job that I'm at now before I even left from dropping off my resume and app. She asked me back to interview because of legalistic aspect but I was guaranteed a job making more than I was expecting. And I'd fill out apps at places that aren't hiring. You never know when they will be and if you make an impression, maybe they will think of you when the time comes! GOOD LUCK!!

I am in the SAME predicament. During orientation the nurse I shadowed, would literally say, "this is not the way you are supposed to do it" "do as i say, not as i do" "if jahco is here be sure to NOT do this" I was told by another senior nurse, whose been a nurse for thirty years and STILL does everything by the book, to cover my butt and the rest will fall into place. Yes, it may take them 30 minutes to pass meds to 30 pts and it takes me 1 1/2 hours. But, I know my pt's are taken care of and I will never have to doubt the safety of my pt or my license.

A lot of times at a facility I did a clinical rotation at, the pump would beep but there would OBVIOUSLY be no bubble. A nurse there told me that if the tubing has any residue on it (finger residue, adhesive, anything), the machine will beep like there is a bubble. so now after priming the tube right before I put it in I do a quick wipe down the tube with an alcohol wipe and the inside where the cassette sits. It seems to help me when I have done all of the above and there is still NO BUBBLE!!

I took medical terminology before A&P and it helped ALOT! if your school offers it i would highly recommend it. I recommend it to all pre-nursing students i come in contact with!!

Honestly, if my DON or charge nurse wouldn't listen to me and I just knew my pt wasn't him/herself and something was really wrong (and my pt had no advance directives or other statements stating that I couldn't pursue other medical help) then I'd call the doctor. Tell him all the signs and symptomotology leading you to believe the pt was heading in a bad direction. He can tell you what to do (but be prepared that he could say to do nothing) You may have to take a talking to by your superiors but you could save someone's grandmother or grandfather or husband or wife!! And as for you not supposed to be assessing or do any nursing except med pass....THAT'S RIDICULOUS!!! Always take a second and assess your pt because I can almost guarantee there is no written rule that says "do not complete an assessment" but if something happens and its something that could have been prevented by taking a quick listen to lung/bowel sounds or checking skin turgor then that's your hind-end and/or license!