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  1. San2003

    Question about insulin QA

    Yes it can be kept at room temp. However if it is refrigerated to start with then it must remain that way. I think its easier to keep it at room temp. Then it is always available on the carts where and when you need it. Not to mention trying to remember to get it when you start or put it away when your finished is just one more thing on your mind as if we don't already have enough.
  2. San2003

    Isn't our workload enough!

    I wonder if the politicians of our industry realize the complex dynamics it takes to care for the elderly? If you take into the consideration that the population is at risk for every possible disease and we have to be prepared to understand how to handle that, in the acute sense, as well helping them to rehabilitate. We have an enormous workload, that makes the task at hand seem almost impossible. We are taught the important steps we as healthcare providers are to perform, to help the injured, sick,diseased, or dying. Help, mend, or cope with what medically is their affliction. Whether that be physical rehab, mental rehab, or the realization that death is expected. Yet with all that going on, we most of the time are dealing with a 30 to 40 patient load. Not to mention a staff that isn't in touch with the full spectrum of what is really going on. Then because of state regulations, we are obligated by law, to complete the necessary paperwork to prove we provided the appropriate care for the current need at hand. Do you ever wonder as if you have been set up to fail? As though the elderly truly are the forgotten generation? Why is it, if these people, are the foundation of our current America, as we know it, is it then, that suddenly, when they are in need of what we as healthcare providers have to offer, are they subjected to the common practice in LTC, as doing the kind of nursing of that we have come up, that squeaks by as being sufficient. When a state inspection is in progress we do our best to do everything in the correct order, have our HIPPA regulations followed, and provide the best care, we can, while being watched, but we shouldn't we have the time to meet all state regulations, at all time? Unfortunately, with a patient load as we are expected to care for this becomes an impossible task. As I asked before; Do you ever wonder if we have been set up to fail?
  3. San2003

    So, I have to be a bad nurse to be a good nurse?

    We in long term care are always chasing the clock. Or should I say the clock is chasing us. You don't have to be a bad nurse to survive. I consider my self a good nurse and I survive. You have to be willing to delegate. Don't try to carry the weight of your world on your shoulders. If you have a cream that is to be applied to someone who isn't in bed well ask them to be put into bed. If it is not reasonable for them to go then, well give the aide the cream and tell them where it goes. I f you are willing to help them as needed they will help you. The CNA's can make you or break you. If you show them that you are not afraid to get your hands dirty they will help you in everyway. Teamwork in LTC is the key. If you see yourself as separate you will be separate and behind leaving late.
  4. San2003

    New Grad LTC Seeking Advice

    I too work a 7p to 7a shift but I am a seasoned nurse. You need to prioritize your work load. Meds have to be out on time focus on getting that done. Paperwork can be prn. Keep great notes as you go. Times, names everything. When everything is done on the floor you can sit down at the desk with your notes and chart and make sense of everything. If you come across a change of condition remember your ABC's. Put one fire out at a time. Keeping organized and developing a routine helps. Anticipate your residents needs before they ask. It does get easier as you get to know your residents. Don't give up you constantly second guessing yourself will make you and keep you a good nurse. Even when you think those around you with experience seemed to have it together they are second guessing decisions they have made.. Don't ever become overly confident those people scare the hell out of me. They kill people. LOL
  5. San2003

    Question about insulin QA

    I work night turn and we are responsible for checking dates. I personally check them every Sunday. That way If they need reordered I fax them out before 8 am and the new vials are there before 2pm. The problem I find is getting everyone to realize the importance of dating them when they are opened. Unfortunately when I find a vial that hasn't been dated I have no choice but to date them with the date from the pharmacy on when the script was filled.
  6. San2003

    What can a Grad LPN (no license) do?

    Im in PA and our board is quite strict compared to many states, but however with that I was able to FXN as a LPN with the exception of verbal orders and I had to have a licensed nurse sign off on the narcotics I was administering. Many places will hire you as a GPN I actually made more money at the first place I worked as a GPN then the first place I worked with a license.
  7. San2003

    Starting Nursing at 52 and Nervous

    Congrats to all the new grads! I am 38 and only 7rs as a LPN Ive been thinking about a RN program. At any age being a new grad is a challenge. As older new grads being seen on the floor its assumed that you are a seasoned nurse and have it all together. Keep it strong I feel with age comes wisdom and you have a sense of the world that the young kids dont have yeah they have advantage of computer knowledge and what not but you cant teach the knowledge of people that comes with age. Bedside manor will take you far and it helps when doing your assessments. Conversation with people is half the battle and if they feel as though they can relate to you on some level they are more often willing to open up more and you will find that treating them medically becomes easier.
  8. San2003

    Share Your Funniest Patient Stories...

    When I was a CNA we had a patient who passed away. Any who I was told the family was not coming in. The supervisor was going on a break and I told her I would watch for the funeral people and direct them on where to exit with the body. It was a 3-11 shift and it was about time to serve dinner we had residents all over the place. A man comes of the elevator dressed in a suit with a trench coat asking for the lady who had passed. I told him where she was and instructed him that he would need to bring his car to the rear entrance because it was about time to serve dinner and we could not clear the dining areas, he would have to take the body out the rear entrance. The man looked at me as though I was from Mars! Turns out he was the son and decided to stop by before she went to the funeral home. OMG Imagine someone telling you that you had to remove your mothers dead body and drive her to the funeral home yourself. I was so embarrassed I hid from that gentleman until I knew he was gone. It was awful!
  9. San2003

    Is this within our scope of practice?

    I completely understand your concerns, especially give his DX of ETOH related dementia but as the others have already mentioned with a MD order your covered. Even here in PA with our strict state guidelines in LTC we too with a MD order can administer ETOH. My concerns are with those family members who are not aware of the legal obligations we have to their love ones we have, take them out on LOAS and give them ETOH! Then bring them back and I have to give them meds as ordered. I know they have had ETOH I can smell it. I then have to call the MD and inform them. Which is usually a MD on call who doesnt know the resident and get orders to hold specific meds. I think if the families realized the significants of this they may reconsider their decision. I mean I end up holding stuff like coumadin, B/P meds and much needed pain relieving narcotics. Just for a couple glasses of wine. I don't think the wine is worth it.
  10. San2003

    What is a typical day like for an LPN?

    I don't have an attitude towards LPN's my issue is the attitudes I have felt towards myself for being an LPN. I am proud of what I have accomplished. When I worked as a CNA, which was for 15 years before I became a LPN, 7 years ago, I really never understood the difference. All of the nurses I worked with seemed equally educated both RNs and LPNs. My frustrations really lie within the western portion of PA. No where is it that I can obtain any additional experience other than long-term care. Which Ive been doing since 1989. I love the elderly people too. I believe they deserve quality healthcare just like everyone else. But I deserve, as well, the opportunity to utilize my education in other areas. Not one hospital in my area will hire a LPN for a MED-SURG unit. They won't even consider us for out-patient clinics. If I had a dollar for every supervisor of mine who told me "You should go back to school. Your wasting yourself" I wouldn't need to work or worry about this. I wonder if they even realized as they were trying to compliment me they were slapping me in the face.
  11. San2003

    What is a typical day like for an LPN?

    Well you can expect long-term care. We are trained to do everything that a RN can do minus IV push meds, transfusions. We have the knowledge yet not the legal authority to do so. At least thats the way in PA. Equal responsibility less, pay that about sums it up. Sorry but you should of went for your RN I wish I would of. I am planning to for this very reason. Little Pretend Nurse, thats what LPN stands for. RN means real nurse.
  12. San2003

    Anyone In Pa Doing "vrp"

    I just finished the program Dec.2008. Its not easy and feels like you will never see the end of it. But you can get through it. It is about 6 months before you can work on your license. Then 6 months of "supervised practice" You will have to have someone else administer your narcs. Also they submit 60 day reports of your job performance.Your supervisor that is. Before any of that even begins you will have to go to an out-patient rehab program. Then after completeing that you will begin weekly peer- support groups of fellow nurses in your same situation. You will learn alot there. Lets us not forget about the costly random urine screens daily calls to an automated system will tell you if you've been selected that day. Like I said its long and feels never ending but it is possible.
  13. San2003

    PGH nurses...Please help LTC question

    You can try Asbury Heights on Bower Hill RD. I worked there a while ago. Its non-profit and surprisingly pretty decent place to work. You should have no problem getting 3-11. Good Luck!