LUV ALZ

It always make me so angry that one person would go against the final wishes of another because they are to weak to let go. How can they feel like they did everything possible when they have violated the person on every possible level? Thank you for putting into words what so many of us nurses have to deal with on a daily basis. There was no failure on your part only selfish cruelty on the other person part. I only hope her end of life experience goes against every thing she wants and that she is cognitively aware enough to know it, but physically and verbally incapable to do anything about it.

For all of you who felt the need for chastising someone who is honestly seeking information on something they do not know, "Shame on you"! It is that kind of reception to questions that keeps people from learning the right way to do things. I am with Rob, how many of you Really want a face full of respiratory secretions or any bodily fluid regardless of the the donors health status?

A hair follicle test will prove without a doubt that you did not imbibe the drugs (they run around $200.00) this will tell what drugs you have been taking and their levels, which will indicate if they are in the therapeutic range or not. Then you tell them "here is a list of all of the medications I have been prescribed by Dr. So & So, now tell me I'm an addict or in denial!" Also point the high volume of people who had access to the drug after you dropped it off, including the nurse that followed you!

I make sure I always stand to the side when when client coughs. Client rcv's 30 inner cannula's a month and is not vent dependent and as a matter of fact right now the client does not even have a spare trach! Protocol for cleaning the cannula is rinse it with tap water and reinsert. This client has been like this for 4 years and has only had one infection (amazing). I glove, secretions are very thick and yellow which is considered the norm for this client. Client does not have TB. I am a converter, though for the life of me I don't know where I was exposed to TB as I have never had a pt with TB. Thanks for the info, I feel more comfortable now.

I just recently started home health as a second job. The client I have been assigned to is HIV positive. Client is trached and does not tolerate deep suctioning. Client has a very productive cough. PC asks that nurse grab inner cannula at the height of the cough and pull it out, thereby catching the bulk of the secretions in the cannula. The only PPE's I have been provided with by the agency is gloves (we get one box a month of which I used 20 the first night alone as client coughs up moderate amounts of phlegm frequently). What are the risks of HIV transmission through phlegm, droplet exposure? I know when a person coughs droplets can land as far as 15 feet away. Am I at risk if it lands in my eyes or if I inhale freshly expelled microscopic droplet via mouth or nose? I don't want to go in there in a bio suit, but this is my first HIV pt and i do want to take appropriate precautions. Client is taking HIV meds at this time. Thanks for any info or links in advance guys!

CAM! Tip offs: 1. to good to be true. 2. Poor English and sentence structure. 3. the request for personal information (why the need to know your maritial status) 4.You are required to spend money out of your pocket for which you will be "reimbursed"

It may sound silly but it has worked for me several times (not just nursing jobs). Get out the phone book and call EVERY doctors office, LTC, assisted living facilty, home health care place and hospital etc.. in it and ask if they are hiring for LVN's. Even if they say "not at this time" you now know they use LVN's. I then take that list and put in an application at every single one and redo the app every 3 months if it is someplace I want to get in at for a specific reason. EVERY nursing job I got doing that did NOT have an out anywhere yet. Good luck with your job hunt.

Yes unfortunately it is like that at a lot of LTC's. You will eventually get the names memorized and the meds memorized. the med mem helps cuz you know what they need, they should be in order in the cart so you can quickly check what you are pulling with what is on MAR. If the skin is intact the aids can do the barrier creams. If you don't see and white bottoms or smell the lantiseptic hunt down the aid and make them take the resident to the room and put it on them.......NOW. After the second or third time they will get the hint. Hint for your aids with the lantiseptic, if it mixed with a little a & d ointment it will come of easier during brief change. It's all about developing a routine. Also look for "stupid med orders" such needing to wake a pt ad midnight to give them a Vit c and get changed so it coincides with another time of your med pass. Paperwork get used to it.

It was supposedly the owner /admin close personal family friends. So if I work there it's o.k for my close personal family friends to could feel free to just walk in off the street and start looking thru everything? Also when I called the on call weekend supervisor and told her what happened she said "you got them out of there didn't you"? I have escorted other people out before and was told it was the right thing to do because of Hippa and privacy issues. But during the write up yesterday I was told "what if that was Joe Blow and this was the only time that they could come" I said 1. call in advance and set up an appointment/ make sure it's all right to come then. 2. What if Joe Blow works 2 jobs and the only time he can come to view the facility is 11:00 at night? Does he have the right to just walk in and start looking around the place and in resident rooms? It all boils down to these were friends of theirs. But I find it odd that a close personal friend forgot to tell you that they were bringing their mother to live at your facility. Oh well at least it was my second job and not my full time job. My first time EVER that I was fired. Reason "POOR CUSTOMER SERVICE" I am a LVN Charge Nurse" You find the residents I will take care of them. As for me personally I would have liked the fact I got asked to leave if i was considering a place for my dad, shows the facility cares about their residents.

O.k,I worked Sat and Sun this weekend. We have been in survey and exit interview was Monday. On Sunday evening I was in a room passing meds to a resident. Cna came to room and told me there was a group of people just walking around the facility and that she had told them they needed to wait for the charge nurse. They ignored her and kept walking. Now this is a locked Alz/Dem facility it was 6:30 p.m on a Sunday. Front doors get locked at 7:00 p.m. I immeditely went to go find these people. When I found them I asked if I could help them and they told me that "their mother was going to be admitted on Monday". We nurses had no info an a possible new admit and we always know at least a day in advance. When I asked who their mother was and if she was coming from home or another facility they just said "we just want to look around". I told them I was sorry but this was not a public place and that they would have to leave, I also told them that if they wanted a tour of the facility they needed come in or call Monday and somebody would give them a tour.. I escorted them to the front door. As were walking there I spoke with one of the women and gave her the analogy of "our residents have a right to privacy how would you feel if your father was in the hospital and I just walked in started looking around his room'? After they left I called the weekend on call supervisor and told her what had happened. She said I hope you kicked them out. At around 9:00 p.m. the administrator/owner came in I told her what had happened and she said "We are not getting an admit on Monday". Got called in today and fired for poor customer service as these people were supposedly very close friends of the administrator/owner. Supposedly I was rude. What gives the administrators friends the right to violate my patients privacy? They were looking into the rooms! If they were such good friends of the administrator why did she not know that they were admitting their mother there? Odd thing tonight on my way to work stopped at store like I ALWAYS do and some man I have never seen before asked me if I was going to work and then asked if I worked ??????, Have I ever worked at ????? and then proceeded to start talking trash about ?????? and kept pausing waiting for me to comment. I just told him I didn't know the place and left. Whole thing felt "funny"

Pharmacy should send a narc sheet with each narc delivered. this provides proof of how many were deliverd as you both have to sign off for the count at delivery. Pages should be removable so that when a card is complete the narc sign off sheet can (should) be filed in the patients chart as it is part of their medical record. The narc sheets show how much was delivered, who took the delivery, who dispensed and when dispensed the medication to the patient.

Apparently they may be unhappy with their lives and feel the need to possibly live vicariously through someone elses goals. You have the right to do what makes you happy. I am an LVN who did all of my pre-reqs except for 2 classes to get into the RN program. I got all A' and B's while I was also working 72 hrs a week, looking for a house to buy and in the middle of a custody battle. I know I can do the RN thing with no problem, BUT, I like being an LVN, I love working with Alz/Dem pt's. They make me happy and I am fulfilled with the work I do. If I became an RN it would mean working at a much lower RN rate to stay in the field I love or not being able to work in the field at all, so I made the decision to stay an LVN. My life, my choice, my happiness. Your life, your choice, your happiness is what counts. Try asking them why they settled for being only an RN? How come they didn't become P.A.'s of M.D.'s?

I had one elderly woman who would hit the call light if her Vit C was not delivered at EXACTLY 7:00 p.m.. She was an ALZ pt. Her daughter insisted she have a phone in her room. At 7:00 p.m. I was doing accu checks. Well when laying on the call light every night didn't get her her Vit C at EXACTLY 7:00 p.m. she started calling 911. Her daughter wasn't very happy with the 6 bills from the fire department in 2 weeks. I finally got that @$#% Vit C d/c'd!

I work with MD pt's who are all ventilator dependent and some are on pulse ox monitors at night. I have been known to be at home and wake form a dead sleep and bolt to the kitchen to answer an alarm, usually the microwave or the oven timer. I always wash my hands before and after I use the restroom. When I need something from my purse I usually start out by doing a full body pat down from the chest to my thighs because I am used to everything being in my scrub pockets. I am forever reaching for my lanyard that has my hand sanitizer on it. I answer my phone with the official company response. When the big guy gets out of the shower I find my self trying to do a quick head to toe skin assessment.

They decided not to write me up. basically I told them "do it, I have phone records clearly showing that I called in 72 hrs to notify you". Nope, they just played nasty. I usually work 8-12 days a month and for March I have, let's count them, 4 days total. I have decided I did not deserve this and from now on if something comes up I will not give them an early notice. I will call in sick EXACTLY 2 hrs before the start of my shift, per company policy. Now try to find somebody to cover the shift!