PeninsulaRN

I work med/onc. We're on 12s. On days it is 1:5-6 Nights it is 1:6-7

We use this on my unit, and I love it. It significantly decreases the risk of med errors. Pharmacy comes up and stocks our individual med carts in the am, PRNs and narcs are kept in the accudose. The best part is, once we scan the wristband and the med, it logs it as administered, so no more documenting on MARs! Ok, I have to admit, I've always hated MARs. Now I no longer wonder, on my drive home no less, if I remembered to sign out that Vanc or whatever. Its great. Occasionally our computers will go down and we have to do it the old-fashioned way. That's when everyone really *****es. Like any change, it will be difficult to get used to at first, and more time-consuming... but as you adjust it will actually save you time and hopefully you'll feel safer giving medications.

My suggestions are to take the NCLEX as soon as you can after school. Its been shown that the longer GNs wait to take boards the percentage of successful candidates decreases. I didn't take a review course. I really feel like you shouldn't have to, if you did fairly well in school, but I see you're already planning to and that's fine. Try to be calm (I know, I know... trust me, I remember what it was like), read and understand each question before selecting an answer, don't cram the night before. I agree, if you don't know it by now, you won't learn it before your test date. Oh, and I respectfully disagree with Shark. I had a few beers the night before and still did fine. You will, too. Good luck!

Well, it depends where the MRSA source is as to what type of isolation is appropriate, you know.

Alright, I'll acquiesce that my post was a bit flippant. However, I maintain that we should not be expected to exceed safe staffing ratios. Luckily we are fairly well-staffed and have only been in that situation once in the entire time I've worked this unit. The situation begs the question, though... if beds are not available within the hospital, why not transfer the patient to a lateral level of care for convenience, safety, and maintenance of appropriate ratios in the ER? This rarely happens, in my experience, and not because there are no available beds in local hospitals. Its all about the bottom line. Sad, but true. What do you propose is a good solution?

:rotfl: So true! LOL!

It may be a wise idea to wait until you have worked as a staff nurse before making such judgments.

Oh no, I didn't mean to imply that I didn't believe you, only that it seems to be a waste of resources.

With all due respect, that's not really my problem. The ER is generally staffed with more RNs and physicians/NPs/PAs, and they are more than capable of handling it. If they are overwhelmed, they go on diversion. Of course, the ER staff need to prioritize with their more traumatic cases but the people being admitted to med/surg are generally stable enough not to need constant care. If you open up the possibility that you can exceed the maximum staffing ratios that we have worked so hard to achieve, it becomes the norm rather than the exception, and that's something we don't want to see happen.

You're welcome, and I hope you find something that suits your needs. I can't believe there are no acute care openings for LPNs where you are.

Holy unsafe staffing Batman! In situations like that, when our staffing is drastically low, we block off rooms that cannot be used. So, if our maximum ratio is 1:6, and there's 2 RNs, we can only end up with 12 patients, total. If they want to admit more than that, send us another RN. Or suck it up and board them in the ER.

:rotfl: So true. "I"m sorry, ma'am, but this is the only room available right now. If Dr. Blank wants to come and construct a private room for you, that is between the two of you."

Well, if LTC is your only option, many of those things you can learn there. Have you looked into the subacute areas of local nursing centers? Those are the people that need slightly more care than the residents and are there on a more short-term basis, they often need wound care, infusion therapy, G-tube placements/care, etc. That might be an idea.

I wonder, is this a facility policy or state-sanctioned? Have you worked other places in your states where LPNs are authorized to do admissions?

Ahh, thank you for clarifying. In my experience, most oncologists are very clear with the patient and their families about prognosis, life expectancy, and if the treatment is curative or palliative. It is really up to the patient and their family what their treatment plan will be. And so, if the patient wants to fight against all odds, let them fight. And if a patient wants to give up and refuse treatment, although I might think their odds are good, that's up to them, too. Sometimes it comes down to a quality of life issue. And sometimes people are tired of fighting.