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.

Totally inappropriate. Mind you, I don't work OB, never have, but that, to me, is as inappropriate as having a MRSA or C-diff patient on my ward with neutropenics.

I've also always planned to go back for advanced education and so I think that may be the impetus to push me to go back sooner. Not an altogether bad thing. I understand that many of you are bristling at the idea that your education is "not good enough", but I don't think anyone is saying that. Its not that you aren't professional, competent nurses, its just that having an entry level BSN can only increase solidarity among nurses. With that, maybe together we can advocate for positive changes in the profession rather than argue with each other. Or perhaps not.

Meh, ditto that. Congratulations on graduating, at any rate.

Meh, this is a strange question. Nurses by nature care, we are healthcare providers. That means that I care for my patients, holistically, attempting to meet all of their needs. In these days of high acuity and decreased staffing, though, that's difficult to do. That's why there are other disciplines (PT, OT, social workers, case managers) to assist us in doing so. Its ridiculous to expect the nurse to do everything for every patient, unless we are performing primary care at a much reduced ratio, and we all know primary care costs too much to be implemented outside of critical care. It is also a matter of prioritizing. As much as I would like to spend extra time with my newly diagnosed patient doing a bit of psychosocial work, if I have another patient who is hemorrhaging, or one going into anaphylactic shock, or one with a vesicant infiltrating, that takes priority. So what you call "not taking the time to care", I call prioritizing and attempting to go home at the end of the day with my license.

We are an RN only floor. However, at previous hospitals I've worked for, LPNs were not able to do admits. The RN must do the initial assessment, admission history, etc. So the RN would "admit" the patient and then turn care over to the LPN. I'm sure this varies from state to state.

Very true, Fergus. At my facility the most they can do is put you on "the list" if the census is high and no privates are available. Generally they do what they can to ensure that employees get private rooms but that's not always possible, either. Which begs the question: if you had to be hospitalized, would you prefer to be at your own facility, or another?

The most in recent history was 13 admissions for a 12 hour shift. Some of us had 2, some 3. I can't remember exactly how many RNs were on. That's not counting in-house and out of house transfers, discharges, etc.

I'm sorry, I guess I don't quite understand your question. Do you mean agree with the prescribed therapy for the patients (i.e. chemotherapy, radiation, etc.), or agree when the patient becomes palliative and is only receiving care and comfort measures?

Meh, I would demand a private room also. There is such a profound lack of privacy in semi-privates, and you're already a bit off-kilter when you're ill enough to require hospitalization. Besides, the last thing I would want is to listen to Jerry Springer at all hours of the day or to hear my roommate's whole freaking extended family visiting.

I agree with llg's post. I've been on many interviews for nursing positions (more than I care to remember, actually) and I've never been asked that question. I have, however, been asked other broad-based questions that require a bit of thought, such as: 1. Our mission statement is . How can you help us achieve our mission? 2. What is customer service to you? 3. What do you feel are your strengths and weaknesses? ...and the ever popular new grad question... 4. What inspired you to become a nurse? What kind of nurse do you aspire to be? You should have a general idea of what is most important to you, as far as the type of nurse you aspire to be, and you could adapt that to reflect your philosophy of nursing, if necessary. Try to be as genuine and creative as possible. Never be afraid to say: "Hmm, that's a hard question. Let me think about that". It will give you the opportunity to examine your thoughts and answer the question as best you can, without scrambling for the first thing that comes into your head. Good luck!