NurseSuzann

Day shift is ready to cannabalize everything because management will do the same to the them and it runs down the line. To think they have it easier is rather ignorant, depending on what type of unit. I find that on nights I am putting out a bunch of fires with less staff, and I find a lot of the patients do not actually sleep on nights and less staff to be there for them/more falls. But other shifts will never try to understand each other *smiley face* is my approach to these people who want to eat me in the morning.

Spicegrl, 40 can be a lot depending on their acuity and it sounds like you have a lot of diabetics, make lists to organize yourself. I find it is easiest for peace of mind if you check/medicate all the diabetics first once you figure out who they are, unless of course you have people who are more urgent than the diabetics, such as your demented patients who could become ornery and even perhaps violent if they are not medicated, again I do not know what kind of floor you have but usually try to prioritize and not go according to the order it is on the MAR, which again is not as easy as it sounds like it should be I know. However it IS possible....and you will be ripping your hair out possibly but try to do your best, go home and have a margarita!

I'm a young girl, but I was orientated to nights mostly by an "old nurse" in a facility I no longer work in, but the note leaving although it incurs rolling eyes, and people who are usually not paying attention to your rambling (so you leave the note so if they dont want to listen they can read! lol) I have a very hard time on nights, because I am trying to be resident-centered, so if I wanted to get everything done I would be hauling everybody out of their beds at 3 and 4am, which I dont believe in. I also wouldnt mind walking barefoot in the snow to work if we could "go back to" your days when you had time for the residents, honestly after some night shifts, depending what happens I feel like I am literally going crazy...especially when I have to leave work late and driving home with the sun blaring in my eyes and I just want to sleep!

I have actually had a crazy number of residents on nights, you dont even want to know but it was more than 55....If you work nights and have a ridiculous number some nights, depending on staffing/if they are able to get anyone else in you have to write everything systematically in priority on a piece of paper and god help you if you don't have angels as CNAs, but try your best and do what you can. Dont kill yourself and make sure you have those moments where you take a deep breath. Also if you cant get non-essential tasks done you must leave notes for the next shift and ignore their rolling eyes, they don't get it that there is more staff on days and it is actually possible to do things whereas running all over on nights for critical situations is a wee bit more difficult when you dont have as many CNAs.

Sounds like you are supervisor/charge/head nurse? In our world, sometimes everyone can only see it from their point of view and some are completely unable to see the "big picture". Find out which ones are just green, or behind in their skills and willing to listen, and educate them. Explain to them (sweetly lol) and maybe they will understand and you will end up with a better floor nurse in the future. Maybe they just dont understand (even though they should)

Help your CNAs but I do not mean this to be rude to them, but don't be suprised that once you are consistently helping them all the time and getting a good working rapport that you will be "the one" that they will come to with all the little problems that apparently havent been addressed or have been dismissed by other nurses. This is somewhat of a privledge, when you become "the nurse to go to" but believe me it will put your work behind when you have to address all of their concerns honestly and fully that others have not. Also be careful, that even if you are rushing trying to get your work done and help out on the floor, that you don't mess up/get behind on your own work! Although I love my job a lot I am realizing that I can help them but they can't help me with charting/giving meds even though many of them could probably chart more fully and completely on the situations than I could. I made my first medication error the other day because I was trying to be a CNA, a medication nurse, and, housekeeper all at the same time during a chaotic day. Ask for help but don't be rude and don't run down a hall to get someone for something you could quickly do yourself, but realize your responsibilities and what is first priority.

Honestly, if you did well in school and are not suffering from anxiety issues severe enough that you may need to see a doctor, you should be fine. The PN exam is not hard if you know your stuff and it sounds like you do. Also if English is your first language you should be okay. Many of the failed applicants have english as a 2nd language, and even if they are incredibly intelligent, it is the language of the questions that is so difficult.

Is LVN and LPN education equivalent? Its double the time now. I'm not sure, and definitely if you're going to be going to Ontario they may not even consider it because the entry to practice requirements there are pretty strict. Maybe they will consider experience.

Honestly, there are some nurses who shouldn't have students. I believe at this point in my career I am one of them. I am fresh out of nursing school, been graduated for nearly a year and I would have a mini meltdown if I were responsible for teaching. Students are more work, as much as they believe otherwise (I did when I was in school). Sometimes nurses can be terse about this increased workload, they shouldn't be. We all have some level of responsibility in "raising" future nurses, although some of us shouldn't be in an active precepting role.

While I agree, I want people to tell me if I've done something wrong. I have found some more serious mistakes, these things happen but I generally just choose to fix the mistake and move on with my merry way. However, I have found some important medications not restarted for a number of days because the other ones did not notice, but we're supposed to be a team right, so its great if anyone corrects it because we're supposed to be working together. I do tend to prioritize patient care and all the documentation pertinent to patient care, however I think that what is happening here is everyone is forgetting and it is easy to put me as the scapegoat.

Does anyone ever feel that people are attempting to pick on you when you are new in a workplace? They are trying to find things you may or may not have done wrong and point every single possible thing out to you, I don't mean just general communication. I mean say a bed doesn't get made, or something is done but not written down (I mean very minor inconsequential things to patient care). I also mean things like, I don't whine that my medication cart was not plugged in and I had to stand at the plug and the garbage was not taken out, but I don't fill out one inconsequential form and I hear about it every time, even though I am not the only one forgetting to do it. I feel as if these things are being blamed on me. Even if someone else does something wrong, I have to point out that I did not work the shift they are speaking of. Why do nurses do this? Especially in anew place that really needs staff. I don't mean communicating correct procedures so people learn, but picking at minor things with a newbie but not caring if regular staff forgets.

Family members would rather have me blame the CNA, however I am honest with them and that seems to be a bad thing according to some people

It is very difficult to do. There are some you can be firm with in the moment but reasoning with them so they will not do it again is difficult at best, but don't forget there are ways to get through to them, just not in the long term generally.

I do not see any advantage in discontinuing a pressure alarm. Please sell this idea to us if you feel your point is valid. However, experience has shown me on more than one occasion that they do work as I have caught residents climbing out and almost on the floor when their pressure alarm has gone off. Please give us your source, because I have never once heard they are not helpful.

Thank you for your feedback. I've since learned a lot about giving Haldol IM in an aggressive patient and also learned that my staff are great at restraining for this act but that sometimes it is not always ideal and I have even had to give it through clothing because it was just not possible to get their shirt or sweater off. Usually we will have a plan. First we get all the other patients and visitors beyond the doors of the particular section then we try verbal redirecting, then PO PRN, which will work if it hasn't gotten that bad but if its gotten bad enough that I have to re-section off the unit I know I pretty much have to go for the haldol. Then we will decide who will approach from what side and what arm/leg and what side I will approach for the needle, Needle in then we let go and get out of the way while making sure all the rest of our unit is safe.

Sorry but unfortunately its all in the routine and you will find you dont have time for niceties and the extra care you want.

I don't think so, this sounds like my job, you have to have a thick hide. It gets thicker as you go too.

I am pretty fresh out of nursing school and unfortunately it seems to be a common failure of nursing schools. They think "old school" that frightening us will toughen us up. Although I do not agree with this strategy I understand the logic of it. Many students have no idea what being a nurse involves and that you have to have tough skin, but especially in the scenario you described, where she is not even in nursing school yet, this is crazy, especially in an era where we need more nurses and we are all working overtime like crazy!

I think personally you should get some hands on experience first. You will not be well connected with your staff if you go straight to unit manager, as a result it will be very difficult to understand them, and them you. However if you do this, I suggest you try to help on the floor whenever you can to get some idea of what those you are managing are going through.

What are some techniques you use when going after a pt. with an injection of Haldol while they are running and charging at other staff? I know it depends largely on the situation and how many staff you can get to help, but do any psych. nurses have general tips? On my particular unit we are not allowed to use restraints and it has less resources (no padded room) I know the other staff will be helpful and know what to do when restraining to give the shot but as a registered staff I wanted to know if there are any tips anyone has, I'm afraid of getting the person with the needle and having them move during and be hurt by this.

When I first started out, I tried to help out all the time. You know what happened? Way behind, no one else can do their job theres only one of me. That doesn't mean of course that I don't help with the little things or even some bigger things (when I have time!). There are things that can't wait, like making sure insulin is given and blood sugars are taken appropriately before so and so has almost finished their meal. Mrs. Jones may have to go to the bathroom and I wish I could help take her right away but I would much rather deal with that sort of mess than someone in hypo or hyper glycemia. There are many different examples too of course where if you get behind, the whole shift gets stalled. What if you have a fall/neurovitals? That extra 5 minutes you had to help needed to be used for the assessment etc. Its a hard world. For the most part we have good CNAs, there are a few who feel they are much smarter, and I am not here to argue that or not, but the second they have their own license, then they can question and assess and deal with what happens when you do certain actions a certain way.

Hi I just got another job in LTC. I am keeping my old job but I am wondering what my dear posting friends think of my description of the facility. I got a wonderful reception, much better than my other first job, and very extensive orientation so far! :) The facility has all kinds of seminars to introduce new staff to the place. I also share a desk with another nurse and it seems like the two nurses really work together on orders and help each other with treatments and such as opposed to my other job where as far as been a licensed staff, you are basically on your own. Honestly everyone has been so welcoming and it seems like there is such team work! The medication pass seems a little bit harder and it looks like they take some shortcuts that I may not take. However everything seems a little chaotic, people everywhere, the dining area and such is not as organized. I did not see the staff getting report from the nurse which made me a little uneasy, but it seems that the CNAs all knew what to do, they had their duties laid out, they got the urines and the nurse I was orienting with didn't have to get on their back. The things I like are; the staff dont force the resident's to work around our schedule and the residents have much more freedom to be people...more team work. I wonder if in your opinion that means it will be much easier even though it is less organized?

No I don't have time...but I don't have time for what I do as it is.

This is ridiculous, only another nurse should be supervising/auditing in my opinion, they understand the complexities of running a floor better.

Thats great :) Wish I heard more of this