itthybitthythpider

I use Anywears clogs, but over the last few months I've developed what I think is plantar fasciitis (intense heel pain when I get out of bed or after sitting for a few minutes, etc.). Are there any good shoes, supports, or ideas you guys have? Thanks...

Ive noticed the trend with skilled, too. SNFs are the new sub-acute and sub-acute is the new med-surg. So all the long-term SNF patients are being sent to ALFs and ALF patients are staying home

Even a wet to dry shouldn't be soaked through. But yes, it would definitely need to be followed up on if you felt there was a mistake. If you look through the chart and everything and it does say "change q3 days and not a moment sooner" I would ask s...

Even if the order states Change every 3 days, they should be changed as needed, also, especially if they are soiled or soaked through. Leaving dressings on that are soaked through is not the norm. I know where I work, we automatically put a change PR...

Oooh! I'd never heard that before. Just the clocks.... That's an interesting idea!

I've got my fingers crossed for you, too. Good luck!

How do you determine tissue tolerance?

You are lucky, coming from a psych background! We get a lot of psych patients in LTC. Some nurses forget they are supposed to be more than passing meds and charting! You'll get the hang of it, though. As far as patient load, it's usually 20-30, depen...

Vancomycin needs lab draws, too. and procrit and epogen

And the argument that ensues during change of shift takes longer than getting the actual work done and staying over! Plus the next shift never has time to get their work done, so then you have extra work that you pass on, then extra extra work is pas...

I've had a couple get upset at me for sending a res out (and especially for sending them out without telling), but I can always justify myself to them and my DON!

Keep your "brain" (the piece or paper or papers you write everything on) close and use it often! I like to color code mine with different pens and I write EVERYTHING down, even if "I won't forget /that/."

For a DNR, we call the doctor and the funeral home and family, and that's it. I have seen police involved, but I think that was for unexpected deaths. The doctor will pronounce when we call with our assessment. Quick and easy, really.

One thing that helped me when I was learning was to take a list of meds I didn't know home and look them up in the drug book. Same with new diagnoses. I'm still learning everyday, too! I love nursing just for that reason

Cheaper supplies, cutting out unnecessary supplies. They don't pay for over time. HUGE focus on therapy, so we have to bend over backwards for them to get minutes in. Skeleton crew for CNAs. No holiday pay for this fiscal year. Luckily, no pay cuts....

They are repeat offenders. I am getting better at saying no, with the help of a couple of other nurses who see what's happening, and my DON. Thanks!

I shed many many many many tears my first year in LTC XD My coworkers and I had a "crying room" (the utility room on one of the stations) where we would go when we were upset or needing to vent or something. It's VERY stressful at first. I agree gett...

That happened to my dad once!

I have boundry issues, too. I'm also the "can't say no" type. I'm getting better at is, since I'm in a more managerial position. I've had nurses ask me what to do, and when I tell them, they then turn around and ask me to do it for them! I understand...

Working off the clock is an epidemic in LTC -.- I wish I knew what to do about it within the facility (and nursing in general) that doesn't call in the state and get me fired....

I've had both the family not telling the resident and the resident not telling the family members where they were going. And both times we got blamed Our admissions coordinator is really good about trying to talk to the families and residents long b...

Patient came to the ER while I was precepting there, so I went to get a history. Me: What brings you to the ER this evening? Pt: Chest pain. Me: What happened? Pt: I was under a car, working on it, when the car fell on my chest.... Me: How long ago d...

My peds rotation was on the pediatric burn unit. There are no words to describe it, but I left every day there feeling ill. I remember holding the 3 year old in the body cast while she screamed in pain and just rocking her for a couple hours. Or the ...

My favorite is when I tell the family that I can't do something, and their response is to look at me like I just grew two heads and each head is speaking a different language at the same time! If my nurses are busy (when aren't they) and I know a cra...

At one building I worked in, my facility got in the habit of not taking "problem patients" back once they were admitted to an acute (usually psych) hospital. Almost like punishment at times. We had one lady with a mental disorder who, during our stat...