freemirini

I think Tankweti's statements are true. As a new RN going into a LTC, I wouldn't emphasize educational level. My first job was at a LTC. After two months, they had me as charge over the whole facility. I also had my own unit of 25+ patients to handle. I think it did irk some experienced LPNs that I was charge. But most of them would be very helpful. One in particular was a bit hard on me at times. I remained humble and shifted my questions to other LPNs. I also let them know that I respected their experience. --On rare occasions, I was acutely aware that I had learned things in school that an LPN colleague hadn't, but for the most part, I learned TONS from them --All in all, as a new grad or even a new nurse, I'd rather have an experienced LPN on my team than (I can't believe I am saying this) another new grad. --When the stuff hits the fan, experience can really be helpful. --I guess it is important to have a balance on the team....experienced nurses with the newbies. I should also mention that I work with experienced RNs and LPNs now along with new grads. I learn from ALL of them. I like a well-balanced team. I am not a charge anymore. In my charge, I like experience. ...hm...I guess most of us would. --So if you are going in as an inexperienced charge, it might be easy to understand that some folks won't be as jazzed about it. ---But accept it and show them that you will bring your best to the team. Draw on their strengths and appreciate them. You will learn a lot. oops...just realized you are LPN...I focused on previous poster. I think you will be fine and learn a lot, just like me. I have found most folks want to help. Some folks are too busy to help. Very rarely, there will be some that just don't want to or just feel irritable...maybe they are burned out. If you find someone is cranky, give them the benefit of the doubt... nursing is stressful. Change your approach, and/or choose another person to help you... I am now in acute care. I miss many aspects of LTC. I am in acute care as I am trying to "round out" my experience. I learned about managing dying patients in LTC....pain, anxiety, breathing, emotional support... If you ever have a patient that is in the dying process and is in anyway uncomfortable (and you can't help it), draw on the other nurses on your team and the provider to find ways to make them more comfortable. I did not learn about managing the dying process in school. Things you might see prescribed --dilaudid, morphine, lorazepam, atropine, oxygen (NC/face mask), suctioning... Remember you can call on pastoral support....and sometimes if hospice is on the case --on hospice... In LTC, you are the one present --and you often must advocate for the patient to the provider. They may not have adequate pain control, etc., ordered. You must advocate for it.

Maybe you should have the title of recruiter and get wages that match the job description... :)

I worked at a LTC and wanted to apply to a new-grad program at a hospital. I was told I was ineligible. That was incredibly frustrating. After six-months of experience at the LTC, I finally got a job at a hospital. I put in hundreds of applications. It's hard to decide what to do as a new grad. Do you hold out for "new grad" programs that may restrict entry to those with a little experience, or do you go for experience where you find it (and it looks somewhat safe).

I am interested in users' book suggestions, too. Here are some patient assessment books on Amazon --sorted by best-selling rank. ---Many of the ones at the top appear to be university-oriented texts. I think the Bates' pocket guide looks interesting, as do a number of other books. http://www.amazon.com/gp/search/ref=sr_nr_scat_227643_ln?rh=n%3A227643%2Ck%3Anursing+physical+assessment&keywords=nursing+physical+assessment&ie=UTF8&qid=1308117110&scn=227643&h=26026932b147891dce0c4173c4a620c9cfe57d80#/ref=sr_pg_2?rh=n%3A283155%2Cn%3A%211000%2Cn%3A173507%2Cn%3A173514%2Cn%3A227640%2Cn%3A227643%2Ck%3Anursing+physical+assessment&page=2&sort=salesrank&keywords=nursing+physical+assessment&ie=UTF8&qid=1308117221

It's not your fault. You are right, it is an oversight. I am a new nurse and can empathize with your situation. I remind myself (when listing my deficiencies) to also note what I have learned and where I am improving. I think the seemingly "mindless machine" is all too often the way of things in hospitals and LTCs... I am also surprised by it. I never imagined it. I guess it's part and parcel of the job. We have to work around it. ...or find another position, perhaps...in some place where the grass is greener... I think there really are some places...but that they are few and far between. I also think that the better jobs will (hopefully) come with increased experience. Good luck. Give yourself credit. Maybe talk with your boss, too.

I have been grateful that the facility hired someone to help... I don't mind helping an agency nurse. --Of course, I am a new nurse...and more likely to be in a position to learn from the agency nurse in many other ways... It's enlightening to read the posts above.

I am a new nurse. I am surprised to see that our ratios are increasing and we are losing support staff (per reduced scheduling of them) --We have been drilled about customer satisfaction... I know this is in relation to the poor economy. ...Cutting the staffing isn't going to help the customer satisfaction. We're all trying really hard... I just don't think this model is sustainable and effective, etc. I know as I get more experienced I will be better at handling stuff. But the experienced nurses are having trouble. I am learning to just remain calm. That's a pretty cool thing. --I can't change anything by getting upset. I just must prioritize and tackle it bit by bit (and delegate --share the load-- if someone's available to help). I just feel a little surprised. I guess naive. Any advice?

Love compression hose....Allegro thigh highs 20-30mmHg from BrightLifeDirect.com....no script necessary. You measure yourself and choose size accordingly. I called and asked for advice as I was near two sizes. I was given good advice.

I actually wonder if linking the scores to reimbursement will cause hospitals to adjust their staffing ratios. In general, I have noticed that hospitals with better scores tend to have better nurse-to-patient ratios. --I imagine that some "flogging" of staff will go on, but if hospitals are losing money they may just adjust their policies.

Describe the tool you created...was it software? A decision tree? ...? Did you collaborate with multiple departments?

I would fix the grammar errors and streamline your sentences. Several of them are overly wordy. On my resume, I omit the term "I" and use phrases consistently. You might also consider that. Example: ORIGINAL TEXT: ...n the critical care unit (CCU) I provided care for a wide variety of patients. These patients ranged from mechanically ventilated, to organ donors and had multiple vasoactive drips running, and/or insulin drips. EDITED VERSION using phrases: CCU Experience *Provided care to diverse population of CCU patients including organ donors. *Managed mechanical ventilators, multiple vasoactive drips, and insulin drips. EDITED VERSION using sentences: In the critical care unit (CCU), I cared for a diverse population of patients, including some on mechanical ventilation and others who were organ donors. I was also responsible for titrating multiple vasoactive drips and insulin drips. (Less wordy: I also titrated multiple vasoactive drips and insulin drips.) I dislike the term "range" in your original as the examples provided don't really seem to fit a spectrum (to me, anyway). Watch your sentence structure.

Be flexible in where you apply. Try long-term care, long-term acute care, etc. ---BUT--also be choosy about what you accept. Make sure you will have a reasonable amount of training and support when you hit the floor. Be careful about home health assignments this early. Some agencies might take a new-grad, but those that do (in my eyes) are rather shady.

Weigh the financial and time costs of the ADN degree plus RN-to-BSN degree versus the BSN degree. I'd also work on spelling and writing. --I believe you meant to write "wasting" not "waisting." A good cover letter, resume, and thank-you letter may help you land a dream job in future.

What I find shocking about nursing is the inadequate nurse-to-patient ratios, inadequate support staff, inadequate/broken equipment/supplies, and run-down environment. I am in my first nursing job --which is in the inner city. It's eye-opening. I like nursing work, but I don't like doing it in such a stressed environment. It can be unsafe.

I think it sounds like you were creative and efficient. Lots of people use cut and paste in electronic medical records... Maybe you can explain it in that light...