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...

Drug seekers have an illness as well. They need help. They, like many other patients, are often non-compliant and may also lack insight. I wonder if you might reframe how you think about those that "seek drugs" (who are in pain). They often have chronic pain - emotional, psychological, physical... They seek relief. Rehab would often be a good option for some of these folks... I think it's often a struggle to deal with our preconceptions and prejudices...and our indignation when things are not as we think they should be. I know I struggle. I struggle every day. Here are some words for inspiration... "One measure of civilization is how well we treat the most vulnerable members of our society." William H. Foege, MD, mPH, Senior Fellow, Bill & Melinda Gates Foundation "It is said that no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones." -- Nelson Mandela "Overcoming poverty is not a task of charity, it is an act of justice. Like Slavery and Apartheid, poverty is not natural. It is man-made and it can be overcome and eradicated by the actions of human beings. Sometimes it falls on a generation to be great. YOU can be that great generation. Let your greatness blossom." -- Nelson Mandela "You will achieve more in this world through acts of mercy than you will through acts of retribution." -- Nelson Mandela

A review puts the MC below the Cardiology III. I tried both and felt that I could hear carotid sounds better with the Cardiology III. --I'm also in the market for a new stethoscope... http://www.forusdocs.com/reviews/Acoustic_Stethoscope_Review.htm http://www.forusdocs.com/reviews/Acoustic_Stethoscope_Review_page7.htm I'm still a bit undecided on what to buy at this point. Looking forward to additional feedback.

I think there are many variables that can go into the reason someone was selected and you were not. Age may have been one of them. It may have not. As others have mentioned, there may have been internal candidates. Maybe the interviewers felt a better connection with some other candidates. ...maybe it was based on something those candidates said. Maybe it was based on the candidates' ages. Maybe it was based on those candidates not being as strong as you, i.e., less threatening to the interviewers' jobs or maybe they felt those candidates would be more complacent in their jobs or even more competent. Better to try to learn from the interview and move forward. Keep applying --to Mayo and to other places.

I think workplaces are more tolerant and are getting more tolerant. I think piercings can pose a risk as other folks have suggested. Myself --I don't wear any jewelry to work ---nothing to get grabbed or caught (e.g., dangling earring)....nothing to remove when washing hands... I don't mind others' decorative body art. I think tattoos are okay if visible in the workplace, but not if they might be offensive to the general pt population. (...that's hard to define...so maybe that's why many facilities just say a blanket "no.") I think piercings are fine --but don't think some of the jewelry should be worn on the job in healthcare if it may pose a risk to the wearer.

I think NoahsMama has a great idea ---ask the mgr, and also inquire about your husband changing his schedule... Also think it's good to inform the mgr that you are interested no matter what. I imagine if they can't accommodate you near-term, they'd eventually be able to do it. I would definitely ask sooner than later.

I just recently had some luck. As a new grad, I have put in hundreds of applications. I am currently working a hard job in LTC. I never dreamed I would handle the number of residents that I do. --I offered to help some of my classmates get a job at my facility, but several would not even apply after they heard about my workload. I think it has helped to have the LTC experience as now I have some interest from employers. I apply to jobs most days of the week, definitely when I am off, and even after work when I am tired. I also put out cold calls from time to time. A cold call is actually what got me my first job --the position was not advertised and they did not have online applications. I was told to come by the facility and apply. I think we are in very difficult economic times. I think it is hard all over the nation. P.S. - I am working for less pay than I wanted... but it's good to have a job. I am also earning less than my classmates (in my current job). I hope you find something soon. I would not move without a job. It is hard all over from what I can tell.

Thank you!

The management position is not ADON or DON --it's for a unit. It is salaried. I am curious which position would help me best advance as a relatively new nurse. I think it's valuable to understand management principles, but I also think clinical experience is very important. I appreciate your feedback. It is helpful to hear from experienced nurses.

I am a new-grad nurse with six months of LTC experience. I have two job offers - one as a supervisor in a LTC (responsible for unit 24/7) and another as a med-surg nurse in a hospital. I also have a third possibility as I have an interview for an ortho unit at another hospital this week. The supervisor position pays more and would offer some great insight into nursing management. The acute-care position pays less, but I'd only be working 3 12-hour shifts per week. I ultimately plan to pursue an NP degree. Any advice? I am shocked that I have these choices now. I have submitted hundreds of resumes since I graduated.