surfnbeagle

Anyone familiar with providing TPN in the home setting? I would be interested in hearing experiences with this. Thank you.

My first weekend and I survived! Actually, it went well. I am trying to be proactive, did a lot of rounds, answered lights, and tried to role model professional behavior. Some of the nurses have told me they are being told by management they will be let go. I don't believe in ruling by fear, I agree educate and motivate. People coming in late, etc...frequent communication with the scheduler at this point. And management knows who is late by the time clock printout they receive on Monday. What I have been told by management is that there is poor follow-up on the nurse's part, and also unprofessional conduct at the desk. Thats where the role modeling comes in.

I believe that in any nursing setting, you learn as much as you want to learn. Take it a step beyond work, and google information regarding the any of the multiple diseases/ syndromes you encounter in ltc. Or for that matter, that you encounter in any setting. Yes, ltc is quite downplayed by many others, and that's been around for ages. And I wish that would die down. Many people say it based on assumptions, and not on their own experience. Good luck!

Life is too short, stay where you are happy. You don't lose skills in ltc, there are quite a lot of skills to acquire! They may be different, but every specialty area has its own unique set of skills. Live life to be happy, not for your resume. Good luck!

I would also like to mention, that they sound extremely disorganized. Their is no logic here, if they feel you should be suspended for performance reasons, then why let you work all week! I can just picture them running around like chickens without their heads...blowing something way out of proportion and trying to find a scapegoat. This is so typical unfortunately. Be kind to yourself at this time. I am so tired of seeing this happen so often to good nurses!!!

Yes, definitely...do not sign anything without careful consideration. There are nurse lawyers out there. If they cannot answer your questions, you have the option to resign and that is your decision. However, before you make an important decision you obviously don't have the information. And that's what you need. Contact them, they may even tell you they don't know yet how long. But at least its a start in empowering yourself.

I am sorry to hear this happened. Administrators will often suspend someone while an investigation is going on, even though a nurse did everything she could have done in a particular situation. Though you are feeling very anxious, you need to protect yourself. This is a very punitive profession, and being proactive is a good thing. Write down all the details while they are fresh in your mind. Do you have malpractice insurance? Whatever the outcome, you will survive this and your career will go on. Let us know how you do.

I think all of the posters have given you some great advice! It sounds to me that your expectations for yourself are high, as seen by wanting to learn. We have all been there at some time or another. Be easy on yourself, you are just starting! I have seen so many nurses try to transition from other specialty areas with unrealistic expectations. If you would like, you can private message me if I can help you in anyway. Good luck!

I suppose it depends on where you live, I am in Fl and some of them do advertise on Craig's list. The best approach is to follow up in person, or just apply in person. I have seen resumes stuck in a drawer, and vacant positions. Face to face contact can never be replaced. Good luck!

I have worked in ltc and in a hospital. Unfortunately, I think too many people jump to conclusions without information. I have seen lousy nurses and excellent nurses in both settings. Sometimes this downgrading of ltc is plain snobbishness. When I was a new grad in the mid 90's there weren't any hospital jobs around. I started out in sub-acute, in a ltc. Somewhere in my career, I did hospital nursing. I really prefer ltc. You do learn something new everyday, critical thinking skills are absolutely necessary, and you do meet some very wonderful people. That being said, a new grad in ltc can succeed, if you need more orientation, please ask. I did. And its worked out just fine.

What interests you more? We have to look at the future, but go with what might is more interesting to you! There are so many other places to work than in a hospital, do what you want because life is too short!

Thank you for replying. I always have supported my CNA's, I was an aide once myself and know how tough a job it is. My CNA's have been my eyes and ears, they are very much appreciated. I was mainly referring to motivating nurses to act professional and do what they are supposed to do for their patients.

Does anyone have any pearls of wisdom for motivating staff? I am considering working at a ltc facility that has a lot of room for improvement. During my interview with the DON, she was telling me they are looking to "raise the bar" at this facility. I like a challenge, and thats why I am interested. Any ideas out there? This is going to be a weekend supervisor position.

Regarding the code status of a patient, ask someone to get the chart and bring it to you then you can actually see for yourself if there is a DNR in the chart. Things change, a new admission might not have a DNR, etc.. Labeling charts is important, but never assume. Even hospice patients can be full codes.

Good luck!!! You will do fine!!

When I fill out a job application, I read the fine print. If you have had a lot of short term positions, you may want to have them on a separate piece of paper to attach to the application. Then write your recent pertinent positions, they only want you to go back so far. Word to the wise, though, if the application says"please list every nursing position you have held, do so". A lawyer advised me about this once! Reasons for leaving can be, position eliminated, downsized, personal reasons, relocated, pursue position as a...I am seeing more and more employers interested in background checks and wanting references from coworkers ( as opposed to employers). People move around a lot in nursing, it can be hard to locate supervisors. Where as giving personal references, shows teamwork, and can be easier to reach than supervisors. HR can only say so much, i.e.: position and dates of employment. I hope this wasnt too much information!!!

It sounds like you know what you want to do, go with your gut. We all have to take some chances in life, however, you don't sound comfortable with the "psych position". If you stay true to yourself, you won't go wrong. Good luck!

Congratulations! Typically, on 3 to 11 you will receive most of your admissions. You also will probably have 2 med passes at 5 pm, and hs. Keep a clipboard with you, with your report sheet, so you can make notes as you pass meds. Find out who your diabetics are, so you can do your blood sugars before they are taken to the dining room. Check if labs came in, have the pts chart and MARS at your fingertips if you have to call the doctor. Oh and make sure your cart is stocked before you start your med pass. Not everyone is considerate to stock the cart for the next shift. The less steps you take the better. Good luck! You will do fine!

In Florida, regulations have tightened this summer as far as which level of background checks they do. They are now probing further.

I agree, keep your answers short and sweet. Chances are you may not even be approached by an inspector. They will probably zero in on adminastrative records. If you don't know the answer to a question, just tell them that you can find out the answer for them. And while you are doing your med pass, also remember your basic dignity issues. Knocking on the door, privacy, covering the MAR (HIPPA, etc.. This is observed even if you are not being followed for a med pass. But don't worry, it will be fine! :):coollook:

Have you approached the staff development nurse? They are usually eager to teach. Please insist on a longer orientation. Longterm care can be wonderful, but I have seen so many people run because they were given a very short orientation.

Have you encountered them shorting their emergency kits?

Ask for more orientation! Its harder to compare as to if one setting is harder than the other. However, as in all situations, remember communication is very important. Contacting families is very important...contacting the MD with the information at hand...labs, blood sugars, vs, etc...Follow-up on labs, double check your PT/INRs....good luck! I remember being there, if I can help in anyway feel free to contact me.

Hi ! I am interviewing for a weekend supervisor position in ltc/rehab this week. I have done this before but I have been out of ltc for a few years. Anyone have any insights as to recent changes in ltc that would be relevant to a supervisor position. Or any other advice that might be helpful. Thanks!!!

i can identify with all the posters regarding their incompetency, and from the age of these posts nothing has changed! I would also like to know if anyone else has noted that their E-kits are not correctly stocked. Three nurses where I worked observed that the amount of a particular medication did not correspond with what was indicated on the outside label!! This was a kit that had not been opened at the facility.