Krisintheweb

Good Luck in school. Nursing school is hard but try to remember to enjoy it! Although I have made some mistakes starting out, I am very glad that I became a nurse. Working as a nurse is very rewarding if you like taking care of people and I always say that my nursing education was the best investment I ever made:idea:. At least I am able to pick and choose jobs in this economy!

Just an update for everyone. I resigned from my SNF job and took a job at an ALF. Wish I could say this was a happy ending but sometimes I feel like I should have stayed with the old job. I got to do more at the SNF. I was learning more at the SNF and they were less concerned with the bottom line. The ALF job is easier but I am afraid that I will loose skills if I stay here long. The surroundings are more pleasant, which is nice but the DON is so cheap with the budget that we constantly run out of gloves and have no 11p-7a nurse! In hindsight I believe it was a mistake to quit the SNF job and just wanted to let others know. PS - what a bumpy start to my new career!

Hi I am a Florida LPN working in an ALF that uses med techs. I work the 3-11 shift and after 5pm I am the only nurse in the building. The 11pm-7A shift has no nurses only a med tech and 2 or 3 CNA's. Our Florida ALF has under 75 residents and includes a locked down unit. The med techs work very hard and do the same work that I do. They pull meds from the cart, count and sign out narcotics, and cosign for me if I waste a narc. First question: What I am wondering is does anyone regulate the scope of practice for med techs in Florida? I have found 2 laws but our ALF does not comply with either one. Florida statute 393.506 link: http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0393/Sections/0393.506.html Florida statute 429.256 link: http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0429/Sections/0429.256.html Because I am the only licensed nurse in the building between 5pm and 11pm and there is no 11pm to 7am nurse I am getting scared about my liablility. I am only an LPN. We have no written job descriptions, no policies in our handbook. I was never trained on what the scope of practice is for supervising med techs. The ALF that I work for is a very expensive and a very high class place. It is owned by doctors and I have a hard time believing that the administration would just thumb it's nose at the law. But then I also wonder, if the med techs are legally allowed to do everything that I do, then why in the world would they be paying me twice as much to be there? Why not just staff the place with $9.00/hr med techs and cna's? Also on nights that I leave an no med techs are on my boss has instructed me to just leave medication doses on top of the cart for the cna's to give and leave the keys to the cart in an unlocked desk drawer available to all staff (and even residents if they walked in). I have refused to do this. I told my boss no way, find a replacement or give me a written policy telling me to do this. Second question: Are we allowed to count narcotics off with med techs if there is no other nurse? And a comment: Med Techs work hard in my facility. They have to do all of my work and also the CNA work. If you are a Med Tech and you are doing all of that work and making less money, then please, go to school become a nurse and get paid for what you do.

Reeveslpn - I think you might be right. This is the toughest job I ever had!

To Redroses13, I must admit - it is hard to find a job as a new grad. I actually drove around all day with resume's in my car and just walked into places. I would ask the receptionist if they were taking applications. Some places told me to fill applications out online, but I think the personal visit helped to put a face with the name. I filled out a lot of applications. I searched state job sites and all of the company websites for job openings day after day until someone hired me. It took a little over a month to find a part time job. If I don't get enough hours I am going to go back around and sign up for prn jobs near my home. Good luck, persistence and determination pay off in the end! PS- I don't know if by SF you mean San Francisco or South Fla.

Thanks systoly!

Thanks to everyone that replied. I worked 3-11 last night and left the facility at 1am. I did all of my meds and treatments right, I helped served dinner (we were short of staff) and I took patients to he restroom when the cna's were unavailable as I did not want anyone to fall trying to go to the bathroom themselves. I had 1 fall report, 1 discharge and several daily and weekly chartings that I could not start until after shift change at 11:30. Oh yea, and what happened to the nurse who was suppossed to be orienting me, she was rolling around in a patients wheel chair because her hip hurt! Everyone got to take lunch and breaks but me. I am considering turning in my resignation. I am afraid if I stay here Iam going to loose my license or die trying to keep it! After this job I am going to try one more place and then it's MacDonald's here I come!

Hi I am a new graduate nurse and I just got my first job in a long term care facilty. We have rehab, alzheimers and a psych unit. I am so happy to have a job and to get 3 weeks of orientation but a few things have me confused. I am hoping to get some imput from more experienced LTC nurses. 1.) Med Pass - we were always taught to check med, dose, patient id, etc 3x. The patients in our facilty do not have id bracelets on. In the mar some of the patients have pictures but not all of them and they don't always look the same as the picture. The alzheimers and psych patients can't always tell you who they are or sometimes tell you they are someone else! They lay in each others beds and I have found some with clothes with other peoples names in them. I have resorted to asking the cna's " is this so and so". The cna's are very busy and I think get a little annoyed with my constant questions about who is who. Even though I am orienting, I do med pass by myself. It seems to take me about 3 days to get the 28 or so residents memorized but I still get very nervous giving medications w/o positive id. Is this common? 2.) Treatments. The nurses mostly just sign off on the treatment book. When I was in school I did all treatments myself at clinicals...if I signed it, I did it. (but I had less patients and no paperwork). Nurses at work say the cna's put zinc and barrier creams on when they change the residents but I have yet to see any white coated butts! The nurses just do the bandaging and dressing change treatments. Is this normal? 3.) In the locked down psych unit patient wander around alot. Men go into women's rooms uninvited. It is common for residents to walk off with other residents items. I have heard family complaing about this. I even had one resident say she had been raped. The regular staff said there is no way this happened and that this particular resident shouts out all kinds of things and that it is a part of her dementia. However, given that the male patients enter the females rooms, I can see that this could have happend...a activities employee reported it to social services. The social service director(who looks like she is 12) investigated it and some of the nursing and cna staff got angry an complained about interfearance 4.) Medpass. I work 7-3, first med pass is 9am, residents are pulled for activities and therapy in the morning. Many of my patients are gone from 9 - 11:30. We are not allowed to interupt therapy or activities for meds. We are suppossed to give meds within a 30 minute window of the time they are ordered for? Excuse me but ***** I asked the ADON what to do about this, she said well we are not suppossed to interupt therapy or activities but sometimes when I worked the floor I would sneak the meds to them in my pocket...I don't want to sneak anything, I want to do the right thing...wish I knew what it is. Currently I start my med pass as close after shift report as possible and get the patients first who I think might leave. 5.) Paperwork. What a cumbersome task. We do not have computer records and the paperwork is totally interfearing with getting the job done. We have 2 people (cna + nurse) recording vitals in three different places...does that make sense? We have 3 ring binder after 3 ring binders full of cumbersome paperwork, that must have your full attention while you are suppossed to be caring for the patients? (don't the patient's need your full attention?) Sometimes I think it would be better to come in 1/2 hour before your shift starts and stay 1/2 hour later to do this while some other nurse is caring for the patients, but this is not allowed. Please let me know...is this just the way it is. Do I just need to learn "real world nursing" as I hear so much about. Can I use the "real world nursing" argument when I am before the board because I messed up (I don't think so) Are there facilities who are better about patient care than this, should I be looking for another job? Somebody with some experience please help me out!!!

Hi Lynnie, well it must feel good to be in demand! Although it is always stressful when we are faced with important choices. I can't speak for everyone, but for me honesty has always been the best policy. I would simply tell the hospital that you have been offered a part time job that would allow you to finish your RN schooling and that at this time you feel that would be a better choice. I would let them know how highly you think of the hospital, how much you appreciate them offering you a job and then I would ask them "If I take the other job at this time would it hurt my chances of employment at your facility later when I graduate." I would then gauge my decision based on what is best for you. Rest assured the hospital or any facility will always make their decisions based on what is best for them. I know that sometimes in the corporate world it seems like honesty is not always appreciated and sometimes even punished, but it is just what works best for me. I like to be able to have open and honest communication with my employers and if I can't be that way then I don't want to work for them anyway. Good luck and don't be so stressed out that you forget to enjoy the fact that you look so good on paper that you actually got 2 job offers! :yelclap: