jeriksmoen

I'm in my third LTC job and all three buildings have been "stone-age" paper. My current building is the most technologically-advanced of the three -- the CNAs chart on a special computer program that allows them to use a touchscreen to record things like how much assistance someone needed with feeding and what percentage they ate. Therapy is a separate department and they do all their charting electronically on iPhones, but then their notes are printed and placed in the chart. Our census is also on the computer, but that's it. Everything else -- report sheets, vital sheets, diet slips, MARs, TARs, appointment requests, therapy screens, telephone orders, etc. are written out by hand. When I take a telephone order from a physician like "start 100mg Colace PO q day for constipation," I write it on a telephone order sheet (which makes a triplicate), write it on the pharmacy order sheet and fax it to the pharmacy, write a chart note, write it on the MAR, write it on the 24-hour report, and write it in the alert book. You can imagine when I get orders on four or five people at once... On the other hand, I find that people tend to read my charting because at least it's legible.

Labor and Delivery -- You are there to teach them how to deliver that baby effectively. Hospice -- This is definitely family and patient teaching. End-of-life spiritual issues for the patient, and for the family: physical and mental changes prior to death, how to medicate effectively for comfort, managing incontinence and preventing skin breakdown, bowel management, what to do when something goes wrong, etc.

I agree with MC3's comment about home health not necessarily being the right choice. In addition to the lack of time, the other downside to home health is that you don't have anyone to give you a second opinion. Whether one of your patients "can't move his neck" and it turns out to be that he worked too hard in PT yesterday and not tetorifice, or a patient has an area of little red dots that itch that turns out to be scabies and not just a heat rash; there's a whole lot the books don't cover. Heck, it took an entire day of watching another nurse before I got the steps to injecting insulin correctly! I know it's frustrating, but their are long-term care places out there that will hire and train you. Also, I've talked to several classmates who started as a CNA at a place (even though they were an LVN/LPN), and they moved up within a month or two (and with a lot better knowledge of the residents!).

For isolation: Negative-pressure protects the Nurse Positive-pressure protects the Patient

Anecdotes for blood thinners (based on well-known brands Calvin Klein and Hewlett-Packard): Coumadin Vitamin K Heparin Protamine Sulfate

Anti-hypertensives are as easy as A-B-C-D: ACE Inhibitors Beta Blockers Calcium Channel Blockers D​iuretics

There are three types of infection that require Airborne Precautions (and it's not Music TeleVision): Measles Tuberculosis V​aricella

I just finished a year of LVN school, and what kept me sane was my mom (a longtime RN) telling me how bad it was 40 years ago. I think it's because all our teachers remember being treated poorly, and feel like now it's their turn. Because if they truly had compassion, they would be a nurse and not just a teacher. Also, now I have the satisfaction of thinking that my career is just starting and it has so many possibilities, and my teachers are just doing the same-old thing.

I am a nursing student six weeks from graduation, and the hospital I am doing my OB rotation at is baby-friendly overboard. They go so far as to discipline a nurse who provides formula, or even a breast pump, without a physician's order. If the baby can't latch-on, the mother is supposed to manually express her milk and "cup-feed" the baby -- no mention is made of what to do if the milk hasn't come down all the way to the nipple...

I am new to allnurses.com, but I need advice from more experienced minds. I am a nursing student, and I have a friend visiting from New Zealand who broke her tib/fib badly and required surgery. I am new to the area and assumed she would get good nursing care whereever she was. Wrong! These nurses leave me embarrassed to be a nurse with their care of everyone on the floor. (I won't go into details now since I'm pecking on a Droid, but that post is coming soon.) My biggest concern is that she is not getting adequate pain control and the nurses seem indifferent, saying her doctor hasn't been by to see her. They are extremely reluctant to talk to me, and I have to ask very specific questions (not" how are her labs?" but "what is her H & H?") How can I get the nurses to work me, or at least care for my friend?

Don't worry about going back on to the floor after bringing up an issue. You found a legitimate problem and handled it appropriately, so walk on to the floor with your chin up, knowing that your attention to detail may make an important difference in someone's life.