lovesmarissa

Hello! I hope this question is on other new RN's minds as well...especially if they've been hired on for 3 12 hour shifts a week. My shift at the hospital is going to be 7p-7:30a. I also have a daughter who is home from school this summer, and I will be taking her to school, picking her up after once school starts. So....how do you night shifters do it? How do you work your days? Do you sleep as soon as you get off work - and how much sleep do you get by with? Do you nap before you head off to work? Yes, I am worried about getting enough sleep, and also exercise.... I'm the kind of person who has to eat during work, so I know I will be eating small meals throughout...and probably not eat as much during the day. Any tips, advice, your best practices, etc are welcome. I'm looking forward to it all, but also want to make sure I've thought out how my schedule is going to be now that I will work nights. Thanks in advance!! Bea

thanks for the ideas....there was a call out to the MD (who is on vacation of course) so he will see her when she gets back. I too think it's more of an RA flare up. She did have cellulitis visualized on the R hand, hence the abt...

Hello! I have a home care patient who has the following dx: rheumatoid arthritis, crohn's, macular degen,history of strokes. She is in hospice. About a month ago she was in the hospital. Upon her return home, she started complaining of pain and soreness to her R hand, which had the IV. She was treated w/10 days of antibiotics. Several days after that, she became swollen again, and we started another round of abt. She has one more day on the Keflex, and when I saw her today she had swelling in BOTH hands, nonpitting, warmth and some erythema to the hands. The forearms were more gelatinous in firmness, but were not really edematous per se. She had swelling in between each knuckle also. No other places with swelling, such as the lower extremities. I thought it may have initially been a case of cellulitis, but now that it's present in both hands I'm throwing it out the window. Another Nurse I work with thinks it's more of a circulation problem, aeb some discoloration to the area that is intermittent-some visits the area looks cyanotic and other times it isn't. Pulses are good and strong.... What to you think? I know I'm missing something here.... Thanks for any suggestions and Ideas!! -Bea

Hello there, Anyone here have any ideas on what else can be done for this patient? He has an ileostomy that is leaking constantly. His skin is so irritated right now, and he also has an old incision scar that is about a half inch wide that the corner of the wafer unfortunately has to go over - he doesn't have a nice smooth surface of skin for the wafer to cling to - so his ileostomy leaks after a couple of hours, no matter how often we empty the pouch or stool or gas, etc...he is currently using skin prep, stomahesive to apply the wafer. I'd appreciate any advice and suggestions on this one - the doc we have read somewhere that heating up the wafer can soften it up, thus allowing it to have a better seal with the skin, but that is not working either. You know how if a wall has a hole and you can spackle over it to make it smooth? I wish there was something like that for him, just so he can have some relief! And maybe some nice uninterrupted sleep too.... Oh....forgot to say, the ostomy nurse from one of the hospitals came to check things out and unfortunately did an even worse job changing the wafer and bag than we've been Thanks :)

Hello! Has anyone heard of The College Network? They claim to be accredited, and have a home based self study RN program... has anyone here gone through them or is going through them? What do you think? Any other ones out there you'd recommend more? I have been on a waiting list to bridge to get my RN, and this seems to be a pretty cool option. Thanks in advance!!

Just wondering what you all do during the holidays for co-workers. Do you give cards out to everyone you work with on the floor? Do you do anything special for the CNAs you regularly work with? Do you limit this giving to those you've connected with on a personal level as well as professional? Do you do anything to kiss up to the boss- in my case the DON? :wink2: Just curious here - it's my first year at this particular facility, and I have some really great CNAs and Nurses I work with. I'd like to do something to make people feel appreciated but not go overboard either....

lots of good advice in the replies....I agree that it is better to work for hospice before the hospital because of the HUGE difference in outlook. I am an LPN and am fortunate enough to work on the inpatient unit for Hospice. We can do most everything, except IVs and delegation, etc..RN scope of practice stuff :) We have had several nursing students who came through during their clinicals and decided they wanted to work at hospice after graduating, and they have been wonderful. I agree on the pathophys, also becoming really comfortable with the main problems we see -- pain, dyspnea, anxiety/agitation, N/V and constipation. Those are the big acute problems we see....hope this helps you, and good luck!

We use MOM if no BM after 2 days, then a suppository, then an Enema of choice on the 4th day. We have something we call the 11th floor special, named after an oncology floor at the local hospital. It is 500ml warm water, 4 oz glycerin, 4oz baking soda. It's not the easiest thing to give, since someone has to stir the mixture and another to keep the enema tip in place.....it does work on the most stubbon situations though, even when the DRE is negative and there is a concern of constipation.

Thanks. I am definitely guilty of not having looked through the forum as much as I've liked....didn't even know there was a LT Nursing forum AND an LPN corner. OOPS.:imbar Let's just say I was extremely exhausted and was hoping to get some friendly advice so I can keep plugging away.

I too used pen and paper. I had my own little abbreviations to speed things up and wrote small so I could write faster. There is something about writing stuff down that helps cement concepts in my mind. I was also lucky that my instructors mostly posted an outline of their lectures on my school's intranet, so I could print that out and fill in as they lectured. good luck with your studies!! lovesmarissa

Hello there! I am new to this site and also a new LPN grad. I just passed the NCLEX and I'm working in a long term care facility (3 12s). Soooo....to all you nurses out there, seasoned and new, what kind of advice can you give me about transitioning into the world of nursing? How about advice on how to make my day run a little smoother? I keep getting stuck at work because I'm running behind. I know this is partly due to my inexperience and therefore lack of organization in a way, etc...What helps you? I'd appreciate any advice and tia.....