emeraldjay

I had a co-worker who had called in due to the amount of snow. I would have felt sympathy until I discovered she lived across the street from the nursing home and always walked. Not to mention the folks from "out in the woods" making it in that morning. Call me a chauvinist but I just snicker madly when these newly pregnant moms call in with morning sickness within a week of finding out they are pregnant, but I'll give you ladies a laugh at my expense, an ER doc took me out of work for a few days for a case of epididymitis. Only thing I came up with that could have brought it on was urine reflux related to lifting while my bladder was full.

I believe that death has a smell, just as I believe cancer has a smell. I don't experience the smell as the OP does. I smell it as almost a metallic scent that I can only equate with what betadine smells like. Then again I can also smell a UTI a day or two before the person shows symptoms. I just chalk up these "gifts" as being born for the job.

Something that helps me on tests is when I do show up for the test, I do my darndest to block out the panicky students and stay away from those who are doing the last minute cram thing. I discovered that I am much more relaxed if I STOP studying at least 24 hours before the test. I also can recall the information much better when I follow that rule. If I study the night before or minutes before, then the information becomes scrambled. Being around people who are in a panick will give me the same mindset.

I know the facility I work for has CNA training on site. The hours of the class are from 7am to 3pm Monday through Friday. Training lasts for about a month, you take the state exams and you get to work as an orientee as long as you pass your written portion. The facility pays for your exams and licensing. My facility is not in Syracuse, it's in Oneida, which is 30 miles east of Syracuse via the Thruway. My facility also advertises for CNA's at $10/hr for no experience, fresh from the class. Since Loretto has so many nursing homes in Syracuse, I would say to try contacting them. There is also VanDuyn near Community General. As far as I know, you can work as an aide in a hospital without the CNA certification, and most hospitals will train you. Depending on the hospital, you might be able to do more than what a CNA in a nursing home would be able to do.

I know of four hospitals in the city of Syracuse. SUNY Health Science Center (Locally known as Upstate Medical Center) is a teaching hospital, unionized, a state job, and has education opportunities up to (I believe) PhD in nursing; St Joseph's Hospital is locally reknown for it's cardiac care and has what I consider the kindest ER nurses in the city; the other two I know nothing about, Crouse-Irving Hospital and Community General Hospital. If you're up for psychiatric nursing, there is Hutching's Psychiatric Center. There are also some smaller hospitals in the surrounding cities depending on how long of a commute to work you want and how close to the actual city of Syracuse you will be living. There is Oneida Healthcare Center with both Hospital and LTC in the same building in Oneida; The city of Rome has Rome Memorial Hospital which also houses an LTC facility; Fulton has Lee Memorial Hospital; Cortland has Cortland Memorial Hospital; Utica has three, St Luke's which has a lockdown psychiatric unit, radiology school, and a neighboring LTC; St Elizabeth's which has a psychiatric unit, nursing school, radiology school, and is a trauma center; and Faxton which is affiliated with St Luke's and has an urgent care but I don't know much else about that one. Those are all the ones within an hour or less from the city of Syracuse. As far as pay goes I have no idea. I do know that Oneida Healthcare pays about $18 an hour for day shift RN's to start, has 12 hour shifts, RN's are unionized through NYSNA and has good medical benefits. Their LTC (where I work) pays CNA's about $10 per hours to start, LPN's $13, and RN's $18, non-union across the board, and just opened a physical rehabilitation section. I hope that helps.

The facility I work in has just a few codes: Code Blue - Cardiac arrest Code Yellow - Fire Code 44 - Workplace violence Dr Strong - Nursing assistance needed Dr Child - Missing child Green Alert - Missing Resident

I have to admit that I am bordering on being a compulsive "popper" with my other half. But I should also add that I have been a licensed cosmetologist since 1994. From what I have experienced in nursing school (I've only made it through second semester) is that there isn't much taught in identification of various skin conditions. Would I let a nurse take care of my blackheads or other pimples? Probably not. I would allow a barber, cosmetologist, or aesthetician to have at it. If I were given a doctor's order than yes I would set about to removing blackheads. For those angry looking pustules on the face, I usually recommend the client wash with plain cold water. Though I haven't looked at or done any studies, I firmly believe that soap causes a rebound effect as far as facial oil production goes. Increased oil production = an increase in likelihood of blackheads.

Here's something I wished they taught me in class: No matter how many times the patient has hit the floor, she/he will still try to get out of bed and walk. Some doctors need a reminder that their patient is not between the covers of a chart/set of vital signs. The patient's peri area that was as red as a traffic light all night will suddenly and miraculously heal when it comes time for the doctor to look at. Some of your co-workers will be shocked and horrified that neither the patients nor staff sleep on night shift. The hospital is not a place for a patient to get some rest. Make sure your partner lifts when "boosting" a patient or you will end up in the ER or tossing the patient in your partner's lap or both. Your second aide on a floor full of assist of 2's will always be treated as the "spare" aide and be floated off unit when it's time for AM cares. Chux pad placement is an artform, those who don't believe this will doom the next shift to a series of complete bed changes. There is someone out there who is teaching beancounters that mandatory overtime costs less than scheduled overtime... Who knew? The patients who acknowledge they aren't the only patients on the unit are probably the ones that need your help the most and ask for it the least. That little old lady with a fracture at both ends of the same humerus is convinced her arm is not broken. There will be times in your career that you will swear family members make mom or dad a full code just to be cruel.

I fully understand that it was a med error, and by the program's standards it is an unsafe. I'm just more upset that my case of, shall we say, stage fright is making me look like an idiot. I can do the tasks well in practice lab and without prompting. The only thing I can compare this feeling to is when I stood for my cosmetology practical and my EMT practical exams. I truly shake through the whole experience. Anyway, I decided this was the last straw, I started seeing a psychologist on campus and am setup with a NP who specializes in psychiatric medicine. I hope I can get this dealt with before it's too late.

I'm in my third semester of nursing school and I'm not doing well at all in clinical. I feel like I'm so worried about making a mistake that I'm making more than I should. These last two weeks felt the worst. To quote my instructor "You're not inspiring confidence in your patients." She also went on to suggest that if it was anxiety that maybe I should consider going on medication. I don't like that idea, even though it is most likely a useful suggestion. I don't know what it is, the moment I know they are in the room, I feel like I want to impress her, but at the same time I draw an outright blank on what to do next. Then I keep questioning myself if I'm doing something right or wrong. It ends in either a mistake or looking, in my opinion, stupid. My instructor also told me today that one of my patients had told her that he didn't think I was going to make it. Today's events were just the icing on the cake. My patient for the day, while being gotten out of bed by PT, saw a pill on her bed and took it. I remember her saying that she thought she dropped one when I gave them to her, I saw her look in her hand as well as reach down beside her and heard her say that no she didn't. Trusting soul that I am did not look at her hand to confirm. When questioned by my instructor I relayed the same story. However when they questioned my patient she claimed that she didn't say anything about dropping a pill. My instructor then told me that my patient either has a slight form of dementia or I'm lying about the pill. Given the tone of her voice and my none too stellar performance over the previous three weeks, I would be willing to bed she believes I'm lying about the pill. Needless to say, I'm really torn up about continuing in the program. I'm looking for some helpful hints, or words of encouragement.

I remember one that got drilled in during our post-op lecture. The 5 P's of circulation loss in a limb. Pain, Pallor, Pulselessness, Parasthesia, Poikilothermia

I love this thread, and as a student, I'll add what works for me so far. 1) Med book specifically geared for nurses; I prefer Mosby's and the PDR Nurse's reference. 2) A good stethescope, Ultrascope and the Littman Master Classic II or Cardiology; yes they are expensive but your ears will thank you when you get that fluid filled patient with a b/p that sounds 50 miles away. 3) A spiral bound memo book 4) Black ink retractable pens, ballpoint but not gel ink, many facilities frown on gel ink 5) Highlighters 6) There's this reference guide called "RN Notes" that's a good buy 7) Bandage shears 8) Good comfortable shoes, I prefer New Balance 9) Colored folders, believe me when you color code things they get faster to find. Now for some optional stuff depending on what your school requires. I have to do concept maps with different colors for various sections so ballpoint pens or colored pencils in green, red, blue, orange, yellow, and black. Get a good word processing program that is easy for you to use and understand; OpenOffice.org is what I use. My mini recorder comes in handy for those fast paced lecture classes, I have both a digital and a micro cassette recorder. I use my laptop, when allowed, to take notes during lecture classes and it serves a dual purpose, my notes are legible and my typing skills have improved.

:roll :roll The next year everyone must wear white scrubs or "orderlies uniform" receive a box of ABD pads and paper tape (for treating that half chewed a**) and listen to our theme song, "Wild Wild Life" by Talking Heads

I'll try to address all of these replies in one go. First and most important, I'm not asking to be exempted from wearing gloves to change linens, that goes without saying I hope. But wet or dry betadine does cause a rather painful rash at the point of contact, a simple heads up on what's soiled would suffice. I'm not asking for a full bed change. As far as the theatrics, jumping back is over the top, I agree. I equate my reaction as if I had touched a hot stove, not really the running and screaming as my original post made it out to be. Poor choice of words on my part. The nurse finding protective gear for me was by her choice, I would have gotten it myself and do so when I know where it is. It wasn't on my usual unit and no two units are keep stock in the same area. Yes I could have asked, but she grabbed what she thought I would need as she was collecting what she needed. The linen that is usually splashed is usually any of the pillow case the pt has their hand on, the top sheet, or the rolled up bath blanket also used to elevate the pt's hand. A simple "I got some betadine on the bottom sheet, can you change it?" would give me the clue not to lean againt the bed for balance doing repo. I added the please change the linen part after asking the shift supervisor for her advice on wording. I consider her to be more diplomatic than I am.

A week or so back, I had written a note in our floors communication book asking that all who use Betadine on a pt to please be careful to not splash it on the linens, and if it is splashed on the bed linens to change them for fresh, d/t an employee with a severe allergy. Most of the time I don't let things like being referred to as a jerk get to me, because I know I have my days and take my humble pie when it's handed to me. I have no problem changing out sheets with tube feed or anything else splattered on them, I'd even settle for being asked to change sheets that had Betadine splattered on them, provided I'm given the heads up that it's there. BTW, I was helping another nurse by holding her pt over for a pulsavac treatment that included betadine in the mix. I told her before we went in of my allergy and she found a face sheild and an isolation gown for me to wear in case of splashing. The patient had her concerns which were easily allayed explaining that I was highly allergic and I preferred that neither one of us had to go to the ER if I had a reaction and we both ended up on the floor. My reaction to the stuff is so quick that if I see anything that funny orange-brown I will jump back as if I had seen the devil himself. I know that's a touch extreme but for me, contact with Betadine feels like contact with a hot stove and leaves what looks like a chemical burn. After this long tirade I have to ask, am I asking for too much?

I still can't forget my first day at clinicals. Now having been a CNA for almost a year prior, I felt pretty confident in my bedpan weilding skills. I was partnered with a fellow student and a rather large patient. The day went progressively from bad to worse it seemed every which way we turned him there was a open area to be found somewhere. By the time we finished washing and assessing him, he asked for the bedpan. All this particular facility had to offer were fracture pans unless an act of god granted you a real bedpan. Can you see where this is going? We get him on the bedpan, and step out to look over his chart, come back the instuctor pratically follows us in to let us know it's time for post conference. I almost forgot about the pan but stopped and checked to make sure I hadn't forgotten it. I called for my partner because there's no way I could have rolled this man on my own, by habit I rolled him toward me but happend to look down at the right moment. I discovered that somehow we had gotten this poor man's scrotum dangling over the edge of the bedpan and under his leg. Let's just say I am glad the edges of the pan aren't any sharper than they are, I'm sure the patient was too.

Oh jeez, where do I begin. My name is Fred. I'm 32, still in nursing school for another 3 semesters. I can't really say what got me involved in medicine in general. My mother had one of those family doctor in a book type of books that I would read constantly when I was barely a teenager. I loved Latin class, which I took mostly because my mother had taken it when she was in highschool in the late 50's. I spent 10 years as a hairstylist which began as the idea I would work my way through college to become an English teacher. That never panned out. I jumped at the offer to join the local ambulance corps just a few years ago and became an EMT, then partway through that class decided I wanted to be a nurse, and to get the experience I took a CNA class at the local nursing home and have been there for a little over two years. Now believe it or not, my desire for the moment is to get into hospice nursing. I can't explain it, but I feel a swelling of honor to provide for someone's care in their final days.

I think it all depends on what sort of time of day your body is best at. In my case, I really don't function well during the daytime, particularly the 7-3 shift. My body always wants to nap right about 9am or so, no matter how much sleep I get. When I was working days at a non nursing job, I still wanted to sleep about 3 or so. and that was after getting to work around 10. I have a night shift job as a CNA now and I love it. I don't feel groggy during my shift unless I am feeling ill or just didn't have much sleep. It all depends on when you feel the most functional/alert that will speed up or slow down your learning. Also to consider, if you learn at the fast pace, the slower pace will be much easier to adjust to, If you learn at the slower pace, you might have a tough time adjusting to the faster pace.

I work as a CNA in a LTC facility, so that experience is what I draw from. I prefer to go with whatever works. As nurses we asses and treat and evaluate the response to said treatment. Maybe I have a simplistic view of the world, but when we discover that reality will not work on a pt living with dementia, why keep on trying. We don't keep feeding the depressed psych patient the same med that turns him/her suicidal just because the med is the current "right" treatment. We advocate for a different type of med, right? We don't give out antihistamine-sulfonomide cocktails to pt's with UTIs when they are allergic to sulfa drugs, do we? So when reality does more harm than good, why would we insist on inflicting that treatment repeatedly? Anyone remember ADPIE? Assess, Diagnose, Plan, Implement, Evaluate. I like to think that a happy and calm patient is less of a danger to themselves and others, than one in distress or anxious. I've only had three patients that genuinely scare me, and that was because their behavior would change rapidly, without any obvious triggers.

I have suffered migraines for the past 10 or so years. My last experience of having to resort to going to the ER for relief felt like a disaster. I knew I needed to be up for work in a few hours and couldn't get to sleep d/t the usual visual disturbances I get. During triage, the nurse actually said, it's 3 in the morning, what are you doing in here with just a headache. Is it really a migraine or are you just calling it a migraine. Why are you coming in now if you had it for three weeks. Only the final question is forgivable, though the tone of her voice isn't. I knew it was a migraine since it was all of the same symptoms as the last headache that got me a dx of having migraines. All I wanted at that point was to get rid of the flashing lights and get to sleep. I even told them what worked the last time, compazine timed IV push. Nurse took off in a huff. I don't remember actually seeing a doctor that night, I just remember the nurse coming back with a tramadol IM and a script for Ultram. Even after complaining that the flashing was still there. Then the most amazing thing happened when I asked to use the phone to call for my ride. I asked them to dial an in house extension and suddenly everyone fell over themselves to be accommodating. Like oh here use this phone. Now that I am on Depakote for the migraines, and Imitrex for the rare ones that get through, I'm treated with plenty of tender care when I say I have a migraine. I also carry a list of allergies and meds since half the time I forget to say all of them and only tell the ones that I think are relavant. I include dosages and freqency of my meds and the reactions of of my allergies. After that, the MD/NP can make the decisions.

Morrisville State College School of Nursing in Morrisville, NY

I work on a LTC vent unit, and have had both wonderful experiences and horrible experiences. Yes, I have even seen at least one patient go home. Some of our pts are full codes, some are DNR's. We have feeders and eaters. Some are being weaned some can't be weaned. I've learned not to panic when a pt comes disconnected, how to suction someones mouth using a yankauer, use a suction swab to do mouth care, and my biggest lesson of how to lift without injuring myself. As a CNA, I'm not allowed to do some things, like tracheal suctioning, trach care, g-tube care and the like; that duty goes to the RN or RT. I've also learned how to read lips. From the sounds of what others are saying, I'm in heaven as far as staffing goes. I have an RN and an RT and often a second CNA as part of my team to care for 11 patients.

Daytonite, you bring up many valid points as to why I do not ever want to be placed in management. I did bring up to some co-workers my spin on the quote, such as maybe she was trying to say that the challenge is trying to please everyone while making difficult decisions. Unfortunately, while we are in the midst of a staffing crunch, many innocent statements such as the one I mentioned in my original post are being taken with a negative connotation. nambour51, there are other issues and negatives, such as staffing, that are generating the negative feelings and I think this quote is just bearing the brunt of those feelings. Her award was for vocational excellence. Yes she does deserve it, judging by the fliers posted I would say she does quite a bit with the Allied Health students. Going by all the responses I should find fault with the newspaper and/or article writer more so than the statement itself. It was paraphrased after all. Thank you everyone for your input.

Ordinarily I would take the quote with a large grain of salt, however this was a quote in a newspaper article about her receiving an award. This same DON also considers it a time management problem when 4 CNA's can't attend to the needs of 40 LTC residents, of which half or more (depending on the unit) are assist of 2. Some units on weekends are left with 3 CNA's for 40 residents, one unit often is left with 2 aides for 29 residents on day shift of all times. For the sake of workplace morale, I am hoping that she was quoted out of context or we're all just taking it wrong. Don't get me wrong, I wouldn't want her position for all the money in the world, I'd be committed to an asylum after my first day.

Maybe it's just me being overly sensitive or taking things wrong, but just a couple of weeks ago our DON was quoted as saying her "biggest challenge was working with the staff." I feel insulted by this, and I am finding it difficult to look at it any other way. I think if she had meant to say that it was a challenge making every one happy or pleasing everyone she could have worded he statement to something innocuous like her biggest challenge was pleasing everyone all of the time or making difficult decisions that everyone was happy with. There are many more in our facility that feel this was a slap in the face. I'm hoping someone could put a different light on this quote.