Nurse424

Tell me about it!! And it's sad and VERY disheartening to those of us who are in this dog eat dog career for the RIGHT reason....PATIENT CARE!!!!!! I got into Nursing because I loved the care of caring and giving to those less fortunate the help they need to become independent again or to live out the end of there lives peacefully and happy. I am in Nursing for the care of patients that I enjoy doing!! I have a big heart and care deeply about everything in my job, my biggest care is my patients, and this highly upsets me...and the fact that we have two Nurses on NS for 98 patients and DS gets 5 then we get told that we are considered STNA's as floor nurses.......SO, on NS all we get is 4 STNA's BUT DS gets 12!!!! Where is THAT legal....MAN I dont wanna get old......I'm scared

Ok! So, I have been in health care over 20 years now working in Major Hospitals as Nursing Assistant and now for 5 years have been working as an LPN. I currently work in a LTC facility with Rehab and just left a facility that was completely Rehab but downsized and went to all RN's. The issue, I have been an old school documentation kind of person well this facility I worked for all Rehab constantly was teaching us how to document for today's Nursing and for Rehab purposes for payment reimbursement for Insurance. Well seemingly what I learned there for documentation the floor Nurses I work with now are familiar with the same kind of documenting. I learned that documenting John Doe is A&O X3 speech clear, able to make needs known, lungs clear, abdomen soft and supple with no guarding present. skin warm and dry, etc etc. But, with it being Rehab...we were always taught at the major rehab facility to chart the patient for example, John Doe ambulates independently with w/w and gait steady. Mr Doe requires assist with ADL's and minimal transfer of gait from sitting to standing. OK!! The issue now at the new facility, even though several other nurses chart the same thing because they were taught the same......we are told the patient does NOT have a steady gait because they are here for rehab and that they cant have a steady gait because then insurance looks at that and states "why is that person here if they have a steady gait." Well, for arguements sake, all the nurses have been arguing this fact because for one, the persons admitting diagnosis is not for "unsteady gait" they are admitted for PN, COPD, Hip Replacement, MRSA, etc...AND if we chart that they have an "unsteady gait and that they are ambulating with w/w independently then they loose balance and fall, why were we letting them ambulate independently with a w/w if they already had an unsteady gait. They are not here for gait, they are here to recover from PN and are weak not here for gait purposes. SO, our thing is if we chart that they have an unsteady gait and are independently ambulating and fall, why did we let them ambulate ind. in the first Well, now our MDS Nurse has taken it upon herself to "Fix" the charting of other Nurses...................UH!!!!!!! Please...........some help and knowledge from some others of you out there in this crazy health care world Now that we are all having a fit about this whole steady unsteady thing.....another Nurse is "fixing" other Nurses charting!!!!! Grrrrrrr

Worrying too much AND too unsure of yourself!! Get some confidence in your title. Utilize your floor nurses to your full extinct AND the NA's . They know patients best and will be with you! As a supervisor, in a code situation you should be in control as far as calling 911, getting papers ready for transport, grabbing crash cart, etc. You keep things running smooth and your floor nurse and aide caring for that patient should be in room, then you as a supervisor will call the other floor nurses and aides to assist while you keep everything in line, papers, 911, calling family, ER, Dr, etc. Supervisor oversees floor nurses and aides. Have faith and trust your staff under you dont control them and think you are better than them, work as a team and you will see things would run super smoothly. Just dont let them run all over you either!

Never heard of ever calibrating a portable pulse ox.....but dumber things have happened!! SHOCK@!?!??! Seriously????? AND, brand new ones are being sold on Ebay every day for 30-40.00!!!!

VERY VERY True!! NOT all capsules can or should be opened!!!! There is a reason they are in capsules. AND if you talk to the pharmacy your facility deals with and they find out that the patient needs there meds crushed they are usually very good at supplementing with liquids or another alternate med or something. Then contact the Dr. Most Dr's are not made aware the patient needs there meds crushed and will agree with alternatives pharmacy suggests for such cases. Also, if order calls for PO, then thats what they mean....by mouth and as dispensed. IF for ANY other reason, you have to crush, place in applesauce, pudding, juice, Gtube, etc, YOU NEED AN ORDER!! You need an order from MD to administer medications crushed in pudding/applesauce in order to be doing so! If state was to come into our facility and we were seen crushing meds and placing them in pudding, not having an order, we would be dinked big time!! As PO stands for med to be given as dispensed, whole, capsule,liquid or otherwise.

I have been a Nurse for 4 years! An Aide before that for 19 years. Personally if this was a scenario I would have been in.....I would have a stopping point a few minutes after being told someone needed pain meds. I would have finished with the process I was in with the new admission, excused myself, told new patient and family I would be back momentarily and excused myself to tend to the need of the pain patient. For one, the family and new patient would have seen you like to care for your patients in a timely manner and don't just let them sit. For two, you are taking care of a the patient who is already a patient there, control there pain before it gets ahead of them and then it takes longer to control and in turn ******* them off and the next day they report you to your DON because you let there pain get out of control. New Admissions in our facility do get taken care of promptly but it is also a 24 hour facility and if everything doesnt get completed on your shift, at least organize everything and flag what you could not get done. Do not let pain get out of control or you will have a very ****** off patient because now they are in horrible pain AND your new patient AND the family that is there with them see that you have patients under your care that are having difficulty controlling there pain so you wont only have one patient who is now out of control with pain but you also have family that will be watching your every move while you are there and they are visiting and your new patient will nit pick everything you do from here on out. Seen it done!! With Admissions, get priority stuff done, continuity of care, skin assessment, fall assessment, allergies, etc done. If minor end of admission stuff needs passed on, it is always a 24 hour facility.

I just started Indiana State University through the College Network 6 months ago and am loving it!!!! Best choice I have made to getting my RN:yeah:

I work in a LTC facility and would NOT be caught without my own pulse ox!!!!! For me.....it's a MUST HAVE!! :redbeathe