indiechic

I got in!!!! I called as you all did and Mckenzie said letters probably didn’t post until Monday, but she gave me the verbal that I made it! Such emotional news. Have been an LPN for 8+ years, am a single parent to two young children, and have felt so down about ever getting my RN so I could move up the career chain. Beyond excited! GeeGee, I’m so sorry this was not your year! I have been in your shoes and know the disappointment. Your time WILL come! Do not give up!!!

Fingers crossed!! ?? Unless there were a lot of applicants with straight A’s and who had the rollover point, I’ve got a good feeling about admission chances!!

@nurseuhlisuh Yes, the repeat deadline extension worried me too. I’m glad more folks got the chance to apply, given the seriously last minute notice they gave in the first place. But, selfishly I also want the best chance possible of getting in with less applicants. Lol. Per the scoring grid on the site, the max points possible one can score is 9. I just got my application review letter and was excited to see I’d scored 8/9 points. They gave me a rollover point for having re-applied years ago. Expecting a decision letter in November. I'm just soooo jazzed they reopened the TADN cohort, it’s a great program and the instructors I had were incredibly knowledgeable. Good luck and keep me updated if you hear anything!

Hi! I got in in 2012, but was dropped towards the end due to my own lack of focus. Now, years later I’m way farther in my career, have two kiddos, and also applied for the 2020 cohort. I wish I could remember what score got me in years ago! Although, when I retook the Accuplacer, my score will get me two points for that alone and the lady in the testing center said that would likely make the difference!

That just depends on your definition of "hard"... I can only speak from working in LTC and having done clinical rotations in the hospitals. I find LTC much more challenging as you generally lack a lot of the support staff that hospitals can provide. LTC isn't for those who struggle with working independently. Good luck!

That's rough, but a common problem. I'd recommend getting on top of your time management and organizational skills now if you want to survive. The only way I function working the floor is by having a checklist of sorts to remind me what I need to do. Hold on, once you get the hang of it you will feel like super woman! :)

Look up your state regulations on your scope of practice as an RN. In Washington state, RN's can pronounce death, but LPN's cannot. EMT's may not pronounce in my state either, the paramedics generally call the medical director on call for the area and tell them the signs of death and he pronounces over the phone. But, not sure about paramedics in my state, though I believe they can. This is one of the many reasons I dread deaths for those that are not already on hospice or have no code status in place.

For an RN, I wouldn't work in a SNF for less than $27-28/hr as a newbie. As an LPN, I made $21/hr just starting in an ALF and knew LPN's making $24/hr in SNF's.

Welcome to the world of LTC! Most nurses have no idea the difficulty this field presents on a daily basis until they are in it. Hope you find a more satisfying situation!

I would recommend calling your state's elder abuse line. If he is a danger to other residents you have a right to protect them. Also, I'd give a discharge notice. As long as you have plenty of documentation showing you've tried interventions for his behaviors and he is non-compliant, discharge is fine. That is, if your administration allow it. You can also call a designated mental health professional and ask for him to be evaluated. Looks good for documentation purposes, even if that's all that comes from it. Good luck!

I have dealt with administrators like this before... It's usually based on wanting to keep their census up and not lose money when the resident is out of facility. Very sad... It wouldn't hurt to call adult protective services. They keep your identity confidential, but will investigate situations like this.

Oh wow... I'm so sorry to hear there is a nurse still working with that attitude. I would have a discussion with your DON about these events. They aren't acceptable and would be considered abuse and neglect. As you already know, we are all mandatory reporters to the state. In the instance of nurses, I always try to give the facility a chance to iron out the situation before calling state, but in the end you have to look out for your residents-- not coworkers. Good luck!

I found myself in a very similar situation when I first got into nursing a couple years ago... I gave it a solid year because I know that changes often have ripple effects for many months. It was exhausting, frustrating, and crazy every day, but I'm really glad I did. After a year and a half at that facility, I left feeling that things were settled and my residents were in good hands. And onto a promotion elsewhere I went! However, sadly not every situation is like that. Good luck!

LPN here in the Puget Sound area of Washington. Starting wages were $24/hr as agency in a clinic and $21 in LTC.

In Washington, the starting is generally $20. I had two jobs when I first got my license, one paid $24/hr and the other $21/hr. In my experience, confidence in the interview translates into higher starting wage. Almost two years later, I'm over $31/hr. Anything is possible! :)

I think that is an uncommon happening, or I just haven't run into it yet... SNF's can change to rehab only by grandfathering in their LTC residents and then relicensing those beds as they transfer or die. But, that is false advertising what you're referring to. I'd recommend your friend keep documentation of that...

Good luck! AL is a peculiar environment to work in, very different from SNF's. I'd highly recommend that you get a copy of your facility's disclosure of services to understand the services you can offer and then get very well acquainted with your state regulations on assisted livings. Also, keep an eye on those CNAs and document EVERYTHING!

That's tough... I like to write job descriptions or required shift task sheets for them to sign and place in their employee file so I have documentation that they have been informed of their required duties and any further slip-ups will be grounds for written write-ups and eventually termination. I also think it's a good thing to check their work every now and then (check briefs, laundry, garbage, etc...) and document your findings.

It sounds like you want to dive into "nurse delegation"... Your scope of practice differs from state to state, but I would ask your nursing director if they offer nurse delegation or extended training. If they don't, you have to switch jobs or wait until you've graduated nursing school. Taking blood pressures should be part of your job right now though...

I'm lucky that my facility still has many of the "grandmas and grandpas", but we also have a few younger residents with developmental or chronic health issues. As a rule though, we try to keep the younger ones as rare exceptions. In my experience, they tend to be the most difficult cases to deal with.

I don't know about all states, but I'd sure hope it's the same as mine... In Washington, all healthcare workers are mandatory reporters for abuse, neglect, etc. and these issues can be called in anonymously to the state department of health. I would recommend your friend documents that she has alerted management about these issues and no changes have been seen, and then she should report it before state comes in and cleans shop. Ultimately, it's her license that is in jeopardy while allowing those kind of things to go on, even if the management should be taking responsibility. Good luck!

You're perfectly fine! The DON is only correct if it is an emergent situation or there is not documentation that you have made reasonable attempts to contact the MD for the Rx. Writing the script later in the day and waiting for the meds is fine if it's not emergent.

I've been there... Hang on! Assisted livings have such vague regulations (at least in Washington) that coming from any other nursing environment, it appears to be a madhouse. And sometimes, AL is an easy trap for nurses to become lazy since it's a very independent role as a nurse. One of the first things I would do is hold a meeting for all staff who assist with medications (med aids/techs or nurses, whichever your facility uses) and let them know your expectations for quality of work, missing meds, missing blood sugars, unexplained med exceptions, MAR holes, etc... When I started this AL position, we were behing on service plans as well, so I'd recommend to start scheduling them and type up a schedule. Our assistant-admin (or business office coordinator) did this scheduling. I did an intensive 3 weeks of catch up where I'd have 4-6 care plan meetings per day, it was exhausting! But, it got the work done quickly and it helped me learn the resident population and their families. As far as the narcotics, I ran into this as well... But, this can differ between what tiers of controlled substances want to lock-up. My current facility was not locking Ativan, but I changed that. Like the previous poster said, documentation is going to be your best friend! Save the memos you create for all the in-services and have it signed by all employees to show you are working to clean up the facility and it's mistakes... For as unregulated as the AL community is, it's incredible how far administrators and nurses let them fall! Keep up the good work! It just takes time. :)

Awesome!! I got my acceptance letter yesterday too! Yay!! Looks like we will be classmates! My name is Alana... I'm so excited!

Awesome!!! Please keep us all updated on your progress and how you like the program!