Norubit15

I am confused, I signed consent for a colonoscopy...

I had the opportunity to hear his story when he came to my workplace. His story is beautiful and demonstrates the power of a nurse's presence and kindness to a patient. I am very proud that he has come so far in life and is now an author and professional speaker, and is able to share his experience with, and challenge others to do the same.

Hello, I attended the bridge program at NCMC Trenton in 2016. The program was very good, and I would highly recommend it. The school presently ranks as the 3rd best nursing school in Missouri of all 2-4 year colleges and universities. The instructors are diligent, want you to succeed and are available to you, in person, via email, etc. what are your questions or concerns?

I would contact the Missouri Board of Nursing on this matter, since this is where you reside.

HI there, It didn't look like you had an answer to your question, so I will give it a shot. From what I understand, both the Level 1 Medication Aide "LIMA" and the CMT courses require one to be a CNA for six months prior and must remain active while a LIMA or CMT. The differences between the two are that a CMT is usually for skilled nursing facilities or hospitals, while a LIMA is for residential care facilities or assisted living centers. You can challenge the exams if you are a nursing student and have completed nursing fundamentals 1 and pharmacology 1 that meets the state of Missouri's requirements. You can find out more information by going to the website at Missouri Department of Health and Senior Services and then enter a search on the two topics. Hope this helps you in the right direction.

Hi there. It's been a little over 2 years since this conversation. How are things going? I have been away from the site for awhile. Did you complete the LPN to RN program?

Go to your State's board of nursing website, there may be a link on I.V. Certification. Many schools offer I.V. Certification courses as stand alone for those not presently certified. I work with a nurse whose college did not offer it for their PN's so she took the course later. Hope this helps!

Way to go! I am considering Excelsior College for my RN. I am currently an LPN. How long did it take you to earn your ADN?

The Saunders books and CD are excellent study tools. You are on the right track. Good luck!

You mention that you are not getting anything right. Are you using a practice exam? I saw several practice exams on the internet available. I would do these, pay attention to the rationales if you get one wrong, and do them over and over until you have got the material down and are "scoring" over 95%.

Hi. Thank you for your reply. Yes, we have door gates and alarms in use for some of the door ways. That does work for some wanderers, but some have figured out how to manipulate the velcro and/or latch assembly and even if the alarm goes off this does not stop them. Conversely some residents did not wish to have them. One in particular is sight impaired and was afraid of not seeing the door flag in place. Has tried shutting the door, but the resident just pushes the door open and goes in. And again, the resident is concerned about running into her own door. This is a challenge for nursing on every front - safety first and foremost. I am looking for solutions to the wanderers and "touchers" in our common areas and hall ways as well. When nurses are using carts with medication and/or supplies on them and must leave them in hallway otherwise have cross-contamination - this leaves the resident and cart vulnerable to injury. I appreciate every post here. Good to know that we are doing some things already that have been suggested.

Yes we have in-services all of the time. All employees of the facility whether PRN, part-time or full-time are required to attend if the in-service is for them ( i.e. CNA, licensed staff, etc.) and if the in-service has been made mandatory. The facility where I work has both mandatory and voluntary in-services. It depends on your facility.

Thank you for commenting! :) Yes, I too have seen many cooperative roommates where one was cognitively aware and the other was not. I am speaking of those with advanced mental decline that wander A LOT. Those that continuously go into rooms and bother residents and their belongings and with little staff to redirect at every second, these residents are being affected by this "wanderer" both emotionally and physicially and in return many of them are returning angst and even physical behaviors back to the other. This is my concern... the welfare of both and how to effectively care for them with minimal staffing? Have any ideas?

I totally understand your predicament. I believe that education of BOTH staff and families of the need for the reduction of transfers to the E.D. is key here. Nurses have been educated on the protocols (varies by facility of course) for providing the physician with the S/Sx of UTI and dehydration and have the ability to provide the treatment once ordered. The families and/or DPOA of the resident's do not always understand nor WANT to understand. I have witnessed discussions with family members where the bottom line was that they feel that their loved one would be better served in a hospital. They believe that the attention their loved one will receive is a better ratio than in the SNF. I believe it may amount to staffing at the SNF vs hospitals as their acuity is different. So...if we can educate the staff and families with the understanding that we have the skills to take care of our residents in the same way (with the same training) as the hospital staff and pointing out that thousands of healthcare dollars would be saved in the process we can potentially turn this current pause in our facility operations around. Of course, there will always be that one family that requests that their family go to hospital. Recently I had the opportunity to explain to a family that even if a hospital agreed to admit their loved one that hospitals too were under scrutiny for the criteria for an admission and that one day soon something such as a UTI with AMS or dehydration would no longer be a viable admission criteria. The family took pause and agreed to treatment within our facility. So it may take "baby steps" but through education and perseverence I believe the situation will turn around. On another note, most SNF's have a medical director that they can call if the PCP is unavailable no matter the time of day or night. If the "on call" physician is advising that all residents be sent out then perhaps they need to re-familiarize themselves with the facility's protocols. If the physician is completely informed of the symptoms my experience is that they will prescribe TX at the facility first and then reevaluate in 24-48 hours time unless otherwise notified. This allows time for labs and other diagnostics to be done on an outpatient basis for review as well.

Good luck on your exam, I am sure you will do fine. It's good to just get it done. :) I studied with friends, used my notes, and studied the books made by Pearson and Saunders-Silvestri - very helpful. Good with critical thinking and those "all answers are right" questions.