Pinkmegan

Love it!! Interesting to read that you can have shared rooms in LTC. These a very much frowned upon in the UK.

CNA to patient "Do you want to see the Chiropodist?" Pt was an above knee amputee, both legs!!

Hi. I am struggling with the problems that you reported right now. If it's not to much to ask, can you tell me how to go about getting help?

Oh at last!! Someone with common sense and who thinks like me!! Crush the tabs separately?? Give each med by gastrostomy tube separately and flush with water between each! Where are they all going to end up?? If anyone can give the rational for this I would really like to hear it!! As for the BS, what do people in their own homes do?? It's like when patients at home are on diamorph suspension. 'Take 10mls!? No way! Swig it from the bottle!!

Defo neurological system! I never bothered much with anatomy, after all, we are not diagnosing! Apparently, don't quote me & I've no refs. to hand, the neuro. system is still not totally understood!

What is 'per diem'!!?????

PRN staff can't be an option surely if they don't know the area??!!

4 of us share the on-call. The 2 senior nurses & 2 of the staff nurses. We are rostered for on call on the days that we work so this does not impinge on our days off. On-call, basically, is for someone to call for advice. On the odd occasion that someone does not turn up for a night shift, or that they have phoned & the message has not been passed on, we are expected to do the shift, whatever we have worked during the day! A while ago, I was getting ready for bed, had put one leg in, when the 'phone rang! The night shift nurse had rung in sick but the message had not been passed on! I had no choice but to get out of bed & do the shift! This back-fired on the rest of the staff as the next day was my 60th birthday & they had arranged surprises for me! After a few hours sleep I went back to accept the gifts, eat the cake &, generally, accept all the good wishes!!

What is the hourly rate for RNs in the USA??

Nothing, again!!!

What a load of rubbish!!!! I am almost a professional mourner after working as a nurse since 1989. We don't attend random funerals but, if I have built up a relationship with a patient, and their family, I would feel extremely guilty if I did not attend. At most of the funerals that I, and my colleagues on our unit, attend, positive mentions are made about us! Sometimes we are asked if we will speak at the funerals. I don't know where you work but, wherever it is, I feel that you should consider your future there as it sounds to be a cold and uncaring environment.

OMG!!! My usual day!! So glad to hear from other nurses of my own age!!! We still manage to do a really good job between changing continence pads (our own!!) don't we????

My point exactly!!!!

Over the last 20 years plus I have attended every funeral of a patient that I have been able to. So have my colleagues. Go with your own instincts.

I'm now entering my 26th year in nursing & it has not hardened me at all, in fact I get even more emotionally involved with patients than ever! My eyes were opened when I did my training as I 'presumed' that all nurses would be lovely kind people! I found out on my very first clinical placement that this was far from the case! Not only were some off-hand & unkind to students but some were unkind, sometimes verging on cruel, towards patients! As most of the ward staff worked together on a regular basis some would even plan ways to deal with patients that they did not like! I hate myself, to this day, for not reporting the nurse who I saw slapping an elderly lady in the face. It was shameful but we all knew that we would be branded as 'trouble makers' & then given an even rougher ride! Although I enjoyed most of my clinical placements I quickly knew that hospital nursing was not for me due to the poor standards, which existed in the NHS back then & which have not improved since! On qualifying I managed to get a post with a charity run high-dependency neuro unit &, other than a few years when I tried a new venture, which did not work out, I've been there ever since. As all our patients are with us long term we build up relationships with them & with their families. Most of the families are lovely but we do still get some for whom we cannot do anything right! (Perhaps due to guilt at not being able to care for their relative??) Many of our patients are young (we take from 18yrs) and many of the history's are very sad. We have had young patients left brain-damaged due to elective surgery, some with genetic conditions which no one in the family was aware of, patients left paralysed due to RTAs and recently a young girl who tried to save her children from a house fire. The children all died and she has severe hypoxic brain damage. We have a wonderful team of RNs and support workers who care for the patients as if they were their own family. It is impossible for most of not to get emotionally attached, myself included, and I have shed many thousands of tears over the years and still do so on a regular basis. I always said that if the day ever came when I felt, for whatever reason, that I did not want to go to work, that would be the day that I would have to leave. This happened in 2005 when a new manager changed our rota patterns making home life difficult and also resulting in loss of income. I chose to leave &, with my husband, managed caravan parks for 8-9 months a year. After the first year, when not on site I went back to my previous employer on a relief basis. After 4 years of this I was missing nursing so much & felt that I was 'wasting' my hard-earned qualifications! Luckily a position became available & I was welcomed back. When I left I had been a charge nurse but now am happy to be just an RN! You MUST enjoy what you do as a nurse. If you don't you can't do your best and the 'hardness' might creep in. When you qualify you need to find the job which is right for you! There are still kind and caring nurses out there! If you are ever in the UK let me know & you can come & meet our team. Best of luck for your training. xxx

It's always been this way unfortunately! When I trained, '86-89' students worked on the wards as members of staff before the degree route took over &, as so many people feel, the standard of nursing declined. The RNs treated us like slaves, at best & ignored us at worst! Many spent all day in the office & we never saw them! If we asked questions we were treated as being an irritation! We started with, I think, 4 weeks in school then onto the wards for 8 week 'placements', covering all specialities, with a week in school between. We worked full-time, days, nights, weekends. We also had all our course work and assignments to complete as well as studying for our end of course exams which were tough! We were the staff on the ward!! There would be 1, or 2 if you were very lucky, RNs & the rest of the staff were students! Some 1st year, some 2nd year & some 3rd. We had to do everything! I was changing catheters, doing complex dressings, passing NG tubes, giving enemas, suppositories etc., removing drains, sutures, clips, and whatever else I was asked to do, within a few weeks! As I was 34 when I started my course RNs tended to think that I could do everything! I did what I could but only, obviously, if I knew how to do it & was confident that I could do it safely. Perhaps, being older, I had more confidence than some of the younger students & would always ask, if a new task, procedure etc. needed doing, if I could try it, no matter how much I did not want to! Not all students had even basic common sense &, thinking back, I'm surprised that all our patients survived, but they did, in spite of us! I worry now how students learn to do all the procedures. Some come out of training having done very little & have to start learning when qualified. If you are the only RN on the unit this could, obviously, cause problems. The only way that you can learn is by doing things. If the RNs cannot or will not support you they should not be working in a training facility! If this happens you must speak to your tutor immediately, ask for support or ask to be moved. It won't make you popular but it will preserve your sanity & ensure that you get the help you need. Be pleasant, offer to help, show that you are eager & willing to learn. If this does not work your placement will be a torment & a waste of time. As you, rightly, say some RNs seem to forget what it's like to be a student. I wish you well for the future. You will get there in the end! Let me know what happens!! xxxx

Scrub shopping?? Do you have to buy your own??

I agree. My problem is not around giving info. its around getting it! I work in a private Neuro facility. Sometimes our patients have to go to Hospital. We don't like it but we have to deal with it. The problem then is we can't get any information from the Hospital. I called recently about a patient who had been in Hospital for 4 weeks. I was, initially, told 'yes he's fine'! When I then asked why then has he been in Hospital for all this time, I was met with 'we can't tell you, you could be anyone'. I had already told them who I was, where I worked & that I am the primary carer for this patient. I then suggested that they look in his file, where they would find the number of our facility, and ring back as they could then check who I was. Guess what? They never called!

But we have 18 patients remember! xx

Sorry, don't know what all your abbreviations mean! Are you commenting on the original posters staffing levels or mine?

Read my post later in the thread regarding staffing!

I,m not posting a quote from your excellent post due to it's length and as, in my opinion, all the points raised are very relevant. I work for an independent facility in the charity sector. (Don't know if you have these in US due to the way your health system works with insurance etc..) We care for clients with Neuro. conditions who need high dependency care. We are split into 2 teams, each with one RN and 5 CNAs on early shift, 3 CNAs on late shift & 2 at night. Each team has 18 clients! I work 14 hr shifts, often with only one short break for lunch! The majority of our CNAs are worth their weight in gold! Any problem with a client, however small, will be reported to me straight away. Very few of our clients can eat independently. As of today there are 8! The rest need help with eating or are on pumps, or both. I try to help with feeding if I can but, with such long drug rounds, this is not often possible. I trust all my CNAs totally to feed all the clients. But to get to your actual point, relatives! They come in 2 distinct groups! Those who are so grateful & who can't thank you enough and those who constantly complain about everything! As I know, and I'm sure that you do to, all the clients get the same level of care so why does this happen? My main theory revolves around guilt. The relatives know that they could or should do more to help their 'loved ones'. At meal times some rels. will happily feed the client whereas others will sit and watch the staff do it! Well, it is our job after all! Others who constantly complain don't appear to want issues addressed. When one complaint is resolved they find another! One example this week, one client with rels. who are 'serial' complainers, was so obviously well cared for, happy and in good health resulted in them having to complain about something else. On this occasion they highlighted minor cleaning issues; bed table a bit sticky, some splashes of enteral feed on bed rail & wall (we know it goes every where if you'r not careful!) all of which would be resolved when cleaners arrived! We all have 'down' days relating to this but we need only to remember that we are doing an exemplary job! Relatives won't change and, if we know that we are doing our best, we don't need to either! We get far less complaints than we do compliments, but we tend only to remember the negatives! Take care, try not to let it get you down as you have many years of nursing in front of you. Concentrate on the comments from grateful rels. I keep some written down to look at when I get home from a bad shift! Megan xxx

Can you then wear what you like colour wise?! If so do you have to buy your own?

You are allowed out in your scrubs????!!!!

It varies but scrubs are only worn in theatre and recovery. When I started nursing women had to wear dresses! Urrgh!! We now wear tunics & trousers, the colour of the top denoting your status. Although this varies from unit to unit.