jcprn

Thank you so much for this post! I am 4 months into my first FNP job and feel like a guppy in the ocean! I only work 15 hours a week, which makes learning a lot longer as well. Your post makes me feel less incompetent and more in tune with doing the best with the experience I have. Knowing that everyone goes through this learning curve and that it does get better is very reassuring! :)

Hi, I just found this response! I did finally receive my license in the middle of May, then applied for my prescribing licenses and received everything in June. I started my job at the end of June and am loving it! It was a long wait though!

I'm hoping someone can set my mind at ease. I graduated my FNP program in February, passed the AANP certification exam on April 2nd, received my certification card from AANP; submitted my application for APRN license on April 9th - PCS received it on the 14th (sent everything certified), PCS emailed me on the 20th that they received my application and that I would receive another email by the end of the week. I have made phone calls and sent emails with no response, other than "you'll get an email by the end of the day" - that was the response for 2 days. I wouldn't be so impatient, but the PCS website says that you will receive approval within 3 days of their receiving your application - it has been a week and I feel like I am getting the run around. I have a job lined up and am just waiting for my license to be able to start. Has anyone else in Massachusetts had issues with PCS? Am I expecting too much, too soon? Thanks for any insight!

This is in response to CapeCodMermaid: I work in a Massachusetts LTC/Rehab center and, unfortunately, I was told by the DON that "there is no difference between an RN and an LPN". I am a new ADN RN and this was very disheartening to hear. I went to school for five years (prereqs and waiting list...) and am "no different"? I could have been practicing three years ago if I got my LPN instead and owed a lot less money! I do not regret my RN decision, but I was put back by the comment - by the way, this DON is a BSN! I do know of a couple local nursing homes that are trying to get all RNs, but they are having difficulty - just wanted to share my experience.. :) Personally, I feel experience speaks louder than degrees and I take advice and learning experiences from the LPNs I work with very seriously and graciously :)

sorry

I am also a newer nurse in a LTC/rehab unit. I have 24 residents with six insulins, five of them on sliding scales, nebulizer treatments, other treatments, vitals, plus the prns needed as I go. I work 7p - 7a and don't begin med pass until 7:30p, and NEVER get done before midnight - it is SO frustrating! The CNAs do not do vitals or blood sugars at my facility and there are about three residents who take their time and pick out each pill, complaining about each one as they take them! I don't understand how to make it any better - the other nurses are done before 11:00! My speed has improved as I was getting done around 12:30am when I first started, but I really can't get any better than midnight without skimping on care or treatments. I trained with one of the nurses who gets done by 11:00 and I have seen her skip the resident who picks at the pills, or leave the pills at the bedside, she also never told me anything about treatments, so I'm "guessing" that is why she gets it done so early. I feel awful that these residents are getting their meds four hours after they are scheduled, but I don't know how to improve....

I understand your situation. I just started working in a LTC on the rehab unit 7p - 7a with 24 residents. It takes me four hours on a "good" day to do my 8pm med pass. We have many residents who are diabetic and need their regular scheduled insulin plus sliding scale coverage, there are also treatments and skin checks that must be completed, as well as vital signs for about ten of the residents. It is very frustrating and I dread anything going awry because there's no time - I hate thinking like that, but I can't help it. I also find that my critical thinking is poor due to feeling pressure to complete the med pass and all the treatments. I am also a new nurse and can't understand how it is safer to have new nurses responsible for 20+ patients in rehab or LTC than being responsible for 6 patients with much more support staff in hospitals. I have even tried applying for home health nursing, but was told that I need med/surg experience - the facility I applied to trains skills and honestly, I know that my critical thinking would be much more clear with only one patient in front of me than it is in front on one resident, watching the clock and worrying about the other 23. I know you were looking for advice, but I just wanted to let you know that you are not alone. UOTE=blinky;6827341]first few weeks went alright shadowing then with preceptor, then doing everything myself with preceptor. went to a different hall this week 16 pts sub acute part of nursing home, needy [pain meds] demanding, two admits. started shift 7pm shift ended 845am no breaks [suppose to get 2 15 min and a 30 min dunner break] made med mistakes [preceptor caught] didnt finish all treatments for 4 or so pts, no charting. Another new RN did the admit work in the computer. previous week i had 18 pts in long term care part and it was so easier. Problem is i am told i will not have a steady "set" of pts for some time. My experience on the sub acute floor was a " normal/ good" night [she's been working that part for 6 months now] after 7am trying to " think critically" just doesnt happen, and ya I take adderall Rx. Mind was just fried, then they wanted me to work my third day same set tonight to continue training had to say no. Took 3 hours for me to pass 9/10pm meds on this set, other sets[17-24 pts] was about 2 hours, on my own. One pt[new admit] fell twice and eventually sent to hospital, barely got paper work together for dialysis pts as well [ 2] Basically if that is a good/normal night and I would be working this set, or the other in the sub acute I don't feel safe doing it for pts or long term for my stress/mental stability. And I can't imagine a "bad night" where I'd be on my own. At nights in the sub acute section basically 2-3 RNs [depending if any others are training] On hiring I asked about pt to RN ratio and was told 12-15, was expecting 8. Up for 15 hrs, slept for maybe 4 feel exhausted, but can't sleep. I have no "seniority" so the set I would like to work i don't think they would give me... What would you do/advice? I'm moving out soon and can't afford to not have this job, hospitals won't hire me as "no experience" of course...