Gchr

Whilst i agree with your plight, I dont feel you expressed why LTC gets a bad rap. It kinda just seems you are directing this to family members. I appreciate you venting though The purpose of my post was to express that family members don't have an understanding of the LTC facilities or are in denial. I worked today at the LTC facility and did not have any encounters with any family members whatsoever. Found out from a few patients that what I thought their ailments were, were confirmed by the doctor and treated appropriately. Therefore, it was a good day. Maybe as nurses we need to do a better job of educating family members and the general public??

GermanicanRN, I don't believe that working in a LTC facility is bad by any means. I happen to like the work and the patients. What I have a challenge with is the family members that have unrealistic expectations or are in denial about the patients care or condition.

I understand the guilt, and I don't say this to be mean, but most of the patients that I take care of cannot be at home unless they can afford care around the clock. We have a lot of patients that think they can go home. The reality is that they cannot feed themselves, bath themselves, or control their bowels. Additionally, since most of them have dementia, there is the additional concern that they might burn down the house or other safety risks. It is sad, but it is reality. I have seen enough that getting alzheimer is not a way to live your final years of your life.

Let's be frank, some LTC facilities are ran well, some are average and some are poor. I had the opportunity to work at two facilities during the past year that I would consider average or above. I never felt once that we did not have the best interest of our patients at all times. What I am challenged with, is that most family members of these patients have very little clue to the care that we provide or they are in denial of the patients condition. First, we do have a lot of patients with dementia that we treat. As anyone knows that works with these patients, it is a progressive disease and these patients' reality is much different than the norm. I am surprised that family members expect that these patients will improve when in our facility. Again, as I point out that dementia is a progressive disease, family members find it easier to blame the facility of mismanaged care or improper medication. Obviously the prescription of medication is left to the doctor and not the facility. Second, as other nurses know, getting patients to take their medication can be quite the challenge. Believe me, we try numerous ways to get these patients to take their meds. Sure they will take them when family is around in most cases, but other times we exhaust every possibility before we have to document the patient refused. Fall incidents....Oh my that is a big challenge! Like a lot of LTC facilities, we have 30 patients in a unit that one nurse oversees. Additionally, we have 3 CNAs. That means at any one time up to 26 or more patients are not being supervised one on one at a time. I cannot tell you how many patients that have not walked in years wake up in the middle of the night and try to walk to the bathroom. I am not sure what goes through their mind that they think they can simply "walk" after not doing it for such a long time. The end result is usually a fall. Again, the family members feels that we are to blame because we were not watching them. The reality is, is that a lot of families come see their grandmother and grandfather for about 30 - 45 minutes once a week. (This is average. Some family members come longer, others don't come at all.) For that 30-45 minutes family members see the "best" behavior of patients. They rarely see the patients refusing meds, spitting medication back out, pooping all over themselves after the CNA just give a complete bed bath 5 minutes earlier or patients attempt to get out of their beds to go to the bathroom or better yet, get dressed to go home because their car is parked in back of the facility. Family members need to get a true reality of what takes place in a long term facility. Yes we try to treat our patients with dignity. Unfortunately, we care givers are not given the same dignity in return.

Please, if there's anyone out there who just did that: just made the appointment, took the test, and waited calmly for the results without "freaking out!!!!!!!!" ... speak up. Some of us (maybe a lot of us) really need to hear from you. :flwrhrts: Why freak out? I just took the test and patiently waited for the results. I passed the first time but had 165 questions. I simply reasoned that if I did not pass, I would take it again. I was confident that I would eventually pass. Let's be honest, not passing the NCLEX is not the end of the world. The day that I took it the kids did not get sick, no patient died as a result of my care, and the house did not burn down. Believe me, I would have had worse days then not passing the NCLEX if that was to happen. Just have to keep life in perspective.

Again, not here to argue with anyone. Just here to post my experience. I initially used the Saunders book. Based on my experience, I found it a bit too easy. I was scoring in the mid to high 70's. Then I tried Kaplan and scored in the high 50's! I found Kaplan more challenging. Also, I believe the Kaplan questions mimicked the NCLEX questions more than any other guide. I passed the NCLEX in the first seating. No I do not work for Kaplan or receive any moneys from them. I could only wish that I did. LOL.

I agree that it does not matter what study guide you use. The objective is to pass the test! That being said, after investigating most study guides, I still found that Kaplan questions were the ones that most mimicked the ones on the NCLEX test. Just my experience....

By far out of all the review programs, (Hurst, ATI, etc.) I found that Kaplan had the hardest questions and easily my scores were lower there. I was scoring in the 70's with ATI and my college instructor advised me that my scores would probably drop into the 50's when I started Kaplan. She was so right. Anyway, what I was told was to shoot for my scores to be in the 60's. Told that if I was scoring in the 60's I would probably be OK for the NCLEX test. Our Kaplan instructor told us the scores in the 60's was very good. Scores in the high 50's were good. Scores in the mid 50's still gave you a decent chance to pass and scores in the low 50's was a coin flip. My overall average was 58 but I was getting more scores in the low 60's by the time I took the test. I passed in my first attempt. I believe that if you are constantly scoring in the 60's and use the same strategies during the test you will be golden.

Kaplan says you have a 50-50 chance of passing it the second or third time. But I agree it is a passable test. Honestly, I take it for the first time next month. Been practicing and hammering questions. Not going to be cocky; but I'll be confident. If for some reason, I don't pass the first time the world will not come to an end. I am still alive, house didn't burn down, kids and wife are OK. Believe me, I have had worse days than not passing the NCLEX. The key is to know the basics and think patient safety! You have heard it before. The test is to make sure you don't kill the patient and prioritize care effectively. (Include delegating.) Best of luck to all you. Just wanted to share my perspective. Don't bring extra anxiety about whether you pass or fail. I believe if you can just relax, give it your best concentration and effort, most of you will pass. Gregg

I am a 52 y.o. who returned to nursing school last year. I did begin my pre-requisites in 2010 and I had previously attended school in the mid 90"s for another degree. I have a strong belief that if you really want something, you will find a way. I complete my program in August and have not found it too terribly difficult. But it is not easy, so I don't want to give you any false hopes. I don't know your situation, so it is not really fair to tell you what to do. Given the fact that hospitals are now looking for BSNs, I would suggest that you pursue the highest degree of nursing that you can. I am getting a RN that took me 16 months. Sometimes I wish I would have pursued a BSN, but I am in somewhat of a different position as I have tons of health care experience and other educational degrees that are very complimentary to the profession. So I would suggest looking into a RN if there is anyway possible. Regardless if you have the drive and passion, I believe you will still be successful. Best of luck in your endeavors.

I have to agree with the comment made earlier by Jeweles26, your attitude needs to be adjusted SweettartRN. Sorry, but no need to sugar coat it. If you are really as good as you say you are, why not consider the job as long as you have an understanding that if you grow the business you get additional compensation in relationship to its growth. A win for you and the employer. I have owned a number of businesses and tried to pay people for what they were worth. If they wanted a raise, I told them to make themselves more valuable to the company. Some did, and I gladly paid them more. Others did not and simply wanted a raise for the sake of having one. While both the hospital and home health company are a business and profit driven, I believe home health is a more revenue driven than the hospital as they cannot rely on funds such as the latter (e.g. tax dollars, donations, grants). Simply if you want more money, go out and generate more revenue for the company. I cannot imagine that if you were to accept the job at the current salary level AND have an agreement to get more compensation for additional revenue growth that the company would not be willing to accept this offer. Otherwise, there is no incentive for you or the company to grow. If that is the case, run as fast as you can away from them as obviously they will not be in business too long.

Not here to scare you a bit, but my nursing school has advised us that waiting more than 90 days after graduation, statistically, the pass rate dramatically decreases. Not that it can't be passed after 90 days, just that your chances greatly decrease. Those are just the facts. Good luck. You will find a way if you really want it!

I just recently went back to school and I am 51. It is a challenge, but if you want something bad enough, you find a way. The one big advantage at this age is that between my wife and I, we have either been or are on most of the medications that we study! I am doing well in pharmacology as a result. LOL