MountainRN53

Great suggestions! My Nurse Supervisor and the Executive Director basically suggested I step down from my Supervisor position and take a pay cut. Due to excessive corporate meetings and my position spreading to different areas, I accepted the demotion but KARMA stepped in and HR made it clear there will be no pay cut. In fact, just recently I received a merit raise. I am 64 and run circles around lazy, overweight staff members. There is times I use the word "old" to describe myself but no more!

Psych nursing is extremely challenging and I commend anyone who can do it. I work with several high functioning dementia patients and even they get on my nerves from time to time. I agree with windsurfer8, those who are saying these things are jealous or ignorant. Sticks and stones...

I have been in your shoes many times. As an RN, I too have been overwhelmed with those taking a multitude of meds including narcotics and patches. I can't imagine how you feel as a CMA. I oriented and "checked off" a new CMA and quite frankly I'm amazed one can watch a DVD, read a book and take a test, and with passing give meds, take CBG's and give insulin. I guess I'm just old school. Nonetheless, you will never regret getting your RN. Currently at 61, I am working full time at an Adult Day Care Center as their nurse supervisor and I've never been happier. Best of luck to you!

I passed my test for the second time 20 years ago. But now I'm back in the NCLEX because I failed a pre-employment Medication test. There is so much to know and so many side effects and the drug calc were insane. I wish I could help you or even give you some new way of studying. I have yet to find it. I'm going to try cramming the classifications. Good Luck to you.

I'm a LTC nurse also. I have worked in over 10 different facilities in 4 different states. Some I brag about and others I do not. I resigned from the last place after 2 months of being assigned to an acute unit of 28 patients with the help of ONE CNA! I asked for help and often saw staff in the nurse station on their cell phones telling me they were busy. At times I had 3 IV's running and new admits upset they were not evaluated by therapy. I didn't worry about my license as much as not being able to provide good nursing care. My state does not recognize nurse/patient ratio. Management is the key.

I wish my facility WOULD freak. I consider myself experienced since I've been in LTC for over 20 years, but P&P changes so often you never know what people are looking for. I have only been on staff at my present facility for 6 months. I too, work second shift and most times leave around 1 or 2am, due to charting, too few or lazy CNA's, or patients requiring more time. Many of us worry about the medpass in general. I think what bothers me most is the sequence of treatments. How would one handle someone who requires a CBG, insulin coverage...eye drops...inhaler...po meds...and or a possible prn pain pill. I was recently told now you have to don gloves when opening Depakote Sprinkle caps. Our in house inservices consist of many little topics I guess they expect you to remember and when you don't they can say you signed saying you did.

Thank You for sharing all your experiences. I am in the same boat. I have done LTC years ago but I don't recall it ever being as bad as it is today. The multitude of meds, sliding scales, younger behavior patients, those who pick and ask about pills, those who come to your cart and want their pills NOW. The job is not difficult just EXTREMLY time consuming. I know it will get better but this facility recently had a few walk out and I think others aren't real excited to orient or be left with orders.

I feel your pain. I have been an RN for 19 years working LTC and home health in 4 different states! Everything you write is everywhere in LTC. I just started last week at a LTC after relocating to the area. Even with experience I too, made several mistakes and sometimes you DO have to consolidate...everyone does it so don't feel guilty. My preceptor took many short cuts but then said don't do this when STATE is here. I even had trouble with an insulin pen but I can change colostomy bags all day. I keep telling myself that the job is not hard its just time consuming. I layed in bed last night thinking of the patients I can recall, how they take their meds etc. Some other nurses can be very difficult and might be that way because of their life. I was feeling intimated by someone like that once and was told by another nurse she hated her life and her job so thats what I have in my mind when other nurses are tough or mean to me...You can use this mind-set if you like:twocents:

I agree with you 100% JCPRN! I am swamped with my job at a LTC. Have to fly through a med pass and I have those ones that roll up to my cart (from the other hallway) wanting their meds NOW! If a wrench gets thrown in like an admission, a burst colostomy bag or someone wanting a new O2 tank I become majorly behind. I try and do have an upbeat personality but inside I'm about to burst! I love the job and I'm making the highest here I have ever gotten paid as an RN. To those looking for work in home health...I did that for 13 years. Even though you get milage reimbursement, is not enough for tires or watching your beloved car go to places you could never imagine! Had one patient where I had to stop and open a cattle gait, drive thru, and close it...in ALL kinds of weather!

I have been an RN for 19 years in home health and in LTC. I was just hired last week at a LTC facility after relocating to the area. I am what the administration calles the "seasoned nurse" who was just hired. I have had 2 days on the floor working 7-3 , then 3 more next week and I'm on 3-11 and off orientation on Friday. The first day I was on the floor the unit manager who was training me, ran off to celebrate her birthday with staff and family, leaving me with unknown "to me" patients. Then also leaving several times to handle things at the nurses station or take several smoke breaks. The second day she left me on my own for 4 hours and when she found I was drowning I was firmly told I wasted to much time and now I'm basically out of compliance with my med times. She then "rescued" me and huffed when pouring up meds to catch me up. I am looking forward to being a great 3-11 staff nurse here and will never "orient" someone like this. To answer your question tho, 5 days on the floor here. Hope you have a far better experience.

I agree with nurse mommy! You know in your heart, right away, that somethings not for you. In my first 10 years as an RN I worked at 10 different places and had an RN license in 4 different states until I found where I wanted to be. I actually recently relocated (again) and just started working at an LTC. The administration calls me the "seasoned nurse" that was just hired. Yesterday I was on my med cart for 8 hours without a break, lunch, water and had to sneak away to the toilet x 1...But I'm willing to give it my best because the staff is really supportive. Good Luck!

At the same time, if any of my AAOx3 patients were up and waiting for me at my med cart, I would go ahead and give them their 7am meds. This is a huge issue where I work. Like certain ones know when you are about to "man" your cart. I would go ahead and give them their meds first. Then I would hear the same person yell "Percocet and Ativan" on the other end of my hallway. I would feel bad for those who were unable to yell, use their call light or even complain because most times they were last.

One week (5 days) but I worked with one nurse who really helped me learn the computer documentation. The program wasnt difficult but there were so many things to remember. And God forbid an incident...on 3-11 this threw a wrench in my whole evening. I worked with another nurse who told me to give all the meds and she would stay at the nurses station and do orders and answer phones...I needed to learn those things also. And when I would try and document I didn't know the patients well and I would always stand corrected.

Hello! My resume screams LTC and Home Health. I recently resigned from my 11 yr stint in home health and at the age of 59, I was hired at a long term care facility...once again. Nothing has changed except for far less pressure sores and restraints...thanks to those dreaded state surveys and of course better management. Tube feeds either by pump or bolus. When I oriented and would ask my preceptor to show me how "state" expects you to do it, the response was we didn't have time for that. The new thing is to clean your blood sugar machine first with a bleach wipe then with an alcohol wipe. After my narc count and report I first run and get all my BS and give insulins before they all take off to go smoke...yes really! And oh the "behaviors"! Most are really sweet in their own way and I wish I had more time to spend with each one.

All I heard with my last job is money money, time is money, we cant afford this and that, you need to speed up and blah blah blah. I heard this alot from my last 2 jobs and I'm sure it's pretty much everywhere. It does get depressing at times, esp when other staff members say "We never have any dressings to work with in the treatment cart". Nursing will always be there for you should you decide to try it again. Good Luck!

You are lucky to be working on a busy Med-surg floor because you have the opportunity to learn so much so fast! I'm sure you will eventually say I don't need to do this or that anymore because I have crossed that bridge. Great "experienced" advice from Laurel.

I am so happy to have found this thread. I was called today for an interview to do home health with pediatrics. They gave me a "nursing test" of 55 questions and I missed 3...but they did not tell me which ones. Stated the clinical manager would go over that with me. I am over 55 and have done the hospital, nursing home and some adult home care stint. Have relocated to the mountains of NC and back in the application process. I am looking forward to taking the refresher courses and enjoy learning. Traveling long distances from home, difficult parents and spoiled manipulative kids are a few of my biggest fears. I am trying to keep an open mind.

I achieved my degree when I was 40 and recall those days clearly. Preceptors lightning fast and most times half your age. Just go with the flow and relax. I'm not one to drink or take script meds but I found a wonder pill called Remifemin! You can get a box of 60 at Walmart. When I know I'm going to have a stressful day I take one and feel really great! Maybe something you didn't expect to hear but us chics over 50 sometimes need a little extra help!

This is great info. Am sincerely considering getting back into HH after a bad experience at an LTC. I worked for over 11 years at a non-skilled staff agency and then became their field assessment nurse. I worked for Gentiva a few years back for a shot time. I'm hoping I can find a good company that supports their employees.

I totally agree with the ratios and of course the mentally extensive residents. Two weeks ago I started at an LTC as an RN Staff Nurse. I was really impressed with the initial orientation process, having worked in other LTC facilites in the past and have been "thrown to the wolves". Everyone was so nice and supportive. I was then placed as everyone told me the hardest wing on the hardest shift. I personally enjoy working 3-11, but found I was basically pulling 10 hour shifts without a break. I had a few patients that would know about shift change and wait for the narc count to be over so they could get their meds before going on their "smoke break". I got used to granting those wishes just to be done with them until 8pm. I was on my med cart for 8 hours straight. If something happened like an admission, a fall or a family complaint, it would throw a wrench in my whole evening. I kept telling myself and others "It doesn't take a rocket scientist...is just very time consuming." The idea of helping someone or having a conversation with a resident was not in the cards. Most of the nurses there were LPN's, who knew all about facility operations and handling any problems. One evening, I was swamped again with a resident who cut her foot and required me to try and find supplies to dress it. Nonetheless, the stream of paperwork involving an incident report. I was approached by a housekeeper who fell on her wet floor and she was told to find the RN Supervisor to have her fill out the paperwork. I was never told I would have this responsibility. I resigned the next day. Everyone was still very nice and tried to convince me to stay. I knew "talking" would not change things after I heard the past history. They did not want to have a med aide and a shift supervisor. They wanted that person to be all in one package.