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Glycerine82 ASN, LPN

SNF/Rehab/Geri
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Glycerine82 has 3 years experience as a ASN, LPN and specializes in SNF/Rehab/Geri.

Glycerine82's Latest Activity

  1. I suck at time management. I spend too much time talking to my patients and doing "extra" stuff for them. In order to allow this, I sometimes document off the clock. If I stay clocked in I get in trouble. If I rush through my documentation, it is sub-par at best. Today I had a discharge, an admit, and a patient actively dying who was getting morphine every hour. That's on top of my other 15 residents. I consider myself lucky because this facility is the best I've ever worked at and the staff are amazing. Management is amazing too. Its just a broken, broken system. I stay because I love what I do. I love it. I love having some rehab patients, some long-term and some hospice. I love getting to know these people and making a difference in their lives. I love being able to bring things up to the MD and have them addressed when other nurses just blow it off. I feel like I'm helping them and making their lives better. But, I digress. Its a horrifically broken system and society likely has no idea what goes on. The kicker is we are almost always in the red. medicaid payments are at an all time low, and most of our medicare patients only stay for short durations. We mostly get cardiac and respiratory pts. that don't qualify for acute rehab. So, while people think the facility is being cheap and someones pockets are getting lined, they're actually losing money.
  2. Glycerine82

    Advice for a new grad

    Reserve judgement until you've been there a few months. Don't do anything you're not comfortable with, LTC nurses can have bad habits. Hopefully they won't demonstrate them to you right away, but Its been known to happen. Get to know your CNAs and help them out whenever you can. Don't delegate out of convenience - there is no such thing as CNA work. It's all nursing work, they just help you with the aspects that don't require a nursing licence. That doesn't mean you will always have time to help them - because you won't. Just remember a lot more goes on after they go in the room and get the patient ready etc. We just see the end result, we don't go through the process with them and it's a tough job. Have vitals, date of birth, allergies handy (at minimum) when calling the doctor or any other provider to order something. (Labs, xrays, meds etc.) Remember these patients are stable and the level of care they get isn't the same as in a hospital. There will be patients you only see one time, briefly. Thats ok and normal as long as they continue at baseline. Give it a good couple of months before you decide one way or another. At first you'll probably feel like you know absolutely nothing but thats OK and very normal.
  3. So, the way I look at the orders in my MAR/TAR is that I am signing off that the task was performed. Whether or not I did it myself doesn't matter as long as it's done. Sometimes I will give apap or other non-critical meds early/late if they are ordered at odd times. This can occasionally cause me to have to sign off a medication after i've given it. For me, I don't stress out about it as long as the person is getting their medications. Usually I just change the order, though. Then there are nurses who skip the OTC drugs. This is a bad habit and not something you should do. If there are a lot of needless vitamins etc. ordered its easier to just talk to the MD and get them discontinued when indicated. Also, many times there are good reasons OTC drugs are prescribed. Probiotics, folic acid, Vitamin D, are all examples of meds that the patients really need to be getting. Eventually you will get a feel for which corners you can cut and which you can't. Until then you just do everything by the book and never do anything you're not comfortable with. In order to get to the place where you're comfortable you have to go through the first year or two.
  4. Glycerine82

    Patients & Pet Peeves

    I have one to add to the list Patients who stalk you around the unit for their meds. I see you. I'm actively helping someone else, please stop staring at me!
  5. Glycerine82

    My facility is restraining a resident and I feel that I can't help.

    This. I work in a SNF and we don't check BP prior to beta blocker administration. The rationale is that folks at home don't check their BP every day and by checking we end up with nurses holding the med for a systolic over 100 and a pulse over 60. Occasionally we'll get someone with parameters & we of course check it when the dosage has recently been adjusted.
  6. Glycerine82

    What tricks do you have for nausea?

    wave an alcohol prep pad under nose, mints, ginger(ale). Idk how the alcohol thing works, but it does.
  7. Glycerine82

    Why would a teacher say that?

    Same. In NS we all went to clinical sick because of the same policy. Miss a day and fail the class. Sucked, because of course we probably got patients sick.
  8. Glycerine82

    RN's skipping vital signs

    Put parameters on the cardiac meds. If they're still documenting on paper that's likely why its easily missed.
  9. Glycerine82

    HELP! - board order due to hospital visit?

    They aren't going to report you for this because you didn't do anything wrong. You're allowed to have too much to drink on your own time and seek treatment for it.
  10. Glycerine82

    Non-negative drug screen

    non-negative means the urine tested positive for prescription medication of some kind. When a valid rx is provided it then gets reported as negative.
  11. Glycerine82

    Possible error in judgement?

    You should have listened to her apical for a minute, which would have given you more information. Then you'd call the doc, because either a) shes in active afib or some other type of cardiac crisis or b) you need to find out whether or not to repeat the EKG and when.
  12. Glycerine82

    5th e-Cigarette Death Reported As Illnesses Double

    Ugh. I'm in MA and presently the brilliant governor has banned all vaping related products for 4 months. The research is pretty clear, and has been - that these illnesses are tied to the oil based mediums in THC vaping products - mostly iliict ones. Vodka comes in many flavors, but it's not for kids. Cigarettes kill how many? They weren't banned. Its better not to start either habit, of course. Certainly if you don't smoke you shouldn't start vaping but for many of us it was a means to an end. Five years smoke free and if I'm not creative I'll have to go back to smoking if I'm not able to stop vaping. (I won't really do that because I"ll drive to maine if I have to but many will)
  13. I think (hope?) you'd be hard pressed to find a nurse who wouldn't have done exactly as this nurse did. My licence isn't worth a fraction of the life of a child.
  14. Glycerine82

    Webcams in Nursing Homes?

    If this were common practice they'd eventually have to provide us with appropriate staffing, which will be fought tooth and nail.
  15. Glycerine82

    Nurse bringing child to work

    personally I wouldn't have an issue with it if it wasn't a typical thing and she got stuck one night, etc. provided the patient room was empty and he was well behaved but i'm gathering this isn't the case since you're posting. If the house supervisor is aware of it I'm not sure what you can really do besides wait for the chips to fall, what specific concerns do you have?
  16. Glycerine82

    WHY?

    pretty much sums it up. My worst day can be turned around when I get a huge smile from a resident I give a big hug to.
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