tracytoon

We have "medtechs" in Florida. I worked with some of them in an ALF and I was astounded to learn that they had a course that lasted just hours to be certified to pass medications!!!!! In Florida they can work in an ALF setting, but not in nursing homes or hospitals. We had a couple of nurses come from another state who said "Where are the medtechs?" when they arrived. We explained that medtechs cannot work in nursing homes in Florida. I wondered why an 11-7 nurse would need a medtech in a small facility. I mean no disrespect to anyone, but there is a good reason nurses are required to have extensive training. I know many CNA's who are top notch and very knowledgeable, and many who think the only difference between a CNA and a nurse is that the nurse gives pills. I personally am not comfortable with this trend. It smacks of greed and it is the slippery slope of irresponsible practices. It is not the answer to the nursing shortage!

We get a dinner, cooked and served by our DON. He even sent all of us invitations, and is passing out gifts at the dinner. Nice of him, since there is no positive reinforcement in our facility, and basically everyone is treated the same, regardless of incompetence, attendance, etc.

Sigh. There is no difference.

I read a great article about healing touch in the March 2004 issue of Spirituality & Health, the article was called Hi Tech and Healing Touch, used in mainstream hospitals. I was impressed and pleased with the integration philosophy.

I followed the RT around for a day when I was in clinicals and she identified different lung sounds for me. It was a great learning experience.

I remember similar problems when I was in school. Nurses and other staff are task oriented, and having students around does change the equation, and we tried to be helpers rather than hindrances. I used to get exasperated when staff treated me badly for no apparent reason, and I was incredulous when the instructor took me to task for allowing them to get under my skin. Sometimes I wondered if the experienced staff even remembered that they were students once, too. It seems more and more that nursing students are treated poorly by those in the profession and that certainly isn't going to do much for recruitment, is it? I know that I considered that when I graduated and applied for employment. I hope that you can resolve this and that your rotations are positive learning experiences.

Have to agree with the mermaid--sometimes there are surprises, and we have beeping from pumps, call lights, motion detectors...the list goes on! I am actually compensated much better than the nurses who work hospital med/surg in my area. I also have a pretty good 401K and benefits. Many of the hospital nurses ask me how I can stand such a boring job. While I don't have to hustle as consistently as they do, it is rarely boring!

I don't think all LTC facilities are bad. The advice to do your homework is excellent. Most locals also know the reputations of the facilities. Long term care nursing means developing relationships with residents and families. Our facility is small and very family oriented, for some nurses this is more satisfying than seeing someone else in the beds every few days. It may not provide much satisfaction for someone who is looking for new, diverse clinical challenges. My satisfaction is knowing I've done the best I can to care for my residents in a less than ideal setting and system for their golden years. And while I grieve each time one of mine passes, I'm reminded of why I chose this vocation when I get thank yous from the families for the little things we do that make an impression. It truly isn't always a thankless environment.

I can remember when nurses still smoked at their station. (Bad habit) I recall a nursing instructor saying "As students, you haven't earned the right to cut corners. When you get into the real world and know what you're doing, then you may not be so quick to judge other nursing performances." I constantly remind myself that no one is perfect. The only time I really concern myself with the nursing habits of someone else is when they are actually creating a life threatening situation for a patient. Two bad habits I have noticed recently: eating nachos at the med cart and never ever stocking it for the next shift. :)

Sometimes the old 80/20 rule comes into effect--I spend 80 percent of my time with 20 percent of the patients.

The only way I can really bring any balance to my ethical self since I work for a nursing home company is to do good things on a volunteer basis. Unfortunately few nursing home corporations are altruistic in nature. It's where our salaries come from. I had to give a cynical little chuckle when the goals for our facility were posted by the administrator. They were all FINANCIAL goals. Not one of them addressed improving patient care. Sometimes you can't change the big picture, you can just make some small personal differences as a nurse.

It's a dietary and sterilization issue. They usually aren't concerned with prescription meds because of the lifesaving necessity...but kosher OTC meds can't contain dairy or animal products such as gelatin, for example. The manufacturer is inspected for ingredients and sterilization by the organization who certifies stuff as kosher. (Sorry, can't recall the name of this entity). I suppose it has grown out of a demand by those who practice a strict observance of kosher dietary laws.

I agree with clerical staff wearing office dress and other staff wearing a different type of uniform; I used to work in a large clinic where everyone wore scrubs; the receptionists, the patient accounts supe wore a labcoat, film librarians wore scrubs--patients could not differentiate between ancillary staff and medical personnel. I don't have a problem with whites, I usually wear them now with a printed jacket if I like. I even iron mine and am constantly teased about my "crispy uniforms". Sorry, much as I loved "Julia" and and her nurse cap. I would be bothered by a cap.

We have a couple of "inflexibles" who insist upon working in one place. I rotate all of the CNAs because I told them they should be able to care for all of the residents. Ours is a relatively small facility so the residents know most of the staff well. New staff is oriented to all sections; I work where I am needed. The ones who refuse to work other sections have been there for a long time and have been permitted to get comfortable. We have a new DON, however, and I think it's about to change. I feel that staying in one area does increase chances of burnout, complacency. Stepping out of the comfort zone is a good thing.

Most of the LPN jobs in my area are for hospice, long term care, offices. I've noticed many hospitals that have stopped hiring LPNs. I remember when I was looking to relocate I applied to some places and even the hospital at the Cleveland Clinic in Ohio called me. I chose the LPN route because I wanted to work quickly and I'm glad that I did. The experience has been wonderful and I think I'll be a better nurse because of it as I continue my education. I've received disdain from some RNs--one who couldn't believe that I was a supervisor--and yet the RNs I work with treat me like a NURSE--we can't change people, only our reaction and situation. There are LPN jobs out there. They may not involve the scope of practice that is desired, but just having the experience to put on a resume is valuable.