Keep_Calm

In my opinion, if he was sating 97% on 2L with a NRM, then maybe he didn't really need it in the first place...? You mentioned he was a frequent flyer. I had a pt. once who was so SOB and we couldn't figure out why. His sats were fine. He continued to c/o SOB and seemed very distressed so we did blood gases. While he was in xray, his son came forward and reported to us that his father "acts this way every time he is in the ER." And what do you know, his blood gases showed that he had actually put himself into respiratory alkalosis by trying so hard to be SOB! Long story short, we took the O2 off and gave him a xanax and he was fine. Maybe this is a psychosomatic issue your pt. is having. Is he holding his breath on purpose to de-saturate. (Is that possible, lol?) Does the attention and the NRM have a placebo effect on him? It is hard to say without more to the story. What did his lungs sound like? What was his WOB like? Chest Xray? PMH? Does he have COPD? Does he need the NRB to increase his hypoxic drive?

AMEN!!!

In a small community (I'm guessing so if you have volunteer ems), I think it would be extremely beneficial to have the EMT cert on your résumé when applying for an ER position. If the hospital doesn't use volunteers in the ER, go on as many runs with the squad as you can to become familiar and friendly with the ER staff. So definitely do it!

You are so right. Instant gratification fueled by technology is finding its way into healthcare. 'I feel sick and I want to know what's wrong right now and I don't want to wait to make an appointment.' We had a mom bring her 9 month old in at 0230 the other morning for what she thought was poison ivy in his diaper area. Really? The baby was perfectly happy and not bothered by this (diaper rash...lol) at all. Smh

Working in healthcare while in school would be something... :)

But I also don't agree with doing something purely because your boyfriend tells you to. Make a list of pros and cons and decide for yourself. Good luck!

Are you doing it for the money or because you think you'll really enjoy nursing as a career? My opinion is that you should go for RN, take CNA/STNA classes and work in a nursing home or hospital while in school. BUT it does take time and determination. Yes, LPN is quicker and just as fulfilling but then you become limited in your choice of jobs when you get done with school. I am an LPN and I did it for the quickness--in hindsight I wish I would have just went for RN right away instead of trying to do it while working and with 2 kids like I am now.

Chalk it up to experience! That's what clinicals are for. It sounds like the situation could have been a lot worse. Be thankful for the experience and thankful it turned out ok.

^this

Ok fair enough. I just see so many RNs who can't even find work, and ninety something percent of hospitals don't hire LPNs anymore--let alone in the ED..... I certainly don't think I am lowly, but some hospitals like to view us that way. Thank you everyone!

I just got the job in the ER!! I was definitely the underdog--LPN going for an RN position. What an amazing thing this has turned into! I guess putting myself out there and being willing to take a lower job to get my foot in the door was worth it. Thank goodness for small rural hospitals not afraid to hire a lowly LPN.

Congratulations! How about: Registered Nurse, State of Missouri

It depends entirely on the situation.

I think you did a great job too. You did what any good nurse would do. You cared for your patient to the best of your ability, you consulted other nurses and the charge nurse, and you did everything you could for the family. With end stage respiratory disease, the patient would have to use accessory muscles to breathe until he, well, stopped....right?

Oooo! Sounds so hopeful for you! I think you did everything you could do for now. Unfortunately waiting is the hardest part. I am going through the waiting game now myself. Maybe a handwritten thank you note would help? Deep breath... :)

I went through that. I ended up getting an interview at my current employer after I had accepted and done some of the paperwork at another facility. I hesitated to even go for the interview but I did, and I got an offer on the day I was supposed to start orientation at the other place. I called and told them I accepted a better offer and that I would not be coming to work there. Burned bridges? Yes, probably. Regret? No. It's business. And I felt the same way you did, but my mom reassured me that it does happen and is not unheard of. Others may disagree, but I say that if you REALLY want to work at Hospital B and you get an offer, withdraw your acceptance with A and go for B. I'd even try to push back your start date at A to see if you get an offer from B. Good luck!

I list employment like this: XYZ Employer City, State Aug. 2012-Present LPN Charge Nurse- 3 East Supervise nursing assistants and care of assigned residents Administer medications and treatments according to physician orders and scope of practice Communicate with physician, residents, and family regarding resident status and care Complete appropriate documentation and charting including incident reports, orders, and care plans Monitor physical and mental status of residents including vital signs, physical assessments, and skin assessments ABC Hospital City, State Oct. 2010-Jan.2012 LPN--PMCU/ICU/Telemetry Performed patient assessment and documentation, measured and recorded vital signs Administered medications and IV therapy Collected specimens, including blood from venipuncture and fingerstick Performed EKGs/ECGs, interpreted ECG monitor strips from telemetry patients Educated patients on conditions, medication, and disease processes List your job duties making sure you use the same tense for all-- labeled, recorded, administered OR label, record, administer

Wow. That just sucks all around. I know how hard it can be dealing with patients/residents like that, but as GrnTea said, you cannot deceive a patient like that and yes, it's your fault. Valuable lesson learned by all.....BUT--and this is what I HATE about where I work too--why wasn't this problem addressed properly instead of nurses lying to the resident? UGH! Plus the nurse that oriented you did it!?!? The blame goes to others as well. I hope for the best outcome for you.

It sounds horrible, I know. BUT--when you get into LTC, things change a little from a medical standpoint. A lot of nursing home residents have advanced directives-DNR or DNRCC. Sometimes there's a gray area as well where the family makes the call whether or not they want their loved one to go to the hospital or not. A lot of elderly, especially alzheimers and dementia patients, do HORRIBLE in an acute care setting because they get even more confused and in turn, they suffer MORE from being there. Sometimes a family or doctor may take a "wait and see" approach when a resident's health starts declining, so not to put them through unnecessary suffering. Then the family will maybe decide after a day or two that, yes, they do want them to go. I used to think some LTC nurses were dumb also, until I started working in one. There are a lot more legal and ethical aspects of LTC vs acute care that I never realized. Some facilities have idiotic policies (like calling the squad to put O2 on someone--thank god not mine) and some MDs make stupid decisions also. Also, an LPN in LTC has a lot of responsibility, but little say when it comes to some important decisions. AND--CNAs/STNAs, while GREAT, do not have much medical training and do basic patient care, and one would not know enough about someone's condition to accurately tell you anything.

This made me lol

Yes, it would depend on the state but also the facility policy. Our aides in the facility I work in aren't even allowed to put cream (other than lotion) on a resident! You definitely would have to talk to the DON or unit manager first. BUT......Here's what I recommend. Since you aren't in nursing school yet, focus on being the best you can be in your current practice as an aide. If you neglect your responsibilities as an aide because you are looking for opportunities to do nursing skills, you will be missing valuable experience in direct patient care and will be doing your residents and co-workers a disservice. I really don't mean to discourage you, but you will have plenty of practice in school. It pays off to have people skills, compassion, and a strong work ethic just as much as clinical skills.

Sent one. :)

I had an interview with a unit manager 3 weeks ago and I sent a thank you note. I had a second interview 2 days ago with the DON. She gave me salary and benefit information and the interview went really well. She said the UM was impressed with me. :) Anyway, at the end of the interview, she basically said they would check my references and then be in touch. I think the UM is doing the reference checking and I think she just needed the DON's "blessing" to hire me. My question is, should I go ahead and send a thank you to the DON?

It does sound wired....better give them a call and get it straightened out. Good luck. I'm sure it's not as bad as you think.

I don't think so....It has to be a misunderstanding. Either I am reading this wrong, or you are misunderstanding. I would think they would talk to you if you weren't doing something to their liking. Maybe just the small group session is being rescheduled and you will continue on with the other portion of your orientation? I don't think that is the way any facility would let someone go, with no explanation like that...