Schmoo1022

I'm sorry! Nurses that have done third know how it is. I have done all three shifts and I can tell you each have their good and bad points. When I did 1st shift it was so much politics, and phone calls, and following up with issues Second shift it's all admissions and sundowners Third shift-lots of cleaning and paperwork I have to say, even though I was never able to get used to third shift, I really liked it. I was able to actually be a nurse when someone needed it. Every shift has there good and bad, but you are right, if it is so easy why isn't everyone lining up lol?

We have three residents who are on Lantus and they do not have BG's ordered. I do check their BG prn if they haven't eaten or are not feeling well, but they do NOT have any standing orders for BG's

Congratulations on the new position! I want to be encouraging and not negative, but my first job out of nursing school was not a positive start and after that I wanted to quit nursing all together. Just know your limits and ask a lot of questions!

Grrrr...This health care issue is a huge deal with me. I love where I work, but the health insurance is awful....if you are even "qualified" for it. We only have a few full time employees..everyone else is considered per diem and do not qualify for health insurance. These poor CNA's work their butt off 5 days a week waiting to be considered full time. Single health insurance is $36.00 a week...family is OVER $200.00 a WEEK! Who can afford that??? Most of the CNA's that are mothers, qualify for state assistance and it's very reasonable, so they go that route. As a nurse with 3 young kids, I can't get health insurance through my job because I am considered per diem and even if I qualified...could I afford the $800.00 a month? I am on the fence about this..My co-workers would be thrilled to only pay $25.00 a month ...even the ones who make $9.00 an hour. It is better than $36.00 a week! I also think it's sad that the company can"t spring for the $25.00 a month...

I swear some people just get a thrill out of knocking people down...you are right ...why did she bother to have you come in for an interview? Please, don't let this person get to you. You will find something!

We use mostly Compazine and occasionally Zofran. I really don't like the Compazine because it seems to make some of our residents extremely loopy. That being said, I notice that we are medicating everyone with an antiemetic everytime they vomit! Even for a quick bug.

It is tough! I worked third for a year...I only got about 4-6 hours of sleep on any given day. With a 3 and 4 year old it was hard. Looking back I realize how miserable and grouchy I was...my poor boys didn't deserve that. I currently work second shift 3 days a week. One boy is in school the other is still home. It is still tough, but much more doable. I don't think I could do full time right now.

I was taught we to never chart names. I have a very high psych population, if I charted every little comment like that, I would never even get out of my seat. We have many residents who say, "Oh I hate that nurse, she is mean. You're my favorite" Oh please! But you can see what I am getting at. If it was really a concern of someone being rude or inappropriate, then I think it needs to be followed up on, but not in the chart.

I would first notify the nurse. They administators may not be family oriented,but most nurses would want to know if a CNA or any other employee was being nasty to a resident. It is so true that any change in the residents routines can really upset them. We have one resident who is truly a lovely man, but he HATES every new CNA for a week or so until they learn his routine...then he starts requesting them lol.

It seems like a cost issue to me. My director would absolutely blow a gasket if you used an injectable,when you could have used food or p.o. glucose paste . But as another poster pointed out, just because someone is conscious doesn't mean you will be able to get food into them. If I wasn't able to get someone to drink/eat I would have without a doubt given the Glucagon. I am just wondering why this residents blood sugars were so low all day and no intervention was done prior to you coming on?

Would you need an order to flush with cola?

I disagree with some of the above post. Sorry! In nursing school, you learn a lot, but you may only do a few hands on foleys, IV starts and you may never access a central line in nursing school. What you NEED to know is the rights for giving medications and KNOW when to ask for help. Much of the hands on stuff is learned by doing on the floor. You should be assessing you patients and starting to put what you learned in school and see how it pertains to your patient. That big picture takes time. There is so much to learn at each hospital/nursing home. Everyone has their own policies, but if you learn to do a good assessment, know when something is wrong and know what to do about it, that's when it all comes together! :)

Hi! We are staffed pretty much the same way. Unless you are working days in my facility, you are the only nurse in the buildning. First, find out what your facility policy is. Second, make sure your aids know what to do. Our aids come and go pretty quickly, so I frequently explain to them what I would ask each of them do to do. I am very specific about this. We do a sort of quick "mock" code. I would stay with the resident, another aid would call 911 and the other would get the crash cart. Our crash cart consist of suction, ambu bag and O2, so I am relying on CPR and how fast 911 services get notified and arrive.

I think they are saying, don't apply if you aren't willing to travel that far or move closer. They just don't want to waste their time or yours, by you later saying "it's too long of a commute"

I ma interested in learning MDS..

Hi, I am feeling discouraged today and thought I would come here to look for some insight. How do you DONS/ADONS feel about your nurses wanting to learn more or a different area? I guess, I thought it would be looked at as a positive thing. I am not getting that feeling at all at my work. I am not sure if it is because we are short staffed, if they don't feel I am a good candidate or if someone feels they will lose their position if someone else is able to do it?? I just don't know. I have asked questions and get a very general answer. I offer to come in on my day off to learn something else and I am told, "don't waste your time...so and so will never leave" It isn't about me taking someones position it's about me understanding different aspects of nursing,feeling challenged and seeing more of the big picture. Maybe I need to move on??

As the title says, I asked to start learning the MDS process at work. Many of you advised that learning hands on was the way to go! Well....my director told me in a not so nice of a tone...." Go take a class" I told her I WAS planning on taking a class, but thought it would go smoother if I had some idea what the content was about. She told me we didn't have need for any more MDS nurses, so I am wasting my time unless I plan on leaving. Needless to say I am discouraged. MDS is something I am interested in, but I would like a little more exposure to it before dropping a chunk on the course. I don't even do care plans where I work! It seems like I am stuck

It was two dosing times..am and pm. Random urine test, TB testing, Disease education and helping the clients find proper follow up health care for other health issues. I did mostly dosing, but there were a lot of physical assessments. I enjoyed it because it was always interesting and went by fast, plus there was a lot of flexibilty with shifts and hours.

This was my first job out of nursing school and it has hurt me a bit. It is definately an interesting area! If you need a job, take it!

CapeCod, What I have noticed is that the DON who are stressed and nervous are usually the really good ones. They ones that get burnt out ...You have the facility and the staff in your best interest. You want it to be a nice, safe nursing home where the residents and staff are happy, but with the state of LTC these days it is almost impossible. Budget cuts and staffing and poor support from higher up will do you in. The DONs that seem to breeze right along are the ones that don't care, don't worry and collect a pay check every week until it is time to move to the next facility.

That is tough too. We see many deaths in LTC, but usually in residents in advanced age and you can see them declining. It is hard to see someone that young with a young family pass away

Heartbreaking.....I don't know what else to say. I'm so sorry

I appreciate all the support by the way :)

I have to say I find more than 3 days in a row too much. Not that I can't handle it, but it really wears on me. Working 24 hours, I have very little stress. I work my butt off when I am there, but I know a day off is around the corner. I am more patient, happy and "with it." I think being a parent is very hard work, but I wouldn't even make a comment about a single guy working part-time. Why would it be any of my business?

I'm a little confused...I may have skimmed right over it, but was this a new order for a narc or the patient just ran out of a narc that was already prescribed? If it was an order already in place, I would have absolutely given the med out of the E-kit. I work in LTC and we don't get admits on 3rd, we also have a rinky dinky pharmacy that has bankers hours. So, if a new admit comes at say 5:30, pharmacy has to make a special trip to make sure the meds are delivered. We are ALWAYS running out of meds and it drives me BONKERS!