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Alisonisayoshi LVN

LTC
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Alisonisayoshi is a LVN and specializes in LTC.

Alisonisayoshi's Latest Activity

  1. Alisonisayoshi

    What are my options outside of a hospital setting?

    Right? Me too! OP I am an LVN in outpatient case management. Our last 3 new case managers have been RN not LVN because of the new Health Homes requirements. Do not count out clinic nursing as the land of just the LPN/VN or the CMA.
  2. Alisonisayoshi

    Should I become an LVN?

    I think my dental hygienist makes about 10 bucks more an hour than me (I don't know about the RDAs though), so if it's about money, maybe go dental. If it's about love of nursing, but you aren't liking rehab, maybe go RN. LVNS work a lot of SNF/rehab.
  3. Alisonisayoshi

    What's up with all the 'failed NCLEX' posts?

    I had a friend of mine in Canada msg me over Facebook awhile back to get an idea of my scope. She was afraid of failing NCLEX because the LVN/PN has a very different scope, and taking her RN NCLEX she knew she'd be asked delegation questions that involved what I (an LVN) could do. She passed, but stated she'd needed a lot of prep, particularly around the scope of PN and UAP.
  4. Alisonisayoshi

    Yikes! Flu Shot!

    I've given myself more sub q injections than I can count without using alcohol. No infection. I put my pump sites on without alcohol. I use alcohol on my pts, but really, it's so they feel comfortable with the injection being "clean". Also, I've been known to do an insulin injection through my pants as well... gross right? No infections though, 16 or so years in.
  5. This week I learned that there are so very many things I wish I'd learned in nursing school, or at least I wish they'd emphasized a heck of a lot more! I learned that, at least where I work, all the NETY I heard about was a lie. I get nothing but support, and help, and praise. Everyone around me seems to invest themselves in my success as a nurse. Either I got lucky or the issue is overblown. I learned that "anesthesia hangover" is a hell for some elderly pts, and though it's trying for me to deal with, it's far far worse for them to experience. I learned that titration down on Haldol is a sucky process in an elderly pt. I felt for her and held her hand. I learned that truly being able to advocate for my pt because I have the knowledge to do so is an amazing feeling. Watching someone get the care they need and deserve is beautiful. Oh and being a new nurse is really really hard, but it is getting better.
  6. Alisonisayoshi

    Scrub tops and bottoms, always the same color?

    I wear grey and teal and grey and pink a lot. I like those color combos. I wear print tops with a neutral pant as well. We can wear whatever scrubs we'd like where I work.
  7. Alisonisayoshi

    Delegation Woes

    I'm a newer LVN in LTC/Rehab as well. I wanted to be that nurse too. I'm going to burst that bubble right now for you. You just can't. No matter how much you want to, you can't. Unless you are in some amazing facility, you most likely just can't. Sorry. I run one med cart some nights, two others. On nights I run two, I have up to 40 residents. 2 g-tubes on that run, mutiple crushes, lots of residents who are very very slow pill takers, tons of Medicare charting, 9 or 10 diabetics, still more residents on breathing treatments, CPAPS to go on before bed, it's an endless list of tasks I've got to do that the CNA cannot do for me. In order for me to do it all, they must get the work I delegate to them done. That doesn't mean I ignore requests from residents, or let people sit soiled, I don't. I don't, however, do delegated tasks. I have medications to give, families to speak to, doctors to call, changes in condition to assess. If I fed and bathed people, how would any of that happen? Would I be providing quality care if I didn't delegate every last thing I could? No I wouldn't. The CNA'S I work with respect me. They work well with me, and they work hard for me. They do so because I made an effort with them, to learn their routines so I wasn't interrupting them unless I had to, to thank them when they did extra for me, to praise them when they were having a rough night, I listen to them about the residents and I never brush them off, and I take the seasoned ones advice on simple CNA stuff (it goes a long way to respect that they have a level of knowledge gained from experience, like how to get a reluctant resident to open their mouth to take applesauce and pills, for instance).
  8. Alisonisayoshi

    The cost of medications and universal healthcare

    If I'm desperate, and without insurance, I will use R and NPH. I have in the past. I've also been a diabetic long enough to remember when that's all we used. Heck I remember learning carb exchanges. As a provider you must know what a roller coaster of coverage those older insulins actually provide, and how using them significantly impacts both my quality and possibly quantity of life. The newer insulins aren't simply more convenient, they work much more in step with how my actual pancreas would work, thus providing for a better control, thus keeping my feet, eyes, and kidneys intact. So, shall I choose a possibly shorter life span for a cheaper price? Should my quality of life be sacrificed for a CEO bonus? Again, it's a gun to my head kind of choice isn't it? I know how my control looked on R and NPH. I know how it looked on lantus (that was a godsend when it came to market) and I know how it looks on a pump. I'd like to live long enough to see my grandchildren one day (should I have them). So, I restate, they give me a life and death choice. It's not a free market. I have no other choice but to buy from them.
  9. Alisonisayoshi

    The cost of medications and universal healthcare

    But how do I stop buying insulin? I'm a type 1 diabetic. Eli Lilly has a proverbial gun to my head. Pay up or die.
  10. I make 24+ a shift differential, I was making more at another facility, but I moved for better work environment. I work LTC. It depends on where you live. I'm pursuing my RN right now for the other poster that asked.
  11. Alisonisayoshi

    Help with a nursing diagnosis

    Also search care plans on here, seriously, some of the advice here got me through nursing school, and I still use it at work, even though my computer system at is a bit more point and click then look up and research. It will really really help you.
  12. Alisonisayoshi

    Help with a nursing diagnosis

    She's not at risk for fluid volume excess, she has fluid volume excess. Now, think about the fluid and the barely audible lung sound, does anything click for you there? I know it's early on, but those things are your physical assessments, and the nursing dx should come from there. Her anxiety can also lead you, what kind of things can anxiety lead to in a pt? What kind of things can uncontrolled DM lead to in a pt?
  13. Alisonisayoshi

    Elevated blood sugar

    Once one is spilling large ketones with high BG any exercise is actually unsafe anyhow...
  14. Alisonisayoshi

    Nursing documentation help

    Omg I love you right now!!!!!!
  15. Alisonisayoshi

    Nursing documentation help

    I love that this thread exists! I'm frustrated with narrative charting in LTC as well. For example, say I need chart a UTI resolving on ABO, is it appropriate to just write: "Resident on ABO for UTI. Resident has no c/o pain at this time, no c/o frequency or urgency. Vital signs WNL. No adverse effects from ABO noted at this time. Will continue to monitor." Am I writing too much? Too little? Yeah, we didn't really do narrative charting in school, and I feel lame.
  16. Alisonisayoshi

    Diabetic Alert Dog at work in Hospital

    I just want to point out that I don't use a dog. I'm a working nurse. I use dexcom. I'm also a special rare snowflake among the non insulin producing folk. I don't have a pancreas. At all. Nothing there. That means no signaling hormones to raise my sugar in an extreme low. The leading cause of death for folks like me, the reason we are given lifespans of max 10 years post op (I'm nearly 16 years out) is that vital little signal. I am my only go to in a low. I free fall rapid drop in any lows. My liver won't dump rescue sugar. Let me reiterate, with all that, I'm still just using a dexcom. I gave OP my advice based on research I did about a dog a few years back. A few points, dogs limit where you can work, dogs can't hold pee an entire shift, dogs are thrown off by extreme scent in environment. So you get a dog who is limits where you work, who you treat cruelly by making it hold its pee, and who can't adequately function because of foul smells. So why the dog and not just the dex? Well the reason can't be brittleness, because if that was a good enough reason, I'd have one (and yes, if I can't self rescue I'm a darn good example). It can't be accuracy because you screw that with extreme and distracting scents. So that leaves the fuzzy and cool factor. They are fuzzy and cool, I will admit that, but in a tight nursing market do you want to limit what and where you can practice?