Manofstone

Well, they made some changes and she got fired.

I finally got to talk to the Director and she let me know that they are making changes to address the one hour before and after. She understands that no one has ever met that goal and no one will. And they are removing verbiage from my write up. I got the impression that they are leaning towards having "1st shift meds", "2nd Shift meds", "3rd shift meds" as the "time" for giving. I would think there would be some additional notes regarding giving the med early in the shift or late in the shift while some meds will have to have a time. Anyways, it was a good talk.

Oh, I am sure that the director will back up my boss. It's just I wanted to point that I expect management to help me see what it is that I need to do to meet the guidelines that they have in place while they also admit that no one has ever met those very guidelines (leading us back to the point that no one has been written up for this for every day that it occurred).

Oh, how do I know my predecessor wasn't written up for this? Well, lets play with that idea. He worked back there a year and a half. He was always done by 10am. Now, where I work, if you get a write up and it's the same write up three times...you're fired. So, I know that he did not receive a write up ever day because he would have been fired on day three for being one hour behind on 12 people. He was there for over five hundred days minus his days off. So that, to me, is evidence that this was not an issue when he worked over there. Also, he wasn't fired, he found work elsewhere and left. And finally, he was the primary 1st shift nurse over there. On his days off there is a nurse that fills in. She usually finishes around 11am. She's worked there for over a year. So no, I don't see how it's possible that she's being written up every day for giving meds late to 24 people for over a year.

I don't think you understand my point. I'm not saying they owe me any details on anyone's performance. I'm just saying that if the claim is that you have to have 45 residents done by 9am and that everyone knows that no one has done that ever (even my boss tells me that)...then why blame me when I'm the new nurse in that section? A write is a way to help someone understand what they did wrong and what they can do to correct it. The write up I received just said I'm in the wrong with no details as to how to get 45 residents their meds by 9am...and during the write up my boss admits that no one has ever finished at 9am. If they view me as a non-conforming complainer then I can't help that when I've made it clear that I am willing to do what ever they want in order to do what they want...only...they are unable to verbalize how to do that.

Oh, and by the way, when I asked my boss about the best nurse finishing at 10am she told me that it was probably because he wasn't doing everything he was suppose to. Interesting confession. Interesting that it was allowed for over a year and a half.

No, my boss works for the director. My point is that if this is a valid reason for a write up then why is it allowed? It must be allowed if no one can finish by 9am and the best nurse back there was finishing at 10am for over a year and a half. Not trying to sound cocky, just trying to understand why it's allowed except when I do it.

I need help with something. I received a write up and one of the things it mentioned was that I need to administer a medication between one hour before the scheduled time on the mar and up to one hour after the scheduled time on the mar. I work with dementia patients in memory care. I have about 45 patients that I have to pass meds too. I come in at 6am and I start the med pass at about 630am. About 60% of the patients need to be seen by 7am and the rest need to be seen by about 8am. On average they each have around 6 or more meds about very other one has a procedure that needs to be done. Most of the pills have to be crushed. And the patients can be slow in taking their medications. Right now it takes me about five hours to get that all done. Prior to this I had worked on the other side of the building in assisted living. Over there I had about 27 patients. I would finish that in about 3 hours. At that time, they had a nurse in memory care that would finish memory care in about 3.5 hours. He did that for about a year and a half and then left and then they moved me over to take his place. By the way, I can still give 27 patients in memory care their meds within about 3 hours...just like I did in assisted living. I'm just as fast as I was before for the last 2 years. It's clear, to me anyways, that the nurse that finished in about 3.5 hours was still not able to meet the requirement of "one hour before and one hour after". I figure that each day he was there that he passed meds to about 12 people two hours after what was scheduled on the mar. I've been over there for about three weeks. On my first week my boss mentioned "one hour before and one hour after". I pointed out that in my two years working there that I've never seen any nurse on first shift, in memory care, do that due to the volume of residents and how the mar is set up. I also asked if the nurse I replaced had received a write up every day, for a year and a half, for not meeting the "one hour before and one hour after". I was ignored. I sent an e-mail to the director pointing this all out and she said she would take a couple days to go over my details and then talk to me. Any advice?

Thanks for the comments guys! I forgot to come back and do an update, but I was able to reach the provider and I was right. If I give it on Monday then the next day to administer the med would be on Wednesday. The non-nurse that told me that it meant every 3 days apologized saying she never saw the order and assumed it meant every 3 days. I was happy to change it back to Q48 hrs before the patient missed receiving his med on time.

Yep, that's my next step.

I thought that it meant that if I give the medication on Monday then Tuesday would be day one and Wednesday would be day two and so I would give it on day two. I'm being told by someone who is not a nurse (our RN is out on leave for two months and we have a director over us who is not a nurse taking her place) that if I give it on Monday then Tuesday would be day one and Wednesday would be day two but I would give it on Thursday (I would think that would be day three). Is that true? I was told this as I was leaving work and so I haven't had a chance to verify this with the doctor and of course today is Friday. By the way, I'm an LVN with just over one year experience working at a facility that deals with Assisted Living/Memory Care. Thanks for any insight you can give me until I can check this with the doctor.

I just graduated from a LVN program in Texas and I'm wondering where would be the best places to look for work? Long Term Care/Nursing Homes is a given...any other places? Thanks in advance for your help.

Mswan, what is a att?

Itzvalerie, thanks! :) At least now I know. I have seen some GVN's post that they were able to find work without the license number, so maybe I'll be able to do the same.

Itzvalerie, just last week. I guess with Christmas coming up that it won't show until January.

Itzvalerie, thanks for the quick response. I did do that for the LVN/RN and also for the GVN and it reports back with "Total Finds = 0". So I'm not sure what I need to do next. I did finish the LVN program and I passed the ATI test prior to leaving the program and I passed the Jurisprudence. Just a little lost on what to do next for my GVN license.

Hello all, I finished the LVN program just last week here in Texas. I'm looking for work and I've noticed that some applications ask for a GVN License Number. I've gone to the Texas BON website and I don't see how to apply for one (maybe I'm overlooking a link). Do I apply for one? Does the school contact the BON and then one is issued to me? I've read through some of the questions about GVN on Allnurses.com and I don't see an answer to my question. Thanks for any help y'all can give me and I hope y'all have a great day. Man of Stone

Thanks, guys!

Hi, How many hours a week is RN school? I'm thinking of working as a LVN as I go to RN school and I'm curious how many hours will I have available for school. Thanks!

Thanks for the information. That is a big help.

Isoproterenol: Used for shock, bronchospasm during anesthesia, cardiac standstill and arrhythmias. Contraindications and Precautions: Tachyarrhythmias, tachycardia, heart block, ventricular arrhythmias, angina pectoris. Soooo...why would you use Isoproternenol if arrhythmias are a precaution for use? Also, I'm not able to find Isoproterenol in my Davis's Drug Guide for Nurses. Is it normal to come across drugs that are not in the drug guide? (I did find the Uses and Contraindications in my Pharmacology book). I'm a first semester nursing student, by the way. Thanks for any help! :)

I'm not aware of a waiting list. Maybe I was lucky? From what I've from the other students, st philips offers more than other schools in the area for lvn. I haven't heard of the baptist lvn program but I heard that the baptist hospital has a nice bridge program to rn.

Oh I don't know what the pre reqs are but if you contact the school and ask for information I'm sure the can mail it to you.

My mom graduated from st philips and many grads work in san antonio. Its really the best school at this price for nusing. One of my friends went to galen and she paid $6 k a semester. She says she learns more at st philips for $2k a semester than she did at galen. The teachers are great and I really like the program.

I was born and raised in san antonio, texes and I'm currently attending st. Philips college for nursing. My advice is to take a look at st philips. The cost for someone living here is maybe about $7k or less for the time it takes (one year). They don't have an rn program yet but it sounds like they will start an rn program in about a year.