nurseguy213 LVN

nurseguy213's Latest Activity

1. 

   Accusations are demoralizing :-(

   nurseguy213 posted a topic in LPN/LVN

   Working as an LPN w/ long and short term patients I report to a Supervising RN, when ABN labs come in or a COC happens, sometimes I get told we, the LPN's, are not passing the meds or making sure the patient gets fluids, it's not an accusation outright, but they say it. Seriously? No formal accusations are being made but getting told this each time is now demoralizing. You're on the phone w/ the doctor both wondering why this is happening despite all the orders being carried out, but when you mention it to your RN Super, that's what you hear, you guys must not be administering what's ordered. Gets worse when the DON says the same thing. Patients are alert, but to the RN/DON I guess there's no other reason for these things to happen, 'cetp to say the LPNs are not doing their job 😞. Breaking your back, behind schedule trying to order more labs, carry out new orders and that's what you hear? I totally feel like leaving b/c of this.
2. 

   PPE shortage and distribution

   nurseguy213 posted a topic in Disasters

   I guess this is more of a rant. I work at one those nursing homes that had an outbreak, it's over now thankfully, but we're still being careful wearing PPEs to prevent our residents and patients from getting sick. We're all suffering from a PPE shortage, and when I walked into work, what I saw kinda pissed me off. I saw admins and other medical staff who don't even work the floor wearing nice N95 masks, not the ill-fitting ones that are a few sizes too small and suffocating, but looked comfy and even had a proper exhalation valve. Did I or my CNAs get any of that, those that have direct contact? No.
3. 

   LVN to patient ratio California

   nurseguy213 posted a topic in LPN/LVN

   I've been trying to look this up and all I get are numbers like 2.4 hours per patient. So here's the question. In a nursing home, short-term rehab (physical therapy), how many patients can an LVN have for med pass? I've seen an average of 25 max 30, with CNAs average of 10. These are 8 hour shifts. I can't seem to get my computer charting done, yes I finish my emar but all the other charting, I'm stuck at work at least an hour more and end up coming in my own time for an hour or 2 to finish if I can't. I've seen the trend, when I have a reasonable amount of patients like 20, I finish everything on time and I'm not rushing my med pass, ADLs or when patients require more time. I'm gonna go out on a limb and say I don't think lazy or slow, I've won emplyee of the month and year regularly, that I give my gift cards to my hard working CNAs. Is my ratio too high?
4. 

   Abusive families

   nurseguy213 posted a topic in LPN/LVN

   LPN here, working in a subacute. One of the family members of a resident is there daily. No one likes her because she's rude, like when a custodian passed by and then out of his earshot, but next to me, she called him a Pendejo, for no reason. I was assigned to her family member, while in the room she was talking in Spanish in front of me and a CNA. She was half talking to her, half talking outloud how she does not like me and that I'm lazy. I didn't pay attention, not letting her know I understand every word. My CNA felt bad, she said none of the staff are lazy and we do a good job, the other family members don't complain except for that one crazy one. How do you, my peers here handle this? I shrug it off, but should we? Should I report each instance? Crazy people talking smack just bounces off, but sane people talking smack? Not sure how much I can take talk about me or my co-workers.
5. 

   Are Patients Cared for Equally? Challenges of the VIP Patient

   nurseguy213 replied to J.Adderton's topic in Nursing

   VIP Residents. In the wing I work in, 90% are comatose or unable to make decisions or care for themselves. Some of these residents have family members that are there daily, some a few times a day. Some are there to care for their loved, they allow us to do our jobs, but sometimes when staff is busy with another resident, they do some care themselves, and wait for assistance as needed. They see that the single staff member caring for their loved one has 10 to 12 residents including theirs and they understand the reason why staff is not on their beck and call all the time. Others not so much, it's like they expected staff to be at their residents bedside and to clean them ASAP. There are regular bed checks done to check if the resident is soiled, why blame the staff member for not coming right away when they are busy cleaning XL loose stool from another resident? I know it sounds cruel but when the other staff member is getting meds ready on their cart to give out, you can't expect them to drop everything that second and assist you, it's not a CODE, your loved one is soiled. We have to put the meds away first, less some resident or curious person come down the hallway and take it. When I've secured the Norco and the locked the cart, yes I'll help you. We treat everyone the same. I feel bad for those that think otherwise.
6. 

   Resident requiring special attention

   nurseguy213 posted a topic in LPN/LVN

   In Sub-Acute with each LVN having 10 residents, how often are we required to look in on the residents. Because 1 resident is confused they want us to check in on them every 30 min. We have 9 other ones to care for. I just feel that it's unfair to the other residents.
7. 

   TB Chest X-Ray

   nurseguy213 posted a topic in Nursing

   I got exposed to TB and have been positive since 2006. My employer at the time told me that I now need to take chest x-rays because the skin test will always be positive. I've had yearly chest x-rays a requirement for work since then. I'ts 2018 and I'm applying at a hospital, they refused my clear chest x-ray taken a day before I applied. They are demanding a skin test or $140 blood test followed by a clear chest x-ray. They asked if I could provide proof of the positive PPD from 2006! Is this fair? Every other medical facility I worked at accepted my clear chest x-ray.
8. 

   HIPAA violation?

   nurseguy213 posted a topic in HIPAA

   I work in a sub-acute facility. The resident in question is alert but can no longer communicate. A direct family member who is the responsible party, asked us not to give information to a friend of the resident. That friend though is allowed to visit. The friend called the unit pretending to be another direct relative on the approved list. We knew who she was and explained HIPAA to her, she was a little upset. It turned out she was with the approved family member. We explained to the approved family member that what the friend did was not right, why did she need the friend to call and pretend to be her? Weird. We explained that medical workers have lost jobs by accidentally or intentionally giving out personal information to those not authorized. Did we handle this correctly? We still have to bring it up with DON on Monday. Just curious.
9. 

   Comatose/TBI patients

   nurseguy213 replied to nurseguy213's topic in Professionalism

   It's just 1 or 2 families our of the 40 patients we have, and boy they are loud. Some are nice and approach me and say, I'm sorry my loved one needs to be cleaned again, I see the CNA is busy, please let them know. I wish they were all that understanding.
10. 

    Comatose/TBI patients

    nurseguy213 replied to nurseguy213's topic in Professionalism

    All our patients are checked at least Q2 hours, we change them 2 or 3 times a shift. I think the family knows they are being unreasonable, they don't complain to me or my charge nurse, just take it out on the poor CNA, if they had a case I think they'd complain to us. After loudly airing their displeasure, if my CNA is not available they would kindly ask me or another LVN for help. SMH
11. 

    Comatose/TBI patients

    nurseguy213 replied to nurseguy213's topic in Professionalism

    Yes they find ways.
12. 

    Comatose/TBI patients

    nurseguy213 replied to nurseguy213's topic in Professionalism

    You are correct, there is a schedule and my CNAs follow it, otherwise I'd be on them about it. I don't think it's fair that a couple of families want all our attention on their loved ones, we're caring for everyone else in our assigned rooms too. The family is aware of incontinence and what it is. The family once threatened to tell the DON, I asked my CNAs, were you doing your jobs? They said Yes, I told them they have nothing to worry about, let them complain, they never did. I just hate their loud voices letting everyone hear how no one is caring for their loved one. I feel so bad for my CNAs.
13. 

    Comatose/TBI patients

    nurseguy213 posted a topic in Professionalism

    I work with mostly comatose or patients whose TBI is severe enough that they cannot care for themselves. My concern is actually how to help my CNAs. We work in teams and care for 10 to 12 patients. My concern is with family members, from 1500 to 1530 my CNA will take vital signs, then start caring patients. Now being comatose or with TBI they are all incontinent. With 10 to 12 patients to clean, it takes a while, they usually start with the ones whose family are fussy. Problem is, being incontinent, after they are changed they sometimes go again a few minutes later. Family arrives to a dirty patient my CNA just changed 20 minutes ago and now I have the family claiming no one is caring for their loved one and blaming the CNA. We can't watch their family members like sitters, which some families have done, hire a sitter who lets us know to change the patient and the sitter helps. I'm sometimes at the point I want to tell the family that they are harassing my CNAs. We care for our patients, otherwise we wouldn't be there. Any advice?
14. 

    When to stop wound vac

    nurseguy213 posted a topic in Wound

    Wound opened on the back, parallel above the waist after staples removed. It was less than .5cm deep and 7cm and 3cm at the widest. After 3 weeks it's now closed and filled with granulation, no drainage, just hairline opening where the edges have not closed or filled. Should vac be stopped now? Change to daily dressing change with triple atb or continue vac til completely closed?
15. 

    Video Assisted Surgery jobs for nurses?

    nurseguy213 posted a topic in Job Assistance

    I'm a working LVN but with more than 10 years in TV production, the installation, operation and maintenance of the cameras and video monitors used in Video Assisted Surgery are the same. I've been looking for nursing jobs involving VAS but have not found anything. Any advice would be most helpful.