nurseguy213

I've been an LVN since 2012, worked homehealth, school nurse, sub-acute and now skilled nursing. I've been offered a LVN job with the county in corrections, full benefits and all. Recruiter said it's a 7 step position, and with my experience they said I'd start at step 4 or 5. I'm still deciding if it's worth the pay cut, their max pay is still $5 less than what I'm making now. Thoughts? Opinions? FYI please go to Gov Jobs, recruiter said they need LVNs! This is in California.

True story Day Shift... Super RN: Are you giving the BP meds? LVN: Yes Super RN: Then why are the morning BPs so high? LVN: Those are taken before the meds are given. Super RN: But if you are giving them, why are the BPs so high in the morning? LVN: (Looking at BP chart) If I haven't been giving them, why are the afternoon BP readings within range? Super RN: Yah, that means you haven't been giving them b/c they are high in the morning! Why do I have to deal with this... FYI, I'm not blaming the previous shift, none of these patients get BP meds at bedtime.

Bottom line, the staffing ratios in places that are NOT considered hospitals suck and is unsafe. I think the people making these decisions don't have family and friends that go through waiting for the 1 CNA caring for 10 patients. If a patient goes #2, how long does it take to clean them? The other CNAs are busy with their patients, the LVN is busy trying pass meds to their 30 patients, so yes people will be left soiled for a while. And that confused patient that can get up and fall who should be in a lockdown facility? That bed tab alarm does not prevent them from getting up, it just gives everyone who can hear it a headache. I don't know how many times RNs have said put a bed alarm, as if that solves the problem of the patient getting up out of bed. With the staff/patient ratios the way they are, it's like someone forgot that these are people and you can't just assign nursing hours to them, some take more time and attention than others.

I guess this is a rant. Even before COVID, there have been staff shortages. I know I only work 8 hrs 5 days a week, but we have average 26 pts in skilled nursing, mix of long term and rehab. I've gone 2 weeks with no day off and the workday does not finish at 8 hrs, more like 10 because of all the charting for more than 2 dozen pts. You look forward to your scheduled days off, but then they ask for you to come in... I can't believe the rules that At Will employees can be fired for not coming in when asked by an employer. That sounds harsh to me, I'm worried about coming in not well rested and making mistakes. Although I've never heard of anyone having their job threatened for not coming in on their scheduled off day, it seems counter productive to have a tired person coming in. Lucky are those that have unions with rules in effect. When you're trying to medicate, chart and do everything in between for 2 dozen pts, after a few days fatigue sets in, and rest and reset time is important, or at least I thought it was since we're caring for people...

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.

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?

Not sure if this belongs here but, what do you do when a better job opportunity arises? Being recommended by a peer to new, better paying job was great. I have no problems with my current job. The new jobs needs me right away and the new schedule is the same as my old one. I told my current DON and she wished me luck, I also stated I wanted to stay part time. But with the way it looks I won't be able to commit. I don't want to quit outright, but this new job needs the position filled yesterday. Is it bad for me to quit and leave them scrambling? I can't eve give 2 weeks notice. Someone said it's the fault of my new job for not being prepared, but their in the same boat, the old nurse is moving. Feel bad.

Thanks for the feedback. I did talk to someone else not involved in nursing, she said to remain professional. I think she told someone else and they politely told the family member because she was suddenly polite the next day.

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.

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.

At the facility I work in, we have residents that have been through strokes or heart attacks with varying degrees of alertness. One of our residents attacks the staff when being changed or fed. Having brought this up to supervisors, we've been told the resident does this because they are soiled or simply in a bad mood and we should wait. But the truth is, the resident does this even when they are clean. But to blame the staff for being slow to get to the resident because they took longer with the last 10.or so residents they are assigned to is not an excuse to get punched, slapped, kicked or bitten. What are we to do?

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.

I've been an LVN since 2012. I was pre-med years ago but only finished 3 years of college because I ended up with a great career in entertainment production. After the layoffs and economic disasters, I was laid off in 2010 and had to go through a for profit LVN school because the community colleges had waiting lists of 2 years for ADRN, and I needed a job ASAP being a single dad. So now I have student loans I can't afford, it's live or pay my loans and be hungry and homeless. I am now trying to get into a 32 unit RN program for LVNs. I tried a for profit school who discouraged me from taking the 32 unit option, they want me to take the 3 year BSN, they told me no one has taken their 32 unit option. I cannot afford to lose that much work to go to school for 3 years. The counselor told me the only reason they offer the 32 unit RN for LVNs is because the CA Nursing Board says they require it so that the RN shortage can be filled. I know I'm not the only one here who wants to further their nursing career but face obstacles like this. Theoretically a 32 unit option should take 12 to 18 mos, which I can tackle. There should be more programs for LVNs who are working and want to further their careers. Or better yet, help us get our RN so we can make more and add to the state coffers.

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.

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.

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

Yes they find ways.

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.

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?

I currently work with LTC patients who live on their own in kinda like a group home. The nursing services provided to them include LVN/CNA and RN visits. They are all quadriplegics, some are vent/trach, others still have trachs and some don't. The agencies that provide nurses are paid through Medi-Cal and the rates are CNA $12 and LVN $18, not sure how much the RN visits are. The shifts are 12 hours, no overtime and no holiday pay. You have 1 patient, you do all the ADLs, cook for them, clean, do laundry ect. I think nurses working these duties should get OT and Holiday, I don't know why Medi-Cal does not pay for OT and Holidays, aren't we people? The rule about being exempt from OT is long and full of legalese. I'd like to know what others are getting paid. I'm in California.

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?

Forgot to add I'm paid $18hr

I'm a new grad, all clinical experience, I live in So Cali. I work extended care 3days 12hours, 1 pt SCI 24/7 vent. I do meds, wound care/treatments, ADLs, cook and laundry. In Cali do I get overtime if I go over 40hrs in a week? Or is extended care exempt? I'm not 1099 so they remove taxes ect, but I get no vacation or sick days. I work for an agency. I've tried looking but it's too confusing.