EMYrn2011

I can give it, but for some reason the facility prefers for the LVNs to do it, if I believe correct they do this to help with the work load. I was told that RNs don't give the po meds, but have been told by several RNs that there are times when they do it bc the LVN won't. Which is what I've started to do.

I get what your saying, but the pt is on hospice. They are an ex-addict, in fact they overdosed which is why they need to be in our facility. This pt also had a sore, that was poorly amputated by a MD who is known to chop limbs off a little bit at a time to get more money. The wound is clearly infected and slowly taking over. Because he's on hospice there's not much we can do but medicated. This pt is regularly agitated, to the point where they swing their arms around none stop, bc the LVN waits until that happens, the does is often not enough to help... It's been an issue of under medicating, which is why I ask my LVN how many time they were medicated, not just on my shift but the other shifts as well. That's where the real problem is. When we come on this pt is so agitated, I don't think there's anything wrong with communicating this problem in rapport.

I get what your saying, but the pt is on hospice. They are an ex-addict, in fact they overdosed which is why they need to be in our facility. This pt also had a sore, that was poorly amputated by a MD who is known to chop limbs off a little bit at a time to get more money. The wound is clearly infected and slowly taking over. Because he's on hospice there's not much we can do but medicated. This pt is regularly agitated, to the point where they swing their arms around none stop, bc the LVN waits until that happens, the does is often not enough to help... It's been an issue of under medicating, which is why I ask my LVN how many time they were medicated, not just on my shift but the other shifts as well. That's where the real problem is. When we come on this pt is so agitated, I don't think there's anything wrong with communicating this problem in rapport.

I was in this same situation. And while it was stressful, I got through it (keep in mind that I am not the best student), will all As. The key is time management. Take it all one day at a time (that's how I studied, looked at what was due when and what test came first and prioritized). It will be hard but you can do it. The fact that your a parent proves that you want it that much more...

I recently started working on a subacute unit; majority of the patients are unable to verbalize needs. Many of these patients have PRN narcotics and anti-anxiety meds. At this facility the LVN gives all the PO meds, and injections; as an RN I am not to give them. I work on the night shift so I'm the only RN and basically in charge. There have been several times where I noticed that two of my patients are visibly agitated, and appear to be in distress. I have been asking the LVN on my shift to give the prn meds as often as they can ex: MS PRN q1hr. They would give it every hr. However, there is one LVN who refuses to give the narc until the patients are visibly agitated. I feel that the med should be given before this happens, to keep the pain in control and to prevent it from increasing to the point where the dose is not enough. Am I right in this case or is the LVN? If so how should I handle this situation? In this facility it is very clear that the LVNs act as if they are above the RNs and often try to tell us what to do...