FlufferNutter

I work with with an 8 year old child in his home. He has Cerebral Palsy, is non-verbal, and for all intents and purposes, he is non-ambulatory. He has a G-tube and a Nissen Fundoplication, but his oral health is a huge concern for me. It is near impossible to brush his teeth. And, he can't swallow, so introducing any liquid into his mouth is an aspiration risk. Dad has me brushing his teeth with plain water and a toothbrush....but half the time, my patient clamps down his lips and I can't really get a good scrub in. His teeth are caked in plaque. I can't even fathom how he is at a dentist appointment.....just getting him in and out of the tub is an Olympic event. Do any of you have any suggestions? Products/maneuvers that may be useful for this type of patient?

At all of the places I have worked, there was never a specific "day" set aside. It makes no logistical sense to have half a dozen incontinent/aide-dependent patients have BMs at the same time. Usually it was based on the 3 day rule. If no BM for 3 days, Miralax is given, 24 hours without result it would be a suppository. If that wasn't effective we would move on to enemas and or digital disimpaction. :/

the fact that you are worried about it speaks wonders. No nursing student graduates with the entirety of everything....I know that sounds lame. But, it's true. Best advice I can give you as a brand new nurse? You suck....you will learn more as you go.....and you already know more than you can even imagine. Have confidence in yourself....you earned it

exactly...what the heck is a toothette doing? My kid barely lets me get any kind of oral hygiene tool near him...

I work with a little guy who has a gtube change order for every three months, or more frequently, if needed. Recently had to change it due to leakage in the balloon keeping it in place.....He squirms so much that it is a huge deal to do.

I like fluffernutters. They're yummy :)

I now work as an RN here and wish my words came with a side of guacamole and schiracha sauce

Just curious if you've ever worked as a CNA? It is a thankless job that is instrumental to us nurses to get our jobs done properly. If I hadn't worked as an aide prior to becoming an RN, I would not recognize that it takes enormous amounts of compassion and selflessness to do that job, and they get ridiculously underpaid. I also work on a psych unit, so I understand the need to be decisive and brusque sometimes.

I graduated in May of 2014. I was hired at a local nursing home in November as the "flipper"....to relieve each full time overnight nurse for their weekends off. The pros? ~Awesome coworkers ( for the most part)on my shift ~getting to know all of the patients on my floor intimately ~gaining much needed practical nursing experience ~Night and weekend differential pay The cons? ( I really wish there weren't so many) ~too many patients to spend enough quality time with any one of them ~way too much paperwork and busywork that takes me away from patient care ~too many overtime hours being given to full time people who have no business caring for patients with that amount of sleep. ~Certain nurses making mistakes on the regular that EVERY other shift has reported to the manager and DON. Yet no disciplinary action has been taken and this is the person who regularly has 30+ hours of overtime on the books. ~My fantastic aides who regularly work double shifts being forced to stay longer because day shift NEVER shows up on time. (with no apparent repercussions) ~having to continuously get up while I am trying to finish charting/count off/give report at the end of my shift to answer call bells and alarms even though the charge nurse and unit manager are just sitting around chatting. ~The insinuation that my aides are lazy because they have 10 minutes to sit down and complete their charting. God forbid an aide ever be caught sitting down!! Even if they're doing the job that are supposed to do. I am grateful to have this job, don't get me wrong. It is a lot of work, but I welcome it. As a brand new nurse, I want all the experience I can get. But I feel like I am never going to be successful in LTC. It's depressing. I don't like having to wake someone up just to give them a couple of Tylenol. I think the amount of paperwork is absolutely redundant. Isn't there a more efficient way to get things done, short of adopting an emar? We waste so many hours just to do changeover.....it's ridiculous. Also, in terms of that "nurse" I was referencing earlier? She is so unsafe. She never does treatments or skin checks, but documents that she does. She pre-signs her MAR. She makes TONS of med errors. She talks down to the CNA's.....apparently she thinks it's above her pay-grade to change or toilet patients. She will literally walk away to find a CNA to do something that would've taken a few minutes. This is not new information for our administration. They know all about it. I don't think there is a nurse or aide in the whole facility that hasn't expressed concern about this person. Yet, she continues to pull at least 40 hours of overtime. Not to mention that she is downright rude to the patients themselves. It's clear in her interactions with patients that she has NO time for them. It's all about the med pass. Sorry that I digressed. But it pisses me off. Either way....I have 5 months under my belt at LTC. I have learned SO much. But I feel like the longer I stay in this type of environment, the worse off I'll be. Any and all advice is welcomed.

I am also in LTC...new grad. I am so disillusioned with this being my first experience in the nursing field. I am beside myself at how my facility is "operated". I'm sure we share similar experiences.

I am a Nurses Aide, as well as a nursing student. There have been times that I have been the "lead" in the care of a patient with an RN. I don't think that is a bad thing. If the nurse isn't comfortable doing something that I am comfortable doing, I am glad to give tips and pointers. I feel that patient care is a team sport, so to speak. I am grateful for the hands-on patient care experience I am getting right now...but I realize that not all new nurses have that experience. Like I said, team-work is key. They can teach me while I teach them. It's a win-win situation in my opinion. And the patient benefits as well.

not acute care....geri psych. The nurses on my floor are unbelievably competent. I was not saying otherwise. I know they are responsible for so much, and they do a LOT of work. Besides that, they NEVER make us CA's feel like we are invisible. I am grateful to work on a unit where the nurses appreciate us and include us in report and other patient care. I feel like a valued part of the health care team every single day. I guess that is a rarity. I was speaking more in general terms...considering my fellow clinical associates complaints. (not people I work with)

As a CNA, I completely understand. I see the nurses on my unit doing all kinds of work. Mostly paperwork, i.e. charting, etc. The rest of the time they are passing meds, which is really time consuming. As a nursing student, this gives me some much needed perspective. I am getting into the nursing field because I want to help people. Clearly, working in a unit such as mine is NOT the place I want to be. I do not want to be a rolling pharmacy. I want to be hands-on, provide bedside care, and so on. This is the main reason I want to go into trauma, or anesthesia, or some other high-energy job. I want to be challenged every day. I don't want to become complacent.

I want to thank all of you who have taken the time to read and respond to me. It means a lot. I will take your advice to heart. All of it was well thought-out and expressed in such a compassionate way. You have shown me new ways to think about and consider my decisions regarding this. I think I will try some other fields first, and possibly take a foray into the NICU. Just to see if it's something I can handle emotionally. If I can, I am sure I will be an asset. But if I can't, I'd rather know sooner than later.

I gave birth to a son 9 years ago to the day. He was a 25 weeker and didn't make it past 12 days. The nurses at MGH are more than half of the reason I am pursuing nursing. I have busted my ass to get here. I have sacrificed everything, even at the expense of my other kids. I want to be a nurse. I am going to be a nurse. I am going to be the BEST nurse that I can be.Those NICU nurses were and continue to be my greatest inspiration. I really want to work in the NICU. I know I am biased. I also know it's probably not a good idea for me. I still want to, though. I want to be there to take care of other people's precious babies. I've long ago come to terms with my own loss. I am not bitter about it. I want to help other people bring their babies home. I think that my experience/bias is a good thing in this type of situation. Do any of you have ideas for me? Where I can apply my passion without compromising patient care? I want to help people. I especially want to help moms that were in the same dark place I was after I lost my baby. To me, being a nurse is a multi-faceted job. I never want to deny the part of myself that feels empathy for my patient. I also never want to deny the part of myself that identifies with my patients. I realize that I am walking a thin line. Aren't we all?