txnurse01

Does anyone know the most effective way to deal with career burn out. I've been am lvn/lpn in ltc for 12 yrs now. I can't afford to go back to school. I basically do the same things as a RN and am smarter than a lot of RNs that I come across who seek my clinical advice. The challenge is gone. The demographics of ltc has changed as its no longer filled with strictly elderly but now has a lot of middle aged younger residents with psych issues that are far more demanding. Plus the state has us bogged down with so much paper work that nursing care isn't as good as it could be. Gone are the days of grattitude from families who don't see it as a team effort but will get in your face over the smallest things. I feel trapped as its all I've known for the last 18 yrs as I spent 6 as a Cna.

Being a threat to himself or others should get him an auto at least 24 Hr psych evaluation in a hospital. Once he becomes violent he has given up his rights. The rights of one ends where another's begins. Poorly handled

Gotta have a telephone order for everything. Lazy nursing on part of the weekend nurse for not having investigated but correct in that no order was written.

Paramedic doesn't technically the physician they are getting orders does after the set numbers of drugs and compressions are done with no affect.

I do. I believe in CYA but also if its not affecting me then why bother. As long as pt care is done. I just learned that the hard way

Oh and on the pain Med issue. If her defers to his wife's judgement then u have to. However if he is of sound mind then u have to follow what he wants. If he wants pain meds then he facility must follow his wishes. Sounds like she just doesn't understand his situation and the unlikeness of dependance. She may end up being asked to leave cuz patient care comes first. Sounds like maybe sum good education may be a good place to start.

Cut the wafer for the ostomy as small as possible to try to keep off he dressing, if hats an issue. Try putting skin prep on the skin prior to placing he wafer on the skin.

Lvn. 12 yrs, but I'll get my RN soon. Lol

Yes they do. Yes it does. I like to sort thru the draw reading the card and read it and u can get an idea if its due he. Once all suspected meds are out then go by the Mar putting them back in as u go. Im happy if my Med pass takes less than 1.5 hrs, lol

Been in LTC 12 yrs now. Sadly it is a lot of sink or swim. See if u can find a mentor nurse there. Someone that can show u the ropes. Tell them you need just a little guidance on paper work. Doubtful you'd get any more days of orientation. Just ask a lot of questions till u got it.

The lvn should be held accountable as h was he one that stated he took care of the orders. As an lvn I do not consider an RN I work with as my supervisor unless they hold the title. If the person came from home a home list would probably be all the had. I imagine a hospitilization and updates werent reflected. However a nurse manager should have caught it the next day as they should have been double checking the orders. Sad but some do hold RN up to a higher standard and it sounds like your supervisors do. Just do at least the Med part yourself from now on.

You call the person whatever it is they prefer and are comfortable with. For instance if a Dr Smith wants to be called by his first name David, then call him David.

The situation dictates that n order to be compliance with regulations that a nurse manager would need to b notified and Tj medication be picked up at a local pharmacy using petty cash. Many contracts with the pharmacy used by the facility do not include otc themselves. Needless to say it would need to be handled quickly and need to be looked atwhy he central supply is unable to keep the place stocked.