misstrinad

I have worked in LTC doing 8s for 7yrs, we don't do 12s here. I like doing 8s because my entire day isn't shot, I can still run an errand after work and get home when my daughter does and cook dinner and have time to do things in the evening. I also only have .6 bid so it's easy for me to pick up OT. I do about 2 double shifts (16 hrs) a pay period and my OT pay starts as soon as I've been on the clock for 8 hrs. So if I need to stay late to chart or meet with the supervisor I get paid OT wages. If I worked this .6 as 12 HR shifts I would have to pick another 12 HR straight time shift to hit 80 hrs for the pay period, and then pick up more to get any OT pay. I'd rather do 2 16 hrs shifts and 4 8s and get the OT pay. Having a low bid also makes it easier to get time off for all the camping I do in the summer.

I'm sorry, but having had an AC IV multiple times I would definitely classify 72 hrs of an AC IV as a 'little discomfort' and not worth even thinking about compared to the issues that brought the hospital stay on. If the biggest issue a patient has is their IV site then they probably aren't sick enough to be in the hospital. Yeah, it's a pain in the butt, but that doesn't trump the fact that medically speaking everytime a new IV is started there is an increased risk, health risk trumps mild discomfort. Everytime.

You did the right thing. Honestly I would report the facility for threatening you, although that becomes a he said she said unless others have lodged the same complaint. Other facilities I'm sure will be aware of the shoddy reputation , just explain during your interview when it comes up. Any facility that doesn't understand why you didn't accept that unsafe assignment isn't a facility you want to work for anyways.

When I was a cna And started at 6am I used to use a before school program that opened at 530 and was able to drop my daughter off And just barely make it to work. Is there any way you can drop them off at school at 615 and make it to work on time? Or is there a friend, grandparent , sitter, daycare you can drop the kids off at and they can take the bus from there? Otherwise finding a sitter to come to your house in the morning is your best bet...good job for a college student wanting to make some extra cash before going to class. As for the rest of your question......Starting so early is sticky...when I started my first nursing job I started at 7am....luckily my daughter got picked up by the bus at 640 so I had just enough time to make it there. As a single parent I work day shifts....but depend on my family to help me when I get mandated for doubles or need some OT . I would like to switch to the hospital but would have to work swing shifts and wouldn't have a set schedule plus would have to start earlier (and I'm not interested in working in a clinic)....Instead I'm staying at a LTC facility for crappy pay because it is 5 minutes from my daughters school, 12 minutes from home, I work straight day shifts, my schedule is set in stone for am unlimited amount of time, And I don't start until 7am. Until my daughter is older this is what works for us. Facilities have different start times....maybe you need to look into working else where if the other options don't work out.

At my facility on nocs there is 32-50 pts on each unit and only 1 nurse and 2 CNAs and no supervisor or manager of any sort. The noc nurses Handle it just fine. That said, if you walk into work and suddenly they attempt to double your pt load and you aren't comfortable with that then I feel you have the right to refuse the additional pts. I had situation a few months ago were I got floated to an unfamiliar unit and was told that 2 hrs into the shift I would be required to take on an extra 12 pts due to there not being a nurse to cover the other med cart and I refused. It was literally an impossible task to even finish all the meds due during the shift due to my lack of familiarity with the unit. Best of luck and I hope you are looking at other facilities.

We use them at my ltc facility. I have used them on many pts during end of life care and can't say I've ever seen sores. I do alternate them with plain swabs with mouthwash diluted in water and we have a mouth moisturizer paste I use a lot of as well in those situations. I will mention it to my infection control nurse and manager. If you can find the study it would be greatly appreciated.

It sounds like no one there is interested in listening to your concerns and there is little you can prove. I would honestly start interviewing at other facilities and feel them out about advancement opportunities. It's always nice to work your way from the bottom up in one facility but perhaps you could move straight into management at a different facility. Good luck, it sounds like a very frustrating situation.

Oh, get to know who the Coumadin patients are so you can make sure new orders on INR day are followed up on. I don't know about other facilities but we do our INRs in house on a portable then fax to Coumadin clinic then they fax us back with new orders and sometimes they come in late and if the nurse working isn't watching for it and gets it faxed to the pharmacy right away we don't get the new dosage delivered until after 8pm or not at all.

This is an amazing answer, I don't have much I could add to it. As a nurse in ltc I depend on my house sup for anything that happens that I am not sure how to handle. Get to know your nurses. When I was new I was calling the sup all the time with questions that now seem silly. Now my sups know I can handle most anything and they are able to spend more time helping on other units. When you come on shift and make rounds to each unit check for orders that need to be 2nd checked or processed because I frequently see orders written at the end of shift and I don't have time to process them and the on coming nurse can't deal with it immediately. Make rounds a couple times a shift and check in with each nurse in each unit, staff will feel like you are really there to support them if they see you a couple times a shift, even if they don't need you. The most frequent comment I see about some sups is nurses complaining they never see them all shift. Good luck, it's a hard job and you will wear many different hats.

Great post! I loved it.

There's good and bad aspects of working in ltc. I have worked in ltc w alzheimer's patients for over 5 years now (1.5 as a nurse the rest as a cna) I love it but one day want to make the move to the hospital for more experience and better pay. You work your butt off in ltc and the time management skills you learn are amazing. It's great patient care experience and in my area ltc facilities provide a set schedule that doesn't change, unlike our hospitals where your schedule changes every 2 weeks. If you continue to look down on ltc you won't be happy doing it. But perhaps the experience will bring a new respect for the work done by ltc nurses. There are very few things in life more special than taking care of the eldest most fragile population of patients.

Too funny! Just remember not to use real names

When I was a student The hospital I did all my clinical rotations at did bed side report, however a large portion of report was conducted in the hallway right outside the room in hushed tones. We poked our heads in so the pt could be informed of shift change and meet their new nurse and ivs and such could be checked on, but the rest of the info was passed on outside of pt ear shot. I liked the system, however we frequently had to pause and wait for visitors, pts, and non medical staff to finishing passing by so they did not over hear.

I am a nurse that used to be a cna in ltc and I never order my aides around. And I help them as much as I can. I can't stand it when other nurses order aides around that are clearly doing their best and working hard. You need to go to the manager. And next time you tell her "its going to be 5 min before I can get there I am busy with pt x, unless you want to come take over in here for me I have to finish with this pt first and then I'll be right there" If this continues its time to look at switching to a different shift, unit, or facility. Good luck, and use this nurse as the example in the back of your head as the type of nurse you DON'T want to be. It does get easier, in a few more months you will have gained a lot of experience that will help make day to day tasks easier.

I would check into some training seminars either on the web or conference style to assist you. Make sure you get adequate training, including learning the jobs of anyone under you that you have not already performed (at my facility each unit has an rn manager). It's nice to hear your facility is promoting from within and also someone that has worked their way up. Make sure you feel ready for the position. I was pushed to apply for supervisor and manager positions but having only Been a nurse for about a year and a half I refused because I feel I don't have enough experience. Best of luck!