AnnetteLPN

I've worked at about a dozen local facilities through my agency, and the majority use terry cloth bibs with either velcro or snap closures on them. Most of them are brightly colored and when on, simply look like towels. Even the better "minded" folks don't seem to mind them (the ones who do, simply don't use them or fold them on their laps like napkins). They are great because they are super absorbent, and really keep people clean. I've been to one place that uses disposable paper/plastic backed bibs (on a large roll similar to paper towels) that were just awful! Didn't absorbe a thing, and they had to tie on, and we often had to cut them off people because the plastic tied such a tight knot. ------------------ Annette, LPN from Massachusetts

I know this is a late reply, but here goes. I"m in Massachusetts, so I don't know about NY but.. Most LTC's start LPN's around 16-18 per hour, days, as new grads. Add a little if your'e experienced. Add $1-$3 for eve/ night/ w/e differentials. Per diem rates (if you are a facilities own per diem staff, that is) are around 18-22 per hour with no bennies. "Agency" (with health/dental and 401k) start at $22-25 per hour days, add $1-3 for differentials. I currently work "agency", working for about half a dozen facilities or so, earning at the lower end of the rates I stated above, because my agency is very flexible and always backs me up. I could make the $25 if I wanted to go to an agency with less scruples and no support. ------------------ Annette, LPN from Massachusetts

I would think that a refusal by a resident should be considered a toileting attempt, at least. If I"m not mistaken, the Medicare rules take "care" or "assistance" of the patient into account (in whatever language it uses)... Let's face it, it's the patient's right to refuse, but we have to make the attempt or the offer to toilet. If they say "no", we are still doing our job. Ask your DON how to document such efforts. There has got to be a way, as long as you document SOMETHING, since that is what gets the bills paid. ------------------ Annette, LPN from Massachusetts

Two points I'll add.. First.. Not all LPN/VN's can get into a hospital. I've been licensed 11 years, and here in Massachusetts, they simply wont' hire us! Second, I'll agree with the majority here. Not a good idea to take that night shift position as your first job. I know a nurse who did just that, and believe it or not, after 2 years in the position, she had no idea that she should have called the MD when one of our patients complained of SOB, had audible wheezing, and an O2 sat of 82%.. This was 2 years after taking the position.... So, it goes to show, even after you think you can handle anything, there are things you miss, or simply don't know/ realize unless you have others to work with and learn by. I know the original post was months ago, but I hope all is well! Good luck, Annette