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rpsychnurse's Latest Activity

  1. rpsychnurse

    Restorative right or wrong??

    It sounds like your restorative program really needs a leader! Is there someone who is in charge of it that you can pose these questions to? (We have an OT and a Home Care RN who are our 'leads') I would say if the resident is A+O you can absolutely take their word about exercises - just ensure that you chart properly to reflect that! The reasons residents who can independently perform ROM are on a program could b a variety of things and that would be for the rehab team/OT/PT to assess. Perhaps they are weak and they are doing the exercises for strength. Maybe they are getting close to D/C and will have to do them on their own at home. Have you ever been to PT? They often send independent exercises home with patients. It sounds to me like yur program needs better direction and more specific care plans though. Bring it up the chain if you can!
  2. rpsychnurse

    Pregnancy and nursing

    One concern I would have is whether or not you will be able to take time off for the delivery/recovery. Many nursing schools have strict policies regarding absences and you may run into a problem. I would talk to the school about your pregnancy now and try and work something out. Otherwise it may be a good idea to delay your start by a semester. Congrats on both the pregnancy and on starting your nursing career! Good luck!
  3. Hey all. So- I've been in my job as charge nurse of a long term care facility for just about a year. And recently I'm finding that I'm complaining more about work and that I'm becoming more short-tempered and frustrated. I'm having many more bad days than good and I hate that. It doesn't help that I'm 30 weeks pregnant. Lol. I just find that I'm struggling with empathy. We have a patient who is completely inappropriate but has no where else to go so we are stuck with him. Basically - he was homeless with alcoholism. I have no idea how he got into the system but he did and now we have to manage him. He refuses to follow rules- always drinking and smoking in facility despite our numerous attempts to provide him support and resources. He just doesn't care- he just wants to drink all day everyday. He is belligerent and rude to staff. He is demanding and entitled. Now- I'm a psych nurse. I get addictions. But I'm not working in psych and I'm sick of putting up with him. I have no sympathy, no empathy, and I find that I'm snapping at him sometimes and being less caring, which isn't fair. It's not my job to judge him, just to provide care. But I am just so burned out with his care. That's one of the biggest problems I have. But also- I find that I'm really struggling to deal with rude and demanding families. I used to be able to brush it off but lately- I just get so frustrated. I don't take it out on them- I think I'm still very professional but it's affecting me personally. I go home stressed, angry, and exhausted. My workload is increasing and I feel that my staff are not dealing with it. Yes- we have heavier patients lately. I feel it too- trust me. But when I have to run around chasing after my aides to get them to do their jobs - well it just sucks. I feel like my staff are constantly putting things onto my plate and I can't do their jobs and mine too. I come to work everyday to multiple sticky notes and questions and requests. Example- Mrs so and so needs shampoo. Okay?! And you could have called the family and asked them for shampoo in the time it took you to write that note! Ugh. I'm just needing to vent. How do you cope with burnout? Tips for dealing with tough patients and families? Besides crying in the bathroom? How do I leave these feelings at work? Thanks in advance from a nurse who is tempted not to come back after mat leave. Help me get past this bump in the road!
  4. rpsychnurse

    New Grad drowning in LTC

    It sounds like you're taking responsibility for yourself- which makes you a great nurse already. The fact that you can recognize your limitations is awesome! We all - old and new grads alike- have things we don't know. That being said- LTC is a tough place- especially for a new grad! So good job for taking it on! You tend to have less staff and less support than a hospital setting which forces you to work more independently. And- let's be honest- grads need support! To learn and to develop your nursing skills. School gives you the foundation but you learn so much more on the floor. My advice- keep at it. Keep asking questions and doing research on things you're unsure of. The nice thing about LTC- you tend to have the same patients for a long time so you can learn about them in depth. Don't be afraid to ask for help from the other nurses. Heck- I'm the charge nurse in my LTC and I still call my manager for help some days! I know I'm not perfect and that's okay! LTC can be an awesome place to work and learn, but it can be overwhelming. Know that you will become more confident in time- you will become faster/more efficient and soon you will be answering questions. But don't be afraid to move to a different area of nursing if it doesn't work out for you after 6-12 months. Or whatever. LTC is a specialty and it can be tough! I know I said this before but the lack of support compared to a hospital can be really really tough. Sounds like you've got a great attitude though- and that matters the most! Not sure if my rambling post helped or not but just know, I've been where you are and it does get better. But I still have days where I want to cry because I'm so darn overwhelmed.
  5. rpsychnurse

    palliative meds

    I've only seen midazolam ordered once for a palliative patient, and he suffered from anxiety previously. Ativan/clonazepam had had minimal effect on him. Normally we use Ativan if anything. I agree with an earlier poster- SC sites are less painful and easier to maintain in palliative patients than IV sites.
  6. rpsychnurse

    My love/hate relationship with nursing.

    Thank you everyone for your kind responses! Sometimes all you need is some support and feedback to get through the tough days. =) Firstinfamily- your comment gave me a lot to think about, thank you! I've already had 2 cases of pneumonia since I started and I think we have a pretty good set-up but I will definitely stay vigilant in my assessments- I can see how it would be easy to be less aggressive in this setting. And it almost does feel like being fresh out of school again although, luckily, I've got lots of assessment and other skills under my belt so I have more confidence than when I first started for sure. I'm definitely already using my psych skills- I had a resident experiencing hallucinations and I almost felt relieved because I knew exactly what to do. Thanks again everyone, I'm sure I'll be back with more posts =)
  7. I think only you can decide what you are comfortable doing. Good for you for standing up for yourself! I have resigned from a job shortly after starting because I felt they were providing unsafe care- and I would do it again. I need to feel comfortable and competent in my job. That being said- I think 14 patients is actually a fairly low patient load in a nursing home. Maybe a different area of nursing would be a better fit for you? Give it time and you'll find your niche!
  8. rpsychnurse

    Daily assignment sheet

    I agree with TheCommuter. You cannot make your nurse supervisor make an assignment sheet. I can certainly agree that assignments can be very helpful. I would continue to bring up why you feel assignments are necessary to your manager, perhaps citing past successes and experiences. Perhaps try to divy up the work between the nurses at the onset of the shift yourselves. Bring up your concerns with co-nurses an stand up for yourself and your patients! Sounds frustrating- best of luck!
  9. Hmm. My workplace isn't like that- but my job is specifically charge nurse and I do expect the LPNs to come to me before calling the doctor. Not that I don't trust them- they're fantastic!- but we work on a relatively small unit and I usually know what's going on with all my residents throughout the day. I also am the only nurse that liases with the docs and does rounds, etc. I still would never be upset if someone went to a doc without telling me if it was warranted. I guess it just depends on your job descriptions and the structure of your facility.
  10. rpsychnurse

    My love/hate relationship with nursing.

    For a few years, since I started nursing school, I've been reading posts on Allnurses to seek advice, encouragement, and on the hopes of finding someone to relate to. So- I've been thinking a lot about my career lately and I thought I would post about it. Maybe it will lead to discussion, advice, or just give someone something to relate to. I worked in psychiatry from when I graduated until a month ago. A month ago I started a new job in long term care, culture shock much! Haha. But seriously- I have to think in a different way. My priorities are different. The meds are different, the rules are different. And- I love it. I've never been happier. My husband can attest to this. I never thought I'd find my niche- but I think this finally fits for me. For now- I'm a bit of a wandering soul. But regardless of how happy and excited I am right now- I'm also frustrated, terrified, completely overwhelmed, and I still feel anxious most days. Why? Because my decisions affect the health of others. Because I'm still learning about, well, everything! Everyday I learn something awesome and new but everyday I have to meet with the multidisciplinary team and family and I have to be confident, in control, and provide answers. Not to mention I'm a charge nurse- so I have to provide guidance to aides and LPNs who honestly provide guidance to me more often than not right now! I don't really have a point with this post. I just wanted to share my experience and my feelings to hopefully find some kindred spirits. Nursing is fluid- it's changing and shifting constantly. Some nights I have to take a quick "bathroom break" to sob for 5 minutes because my ******* IV won't prime. Sometimes I go home grinning because I made a suggestion the docs went for and I was right! Most nights I go home with my head spinning with all the things I need to do right now to improve life for my residents! I love my enthusiasm and I hope it stays but I'd also like my brain to relax sometimes! In closing- I guess I just want to thank allnurses for helping me through lots of trying times. I've landed in a great place an I'm so very thankful- and I hope to keep coming here (no longer as just a lurker, this is my first post ever!) and joining in stimulating discussion. Am I competent? Do I have graditis? Am I too inexperienced to e in charge? Am I too young? Too confident? Too shy? Do I know enough? All these questions fly in and out of my mind, plus a whole lot more. How lucky am j that there is a place I can come where so many understand exactly how being a nurse is a struggle but also all they ever want to do.