rpsychnurse

I'd have to see the patient to give any specific advice, to be honest. That being said- I wouldn't use a 1 1/2" in the deltoid in your situation. I've hit bone with a 1" on a frail elderly man before. Go back to the pharmacy and ask for a smaller needle if you're set on a deltoid injection or ask for teaching on ventrogluteal injections- they're pretty simple as long as you know how to landmark.

I'm in the same boat as you! Complete introvert here and I feel like 80% of my job makes me uncomfortable because I have to deal with people. I don't have much for advice- I just try to make the most of my alone time on breaks and at home. I also try to do anything alone at work that I can. For example, lots of the staff chart together at a big table at the end of shift. I sit at my desk and chart on my own so I don't have to visit with them.

Don't blame your previous company or tell stories about how bad it was. It doesn't matter if it's true- most people won't care unfortunately. If they ask why you left it's enough to say that it wasn't a good fit with your values or something along those lines. In my opinion leaving one job shouldn't be too much of a black mark. Good luck!

I haven't been in your position - at all - but I thought I'd chime in because no one else has yet. I have a little baby (9 months old) and I went back to work when she was 6 months old. I think that if you have a lot of support, mostly from your husband, you can succeed at this! Especially because he can stay home with them at times. Are you going to be working on top of school? That may be harder. However- if you're going to school and treat it like your 'job' and ensure you have adequate alone time to study I think you can do this. Good luck!

Med errors are not uncommon and not unexpected. Be honest with your preceptor when you go back so she can help you work to prevent any future errors. What happened to make you think you made an error? Figure out what you can do differently next time! For what it's worth, I've made my fair share of med errors and have only learned from them. If you are honest and work to prevent them I don't see why you would ever lose your job or licence. Good luck!

As a Registered Psych Nurse in Canada I just want to chime in! If I could go back I wouldn't take the RPN program again. It really limits your future as a nurse and I'm regretting it now. I would go for your RN and then work in psych- you'll have much more flexibility. Good luck!

Our docs will occasionally prescribe PRN antipsychotics without a scheduled dose and I think it can work quite well at times. Talk to your doctor about it- why does he do it? Just because it's a big push to get rid of antipsychotics doesn't mean it's always the right thing.

You've had one shift. Just one. You should feel overwhelmed! You're not expected to get it yet! But it will come quickly- don't worry! Write down questions you have, ask for help whenever you need it. Watch how the other staff get through the shift- you'll learn from them! Take a deep breath and do yur best. You can do this and, trust me, it gets better.

Hey! I've never had a peer interview but I would try not to stress. It sounds to me like you did well in your initial interview- otherwise they wouldn't have scheduled the peer interview! I imagine they will mostly want to see how you communicate with other staff members and they may ask you some more normal interview questions. Just be yourself!

I completely understand where Amber was coming from- but I think she should have handled it better. Just hanging up on the other nurse was quite rude. I think she should have explained her situation to the other nurse and told her she would call back in ten minutes. Or she should have pulled Tiffany from her assessment to help with the more urgent patients. I just don't think she communicated as professionally as she should have.

I set a couple of alarms (just in case- I'm often up by the first one) and have my Keurig auto set for when I wake up so I can make coffee right away! I work exclusively day shift (0645-1500) so I guess I'm just in a pattern by now. I also have a baby who is an earlybird- she doesn't sleep in much past 0530 so she makes sure I'm up in time! If I've gotten little sleep the night before I load up on coffee and snacks (not healthy, I know) and try to talk to people as little as possible at work!

Are you asking for which medications are given at bedtime AND affect blood sugar at the same time? Depends on whether or not your patient is diabetic! Lantus/other long acting insulins, some sliding scale insulins and oral antidiabetics could all be given at HS. I would ask your instructor- I don't understand why you would just need to know a list of these medications. Knowing what an HS Lantus or Humalog would mean for the patient is a different story.

That sounds like a poorly done admission! Usually we have med orders before the patient even gets to us but if we don't I will get them from the on-call doc. I wouldn't give anything or enter anything without orders, personally.

I would recommend speaking with your manager about your concerns and, if she continues to accuse staff, I would go to her higher ups with the situation. Best of luck.

Regardless of why you left your previous jobs I wouldn't lie about them to future employers. You could omit them from your resume- but if a future employer asks about where you have worked previously I would tell and and just explain that you left as it wasn't a good fit, or something vague like that. It sounds like you have insight into your illness- it mat be a good idea to talk with your therapist (or find a therapist) about the stresses you've experienced at work so they can help you cope and advocate for yourself if needed. All you can do is keep applying for jobs and show them your best at interviews. Be honest but don't share all- employers don't care to hear about past drama (in my experience). I think you've gotten some good responses here- there's not a lot we can do to help you other than to encourage you to keep on trying. Good luck!

RPN checking in! You would not be able to get licenced as an LPN as far as I know. However- you could apply for LPN positions in areas you're qualified to work in (everything except peds and obstetrics), I suppose. I can't imagine you'd have much success... You are definitely qualified for RN positions as long as they aren't in peds/obstetrics though. Lots of employers don't post jobs for RPNs specifically- they usually post for an RN but you still would likely qualify.

I just want to chime in and say that you may be disappointed if you think you won't have to do all of those things in assisted living. The patients aren't as acute, but you have more of them and far less support staff than hospitals. You won't (likely) have an RT or wound care nurse available - maybe by phone or email. You'll be doing meds, treatments (including wounds and nebulizers!) for a lot of patients. The grass isn't always greener- assisted living is tough too.

We have 50 beds and are staffed quite well, in my opinion. Days: Two LPNs (they split meds/treatments for all residents, one goes home at 12), one charge RN, and 7 HCAs (6 take assignments and one does the baths). Evenings: One LPN and one RN (they split the patients), 6 HCAs(2 only work 6 hours) Nights: One RN and one HCA(this is poorly staffed in my opinion- I'd love to see two HCAs on nights).

I know wood anything in our hospital is frowned upon by IP&C - because of its porous nature I think.

I feel incredibly safe reporting errors/near misses/incidents of any kind. I do work in Canada, however, and I think we have it a bit better here in this way. We have a great online reporting system for incidents affecting patients where you can choose to remain anonymous to your direct manager - I've never known anyone to feel the need to do that though. I find that our health care system works well with staff to deal with adverse incidents. We are also unionized throughout my province, which is another huge help.

You'll become more efficient with time- don't worry! Co-workers faking vitals and blood sugars is very serious. I would report it to your superiors and don't fall into it! It will take a hell of a lot more time to deal with a patient in DKA because you faked a blood sugar than to just check it in the first place. If there are vitals/blood sugars that you feel are unnecessary, ask the physician to decrease them. Otherwise- they're there for a reason. My thoughts- ask pharmacy/physicians to change some med times to make your pass easier. Having so many times sounds really tough- and I can't imagine it's necessary for all the meds to be staggered that way. Trying to decrease interruptions- especially as you're still learning- is a great idea. You'll get better at prioritizing as you go! If it is a no-urgent PRN request- make a quick note of it on a scrap paper or brain sheet and say you will pass it with their regular medications when you get to them. Try to avoid other distractions- delegate as much as possible to care aides/other staff. Patient is requesting an attend change? Delegate. You don't have time for that during your med pass. Patient asks you to go get a warm towel for them? Tell them you can't right now but if they can ask their care aide they will help them. Definitely ignore the phone calls if they're not your explicit responsibility. They will call back if it gets missed- trust me. If that isn't possibl- ask your manager if you can get a portable phone to carry with you. Honestly, it sounds like you're managing really well to me. In time, as you get a routine down and are more comfortable in your job things will go more quickly. Something I try to remember is to give important meds (insulin, time-sensitive meds, etc) first and then worry about the rest.

I have no experience with agencies but I would recommend applying for jobs in rural areas to increase your chances of a callback. Good luck!

I'm going to agree with charting- it's so time consuming! Also- phone calls and processing orders. We don't have a unit clerk and it's an insane amount of work on top of everything else I have going on. If I could just get rid of the clerical stuff I would feel so much less stress.

You're completely entitled to your opinion about LTC- but I found it a bit offensive that you said LTC doesn't require critical thinking. I'm not sure where you worked but as a charge nurse in LTC I'm critically thinking all day everyday and - my job is definitely not tedious! LTC patients have numerous diagnoses and countless medications to keep track of. Trying to assess a dementia patient who can't answer your questions is incredibly challenging. Trying to manage emergencies with little to no support (no in-house doctors, RTs, code teams, etc.) takes a lot of skill, in my opinion. Just wanting to point out that LTC can actually be incredibly challenging and isn't just "basic", "tedious", or a "bad career move". The geriatric population needs quality care just like anyone in the hospital. And to address the actual thread- yup, staffing sucks in LTC. That I wholeheartedly agree with. We are expected to provide high levels of care with minimal nurses and aides and staffing seems to keep getting cut while patient acuity rises. I adore my job but it breaks my heart to see the stresses my co-staff deal with due to poor staffing levels. And I think our facility has it pretty good compared to a lot of places. It's a system wide problem and I definitely don't have an answer.

I don't know if nurse manager means something different where you are located but here a nurse manager takes on significant responsibility. Usually years of experience is required- I'd be very wary of being offered a management position as a new grad. You don't have the experience to perform as a manager yet, in my opinion. I would urge you to look for something else- management isn't something you should go into lightly and it doesn't sound like it's something you really want anyways.