Emily456

I actually had a very smooth transition in the LPN to RN program. My school used to require nursing students to get their LPN before entering the RN program. Recently they began accepting "direct entry students" (students with no nursing background). Our school requires us to take specialty HESI's and an exit HESI prior to graduation. The only people in our class who passed first try are those who got their LPN before RN. I think for an ADN nursing program it is more beneficial to get your LPN first. Only because you learn the basics of nursing in LPN school. You learn the knowledge and skills of nursing in LPN school, and then learn how to critically think and apply that knowledge further in RN school. Whereas direct entry students are being forced to learn all of the basic knowledge, comprehension, critical thinking, and application in just 2 years. That's quite challenging. So, like I said, my transition was very smooth!

Hello everyone, So I'm about 5 weeks from the end of my RN nursing program. I'm going to be graduating with an ADN and already have chosen a bridge over program to further my education so a BSN. Working as an LPN, I've truly come to love being a nurse. I've had some awful days and some great days. I truly do have a passion for this field. However I've only been an LPN for about a year and a half so I don't have tons of experience. Over that span of time I only worked in skilled/ assisted living facilities. And while I love getting to know my residents over time, I often times find myself bored. Geriatrics is my comfort zone. I finally feel like I've gotten a hang of this type of nursing. But when I'm at work I don't feel like I really get to use my critical thinking skills to their full extent. I love having the time to think things through and focus on what is going on with my patients. Which is very hard to do considering I manage 38 patients while at work (yikes). I feel like I'm just a robot passing pills all day. This is why I loved my ICU clinicals because I had less patients, and more unstable patients with complex problems. I really had to think everything through which is what I love. So my question is, what type of nursing do all of you experienced nurses recommend I start out in? I know ICU isn't likely, unless I do a nurse residency program (which I really want to do). Any suggestions for different types of nursing that I could try out based on my interests? also, I know that hospitals are starting to eliminate ADN nurses. So will places still hire me as long as I'm working toward my bachelor degree? Thank you in advance!

Thank you for your reply. So does this mean that I cannot get hired in other states with my active RN license? Or does this mean that I cannot continue my education in another state?

Thank you all for your suggestions. They were very helpful. Unfortunately my efforts to use them were never successful. This patients family came to visit for a week. After they left the patient lost it a little bit. Pt. became very aggressive and actually pinned me against a wall and hit several of my co-workers. The patient also got in several verbal/aggressive arguments with other patients. And almost knocked down 2 patients using walkers, forcing the Paramedics and cop to restrain them before they took the patient away. Very sad. Pt. went to the hospital and was then admitted to Geri psych, and never came back.

Thanks to all who replied. Just so you know the outcome, we actually set up a smoking schedule. And we also found out that we actually are allowed to let the patient smoke in the court yard. So, the patient no longer needs an escort.

Hello everybody! So I've been working as an LPN for a year and a half now. I am also attending school to become an RN. I've got some questions and concerns about applying for a license in a different state. So before I went to LPN school, I applied to Kent State University's 4 year nursing program. Unfortunately, there was a huge waiting list that was going to prevent me from starting for 2 years. So I decided to go to Fortis College to get my ADN and to then do a bridge over program to my BSN through chamberlain college. Now I am 3 months from graduating, and I recently got engaged. My fiancé has gotten several job offers for hospital administration positions, but they're all out of state. So it looks like we're going to have to move. I'm a little concerned about being approved for licensure in different states. The states we're looking at include North and South Carolina, Tennessee, Kentucky, and Virginia. I know that my school is ACCSC accredited. And when I applied they told me they were fully accredited. But I don't think that I fully understand what this means. I believe that ACCSC is a form of national accreditation. So does this mean that my nursing education will be sufficient for their requirements? Also, is my application for licensure likely be approved after I pass my boards here in Ohio? I've done a lot of research but cannot seem to find an answer.

Thank you, TheCommuter, I agree that it's a nasty habit. But thank you for your reply. It was very helpful. I will have to collaborate with my colleagues to see if we can set up some kind of a schedule.

So I work at an assisted living facility. And we recently got a new patient who smokes. Initially when she came they let her smoke in the courtyard. Eventually we found out that this is not allowed. She is an elopement risk (is very unhappy that her daughter put her in our facility) and attempted to elope 3 times the first day she was admitted. So now we have to take her in front of the building to smoke and sit with her until she's done. I've got 40 patients. My job as a nurse is to heal. Not to take people outside to smoke. I am also a non smoker, and hate to be around it. It's very irritating to my throat. Sometimes my aids take her out because they are smokers as well. The patient gets very irritated because often times we're extremely busy and can't take her outside immediately when she demands it. She screamed at me because I couldn't take her out because I was meeting with a patients family. She came to my office and screamed at me, in front of the family. My question is, do I have the right to refuse to take this woman out so smoke? I don't have time, and I don't feel that it's fair to have to expose myself to second hand smoke when I should be caring for the ill.

I wasn't grieving at the bedside with the family. I sat with the wife, who is also my patient, because she was very upset and distraught and was asking questions. And her family had just stepped out. I didn't feel it was appropriate to leave her all alone with so many questions. Exactly, it's my job to support my patients and their family. She's my patient. So I will have to completely disagree that this was "overstepping boundaries". I have 40 patients. So my lunch break was the only time I had to sit down with her to offer this type of support and answer her questions. I understand the medicating off the clock comment. I would like to know what you would do, however, If you had a patient who was dying and suffering and you aren't allowed to clock in early and the family is sitting there begging you to make their father comfortable. No night shift nurse. Hospice had nothing in their lock box. This was a special circumstance. I'm not going to stand in front of a family and say "oh sorry you'll have to wait 20 minutes until I clock in".

Graduatenurse14, I'm very aware that Giant Eagle is a grocery store, thank you?

I think it's a very legitimate question. I was thrown off by this in my first interview. But then I got on the floor and I understood why. You've got to know how to delegate, manage, support, and work together with your CNA's/RCA's/STNA's, what have you. When I first became I nurse (just a year ago) I learned the hard way, that you can't let your nurses aids walk all over you. Because things simply just won't get done. Don't get me wrong, you cannot dictate them around and speak condiscendingly to them. Nurses aids and the unknown Angels of the nursing world. They're your eyes and ears, and they know those patients better than anybody else. So treat them that way. You've got to work with authority, and as a team. knowing how to work with your aids in a way that they respect you, get things done, but also feel that they can come to you is incredibly important. í ½í¸Š

Kali_Dreams thank you so much for you reply and advise. I appreciate it. That's what I'm leaning toward

Hello. I work in an assisted living facility. I've worked there for only about half a year. I've got two patients: a husband and wife who lived in an apartment together. On the shift 3 days ago, the husband began to decline. yesterday, I came back into work and he was actively dying. I was the only nurse to truly take care of he, and his family, during his decline (we don't have a 3rd shift nurse, because we are assisted living and he really got bad over night). So as soon as I got in, even though I was off the clock, I medicated him immediately. Unfortunately he wasn't able to take mess PO anymore, so I had to give oxycodone rectally and the Ativan sublingually (due to its ability to dissolve easily), per his hospice nurses directions. I was doing my best to get liquid morphine for him all day. I hounded the doctor until he wrote the prescription and sent it right away. And called the pharmacy as soon as he sent it to make sure that would send it out IMMEDIATELY. Unfortunately pharmacy is 3 1/2 hours away and have no back ups. So I had to medicate him rectally and sublingually until they could deliver. All day I checked up on the family, especially his wife because she is my patient is was struggling tremendously with the pending loss. I made sure I was in the room every 2 hours, on the dot, to medicate him and make him as comfortable as possible. When my lunch break came I chose to sit with the family instead. Lots of tears lots of hugs. When the family stepped out I sat with his wife so she wouldn't be alone in her time of grief. At the end of my shift, the family called down in a panic. I felt for a pulse, listened for respirations. He was gone. They all hugged me telling me how thankful they were and how I was a great nurse. (I am a new nurse. I'm only 22. So I think they were surprised with how empathetic I was). This is why I became a nurse. I was to help people. And although this situation made me incredibly sad, I feel honored to have been there when this wonderful man left the world. And I feel honored to have been there for this lovely family in their time of need. My question is, is it appropriate to go to the funeral? When my grandfather passed, all of the nurses came and my mom was very touched.

I agree with you Saiderap and here.i.stand, it's not safe for her. I've expressed concerns. But I think it's time to go to the next person up. Because something needs to be done, and nobody seems to be taking the nurses opinions seriously. All that's ever said when I bring up this problem is "well census is low". It's sad when money is the main concern. They'll tell us it's not big deal, and that we can handle it, until something bad happens. Then they'll throw us under the bus.

icuRNmaggie i have been thinking about finding new employment.

Yes, I do have 2 RCA's on staff. And if an elopement occurs everyone in the facility knows to come running. I am aware of the poor staffing. And I've made many complaints. Unfortunately I get the same answer every time. "Well census is low and we gotta take what we can get". This is an assisted living facility that seems to be turning into a nursing home or dementia unit. My patient does get seroquel and Ativan. One PRN seroquel and another scheduled for 4 pm. The Ativan is at 2 pm. I've documented all behaviors. And notified the doctor and family. The doctor has come in and I have him read the behaviors. It took 3 months of nagging from all of the nurses to get him to agree to even order the Seroquel. He's always very hesitant to order any type of antipsychotic medication or narcotic. The family is considering switching physicians, but haven't come to a conclusion. My patient does get aggressive. I have another very confused patient who carries a baby doll and my patient has tried to push, hit, and rip the baby doll out of her hands. My patient slams the door yells and insults us. I can handle that. I will read up on the protocol. I guess it just doesn't seem right to leave my other 40 patients behind with nobody, some of which are incredibly confused. Considering that she is a sun downer. So only me and 2 RCA's are on duty after 2 pm. By 6 all administrative positions are gone, which is when it really starts to escalate. one thing that really helps to distract her is to talk about her grandson. "The baby with big blue eyes". Also to invite she and her friend to fold napkins. But when she really gets going, there's no stopping her. As for going along with her delusions, I do do that with her and it works. I guess my problem is when I'm in a med pass, she won't take her pills, I have to give insulin, flush peg tubes, do treatments yadayadayada... And then she's trying to escape im getting phone calls and orders, and my other patient is trying to pull the fire alarm. I hate to say it but sometimes I just can't find the time. Nurses keep telling me that I just need to accept that this is how it is in long term care. And I guess I do have to accept it. It just doesn't seem fair to me, or the patients, that I cannot devote as much time to them as they need me to. Because I'm working in a facility that has patients like a dementia unit/ nursing home that need extensive care, and we're still staffed like an assisted living facility

Hello everyone, i am am a new nurse. I've been working in long term care for about a year. I am currently working in an assisted living facility. I have an incredibly aggressive dementia patient whom which I am having a very difficult time controlling. The patient is very mobile. They can dress them self and feed them self. In the morning to early afternoon, my patient is very calm, but about an hour after lunch becomes very aggressive. The patient begins with asking the same question multiple times. Like "how would I go about getting to giant eagle". Next, they patient becomes paranoid. We have the patients hearing aid charger in our nurses station. The patient will come in and say "that has my name on it, you stole it from me". Next the patient begins tearful saying that they want to go home. And "why am I here I can take care of myself". I do my best to distract them. But unfortunately the distraction only lasts for about 5 minutes and the patient is back at it again. The facility is small. So only one nurse is onl duty at a time. So, with 40 some patients, I don't have the time to distract the patient every five minutes. After a couple hours of distracting, the patient becomes aggressive. Yelling at the patient and staff that they need to go home. Requesting to call the daughter. Which, if I have time, I call the daughter. And as I'm telling the daughter what's going on before handing over the phone, the patient is yelling "it's me! She won't let me talk to you!" Finally, the real problem is the end of the day. When the patient starts standing by th door saying that they are going to leave. Our doors must be held down for 15 seconds before they open (without a code) and then the door opens and an alarm goes off. My fear is that my patient will hold the door down long enough and get out. I know the elopement protocol. But I don't know what to do with my actual patient when they get out. Everyone says "well try to coerce them to come back inside". But with this patient it's impossible. Am I supposed to call 911 and follow the patient down the street until they show up? But then I'd be neglecting my other 40 some patients. I'm not allowed to touch the patient and physically carry them back in. What am I supposed to do if they get out and I witness it? Follow my patient or no?