nursechilespice LPN

So this is my second evening shift in a row working with the same assignment (on a CCC vented floor) two of my three patients are in the same room (let’s call them patients A, B and C) I was about 40 minutes late to feed patient A, because patient C was throwing up excessively after suctioning. i apologized to patient A, told him I was with alittle busy with patient C then patient A stated “you know what, I know you’re a nice person, but all weekend you’ve been a space cadet and I’m going to go to the manager because I don’t feel safe.” i asked him why he would say that, and his main points where: 1. Yesterday he said I gave his Advair (that he refused) at 2200 when it was supposed to be at 2000 (implying that I gave it late.) I told him his MAR is scheduled at 2200 but if he wants it earlier I could reschedule it- he was not pleased with my answer and didn’t believe me. 2. Patient B, patient A’s room mate, has g tube feedings- at lunch the day shift nurse is supposed to give patient B three salt packets that’s provided in the daily bags wit the feeds- I noticed yesterday AND today that there was three salt packets and asked patient B if the nurse gave him salt for lunch- patient B said he wasn’t sure, and patient A (from bed, with the curtain drawn, as always) yelled out at me that “he got his salt”- when I said that there was three salt packets from yesterday and another three today, patient A said “well, patient B’s mom was here so he must have got it.” 3. Yesterday when putting patient B back to bed I noticed a sign for the nurses to put a brown soaker for Bowel Routine on Saturday’s- yesterday was Saturday and when cleaning patient B he had a large BM- I asked for clarification if I should put a new brown soaker for patient B and patient B told me that that’s only for the morning shift to do- I didn’t need to. So that made patient A Upset that I had to ask. 4. Patient A was upset that he had to keep “looking out for his roommate” and didn’t like that I was so “unaware” of his Bowel Routine and didn’t like that I was asking questions to patient B- he stated that “you should just know.” I think he just taking his anger out on me. He’s had a bad few weeks personally (family, ex gf, etc) yesterday he barely spoke to me because the morning shift nurse yesterday (new nurse- didn’t know his care) didn’t do things “as he liked” and he was in a horrible mood all evening yesterday- even today as well. he seems more calm and talkative now after, but I’m 100% officially done with patients/ coworkers treating me like a punching bag- I’ve only been working for a year, and whenever things like this arises I turn the other cheek. im not angry, or upset, but Im thinking, should I call his bluff and speak to the manager? Should I let it go since it’s (sorta/kinda) resolved between us? im just concerned that he’ll paint a picture that I’m incompetent. I am not incompetent, but I should be treated with respect.

Thank you for the advice, I scheduled a meeting with my manager, I’m alittle nervous because I’ve never done this before, but it’s gotta be done. He referred to me as a “space cadet” to insult me- like “spacey” or “dumb”

I know it decreases patient risk for falls when two caregivers are present during the transfer of a patient by ceiling/ hoyer lift, but I’ve seen a colleague do a successful transfer (I walked in as they where being lowered to bed) alone. I told them just to let me know ahead of time so I could help them, but it got me thinking- would management write them up (if it was the manager instead of me in that moment) even if there was no damage or injury done? I tried to look into my CCC hospital policy for ceiling lift but I couldn’t find anything... what would management do?

I guess incase of any malfunctions?

Thank you very, very much! I really appreciate the constructive advice

Maybe it’s just depends on where we are all located, most hospitals in Toronto have “brown soakers/ sliding sheets” and “blue pads”

It’s a sliding sheet! Haha we call them that interchangeably here- it’s more dense so any loose BMs wouldn’t soak the entire bed.

Thanks! I sincerely appreciate the insight, When it comes to my personal life, I feel like I don’t have any issues setting boundaries etc. But within my professional practice with dealing with patients, I tend to stop myself in the moment because I’m worried of “saying the wrong thing” in the heat of the moment (such as telling people off... which is what I DO NOT want to happen) I value having a good quality nurse/patient relationship, so I stopped myself and thought patient A was just trying to help- which was wrong, I know. I definitely know this is something I need to work on, which is one of the points that I will be discussing with the manager. Is there any resources you’d recommend to develop this skill?

I have an interview in another unit in the hospital I work at for a full time position, the thing is I have work on my home unit at 3pm and the interview is at 2pm... would it be weird to wear my (clean) scrubs? I’ve only had alittle over a year of working as a nurse, so I feel like i still need to be formal (and dress for the interview) I know a couple of nurses that had 15+ experience that wear scrubs in their interviews... would it be ok for me to as well?

I myself am currently working for a quadriplegic, trached gentleman- been working overnights in his home for a year now, and the past couple months I’ve been noticing his middle aged wife and twenty something kids have been mixing their laundry with his and they leave their dishes from morning to dinner time in the sink and expect me to clean up after the husband as well as the rest of the family- I graduated in 2017 and got my license in 2018 so this was my first job, but I’m debating on leaving soon... it’s a non agency job, so i have to be careful and leave on good terms, but i understand how certain families expect you to do their dirty work when you were hired to care for the patient... hopefully the case manager will be able to clear the air with the family and boundaries will be set for you not to feel that way- you are a nurse, not a housemaid.

Hello there! I was hoping to get some feedback and constructive criticism for my updated resume- I'm working as a RPN now, but I wanted to update my resume incase of any opportunities showing up. PLEASE NOTE: the formatting from word to this website is very off- please excuse this, I'm just looking for feed back about the content I'm putting in my resume. Here it is: PAULINA PETIT (ADDRESS) (Cell Phone) (Email) PROFESSIONAL SKILLS Enjoys working within a team environment Can effectively multitask and be organized Proficient in Microsoft Word, Excel, Outlook, Powerpoint, Adobe, and EPR programs (iView) WORK HISTORY Registered Practical Nurse August 2018- Present West Park Health Care Center 2W- CAVC (Chronic Assisted Ventilatory Care) Provide nursing care for patients requiring ongoing mechanical respiratory assistance (2-3 patient load) Administer medications, perform head to toe assessments, vital signs, inserting intermittent or indwelling Foley's, measure in and outs, documentation, reposition, safely transfer patients in and out of bed, provide bed baths and showers, assist with meals, provide oral and deep suctioning as per best practice guidelines of West Park Registered Practical Nurse June 2018- Present Overnight- At home stay Provide oral and deep suctioning via tracheostomy, perform in and out catheterization and record input/output Administer medications, reposition every 2 hours and perform head to toe assessments PSW- Personal Support Worker May 2017- August 2018 ParaMed Home Healthcare Support client quality of life and health, and support emotional and social needs of each client Assist with ambulation, meal prep, feeding, bed baths, changing bed sheets and other household duties Housekeeping Supervisor May 2012- Feb 2017 Quality Suites Toronto Airport Conduct daily inspections for cleanliness of all hotel areas: public areas, rooms, laundry etc. Ensure smooth work operation so that areas is clean and safe; take immediate action to rectify safety concerns CLINICAL PLACEMENT EXPERIENCE Michael Garron Hospital- East York General January 2017-April 2017 H7- Respiratory Provide independent student RPN care under delegation of RPN preceptor to full load of patients (6-7 patients) Worked 8 hour day shifts with Preceptor for 480 hours for full semester (4 months) Humber River Hospital September 2016-December 2016 9W- Acute Medicine Acute care and provide student RPN care under supervision of RN clinical instructor (3-4 patients) Worked 12 hour shifts with clinical instructor for 192 hours for full semester (4 months) McCall Center for Continuing Care January 2016-April 2016 Fourth Floor- Palliative Care Palliative care and provide student RPN care under supervision of RN clinical instructor (3-4 patients) Worked 6 hour shifts twice a week for full semester (4 months) EDUCATION Humber College Institute of Technology and Advanced Learning Tourism Management- Travel Industry Services (Diploma) Completion: April 2014 Practical Nursing (Diploma) Completion: July 2017 CERTIFICATIONS AND LICENSES College of Nurses of Ontario (CNO) RPN Registration Number: AH021463 First Aid and CPR/ AED for HCP ASIST- Applied Suicide Intervention Skills Training N95 Mask Fit Certification Humber College's Sickle Cell Workshop 2017- Changing the Faces of Pain And that's it! Please let me know what you all think. Thank you for taking the time to read through my resume and responding! Much appreciated Cheers Paulina

I work as a private Duty Nurse for a quadriplegic, trached client over nights 3-4 nights a week, I also work partime at a chronic care facility 3-5 days or evenings. I'm also taking classes to get some certificates to work in acute care and eventually as an RN in the ER. I've been feeling burnt out lately- the private care I provide was technically my first nursing job and I've been there for almost a year- however, its in another city and I travel almost 1.5 to 2 hours to get there for 8 hours work... I've been thinking of asking to work only 2 days a week to give myself a break but the wife of the client (in her late 40s early 50s) complains often how she can't find nurses to work (their insurance pays me) they pay out of pocket for PSWs to come in to help overnights (they are well off, but who doesn't want to save money?) So I feel guilty for asking... I know I shouldn't. my Chronic care facility pays (wayyy) more than their insurance does and it's 30min walk from my house, so I don't want to have my hours cut there... Has anyone else been through a situation like this? How did you resolve and get through this situation? I feel like I'm stuck there. Im a new nurse so I was looking forward to working in different facilities but I feel obligated to stay with them...

Hello all, I was wondering if anyone could read my resume and give me any pointers to improve it and what to add, I'm within my first year of working as an RPN and I want to have my resume on point and ready to go when I need it! : PAULINA NICHOLE PETIT (Address) (Cell Phone) (Email) PROFESSIONAL SUMMARY Registered Practical Nurse with experience in Acute Respiratory, Chronic Complex Continuing Care, Longterm care, and Home Health Care, looking to utilize and expand my knowledge to provide excellent client centered care that are aligned with best practice guidelines. PROFESSIONAL SKILLS • Committed to providing exceptional nursing care by adhering to the best practice guidelines • Committed to protecting and maintaining patient safety • Has excellent time management skills • Able to multitask effectively and remain organized • Proficient in EPR programs such as iView, Citrix, etc. WORK HISTORY Registered Practical Nurse August 2018- Present West Park Healthcare Center 2W- CAVC (Chronic Assisted Ventilatory Care) • Provide nursing care for patients requiring ongoing mechanical respiratory assistance for 22 bed unit (2-3 patient load) Registered Practical Nurse June 2018- Present Private Care – Overnight Stays • Provide oral and deep suctioning via tracheostomy, perform in and out catheterization and record input/output • Administer medications, reposition every 2 hours and perform head to toe assessments Personal Support Worker May 2017- August 2018 ParaMed Home Healthcare • Support client quality of life and health, and support emotional and social needs of each client • Assist with ambulation, meal prep, feeding, bed baths, changing bed sheets and other household duties EDUCATION Humber College Institute of Technology and Advanced Learning Practical Nursing (Diploma) Completion: July 2017 Emergency RPN (Certificate) Expected Completion: May 2020 LICENSES AND CERTIFICATIONS • College of Nurses of Ontario (CNO) RPN Registration Number: AH021463 • First Aid and CPR/ AED for HCP • N95 Mask Fit Certification • Humber College’s Sickle Cell Workshop 2017- Changing the Faces of Pain • ASIST- Applied Suicide Intervention Skills Training Please don't mind the format too much, I just want some insight and advice on what I can change and how to make my resume better! thank you all! -Paulina

Hello! I graduated from Humber's RPN program last year and I was wondering if I get get some advise or guidance- I'm interested in applying for a bridging course for RN. However, I need to upgrade my Pharmacology 2 and Nursing Leadership to 75% to meet requirements. I've messaged Humber and George Brown to see if there's anything or any course I can take to upgrade my marks, but I was wondering if anyone else has been in this situation and we're able to still bridge into RN. I'm currently working as a RPN, I don't need to bridge immediately, but I would like to within 2-3 years. Thank you! -Paulina

Thanks! I hope I do

Congratulations! Be organized- with time, what to study, and be mindful of due dates. First semester will seem overbearing and the majority of the time it's gunna seem like you're teaching yourself- don't give up. Stay focused, and ask yourself or jot point notes of what you learned at the end of every class. Good luck!

Hello! i'm a new RPN grad from Humber College in Toronto and I'm having trouble finding work in my field... It's even difficult to find a casual position. If anyone could please critic my resume and cover letter it'd be much, MUCH appreciated! any advise would be amazing... I'm trying to keep my head up and improve my resume and interview skills, thanks everyone!-Paulina Cover Letter: PAULINA PETIT Address Cell Phone Email Friday, April 13th 2018 Hiring HR Manager [institution name] Dear Hiring Manager, Please accept my application for the position for Registered Practical Nurse at [institution name]. As a new graduate from Humber College's PN program, I had completed my pregrad hours on the H7 Inpatient Respiratory floor at Michael Garron Hospital and have learned much about evidence based practice and client centered care, as well as utilize my knowledge, skills and judgement to prioritize client needs while balancing full patient load (6-8 patients per shift). My current position at ParaMed as a community PSW and my previous experience from the McCall Longterm Health Care facility, Humber River Hospital and from Michael Garron Hospital has greatly equipped me to serve my clients and to provide quality client centered care. I want to be able to keep learning from you and your team so I can one day obtain my RN license to serve a broader spectrum of clients within Toronto. I also plan to one day work with Nurses Without Boarders and the Canadian Forces to help clients worldwide. I truly believe I can contribute to the quality service of care of the hospital. Please feel free to email me at (email) or call (cell number). Thank you for your consideration, I hope to hear from you soon! Sincerely, Paulina Petit (Resume enclosed) PAULINA PETIT Address Cell Phone Email PROFESSIONAL SKILLS • Enjoys fast paced work environments • Has advanced interpersonal skills • Enjoys working within a team environment • Can effectively multitask CERTIFICATIONS AND LICENSES • College of Nurses of Ontario (CNO) RPN Registration Number: AH021463 • First Aid and CPR/ AED for HCP • ASIST- Applied Suicide Intervention Skills Training • N95 Mask Fit Certification • Humber College's Sickle Cell Workshop 2017- Changing the Faces of Pain • Smart Serve Certificate • Customer Service Skills Certificate EDUCATION Humber College Institute of Technology and Advanced Learning Tourism Management- Travel Industry Services (Diploma) Completion: April 2014 Practical Nursing (Diploma) Completion: July 2017 CLINICAL PLACEMENT EXPERIENCE Michael Garron Hospital- East York General January 2017-April 2017 825 Coxwell Ave, East York ON. M4C 3E7 H7- Respiratory • Provide independent student RPN care under delegation of RPN preceptor to full load of patients (6-7 patients) • Worked 8 hour day shifts with Preceptor for 480 hours for full semester (4 months) Humber River Hospital September 2016-December 2016 1235 Wilson Ave, Toronto ON. M3M 0B2 9W- Acute Medicineo • Introduction to acute care and provide student RPN care under supervision of RN clinical instructor (3-4 patients) • Worked 12 hour shifts with clinical instructor for 192 hours for full semester (4 months) McCall Center for Continuing Care January 2016-April 2016 140 Sherway Drive, Etobicoke ON. M9C 1A4 Fourth Floor- Palliative Care • Introduction to palliative care and provide student RPN care under supervision of RN clinical instructor (3-4 patients) • Worked 6 hour shifts twice a week for full semester (4 months) WORK HISTORY PSW- Personal Support Worker May 2017- Present ParaMed Home Healthcare • Support client quality of life and health, and support emotional and social needs of each client • Assist with ambulation, meal prep, feeding, bed baths, changing bed sheets and other household duties Waitress August 2017- Present Brass Rail Tavern • Serve drink orders to multiple tables while ensuring comfortable and enjoyable client environment Housekeeping Supervisor May 2012- Feb 2017 Quality Suites Toronto Airport • Conduct daily inspections for cleanliness of all hotel areas: public areas, rooms, laundry etc. • Ensure smooth work operation so that areas is clean and safe; take immediate action to rectify safety concerns Server Oct 2013- June 2016 Airport Gate Bar and Grill • Take orders and ensure quick, fluid service so that guest experience was pleasurable • Clean kitchen, dining areas, washrooms, patio, staff areas, prep areas, fridges, freezer and storage areas

Thank you!!! Sorry for the late response, I appreciate the critic! I love how you went in full detail!!

What do you prefer? The one step, or two step method?

Hey! Sorry I should have been more descriptive... Within my pn program in Canada, there are two methods of obtaining a BP reading one or two step. Basically one step is just using the base BP reading as a reference to go 30mmHg above to have an 'accurate' systolic pressure, two step is also looking at the base reading, but if there is no base available to palpate the brachial artery while pushing air into the arm cuff, and obtaining a 'predetermined' systolic by going 30mmHg above the point where the brachial pulse can not longer be palpated, then when air is slowly released from the cuff the point where you can feel the pulse is the predetermined. From there you go 30mmHg from the predetermined to obtain a systolic pressure. Sorry for the long explanation! Hopefully I explained well enough

I was wondering if nurses after crushing tablets for a g tube administration, do they ever mix crushed tablets with liquid Meds like liquid multivitamins, or prosource? Or do we mix crushed Meds with water, administer, then after administer liquid Meds?

Hello all! I am currently trying to create a scholarly paper based on my SOAP note based on the following case study scenario (our scholarly paper requires us to add additional things we as nurses could ask the client or procedures we would need to do for assessment that is RELATED to the "topic" or "main issue" of the case scenario... Says my teacher.. . PLEASE! Critic my SOAP note, tell me what I missed, etc. Your help is greatly appreciated! CASE STUDY SCENARIO: "A 17 month old male toddler is due for a checkup and is brought in by his parents. As the practical nurse on duty at the clinic, you are required to perform a physical assessment. At the start of the assessment, the toddler is crawling around on the floor while his parents are preparing a snack of Doretto chips and bottle of juice substitute. You notice that the toddler's weight is written down on his chart as being 32lbs, and has all up-to-date immunizations. The last visit made was at the 1 year (12 month) checkup and it is documented that immunizations are up-to-date. The parents state the child insists on being carried and if he is left to crawl around for too long, he would roll onto his back and start to cry uncontrollably. The child begins to cry as you are talking to the parents because he has just finished his beef jerky." My SOAP Note.. S- 17 month old toddler is brought in by his parents for his checkup. Parents state the child "insists on being carried and if he s left to crawl around for too long, he would roll onto his back and start to cry uncontrollably." (Additional subjective questions to ask the parents include socioeconomic status, ethnicity, family history of illness, maternal gestation health (any issues with alcohol or drug use), child's usual feeding patterns, what his meals and snacks usually consist of, how his bowel movements are, allergies or medications of the child, how much food does the child usually eat, ask the parents for a 24 hour recall of all meals and snacks eaten by the toddler, if the child has developed any motor or social skills since the one year mark, if the parents have tried to encourage standing and walking for the child, their methods for dealing with tantrums and what the parents think a healthy weight for the child should be.) O- The child is a 17 month old toddler, weighing 32lbs and has all immunizations up-to-date. The child is observed to be crawling around the examination room while both parents are preparing a snack of Doretto chips and juice substitute. When speaking to the parents, the child begins to cry because he has just finished his beef jerky. (Additional objective data requirements (depending on toddler's temperament- less intrusive to more intrusive) include the "head to toe" assessment to identify any abnormalities such as muscle dystrophy that is more prevalent n male toddlers and may cause fatigue and irritability of the child (and cause delay of standing and walking), "head circumference" measurement, measure height and weight (again) to calculate if the child is within a healthy BMI range, Vital signs (BP, P, T, SpO2, R), and assess ability for standing, walking, speaking (a few words), etc to assess milestones met.) A- Lack of nutritional requirements and independent motor movement for healthy growth and development for toddler R/T lack of knowledge from parents AED irritable behavior from child when crawling alone for too long- and "insists on being carried"- lack of independent movement. P- Educate parents on nutritional values and requirements for every meal and promote more varieties of fresh fruit, vegetables, meats, dairy, etc. refer to a child dietitian to help parents budget healthy meals and snacks that can be affordable depending on economic status. Educate parents on outdoor and indoor activities and games to help encourage the child to stand and take steps on their own and develop confidence to take on a more "independent" movements. Educate parents to record meals and snacks in food dairy to keep track of healthy eating and amounts, as well as measuring weight and height (horizontally, until the toddler can walk) Educate parents about positive parenting styles for toddler tantrums (ignore, or providing praise for good behaviour or acceptable punishment for bad behaviour) Thank you again for taking the time to read everything! I'm not familiar with toddler development, but I did some research, and added procedures I would need to do... Please let me know what you think. Thanks

Jamie Lynn was admitted to your acute medical unit at 0600 hrs today for investigation of query appendicitis”. You are assigned to care for her on the day shift. The radiological department was very busy last night and the portable x-ray machines were broken and being serviced. Jamie Lynn is still waiting for her abdominal x-ray and other radiographic tests. At the start of your shift 0730 the call bell is constantly ringing from Jamie's room. When you enter the room Jamie is very upset and her mom is with her. Her mom is very angry that the x-rays have not been completed. Jamie is pale, sweating, and very anxious. She is moving about constantly in her bed and her intravenous line is wrapped around her arm many times. The dressing that maintains the intravenous is damp. You do a quick physical assessment and note the following: • Vitals: T 38.9 P124 R26 BP: 145/70 Sp02: 97% on room air. • Pain: 8/10 on a scale of 1 to 10. Region: right lower quadrant of abdomen. • Client guards abdomen on palpation. Cries and screams don't touch me” during palpation. At 0745 you notify the charge RN of the situation and prepare your information and call the MRP Dr. Williams to inform him of Jamie's present condition. The doctor orders pain control, states he will see the patient before 1000 hrs, and orders the IV solution to be changed to D5W to run at 100 cc/hr. You also plan to call the radiology department and discuss the situation with the radiologist on call, Dr. Amouz-Kant and arrange for her diagnostic tests to be completed as soon as possible. After these phone calls, you discuss the issue with Jamie and her mom and give them an update of your plan for this morning. At 0800 you ensure that Jamie's intravenous catheter is in situ and change the dressing to secure it. You change the IV to run the new solution. At 0815 you have the RN on your team administer 2 mg of morphine sulphate and 25 mg of gravol via the intravenous. Here is my narrative note...26/10/2015 0730 patient is alert and awake with mother present. Patient is pale, sweating, anxious and constantly moves about in bed. IV line wrapped around patient's arm- dressing that maintains IV is damp. T 38.9; P 124; R 26; BP 145/70; Sp02:97% on room air. Pain of RLQ region of abdomen is 8/10 on scale of 1/10. Patient states don't touch me” during palpation and guards abdomen on palpation. Paulina Petit RPN 0745 notified charge RN of situation and called MRP Dr. Williams to report patient's current condition. MRP TO pain control, IV solution to be changed to D5W to run at 100 cc/hr and states he will see patient before 1000. Then phoned oncall radiologist Dr. Amouz-Kant and discussed situation to arrange patient's diagnostics to be completed asap. Updated patient and mother of care plan and discussed the issue with patient and mother. Paulina Petit RPN 0800 patients IV catheter is in situ and changed dressing of IV. IV solution changed to D5W run at 100cc/hr as per MRP TO. Paulina Petit RPN ... Sorry for the LONG text, I'll dismiss my DAR, (Objective/Subjective, Action, Response) I know that DAR's are more patient centered and focus primarily on patient's concerns and how to solve them... If anyone could please read over my Note and critic it I would greatly appreciate it! -Paulina