msnursekim

Sounds like you are working in my fantasy facility! lol I have heard of places like this but have never really encountered one. Your residents must be really high functional. Don't be surprised when they start declining and you start having those awful incident reports to fill out! Enjoy the good times while they last...it doesn't matter if you are in a "upscale" facility or not, it all depends on the condition of your residents. Good Luck to you

:flowersfoThanks to all of ya'll for making me feel better! I was doubting myself there for a while...good thing came from this. Have new grads on duty that read the site and have started asking me questions on how to pick up on body language with access of demented patients...getting some good teaching in. thanks again "the Tylenol Queen"

Unfortunately, in LTC it seems we have cycles or runs of falls, deaths, incident reports, etc. I think it just goes along with LTC...but 10 incident reports a week does seem like a lot but it also depends on how many residents you have declining at one time. As you said, you do have several in this process so seems like it would be logical to expect more incidents. Hang in there...as the old saying goes,"...this too shall pass." Thank goodness you have caring CNA's. Treasure them because they are hard to come by in this day and age. Have you asked the aides what they think could be causing the problem? Many nurses overlook the aides as an input but they are really a goldmine for information on residents.

you say, all of a sudden , you have more combative residents racking up tears and bruises? my first instinct as a 28 year veteran lpn is that you have a new employee that is agitating or abusing these residents. think about your nursing environment...what has changed from when you first started there compared to now? think cause and effect...something has triggered these residents to become combative now, which we all know leads to tears and bruises.

First of all, sorry for the caps, just easier for me to type without typos. We have to sign out tylenol just as if it was a darvocet, tyl #3, etc... because of our pharmacist. She thought it was a good idea to track use and yes they are locked up with narcs. Her quote, tylenol is for pts, not employees! She had aproblem in the past with pilfering of stock tylenol.Thanks to all of you for your validation...made me feel better. I was beginning to doubt myself,but as you have stated, dementia pts do have pain and a quiet restful night for all of us is the results of giving them their prns. Thanks again!

I NEED SOME INPUT HERE...I'M GETTING TEASED AT WORK AND CALLED THE"TYLENOL QUEEN" BECAUSE I GIVE TYLENOL OR PAIN MED ORDERED TO MY DEMENTED PATIENTS THAT CAN'T ASK FOR THEIR PRN'S OR DON'T REMEMBER THEY HAVE PRN'S TO TAKE. I DON'T GIVE THEM JUST BECAUSE...I USE BODY LANGUAGE AS ASSESSMENT TOOL OR ASK "HOW ARE YOU FEELING TONIGHT" IF THEY CAN TALK AND GO WITH WHAT THEY TELL ME. IF THEY SAY, "OH, THIS WEATHER IS MAKING ME ACHE ALL OVER" OR SOMETHING SIMILAR I WILL ASK DO YOU NEED SOME TYLENOL OR SOMETHING TO HELP RELIEVE YOU? NINE TIMES OUT OF TEN, THEIR RESPONSE IS YES. MY CO-WORKERS OBJECT BECAUSE THEY SAY, WELL THEY WILL ALWAYS SAY YES. I DON'T AGREE. I DON'T FEEL MY CO-WORKERS ARE LISTENING OR OBSERVING WHAT THEIR PTS NEEDS ARE...DON'T HAVE TIME ETC. ANOTHER REASON FOR THEIR OBJECTIONS IS AT OUR FACILITY, TYLENOL HAS TO BE SIGNED OUT SIMILAR TO A NARC AND IT "TAKES TO MUCH TIME OR TROUBLE" FOR THEM TO DO SO UNLESS THEY ARE SPECIFICALLY ASKED FOR A PRN. AM I WRONG IN TRYING TO HELP RELIEVE DEMENTED PERSONS ACHES AND PAINS ESPECIALLY WITH A DX OF ARTHRITIS IF THEY CAN'T ASK FOR IT?

:loveya: This topic has been so educational to me...I never knew there was such a difference in pay scales across the country for LPN's. I live in Mississippi and work in a small community LTC facility and have found that my facility is in the mid section of pay scale which pleased me no end. Having lived and worked in MS for a while, you get used to being low on the totum pole so to speak. My facility has a base pay of $13.00/hr with 10 cents added to base per year of experience plus $1.50/hr more for diff on 3-ll hours and $1.75/hr more for diff on 11-7 hours. We work 12 hour shifts and everyone recieves some part of the diff agreement. Even if you work 7a-7p, you still get the diff rate for 4 hours . Also, there is a sign on bonus of $1000.00. Anyone interested in a small friendly community with good working environment, come on down to Mississippi!

You might try buttermilk or sweet milk with cornbread and add promod to this mixture. I know alot of people don't like buttermilk, but our little southern residents love this as an alternate with milkshakes. they get tired of the sweet taste quickly. This really works to put the weight on! Good Luck!

It has been my experience as a 26 year veteran LPN, that all you have to do to be a good LTC or geriatric nurse is to turn the initials around to TLC...tender loving care. Treat your residents as you would have your family member treated and you can't go wrong. It is sad to say but so true in our society that you will be considered family to some of your residents because they have none of their own or have been "forgotten" by their true family. Hang in there! LTC nursing can be very rewarding.:)