mtjoanna

In my experience, the oxygen is occasionally helpful to the dying person. If they have been on oxygen for a long time, there sometimes seems to be an anxiety/restlessness when the tubing is removed--having it present feels "normal/safe" to them. We d...

I work nights at a LTC in a small town with a typical census of 45-50. I'm the only nurse in the building from 1800-0600 which means that I cannot clock-out for a break. Ideally, there are 3 CNAs on the open unit and 1 in the SCU (special care/dement...

If you do take the higher-paying non-CNA position, it would be a good idea to ask to orient with the CNAs at whatever facility you end up working in so that you have a better idea of their work-load. When I was working as an aid, I could tell which n...

I work in LTC and we sometimes have transitional/rehab patients too. Had one fellow, double BKA, brittle diabetic, post-op broken hip after his stump got stuck and he fell/twisted. Had been with us for about 6 weeks, had been on PO abx 3 times d/t re...

As Marshmallowstar says, we get to know our patients and have a basic idea of who is ativan-seeking and who is not. Some patients can be extremely manipulative and convincing with their s/sx, so I learned to rely on the VS and other observable signs ...

The first code blue I was involved with, as an aid, was disastrous. Pt with blue lips, no pulse; we called and started CPR (not allowed to use the crash cart without the hospital CPR team there). 1-2 minutes later, the hospital operator called us bac...

When I realized my CPR was about to expire, I asked my work about it and was told that we had to find our own classes--and this is when I found out that none of my CNAs have their CPR, because it's not required! I was shocked--I had simply assumed th...

I work nights by choice. It takes me out of the office politics and away from the eye of my DON (who is not an ideal boss: see the post "My DON came to my house today" in the geriatric nursing section for further details). Being out from under her di...

Agreed! I enjoyed working at the hospital prior to Magnet; the union helped keep the hospital honest but Magnet made it much less pleasant.

"And the administrator's response to the DON coming to our house? Does the admininistrator have enough clinical background to appreciate why you held the lasix and the communication issues with doctors after hours?" The DON and the administrator hav...

Actually, the worst that could happen would be an allergic reaction if the person accidentally taking the wrong med had an allergy to Sennakot. Even something as innocuous as Senna could cause anaphylaxis. And yes, it is very unfair to the CNA to put...

I left my job at a Magnet hospital largely because as an Associate's degree nurse, not a Bachelor's, I was definitely feeling squeezed out and pressured to leave. I'd like to get my BSN, but finances won't allow it just now and I was definitely unwe...

The day shift faxed the results to the doctor. I came to work and was slammed from before I even clocked it--hospice wanting me to help figure something out for a resident I'd not even met yet, a fall, dealing with short-staffed CNAs and grumpy kitch...

True; how do I delete/edit the post and how do I post a photo without linking it to my facebook?

I did just have a meeting with the administrator of the facility. Talked about my level of discomfort with having work invade my home and the fact that a reasonable nursing action on my part caused such hullabaloo. I've always been very aware of the ...

First is an observation--this is not an easy post to read or get through as it is written almost as a string-of-consciousness rather than as a paragraph with punctuation and easily seen points and questions. As far as crushing meds, you do need to m...

That and at this hospital, good care is not guaranteed. They almost cost me my leg (crush injury that started to necrose in the muscle. Wouldn't take my concerns of tunneling seriously--and I was a very new nurse and trusted the more experienced prof...

By the way, the doc did finally respond with orders to continue the lasix 40mg but to also add KCl 10 mEq BID and recheck potassium level in a week.

Document, document, document! Note every time he strikes out, especially at peers. Document your reporting his behavior to the supervisors and doctors. Chart the times these occur and the specific interventions you tried. Sometimes, having all that d...

There are limited employment options in my little community. I could apply to the hospital, but then I'd be working directly under doctors that I don't respect or trust. My parents live in this community and Dad is stage 4 lung CA so I'm pretty much ...

Part of the issue is that in our small community, our doctors are the hospital doctors who are on-call for the ER. It has gotten somewhat better since a couple of new PAs have shown up. We (the nurses as a group) have been known to wait for the clini...

You are only missing my DON. I chart just about everything, including when the docs are contacted and when they say yay or nay to the pt being seen. I've also been known to contact family/guardians and get their permission rather than the DON's, whic...

Our doctors have made it clear that they are not to be called unless it is an after-hours emergency--and critical labs don't count to them. It drives me nuts sometimes... We have to call them ahead of time for permission to send residents to the ER, ...

I have sometimes made my DON and administrator unhappy d/t thorough charting of behaviors. My first job out of nursing school was as a psych nurse, and there you really, really learn to CYA. As the others have said--always chart. Be deliberate with y...