mtjoanna

mtjoanna

psych and geriatric

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All Content by mtjoanna

  1. Role of an RN in long term care facility

    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...
  2. Is being a CNA imperative?

    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....
  3. Dumbest thing a doctor has done/said to you

    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...
  4. Withdrawal Protocol Question

    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...
  5. Code blue on psych floor

    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...
  6. So Frustrated about CPR Renewal

    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...
  7. What is your schedule like as a nurse?

    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...
  8. Magnet status

    Agreed! I enjoyed working at the hospital prior to Magnet; the union helped keep the hospital honest but Magnet made it much less
  9. My DON came to my house today

    "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...
  10. Magnet status

    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...
  11. My DON came to my house today

    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...
  12. My DON came to my house today

    True; how do I delete/edit the post and how do I post a photo without linking it to my
  13. My DON came to my house today

    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...
  14. New Lvn nurse left Ltc advice

    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...
  15. My DON came to my house today

    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...
  16. My DON came to my house today

    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
  17. Combative dementia patient

    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...
  18. My DON came to my house today

    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...
  19. My DON came to my house today

    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...
  20. My DON came to my house today

    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...
  21. My DON came to my house today

    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...
  22. Charting behaviors

    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...