SLS_RN

So sorry this is happening to you OP. It sounds like possibly an issue with the alaris pump. Can you look into doing CEU's about medication errors. There are a lot available on line and it will show initiative when you do speak with your boss again that you have taken steps to give "corrective action" to your self. Do you have malpractice insurance? If so this would be a good time to call them! With it being a med like insulin I would expect a write up or progressive discipline but hopefully they leave your license alone. We all make mistakes. Hang in there!

You would be wise to invest in NCLEX RN review materials. Scope and roles or RN and LPN are very different in terms of NCLEX. Maybe look at selling those to put money towards the RN review materials. Best of luck to you!

Get your own pregnancy test.

I graduated with my ADN at age 20, BSN at 23. Hopefully will be able to do a MSN in the next few years.. Still unsure which route I want to go!

I'm not sure I completely understand your post but I am guessing you did not pass NCLEX and are wanting to work as an STNA until you are able to pass? Reading between the lines so correct me if I am wrong. I am in Ohio also. I am not sure what test you want to challenge. There really is no challenging your nursing boards. If you fail, you retake. Your STNA certification is maintained through the Ohio department of health and they have a search on their website for the nurse aide registry that is public.. You can search yourself. Again, correct me if I am wrong but I am guessing that since you have a BSN, maybe you have not worked in a few years. STNA license requires at least an 8 hour shift worked in a facility/company every 2 years to stay active. Make sure if you have worked that the facility reported your last working day to the nurse aide registry. If you are expired and have not worked you are out of luck unless you are willing to take a refresher course. If you have worked and it wasn't updated, call the facility, it is a simple fax with your name, registry number, first 8 hr day worked and last 8 hr day worked on facility letterhead. I would encourage you to just buckle down and study for boards.. I think it is every 30 days you can take boards if you fail.. And take it as soon as you can. You really will remember more the closer you take it from school ending. Best of luck to you OP.

I don't know what policies are in your state, in my area for any and all injuries that are of unknown origin has to be reported to department of health...documenting in the narrative "injury of unknown origin" is always a no no. May be something for you to check into. Check with your DON. Also instead of writing up a narrative, maybe it would be a better idea to make a list of all the things you need to be assessing for and including with the documentation of a skin tear. If you have a narrative already prepared it is possible that maybe you would overlook some details. For example almost like a check list, even write it up as such and make notes on the paper with size, drainage, etc as you assess the area. Also good idea to put on there your notifications. As someone earlier mentioned I would call at the end of my shift.. That way you know for a fact it is done. I have also had family members come in first thing and be upset that they were not notified of an injury, regardless of how small or minor. They will appreciate the communication. How this is helpful.

[COLOR=#000000]Hi There! I have worked in a SNF for about 8 years now. I was a CNA until I got my RN and have worked as a floor nurse and also in administrative roles. I have also done ER and currently work case management for a primarily geriatric population. You ask some good questions! 1. There are really not any duties I was asked/expected to do that I did not anticipate. I was familiar working as a CNA as to how the facility ran, routines, etc. I was also aware of my state's nurse practice act and was familiar with my scope of practice. I think the biggest thing nurses new to LTC struggle with are the staffing ratios and time management. If at all possible, I encourage you, if you are a student, to get some experience as a CNA if you have an interest in working in this field. 2. Most satisfying part of the job is forming bonds with your residents/patients. You see the patients many times for weeks, months, years even and form friendships and relationships with them. If you are the type that values a working relationship with patients, this may be the field for you. For me, I enjoyed learning my resident's norms, having conversations about their life experiences. I enjoyed taking care of post-surgical patients and watching their rehab progression. It is also an honor to care for those at the end of their life-many times, the SNF nurses is all the patient has. Other times it is caring for not only the patient, but for the family as well. 3. The most dissatisfying part... probably the workload. Time management can only get you so far. There are good days and there are very bad days where nothing goes right.. you have falls with injuries, admissions, discharges, upset family members, send outs to the ER, wandering residents, angry residents. It can get crazy. It can be fun, but crazy and in the moment very stressful. 4. Adapting to a difficult situation... I cannot think of specific example at this time.. but it is not unusual for there to be multiple things going on and you need to prioritize your day. Between the routine-medications, treatments, skin assessments, etc. you also have the variables of the MD coming to round, ER send outs, admissions and discharges..sometimes multiples, upset family members. Being able to coordinate those. Going from sweet talking someone to taking their medications to speaking with an upset family member, to having to make a difficult phone call that a loved one has indeed passed away can take time. It is hard to wear all of the hats. It takes a long time to be able to jump from task to task with different approaches for different people. I hope that is enough of an answer? 5. There is an ocean of information that I was not taught in nursing school. Truthfully, nursing school teaches you enough to be a somewhat safe nurse. For me, it taught me to use my resources, to look things up, to be familiar with what I could and could not do. There is no way to do every single skill or task in nursing school. You will learn every day in practice. Just be honest with yourself with what you do know and what you do not know. If you have questions, ask! it is always better tp be upfront and truthful than to have to come back with your tail between your legs. If you are in doubt, look it up. You will be slow for awhile, you will feel like you know nothing. But you will have that moment of epiphany down the road where things will just click for you. Just another note too, if you are interested in getting into LTC, there is beginning to be a shift.. at least in my neck of the woods.. away from LTC and towards post-acute care. We are seeing higher acuity patients as hospitals are discharging sooner an there is more of a push and funding for long term patients to stay in their homes longer. Best of luck to you OP! I have had some of my best nursing experiences in LTC and most certainly have learned a wealth of information! I'm sorry.. this was a quick response and my answers probably are not as good as if I would have sat and thought about things for awhile :) [/COLOR]