sweetielin

i started at lower than anyone who has posted so far: $9.50 an hour. what a slap in the face! i wanted to cry when i found out what i would be making. it's embarrasing to even post it. that was in 2004. i have since moved to nights and gotten a raise. still i am making less than just about all the other poster. what keeps me where i am is the people i work with and also i would have a good bit of driving if i went anywhere else.

i always call in as soon as i know that i will not be able to come in. i understand what it's like to work short staffed. what i don't understand is that night shifters are written up if they call in after 3pm but day shifters routinely call in after 5am. thankfully, we are not responsible for finding our own replacements. there was an incident where a cna had an injury and called in the night before she was to return to work. she was told to come in anway, that they could not get a replacement for her. she came in that morning and had an xray. turned out that her foot was broken.

usually our schedule is posted a week or 2 before it begins. a while back, there were going to be changes in positions of some of the nurses and the whole schedule was covered up except the very next day. this was very unfair. i assumed that the point of it was to keep the changes a secret and decrease the controversity of it. covering it all up only escalated it.

guess my hospital qualifies then:chuckle

do not dictate your h & p and progress notes during shift change in the room where we are suppose to get report.

i have never done anything other than team nursing. at my hospital, the rn is usually responsibly for the ivs, initiating care plans, admission assessments. the lpn is responsible for all po/pr/sc/im meds, dressings, accuchecks, tube feedings, breathing treatments, checking night work,and whatever the cna is too busy to get to. several duties are shared and done by whoever sees the need to be done such as inserting foleys and ng tubes, trach care and suctioning, charting, updating care plans, admissions. lpns do frequently help out by flushing peripheral ivs, hanging fluids, sometimes hanging ivpbs. rns help lpns by giving pain pills, checking night work. they will do some of your accuchecks or dressings if you get behind. our shift works well together and we have the mentality that it doesn't matter who does it, just that it gets done. our supervisor comes to the floors and helps out whenever possible. i have heard a lot of nurses say they hate team nursing. i can see where it would be bad if you had a nurse that didn't pull their weight. luckily, we don't have that problem. also, the teams help other teams. we will respond to call from each other's patients if their nurses are too busy. if one team is overloaded, the other team will jump in and ask what needs to be done. if everyone pulls their weight and works well together it can be a great thing.

team nursing is the only thing i've done but i like it. i have the suspicion that if our hospital went to primary nursing, they would routinely saddle us with 10 patients each. on average, an rn-lpn team has 15 pts. one team can have up to 17 though. if census is low, they will cut an lpn or move her er. this leaves one lpn for 18-23 pts. the rns split those. so if i have 20 patients, each rn has 10 of those. it's overwhelming to be responsible for all meds except iv, dressing, accuchecks, tube feedings, checking orders, checking the night work. then sometimes you have to call the docs. the aides are usually busy turning so i have to interrupt my med pass to take people to the bathroom. thankfully, the rns do help or else i would quit asap. usually the rn will ask what you need or she will say what she will do to help. i think a lot of times, they don't really understand why it is so overwhelming but at least they do try to lighten the load. i look forward to getting to sit and chart. luckily we don't have that many pts too often. it's nice to have a partner to help each other out. the rns are usually done with their med pass before the lpns and free to start opening charts. we don't keep track of who does more charts because there are times when one person opens more than the other then it may be different the next time. we do what we can. we are all busy and just get it done instead of worrying who did what. as long as it gets done. there's not much than lpns can't do at our hospital, so we can help out a pretty good bit as time allows.

where i work, you are lucky if you only have 10 pts for 1 rn and 1 lpn. we can have up to 17. if there are between 18-23, 2 rns and 1 lpn. really it is too much. the rns do the ivs for the most part but lpns can do all but pac and ivp. lpns give po/im/sc meds, do dressing, accuchecks, tube feedings, paperwork.

i work nights because i've always been a night owl. i hate getting up in the morning and am much happier to get up in the evening. i worked days for 3 months after i became an lpn. i was exhausted all the time. i was scraping by on 2 hours a sleep a night. i had a hard time falling asleep despite being exhausted. i never felt like doing anything on my days off. other reasons are that my mom works nights and i was able to get on her shift. i like having less "big bosses" there to get in the way even if it also means less ancillary staff. the night shift has a 4-3 schedule. the day shift has 3-2. i love having 3 or 4 days off each week. it gives me more time to recover and actually do things. our shift works together very well. the day shift doesn't seem to do that for the most part.

i don't know if it is just part of working in a small hospital but most of our ancillary staff isn't even there when we come on at night. laundry and housekeeping leave at 2:30p. rt and lab leave at 7p on weekends. rt stays until 11p during the week. lab until 12a. it is definately frustrating having the jobs of other departments while they are still there. most of the time i just go ahead and do it because in the time i spend trying to get someone, i might as well have done it myself. it's so aggravating to call resp for something and have them say "can't you do it?" i don't call unless i really need something and am very busy. i'm rushing around trying to get all my meds out among other things and they are sitting around reading the paper. why should i have to do your job when you are sitting there relaxing and i am swamped? we have to do all ekgs and treatments after they leave. not all are like that but it's one of my pet peeves. housekeeping used to clean the nurses station but they don't anymore. not that i see anyway. that has become the night nurses' job. our report room is also the break room. when we come in, there's so much stuff on the table you can't even see the table. we clean up after ourselves and everyone else. we are all supposed to be adults and should not leave our messes for others. we cannot change the sharps containers when they are full because we don't have the key. same with paper towels and soap. i have reported full sharps containers to the housekeeper that comes in right before we leave only to come back that night and it still be full. on the weekends, it is the worst. the floors are so sticky and nasty that you have to mop them to be able to stand walking on them sometimes. we have to clean rooms after discharge only if we are short on rooms, thank god. we don't have pharmacy during our shift either. more than half the time, the meds on the cart are not filled correctly or are not there. piggy backs are missing or mixed incorrectly. it used to be good and the pharmacy used to even mix the iv fluids that needed kcl or mvi for bags due to run out on our shift. now this is never the case. our don told us pharmacy had asked that the night supervisor bring the orders that were written throughout the night and put them in pharmacy. she told us that she would tell him "no". the next thing we know, there is a memo up saying it is to be done. the supervisor goes through them and even puts them in order. i would not think so much about this if we could actually depend on pharmacy to have our meds right. when i worked days, every time i went down there they were looking at pictures, the computer, and chatting. also, i didn't think you could refuse to come back if you were on call. this happens with some of the lab and pharmacy personnel. they expect us to call the md to get it changed or held until they come in. i think that is just ridiculous(sp). sorry this is pretty long but we have been having more problems with ancillary dept lately.

i wish our hospital monitored it. maybe then we wouldn't come on and find empty soap dispensers, paper towel dispensers, and alcohol dispensers. it wouldn't even be so bad if they would leave us a key to them and supplies to refill them. housekeeping leaves at 2:30 pm and doesn't come on until 6:30 am.

yes. more and more every week. we do team nursing at my hospital. typically, i have 15 patients but there are times when i have had up to 23. if there are more than 17, there are 2 rns instead of one. it's hard getting it all done lots of times. po, sq, im meds, accuchecks, dressings, g tubes and bolus feedings, caths, plus we have to check all the orders before our med pass. that can until 8 or 9pm. sometimes even later. then our cnas are busy with all the total cares so in the midst of this, having to taking people to the bathroom before they will take their meds. no acuity is ever taken into account. on the weekends, we don't have a ward clerk so any admissions that come we have to do all the paperwork. weeknights, we have a ward clerk until 11pm. if it wasn't for the help of my coworkers, i would have left a long time ago. when i first started 15 patients wasn't so bad. it was pretty easy most nights. now it seems the patients require more and call constantly. not to mention, the other departments aren't there on the weekend. so we have to be respiratory, lab. respiratory is there until 11 during the week and lab until 12. but if someone needs respiratory, you might as well go ahead and do it in the time it takes to get respiratory. especially suctioning. it's becoming more and more often that i don't even get to eat. sorry, i just had to vent after a rough week. the good thing is that we have good nurses and cnas on our shift and everyone helps when at all possible.

i only had to wait a couple of weeks. :)

at my nursing school, those that weren't already cnas were offered certificates once we completed the first part of clinicals. i was already a cna though.

we got to practice on each other in class and that helped me not be so nervous when i got to sticks patients. luckily enough of us were willing to be practiced on. good luck.