Quinnbee

Yes, and sadly, I'm learning that very quickly. Luckily I have a great team that I work with, and my unit has been a very supportive environment. Which is probably the only reason why I'm still at this facility.

Generally, I don't give IV pain meds once my patients are out of their acute pain stage. If they've just come out of surgery, I'll give IV for the first few hours, until their pain is under control, then transition to PO for the duration of their stay. I explain this to them beforehand, and let them know that their POs will be given in a way where we can catch the pain, before it gets to be unbearable. One thing that I really enjoy is educating my patients. And with the patient population that I'm currently having, it's practically nonexistent. I'm aware that PO pain meds work longer, and sometimes better to relieve pain, but my frequent flyer patients rarely want to hear anything about getting PO meds. These are patients with histories of IV drug use, so all they want is what they know. I've had patient's outright tell me that they only want IV pain meds and nothing else. Given like they're scheduled, even though the meds are prn. I've had patients ask me to write down when they last received IV pain medications, and when they can get them next. Patients who have woken up out of a dead sleep to tell me that they're having 10/10 pain that 1.5mg of dilaudid did nothing to relieve. At points like this, the frustration sets in, but I'm taking the advice from several replies, and disengaging. Handling these patients in a literal and objective way is what I pray I can do from here on out.

Thanks for the advice, you guys, I sometimes find it hard to disengage, but I think it's definitely something I need to start working on. It's especially difficult when I get one or two demanding patients that take up most of my day, and by the time I'm done with them, I have very little left to spare. @ruby_jane Our standard ratio is 5:1, but most of the time we're at 6:1 or 7:1, with several admits and discharges throughout the day.

Hi all! So this is going to be a rant slash plea for advice. I've been working as an RN for about 6 months now, and my patient population has really been terrible as of late. I work on a fairly busy med surge floor, and recently, it feels like every single patient I take care of, is just there for the pain medications. I'll have patients that come in for intractable pain, n/v, from surgeries that they had 6-12 months ago. And when they're assessed objectively, scans show no abnormalities, and vitals are also within normal ranges. Yet, they'll complain of 10/10 pain, that doesn't get relieved with heavy doses of morphine, oxycodone, dilaudid, etc. These are patients that have histories of multiple admits at multiple hospitals for the same issues. At what point do the doctor's decide to stop admitting patients like these? When do they stop giving in to their tantrums? Just last week, when I let one of my patients know that she would be getting discharged and I had to stop her IV dilaudid, I walked into her room 10 minutes later to see her on the floor, claiming that she had fallen and hit her head. No bruising, no lump, no cuts, not even a hint of redness to her head. In the same week, I took care of another patient complaining of abd pain, n/v, and after being told she would no longer have IV pain meds ordered, she mysteriously started vomiting up all her oral medications. Always when her door was closed (requested by her), and almost on the hour episodes of emesis. No vomiting when she ate food, but any oral pain meds would be upchucked within minutes. And of course IV zofran did nothing for her nausea, only the promthezine ever worked, and only for a very short time. It's gotten to the point where I feel that if I continue like this, I'll slowly come to hate and resent my patients, and nursing as a whole. I'm just barely starting out as a nurse, and this is not the outlook or mindset that I want to have. Please, please share any tips or advice on how you deal with patients like these.

Thank you guys for the advice. In the two months that I was at the facility, I feel like I really strengthened a lot of my nursing skills, and I want to be able to put that forward if I am called for an interview. Like @TX.RN.Shannon said, I don't want to have to pick my words when I'm asked a question about my prior nursing experience. So for now, even though I'm apprehensive about the short length and the DON, I decided to put the job not on my resume, but in the applications, only if asked.

I recently quit my first LPN job at a LTC facility due to unsafe work conditions. If you'd like to read the whole story, please refer to my prior posts. There were so many things that added up to my decision to quit, but ultimately, the management, staffing coordinator, and the DON were the main reason why I ended up leaving the job. I contemplated leaving the job within my first week while I was orienting, because I found myself almost in tears daily because of the sheer lack of support and guidance from other nurses and the staff. The nurses that were meant to be teaching me would leave me to complete their med pass, in order to take hour long smoke breaks or to chat with people. On day two of my orientation, the nurse left work and went home early, because she was tired and didn't feel like staying for her full shift. The nurse did so with the permission of the staffing coordinator, and I was left by myself to complete her med pass. I ended up staying with the facility for 2 months, mostly because I forced myself to stick it out for the sake of it being my first nursing job. My decision to quit was not one that was made lightly, I thought it over for weeks, before I finally hit a breaking point with the DON. I turned down 4 other job interviews because I had been offered this job, but after quitting, I'm not sure how to go forward. My question is, should I update my resume to reflect this job? I would like to start applying for other positions, but I'm unsure as to whether I should list this under my job history. I don't want to put other job opportunities in jeopardy by listing this job. I may have hated every second of my 2 months at the facility, but I strived to always do my best for the sake of the residents. Knowing the vindictive character of the DON, I have no doubt that if a potential employer were to call and ask about my 2 months at the facility, she'd have no problem smearing my name. I figure that if I was able to get 5 call backs for interviews with my current resume, then maybe I don't need to list this job. Thoughts?

Oh I did! Waking up this morning, I felt such an immense relief at the thought that I would never have to go back to such an unpredictable place.

Thank you guys for the support, as this is my first nursing job, I wasn't sure if this was the norm for everyone in LTC. Something in me kept telling me that this wasn't a good place to work, but I wanted to at least get some sort of nursing experience on my resume. I feel like I should have known what kind of place this was, when as a new employee and a new grad, I received exactly 3 days of orientation before I had a station to myself. Today, I ended up quitting effective immediately. I was finally able to speak with the DON about the issue and I was basically told that in a LTC facility, it's normal to have one nurse taking care of anywhere from 40-45 residents, and that I should get over it. I was made to feel like an idiot for even questioning the situation and that's when I truly realized that this was not the type of place that I wanted to work in, let alone have as my first nursing job. The DON was rude and demeaning in her manner of speaking and I honestly couldn't take it any more.

Hello! I've recently started working at a LTC facility as a new grad LPN for about a month or so. We work 12 hour shifts, and most of the time, I work mornings, but I decided to try out night shifts a few days ago. A little background about the facility, it has a very high rate of turnover and I was made aware of that before I started working there. What I wasn't aware of was just how demanding and unorganized the facility is on a daily basis. There are two nurses on the floor, one on each station, with a census of about 45 residents. One station specializes in skilled residents, while the other is LTC residents. In a typical work week, I as a full-time employee will work 3 days a week, and get the other 4 days off. However, in those 4 days that I should be able to rest and decompress, I'll get calls and texts from the staffing coordinator, asking me to come in and work shifts that other nurses have called off. During my first few weeks, I was averaging 80 hours per week, and I was starting to feel extreme fatigue. As a new employee, I didn't feel like I had the right to say no, that is the way the facility makes me feel. Recently I've become more willing to say no and refuse extra shifts, and just a few days ago, I was asked to work a night shift, to which I agreed. About an hour into the shift, the nurse on the other station comes to me and tells me that he will be leaving after he finishes passing his 11 PM medications. This is the first that I'm hearing of this, so I called the staffing coordinator. I was met with an answer of "don't worry, he'll pass the night meds." During our entire 10 minute conversation, the staffing coordinator managed to avoid answering my question of "why wasn't I made aware that I would be the only nurse in the building, taking care of 45 patients." Not only was the nurse's early departure pre-planned, but the staffing coordinator was very much aware of it when she asked me to work the night shift. I had no warning of any kind, and I was basically forced to take report from the other nurse, who then proceeded to skip his way out the door. So there I am, a new grad and a new employee, pitch black nighttime with two aides and 45 patients. I was quite honestly scared, because some of the residents were high fall risks, and I had no one there to turn to if I needed help. The aides were helpful as much as they could be, but with several residents to themselves, they had their hands full. A few of the high fall risks were also dementia residents who tended to wander at night. Somehow, I managed to get through the night and I passed meds to all 45 patients, which was like it's own circle of Dante's Inferno. After all was said and done, I contacted the DON, because I was not comfortable with how the night had gone down. I ended up calling and texting the DON eight times, and every single attempt was ignored. It made me feel like she was basically condoning what had been done and I felt that I had no one who would stick up for me as a nurse. My question to you guys is this; am I being a crybaby about this situation and do I just need to suck it up and roll with the punches? Or was this an unsafe situation for both me and the residents that I took care of that night? From what I've come to understand about this facility, this same situation has happened to several nurses before me, and the administration and the DON have done nothing to fix the problem. I'm still working at this facility, but I am considering terminating my contract with them, because I find myself feeling a sense of dread every time I drive to work and every time I get a call or text, because the staffing coordinator continues to badger me about working extra shifts.

Hi guys! So, I took my HESI A2 Entrance Exams yesterday and I was able to pass all the sections that were required of me. I just figured that I'd post some of the things that helped me succeed. I put off taking the HESI for the longest time because I was afraid and the deadline to apply to my school Nursing Program was creeping up fast. But every time I thought about taking the HESI, I would get this pit in my stomach. I finally bit the bullet and set up my appointment and basically forced myself to take it. A&P 30 Questions Score – 90% Study - Free Flashcards about HESI-A2 ANATOMY Practice – Free HESI A2 Anatomy and Physiology Practice Test Question 1 of the Anatomy and Physiology Practice Test for the HESI exam These two practice tests were actually the most helpful because there were a few questions in the practice that were on the actual test. And other thing you absolutely need for this section is a basic knowledge of A&P. There are some questions that you won't see the answers to on any study guide, so it really helps to have that basic knowledge so that you can recall things. That way, even if you don't know the correct answer, you can make an educated guess based on the things you've learned. Math 55 Questions Score – 96% For the math section, I have to stress knowing how to multiply, add, and subtract fractions. And not just adding and subtracting two fractions, also know how to work with three fractions, some may even be mixed numbers. The majority of my math portion was made up of fractions and proportions, so really understand how to solve those. There were some questions on the HESI where I had to type in an answer rather than pick from multiple choices. Those questions almost always had to do with conversions and percentage, so know how to work with those too. For metric conversions, the YouTube video was my lifeline, without it I wouldn't have known what to do. Watching the video will cut out some of the conversions that you'll have to memorize, and the link to Quizlet will take care of the remaining conversions you should know. The trick I used was to memorize all the conversions I needed, then as soon as I got to my testing center, I wrote them all down on my scratch paper, so it was like a little cheat sheet when I was taking the math portion. That way, you won't have to store all the conversions and try to remember how many centimeters are in an inch off the top of your head. There were no temperature or Roman numeral questions on my test, but that may be different for you, so brush up on those as well. Study – Kilo, Hecto, Deca, Unit, Deci, Centi, Milli. King Henry Died Unexpectedly Drinking Chocolate Milk. Hesi A2 - Measurement Conversions Flashcards | Quizlet Practice - http://www.proprofs.com/quiz-school/story.php?title=hesi-practice-test Reading 55 Questions Score – 90% For the reading portion, I didn't do as well as I had wanted to because I ended up second-guessing a lot of my answers. One thing I noticed was that for the questions asked in the reading portion, almost all the choices given were plausible. So, it's up to you to really decide which answer goes best with the question asked. There really isn't a method to study for the reading portion, but taking the practice tests will most definitely help. In the links I've provided below, there are practice questions on all knowledge sections for the HESI, so I recommend going through all the ones you'll be taking, multiple times. I also recommend reading the explanations for why an answer is correct or incorrect. Practice - http://www.hesia2practicetest.com/ http://www.test-guide.com/free-hesi-a2-practice-tests.html https://uniontestprep.com/hesi-exam/practice-test Grammar 55 Questions Score – 96% The majority of the questions in this section were about choosing which sentence was grammatically correct, choosing which word would make the sentence grammatically correct, and choosing which word in the sentence was used incorrect. The only advice I can give for this one is to do the practice tests provided in the links above and this one here as well. The link below has the most similar question to the ones that were on the HESI. Practice - http://www.proprofs.com/quiz-school/story.php?title=hesi-grammar-vocabulary-practice-test Vocabulary 55 Questions Score – 100% On the vocab section, I didn't do any studying because I knew I was set on this section. If you're an avid reader like I am, then you won't have any trouble with this section. If you don't read as much, then I would suggest going into Quizlet and typing in HESI A2 vocabulary. There are literally hundreds of learning sets that people have created and they will help you immensely. Last few tips, when you're taking the HESI, I would suggest starting with the subjects that are the most difficult for you, then moving on to the easiest. There will be word problems on the math portion, but don't be scared of the problem just because it's long. Read the paragraph in portions, then pick out the numbers that it gives you to work with, then you should hopefully be able to go from there. Lastly, try to relax when you get into the testing center, it's very easy to freak out and answer something incorrectly, even when you know what the answer is, so calm your mind. Take your time with answering the questions, and try not to second-guess yourself, because odds are, you were right the first time. Good luck!

Thank you! I'm so happy, and I know that you'll pass yours too, just breath and relax, thirds time's the charm!

I'm not sure if we're allowed to post links on here, but for Math, I used for metric conversions because I knew literally nothing about it beforehand. I also used https://quizlet.com/54064792/hesi-a2-measurement-conversions-flash-cards/ for unit conversions. I knew nothing about these either, but studying those two things helped me get a 96% on my Math section. As for A&P, it's more of a hassle to study for because it really is too broad a subject. I used www.studystack.com/flashcard-653370 to study, but when it came time to take the actual test, almost all the things I studied were unhelpful. I had to look at the questions and then use previous knowledge from my A&P classes, the process of elimination, and common sense to weed out the incorrect answers. Some of the questions are common sense proof, and you actually have to know them, but for the most part it wasn't too bad. One thing that I would tell you is to relax. When I first started taking the test, my hands shook so badly because I was extremely nervous, I had thoughts about having o retake the test if I failed and it just made for an unpleasant experience. However, after taking the first section and seeing my grade, I started to become more relaxed and I did very well in the other sections. Also, it helps to start with the most challenging sections first, then work your way to the easiest. That way, you won't have it in the back of your mind that you still have to take the Chem or Bio section, and then start freaking out.

When you were taking the test, what concepts were harder for you to remember or work with in the Math and A&P sections? I didn't take the Bio or Chem sections, so I'm not sure how to help with those.

I'm sorry that you didn't pass, I know that it can feel horrible to study so hard, and not do very well. I took my HESI yesterday after studying for 2 days and I was able to pass, thank God. What were your individual scores? I may be able to give you the links to some of the study guides that I used based on how you did for each portion. Did you pass some and fail some and what was your overall score?