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Jen4nursing

Jen4nursing

LPN
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  1. Jen4nursing

    For all new LPNs

    Hi kbvn3210, I lnow it seems overwhelming at first but you will get the hang of it and a routine will develop. How long have you been working LTC? I always started my vitals for BP meds right after report and those that had foleys or circaid dressings I would do then when 0800 came i would pop the meds for each patient in the dayroom having breakfast and used a zigzag pattern to get to the ones in the rooms. Then I would chart what needed to be charted and then take a break. Unless some incident occurred lol. Then I would do wound tx and then rounds. Then the next med pass I would do all my diabetics before lunch and pass the 1300 and 1400 meds together. Then I would chart, order meds, clarify or put in orders, finish wound tx. Then 1700 med pass I would start with who was at my cart and in the dayroom for dinner and then zigzag through the rooms. Then I would catch up on more charting such as UDAs and monthy summaries. I was busy from the time I got there until I left. Give it time it takes time to get a routine that you are comfortable with and what works for you. Hang in there it will work out.
  2. Jen4nursing

    For all new LPNs

    Your very welcome. Like I said if you go into LTC just remember it is going to take time to establish a routine. You will not be as fast as the other nurses and you shouldn't compare yourself to them either. Find a mentor if you can. Also please double check your medications before you give them. This is critical because I was doing a med pass on a new floor I didn't know the patients and there were no name bands so I asked the CNA if that was such and such and she said yes i put the pills in his mouth and looked at the.photo again and realized it wasnt him so i told him please spit those out. It could have been horrible. I confronted the CNA and she said she was busy and really wasnt paying attention. It could have been so bad. The guy also was almost like a twin to the other guy so it was subtle features that made me take a second look. Also never assume anything fact check it because as a new nurse this also got me in trouble. I had a psych patient and when given report the nurse told me she gave that medication (psych med injection) the medication sounded the same as another one and I just assumed she was talking about the psych med. Come to find out she did not give the psych med and he went off throwing stuff and attacking staff they said it was because I failed to fact check and just assumed. So be careful. Check check and check and for the love of God document everything. You will do great and please continue with your education it will open so many doors.
  3. Jen4nursing

    For all new LPNs

    Hi Valleyval621, First let me apologize for not getting right back to you. Life has been hectic. In my first year of nursing I started as a vent and trach pediatric nurse because this gave me a specialty skill. It is in a home care setting but you only have one patient and as a new nurse I thought this would help me be more confident and not so nervous. After getting 2 years experience in that setting I moved on to geriatrics. I worked in all units the sub acute, alzheimer/dementia, and 2 ltc units. I felt more comfortable in home care pediatrics because it allowed me to not get in over my head until I gained more confidence. Ltc is very busy for a new nurse and you will feel in over your head at first. The important thing is to find a mentor (a seasoned nurse). I was lucky to have one and boy did she help me a lot. My first week I had a code and she walked me through the whole process. The med passes were crazy but once you get to know who takes what and who they are you definitley get faster at the med pass. I feel you should get the clinical experience because you are going to get your RN and if you have a clinical background this will help you land a job. Homecare pediatrics is great if you want a specialty skill but you would need clients on vents and trachs. All in all it is up to you but nursing is not easy or everyone would be a nurse. You will hear horror stories and nursing homes are notorious for heavy patient loads. I worked with 25 patients a day and when I worked nights I had 50 patients. After 3 months of working there I gained confidence in my skills and I really enjoyed it. My issue was with management shoving more work down your throat daily because other nurses were slacking and our unit manager never helped on the floor. So I had to do med pass, wound tx, charting, had 2 incidents to report one day and had a discharge, transfer, and admission all back to back and my manager did nothing to help me instead she yelled at me that they need measurements right now. I was in the room with an admission. I told her I dont have time why cant she do it and I got wrote up. So my story to you is nursing homes will give you the experience you need in a clinical setting but is also very stressful. If I was a new grad going into a nursing home I probably would have quit. However there are new grads that do great and there are nursing homes that are great to work for you just gotta find the right one. I wish you the best on your journey and if you have any other questions please feel free to ask me. Congratulations on becoming a nurse it is very rewarding.
  4. Jen4nursing

    For all new LPNs

    I remember how it was my first time as a new LPN the only job I could find was homecare. Eventually 2 years later I landed a job in a nursing home. So all you new LPNs I would love to be your mentor if you have any questions that will help you on your journey please ask me if I don't know the answer I will help you find it. I know I was scared my first time my patient was a 1 year old with a trach and she desatted a lot. It was a challenge and even harder because I didnt have a mentor. So please lets discuss strengths and weaknesses you all have as a new LPN and remember the only dumb question is the one you don't ask
  5. Jen4nursing

    Ex Employers giving bad references

    Thank you all for the responses I have a job now because God is great. I will definitely use all your advice in the future. Thank you
  6. Jen4nursing

    Ex Employers giving bad references

    Thanks for your comments. I did have a job lined up when I put in my resignation letter because I wanted to leave on good terms but the second they got it they fired me. I found out from a friend that he was giving me a bad reference. Also I had 2 NP's as a reference so I thought I would have no problem getting that job. But the ex boss gave bad reference and I dont know if I have the job now. I have not been told they are not hiring me only that they are waiting for a position to open and they will give it to me. But I had an Interview on Monday the 13th and sent resignation letter the 13th and was called by the administrator on the 16th telling me to come get my last paycheck. Maybe I just need to wait a little longer but I am still putting in applications while I wait.
  7. Jen4nursing

    Ex Employers giving bad references

    So I was just curious on how many nurses have left their jobs due to hostile environments and the boss fires them as soon as they put in their letter of recognition. I am in that boat now and I need that reference as that is my only clinical experience. How have you all dealt with bad references?
  8. Jen4nursing

    Bad management

    NursesRmoFun, I honestly feel that LTC facilities are just difficult period. I worked in their sub acute, Alzheimer/dementia and both LTC units and they were all horrible. The gossip and laziness were beyond control. Cnas ran every unit. They would give showeres and not tell the nurse so we could do skin checks then when they came out of the shower room I would ask do they have any skin issues, and they respond no. Had three days off came back in and same resident has a DTI. They are vindictive and when you ask why they told you the resident had no skin issues they tell you I did tell you basically putting all the blame on you. The other day shift nurse would have potlucks at the nurses station, gossip and was very loud laughing and joking with the CNAs. This was acceptable by management as she was there too. All while call lights are going off and residents foley bags need emptying. Just all around evil people. I sometimes feel I should just get out of nursing because no one cares anyway. at that facility so I am glad I left.
  9. Jen4nursing

    Bad management

    Kooky Korky I just want you to know that the "Don't question my intelligence" was not directed towards you. It was the other post that insulted me. Anyway I like the advice you gave and your right getting out was my only option. I just should have seen the red flags there with all the good nurses and CNAs leaving I should have left with them. Lesson learned for sure. I am halfway through my Bachelors degree so maybe that will open more opportunities for me away from LTC. djh123 That post is hilarious I was thinking that sounds like a place for me hahaha. I am beginning to think that all LTC facilities are bad. Thankyou all for the repsonses.
  10. Jen4nursing

    Bad management

    Thank you Smiling Blue Eyes that is so true but my problem is that I tend to not say anything until it builds up and eventually I can't take it anymore. Your right staying calm is the right way but I tend to react in the moment and I need to work on that. I also need to understand that we all don't have the same compassion or work ethic. I know I have my own faults and will work on them but I just wish those that worked in LTC were more compassionate I mean these are people's family. These patients are important to someone. I burnt out and I have only been in LTC for 2 years before that I worked pediatric trach and vent home care settings. The atmosphere is so different. I have been a nurse for almost 5 years and this is the first place I have worked that I have seen people that blatantly just don't care.
  11. Jen4nursing

    Bad management

    Autumn apple that is a great saying and you are correct we do deal with difficult patients all the time. Thank you for sharing that.
  12. Jen4nursing

    Bad management

    Rose Queen, You are correct also I did not help the situation but when your patient is almost on the floor and the CNA told you I'll be there in a minute it is what came out of my mouth I may have been in the wrong but it was not done to demean the CNA it was that I needed help now before he falls. I respect your responses everyone's in fact. Please if there are other ways you deal with insubordinate staff please share with me again thank you for all your responses.
  13. Jen4nursing

    Bad management

    Thank you Kooky Korky, This is the response I have been waiting for. I know how you feel on not getting recognition for your hard work. This is how I felt at the job I quit. You are also 100%correct I need to be more assertive in my position but I will always have the respect for CNAs that actually do their job its the ones that are there just to socialize that get under my skin and this is where I need to internalize the most. I treat parients and their family like they are my own. I did not want this resident to fall and I was yelled at for changing my tone when I said "No Now" right in front of the CNA this is not okay either. The CNA said he did not feel like I was yelling he said you needed my help that it was okay. I apologized anyway as I did not want him to think I was yelling. The unit manager saud thank you to me for apologizing yet the next day I was called into administration and was write up. When you get attacked daily for being an advocate for your patients it does wear you down.
  14. Jen4nursing

    Bad management

    Well i thank you all for your input and will definitley work on my communication skills as suggested. Just so everyone is aware I am an American born and bred and yes I am bilingual but my first language is English I am a straight A student and English and writing happen to be where I excel. I have been on the Deans List every year. So for me it is hard to type on my cell phone and when I am so full if emotion I do miss the grammar errors. So please don't question my intelligence. I am simply asking how do you handle problematic CNAs when you have no management of any kind standing behind you. I assure you I am a very kind person and all those that know me understand. You all don't know me. I respect your input and will definitely use the advice but when you have gone by the book and other nurses opinions and you still can't get through to your staff and your patient gets injured or falls because the CNAs simply won't do their job because there are no repercussions where I work then wouldn't you get fed up as well????? I am simply asking for advice on how to handle insubordinate staff when no one backs you up. Thank you all for your input.
  15. Jen4nursing

    Bad management

    I again apologize for the errors in grammar as I am writing this on my cell phone. I also would like to point out that I have never asked the CNAs to do anything except for their job. When I had time I helped pass trays, ambulate, change briefs, and put patients on and off toilets and in and out of bed and changed bedding. There were times when I was crazy busy and when I asked for vitals or to help turn a patient they would whisper amongst each other where I could hear "what a *****" and I asked nicely these were just vindictive women I have no other word for it. The other nurses told me to stop being nice thats why they are targeting you. I put up with it for a year before I started writing them up and when I started the write ups thats when they started complaining to management. Nothing was ever done and they knew they could get away with insubordination. An example was with another nurse and a new CNA the nurse asked her for vitals and the CNA started yelling at her and told her "dont tell me what i have to do i know my job i have been a CNA for 14 years "and the nurse told her "I am your superior and you will do as I ask it is in your job description" and the CNA continued to yell obscenities and the nurse told her "I am done talking to you". It was reported with witnesses and she still works there. This is why we have so many nurses quitting and they all said the same thing "The CNAs run the units". Also we do have a chain of command its like this: Nurse>>>unit manager>>>DON>>>>administrator. These steps are never taken it goes direct to the administrator because again the problem CNAs are related to him or they have been friends of the family for years. Its a no win situation. This administrator was asked to step down due to complaints from nurses. He has been fired from every administrator position he has had at other nursing facilities. The unit managers are LPNs and grandfathered in because to my knowledge they are suppose to be RNs. I was just wanting to see how other nurses dealt with insubordination when you have managers and DONs and administrators that wont back you up. Thank you all for responding.
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