... I am new to nursing and ALREADY NOTICED/KNOW that things aren't exactly like nursing school. For starters, I did every one of my nursing school clinicals in a hospital setting and our courses were geared more toward managing the acute-care patient too boot.
I work at a SNF/LTC facility where not only to I pass a litany of oral medications per patient, but I do wound care, feeding tube administration, and the occasional IV antibiotic administration. All for 25 pts per shift. I runn my butt off!!
Oh, and only had 3 DAYS of 'training'.
Is this the type of place people warn about when they say "you'll put your license on the line" ??
Or, is there something more specific I should be looking for and worried about??
A want to avoid such a place, especially as a NEW GRAD RN.
Bhahahahaha!!! "Serious editing by AN administration"?! Two posts have a note about being edited, and one of them is YOURS! Mine was the other and it was not d/t inappropriate comments. I don't see that any have been removed. Are we reading the same thread?
And it explains a lot that you would have an opinion on a post that needed serious editing by AN administration d/t inappropriate comments. My comments stayed bc they were appropriate. Others' were removed as deemed fit by admin, so you dont have enough info to make an accurate assessment. Thanks for your concern, though!
Bhahahahaha!!! "Serious editing by AN administration"?! Two posts have a note about being edited, and one of them is YOURS! Mine was the other and it was not d/t inappropriate comments. I don't see that any have been removed. Are we reading the same thread?
Understood. The thing that's troubling me is that so many of my patients are incredibly THIRSTY when I give them their pills. We learned in nursing school that the feeling of thirst diminishes with the elderly. And that adequate hydration promotes adequate tissue perfusion, thereby reducing the incidence of pressure ulcers, infections, and heck even codes. Each of my 25 residents/patients gets an average of 8 medications on my shift (2nd) alone. I was taught that the elderly metabolize medications more slowly (ok, so everything slows down with them except BP), so if my people aren't well hydrated, we are asking for trouble. Obviously, I have some work to do with time management, the place I work at has unrealistic expectiations, &/or I should be delegating more.
I would like to figure out how I can delegate more effectively to my aides. We got oh, 1 chapter on managing styles in nursing school.
To be honest, I am struggling to worry about and learn MY job 1st. I must say that I'm feeling resentful towards the established nurses who haven't delegated a thing to these aides. We nurses run around like mad-women while many of the aides sit around and play on their iphones.
Delegate encouraging fluids to the CNAs, and make sure the CNAs are compliant.
Understood. The thing that's troubling me is that so many of my patients are incredibly THIRSTY when I give them their pills. We learned in nursing school that the feeling of thirst diminishes with the elderly. And that adequate hydration promotes adequate tissue perfusion, thereby reducing the incidence of pressure ulcers, infections, and heck even codes. Each of my 25 residents/patients gets an average of 8 medications on my shift (2nd) alone. I was taught that the elderly metabolize medications more slowly (ok, so everything slows down with them except BP), so if my people aren't well hydrated, we are asking for trouble.
I don't know if anyone has brought this up, but in some pts, we would be asking for trouble IF we give them too much water; some residents are either on fluid restrictions due to CHF and renal failure, or new specific consistencies due to aspiration risk.
Just something to keep in mind; balancing fluid restriction, and ensuring preventative skin treatments get done; making your own brain sheet may help-for instance, getting glucometer and VS are done, insulin administration, first med pass, treatments, then second med pass.
I disagree with everyone else about letting Cna's getting vitals.
Get your own vitals.
Yes,it will take time,and you will have to do it after med pass(except bp or pulse which you take right before giving bp meds)
In my state,Cna's are not even tested on how to take a bp.
As far as making the med pass shorter,what i do is this:
when i worked evening shift,and lets say a pt had scheduled 5pm meds and maybe 1 or 2 meds scheduled for 9pm i would give all of them at the same time...usually between 4pm to 6pm. If they were cardiac or meds for diabetes i would not give those at the 5pm med pass but colace and Aricept? Yup,i gave it at the 5pm med pass.
Also,i started me med passes at 3:45 pm, but without the cart.
I know its not protocal,but those patients who came to me, i prepared their meds first.
That would be AWESOME! However, all vitals fall to me, CNA's aren't allowed to do them in my facility =(
So when you see them sitting and playing with their phones, you say something like, "I need vitals on the patients in 201 and 203. Also, Mrs. Smith in 207 needs to have her water pitcher refreshed. Let me know if there's anything "off" with the vitals. Thanks." And you move on. You shouldn't need to beg them to do their job; it's what they're getting paid for. When you ask an aide about the vitals, if she says she didn't get them, you just tell her matter-of-fact, "Well, I need you to take those vitals now." Don't worry about being liked by them. (That doesn't mean you should be disrespectful.)
Some aides will just try to push you. You have to let them know that when they work with you, you expect them to do their work.
nurseprnRN, BSN, RN
1 Article; 5,116 Posts
We done here yet?