Several topics-new to LTC

Forever Sunshine, ASN, RN · Apr 6, 2010

So I've been off orientation for about a week. The other night, I experienced seeing someone dead for the first time. She wasn't my resident, but I wanted to go in and look just so I could get use to this kind of thing. She was a DNR. For about a day after that, I thought maybe LTC wasn't for me. I couldn't get her face out of my head. But I'm feeling better about it now. I don't really have any questions about this experience...I just kind of wanted to talk about it/get support.

Last weekend one of the patients on my unit was dying. Shes been dying for awhile, she probably still is hanging on for life as we speak. We were pretty sure it wasn't going to be much longer so I was off for a couple days and I thought she probably did die the next day after I worked. I had a dream about her, I couldn't stop thinking about it. I literally had a day of mourning.. I found some posts on here to read, that really helped me.

https://allnurses.com/nursing-blogs/self-assessment-your-380435.html

https://allnurses.com/nursing-blogs/nurses-coping-personal-392346.html

LA_StudentNurse · Apr 6, 2010

First time I had to deal with a DNR elderly person brough in from a SNF; I was doing my extern hours as an EMT. Apparently a senior citizen was given CPR at a facility but it was not until she was revived that anyone mentioned she was DNR. Because she was revived, they had to transport her to the ED. She was admitted and put into a 4 bed observation room in the ED. I vaguely remember the nurses talking about some kind of error but this was just in passing and I did not pay any attention. I was working and some errand took me to the room the elderly woman was in. All beds in the room were full as were the drapes around the beds. I noted that the woman was in a semi fowlers positon, was asleep and comfortable...but she was really still...so I went to the RN and report same--pt really still. The RNs eyes became saucers and she rushed in; the DNR had passed but no one has told the RN the DNR situation. She was about to call a code when someone took her aside and explained the situation. The RN was so ******; her heart rate must have skyrocketed.

The next encounter was while I was a student-nurse nursing assistant. A woman had fought the good fight but she lost--it was expected since she was in the ICU. I was charged with watching the ICU monitor, etc.and noted she passed with no family present. Shortly after she passed, I was charged with packing her up and transporting her to the morgue. I had help from a CNA and together we transported her down the basement. Because the morgue was locked and we had to get the security guard...whose office was across the hall and one door down. He quickly opened the door and could not get out our of the way and back behind his closed door fast enough. I can only assume that he was uncomfortable with death and bodies.

As for the CNA and I, we had worked with the deceased and were happy to give her the dignity in death she deserved. We took great care loading her into the refrigerated unit--as if she were our own relative. We were in no rush and when we were done, left to attend other duties. Afterwards, I had no bad feelings about our job and in fact, I was happy to care for her at that time.

There have been other deaths over the years, but I still care for these people as if they were my own relatives...they deserve dignity even in death. :twocents:

jackierocks · Apr 6, 2010

where do you work? I currently have 35 patients on my shift and am completely overwhelmed.

SuesquatchRN, BSN, RN · Apr 6, 2010

You will get this down. And you'll actually get your residents care for while fighting fires.

Get the hang of the facility and how it operates and when a job you want opens apply. I was the night charge RN for a month when an opportunity for a unit manager opened up and I applied and got it.

Hang in. 20 is really a reasonable load.

CapeCodMermaid, RN · Apr 6, 2010

Most facilities around here have 40 residents to one nurse at night so 20 should be manageable for sure. You might want to get more LTC experience before you start applying for other positions.

makes needs known · Apr 7, 2010

The SV of our facility (120 pts) does not take a pt load of her own. The charge nurses on each floor have between 20-40 pts. SV's handle emergencies, hang IV meds and work on staffing problems, etc. Most of nurses have a 40 pt load, except for the SV. She's in charge of the whole building.

starletRN · Apr 7, 2010

I might be showing my ignorance, but what does SV stand for? I'm new to LTC. Actually, haven't started yet. :)

SuesquatchRN, BSN, RN · Apr 7, 2010

Supervisor.

starletRN · Apr 7, 2010

Oh okay. I had a feeling it would be something obvious. :clown: Thanks!