What is a typical lpn day like?

PatrickJ · Jul 29, 2004

1, make sure state is not in

2, get report, count narcs, get coffee and head to kitchen for a slice of toast or if lucky, some bacon and a english muffin.

3, do accu checks

4, give insulins

5, pass meds to those unfortunate souls who worked a lifetime, planned on retirement and golden years, who were made to get up at 4:30 in the morning. They will be the ones asleep in a wheel chair near your med cart.

6, find the rest of your patients and finish your med run. OMG would be nice to be able to do it in 2 hrs.

7, post med run, chart on the mandatory ones, and situational charting.

8, do treatments, or start them, then head off to lunch.

9, answer the 16 phone calls you will get on lunch.

10, return for noon meds.

11, finish charting, and treatments.

12, go out and return your exit seekers

13, knowing it is not 1400 hrs, (2:pm) yell at your aids, for the umpteenth time you need your vitals by 10 am :-)

14, give report, count narcs,

15, go to your car and head home.

at the end of this all, smile knowing you made as many peoples day a little bit brighter because you made no med errors, touched all your patients, looked into each room each time you walk down the hall, and helped some peoples bellies get that full feeling because they can no longer feed themselves.

Nursing is good, I like it tons.

All this after a 20 year career as a police officer. Go figure.

Now ask me what a typical day as a street cop is like hehehehee

JessicaAAA · Jul 31, 2004

Wow what is a typical day as a cop like? What made you go into nursing patrick? and how long have you been doing it? What are the pros and cons of nursing... Can anyone give me the top ten reasons why its worth being a nurse?

tiroka03, LPN · Aug 1, 2004

I start off by getting coffee and then report, in that order exactly.

For the first hour I am giving scheduled meds and prns, and helping the aides toliet and quiet pts. I work nights. I try to do any admissions and check fluid levels on feeding bags and IV's. I check on any pt that is not stable. I also use this time to clean off the tops of the carts and empty the garabage, and to fill it with syringes and needed supplies. I do a narc count too.

Then the next hour:

I go through the mars and establish who gets meds, accu checks, treatments, and tube feedings and IV's. THis step is pretty mundane as I work this unit full time. There are always changes, but unusally not too many surprizes.

I then check if there are labs for me to get, or the RN to draw, (At my facility, in a pinch the LPN's can draw labs and start IV's.) I check to see the labs drawn yesterday have come back, and what the results are. If something doesn't make sense, for instance a very potassium level, but we give potassium supplements, I make sure we have stopped, or inform the oncoming shift. I check if an INR was drawn the level is theraputic to that patient. ect. If the RN is to draw labs, I prepare the tray and tubes and labels I also check to see all labs values have come back, or I will call the lab and request another copy. I may have to call the MD depending upon the result.

I then check to see the new orders. Have they all been transcribed? I note them to review them with the next shift at report time. And also for my benefit.

I then look at the faxes for the day. Have they all been responded to? If not, I will note that for shift report.

Then I do medicare charting and unit charting, and charting on anything I couldn't get to previously.

I usually have scheduled meds and such all through the noc and prns and tolieting ect. But it slows down around 1 in the morning and I try to get a break in then.

Then I will do unit chores, like chart vitals, clean up the med room, and order supplies. Depending on the day, I am doing either med change over, or what I call plastic changeover. Once a week I go through all drawers on the med carts confirming meds are there, and there is enough MOM and Tylenol, and Mylanta, and dressing changes. I look for anything to make med passes easier. Plastic meaning all nasal cannulas/masks, foley graduates and collection bags, Feeding tube syringes and grads, ect. I will also check the glucameters and make lists for me to follow the next day.

I will then try to get a start on discharges, people going home or to another facility. THe paperwork is endless. Anyway I can support my shift or the one following is my goal at this point.

Then morning rush, impossible to describe - you just have to work your plan. Who gets what when, you do have some choices. For instance if you go into a certian room, you will find not only that pt but the roommate has a sudden urge to pee. Quesse what , you will need to drop your program and toliet them. Takes up your time. So plan which rooms you can easily get in and out of fast, and to there first. If it is a person who takes forever to walk to the toilet, make sure you enter, after the aide has, your chances are impoved you can get in and out faster. The morning is all about getting as much done as quickly as possible.

Before report I have documented urine outputs, accuchecks and sliding scales both on the mar and the nurses daily report sheets. I also throughout the night document on the report sheets prns given or unusual happenings. For instance did I place a bed alarm, or protective boots ect?

We tape report, so I take my notes and do that. I then use the rest of the time to finish med pass and restock and prepare the the next shift.

There are times when the unexpected happens, someone dies, or starts going south. These are especially difficult times. Again, just do one step at a time. Keep moving, work your plan. Keep going and it will get done.

Sometimes you will met yourself coming and going in the halls. Other times you may have a slower day. When it is more slow just enjoy it.

A little tidbit that may help you. When I first started nursing, it was in a hospital. A nurse in her 70's trained me in. She walked slow due to artheritis. But, this nurse ran circles around me. She would do a hard pt and give me an easy one. She would be sitting drinking coffee at the desk waiting for me for 15 mins until I got done. The thing she taught me was to organize. If you are to do a dressing change, make sure your are bringing all the supplies, and extra, and pain pills and water and ect the pt could possible ask for. When you do this, you save steps, thousands of them. I still forget things and make the extra pass down the long hall, but not so frequently as I first did.

I work in a nursing home, but a rehab section, not long term

good luck

michelle95 · Aug 1, 2004

13, knowing it is not 1400 hrs, (2m) yell at your aids, for the umpteenth time you need your vitals by 10 am :-)

:chuckle The same with I&O's.

JessicaAAA · Aug 2, 2004

Thanks for responding it has alleviated some of my fears... i will tell you how it went on my first day...

KacyLynnRN · Aug 10, 2004

1. get report

2. say hello/good morning to all my patients..give breakfast insulin if needed

3. look up labs & call any criticals, check charts for orders, check that any pt.'s going to OR/Endo/Vasc. lab, etc. have consents signed and on the front of the chart and call down to see what time they will be picked up, then let the pt.'s know

4. see all patients again..pass meds and do their assessments

5. chart

6. look at pt.'s charts, see what care plan is and update pt. on what will probably happen today, take off new orders

7. do lunchtime accuchecks, check with CNA if she needs help with beds/baths/etc., update RN on my patients

8. go to lunch and cover for others' lunches

9. pass more meds, check charts for orders, if pt. is coming back from OR make sure I have everything ready for their return, talk with any pt.'s being discharged (RN does discharge paperwork)

10. check with my CNA concerning vitals, etc.

11. check charts for any orders, do dinnertime accuchecks, give dinner insulin if needed, update pt.'s on their POC and what they can expect to happen tomorrow

12. do chart checks to make sure all orders have been taken off and completed and write shift notes on all my patients

13. go to report

14. say goodbye to my patients and see if they need anything before I go

That's a very small glimpse of a day in a med/surg LPN's shift...of course that is a perfect day with no new admits!! :roll

Kacy

Litlbabynurse · Aug 10, 2004

Hi, just dropping a line to say hi to all, and how all is going in the world of nursing... am about to start a job and am a little nervous... I hope all turns out ok... What is a typical day for an lpn like? can anyone describe their own experiences?
Thanks
jessica

My routine is probably a whole lot different than the ones you've read so far. I work nights in an NICU.

1. Stand at the desk and wait while everyone else argues over what patients they want to take for the night.

2. Take the leftover assignment and get report. I have a patient load of anywhere from one to four patients, depending on acuity, so report doesn't usually take long.

3. Go to each patient and eyeball them, measure ET tubes, check IV fluids and rates, check IV sites and lines, glance at the monitors to make sure that we are all currently ticking along at a nice base rate, make sure there are no surprise messes in the beds that need to be cleaned up quickly, and greet/talk to family members that may be at the bedside.

4. Check my charts for any orders that may have been missed on the previous shift and any labwork that will be needed during my shift.

5. Find out what doctor is on call and make sure I have that pager number written down somewhere in plain sight.

6. Find the RT and remind her/him of any blood gases that I will be drawing during the night since they have to be at the bedside to run the labwork.

7. Spend the next 11 hours doing assessments, vitals, feedings, and labs. My patients usually have to be assessed and vital signed every 1-4 hours, again depending on acuity.

8. Spend a lot of time praying that none of them decides to crump or self extubate during my shift. Of course, if that happens, that adds a little more chaos to the night.

9. If I get an admission, the RN will do the admission assessment, then pass the baby off to me for the rest of the work.

10. Keep a close eye on lab results and call the doctor to notify them of all blood gas results. Take orders as needed, implement those orders and notify RT if I need a vent change, etc.

11. At some point during the night, I try to take a lunch break and a smoke break.

12. If parents are present, I often do teaching and facilitate bonding between the baby and parents.

13. At the end of the shift, I make sure that everyone is straightened up, clean, positioned well (of course, I do this throughout the night too) and then give report to the next victim.

14. Go home and collapse.

laurel · Aug 11, 2004

hi im an IV nurse when I first get to work I pick up 2 pagers which usually covers ICU, the cardiac step down unit, all codes (in the ER and the rest of the house) and all open heart surgery starts, the telemetry floor 30 beds and the med surg floor 30 beds. So for the first 3 hours i am usually running from place to place answering pages. LOL. at 0830 our next staff people come on and they get one of my pagers and that unit. The rest of the day is spent restarting out dated sites outdated tubing changes iv site checks and iv starts when needed central line care and assisting in PICC line insertions and we do place midlines also. I do alot of problem solving with pumps and such for the floor nurses. We truly are very busy

nursedawn67, LPN · Aug 12, 2004

LTC......Arive 6:45 am, shift starts at 7, but don't wait that long punch in immmediately. Get aides vital signs list, alarm list, and food acceptance list together. 7:15 am get report and count narcs. 7:30 take smokers out for the morning smoke. 7:45 to 8 am start med pass. 10 am finish med pass do whatever treatments need to be done, check on other nurses to see if they need help. Chart and check any necessary labs and the such. Maybe fit quick break in. 10:45 go to lunch. 11:30 insulins and smokers again. Noon med pass, 2pm more treatments, IV's eye gtts. 2:30 chart vitals and any other charting not done. 3pm give report and count narcs. sounds easy but also add in at anytime of the day emergencies, phone calls and call lights...oh yeah and any prn meds needed.

TBLPN, LPN · Aug 13, 2004

i work 7p-7a in ltc. a very hectic unit. something always going on. when i get there, first and foremost, top priority, is my mt. dew for the noc. i then get report and count narcotics. talk the my cna's that i will have for the noc and give them a quick report on who i need them to keep a "careful" eye on or anyone who is exhibiting "new" behaviors. i then start my med pass, which can take anywhere from 45 minutes to 2 hours depending on the mind set of the residents. then treatmets. i then continue to do medicare charting and "special" charting. at 11 pm i get report from the other nurse and then i have all 54 residents for the remainder of the noc. i then proceed to do glucometer readings, 24 hour reports, census sheets, skin assessments, return meds, order meds, file faxes, note the ones that have not yet been responded too. i also handle labs in the am, fax all results to md. about 3 am i continue, once again, on medicare charting and treatments (i'm working 2 shifts basically). i also set up my med book for my 5/6am meds/insulins/accuchecks/g-tubes. then when 5 am hits, watch out, accu checks, med pass, insulin, i&o's, morning staff coming in, i have to set up schedule/worksheets for morning cna's, everyone griping about what sheet they have. then at 7 am be ready to give report and count narcs again. it's hectic......but again, once you get into a routine, it's not bad. good luck!:rotfl:

txspadequeenRN, BSN, RN · Aug 14, 2004

Well I am a Alheimers LTC nurse and here goes. (Medicare unit)

1. Just peek through the secured doors to see if the night nurse has her head on the desk. A sure sign I need to go home ,as well As if they start waving you to the desk.

2. Take report through all the screaming of patients " I need to find my car I have a dinner date with the Govener" or " I need to call 911 there is someone in my house".

3. Make sure all the staff is there, sometimes we dont get this important information.

4. See who needs accuchecks/ insulin. We have a nurse for meds.

5. I have 30 people to do assessments and medicare charting on so I get busy. Doing treatments and tube feedings along the way.

6. By this time we start to have some behaviors and I start looking for the ones that might need meds.

7. And I repeat # 5 and 6 for most of the day. I put out fires between staff and families

8. I dont get a chance to have a break or lunch I just order out and eat while charting. I work with another nurse we both do the same thing.

9. Alot of my day is making sure these little people stay safe, keeping them inside and off the floor things like that.

10. I also do Poop patrol making sure we dont have any spreaders !!! KNOW WHAT I MEAN...

11 I rarely get out on time and when I do Im to tired to walk to the door. And if I make it outside I have been with the alzheimers patients so long I forget where my car is!!!!