I'm an LPN, finishing my RN. I have had so many nurses/doctors/instructors etc tell me lately that I MUST work a few years in a hospital, that LTC isn't real nursing, I'll lose my skills, "You're too smart to work in a nursing home," you'll never get a job anywhere else, your whole day is figuring out how to make them poop. I can see where they're coming from, really I can.
I love coming to work every day. I know those 32 dementia residents like the back of my hand. I know how to soothe them. I figure out when they're hungry/tired/have to pee/in pain when all they can tell me is "AAAAAHHHHHH!!!!" I have time to sit under the table with a lady and help her clean the floor with her sock. I have time to sit with an anxious resident who is screaming, not from pain, but from fear and confusion, and stroke her hair while she falls asleep. I have time for that macho man to "help" move the furniture around. The man who can't remember he can't walk sits behind the nurses' station with me while I chart and eats bacon and eggs so he won't fall. I have time to give a bath now and then. I have time to have popcorn fights with them. I argue, sweet talk, and get feisty with doctors, pharmacies, case workers, administrators and others to make sure my residents get what they need. Like my med surg instructor said, "A monkey can start an IV. A monkey can do procedures. That's not nursing." And that makes sense.
I may want to move on some day. I'm still very young. But for now, I'm where God wants me. And I'm blissfully happy.
Specializes in Gerontology, Med surg, Home Health.
Ladies-
Cut yourself 25 miles of slack! You just started and can't expect to get everything done the right way and on time when you are so new. I've told all my new nurses I'd rather they get things done the right way. The being on time part will come (or not) with experience. Move some of the A.M. meds to the afternoon or better yet, get rid of some of them. No one (unless they have skin issues and this too is debatable) needs vitamin C and a multivitamin and iron and calcium and...the list goes on. Talk to your pharmacy consultant. We had many residents getting anti hypertensives (I'm talking old demented residents who had been there for years) four times a day with parameters. I looked back and saw that for the past year, not one dose had been held for low blood pressure. We first got rid of the parameters, then upped the dose and gave it twice a day instead of four and the next move is once a day. It takes lots of work and time to cut these meds down but in the end it benefits you and certainly benefits our residents.
Specializes in Did the job hop, now in MS. Not Bad!!!!!.
Ladies-
Cut yourself 25 miles of slack! You just started and can't expect to get everything done the right way and on time when you are so new. I've told all my new nurses I'd rather they get things done the right way. The being on time part will come (or not) with experience. Move some of the A.M. meds to the afternoon or better yet, get rid of some of them. No one (unless they have skin issues and this too is debatable) needs vitamin C and a multivitamin and iron and calcium and...the list goes on. Talk to your pharmacy consultant. We had many residents getting anti hypertensives (I'm talking old demented residents who had been there for years) four times a day with parameters. I looked back and saw that for the past year, not one dose had been held for low blood pressure. We first got rid of the parameters, then upped the dose and gave it twice a day instead of four and the next move is once a day. It takes lots of work and time to cut these meds down but in the end it benefits you and certainly benefits our residents.
Eek! No parameters? I'm always worried bout BP meds without them. I also always thought the MD should be aware of them before prescribing such powerful drugs.
Hope to be starting in NH soon. Thanks for this positive reply CapeCod!! Now, how can I help?
Specializes in Gerontology, Med surg, Home Health.
In today's nursing facilities, we try to make the atmosphere as home like as possible even on the sub acute units. I am on anti-hypertensives (the stress of being a DNS I think) but I certainly DO NOT take my BP every day before I take the medication. It might be reasonable to check BPs for a week or so after starting a new medication or changing the dose, but it really isn't a standard of practice to continue to check blood pressures on residents whose medication regime is stable. We waste so much time on needless things that we often do not have the time for what really matters.
i totally agree with capecodmermaid. those of us who have worked in ltc for a while agree with the idea that parameters are usually only given when a new med is initiated or if the resident's bp is labile. i have people on 4 bp meds at once sometimes, and we check bp once a week, after they're stable. i realize that a nurse in a hospital would find this outrageous, but it's standard practice in ltc. i also agree that we spend a lot of time doing needless tasks...such as charting that bp in the mar, chart, report and vital signs flow sheet. we're not acute care.....we are their home away from home. (of course, we check vs anytime things seem "not right"). believe me, when you go from a hospital setting to ltc, you'll be surprised at many things!
CapeCodMermaid, RN
6,092 Posts
Ladies-
Cut yourself 25 miles of slack! You just started and can't expect to get everything done the right way and on time when you are so new. I've told all my new nurses I'd rather they get things done the right way. The being on time part will come (or not) with experience. Move some of the A.M. meds to the afternoon or better yet, get rid of some of them. No one (unless they have skin issues and this too is debatable) needs vitamin C and a multivitamin and iron and calcium and...the list goes on. Talk to your pharmacy consultant. We had many residents getting anti hypertensives (I'm talking old demented residents who had been there for years) four times a day with parameters. I looked back and saw that for the past year, not one dose had been held for low blood pressure. We first got rid of the parameters, then upped the dose and gave it twice a day instead of four and the next move is once a day. It takes lots of work and time to cut these meds down but in the end it benefits you and certainly benefits our residents.