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A Day in the Life of an LPN

Amy (not her real name) is a licensed practical nurse in California. She got her LPN five years ago. Her first job was in an extended care facility (nursing home), the graveyard shift in the middle of the night. Amy did well working at the nursing home. Within a couple of years she was the supervisor of the aides on the graveyard shift. She had 70 patients under her care. It was hard work, which she didn't mind.

But after four years at the nursing home, Amy felt the need for a change. She wanted to work days so she could have a more normal social life. She applied for a job with an employment agency that places practical nurses into homes where care is needed. This agency pays almost as much money as her night supervisor job did. She is now working in the home of an elderly couple. The husband, who is 84, is in pretty good shape and doesn't need nursing care. The wife, who is 80, has advanced Alzheimer's disease. She has already lost essentially all her short-term memory, so she never remembers Amy from one day to the next. Amy doesn't mind, because, although she is confused, Mrs. Johnson (not her real name) is pretty happy and easy to take care of.

The biggest challenge for Amy is to try and keep Mrs. Johnson relatively quiet, and make sure she takes her medications, as well as trying to get her to eat.

Amy begins her day talking to Mr. Johnson. Of course they have to be in the same room as Mrs. Johnson, who will wander away and get into trouble if they take their eyes off of her. Usually Mr. Johnson says, "I think she's a little better today." Amy knows he is just saying what he wishes were true. Then he will tell her if Mrs. Johnson ate any breakfast. Since Mr. Johnson is his wife's main caretaker, his only time for himself is when Amy is taking care of her. He uses this time to do errands and to get an emotional break.

The biggest challenge for Amy is to try and keep Mrs. Johnson relatively quiet, and make sure she takes her medications, as well as trying to get her to eat. She has high blood pressure as well as osteoporosis, thin bones. She needs to take two pills a day, plus a once-a-week medicine for her thin bones. She also has to take calcium and vitamin D to strengthen her bones. She has fallen and broken her hip in the past. That was before Amy's time. The surgery she had, and time in the hospital, was followed by a tremendous worsening of her memory, which is why Amy is there now.

Amy gives Mrs. Johnson her medicines in the morning after breakfast. Breakfast is a challenge. Mrs. Johnson does not want to eat. She has lost quite a bit of weight. Amy will give her Ensure to drink during the day as much as she can. Some days are better than others.

Amy has found a number of ways to keep Mrs. Johnson quiet and happy. She does like watching television, cartoons actually, although she won't hold still for an entire 30 minutes. Amy turns on the television whenever they are in the living room, and puts on the Cartoon Network. Mrs. Johnson also likes having her hair brushed and braided. Amy does that every morning. Sometimes she can read children's books to Mrs. Johnson, sometimes not.

One of the hardest things for Amy is to try and keep Mrs. Johnson clean. Sometimes she can get her to sit in the shower on a special chair, and she can use the hand nozzle to gently spray her. Amy uses a little liquid soap that Mrs. Johnson likes because it smells like lavender. Then Amy sprays the soap off, dries her and puts her in clean clothes. Some days, she can't get Mrs. Johnson anywhere near the shower.

By the end of the eight-hour day, Amy is ready to go home. Mr. Johnson takes over his wife's care. Amy knows that this can't go on forever, but for now she is happy to help him. That is why she trained as an LPN.

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