New RN working in Group Home

hey, sorry it took me so long to get back to you. this week has been so so busy at work. ive been working on these audits, which have to be turned in by the end of the yr. since i have so many houses, its pretty stressful and a lot of work, pretty slow going too bc i have all these houses spread out all over the place, so just driving there takes awhile. im doing well though. my boss saw the audits ive already completed and she said that she's never seen an audit so thorough before and ive done such a good job she wants me to teach the other nurse....who has been there for months, she trained me....how i do them. so i guess im doing well. i just hope i dont cause any conflicts by creating more work for the other nurse whose been there for awhile.

anyway, about what you did with the bp issue, i dont know who you are supposed to report to, but for me, i give my boss all the problems i found with the audits, she forwards them to the house managers, associate directors, and directors. then the staff will eventually get it too, and hopefully fix the problems. they are given a two week period to fix the problem and get things up to date, then i go back out to the house to see if they did it. do you have someone overseeing all the houses in your program? or are there only the two houses that you work at? either way, you have to document that you found the problem, and document what should have been done in the first place. and it would be a good idea to talk to the staff as a whole, or at least the manager and tell them what to do. then your ass is covered, the documentation is a must, then when the state comes to audit your job is documented there for them to see. what i would do in that situation is also check the patients blood pressure myself whenever i was in the house. at least it shows that you yourself are taking action to check it. i know you cant do it everytime they get their meds....but thats in a hospital. remember, the reason you do that in the hospital is bc these people arent stable so they need to be checked for these things. once they are living in a group home, they shouldnt have problems with this stuff, it should have been worked out during a hospital stay, or their doctor would have ensured their bp meds were regulated correctly so as not to cause any major drops in their pressure from their meds. do you get what im saying? i dont know if i worked it correctly. its easier to speak this stuff rather than write it. with my job, i dont have anything to do with med administration. i do quarterly audits, checking that they are following procedures, and i do narcotics counts too. thats about it.

again, ive written alot to you, i cant help it. sorry. one more thing. for your hospital job that you want to get, have you thought about getting some relief work at a hospital? most of them have the option of working just one or two weekends a month, or one shift a week. that way you can get your skills and still focus on the job you love. i think that might be a good idea. you should do it soon though before all the knowledge from nursing school starts slowly getting forgotten. it just happens unless you are exposed to it on a semi regular basis. i know ive forgotten alot of things already and i did work for a year, though from that year i learned and do remember so many things that ive found useful in my current job. i know i keep mentioning it, but i think it would better your nursing career and you would be much more sure of yourself. either way, its your call. did i answer your questions? i like writing to you too. i dont know anyone, except for the part time nurse i work with sometimes, that does what we do. its fun to compare notes and see the similarities in our jobs.

did i tell you that one part of my job is to educate the staff? i have to give inservices to all the people that work in the houses...two hrs each. that is something im very nervous about, but i know its necessary. im starting with one about the importance of documentation...tying it in with all the paperwork i find missing from the patients binders during my audits. the next one im doing is on pressure ulcers, how to stage them, prevent them, and treat them. both of them are so important. these people that work in the houses are not trained/licensed healthcare professionals. they are awesome at their jobs, but they dont have a strong background in medical, so this stuff i think is very important for me to teach them. i just HATE public speaking, but this will get me over my fear of it i guess.

well, thats enough for now, ive written you a novel. get back to me when you can. i enjoy reading your responses. let me know about any potential jobs you see in hospitals.

see ya!
donna

hey,

sounds like things are coming together for you. thats good that they are listening and taking the bp like they should be. i think the inservice is a good idea, but i kind of doubt they will always do a manual bp. i know that the automatic ones are sometimes inaccurate, but sometimes its hard to get them to even take the blood pressure, let alone do it manually. let me know how that turns out, i just know in my houses that would never happen. the people that work at my houses are very good at what they do, but they dont really do things that are "above and beyond" they stick to their job description and if a task falls outside of it, then it will rarely be done. i have a questions, are your people working in the houses in a union? at my company, they are all in a union, everyone that works for them, except me and the managers. they formed a union just for them. im just curious to see the differences between nonunion direct care givers and union ones. ive been so busy lately. i have until the end of december to finish my audits, which have been going well, but i have a few houses that are completely far away from the others. ive got to spend a few days going to these far away areas and hopefully things are going well over there. it would suck if there's lots of problems and people arent filing things correctly. do you have lots of people with pressure ulcers? there's a few in my houses, especially the people confined to the bed. all the other are up and about all the time so we dont have to worry too much about them. are people you work with educated on how to prevent them....turning, putting pillows under their ankles to lift their heels off the bed, etc? how much medical information do they know? are they licensed or just trained in the tasks they have to do? my people dont know much about healthcare. they learn as something comes up, but most of them have no background in it whatsoever, so im always teaching them things, etc. just curious. well, have a good rest of your weekend!! good luck with your audits.