[eldragon]

I am finishing up my fourth week at a SNF, as a medication nurse (LPN.)

I am a very ethical, diligent worker. I always follow through with anything that I know needs to be done, and get everything done, and could be said to be an over-achiever in that way.

My problem is that I am realizing, much to my dismay, that the other two shifts - swing and graveyard - nurses aren't pulling their weight around my unit.

Here are some examples:

• Leaving me, the dayshift nurse with the heavy load, without supplies. So I order a boatload of supplies, and they come in the next shift - but nobody puts them away. Instead, they take from the pile of supplies, and leave the bulk there for me to put away when I come on shift. This goes on day after day. Incredibly, I rarely have essential items, such as glucose test strips and lancets and am constantly ordering them. Yesterday I wasted two trips from a patients room, because the first time I noticed the glucose test strip container was empty, and the second time, I saw that the spent lancets were in a cup - not in a sharps container - where only news ones were supposed to be. I had to go back to the locked med room twice to re-stock.
• Medications are signed off on, and there is no way these were given. This has happened twice, with two other nurses, in the past week. As in, a new patient comes in and his/her medication isn't in yet - but other shifts sign off on their meds, saying they gave them. I hunt and hunt all over, and do not find their meds. I call the pharmacy, and am told the items are on backorder, and have not been delivered. This makes me look like a loser, because previous shifts are signing that they gave all these meds, that do not exist. I have to go in and chart and follow up, and check orders, and re-fax them, and call the pharmacy - only to find out that the medication couldn't have been given by previous shifts. Then I look like a rat. Get it? This keeps happening.
• And to add to the last part - last night a new medication nurse on the second shift came on and took the med cart out on the floor...(I was charting at the desk) and went to several patient rooms, passing meds. Opening the cart, getting items- pouring water - going into the rooms - for a full 30 minutes. The problem? She had left the MARS at the desk. This is a SNF, and orders change daily. You can't do this from memory.

The consequence of these things is that I am always running to get my things done. I am the busy, dayshift nurse. And at the end of the day, I am so stressed out, I can't stop thinking about work, and can't sleep at night.

There are other examples of things going on, but these are the biggest and worst.

Is this common behavior amongst individuals I thought were professionals, or just bad luck for me to be working with slouches?

Help!

[Diary/Dairy]

Originally Posted by eldragon

• Leaving me, the dayshift nurse with the heavy load, without supplies. So I order a boatload of supplies, and they come in the next shift - but nobody puts them away. Instead, they take from the pile of supplies, and leave the bulk there for me to put away when I come on shift. This goes on day after day. Incredibly, I rarely have essential items, such as glucose test strips and lancets and am constantly ordering them. Yesterday I wasted two trips from a patients room, because the first time I noticed the glucose test strip container was empty, and the second time, I saw that the spent lancets were in a cup - not in a sharps container - where only news ones were supposed to be. I had to go back to the locked med room twice to re-stock.
• Medications are signed off on, and there is no way these were given. This has happened twice, with two other nurses, in the past week. As in, a new patient comes in and his/her medication isn't in yet - but other shifts sign off on their meds, saying they gave them. I hunt and hunt all over, and do not find their meds. I call the pharmacy, and am told the items are on backorder, and have not been delivered. This makes me look like a loser, because previous shifts are signing that they gave all these meds, that do not exist. I have to go in and chart and follow up, and check orders, and re-fax them, and call the pharmacy - only to find out that the medication couldn't have been given by previous shifts. Then I look like a rat. Get it? This keeps happening.
• And to add to the last part - last night a new medication nurse on the second shift came on and took the med cart out on the floor...(I was charting at the desk) and went to several patient rooms, passing meds. Opening the cart, getting items- pouring water - going into the rooms - for a full 30 minutes. The problem? She had left the MARS at the desk. This is a SNF, and orders change daily. You can't do this from memory.

The consequence of these things is that I am always running to get my things done. I am the busy, dayshift nurse. And at the end of the day, I am so stressed out, I can't stop thinking about work, and can't sleep at night.

There are other examples of things going on, but these are the biggest and worst.

Is this common behavior amongst individuals I thought were professionals, or just bad luck for me to be working with slouches?

Help!

Number 2 should DEFINITELY be written up - charting that meds are given that they cannot have received at all is FRAUD!!! Document document document and cover thine a$$$!

[Diary/Dairy]

BTW - these people are just being lazy, they need to be discouraged from this type of behavior.

Take care of yourself too - you will get burned out if you don't.

[eldragon]

But other facilities are not like this, right?

Please tell me they aren't all like this.

Is the trick to just ignore what other shifts do?

[Diary/Dairy]

I'm sure they are not all like this!!! Talk to the oncoming shift in a polite and diplomatic way asking them if they can help put away supplies and other tasky things. Tell the offenders about charting what they did not give, but DO cover yourself. Talking to other people can help you find a place of employment that might suit you better. Good luck!

[catlynLPN]

I am nightshift. I work in a LTC part time, about 3 days per pay period.
What you describe, I find also.
Supplies are never on the cart. I make trips back to the med room looking for stuff.
It would be so much easier if EVERYone would restock the cart when they finish giving their meds, then everything would be there for the next med pass.
Some meds are not ordered, or maybe ordered and not yet delivered, so it's the weekend and I'm without some meds. I have to go all over the facility to find something to borrow, and I know we're not supposed to do that, but the pharmacy gripes if you call them to reorder a routine med on the weekend.
My medication cart was so filthy, it made me sick to give meds off of it. Everytime I'm there, I've been making an effort to clean part of it. I took all the liquid bottles out and washed off the spilled medicines, and washed out that part of the drawer. There were pills in the drawers, that had probably been there 2 years or longer.
The top drawer was so disorganized you searched for stuff for ten minutes before you could find it.
Eye drops were mixed up with nose sprays and inhalers, etc, that kind of thing.
Just nasty and disorganized.
You should have seen the refrigerator in the med room. I bet it had not been cleaned in 5 years. There was gunk in there that was so DRIED I had to soak it to get it off. I used bleach on the whole thing.
There was a bottle of mustard that should have been thrown in 2004.
And, yes, they put food in the same refrigerator that they keep medicines in. They even have to put urine specimens, blood cultures, and that type of thing in the VERY SAME fridge, because the nursing home is too damn tight to buy enough fridges to be able to separate all that stuff.
And I am just a part time nurse. I'm only there, as I said, about 3 days per 2 weeks. You would think that the full time nurses would make SOME effort to do some of this cleaning, but NO, they don't. It's the part time LPN that makes the effort to clean up some of the filfth off the cart and fridge.

People are put to bed with their clothes on, and the CNAs act like it's beyond their line of duty to go in there and take their clothes off and put a gown on them.
The patients get no mouth care. I never see dentures removed and soaked, and I never see a toothbrush in anyone's room, except the patients who are with it enough to be able to do that for themselves.

Snacks are sitting on the desk every night when I come in, that haven't been passed out.
The administrator sent out memos to every nurse and told us we would be responsible to dig thru the urine soaked and BM'd laundry to GET OUT THE TRASH, because the CNAs are putting the trash in with the laundry before taking the barrels outside by the laundry.
I'm not doing that. I am not digging that laundry.
If those CNAs are so damn lazy they can't separate the trash then the administrator needs to somehow mark the barrels so they know which hall they came from, so they can identify who put the trash in there. But this LPN is not digging in that.

I could go on and on. This kind of crap is every night that I work.
I honestly do NOT know what keeps this place open. I don't understand that the inspectors do NOT see this stuff. Are they just turning a blind eye, or what???
I see it! It's enough to make you sick, I hope I never have to live in a nursing home when I get old. I hope I die before I come to that.

[ChanceORiley27]

Wow - I thought I had it bad... Holy crap.

I think that there will always be shift dissent - to a certain degree -because we're all overworked and most humans need someone to blame at least once in a while.

I work nights and sometimes the day shift drives me nuts. Quite frankly my shift passes 3/4 of the meds, does 3/4 of the tx's, and all the extra crap - testing accu check machines and the like - and yet they complain because THEY'RE busy. In all honesty - EVERYBODY is busy. Hell - at least I don't have management breathing down my neck.

However, I think you need to find a new job. LTC jobs are one in million and usually pay about the same. We might always be short staffed and short supplied but at least you could find a place where other shifts do carry at least SOME of their weight. Heck - I'd drop dead in shock if someone asked me to order my own supplies.

I work in Indianapolis, IN. I'm very curious where you're located that you have to order supplies.

As for aides leaving people in gowns and not sorting trash from linen. Write them up. If after three or so write ups they still haven't been fired. Ask the DON what the hold up is - that sort of behavior is not okay.

Sidenote - my rule of thumb is to quit if your so miserable you think about work constantly at home. Once my fiancee start commenting on how I complain about work constantly - it's time to go.

[Happy TBA Nurse]

I used to work in a similar enviornment. As a regular daytime nurse I built a relationships with the other nurses and could see what their weakness/strengths were and would give assignments out accordingly. One person cannot do everything and you have to delegate. If I continued to have problems I would report it to my supervisor although nothing was usually done about it. I also worked in a filthy place I was constantly cleaning and organizing. I just did the best I could for my clients. I currently have a new job. It is very clean and the types of errors others have reported would never be seen here. The person would be fired fast. Everyone knows that here and people do their part.

[squeakykitty]

Originally Posted by eldragon

• Medications are signed off on, and there is no way these were given. This has happened twice, with two other nurses, in the past week. As in, a new patient comes in and his/her medication isn't in yet - but other shifts sign off on their meds, saying they gave them. I hunt and hunt all over, and do not find their meds. I call the pharmacy, and am told the items are on backorder, and have not been delivered. This makes me look like a loser, because previous shifts are signing that they gave all these meds, that do not exist. I have to go in and chart and follow up, and check orders, and re-fax them, and call the pharmacy - only to find out that the medication couldn't have been given by previous shifts. Then I look like a rat. Get it? This keeps happening.
• And to add to the last part - last night a new medication nurse on the second shift came on and took the med cart out on the floor...(I was charting at the desk) and went to several patient rooms, passing meds. Opening the cart, getting items- pouring water - going into the rooms - for a full 30 minutes. The problem? She had left the MARS at the desk. This is a SNF, and orders change daily. You can't do this from memory.

There needs to be writeups and incident reports about this because it's neglect and false documentation. And talk to the manager about the restocking.

[eldragon]

I actually was pulled aside today and apologized to by the RN Supervisor in charge, because she said I should not have to be spending so much time trying to get med orders filled.

(I should, of course, be charting instead.......with all that free time I have after pushing 300 pills and everything.) I swear....we had another impromtu meeting today about charting and how the poor owner, (who owns the local hospital and 4 LTC centers, ) is losing money by having so much help.

Right, so I guess he's in it for the charitable aspect.

Crap, I don't sit down from the minute I clock in fifteen minutes early until the second I clock out up to 30 minutes late. I usually get to sneak in a 10 minute lunchbreak, if I'm lucky. I just have too much to do.

And then it's never enough. Slaves wages, I tell you.

I'm 44 years old, and not sure how long my mind and body can keep up with this pace. I am in shape and everything, but I am a FAST walker. In the mornings, I get alot done - and in the afternoon, I'm almost hunched over.

Is it worth it?

Oh, I'm in Missisippi. They can't keep CNA's, so they never fire them, but in my opinion, I have no problem with the ones I work with.