Doing Without a P.O. Med Nurse - HELP!!!! - page 3

by soundsLikesirens 3,297 Views | 33 Comments

I have recently returned to nursing after a 7-year absence. I've been on a busy med-surg/oncology unit for 3 and a half months now, and when I first began, it was great. Of course, I was learning (still am), but when I started,... Read More


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    Hey, to SoundslikeSirens from Bora Bora. I love it. I don't know where Bora Bora is (isn't that a remote island somewhere?) but I do see most of the responses are from the north. I be in the south and I guess I be really stupid. I was an RN on a medicare skilled floor in LTC. I was the only nurse with 41 residents and we may have 4 CNA's on a good day. I did med passes, tube feedings, skin treatments, etc. and of course, all the required documentation required. (haha) Even our LPN's did this. We are way behind I think. When I get old and need my diaper changed I probably should think about moving north or at least to Florida.
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    The hugs and the being able to be there for someone who is down is why I love my job. I guess I am fortunate. I work LTC, but in the alzheimer's unit where there are only 12 residents with a cna and a nurse. I am creative with the hour leeway at times, but only because if it is too late, they won't take their meds. I do also work the floor occassionally, and don't like that as well, because there are sooo many pills and such a short amount of time. Many of the residents are used to the way a certain nurse does things and they like to keep it that way. Which can make it very frustrating. I do enjoy ltc, don't know why some people think that if you work in a nursing home that you aren't a real nurse, that irritates me.

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    Hi, Im a nurse in England and Ive never heard of a meds nurse before.Ive just left a job in a 56 bedded nursing home and it was a nightmare doing a med round on a morning, it could easily take 2 hours, without many interuptions. Ive just started a new job on a 15 bedded rheumatology ward and cant believe how much time is taken up doing meds, (Ive been out of hospitals for several years)
    Why cant you take the med trolley with you?
    Im soooooooooo jealous of places with med nurses.It must make the job a hell of a lot easier and safer.Although I prefer primary care it is not always feasible with staffing levels.

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    I was talking to another RN last night...she said her unit director made the ridiculous claim that the more patients each nurse had, the better care they received!!!.......HELLO.........
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    Hey, BoraBora, I would give a new Merck Manual to come and give you a hand. Not because your job is easier. I just love your part of the planet. Do you wear flowers in your hair when you go to work? I wanted to jump in here about med aides. They are essential! I worked with one MA, 5 cna's and another RN, 60 patients, some skilled, some alzheimers. I did the diabetics, treatments and tried to pick up the prn's, answered the phone - The RN is expected to pick up the slack. The aides and MA were pounded. I was trying to pass pain meds and get the diabetics covered when they came to recruit me to help feed. For the first time in my career, I refused. (They managed). Why is staffing always cut in the evenings? That's when families come in with 100's of questions. Sundowners abound. Constipation and diarrhea manifest. People fall. I know this happens during the day too, but generally there is more help -although still not enough. I worked at a wonderful little hospital last week that had a charge nurse and an extra nurse to do nothing but put out fires and cover the "unexpected". He was busy the whole time. With all due respect, I still contend that there would not be such a great need for the checker uppers if there were more help. Say what you will about doing it right the first time, by the time I end a shift like that, I can hardly think straight and yet I'm haunted by the needs unmet - the people who are so hungry for someone to sit on their bed for ten minutes and just be with them. It would be more therapeutic than all the pills in the world. Just venting. Thanks.
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    To sirens and Mustang: I am glad I found this site. I didn't realize how much I needed to vent. Siren, in regards to that person that told you the more patients you have the better nurse you are - well, I can not print what I want to say, but that is like telling a teacher, the more students you have the better teacher you will be. She/he must not have ever been overloaded or he/she is delusional. And to Mustang, you are right about the 3-ll shift, esp. in LTC, with all the Sundowner's and families come to visit it can be a nightmare. I have worked all shifts and I still don't understand why they can't get the 11-7 shift to do more. Since that is the hardest shift to fill, I have a feeling that they are worried that if they give them too much to do, it might run them off.
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    "Why can't nights do more?" Have you ever worked nights? Nights routinely has the least staff, the least margin for crises, and the least input into the unit. (Staff meetings- routinely 10 and 4- maybe 6pm. Never seen a day nurse required to wake up for a mandatory 2AM meeting- not once.)

    HOPEFULLY there is a little downtime for nights- IF the patients are able to sleep. Doesn't happen, trust me. Nights is when they get confused, scared, ring the bell 1000 times, etc. Nights is when more of the sick emergency surgeries come out of the OR.

    There is a little less planned activity on nights but we have to rush to clump those activities into the first and last 2 hours of the shift in an attempt to let the patients sleep. The little downtime that may happen in the middle is stuffed with scut work- chart stuffing, chart checks, whatever.

    And of course, if a patient arrives sick or crashes in the middle of the night, we have minimal backup. Trust me, many MANY docs lean on us night nurses a lot more than they do on days. On days they are more likely to get involved- nocs, they don't want to get out of their warm bed. If days gets 4 admits, someone is calling around for more staff. (Trust me- I get those calls.) If nights gets 4 admits (after starting shorter than days), too bad. "We can't call people at 2AM..."

    Yes, there is the occasional slow night shift. But at least in the hospital, not much more often than on days. And when all hell breaks loose, we are on our own.

    Asking nocs to do more of the scut stuff is pretty insulting- makes us into techs and the day staff into the professional nurses. There needs to be respect between the shifts. If you think nights has all sorts of extra time, work a month of nights. Then let me know what you think.
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    I couldnt agree more! I work 7p to 7a and I run, run ALL NIGHT LONG...less staff, too. The call light rings all night long...frequently, we find out they are sleeping in the daytime/up at night. And we get to reap the "benefits" (?). It's no party.
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    11-7 should do more??? Come On !!! Contrary to popular belief, LTC pts don't sleep at night. They are lonely and scared, and needing attention, sore from PT and asking repeatedly for pain pills +/or hot packs, they need to pee (constantly), they're confused, disoriented, often combative. Strangely enough, the patients who are alert, oriented, and ambulatory during the day, can not seem to breathe without assistance, much less turn over in the bed. We have more patients per staff member, more treatments(since we have so much time!), and the same amount of documentation per pt as the day nurses. If we have an emergency, injury, or a patient codes, we have no one to call for backup help...what we see is what we've got! and we must always deal with the on-call Dr's (if they answer their pages). Yes, I imagine it does seem much quieter at nite, because all the "brass" and family members have gone home, but the night shift works every bit as hard as the others- and often has to do it on less sleep, because of the demands the 'daytime world' places on us as well.
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    Oops, I see I hit a few nerves regarding the 11-7 shift should do more. I confess the only night shift I worked was on a psych unit with about 10 patients. Our biggest problem was figuring out what movie we were going to watch that night. Sorry, folks.


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