I can't stop crying... need encouragement... - page 3

I work at a long term care facility on the 11-7 shift, and tonight's shift has been a nightmare. I am the only RN in the building with 156 residents and 5 LPNs. Any emergency or crisis is my... Read More

  1. by   Bipley
    Quote from Angie O'Plasty, RN
    ...I don't understand how these facilities get away with it. ...
    I know how facilities get away with it. There are too many patients, not enough money, and the work has to be done.

    During my care home days I literally would have a 1/2" tear in a screen door and I would be written up for it and my facility license wouldn't be renewed until I fixed the hole.

    One day I asked my licensing authority why a 1/2" tear on a screen would prevent me from obtaining my annual license while others were feeding their people lettuce soup and cowboy beans (lettuce, salt, pepper, and water=soup and cowboy beans were pinto beans) DAILY and the slightest infraction was a mega issue for me??? She explained that there just aren't enough good care homes out there and the good ones need to stay good so they have a place to refer. If they closed down all the bad places they would have to place all their patients. They have nowhere to place them. Thus, welcome to the system.

    Sad, eh?
  2. by   BabyRN2Be
    Oh Lori,

    That was indeed a horrible night. I really can't blame you for crying. *hugs*
    If you get the chance, talk to someone ASAP, the NM, the DON, anyone. You have too many people to take care of and not enough help.

    I'm so sorry you are going through this... as other people have said, it's really important to protect yourself right now, CYA and document EVERYTHING.

    Also, please remember to take care of yourself. I'm really sorry and I hope that things change pronto for you! These aren't flowers aren't real, but I do hope that in some way they cheer you up. :flowersfo
  3. by   LoriAlabamaRN
    Quote from BabyRN2Be
    Oh Lori,

    That was indeed a horrible night. I really can't blame you for crying. *hugs*
    If you get the chance, talk to someone ASAP, the NM, the DON, anyone. You have too many people to take care of and not enough help.

    I'm so sorry you are going through this... as other people have said, it's really important to protect yourself right now, CYA and document EVERYTHING.

    Also, please remember to take care of yourself. I'm really sorry and I hope that things change pronto for you! These aren't flowers aren't real, but I do hope that in some way they cheer you up. :flowersfo
    Thank you... things are doing better. It was just so hard that night. I feel really guilty about saying anything, I didn't intend to get myself flamed. I guess I should elaborate (for the people who decided to jump all over me). The crux of my job is my availability. There are 4 units here. At certain times of the night, I do rounds and the LPNs know that. Otherwise, I'm expected to be in my office near my phone in case of emergency so they don't have to call all over trying to find me. I really do work hard, and although I have time to come here and catch my breath, I also am paid salary, NOT overtime and yet work at least 2 hours of unpaid overtime per night. The majority of my work happens after 6am, when the callins come in, the residents are awakened, and the shift report is completed. I do have some spare time in my office. And when my work is caught up, the only internet site I go to is this one and the one for nursing prayers. For those of you who supported me, I sincerely thank you.
  4. by   LoriAlabamaRN
    Quote from Bipley
    I know how facilities get away with it. There are too many patients, not enough money, and the work has to be done.

    During my care home days I literally would have a 1/2" tear in a screen door and I would be written up for it and my facility license wouldn't be renewed until I fixed the hole.

    One day I asked my licensing authority why a 1/2" tear on a screen would prevent me from obtaining my annual license while others were feeding their people lettuce soup and cowboy beans (lettuce, salt, pepper, and water=soup and cowboy beans were pinto beans) DAILY and the slightest infraction was a mega issue for me??? She explained that there just aren't enough good care homes out there and the good ones need to stay good so they have a place to refer. If they closed down all the bad places they would have to place all their patients. They have nowhere to place them. Thus, welcome to the system.

    Sad, eh?
    That's awful! Why is it the ones who work the hardest for the comfort of the residents are the ones who get in trouble for the slightest infraction?
  5. by   LoriAlabamaRN
    Quote from SmilingBluEyes
    How are you doing today?
    I am doing a lot better. I do love my job, I just never had a night that awful before. It helped so much to vent a little (although I wish people hadn't tried to turn it against me). At least that morning when I did 6:30 rounds, I got about 15 hugs from residents who hug me every morning... it never fails to make me feel better.
  6. by   LoriAlabamaRN
    Quote from Franemtnurse
    Oh sweetie,:kiss
    I'm sooo sorry. Sounds like Satan is working overtime against you. Here's a big shoulder to lean on, a bended ear for you to speak into, and a great big hug, hon. :icon_hug: Remember, we are a caring bunch. It's what we do. And if we don't care for and support one another, than nursing has gone down the tubes. You can PM me any time you'd like.

    :kiss Fran:redpinkhe
    This helped me so much, Fran... I want to thank you. I appreciate every word, in fact I saved it in Word on my computer so I could print it out and keep it in my desk for encouragement. Thank you again...
  7. by   TVCRNEMT
    what you need to do is delegate. Clients who are more acceptable to fall,need to be assigned to your staff, so that one care giver does not have the Lions share of the clients that fall. Invole everyone in to a team so that each and every one, when in an area of a client(resident) who is prone to fall, the clinition and all other ancillare staff will check on these at risk residents. More then one pair of eyes, all avaliable eyes., This should be documented , all fall or potential fall and be reportated to your charge nurse but also your Nurse risk manager. If you have incident reports thay need to be compleated. If you and your peers continue to just fix and talk about the problems, there will not be the written documation confirming the importance of this matter. If any problem falls in a catorgory that can cause problems to , Health care workers, Clients(patients), family members or any visitor you need to document on the proper document, IE: incident report.
  8. by   LoriAlabamaRN
    Quote from TVCRNEMT
    what you need to do is delegate. Clients who are more acceptable to fall,need to be assigned to your staff, so that one care giver does not have the Lions share of the clients that fall. Invole everyone in to a team so that each and every one, when in an area of a client(resident) who is prone to fall, the clinition and all other ancillare staff will check on these at risk residents. More then one pair of eyes, all avaliable eyes., This should be documented , all fall or potential fall and be reportated to your charge nurse but also your Nurse risk manager. If you have incident reports thay need to be compleated. If you and your peers continue to just fix and talk about the problems, there will not be the written documation confirming the importance of this matter. If any problem falls in a catorgory that can cause problems to , Health care workers, Clients(patients), family members or any visitor you need to document on the proper document, IE: incident report.
    This is very true! We have a great Risk Manager, and incident reports are always completed, both in the computer and on paper. Copies are sent to me (shift supervisor), the DON, and the Risk Manager. Twice weekly meetings are done regarding fall elimination. Interviews are completed with the staff involved so as to be reviewd to see if everything was handled correctly. First time fallers receive an Alertmate, if they remove it they get 4 rails up and a bed alarm. Our really sneaky ones have to have mattresses on the floor and a very low bed in between them. I'm all about CYA, and the reason I spend so much time on each fall is because I document extensively. I've also prepared an inservice regarding the events of last Thursday night/Friday morning and how we can work together to ensure it doesn't happen again. I'm a bit ashamed about having come on here and admitted crying and feeling so overwhelmed- I think there are a couple of posters on here who sniff weakness and pounce, but there are enough genuinely helpful/encouraging people that its worth having to ignore a couple. TVCRNEMT, thank you for the feedback and advice. I'm goign to do just what you said
  9. by   greatshakes
    Oh Lori
    I feel so for you. I feel that the supervisor had probably had too much and maybe you needed to stand up and scream "enough is enough". One RN to so many patients is just an accident waiting to happen. You can't be everywhere and these patients will walk despite every attempt you make to ensure safety. What are the administrators waiting for? You to keel over from sheer exhaustion or a nervous breakdown? Is there anywhere else you can work with realistic loads? Crying is always good but even with crying you are left with the paperwork, the responsibility. Do keep us posted. One fall is bad enough to have to contend with let alone six. Maybe if the families sue the facility may just realise how they are endangering their staff. Have these patients had medication reviews done in case the meds are causing dizziness etc and do you have a falls program in place.

    Hassled
  10. by   greatshakes
    Oh Lori
    I feel so for you. I feel that the supervisor had probably had too much and maybe you needed to stand up and scream "enough is enough". One RN to so many patients is just an accident waiting to happen. You can't be everywhere and these patients will walk despite every attempt you make to ensure safety. What are the administrators waiting for? You to keel over from sheer exhaustion or a nervous breakdown? Is there anywhere else you can work with realistic loads? Crying is always good but even with crying you are left with the paperwork, the responsibility. Do keep us posted. One fall is bad enough to have to contend with let alone six. Maybe if the families sue the facility may just realise how they are endangering their staff. Have these patients had medication reviews done in case the meds are causing dizziness etc and do you have a falls program in place. I'd be angry, very angry at leaving you or any Rn in this situation in the first place.

    Hassled
  11. by   Cute_CNA
    I'm glad to hear you are doing better, Lori, and hope things will continue to improve for you. :icon_hug:
  12. by   bethin
    156 residents? OMG! Even with 5 LPN's that's alot of responsibility. I'm a CNA so I can't imagine the stress and responsibility nurse's have.

    I'm sorry you're having such a crappy night. It's heartbreaking about your hospice pt. With such little help it's amazing there wasn't more falls.

    Lori, take a deep breath and remember that a shift does end (eventually). I hope you can go to sleep when you get home.

    Take care!
  13. by   bethin
    Quote from LoriAlabamaRN
    I want to thank everyone again for your support... yes, I do have the LPNs here. They each have a hall, and handle the meds, normal assessments, etc. If there is a fall or a worsening of condition, I am called to assess the situation and make the decisions based on what I find. Usually it is bearable, but with six falls that night PLUS my sweet lady hemorrhaging, I was so overwhelmed. I try to take things one moment at a time, but if twelve things are happening during that moment, it gets horrible. I also have my own "normal" duties, such as paperwork, RN assessments, incident folders, evaluations, matchbacks, call bell audits, med pass reviews, total care cards, turn schedule random checks, grand rounds, regular rounds, schedules, call-ins, finding people to cover the callins, preparing the shift report, admissions that aren't done during the day, following up on resident complaints, creating and giving inservices... I feel a lot like that guy on stage spinning plates on top of sticks and running from stick to stick to keep them from falling.

    Lori
    Are you supposed to be God or something? Oh, sweetie, I'd be overwhelmed too with that list.

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