Concerns about orientation...

Specialties Geriatric

Published

My full time job is in a clinic...that is going great. But...I also accepted a PRN position in a 75 bed LTC. I've done two nights of orientation and I am not sure what too think. I don't need this job to survive, but it sure helps out.

The first night, I spent four hours on one unit and then someone on the other unit got sick and went home, so they sent me to the other unit to work. I got no orientation...I was simply told which residents were incontinent and told to go do their bed checks and do pericare. I was not shown where the peri wash and pads were, I was not given any indication of who needed two people to assist, and when I asked, I was told that I should be able to figure out residents without asking a million questions...after all I worked in a hospital and had different patients every night. I charted something that went on with one of the residents and the nurse who was supposed to be doing my orientation read it, told me that I write too much, and then changed some of the things I documented (like the time of the incident, something the resident said).

The second night...I was put on a unit with another PRN nurse and a PRN CNA...they had both been there for a few years, but had never worked on the unit we were assigned to. My orientation consisted of the other nurse handing me the keys to the med cart and informing me that the best way to learn is just to jump in and do it...then she sat down in a recliner and went to sleep. The CNA and I made rounds, waking up every resident because we weren't sure who might be incontinent, who needed help to the bathroom or how much help they needed. The other nurse woke up just in time for the 0600 med pass and stood over my shoulder so close I could barely get to the cart. She also told me that if I stopped to wash my hands after every med I gave, I would never get done in time.

I should have said something to the nurse on the second night...I'm am so bad at confrontation that I just let it go...I was wrong there. I am going to talk to the HR people about the nurse changing my charting and the nurse sleeping, but I am not sure where to go from there. I really hate to quit after two nights, but I am sensing a pattern here...both times I have worked, I have said I dread going back. I think it will be better when I am on my own and am actually charge, but I have second thoughts about going back at all.

Any words of wisdom???

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Document everything that you have said to us, send it to the manager there, as well as their version of risk management, and QUIT.

There is no reason to put up with any of that, and for a nurse to change your charting, they need to be turned into the BON for that. It it 100% illegal to do that.

You are jeapordizing your license that you worked too hard to get. This is one way to lose it and lose it fast.

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I agree with Suzanne.

Changing charting??? Inexcusable, illegal...and makes you wonder what else this person is capable of doing. "you write too much"....is that compared to her who writes (or does) very little?

And sleeping on the job! Automatic termination anywhere I have ever worked.

Write all this down while it is fresh and give to administration - and get out!!!

I really have to wonder about the care these poor residents are getting!

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Sigh...my husband thinks I am just finding things to complain about since I would really rather have that one or two days a month off rather than spend it there. I really don't mind picking up a shift here and there and the money is actually quite good ($3 more an hour than the clinic)...I don't think he is right, but maybe. The resident whose charting was changed has since died...obviously, they can still access her records, but I'm not sure how willing they will be to do it. I talked to a friend who also does some PRN shifts there and she said more than likely, I will be told I should have done something about the sleeping nurse...it's going to make me look like I can't handle difficult situations, I can't let people walk all over me, I know the BON has rules about sleeping, what if something had gone wrong, etc...

So glad it is Monday morning and I am off to spend the day in my nice safe clinic with nice safe coworkers...:)

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No No NO. These things should not be happening, even in LTC. The sleeping nurse is wrong on so many levels. Are you on staff at the facility or agency? At the very least, you would think they would orientate you better since you will be one of theirs?

Most LTC have some type of system to communicate basics to the CNAs. We have stickers outside the door that tell us if someone is one or two assist, fall risk or CPR. It is also in their ADL books (not that you would have time to read these!)

Changing your charting.....we all know what is the right thing to do on this subject.

What I would do is approach the DON and ask her for a meeting. Review the fact that the other nurse was "unavailable" and that inorder for them to retain you as a prn you would like at the very least an basic orientation. Where supplies are, charting basics for the facility, etc.

If they are really interested in keeping you they will

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Specializes in Psych, Med/Surg, LTC.

And I always thought orientation meant to be shown around, shown paperwork, residents likes/dislikes, and get a feel for the routine. I never knew it meant to jump right in while another nurse takes a nap. :uhoh21: :angryfire

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I agree with Suzanne, makes you wonder, if this nurse has time to sleep while you were there to watch over the residents, who watches over them when another nurse isn't on the floor. I work LTC, and I will tell you up front, if another nurse even thinks about changing my documentation, they have had a bad day, and I'll be dipped if somebody else is going to sleep while I am running my buns off. They may not do any work, but, I'll make sure they don't get a good nights sleep either!

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Specializes in LTC, Hospice, Case Management.

Heres my 2 cents from a LTC nurse of nearly 20 years and generally a staunch supporter of LTC nurses in general... I say RUN FOR YOUR LIFE, or at least go let the DON of the facility know what is going on. This is horrible and if it was happening in our facility one of us admin nurses would be in there in the middle of the night to wake/confront and fire sleeping nurse. Unexcusable!

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As a DON, I encourage you to go to the Administrator whether or not you stay. Your heart is in the right place, and confronting these people on your own could be worse than what it's worth. You are probably dealing with deeper problems than the management even knows. Or this may be the standard there. I would suggest that if you otherwise think you'd like to work there ask for orientation on days so you know the nursing ins and outs of the job. But insist that these unsafe and unethical practices stop. Sometiems nurses hold facilities hostage until the leader steps up to the plate to get rid of them. This is no excuse for the poor performance. You are really obligated to report the sleeping nurse to the BON. Don't hesitate. Perhaps report the nurse who falsified the record too. If you don't get satisfaction from the administrator, you may want to notify the owner of the facility. Depends on if you stay or not. Could be hard for you after you do this. Does your clinic do business with this home? Difficult situation, but reporting is mandatory. You've told people about it, so you are liable.

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