Cry or scream.. venting thread - page 2

Please, I just need to rant a bit. I work in LTC facility with 84 residents, approx 18 medicare currently. I am the MDS coordinator and considered part of nursing management. We recently had state... Read More

  1. by   firstyearstudent
    Quote from CapeCodMermaid
    In no other industry are the workers so coddled.
    Really?!?!?
  2. by   MarySunshine
    I don't feel coddled at work. I don't even feel well treated.

    With that said, to the OP, is your nurse-patient ratio reasonable? Is it the same ratio you used to work with? Would you feel comfortable working a nursing shift at your place? I bet the answer is yes, but I just wanted to confirm it. I've seen managers just about drown in their patient assignments if they actually take one -- they can be surprised just how hard it really is. Again, it sounds like you understand the situation just fine and that you're seeing work ethic problems here.

    I'm sorry you're having to deal with unsafe, poor staff.
  3. by   brendamyheart
    Quote from Nascar nurse
    Please, I just need to rant a bit. I work in LTC facility with 84 residents, approx 18 medicare currently. I am the MDS coordinator and considered part of nursing management. We recently had state survey, and had the WORST survey we have ever had (total 19 tags - at least 14 related to nursing). We had tags out for B&B assessments not matching MDS, Dietary marking wrong weights on MDS, medical appointment not being scheduled/followed thru, nursing not updating the careplans w/ order changes between MDS cycles, social service and activity careplans, on and on and on.

    My frustration.. after NUMEROUS INSERVICES, nurses still not following up to schedule appointments, alert INR not called to the dr. til the following day, B&B assessments state "Res. incontinent", but the nursing summary &/or narrative note states "continent" (often documented by the exact same nurse!) (No chance the MDS will match, cuz the stinking documentation doesn't match - happens at least 3/4 of the time SINCE we've done the inservices), new admit with drawings on admit nsg assessment to indicate open areas with no assessment of actual size, color, drainage, depth, etc., nurses notes that state new order received and noted - but not actually carried thru with - do you get the point. could go on and on.

    We have, as stated, done plenty of group inservices. Than I decided to try 1:1 inservices w/ specific points to emphasize (non-confrontational), ADON and DON have been doing "teachable momements", which is a written notice that you're pretty much not doing something correct and you have been instructed HOW to do it right in the future. Now they have started writing nurses up because they just don't seem to care. I hear them talking aboutabout us (management). "All they do is ride our a$$. If they think it is so easy, they otta come do it". Well I did it for years, I WORKED my way into the position I've got. I couldn't possibly go help them. I am spending all day doing my own job and re-writing 3/4 of their job so we can pass state on re-visit. Of course this is causing a great divide in our work place and making it out right miserable for all. Dietary supervisor is still putting wrong weights on MDS even after corporate consultant called in to inservice her. They hired an Activities direction with absolutely no experience - so I gotta re-do a bunch of her stuff too.

    I just want to know, why are so many (at least at my place) willing to just get by. What happened to having pride in your work?

    I just want to fall down in the hall, kick and scream and yell "what the heck is the problem here. Get it together or get out!" Unfortunately, I'm not the boss.

    Please don't turn this into a management vs floor nurse attack. I know there are many hard working floor nurses out there in long term care and I have been one of them for years.
    I have the same problem too. I try to do the best I can. That is all you can do. Your job is to collect accurate data. If I see some thing wrong, I look for myself. If questioned by state. I can explaine myself. So far, thank God, no problems!!
  4. by   25(2)+2
    i am only a cna/med aide but let me tell you about my night last night. I came into work thinking i would be on one station all night when i was told at 3 am i would be working on a different one because they were short. that was fine with me. no problem. the first half of the night i did all the extra duties we must do as aides putting linen in the rooms passing ice cleaning wheelchairs etc. then i go over to the other station at 3 to find no linens in the rooms and no ice passed. the aide that was there with me told me the aide who left at 3 told him the linens and ice were passed. then i go to get a resident up and she was left with her socks on all night long she had an indention in both her legs from the elastic. the other thing that gripes me is when rom charting and behavioral charting gets done right at the beginning of the shift. what happens if there is an emergency and a resident is taken to the hospital. what about when you here other aides who have no patience with the residents. i as a nurses aide feel like a real B----. i never used to complain and tried to have compassion for my fellow workers but the more i do this job the more consciencious i get about what i am doing. i don't think i would want to be an rn just for the fact i know that my personality would change radically for the well being of the residents it has somewhat already.
  5. by   TrudyRN
    I know you said that you are not the boss, Nascar, and that means you can't discipline staff for not complying. Therefore, you must either let it go, find a way to get the boss to tie staffs' paychecks to them being compliant, or report the facility to accrediting or licensing agencies, newspapers, senior citizen groups, etc. (anonymously, unless you want to be fired or forced to resign and/or blacklisted).

    What are your boss' priorities? I bet she'll pay attention to the red flags the facility got on this latest inspection.

    I am really troubled about the pt who was sent out with CP and admitted to the hosp and not one word was charted. Did the nurse run out of time to chart? Does she know she can do a late note? Again, though, if you are not the boss there, you kind of have to put it out of your mind or do the things listed above.
  6. by   TrudyRN
    Quote from 25(2)+2
    i am only a cna/med aide but let me tell you about my night last night. I came into work thinking i would be on one station all night when i was told at 3 am i would be working on a different one because they were short. that was fine with me. no problem. the first half of the night i did all the extra duties we must do as aides putting linen in the rooms passing ice cleaning wheelchairs etc. then i go over to the other station at 3 to find no linens in the rooms and no ice passed. the aide that was there with me told me the aide who left at 3 told him the linens and ice were passed. then i go to get a resident up and she was left with her socks on all night long she had an indention in both her legs from the elastic. the other thing that gripes me is when rom charting and behavioral charting gets done right at the beginning of the shift. what happens if there is an emergency and a resident is taken to the hospital. what about when you here other aides who have no patience with the residents. i as a nurses aide feel like a real B----. i never used to complain and tried to have compassion for my fellow workers but the more i do this job the more consciencious i get about what i am doing. i don't think i would want to be an rn just for the fact i know that my personality would change radically for the well being of the residents it has somewhat already.
    You need to write up these problems, keep a copy, and give the write-up to your boss. I would not want to do my own work then have to do someone else's, too. And the socks causing an indentation - what if that were a diabetic or someone with compromised circulation. The results could be pretty serious.

    I have seen patients whose staff did not remove their various splints for days on end, apparently. Plastic or plaster splints, held on with ace wraps. When I would take them off to assess the skin, nerves, etc. underneath, I would catch the stinkiest odor (from sweat, no washing x how many days), wrinkles in the skin from the elastic wraps that had slipped out of place, and, horribly, some ulcers. One patient had 7 SEVEN ulcers from where the splint had been left on forever and it had actually created some ulcers on the opposite leg, too, from unrelieved pressure. I was appalled, angry, did a quick on-the-spot inservice and told the nurse relieving me, hoping she'd pass it on to the next shift, etc. I also put a note above the pt's bed saying to remove the splint and wraps q shift to eval neurovascular status and to wash/do skin checks, which I was ordered to remove, due to HIPPA. (Thank you, HIPPA, such BS) So I put the notice on the med cart and at the desk, where it couldn't be missed. The result: people decided it was easier to leave the splints off altogether. And some staff even said that a nurse couldn't order stuff like that. So, I got a doc's order for same. Sigh. Sometimes, we just have to do the best we can.

    Keep on keepin' on, 52, keep being conscientious and compassionate (toward the residents). Do not let fear of personality changes keep you out of nursing school. Please. Don't give so much power to the bad people. :spin: :Melody:
    Last edit by TrudyRN on Nov 5, '06
  7. by   Simplepleasures
    Maybe if we nurses wake up and UNIONIZE we can actually have enough staff to BE ABLE to do our jobs properly, maybe we nurses would be HAPPIER in our chosen profession, then the patients would be happier, and maybe the managers would follow suit.Could there be a light at the end of the tunnel??

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