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.