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- by WldChrry Dec 25, '12I need some nurses to relate to right now. I had a horrible night last night at work. It was Christmas Eve at my LTC facility (I just started there about 2 months ago), which just makes things worse because we were under staffed, and management was racing to get out and start their Christmas festivities. So let me paint the picture of what happened....I was assigned to two floors of patients (40 total), and these were two floors that I had never worked on before I start my shift (3-11) and first thing that happens is a patient needs to be sent to the hospital-this took up about 1.5 hours of my time. So when I finally get my med pass started on the first floor, it is 430pm. All goes ok, I get both of my med passes for the first round done, and I go to my dinner break on time. What do you know, but 5 minutes into my break I am interuppted by the pharmacy delivery Well guess what?! The facility decided that they were going to order Tamiflu for every single resident, and guess who got stuck with the task....yup, the 3-11 nurses. So between the time the meds were delivered (730pm) and 11pm when my shift ended, I had to do my night time med pass for 40 patients, do all my treatments, all of my charting, track all of my fluids in the computer, AND give Tamiflu to ALL 40 residents, AND chart the order in everyone's MAR And oh, by the way, the resident that was sent out to the hospital returned at 1045pm. REALLY??!!I need other nurses to relate to right now. Have you ever been in a situation like this where you feel it is impossible to get everything done, and you are forced to cut corners and deliver care that you are less than proud of? I love what I do, and I strive to be the best nurse I can be, but I believe it was unfair and unrealistic for the facility to lay that task on us and expect us to get everything done and done right. I left work not feeling good about myself, and I just need some support. Thanks
- Dec 25, '12 by eatmysoxRNEveryone has those days. Sounds like you still did a great job.
- Dec 26, '12 by Kittypower123That sounds like a terrible night. I've had those too. It's very frustrating. After all, there is only one of me. I've learned that I have to prioritize. Although every task is important, all tasks are not equally important. When I am having an impossible night (I work 2-10), I do the most important things first so that the least important things are the ones that don't get done.
In your case though, whoever got the order from the MDs for the Tamiflu should have also put it in the MAR. Also, I can't imagine all the MDs who have residents at our facility actually okaying a blanket order for Tamiflu. After all, do all the residents display s/s of flu? The MDs for our facility would only give an order for Tamiflu on a case by case basis (and frankly, I've never given a resident Tamiflu). Why would you give a med to residents who don't need it? What about allergies or contraindications? Seems a bit fishy to me.
Anyway, I'm sorry you had such a rough night. Keep your chin up - it gets better!
- Dec 26, '12 by WldChrryKittypower, I really didn't think a blanket order for Tamiflu was necessary either. There have been a few positive cases of the flu at our facility, and alot of the residents have been running fevers, coughing-basically having URI symptoms, but to treat with Tamiflu when the resident may or may not have the flu...I think it's ridiculous. The biggest problem was that there was not adequate planning. Apparently that day they decided they were going to order Tamiflu for everyone, and then when the delivery came that night, everything was left up to the 3-11 nurses. Ridiculous!
- Dec 26, '12 by CapeCodMermaidWhen I was running a very busy subacute unit....day 2 on the job. I had 6 admissions, 5 discharges, and 5 people sent out rescue---did CPR on 3 of them before rescue came. Everyone lived. No mistakes were made. I got called to the office the next day because a family member complained their mother was late to the hair dresser!!! I wrote out my resignation in front of the DON and told her if she cared more about hair appointments than she did peoples' lives, she had the wrong nurse running the unit. She didn't accept my resignation, but got my point. We've all had impossible shifts. Do the best you can. No one ever died from missing a hair appointment or a shower.
I'm with the rest of the folks who think Tamiflu for everyone is utterly ridiculous.
- Dec 28, '12 by LTCangelMy DON likes to say that we are a 24 hour facility and that it's ok to pass some things to the next shift. That resident returning at 10:45 would have been something that I would have passed along. A set of vitals, a note to say they have returned and then passed any new orders and the full assessment on to the next Nurse. Especially, if I had completed all the work for all of those silly Tamiflu orders. You are only one person, sounds to me like you did an awesome job and I'm amazed you were even able to get a break. Kudos to you!!
- Jan 5 by MandylpnYOU DID A GREAT JOB, PAT YOURSELF ON THE BACK, and 40 rez to one nurse is absolutely wrong!!!!!!!!!!!!!! are you still working there?
- Jan 5 by PankaD89I would have had a FIT over the Tamiflu alone, never mind everything else. I'm not going to administer a drug that isn't ordered & you better bet I'm gonna have someone helping me enter 40+ orders. I agree with everyone else, sounds like you did great!
- Feb 5 by Rach823RNAlthough I cant speak for how the orders were handled in your case, Tamiflu for everyone is actually quite common. We treated all 350 of our facility's residents with it prophylactically when we only had a few confirmed cases. No they don't swab everyone, but yes "URI-like symptoms" are considered "flu-like symptoms" in LTC when it comes to the CDC... Check with your facility's policy (there should be a standing flu outbreak/tamiflu policy), and ask your facility's infectious control/nurse educator questions to educate yourself. They'll appreciate your initiative to learn, after all that's what nursing is all about!