I received a "write up" warning at my LTC - page 2
by Blackcat99 | 8,015 Views | 32 Comments
Apparently, I have committed the terrible sin of "working overtime." How dare I want to be a responsible person and do the " medicare charting" before I go home. What was I thinking?... Read More
- 2Jan 20, '13 by Joni's MomQuote from Anne36Next time this happens, do what you can, then you give report and let the on-coming nurse take over, state you would love to continue to finish what was started, but can't d/t overtime. If she complains bring it up to management. Also state she will have to chart on her patient interventions.I had to work over for the last 2 shifts I worked. The reason is that very near to end of my shift, right before I give report an incident occurs, such as a skin tear or resident behavior. What am I supposed to do? I am damned if I do or dont. No overtime but I have to chart on things like this and follow up on the issues. This is so frustrating. I clocked out both times and then went back to chart. I had a very busy day once last week, with a new admit that caused me 30 minutes of overtime and I still did not get everything done correctly that day and found I made a mistake because I was so rushed.
We had some CNA's report skin tears or other incidents just before we clocked out. No good timing, bring this up in meetings.
- 5Jan 26, '13 by NurseGuyBriWhere I'm at, we have this thing called teamwork and trust... If something happens near the end of the shift, the supervisor steps in and helps finish it up so report can be completed. With the funding dropping the way it is, Overtime is more and more worrisome for employers. Some is inevitible. If you are consistently out late, it is a red flag to me that something is wrong. It's wrong to assume that it is the nurses problem. I'm betting that it's a mixture of things; things that can be adjusted or helped with.
Like I said, our facility would not survive without teamwork, that's what really makes it work. Any manager/supervisor worth a can of beans would sit down with you and try to come up with a solution before writing you up.
- 2Jan 30, '13 by noc4senufAs a DON, I have faced the issues of nurses working OT for years. I have always put out the policy that all overtime needsto be approved by managment before it occurs. This way each time it can be looked at to see what the specific issue was at the specific time. Management also has their toes held to the fire for the budget. I have known DON's to lose there positions for letting the OT kill their budget. I also havew had issues where the same nurse would incur OT each time they worked but, no one else doing the same job had any problems with getting done ontime. Has a time study been completed? have you went to managment to see what it is they could help you with?
- 0Jan 30, '13 by Blackcat99Most of the nurses here have had to do overtime in order to complete their work. Right now, they are not writing anyone up, because they are losing nursing staff. There is one nurse here though who always has a lot of overtime. It doesn't matter if she had a "good night" or "bad night" she always has a lot of overtime. I don't think the management here would be interested in helping anyone. The environment here is harsh and unfriendly. It's
"Every man for himself ". No teamwork here.
- 3Jan 31, '13 by Keep_CalmOh, I could write a whole post on this......
First, it's nice to hear that people are having the same problems as me. I have found that I really do not like LTC. I love the residents, but I hate all of the paperwork and covering my and everyone's A** with paperwork. I hate being told that I can't use my nursing judgement, there must be an order or policy. There is some teamwork at my facility, but there is still an underlying hostile tone to the work environment.
I am not full time, but I do feel the pressure from others to clock out on time. (BTW I work second shift.) I had a nurse's meeting yesterday that I came out of very upset. The unit manager and DON basically just sat there and told us everything we were doing wrong. Of course, that is what the meeting is for, but a lot of was issues that could've been taken up individually. For instance, an EKG patch was found on a re-admit 2 days after she came back from the hospital. The unit manager was appalled and said, "How could she have had a good skin assessment when no one even noticed the EKG patch!" Well, I was the one that did the assessment (along with the RN supervisor), and yes, I was in a hurry and I didn't see the patch. I was in the middle of my 2000 med pass and I was only looking for bruises and open areas, etc.- not patches, the aides should have taken care of that. Yes, you have to do a super quick assessment when you know you have to go out and talk to the family, write up admission orders, make skin grids for all the stupid little bruises, care plans, etc., etc., etc....AND clock out on time. You HAVE to rush through almost everything! THEN, they told us that that now ALL skin assessments have to have 2 nurses co-sign. (Yeah, f***ing right.) The problem is, we already have a lot of bullsh** paperwork to do on every little f****** thing and now they are piling more and more on us. There are 2 of us on the floor and each of us has approximately 2 skin assessments a day (+/-). Now how is that going to help us manage our time any better? Plus, we were given assignments for change over. So I have 4 residents for changeover and I work part time. I may end up having to do all 4 on one night. How in the H*** is that going to happen and me still get out on time? It was going just fine with everyone working together on change over, why change it? What about teamwork? I never heard anyone complain.
Anyway, it all just makes me want to cry. So, I feel for ya. They keep giving us more and more. They actually told us that we were going to have to start signing out washcloths. Yup.
I don't know how any one could change this. It's management and medicare. It really sucks. I wonder, are all nursing homes this bad to work at?
- 6Feb 2, '13 by NurseGuyBriI hate to hear all of the trouble with LTC. I feel for you, I do- but there are some things you have to short cut and some things you cant- an admission skin assessment is one that you cannot short cut. Before I get beat up, trust me- I know you are overworked and underpaid, you don't have to say it. I have been in LTC a while in many different hats, so I know. My facility has done the same yours has- with each thing missed, we have added a new step to cover it. We do that because LTC Regulation mandates that we self-audit and come up with a stable plan to prevent recurrence. WHen we identified a similar situation that you have with the patch, we reacted the same way because we can get in so much trouble with state over that AND it's substandard care. Now- please don't get mad, I'm only stating facts so far. I have learned that the above situation is NOT EFFECTIVE. Adding more paperwork does NOT fix the problem and makes it worse for you on the floor- but sometimes hands are tied and we have to try to find a solution that the survey agency will accept. I have started making deals with our nurses. When they make a mistake related to Admissions, orders, or skin, they get to make it once. If they make it twice, I have that nurse do the paper skin check (for example) with a sign off. Once they are consistently done right, I take them off again. I know I KNOW I KNOW it's too much work, but it just has to be done right. I dont think you should be beat up, either, for making a mistake, that's hostile. If your underlying environment is negative and lacking, you need to get out. There ARE GOOD LTC's out there! You sound like a conscientious nurse and deserve a break sometimes As for having meetings, we do that so that we can keep people on the same page- I don't like to go to people directly when a first issue is made, I make general statements to the group to be mindful and watchful. Then, if it continues, I go the personal 1:1 route. I feel the meetings are the most delicate and non-specific way to remind us what needs to be done. Not everyone agrees, that's fine. Also, Meetings should *not* be about telling you what you did wrong, it should ONLY be about what you need to do to make it right. I think you're in a detrimental place where you work I hope it gets better.
- 4Feb 5, '13 by Keep_CalmI agree 100% NurseGuyBri. Everyone has a job to do and (almost) everyone has someone over their head telling them how to do it better/different. Part of the anger in my first comment had a lot to do with my own feeling of inadequacy after the meeting. Something I am not used to feeling in my job and have NEVER felt in any job I've ever had. I AM a very conscientious nurse and I am not used to doing things half-assed. I have only worked there for about 5 months and it's my first LTC job in 9 years of being an LPN. After venting, and thinking a lot, I have come to realize that I will be a whole lot less stressed if I put my priorities in order. #1 being resident health, safety, and well being. This includes skin assessments (although, I still despise paperwork on bruises being perceived as more important than mental health, lung sounds, etc.). Clocking out on time vs doing my job well isn't going to stress me out anymore. I refuse to race against the clock. If they want me to sign out washcloths (still lol at that) then I will. I bow down to the management gods. I will do my job as fast as I can--BUT I will do it well, whether it takes 8 hours or 9 (or more--blah) If that isn't acceptable, then they can let me loose.
- 1Feb 18, '13 by ybanurseIf you short of staff 3 CNA's on a floor with a bunch of fallers who wear alarms How you gonna do rounds and as a nurse do my work if all the alarms keep going off, Ive got a high risk faller sitting at the desk with me in w/c cause they can't keep their @&*% IN THE BED AND THE UNIT GOING HAYWIRE Nobody's coming to help cause most likely the supervisor has a cart ( somebody called out) and she tells you your on your own