NURSING JUDGEMENT. - page 2

by fairyluv

3,554 Views | 16 Comments

The other night I went to work (3-11) shift. I got report from dayshift nurse. I asked about a specific resident who had been on antibiotics for a UTI for a few weeks now, was told that she was OK, had pain pill earlier that... Read More


  1. 5
    Quote from alika
    Sounds Like you work at a facility just like mine. Twice now in the past few months I have came across a resident who had passed and rigor mortis had set in. It is the total lack of competent CNA's. We are working so short staffed it is not funny. I have right now 37 residents as does my other nurse. I have total dementia patients along with Pain pill seekers, and very Demanding families. I totally depend on my CNA's to be my eyes and ears when I'm busy. But my facility is more worried about the money issue rather than the safety of their residents and staff.
    I have educated angry CNA's on this forum and will educate angry nurses as well.

    If you're ''so short staffed it's not funny'' , how can you deem your CNA's incompetent? what is their Pt ratio?
    They have nearly just as many patients as you, and probably have more involved tasks (have you ever showered and dressed a contracted patient? - it's time consuming. Now lets say theres 4 Pts like this. Think about it)
    Now I know that you probably have to give meds for 20 patients, change bunch of stage 3 / 4 dressings, but the CNA's do the lower level care that is just as involved and time consuming.
    Just as you were too busy to notice a freshly deceased Resident, they were too busy as well.

    Edit-
    Now if they are busy hanging around the nurses station on their phones, calling they's baby daddy and eating bon bons then yes, they're in the wrong.
    BrandonLPN, RNstrong, Hygiene Queen, and 2 others like this.
  2. 0
    Obviously you do not read my post close enough. I currently have 37 residents. That is roughly 10 meds a piece. I also do have wound dressings on my shift. My Aides on the other hand have around 10 residents each. And Your "edit" Is what I'm talking about. I am constantly looking for these girls. They are either in break room with their "buddies", or on their cell phones. They hide in residents rooms. And when I say Incompetent...I Mean it!. Please don't assume I'm angry! I'm not I'm ******! This is my passion and my job! I can't afford to lose my licence because my Aides would rather talk on their cell phones than take care of these wonderful people. And before You say it, yes us Nurses have complained till we are blue in the face. But we get no back up for the"higher" up people. We are told to Quit picking on them. Or to write them up (which we do). But that gets us nowhere. In fact that usually makes things worse. Then they gang up together and make the environment worse. I love my job. I love my residents. But sometimes it is very hard to do my job safely without the right staff. And just to add..I do have a few wonderful Aides that I work with. Just not enough.
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    Oh and yes I do total care every shift on at least a few of my residents because we are short staffed. I have 3 MS patients that are contracted. So I do understand that.
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    You know, I'm really shocked at the amount of people who think that RNs have just never done any kind of bedbath or hygiene care, much less changed a dirty brief or ambulated a patient to the bathroom. Lol, I guess all we are is glorified techs if all we do is pass meds and change a few dressings! Of course, let's not forget all the time we spend sitting on our butts charting...ugh...I wish there would be a little more understanding of EACH OTHER'S roles. How about we stop talking about how much more work we do than each other and try to WORK TOGETHER?
    RNstrong, dishes, and Hygiene Queen like this.
  5. 0
    well, I was an aide for 17 yrs before I went to nursing school.. so i know how hard they got it. If I know my aides are doing there job, I don't haggle them to do something. If I'm passing my meds and a resident needs to go to the bathroom. I will get them up and do it myself, cause in the amt of time it takes to find my aides and interrupt them putting someone to bed or while they are doing there rounds, i could have that resident in the bathroom and taken care of. It comes natural to me I guess to just go ahead and do that. what doesn't come so naturally to me is my nursing process, I guess in time and with more experience it will. I'm like a baby nurse. I'm learning thru trial and error as I go. I just wish my facility was better at mentorship than throwing around "it's your license!!" I have heard that a lot lately. (not just towards me) and It's really making me question if I still want a be a nurse. I've only had my lic for 6 months.
  6. 2
    To be quite honest, the dayshift nurse may not have known about the change in condition. Many factors could have come into play; resident may have slept for a while that afternoon, dayshift nurses and aides may have simply been too busy to spend much of the afternoon in that residents' room... if your facility is as understaffed as many, then chances are good that truly no staff member got to spend as much time with that resident as they are supposed to. Furthermore, sometimes condition changes can come on very quickly. Anyway, you did do a very good job and you should be proud that you used your critical thinking and nursing judgement, so kudos to you. At the same time, be careful with having an attitude of "oh the dayshift nurse just ignored the situation and now she's covering her ass" because you don't know that for sure. When nurses make assumptions like that about each other, that fosters the cattiness that runs all too rampant in our business. Good luck!
    fairyluv and Pepper The Cat like this.
  7. 1
    Good job! I know exactly where your coming from, I to have used my nursing judgement and sent a gentleman out just the other day. The nurse I was working with said to me "your sending him out for a cough? you must like the extra paper work. They are just going to send him back...but you do whatever." Well I sent him out, and he was admitted with CHF exacerbation! He is also in the ICU. Sometimes us 'newer' nurses do know what we are doing! Keep up the great work and continue to use your judgement!
    fairyluv likes this.


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