Well, I've worked rehab, subacute rehab most of my career. I did a short stint in L&D and it just wasn't for me. I love rehab, but at my last job (which i was just let go for using FMLA time) I was one of two nurses that worked our tails off. I would be honored to work with a DON/DNS like you who actually shares my views. My last DON is not seen, only heard when she writes someone up for a ridiculous issue. She rewards some of the laziest, not-so-smart nurses in the building. I know I probably sound totally stuck-up, snobby, and rude. But really...they have no common sense. I'll give you a few examples if you don't believe me.
1. RN writes in LOG BOOK for MD: pt with fever 103.7, crackles in left lower lobe, SOB at rest and with exertion. He did not see it for two days, and none of the nurses who took care of this poor patient did ANYTHING about it either. Why wouldn't you call an MD with this info? Poor lady ended up in the hospital despite trying to keep her there on IV abt, o2, etc.
2. An admission that had travelled from another state (very unusual in out setting) for almost 3 hours. Came in at 10am, was admitted for therapy after being in a motorcycle accident. Had severe pain, broken ribs, broken pelvis, cracked vertebrae, etc. Had transfer orders for oxycodone and morphine. Despite this poor man c/o pain to the RN in charge of him since 10 am, she refused to medicate him. I came in at 3, and I was the one who went to the backup narcotic box and got this poor man some meds. I had to give him a whole lot extra (with orders of course) to get his pain under control. The admission orders weren't written out, the admission assessment was not started at ALL, nothing. None of the admission was even started. She was sitting in the office eating popcorn and drinking a soda when I came in, laughing with her coworker LPN. I was so angry, and despite complaining and the pt making complaints, the DON refused to say anything. Sorry, but patients in pain who are left to suffer just touch a nerve with me.
This is already too long, but I was continually left more and more work from these particular nurses. Despite our own shift having less than half the staff of days, we were left with orders, even STAT or NOW orders, from MD rounds at 8am. Yes, 8 am. More than a dozen times. I made copies, complained, nothing happened. MD's complained, nothing happens. Admissions left for us with nothing done. Now, I understand it may happen once in a while. I know things happen. But EVERY day? Admission coming in at 1pm or 2pm, I can understand not having time. But at 10 am? 11am? And all I am asking is to do the meds (because it takes about 12 hours to get pharm delivery) and MAYBE the initial assessment. Sorry, but a patient should at LEAST have a nurse in their room doing an assessment of basic needs when they come in. Can you imagine being left in pain for 5 hours before you get any relief?
Sorry this was such a rant. But CapeCod, I've read a lot of your posts, and you sound like a director that's got a good head on her shoulders. All your asking is for some work, some common sense, some nurses who do what we were taught to do. Nothing wrong with that. I too see incredibly lacking nurses where I used to work. Patients suffered because of it. I'm not talking about nurses who are just new and need a little time, I'm talking scary nothing-ever-changes nurses. I don't know what the answers are. Hell, I wish I still had my job. I really did love it. I hear from a couple nurses who still work there and it has only gotten horribly worse. I don't know what the answer is. I know there are SO many great nurses out there that work their butts off in a very less-than-respected area, and I take my hats off to you. I would love to work with the nurses on this board any day.
CapeCod I would love to work for you. Where do you live? LOL.