Who Must "Take the Fall?" - page 3

I have wondered for many years about who is ultimatly responsible when a nurse who works in LTC has something tragic happen to her patient. Most nurses who have worked in LTC understand that they are... Read More

  1. by   TrudyRN
    Quote from CapeCodMermaid
    First let me put on my asbestos suit as I'm sure I'll get flamed......okay.
    1.As far as I know, there are no mandated staffing ratios in a SNF in Massachusetts so the numbers are pretty much up to what corporate decides.
    2.Most short staffing is caused by employees calling out so why do you all get mad at management when it is your friends and co-workers who have called out leaving you short. We work all week to make sure there is enough staff and then 2 people call out because they'd rather party than work. How is this management's fault?
    3.You make a med error or a treatment error or forget to do something and the patient suffers harm. The facility could get a G tag for which the DNS is considered responsible by most corporations even though she wasn't even in the building at the time the mistake happened, and yet you all seem to think you should not accept any of the blame.
    It's very easy to blame short staffing, too much paperwork.too many interruptions and the like for mistakes you've made. Most of the mistakes I've seen made were due to lack of following the procedures and disregarding the standard of care.
    I've made a few med errors over the course of my career and I cried over every one of them. Did I blame management? Nope...they were my fault and not only did I write myself up for them, I came up with my own plan of correction.
    All y'all seem to rant on and on about management. I'd like to rant on and on about nurses who don't want to take responsibility for anything they do. We all know good and rotten nurses...good managers and those who would sell their grandmother....let's try not to paint everyone with the same broad brush.
    It takes all to make it work. Management, Admin, staff all have to be responsible and mature. But the original point was that there were just too many pts to give good care and she spoke up and got burned.

    Call-off's are the responsibility of Management to cover. How are staff nurses suppossed to find substitutes? And staffing should not be so bare bones that 1 or 2 call-off's cause havoc. Call-off's are certain. Plan for them in advance - like death and taxes.
  2. by   Simplepleasures
    Quote from CapeCodMermaid
    flame away,honey. I was on the dementia unit today feeding residents while the charge nurse and med nurse sat behind the desk doing paperwork....THEY get paid for every minute they are in the building but were out on time....I on the other hand had to stay late to get MY work done because I pitched in to help them out. It won't happen again...I you say I am the problem???
    Look CapeCod, I dont know you from Adam, all I know about you is what you post.When you make assertions that nurses who have problems in LTC are "slackers" and "lazy" you have made yourself a part of the problem. I dont know what goes on in the LTC you work in, but the concensus of most nurses that post on the LTC forum is that there are SERIOUS problems in LTC and the blame does partially lie with we nurses who continue to put up with deplorable work conditions.For management to deny their own complicity in the LTC situation is really just such a slap in the face of hard working nurses.
  3. by   Jedi_Iatros
    I'm done working LTC. For 3 years I've been taking all kinds of abuse from management, family, residents, and other co-workers.

    I'm done!

    Right now, I'm working as a unit clerk/tele tech (not exactly happy with this job) and I'm getting somewhat the same pay as an LVN. I don't miss being an LVN in an LTC enviroment.

    Edited in:

    I am taking classes this semester. My goal's to pass that RN NCLEX and take the registry board later to be an EMT-P. I'm not going to let my experience of working LTC put me down.
    Last edit by Jedi_Iatros on Jan 4, '07
  4. by   Simplepleasures
    Quote from Jedi_Iatros
    I'm done working LTC. For 3 years I've been taking all kinds of abuse from management, family, residents, and other co-workers.

    I'm done!

    Right now, I'm working as a unit clerk/tele tech (not exactly happy with this job) and I'm getting somewhat the same pay as an LVN. I don't miss being an LVN in an LTC enviroment.

    Edited in:

    I am taking classes this semester. My goal's to pass that RN NCLEX and take the registry board later to be an EMT-P. I'm not going to let my experience of working LTC put me down.
    Good for you. Im glad that your bad experience in LTC has turned into something positive for you!
  5. by   bshaw96
    Quote from CapeCodMermaid
    flame away,honey. I was on the dementia unit today feeding residents while the charge nurse and med nurse sat behind the desk doing paperwork....THEY get paid for every minute they are in the building but were out on time....I on the other hand had to stay late to get MY work done because I pitched in to help them out. It won't happen again...I you say I am the problem???

    See, THIS is a problem for me. You are talking down about them for "doing paperwork". And acted like it was a HUGE favor you fed the residents. First, paperwork has to be done. It's a big part of the job, in all areas of nursing, but esp. LTC. If not, I'm sure they'd get wrote up eventually. Second, you say you won't help feed the residents again b/c it made you late getting home? So basically, as long as you get home on time, you don't care if your residents get fed or not?
  6. by   SuesquatchRN
    What Cape Cod Mermaid said is getting quite distorted.

    She helped them. She is not required to feed - which happens to be my only hated part of nursing. She fed anyway so that the floor nurses could catch up. That put her behind while they sashayed out on time even though they would have been paid for staying. CapeCodMermaid, as management, does not get paid anything for extra time put in. I would have been annoyed, too.
  7. by   RYNOBLASTER30
    The system.
  8. by   CapeCodMermaid
    Quote from Suesquatch
    What Cape Cod Mermaid said is getting quite distorted.

    She helped them. She is not required to feed - which happens to be my only hated part of nursing. She fed anyway so that the floor nurses could catch up. That put her behind while they sashayed out on time even though they would have been paid for staying. CapeCodMermaid, as management, does not get paid anything for extra time put in. I would have been annoyed, too.
    Thanks Suesquatch. To the other poster who intimated that I only cared about getting out on time....cripes!! Get the point...the point is, it is NOT my job to feed and yet because we were short staffed, I did....the staff nurses whose job it IS did not. That is the point. Another point...you all like to call management pencil pushers. If we don't push our pencils no one gets paid....why must the staff continually holler at management when it is their friends and coworkers who constantly call out??? I'm there....they are there....their friends have called out and somehow they think it is the fault of management....oh so easy to blame others instead of looking to yourself. And face it...some nurses are slugs...some are slackers...not everyone is a wonderful nurse who is just 'overwhelmed with all the work management expects of them'......
  9. by   CapeCodMermaid
    Quote from bshaw96
    See, THIS is a problem for me. You are talking down about them for "doing paperwork". And acted like it was a HUGE favor you fed the residents. First, paperwork has to be done. It's a big part of the job, in all areas of nursing, but esp. LTC. If not, I'm sure they'd get wrote up eventually. Second, you say you won't help feed the residents again b/c it made you late getting home? So basically, as long as you get home on time, you don't care if your residents get fed or not?
    No kidding BShaw...paperwork is a big part of nursing. MY reports have to be in on time as well. I've worked 13 hours a day for the last 3 days so don't talk to me about getting out on time. I do what needs to be done for the residents first and then deal with the paperwork. I can't say the same for my staff who at most times appears not to give a rat's ass about anything but their paycheck.
  10. by   banditrn
    Capecod - but sometimes management DOES put us in a no-win situation. If the paperwork isn't done exactly on time - they scream - then there is the problem of overtime - we can't have any. And patient care can't suffer.

    I'm wondering why you were feeding someone and not one of the aides or dietary staff?

    So much of what we do seems so redundant to me - blood sugars that have to be charted 3 places to name one thing. Weekly vitals that go in the MAR and chart, etc. None of this stuff in and of itself is a big deal, but multiply it by a large number of patients.

    So if they let the charting slide, and feed the patients, will you or someone further up the ladder complain when they have to stay overtime to do it all? Or will they hear the old saw "Well, back in my day, I was able to do all that, plus give bed baths, too!"?

    If the charting and paperwork isn't done 100%, what are they going to hear when it's time for state to come in?

    We had a nurses meeting the other day - admin. spent 2 1/2 hours talking AT us - maybe they should try talking TO us for a change - about some of the new paperwork they're going to 'ask' us to be doing. In addition, apparently that same morning, several of the resident woke up with diarrhea, everyone was busy cleaning them up - and breakfast was late. OMG!! The admin. and DON carried on about that, and the DON actually pounded her fist on the table.

    What were they supposed to do? Put a cork in their behinds and shove them out? They also brought up the fact that this one lady is 'supposed' to be sitting in a regular chair to eat - not her wheelchair - and they called it 'laziness' to not put her in a regular chair - even tho they tried to explain to them that the lady doesn't WANT to sit it a dining chair and will fight and swear when they transfer her. It's an 'event' each morning when they do it, I've witnessed it when I leave - but the administrator says "Well, I wouldn't want to eat in a wheelchair!"

    My thought is, OK, then you come in early and put this LOL in a dining chair then.

    No, I realize there are issues on both sides of the aisle, but I'm beginning to feel like no matter what we do, it isn't going to be enough. I'm tired of it.
  11. by   banditrn
    Capecod - another thing, about being mad at our 'friends and co-workers' - well, yes, those of us that DO come in on time, and don't call in sick often do get mad at people like that - but we didn't hire them, and we can't fire them.

    There are nurses and CNA's who routinely come in late and call in sick - the DON mentioned this at the meeting - she mentioned one CNA who had been late everyday for 3 months. Well, what I want to know is, why is she still there?

    There is also a day nurse who routinely calls in sick the Monday after her week-end off. She has worked there for YEARS. So NOW the DON wants nite shift to put a note on her door if this particular nurse calls in. What, she can't check when she comes in to see that she's absent? She wants us to get involved in something that should have been taken care of long ago.
  12. by   SuesquatchRN
    Quote from banditrn
    There are nurses and CNA's who routinely come in late and call in sick - the DON mentioned this at the meeting - she mentioned one CNA who had been late everyday for 3 months. Well, what I want to know is, why is she still there?
    Where I was, there were no replacements. And everyone in the facility was pretty much related to one another, so the meds nurse who was 5 - 10 minutes late every morning was also the ADON's DIL.

    It's hard to get nurses and aides when the pay is less than comparable facilities and the work is backbreakingly hard.

    The management, though, usually doesn't get to set pay rates, although I believe they could certainly advocate for us better.
  13. by   Simplepleasures
    Quote from Suesquatch
    Where I was, there were no replacements. And everyone in the facility was pretty much related to one another, so the meds nurse who was 5 - 10 minutes late every morning was also the ADON's DIL.

    It's hard to get nurses and aides when the pay is less than comparable facilities and the work is backbreakingly hard.

    The management, though, usually doesn't get to set pay rates, although I believe they could certainly advocate for us better.
    Even though I may seem to be anti management, Really I am not. The truth of the matter is I am anti LTC multibillion dollar a year industry that has created this nightmare. The mangement and even administrator may actually try to advocate for their staff and generally for a better workplace, BUT they dont usually last too long in that role, because it would COST too much MONEY.As CapeCod said, there are no staffing quotas mandated by state in LTC. So the corporate greed continues and the MESS in LTC continues.

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