need to terminate

Specialties LTC Directors

Published

Late one evening this past weekend, I dropped in at work just to see how things were going. Typically, my staff gives great care. But one of the halls reeked of urine. I began to check and found extra pads under several residents. Half the residents were wet, one so much so that his sheets were brown almost the entire length of his body. I was so angry! I found the aide, who began to give me every excuse in the world. (All the residents in question were assigned to her. All the other residents in the building were clean). I told her not to bother with excuses, they were not short staffed, she has worked there 3 yrs and so knows what to do. I made her stay over until she had everything done right. I have suspended her for her next 3 scheduled days. I think she should be terminated, but hated to make that decision when I was angry. She has always seemed to care so much for her residents. She has trouble keeping her mouth shut and is over dramatic, but did seem to really care. To make it worse, today I found out that she had left the building earlier that day without clocking out. So I guess I am just venting. I know what I need to do. I hate firing people, but my people have to be taken care of.:crying2:

Specializes in LTC, geriatric, psych, rehab.

Rather than be too lengthy, I had not discussed the charge nurse concern. The LPN on the floor was brand new. It was only her 2nd day out of orientation, and naturally she would still be a bit uncertain as to how to handle a difficult situation. However, ultimately in charge is the 7P-7A RN. When I drove up, I caught her leaving. She came right back. Said she was going home to get her keys. That is a 20 min trip, and she had not clocked out. I was so upset over what I found, so I unloaded on her also. Did she not notice the odors? Why was she not supervising the aide? She had done no treatments. I stayed until 10:30. She still didn't do any treatments. They are due at 8 and 9PM. Does she think those are ordered to take up paper space? And yes, the residents who were so wet were those who could not say anything. So I have suspended the RN as well. When I called her in to discuss the matter further, she questioned if I was writing up the LPN on the other hall. First, that is none of her business, and second the other hall was okay. She is refusing to accept any responsibility for the situation. I found this Saturday. Today is Wednesday, and I am still pretty upset. It is just negligence, and I will not have it. I did not terminate immediately only b/c I try not to make any decisions when I am angry. I think I will terminate the RN as well.

When I got home that nite, my 21 yr old son was visiting. He asked what was wrong, and I told him. He said, "So, you walked in and found your nursing home looking like all those other ones?" That made it worse. He was refering to other homes around here that are known for being nasty. I expect my people to be taken care of right. Well, I just need to do what I need to do and move on. Amazing how people have stepped up to the plate since Saturday nite. They others really are working hard.

Thanks again.

To reinforce things, after you have dealt with the nurses, at your next employee meeting I would make a point of discussing this with those that are left and emphasizing that anyone else who lets their job performance deteriorate to that point can expect the same treatment. Occasional reminders should get and keep them on their toes.

Specializes in Geriatrics, WCC.

I make it a point to go in at times on off shifts and weekends. Just to drop in and make a walk through. Amazing how it flies through the building that the boss is there.

Specializes in ED, ICU, PACU.

With the added explanation, I take back what I earlier said and now feel that heads should roll.

Specializes in acute care and geriatric.

You need to do more night surprise inspections and yes, heads should roll, an RN Abandoning ship without clocking out....unacceptable and her excuse is unacceptable, if she hadnt met u who knows where she was really going to and for how long,...You have your work cut out for you!!

Travel50-

I think you're doing the right thing.

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