other nurses not letting you do your job

[karenp31]

I have been back doing MDS's for about 2 years, after doing med-surg for a couple of years (I did MDS for about 5 years previously). I just started a this postion, MDS casemix and PPS for a 50 bed SNF. I can't believe the additudes of some of the staff here!! The job is pretty much the same as before I left, not much you can do with the RAI proess to make it different at different facilities in the same state, but I just don't know if I can work with some of these people.

What happened today by far was the worst . I went to do a admission assessment on a resident. I usually check the treatment sheet, count the meds on the MAR (I always wait until nurses are done with their med passes), check the CNA sheets, grab the chart, then go to the room to assess/interview the resident.

Today I went to grab a chart on the person I was doing and the floor nurse stopped me, saying "you can't have that". I said, "oh, do you need it first for a while? What time do you think I could have it" She says "I don't have time for you today, you can have it tommorrow, maybe". Well, at this point I was flabbergasted. I basically asked if she was joking, and she said "nope". The DON was sitting right there, her office is literally 2 feet behind where this took place, and she never said a word. She looked up a couple of times, but never commented.

I returned to my office to calm down, then went and talked with the DON. She basically told me that the nurse was having a bad day, and I better just do that resident another day, and oh, BTW, maybe you shouldn't do anyone on that hall today. I tried to explain the importance of doing these assessments timely, and that I was NOT going to back date just b/c the floor nurse was having a bad day, but got no where.

I am still the new kid on the block, I hate to start making waves so soon, and I'm at a loss on how to handle this. Is it not bad enough we have to deal with no charting/documentation, trying to follow all the guidelines, make sure careplans are prefect, keeping track of all the timeframes, etc, etc, but now I have to worry about not being able to do my job b/c a nurse is having a bad day?

Any advice welcomed............please help!!

[susanthomas1954]

Was teaching a few new nursing students some rudiments of the MDS/RAI process today. They were very impressed that there is one tool that designates reimbursement, helps begin the care planning process and gives the state our QI information. Makes me realize how important what I do really is. Yes, I am the most important nurse in the building at times. I can still run a code blue, I CAN, but WON'T do a floor shift, CAN and WILL do an occasional supervisory shift, but to me: Seeing the facility get paid what we deserve is just as important. My Med A daily rate was $60 over budget for September, and even though only the Administrator, Rehab Manager and Business Office Manager and myself were privy to that, I can look at the patients, the staff and the building and know, KNOW, that I am as good as it gets. I have a very important job, and I do it to the best of my ability. The IDT management is like herding feral cats. Nasty nurses who hate my care plans and their own jobs don't bother me at all. If I did my job the way they do theirs, our facility would close. I don't care, I've found my bliss.

[rapkeygurl]

wow can I relate, friday I also gave our nurses an inservice on documentation, and one nurse actually told me " I dont know why you came up with this and why we have to be responsible for our nurse aides I can barely get my own job done." I am thinking to myself when I was working the floor-- no med aide--only 3 nurse aides and we seems to handle it ok even on the bad days with several incidents and sending a few to the hospital and transports. What are they teaching them these days in nurses t raining?? They only want to fax a doc instead of calling them. they dont follow up on important things. And to top it all off our cooporate medicare biller (not a nurse) calls and tells us we are on vendor hold--- which was not the truth and scared me to death because I also teach our nurse aide course in this small town and we could not survive without it. I am like you I do enjoy trying to get the best bang for the buck so to speak. I know our nurses are doing the work but I cant get it collected because of poor charting and that is what is sad to me. I got approval for a new nursing initial assessment that follows the mds. I hope this will work for us. They dont like my careplans either and I make nursing staff look at them now they did not even do that before lol sad.

[ellakate]

Does anyone's job description say that it is a responsibility to complete documentation in a timely fashion?

[rapkeygurl]

funny thing is I never even got a job description. I do have one for the states nurse aide curriculum which I do follow. But.. they want to put the adon and mds duties all together and I only agreed to work 3 days -2days doing MDS data and one day in nurse aide training. Plus on top of that I am trying to complete online RN program. I am currently an LVN.