Hygiene Queen, RN Guide 24,143 Views
Joined Sep 13, '07.
Posts: 2,366 (72% Liked)
I am a strong believer in therapeutic lying.
It has its place!
[QUOTE=SummitRN;9269158 No, EMS is not "just ambulance drivers." But plenty of EMS folks can't tell a RN from a CNA and love to rip on "those nurses at the assisted living center who only wipe poop and can't start an IV."[/QUOTE]
My step son is an EMT. He came home and told me about a call they had made to an assisted living facility. He chuckled and asked me, "Uh... do they teach nurses about blood pressures?"
I was immediately irritated because I knew what was coming. I said, "Of course!"
"Well... how much detail do they go into it? I mean, do they just show you how to do it on a machine or--"
I cut him off and explained what nurses are, indeed, taught. I then asked him what the hell happened that he would even ask and why he was so haughtily amused.
"Well, there was this nurse there. She told us the patient's blood pressure was 'usually a higher number on the bottom', so we're thinking either that was a stupid nurse or they don't teach nurses anything."
"That was not a nurse. It was probably an aide... wait... no... not even an aide. If it was assisted living, it was probably not so much as an aide. No training. You weren't talking to a nurse. There is no way! Now you go back and tell all your friends what I said and preserve the dignity of nurses everywhere!"
So, no. The EMT's don't always know a nurse from an aide from a person hired off the street. If he hadn't asked me, he would have really (and stupidly) thought nurses were the dumbest things ever.
Let's see, I've sent patients out for sepsis, brain bleed, MI, fractures, pneumonia... I could go on.
If I have an 80 year-old pt on Norvasc, metoprolol, lisinopril, Lasix, Novolog, Levemir, Nemenda, Risperdal, Ativan, Coumadin and Norco, you tell me some things I might have to worry about.
Then I have that person who won't take their meds. Then I have to think. Maybe if I can get them to take the Risperdal, maybe I can get them in a better place to take the rest... but no... Meanwhile, I'm on the phone getting a clonidine patch because I can't have a pt, who won't take their meds, running around with a BP 180/90. Oh, I can crush 'em, but they won't take anything by mouth... which leads to issues regarding that insulin... then I get their lab results... and now I have to go do that EKG... and now I'm coordinating a cardio consult... Meanwhile, somewhere in the dark recesses of the unit, there is a pt deciding now is a good time to strip naked, streak the unit and fall in the process...
Oh. You do not even...
Reminds me of a song:
"Come back, when you grow up, Giiiiirl
'Cause you're still livin' in a paper doll world
(Psych) ain't easy
(Psych's) twice as tough
So come back, Baby...
When you grow up!"
Well not to mention there already is many behavior problems. They constantly swing at me, punch or kick me. Not to mention the are constantly being aggressive to each other (clawing, taking swings, trying to stab with forks, etc.) during the day, thank goodnesss I haven't witnessed it happening at night. I have tried explaining to management and they tell me they will see what they can do, then as I expected they do nothing.
This thread makes me so mad!
I'm just angered by these facilities. I'm sure it probably markets itself with photographs of charming, smiling, high-functioning elderly people being hugged by their charming, smiling, completely satisfied daughters. They probably boast about how each and every resident is unique with a story and how they strive to take that into consideration to provide the best gosh-darn care ever!!!
But they don't. They don't care what anybody's story is or what their unique needs are. They only care about filling the beds. Safety and care be damned.
So now you have Cmtz108 coming in there, green as peas, trying to figure out what the hell she is supposed to do. She is so new that it probably didn't strike her as funny that she was responsible for 15 moderate to severe dementia patients alone. Anybody who know their dementia patients knows that this is asking for trouble. Toileting issues aside, but what about the behavioral issues that bound to happen sooner or later? Where's Cmtz108's help then?
Cmtz108, I'm very curious... have you reported your concerns? What do you plan to do?
I am willing to bet dollars to donuts that, should that resident have a fall-- or is injured in any way, while you are attempting to transfer them yourself, The Big Shots at that facility will throw you under the bus. I'm guessing this is an assisted living facility? No hoyers or other staff? Sounds like the level of care is not one conducive to the care of this resident. Either The Big Shots are not aware this resident isn't a fit anymore, or are blatantly turning a blind eye because, ka-ching, a filled bed (even an inappropriately filled one) is $$$$$$.
Protect yourself. Do not transfer this resident alone! And this place doesn't just need "another CNA"... they need to have this resident in an appropriate level of care with the appropriate equipment. If you needed 3 aides, then this resident likely needs some type of lift. You also mentioned that this resident "stopped being able to walk". Has this been reported? It needs to be reported and a change in the plan of care (and the level of care) needs to be made. If They know and don't care, find a better place to work, if at all possible.
Yes, many if not most psych units are locked. In fact, I've never been in one that wasn't. (Not that I've been in a lot of them.) This is done to keep patients safe and to minimize distractions. And no, it wasn't at night, so it wasn't creepy at all.
We have one unit secretary who is amazing. She can do anything, does it quickly and is the resource person for all the other secretaries. She is a secretary only and absolutely does not double as a tech in any way shape or form, so she's always right where she's needed. She's day shift so they're luck lucky lucky.
On PM's we have the nicest woman I have ever had the pleasure to meet. She is excellent. If she hears me repeating back an order for x-ray, she already has the screen up looking for an open slot. She knows her resources. Unfortunately, she sometimes gets pulled to do transports or work the floor in a pinch, leaving us without a secretary. She's a good well-rounded worker.
Only knew one bad one. We had a tech that filled in as one and she was useless, but she did it eagerly because it was "cushy" and got her off the floor. Tossed things she didn't understand or know how to do back at the nurses. Didn't try. Didn't want to learn so that she didn't have to do anything. Only answered phones and barely listened before she immediately said, "I'll get the nurse" when a nurse wasn't necessary, pulling us into calls (that she could have handled) that interrupted our work. If there was a urine to go to lab, I learned to take it myself because she'd forget about it "because she didn't have time". She clipped coupons on weekends. Absolutely worthless. Thank goodness she didn't fill in often and I'm not missing her now that she's gone. She was a lazy tech too, by the way.
What makes the good ones good is that they: anticipate needs, take accurate messages, know when to direct calls to the nurses, get things done quickly and keep us up to date with any glitches they run into and work hard to get those glitches resolved. They don't complain, they are professional and go with the flow.
I LOVE our secretaries
I am so not into geriatrics or wiping old peoples asses to be blunt!
Okay, I mentioned earlier in this thread that I respectfully wear my white uniform dress and cap for Halloween. So, I wore it today at my elderly daycare job for our party. Cap, dress, white hose, pin, spiffy white shoes... the whole shabang. Well, as usual, the old folks love it! I must have gotten a hundred complements on how professional and impressive I looked. It was so nice!
But I forgot how crazy some men get over this! Can somebody please tell me what is so sexy about white hose and comfort shoes???? I had one old guy clutch his chest and tell me to check his pulse and later, "If I came to you to get my pulse checked, you'd have to call an ambulance!" Then he and another old guy were ribbing each other and winking while I was passing my meds... Good grief, kinda funny but
And Bookworm, too...
Maybe I'm just low class or tacky, but by golly, these stories had me laughing so dang hard!
I'm sorry you don't get it.
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