CoffeeRTC, BSN 16,789 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,632 (23% Liked)
Hard for me to see how you did the wrong thing, except in one area that I'll get to in a moment. From what you've described, your mom received care well beyond the level she would have had you left her in the care of others. Your fear is that you somehow hastened her passing - you might want to consider the possibility that your repositioning at that exact moment actually bought her some extra time, albeit just a few seconds. Equally plausible, no?
And, for the record, yes, I had the honor of being my mother's caregiver for the last 4+years of her life, and yes, I had a client pass while being repositioned - several months ago, and I was doing a brief change. Pt. arrested as I was putting the fresh brief on, and I buttoned everything up only to find the pt. had gone completely limp. Got pt. on their back, called for an RT first (1st person I saw) who flagged the charge nurse down, who knew the pt. was on hospice and was DNR/DNI. So - no CPR, and we did a quick prep while the desk nurse notified the family and hospice. Tends to be something of a shock, even when you're not a family member.
As far as my criticism - just on one point, and it's very common. When you accept the role of caregiver you absolutely MUST TAKE PROPER CARE OF YOURSELF, and it sounds like you weren't and aren't. Yeah, you're grieving; been there, done that. It takes a bit to assimilate all that's gone on - true dat. But - you still have one last obligation to your mom, and that is to continue on and have a good life. Counseling if you feel you need it, but more importantly to be good to yourself. Cut yourself some slack, sit down with some trusted friends and talk about the good times both past and future. I've no doubt your mom would want you to. Take it from one who's been there.
The state forums are awful. They used to be really nice, but I agree that they are now all about this or that school waiting list or the New Grad program at hospital x,y,z. I wish they'd separate that stuff from the state forums again.
I went back and read the thread you started about a year ago in which you also insulted the LTC specialty. You fell over yourself apologizing when you were called on it then. Those apologies don't seem to mean much, as this is truly the way you really feel, about all of those nurses and about yourself. How do I know this? Because here we are, exactly one year later, having the exact same conversation.
Brutal honesty here.....I have no patience for this. If you hate it, go do something else. You are past the year mark. Reapply at the hospital that fired you if you would rather be there, but knock off this "poor me" stuff. It is unattractive and habit forming. You aren't a victim of anything but your own imagination at this point.
You're impressed by flexiseal skills?
LTC friends, I would not be insulted by her post... she's clearly being facetious,.
I'd start by referring to Ativan as a benzodiazepine and not an opiate.
For someone in casual conversation I would have a hard time not smiling and saying "Wow, that is really creepy" in response to the comment in the OP.
That is why I am so confused by this. No diagnostic testing was done to prove this pt wasn't infected. That why I asked her, bc there was no infectious disease doctor on and no stated reason for discontinuing the iso order. The order just stated, "D/C Iso". All of the dayturn nurses were questioning it in report, I wanted to be able to give them an answer, not just" because the doctor said"
Your stethoscopes were not lost. They walked away around the neck of someone else.
Either keep your scope on your person at all times.. or use the Fisher-Price model provided by the hospital.
I found I could hear everything I needed to hear with ANY stethoscope. I could even diagnose with my ear to the chest if need be.
Save your $$$, fancy scopes are not necessary.
I will look in Indiana.
Keep a stick of gum or a piece of peppermint in your mouth and keep it moving because, Suga, you ain't seen nothin' yet.
It's not entirely management. Based on the 5 star rating system, the more RNs the higher star value.
Many insurance companies want RNs on staff. And, at least in my state, LPNs can't assess. Most of what we do other than push pills has to do with assessment.
Whether you report directly to her or she reports to you I would still approach it in the same manner as we are all wintegral parts of the whole.
I go into these things, or at least I try really hard, first determining what outcome I'm looking for. If it's anything remotely like validation I check myself and realign. Once I know I sincerely want the outcome to be say a good working relationship that benefits everyone then I know I'm ready.
"Can we talk about how to handle errors and disagreements in our practice? You bring a lot of experience to glean from and I would like for us to be able to give feedback without either of us feeling like crap and I tend to have a negative gut reaction to criticism that feels personal and/or punitive. On the flip side I respond well to suggestions of how to achieve a better outcome.."
For that to work you have to be able to check your pride, not throw up in your mouth as you say it and be able to be strong while simultaneoulsy being soft, it's all about what you want the end result to be and how to get it. Give her a road map she can follow and invite her to take responsibility to communicate better herself. This will decrease defensiveness and direct the attention off of you and back to the collective goals.
Left LTC 2013 after 25+ years working my way up from aide to DON due to much of the reasons above. Said I was never ever ever going back to LTC. Well, you know how the story goes....plans/God laugh/etc.
I've been back in for 4-5 months now. Accepted an interim DON, that turned permanent position from an old boss. Facility in a very tiny rural town and old boss promised this would be different than any facility we'd been in before. We'd worked together before in a high class, crazy, start up, high medicare turnaround facility. We only half liked each other but often argued a bit due to the craziness of the place.
This time, he is 100% correct. Now I remember why I loved LTC. Nice little 45 bed facility, good "hometown" type employees as well as families. Expectations are reasonable for all levels of employees and as a result, care is good for residents and staff is happy. Families are obviously happy because their person is happy. (Think - no state complaint surveys in...well no one can really remember the last one. This has renewed my hope in LTC as a whole.
Another initial post from a first-timer!
I was mandated so much in my early career at a LTC, that it's a make it or break it issue with me now. I haven't been mandated in probably 20 years, if it happned I'd stay over, but only due to my license. I would seriously hold it against my employer though and give my notice as soon as I could secure another job. Recently they hired a RN that appeared less than reliable to the shift following mine. When I asked my supervisor what she would do if that new nurse didn't show that night, she insinuated I'd have to stay (The nurse did show up). Needless to say, that didn't sit well with me and I immediately found a new job. I'm too old now and will not play the mandation game for any employer; they might stick me once, but then I'd be out.
Advertise With Us