CoffeeRTC, BSN 16,474 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,618 (23% Liked)
I work in a LTC facility with 50 beds. Some days I'm supervisor and have two LPNs other days I'm on a cart and have the facility plus a 24-26 resident assignment depending on what hall I take.
As far as stress....every day is different. We have a good turn over of residents. Some shifts are more stressful than others. Stress to me would be different than what it is to another nurse. After 20 years...I get kinda numb to it, LOL
I had to call off once for "having a baby." She was a few days early
My favorite of all time came from a CNA's husband "yeah, she won't be in tonight. She has a real bad yeast infection." He went on to describe all the issue she was having in full graphic detail.
While I never practiced as an EMT, I had taken the classes, did the ride alongs and got certified. I see EMS point of view. I've also been the only nurse on duty taking care of 50 residents with needs.
When your local EMS has the same type of issue with the local LTC, has your director ever voiced their concerns with the administration of that facility? I strongly urge you to have a meeting or at least a call with the DON. Some nurses are just clueless on the life of an EMT or Paramedic. It doesn't need to be an us verse them. We have a great relationship with our local service (including the 911 services).
Nurses....if you see EMS treating your nurses like crap...get to the bottom of it. Call them out. yeah, some folks just have a bad day.
If we call EMS, we work as a team. CNAs know to get the room ready (clear out all the WC, chairs, bedside tables etc) and to get the resident ready (clean gown and brief) if we have more than one nurse on...we take turns getting the papers ready and taking care of the resident. Have someone greet the medics when they come in. yeah...all of this is thrown to the side in a true 911 emergency code.
We just recently had a 911 code. CPR was started, defib uses EMS arrived on the scene and took over. While I wasn't around for this one, in the past, after it was done..we would reach out to the EMS team and ask for feed back. Sometimes it isn't nice to hear the negative critic, but it is good to learn from these situations.
the blue dye in the roxinal...I'm just guessing since this is a hospice patient.
I'm not quick to say quit, but I can't see this being good. I've been in LTC for ever but I would never be able to work with that ratio. I have 50 where I am now. Most are skilled and about 10 or so are LTC with not that many needs. We staff with 2-3 on...never less that 2 on the 11-7.
If they said there would be two on 11-7 and they are now staffing with one, I can't see this being good. I don't think explaining this in an interview would be bad.
COPD, CHF, Diabetes are our biggies. Hip and knee repairs and fractures. Dementia care.
I will try and be helpful
If this is LTC...it is just way to common. What are the reasons they are calling off? What is staffing like?
We have been running very short. CNAs are doubling or splitting 8 hour shifts so they are working 12-16 hours 3-7 days a week. Yes...I said 7. Many are single parents or parent with a few children. They have bills, they need money. CNAs don't get paid enough as it is. These ones that sign up to work extra are making it so that we are not short staffed by filling the holes. They get burnt out very fast. Now...add in a call off for a legit reason or even something not (too much partying the night before) Cue the resentment and increased fatigue by the staff...cue the cycle of call offs.
So...adequate staffing and a good prn call in staff.
Generous time off or flexibility for illnesses or emergencies.
Staff appreciation ...little things add up.
Enforcement of discipline process when there are call offs.
Giving the levimir instead of the sliding scale coverage was a med error. Was the doctor called to adjust the 9pm dose to the 15 units? why not? What was the 9pm reading? They didn't get coverage for the 4:30pm reading. The doc probably would have just ordered the 15 units and to continue with the regular sliding scale coverage.
bottom line..orders were not followed, a med error occured, nurse was practicing medicine by not giving what the doctor ordered.
Oh...answering the OPs question.
Sometimes they might be upset that we didn't call sooner. Often times, it isn't our fault. Resident might have refused (well documented) or maybe the condition changed quickly or maybe I just walked into this mess.
DNR doesn't mean...do not treat.
I have been in LTC for many years and it has been ages since I had difficulty with the local EMS. We utilize private company for most transports but if they are busy or we need help stat then we call 911 and we have help within 5 minutes.
When I hear a coworker complain about the EMS, I have to ask a few questions first. Many times, it is our (nurses) fault. Yes, I am willing to take the blame or at least put it on my coworkers. When we decide to send a resident out, unless it is an extreme emergency, then we should have a complete or at least focused assessment including baseline for that resident, I would expect a clear path has been made and if there is time, basic paperwork and having the resident cleaned up if needed. Greet the emt/ medic and give them a brief report...not just point the way.
We are not "stupid or lazy" but sometimes things get crazy. I work part time so I might not know complete histories, but I am willing to share assessment and reason for transport and every bit of information I do know. Sending a resident out for AMS and not checking vitals, O2 sats or a finger stick on a diabetic???? Yeah, If I was EMS, I would be pissed.
Sounds like a horrible first day. What makes you think they are treating you that way? do they offer more help? Do the other nurses hover?
I would suggest trying to be organized. Now that you've been there for a while, are you familiar with where things are located?
I would walk around, look for things etc. Get familiar with your unit. Where are the supplies, where are the list of phone numbers, etc? Organize your med and treatment cart at the start of the shift, load it up!
Make a list and try to organize your shift....ask the other nurses what they do. What works for them?
Being the new nurse stinks and it takes a while to get a routine of your own. Its worse when the other nurses are not working as a team with you and offering help.
I agree with the others. This week with the norovirus and C diff outbreak, I've stepped up my game. Wiping my shoes and leaving them in the garage and changing as soon as I got home.
you should be able to find this on the state's website.
There is a Facebook Pittsburgh nurses group that is fairly active. Check it out if you are on FB.
Have you ever looked at the consent forms for those trampoline parks? You sign everything away when you let your kids go there.
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