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If this is the case, document carefully. When things go wrong, mgmt will
blame staff and point at you and your team. If it is really out of control,
start looking for a place where safety and good practice are in place.
Yes I work per diem in such a facility. Management told me 'they have my back' and give me permission to 'counsel' assistive personnel. What happened to accountability such as write-ups and suspension without pay for offenses totally degrading to the resident and could be considered mental abuse to a hospice resident?
Yes, but my problems are different than the ones you describe. Management IS the problem at my facility. We bedside nurses can't win no matter what.
Here's an example. We started med scanning about 2 years ago. The hospital tracks our scanning percentages and you basically get punished if your percentage drops below 80%. (They used to post people's scanning "grades" as if they were in elementary school... they've completely lost sight of what nursing is about, ridiculous.) The people making these rules have never scanned a medication in their life and probably don't even know how to turn the computer on/log in to the system. Our system is so poorly designed that half the time, the scanner is not working or the barcode won't scan because the pharmacist signed his/her initials over it. We have exactly enough computers for how many rooms we have... we are "supposed" to have 3 extras that have scanners, but you can imagine how often those are around- especially during the day when social work, nutrition, PT, residents, med students, nursing students, etc. are ALL trying to get on the computer. If we are at full census and I don't have a working scanner in my room, I do not go steal one from another room and create more work for my colleague who is taking care of that patient. If my patient is screaming in pain, I have morphine ready to give him but my computer won't start, I don't go looking for another one because the idea of leaving my patient in pain to go searching for another computer so I can scan the VIAL I already withdrew the med from is preposterous to me. (As far as the powers that be are concerned, your scanning percentage is a measure of how good of a nurse you are. I believe that leaving my patient to scream in pain while I search for a computer for 10 minutes would make me a bad nurse.) The other day, we were 100% full and when I went to give 8am meds to one of my patients, I found that the computer in her room did not have a scanner attached to it. 8am is when we give all morning meds so I was certainly not about to go steal from another room and compound the problem by forcing my colleague to have to do the same thing. There were 2 computers in the hallway with no scanner and one with a scanner that someone was using. I have a brain and I can read... I can look at the order on the computer and read "Augmentin 240 mg PO TID" and see that in my hand, I have 240 mg of Augmentin. We safely gave meds ALL THE TIME before scanning came about. Anyhow, my floor also asks people to log the problems they have with scanning. Then when you do, they basically yell at you for not wasting 20 minutes to fix the problem before you gave the med so you could scan it. (I don't get paid to fix computers so I'm unwilling to go out of my way for something that's not my job when I have enough stuff to do.) On the flip side, they are also involved in this stupid project where they bring tracking devices in every 3 months, have nurses carry them and when they beep, you have to tell them what you are doing. If you ever were looking for a computer so that you could scan your meds while carrying this thing and told it as much, the hospital would graph that as a "waste of [nursing] time" and then send out a power point with bar graphs and pie charts saying that nurses waste too much time and don't spend enough time at the bedside.
I'm so frustrated with all this bs because they can't have it both ways. Either they want me to waste my time looking for the equipment needed to complete things they way they want it done or they want me in one of my patient's rooms at all times. /end rant.
I am fed up with a lot of things and yes poor management is one of them. I work on a unit where the nurse manager likes to micormanange and many are tired of it. I am fed up with staff who are still working on the unit and clearly the unit is too fast paced for them to handle and many worker have complained about it to the nurse manager. I'm tired of getting pulled aside by management for something the doctor should have done and I missed it, so it counts aganist the unit when audits are done. I'm tired of management standing up for the doctors who because of what they didn't do, the unit gets dinged for a miss on something. The crap that comes out of managment's mouth about particular doctors being good at certain things, but yet the doctor is not being pulled into an office to discuss what they should have done or better yet even being notified at all. I am a human being who is a RN. SORRY I CAN'T ALWAYS REMEMBER FOR THE MD HOW TO DO THEIR JOB FOR THEM WHEN THEY CAN'T REMEMBER. I'M BUSY TOO DOING MY JOB ALONG WITH THE OTHER PEOPLES JOBS: cna, casemanagement, physical therapy, secratary, monitor tech, occupational therapist, security, house keeping, etc, the list is endless. SORRY THAT I CAN'T MANAGE TO REMEMBER HOW TO DO ANOTHER HEALTH PROFESSIONALS JOB ALL THE TIME!!!!!!!!!!