Okay, I am totally taken aback by what I experienced today at work.
I am at the end of my orientation and I was with a float filling in on the floor who was supposed to be the desk nurse for 4 hours to have me learn the paperwork side of the new admissions (which we had an admission) and how to enter the orders. This is an experienced nurse at the facility and both times now that I was with her she did everything saying we had way too much to do? I asked about the admission who came at 6p and we had to go out on the floor at 7p, but we could not do that. The point of the assistant DON putting me there in the first place. So, again I learn nothing and figure everything out for myself because no one lets me do anything but treatments, suction, trach care, meds, head to toes, basically all one on one patient care.
Trying to sum this up.
I tell assistant DON that I need to know the paperwork side of an admission, discharge, send out to the hospital etc. I am orienting with a float that supposidly works my floor often, idk. I have been with her twice, and with a float nurse on another day. I basically was orienting them to my area, and doing all the patient care and whatever else they needed.
So, long time nurse gives me bogus excuse why I can't do anything. Oh, BTW she enters orders totally different than the 1st nurse who showed me? Confused? She says we have way too much to do, there are like 15 orders and we have 3-7. I am supposed to learn the paperwork side of an admission, discharge, and other paperwork aspects. We had an admission at 6p, but we couldn't do that for some reason or another. So, I can't get anyone to teach me anything here.
My weekend RN supervisor had our area from 3-7p, he oriented orginally to my unit and area but somehow took longer to complete the med pass than I do and he forgot a lot of things in the process. He has been a nurse all of 4-5 months, he can't do my job but he is going to supervise my job? So, I came on the floor at 7p. I noticed he never came to nurses station to get any tube feed stuff. I was suspicious. I found my patient whose tube feed goes up at 6p to 6a not hung at 830p. I ask long time nurse, he signed off how do we handle. She said he got confused because my patient asked him to suction? Well, he never got the bag, the feed, or anything yet he signed it off so it seems like he just signed off stuff he didn't do because none of the feeds he needs is on the cart. All of my gravity people are unhooked, I do not think anyone got their feeds but know 1 did not. I asked if we tell next shift to go for 2 1/2 extra hours, or do we let someone know, what do we do. Going along I had to suction my patient with a trach and he was just suctioned by my Sup. who said what an ordeal it is to suction the patient. I suction him all the time, just suctioning and cleaning a cannula. He said he didnt get his breathing treatment so his secreations were worse. No one on trachs were hooked up to the nebulizers and they dont take themself off. One family that sits with their mother all day, said she was missing her breathing treatment? I ask long time nurse, ignore? So, idk. He had stuff signed off, he stuff that he didnt sign off, idk what he did. However, he is going to supervise me doing my job and he can't do my job? Plus, with how he operates Im scared to have him sup me.
So, long time nurse says you finish meds and treatments with one hour to go I have to send patient to hospital. Hello, I am not here to do everyone's job for them I am here to learn. So, I say I don't know how to send anyone to the hospital can I go with you. No you need to do this, here's my badge and the keys to meds and narc's. So, I finish med pass.
A patient of mine asks about a patch s/he had on friday that had not been applied again. Its for pain and s/he is in pain. Very high cognitive functioning, this person knows if his stuff is applied or not. So, I ask long time nurse s/he says its not being applied. She talks about falling off or aides take the patches off. Umm, okay if aides take them off they are d/c ing a med and hello!!!! So, thats bogus. The order for the patch is in the cpu, its being clicked as administered and not being administered. Then there is a order for verify placement Q shift, and guess what all signed off. So, long time nurse says falls off again. They don't fall off. Then she says probably don't have, umm what from an order 4 days ago that was already given once. I find med in med cart unopened, I say see could not have been given bcuz not open. How do I handle this situation? Nothing, nothing, nothing. I said could you leave a note on report to have her admin in the morning, nurse says yes, doesnt put it on report, is this stuff the REAL WORLD i was told all about or is this beyond the real world.
So, then she tells me I can go and I said we have treatments that have to be done and its a specified treatment day there are others that need to be done. She said of the ones i know pick the most important and do it? Umm, so I used my 1 week and 3 day nursing experience to judge which of all the important wound care to be done I would do? I went to sign off that treatment, and found Sup RN signed off all the dressing changes and treatments..........maybe he should have been putting up tube feed instead of signing off everything he didnt do.
Is this reality? When do I speak up?
