what would you do?

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Hi,

I am a orienting in a LTC facility and these are some things that have happened in the first few days:

1. catapres patch stuck to pt's shirt, mentor pulls it off and sticks it on his chest and tells me he'll call the dr and get an order for a new one. never did. the next day the patch was gone. again, i am told that he will call the dr but he never did

2. placing a new fentanyl patch on a resident and the old one is nowhere to be found. I am told it's not a big deal (i always thought old patches need to be wasted w/two nurses??? and if one gets lost it's kinda a big deal!)

3. respiratory therapist uses roommates toenail clippers to pierce a bottle of sterile water used to humidfy o2 via trach mask. eww

3. resident tells cna to shut up. cna replies, "you shut up!"

These are just a few examples. Believe me, I am not perfect. I am harder on myself than I am on anyone else but do you think i'm being nitpicky?? it's really hard for me to speak up cuz i'm so new but at the same time, I feel so guilty.

anybody have any input or advice?

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Sad thing is if you quit there and go somewhere else, it will probably be happening there as well. All my experiences in long term, have been that way. On another note I would definitely speak to someone about the things that are happening. Eventually, you won't have many friends there; or someone may actually do something about it. Good luck :)

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LOL Wow! "No you shutup!" that is too funny.

Is there a DON or anyone higher up that you can report this to? This is unethical and just plain nasty.

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Specializes in Nurse Leader specializing in Labor & Delivery.

The toenail clipper thing is nasty.

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#3 re: Toenail clippers. GROSS. How unsanitary.

#4 re: CNA. This constitutes verbal abuse, should have been reported. Unacceptable, CNA should have been removed off the floor, and investigation started immediately.

That is not being nit-picky. How is this CNA going to respond when a resident hits/kicks her? She shouldn't be working with vulnerable people imo.

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Specializes in Medicine.

You might have to take it up with management with the fentanyl patch. As for the social situations, those things you can take upon yourself and speak up. If you see people fighting you can step in and say "Please calm down, this is NOT professional behavior, we can work this out w/o those words."

The people that you take care of are YOUR patients as well. If you see something that's not right say something. Don't be abrasive about it, find your own way of telling someone something w/o coming off as an arrogant ass. Nurses should be able to deal with these social situations, we work with people, it's the nature of the job.

Doesn't matter how new you are, telling someone "shut up" in any job is not the way to go. Not the way adults should act. You don't need to be senior to tell them to shape up. You can come off as the more mature and calm nurse. As long as you don't add fuel to the fire, people will start to respect you for having a calm head.

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#3 re: Toenail clippers. GROSS. How unsanitary.

#4 re: CNA. This constitutes verbal abuse, should have been reported. Unacceptable, CNA should have been removed off the floor, and investigation started immediately.

That is not being nit-picky. How is this CNA going to respond when a resident hits/kicks her? She shouldn't be working with vulnerable people imo.

yea..that.

As far as the meds...Even if it was a busy, busy day (LTC is hectic) if the next day they came in and remember to call...they should of. Sometimes beter late than never.

Is the resident picking at the patches or are they just getting rubbed off with the clothes or the cnas during washing? Those are some things to consider before placing a patch or even using it as a form of med. Can you use it as a learning experience and call the md yourself? We don't use the two nurse system when wasting the old patch..probably should, but often times hunting one down is going to be hard.

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Specializes in Acute long term, clinical, office, etc.

what you saw was wrong, but in no way am i trying to defend them when i say, maybe you do not have the whole picture. being new, co-workers develop a weird since of communication with each other, like maybe the two you mentioned. as those in the medical field become seasoned, we lose some perspectives we were taught when we were green. in other words, we become lazy, take short cuts, and get tired of the staffing to patient ratio issues and such, that we do stupid things like using the nail clippers you mentioned or not making an issue about the clonadine or fentanyl patch.

at one point fentanyl patches were removed, cut up and placed into sharps container and witnessed by a second nurse. i have found patients with old patches of clonadine or fentanyl not removed and new ones applied. we get so regimented in becoming a drug pusher we do not stop to realized what effects this has on our patients.\

you are new and you have not seen the worst of it yet. my advice to you is to mention it to your nurse manager or educator. go through your chain of commands. use these incidents as teaching tools as not to repeat the act yourself.

be the good nurse you were taught to be. call the doc for the order. destroy the fentanyl patch with a witness and document your butt off. as for the other issues you mentioned, let the department head handle that. you do not want to place your license or patients at risk for harm nor do you want to alienate your peers. nursing requires we work as a team regardless of the title behind your name.

i think by doping what i recommend you will be able to sleep at night and keep your job until something better suits you, but remember, the grass is not always greener on the other side. the economy is tough and jobs are hard to come by. you must pick your battles and remember "nurses eat their young".

this coming from a licensed nurse of 21 yrs and in the medical field 25 years total. i work for a hospital for almost 10 years now. for the most part it's good but i have seen things that will make your head spin, it does mine. but i know for the most part, the staff care for our patients and they receive great care.

take care. i am here if you need to vent or talk. you will need an outlet or nursing will drive you crazy!

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