Am I too slow or too thorough?

[dinkymouse]

I am a 3-11 RN charge at my ltc facility. Generally I have one med tech and we each take a wing to pass meds. We have 21 diabetics, many of whom get insulin twice during this shift. Of course I have to do that. I have to supervise the dining room, I generally try to pass meds during this time. I do any dressing changes in the building and other treatments on my wing. Any situations that arise like falls, acute illnesses, transfers to hospitals, new orders and family or resident complaints are my responsability. We have no one to answer the phone after 4p and I generally have to chart on 30+ patients a shift. If someone calls in I have to find a replacement. I am never done at 11p unless I have 2 med techs. Sometimes not even then. Last night I had 2 acutely ill patients that I had to send to the hosp. (Both at the same time) A fall, a resident who purposely pulled out her cath and 2 residents who yell the entire shift and anger the other residents. Any res. on ATB's need assessed and charted on. There are urine dips, residual caths. I am sure u get the idea. I had all of this last night and also had a g-ttube pump that wouldn't run. The 11-7 lpn sat and watched me do the residual cath, dressing change and a + ua dip which meant calling doctor. I asked her to get the ATB out of the ER kit and she didn't. :angryfire At 3am she started screaming at me, "This is ridiculous. There is no reason you should be so late." IN front of cna's. She wanted a chart I was working on. I told her that I needed to finish it and she kept screaming. I finished the chart, told her would discuss this when she was calmer and went home. Still had stuff to do but I just couldn't deal with her. So tell me am I too slow or take too much time assessing things and such, and should I have walked out.

[Daytonite, BSN, RN]

Been there. Had to do that. The work never seems to end, does it? You're just conscientious. You need to address this LPNs behavior and attitude. I'd write her up for the screaming--that was inappropriate. I'd talk to the DON and ask her how she would want you to deal with this LPN if this screaming behavior happens again. Personally, I'd tell her to mind her own business and go about doing her work and leave me to mine.

[Simba&NalasMom, LPN]

Oh, sweetie, that's insane! How many residents do you have total? It goes without saying that your workload is ridiculus, but I think all of us who have worked in LTC know that the powers that be never consider level of acuity; the attitude is "Oh, well, it's LTC, they'll be stable, so we can give nurses 50+ patients and they can handle it."

Your NOC nurse needs a serious attitude adjustment; I agree with Day's answer that this needs to be addressed. I wouldn't go so far as to say she needs written up right away because I don't know what else, if anything, has been done to deal with her. To answer another question, never walk off the job until it's done; your residents must come first (as I'm sure you know) and it'll only come back to bite you in the butt, the facility will still have the same workload, and Nurse Ratchett will continue to berate other nurses. Having a hot temper myself, I would have been tempted to say "Look...would you rather I did these procedures and or would you like me to pass them off to you? Cause there are plenty of nurses who don't get done on time and pass their stuff off to the next shift so they don't have to stay late. You should be happy I'm not one of those." Of course, that would probably inflame the situation so I'm not advocating that as a solution LOL. Maybe saying in a calm tone "I'm sorry I'm running late, bear with me and I'll get done ASAP so you can get on with your night." Sometimes an apology up front will take the wind out of a cranky person's sails.

Above all, what aggravates me is that we are all supposed to be on a team and she sat back and watched you get your stuff done and couldn't even get you an AB out of the E box. What an awesome team player...not. :angryfire

I've worked with some cranky NOC nurses (I think that a few [NOT ALL, for those awesome NOC nurses out there] choose NOCs cos they don't play nice with others) but more often than not, I've had NOC nurses who will come on, find out about a shift from hell, and say "Don't worry, I have you covered...what were you not able to get done?"

Anyway, I digress. No, you are not slow. I've seen 20-year nurses with a much lighter workload stay a couple hours late to get the job done and nobody has said "boo" to them. I think maybe you're questioning yourself because another person treated you badly and that's a normal reaction. But the shift is over, it's a new day, and it's time to stop second-guessing yourself. Thorough is always better than rushing to get things done for the convenience of other staff. Stick to your guns, sweetie, and have a fantastic thanksgiving! :icon_hug:

[Jerico, BSN, RN]

Straight out of nursing school my first job as an RN was in an inner city ER. My preceptor repeatedly discouraged me when I started the ER. She would jump on me at least once a day, usually 2-3 times; and would CONSTANTLY tell me I was TOO SLOW. She'd tell me "you'd be a great ICU nurse, you are so detail oriented and analytical". (Which I am). I'd be a good ER nurse too, if you'd precept RIGHT!!! :chuckle

Well, I was SLOW compared to HER - who had been in the same darned ER 16 years!!

When I'd mention to her (in a nice manner) she was doing her berating in FRONT of God and everyone (including patients) she would deny it!

She was an ASS and extremely UNPROFESSIONAL. How she had stayed for 16 years I have not a clue!

We could not have been more opposite. I finally told the Dept Administrator I would not work with her (this is AFTER I'd complained twice about her) because this nurse: A) treated patients like dirt/jeopardized safety and B) treated ME like dirt and C) was jeopardizing my license and was going to get ME and the facility SUED (am a former hospital administrator and know risk when I see it).

When I met with them the THIRD time over her they told me "it wasn't a good match" as I was telling them I was leaving (I already had a new position elsewhere anyway).

Get this: the nurse who hired me TOLD me she needed my maturity on this day shift (where the preceptor/nurse from hell was working). BOY she had THAT pegged!