Bad Day (kinda Long)

Published

Specializes in Psychiatrics.

Okay....so I get that I'm an agencey nurse and that I walk into a nursing home and I get report...go in and do my thing and go home....I GET THAT...

BUT PLEAST GIVE ME THE DECENCY TO WARN ME ABOUT:

*patients that are known to hit

*patients that have family that are known to call and cuss out staff memebers

*patients that are going to spend 1/2 an hour asking about each medication

*patients that are so confused they think that they dont know theyre own names

My day started off:

I get to the facility where I've never been to before....I get there and introduce myself....which I do at every facility... I get a blank look and then the DON states..."You're not supposed to be here."

Ummmm okay.....I was called at 10:30 to come here...but okay. I think to myself....theyre gonna send me home....second time this week....

The DON goes into her office....tells me that STATE is there....its crucial that they pass this revisit....and that she has to check to see if I'm even supposed to be here.....

Turns out that I am supposed to be there and that I am filling in for someone else.....no one bothered to let the staffing cooderantor know...

SOOOOO: I start my day:

One nurse wants me to do some orders:

okay not a problems: just show me how you do them so that I do them according you your facilities policies.....simple right????.....nope it takes them handing it off to four nurses before I get shown how to do the orders.

Then I start passing my meds....no big deal right....WRONG

I get about 7 people done.....then I get to resident G: resident G has an order for med pass and a change of a phentanol patch....no big deal...right...WRONG....I go in....introduce my self....ask to look on his back to change his patch...and WAM...get punched in my clavical....it knocks me on my a** and I think OMG what just happened....two aids walk in and help me get the guy calmed down....turns out he has alzheimers and no one bothered to tell me.....

NEXT ISSUE:

I do my blood sugars...I have a resident have a blood sugar of 75...I wait to give her insulin...(order reads for a sliding scale....below 120 no additional units.... but 7 units with each meal).....unit she is eating. I tell her that I am giving her insulin...she knew what her blood sugar was...knew what medications were....and she had no problems...10 min later she hads a fit that I gave her insulin.......(she had two large balogna sandwhiches and a large bowel of strawberries on top of milk and juice... she had plenty to eat).....about and hour later I get a phone call from her daughter yelling at me stating that I'm going to lose my lisence....that I'm dumb and stupid and dont know what I'm doing.....shes going to report me...I'm going to lose my job...ect....{I come to find out shortly after the phone call that this happens on nearly a daily basis....and I wasn't warned}

THEN

I had a resident who wanted milk of mag....okay I give her milk of mag... less than an hour later.....she says its not helping...i give her bisacodyl... now she says her ribs hurt.....i give her loratab.....she says that doesnt work....now she has cramps from constipation.....and the pain pill didn't help....(I find out after dealing with her for about oh.....5 hours....that she does this every night)

SO;.....I get done with passing pills.....

Now I get to do treatments.....usually no problem....

I have to do a treatment where I pack a wound on a chest wall....all the way down into the lung cavity...you could actually hear the lung expanding...it was a kinda swishing noise....but no one could find any of the supplies...finally did....got the dressing done....

NOW CAME THE CHARTING AND THE ORDERS: (only about an hour after my scheduled shift is supposed to be done)

I count my narcs and go home

WHAT A MESS

any other experiences like this??? ANYONE

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Specializes in LTC, MDS, Education.

Next time you go, it will be a little easier! :smokin:

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i don't know about normal, but it sounds crazy. you really could have gotten hurt by that pt. hope u wrote up a incident report. and somebody had to call u 2 come 2 work, instead of someone just giving u a blank stare. u going back? ouch

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Specializes in Psychiatrics.
i don't know about normal, but it sounds crazy. you really could have gotten hurt by that pt. hope u wrote up a incident report. and somebody had to call u 2 come 2 work, instead of someone just giving u a blank stare. u going back? ouch

Actually....I informed "management"....they told me that this was normal behavior for this resident....and that an incident report woul dnot be needed in this type of situation because I was not physically hurt.....

And YES I could have seriously been injured....I was lucky that I wasn't!!!!

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i don't know about that. sounds a little shady to me. what if a staff member hit a pt. they would be filling out all kinds of paperwork on you. and easy for them to say, they didn't get knocked to the floor, and sometimes you may not even be aware you have an injury until days later. it sounds like they are making excuses and need to hire some pt sitters perhaps.well anyway hope your not hurt, but just in case i would have a incident report on hand and make copies take care of yourself first

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Specializes in Psychiatrics.
i don't know about that. sounds a little shady to me. what if a staff member hit a pt. they would be filling out all kinds of paperwork on you. and easy for them to say, they didn't get knocked to the floor, and sometimes you may not even be aware you have an injury until days later. it sounds like they are making excuses and need to hire some pt sitters perhaps.well anyway hope your not hurt, but just in case i would have a incident report on hand and make copies take care of yourself first

Thats kinda what I thought....but I am only AGENCY....and I knew at the time I wouldn't bruise....today there is no mark what so ever...

So I went with the flow....even though I probably shouldn't have.....

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Specializes in ICU.

there are some days that are just bad bad B movies and surviving them means you find the entertainment in the situation. :smokin:

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Specializes in Utilization Review/Case Management.

My mom always told me to "pick your battles". Maybe this one was not worth fighting at this time. Make sure you are prepared before you start, and make sure the expected outcome is worth it (expected outcome is not necessarily the same as the desired outcome. ie: Is what you want really what will likely happen?)

Don't beat yourself up, we all second guess ourselves, just learn from the experience and move on.

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What type of report did they give you? My biggies are to ask about behaviors along with rest of report. I also ask..."any family issues I need to know about?"

BTDT and have the tee shirt too.

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Specializes in LTC,Hospice/palliative care,acute care.
Okay....so I get that I'm an agencey nurse and that I walk into a nursing home and I get report...go in and do my thing and go home....I GET THAT...

BUT PLEAST GIVE ME THE DECENCY TO WARN ME ABOUT:

*patients that are known to hit

*patients that have family that are known to call and cuss out staff memebers

*patients that are going to spend 1/2 an hour asking about each medication

*patients that are so confused they think that they dont know theyre own names

My day started off:

I get to the facility where I've never been to before....I get there and introduce myself....which I do at every facility... I get a blank look and then the DON states..."You're not supposed to be here."

Ummmm okay.....I was called at 10:30 to come here...but okay. I think to myself....theyre gonna send me home....second time this week....

The DON goes into her office....tells me that STATE is there....its crucial that they pass this revisit....and that she has to check to see if I'm even supposed to be here.....

Turns out that I am supposed to be there and that I am filling in for someone else.....no one bothered to let the staffing cooderantor know...

SOOOOO: I start my day:

One nurse wants me to do some orders:

okay not a problems: just show me how you do them so that I do them according you your facilities policies.....simple right????.....nope it takes them handing it off to four nurses before I get shown how to do the orders.

Then I start passing my meds....no big deal right....WRONG

I get about 7 people done.....then I get to resident G: resident G has an order for med pass and a change of a phentanol patch....no big deal...right...WRONG....I go in....introduce my self....ask to look on his back to change his patch...and WAM...get punched in my clavical....it knocks me on my a** and I think OMG what just happened....two aids walk in and help me get the guy calmed down....turns out he has alzheimers and no one bothered to tell me.....

NEXT ISSUE:

I do my blood sugars...I have a resident have a blood sugar of 75...I wait to give her insulin...(order reads for a sliding scale....below 120 no additional units.... but 7 units with each meal).....unit she is eating. I tell her that I am giving her insulin...she knew what her blood sugar was...knew what medications were....and she had no problems...10 min later she hads a fit that I gave her insulin.......(she had two large balogna sandwhiches and a large bowel of strawberries on top of milk and juice... she had plenty to eat).....about and hour later I get a phone call from her daughter yelling at me stating that I'm going to lose my lisence....that I'm dumb and stupid and dont know what I'm doing.....shes going to report me...I'm going to lose my job...ect....{I come to find out shortly after the phone call that this happens on nearly a daily basis....and I wasn't warned}

THEN

I had a resident who wanted milk of mag....okay I give her milk of mag... less than an hour later.....she says its not helping...i give her bisacodyl... now she says her ribs hurt.....i give her loratab.....she says that doesnt work....now she has cramps from constipation.....and the pain pill didn't help....(I find out after dealing with her for about oh.....5 hours....that she does this every night)

SO;.....I get done with passing pills.....

Now I get to do treatments.....usually no problem....

I have to do a treatment where I pack a wound on a chest wall....all the way down into the lung cavity...you could actually hear the lung expanding...it was a kinda swishing noise....but no one could find any of the supplies...finally did....got the dressing done....

NOW CAME THE CHARTING AND THE ORDERS: (only about an hour after my scheduled shift is supposed to be done)

I count my narcs and go home

WHAT A MESS

any other experiences like this??? ANYONE

Those behaviors (residents and families) almost seem the norm in LTC these days.Our MARS list the resident's diagnosis-anyone with any type of dementia listed should be handled with caution.In the few cases where the diagnosis is missing the meds can sometimes offer a clue.... As for families-identifying yourself as un-familiar with the situation and turfing the call to the supervisor is the way to go.End the conversation when the abuse begins.You certainly followed the IDDM resident's orders and used your nursing judgement.No one has to accept abuse like that...... As for residents questioning their meds-this often happens when they see an unfamiliar face-offer to come back to them and get the rest of the med pass done.Check their care plan and follow it-many of our more manipulative residents pull this with un-familiar staff.Sometimes they just want to know that you KNOW and are competent.Sometimes they just want to suck the life out of you and you have to set limits. .... Our MARS also hold up tp date pictures of each resident-many dementia residents don't know their names.They may have forgotten they have been married.That's why we use wrist bands and pics. .... I would not have asked you to take off orders on your first visit-you need time to familiarize yourself with the residents ,the policies,procedures and the home's routine first. We have a bowel program-it is a matter of policy and procedure.Many residents forget not only their names but when they moved their bowels.....As for treatments-some units are better supplied then others.I work on a unit now where we all strive for 100% accountability.Supplies are re-stocked,O2 and suction are set up and ready to go-we have up to date signage in the work area and a communication book. for new orders and problems.I hate getting pulled and opening up a med cart missing meds and a treatment care without basic stuff like tape and saline.But as an experienced nurse I am able to roll with it.The good thing about working with an agency is you get to pick and choose.You never have to go back to that place again.Or if you do you will be familiar with the residents....

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