its been such a bad week!

[CashewLPN, LPN]

hi guys...

please forgive my rant for the time being.... Its been a bad week...

well... as background... i have para-influenza.... yep... the flu. woo hoo... but.... its ok, I'm getting better... but it all started off yesterday on the 12a-8a shift... it was quiet... everything was seemingly ok... one of our residents decided to wander out of the room, then, sit on the floor and scream her little head off..... fine, no prob.... me and my nurses aide put her in a recliner, as per orders, and wheeled her into plain sight... (her room is pretty distant from the nurses station...)... Then, all of a sudden, I hear the kangaroo (feeding pump) alarm in another room go off... I turn it off, and notice that one of the residents ( the dude w. the feeding pu mp's roommate) was AWOL... I ask my nurses aide ' hey-- where's mr. x....' she replies, he should be in his room.... so, now, we notify the RN Supervisor (I'm an LPN) and, lo and behold, a few minutes(90 to be exact) later, after searching the whole building (roof and basement included) we get a call from a local ER, (at which point, I thought the man was hit by a car or somthing) that the cops saw him wandering w/o a jacket and got an ambulanse to take him to ER.... we got him back a little after 7am..... needless to say, the hour that he was gone was SCARY! and...on top of that... the RN supervisor did not follow protocol after the search of the building (call the DON and the family and the cops and the local ER's).... I had my aides and myself write statements, (in 3 seperate rooms...) sign them and put them in sealed envelopes.... in the AM, I got to speak to the DON and ADON... but, what really gets my goat, is that after we wrangled up the RN supervisor when this all went down... she locked herself into the conference room to catch some zzz's... she accused me and my staff of sleeping instead of watching the residents.... Pure horse hooey... anyhoo... now, on to today...

Got to work, not a problem in sight... or, so it seemed that way... dinner trays went ou t, a resident threw his milk at me... ok, that I could deal with, I'm getting good with dodging milk.... then, 6pm meds roll around.... I'm doing meds, when a resident came up behind me, grabbed the collar to my scrub top and my bra strap in one fell swoop, and began shaking me around..Screaming "I'm gonna get you ***** I'm gonna break your arms" ( the resident has pretty severe alzheimers type dementia... violent swings happen sometimes, but he's been pretty calm lately) mind you, I dont work 4-12;s too often, and I dont know the staff names too well.... but, a well placed 'HELP!! GET HIM OFF OF ME! HELP!" coming out of the nurse works wonders... 3 aides and the porter later (yes, it took 4 people to get him off of me) and, I ask the RN Supervisor (different woman) for an accident report, as I'm feeling pretty sore... she says ' ok in a bit' ....everything calms down a bit... until the daughter of the first, missing for a while resident comes in, saying that she'll put her dad's shoes up on the top shelf where , and I quote "He cant reach them"... 5 mins later, he has the shoes and is making for the door... mind yas, shoes or no shoes this man walks out constantly! and yes, he wears a wanderguard, but knows how to disable it... then.... another resident, a sweet, cute man, comes up to me and says 'honey, did that big oaf hurt you? if you want I can run him over with my chair?' I assured him I liked the gesture, but it wouldnt be necessary, but, we had a big hug, and it was nice for a while...... (this res is my quazi adopted uncle... we get along well) then another resident is yelling to be changed.. (he was just changed... you go in there and he's saying 'hi nurse, and what a lovely evening it is...and, did you know you have some lovely breasts?' GRR. yes, I've spoken to him about his attention seeking behaviour... but, I just dont feel comfortable 'hanging out' in there to give him the needed attention when 1) theres 39 other residents that need help and attention and 2) when all eyes dont come up past my collarbones.) ooh... but, then, another decent moment-- a fellow nurse and I went looking for dinner... it was now about 8:30, so we were paroozing staten island for dinner on thanksgiving night.... so we went to Perkin's (like a Dennys. same deal.... dame company) and got our meal and some milkshakes.... when we were int he lot we noticed that the 'milkshakes' were quite warm... hot actually... turns out it was cream of turkey soup. they switched them asap, and apologised profusely (it really is ok, I swear!) and we got our 'heal anything' chocolate malteds.... now, back to work... my boyfriend calls, wishes me happy thanksgiving... comes by and visits on my 'cig' break... got another nice hug, plan our black friday, then, I went back upstairs, and another res. comes back from pass, and has respiratory distress in the elevator.... which is isint a big deal per se.... esp when his friend goes 'Dude, you cant keep doing this every time you get to the floor... you gotta stop playing around w/ the nurses...' YES... a cry of WOLF.... res was walking and talking fine when I spied him through the bend mirror (our floor is a giant L... I have a mirror to see from one side to the other) and began his 'distress' when I got around.... now, being a good nurse, really, what am I to do... transfer him back t bed... restart the o2 via nc, po2 checked before and after (99 and 100% respectively) grr again. now, at a quarter to 12 the supervisor FINALLY comes up with the accident report... and goes 'do you want to go to the ER?' my reply, which I admit was a touch snipppy... 'If I was wanting to go to the ER, you'd have known about it hours ago' and, then... which was nobody's fault, I had a resident, who began to vomit at 5 mins to 12, when I just documented that she didnt vomit at all. oh well... no biggie... I think she may have an adhesion-- she's s/p fairly recent abd historectomy. oh, then I went home.... got something to drink-- orange pineapple juice, and a little shot of orange rum...(medicinal purposes.. I swear!) mixed them together, then got up on this board... Yay.

now, I go to sleep.

wow... thats a long post... I apologise for misspellings and grammar and whatnot...

g'night and thanks for the breathing space

--Barbara

[VivaLasViejas, ASN, RN]

My sympathies, Yeti!! Hope the next week is better.:kiss

(((((Yeti)))))

[Rapheal]

My sympathies as well. I enjoyed your post though- you have a great way of telling a story. Hope next week is better.

[lanilpn]

hope that your next week goes better. trust me when i say that it will be better. i remeber those days:eek: I too, enjoyed your story telling:) just remeber that is one of the reasons why we are here, nurses need nurses:kiss

[Tweety, BSN, RN]

What they said above. Take care of yourself.

[unknown99, BSN, RN]

Yeti,

You are an angel to deal with what you do when you go to work. Thank heavens that the good lord put nurses that care enough about these type of patients on this earth. If it weren't for compassionate, caring nurses like you, how would these patients live what little life they have?

:) :) :)

[ktwlpn, LPN]

Just another shift in LTC......:roll The elopmentment is a serious situtation-here in Pa the crap hits the fan when that happens.....Does he remove his wanderguard? If so you could try sticking them in his clothing-maybe little pockets sewn into some articles of clothing in areas that he would not find...Like the back of his shirt collars....Good luck

[CashewLPN, LPN]

hi guys....

hmm.. after 2 days off, with telling the supervisors calling my house 'no' 2 days in a row for extra shifts.... I'm a touch calmer...:) (just had a nice lazy day with the b/f... it was such a change of pace, It was great! we went to B&N, and the Comic book store, and then we watched LOTR the 2 towers.. and found the easter egg....:chuckle:)

now, with elopement..... we've tryed everything with this dude... I actually put the sensor IN the lining of his shirt one day.... the problem is that he has learned how to disable the system.... :eek:hmm.. I was listening to one of my fellow nurses say-- 'gee, he's got dementia, how could he figure that out'... my prompt answer is 'he isint dumb-- dementia and stupidity ride in two distinctly different boats.' see- I get worried sometimes, b/c a few years ago, up here in one of our major state run LTC's (its out in the middle of the woods, with an extensive set of grounds) a res tried to elope and froze to death near the gate.... (they found his frozen corpse the next day.) (insert grue/shudder here) so... I aim to not have this dude freeze anytime soon...

anyhoodles...:) ok guys... I'm to be out and about... I'm on a weeks vacation...

:kiss

thanks for hearing me!

--Barbara

[ktwlpn, LPN]

Originally posted by Yeti1313LPN

hi guys....

now, with elopement..... we've tryed everything with this dude... I actually put the sensor IN the lining of his shirt one day.... the problem is that he has learned how to disable the system.... :eek:hmm.. I was listening to one of my fellow nurses say-- 'gee, he's got dementia, how could he figure that out'... my prompt answer is 'he isint dumb-- dementia and stupidity ride in two distinctly different boats.' thanks for hearing me!

--Barbara

I cannot stand it when co-workers treat the demented like idiots...I spend aloit of time educationg and teaching by example.The worst is select staff members that seem to take the behaviors of the residents personally....That really spanks my butt....Your guy can punch the code into your keypad? Or does he disable your system some other way? He may have to have 1:1 until he gets past this stage...the staff will love that....We had a visitor let one of our residents off of the unit-the crap really hit the fan over that....And NO EXCUSES.We all got our butts reamed.....So now the code has been changed and no-one but staff is supposed to know it.

[barefootlady, ADN, RN]

Your sescription of your shift made my head !

Hope you have a better week. But, as we all know, things happen quickly and easily in LTC facilities today.

Enjoy the holiday season.

[CashewLPN, LPN]

hmm... our wanderguard system is fairly simple.... (which stinks..)

it involves pushing 2 buttons at once.... one on the front, and one on the side of a box... gee... how difficult.... we're asking management to upgrade..

(its only rigged to the front door.... but, everything else is keyed.)

what killed me was when his daughter put his shoes on a high shelf in the closet and said 'with his shoes up here, he cant get them, so he cant get out...'

5 mins after she left... he had his shoes (stood on a chair.) had them on, with his coat on the other day... (She wanted to take his coat, but I talked her out of it... If he gets out, at least he'll be wearing a coat, I figure) but... then again, no coat and no shoes has not stopped this dude.

We;ve also just fired a security guard who HELD THE DOOR OPEN for another resident... who, thankfully didnt get past the gate.

anyhoo...

I also detest when some people say 'LTC is a break.. its like babysitting'... :) I've bounced around a bit in my jobs... I can say, I;ve done a little bit of everything... oh well...

ok kids... Enough ranting from me, I'm off to the showers

-=Barbara

[CoffeeRTC, BSN, RN]

Been there with the elopement issues.. Many years ago, before wander guard and locked doors, one of our wanderers decided to take a walk down our drive way on to a pretty busy road. As if that wasn't bad enough one of our state inspectors was nice enough to pick her up on the way in to do our annual survey:eek: . Yep that was a fun one. Needles to say, we got a system in place. Some of our res are able to disable the system too.... isn't to hard since we've had the same code since 1996:eek: I've been begging them to change the numbers for years!!

I too love it when I'm told we "babysit". Now I have 2 toddlers and know what it's like to watch kids, but dealing with 150+ pound 70+ year olds with dementia, agitation, paranoia, halluciniation, incontinace, and the strenght and will to over power 2-3 nurses isn't what I call fun babysitting... Opps what about dealing with their underlying medical conditions all while "baby sitting" them and dealing with 20- 30 other residents. I'd like to tell "those people" if its sooooo easy you come and work a shift or two to "just relax":eek: