Can I get a break, please! (long, sorry)

[chevyv, BSN, RN]

I'm a newer LPN that works limited casual hrs. There haven't been many of those since I was hired back in Jan. I concerned myself with finishing the rn degree I've been working on. I decided to take the rn boards in sept when the kids go back to school. Lucky me,work called and I actually got in 4 days in a row. I thought I would finally get a grip on everything that needs to get done and I did really well the first 2 days.

Tonight, which was my last shift of the stretch, was a different story. It started this am with a phone call telling me to come in early to fix my note on a resident with a new bruise. I charted what I saw, but wasn't really comfortable with my wording. In ltc, I understand that we have to be thorough due to abuse accusations. This resident was on a blood thinner and has many bruises. I came in early to find out I needed to call the family and update as well as the physician.

I get the doc on the phone and he flips out because I'm wasting his time paging him for a pt with a bruise. In the end, he tells me my DON will be getting a call. No matter how much I try to explain to him the my DON was forcing the call, he just kept on.

Then I get a return resident who is at the end of life. There is pain, pain meds have been faxed, but they won't come until past midnight. Of course we have no liquid pain meds in the contingency box. Back to call the doc. Takes 2 pages for him to call me back, but I finally get what I need. Resident is now in pain and has high anxiety.

I've never done orders so now is my chance to figure it out. Unfortunately, it takes me forever to figure this part of my job out. Enter them here, put this there, stick this on the MAR, put this in the chart, and make sure you write a detailed note.

Now here comes another resident, fresh from the docs office. With 4 more orders to muddle through.

It's now quitting time for most people, but I'm just stuffing my lunch down my throat while I try to get everything done. My 8 hr day has turned into an 11.5 hr day. Oh, on the way home I get stuck by a 35 minute train. That's added on to the 45 minutes it takes just to get home. Now I can't sleep. Does it ever get handleable?

[sasha2lady]

YES...IT DOES GO SOUR AT TIMES. i take it you were on the day shift? where was the charge nurse???? the charge nurse could have handled the pharmacy deal....and the new orders from that appointment. and go ahead...let that doc call your don......he'll just end up chewing her out too...so she'll get whats coming to her. I have rough nights..i work 2nd....I usually come in the door and get pounded with 4 hours worth of day shift charge nurse leftovers plus my own 8 hours worth to do. I prioritize though.....I sort through the mess thats been left to me...and what can wait goes in the doctors box for the next day....whats most important and needs to be addressed today. ill take care of it. I have been used and abused with my work.....they hand stuff off to me b/c 1. Im faster 2. they know Im reliable and if i say ill take care of it...I will and 3. they know the other nurses i work with on my shift wont do any extra of nothing even if its their patient!....I have since cut back on this though b/c I reached a boiling point and said enough was enough.

[TheCommuter, BSN, RN]

YES...IT DOES GO SOUR AT TIMES. i take it you were on the day shift? where was the charge nurse???? the charge nurse could have handled the pharmacy deal....and the new orders from that appointment.

At every nursing home or LTCF where I've been employed, the LPNs are their own charge nurses. In other words, I'm in charge of my hall of residents. If new orders, appointment scheduling, or anything else arises, I must handle it since I am my own charge nurse.

[chevyv, BSN, RN]

Yep, this is how it is where I work as well. I can ask other nurses for help, if they are approachable. There are only a few that are. Some nurses really would rather eat their young than guide you. Sad, but many are burnt out and they've seen so many newbies come and go. Perhaps that is the reason why. I'm not sure, but I sure hate it when I have to work with them. Makes my night worse.

[systoly]

I think you did well. You learned a lot that day and you took care of stuff. Never mind the flippin' doc. You accomplished your mission (updating him of the bruise), the rest is blah,blah, blah. I think it's funny when they complain of a waste of their time, but are willing to go on et on about it. If he's got the time to call the DON, then he's not that busy after all. If he is truly concerned about the use of his time, he can tell the DON to use faxes for this kind of communication. And to answer your question, it is those kind of days that teach us how to manage and handle difficult situations. We don't grow during the easy shifts.