i am sooo aggravated right now...the past few months have taken a toll on me & i have felt myself being turned into an absolute monster, do you hear me...? im more agitated/snappy than ive ever been towards everybody(except my residents). i work 12 hr night shifts & the load im expected to carry is too much. ive tried complaining, rationalizing & sharing suggestions for improvement with the don without success. she wont hear me out. she wont hear any of us. only a few others on nights have tried to talk to her & they got shut down like i did. the don said "nothing is going to change, it will stay like it is!" i have 40 residents half of which are rehabs. they are split up so i do 2 halls...i cant be in 5 places at once. every one of them wants their hs meds at the same time, not possible. the hs pass has been taking me 5 hours to do. once its done i have to do my charts which takes about 3 or 4 hours to do(>16/night),txs, skin checks, chart checks (3-60/night),sending meds back (usually takes 3 totes to send them all back, not counting narcs), checking meds in, checking for expired meds,checking the cna's flow sheets, giving prns all night long & documenting on that, getting the uas that day shift constantly puts down on the lab books, filling out the lab sheets.....just to name a few of the things done on nights. i heard a day nurse say "nights is easy, they only have to do a few more papers and thats it"....omg...i wanted to explode! most of the day nurses are know it alls who like to argue & think they are always right about everything. the don specifically said that all meds should be timed for the day shift unless its q 8 , q 12 or q hs specifically....when we had them changed, the day nurses went & changed all of them back to where we give them.....tell me why you would give freakin vitamin c, oscal, and eye vite at hs?????????? they do the same with the txs...on day shift they get a nurse per hall,a med aide on assisted, a charge nurse, 3 rns are in the bldg, plus they get a cna 2 that does all of their txs....we get nothing. changeover is the worst...we have assigned mars/tars to do...6 each for each ft nurse...yet..only about 4 of us actually do oursi found over 50 holes on the tars for last month..the don said that if they werent done then us night nurses were responsible for doing theirs for them....whatever! i will not do this again...next time i will not check or sign anybody elses...they can make their own med errors or get behind like we do...i dont care anymore. its gotten so bad that i physically feel sick when i pull in the parking lot....i keep headaches that turn into damn near migraines by the time i leave, my stomach hurts and burns all the time when im there, i always feel like i forgot something in the midst of doing everyone elses work it seems, i have made myself a dr. appt to see about starting some anxiety meds before i have a massive eruption in there. i think this is all a result of failure on mgmts behalf, as they seem to live by the code of if they dont know about it they dont have to fix it.she keeps giving us more and more to unrealistically do, yet offers no help or explanation &wont allow anyone to come help on that hs pass...there is a day nurse who gives acs insulins and meds when we come in at 7....which throws the night nurse on that hall off....and hs insulins have to be held and so do narcs....i mentioned this to the don before & all i got was "shes just slow"....slow my a@@! this was a military nurse! shes slack & lazy..not slow...ive seen her be at the top of her game before, this is unacceptable...luckily i dont have the added stress of working behind her cuz id be filling out med errors left and right. am i wrong to believe that if you are getting paid to do your job, you should do it...and if your job is to direct and manage....should that not be done? why do issues go unaddressed? is it just easier to pretend the issues dont exist vs dealing with them and figuring out a solution that will work? another thing...all of us on nights dont have a clue anymore about whats supposed to be going on....we ask and dont get any answers.....just looks. if i was a don, and my nurses had ideas that might work...the least i could do is hear what they are and see about getting things fixed....we were talkig one night and said that we all need to have real orientation since she changes things so much and nothing is ever enforced or followed through with on her part....i hope to be out of this place in about 2 yrs...once i get some finances dealt with and get to where i can afford a slight pay cut. the stress is just enormous. none of us are on the same page about anything. we all know different things that shes told us or put up notes about. its mass confusion all around. what is one supposed to do when they dont have a choice but stay where they are? i dont have a way out of here yet. im slowly working towards it best i can, then when the day comes that i can leave, i plan to run out the front door. just seems like an awful lot of unnecessary mess.
i have worked at few rehab facilities and at all those facilities the patient to nurse ratios are the same, up to 25 on days and afternoon shift and up to 40 patient on night shift. you might try to organize your work little better. try to use a flag inside mar book. pull all the flags out for those patients for your first med pass. you know that you have one hour before and after scheduled time to administer your meds. start with patients who needs prn pain meds. while getting their prns if they also have scheduled medications then give both prn and scheduled at the same time. if you have patients who have peg tubes who needs peg tube site treatment, bring med and the dry dressing and give medicine and do the treatment at the same time. for patients who are on tube feedings i usually wait until their feedings are done so i can give meds and do their flushes at the same time. in between your med passes try to do your charting done and treatments and take your break.
It sounds like communication between the shifts has totally broken down at this point. Shift wars are never a good thing, and from what you posted it sounds like days and nights are severely at odds with each other and resorting to petty bickering and complaining instead of dealing with the problems at hand.
I wanted to gently point out that even as day shift might have an unrealistic idea of how busy you really are, you might have an unrealistic view of how truly busy they are, too.
Why can't you talk, calmly and professionally, with the day shift nurses about what you are going through and see if you all can work out some compromises with med times, treatments, etc. I think approach is key here. If these are reasonable people at all and you explain your plight (have to be on many different halls, patient load, the fact that you are spending five hours on the HS med pass, etc.) do you think there's any way they would be willing to work with you to shift some of the meds back to days?
I think the OP might just get the point about paragraphs and pink lettering by now for some reason....
Anyway it sounds like you need a break, this workplace sounds dangerous so maybe it's time to brush off the resume and look for another job. You've had some nursing experience so that should help you find something better.
Ms.RN
917 Posts
i have worked at few rehab facilities and at all those facilities the patient to nurse ratios are the same, up to 25 on days and afternoon shift and up to 40 patient on night shift. you might try to organize your work little better. try to use a flag inside mar book. pull all the flags out for those patients for your first med pass. you know that you have one hour before and after scheduled time to administer your meds. start with patients who needs prn pain meds. while getting their prns if they also have scheduled medications then give both prn and scheduled at the same time. if you have patients who have peg tubes who needs peg tube site treatment, bring med and the dry dressing and give medicine and do the treatment at the same time. for patients who are on tube feedings i usually wait until their feedings are done so i can give meds and do their flushes at the same time. in between your med passes try to do your charting done and treatments and take your break.