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Discussion

what chain of command?

oh, what a day! It seems as though I say this every day. All of the days run together. Can't get the meds from pharmacy, can't find the order on the chart, lab results are locked in an administrative office, medical director won't return phone calls....

and it really is every day!

the same family member calls every hour to rant and rave about the horrible care her mother is getting, while a different family member (same resident) sits in the room with the resident and rants and raves...

meanwhile, it's almost lunch time and I haven't finished my 9am med pass, and now I have to prioritize...finish this med pass or start accuchecks and insulin before lunch...

oh, did I say can't find the meds...30 minutes looking for an order because pharmacy has not sent med because they don't have order...but the med shows up on the electronic MAR..no order on the chart...and no medication on the cart

found the admission nurse that handled the new order, she can't tell me where it is either.

accidentally found an order for accuchecks that is not on the emar...and hasn't been done since who knows when, because I can't find any documentation on eMar or paper chart either....while in the same chart found errors in some other orders...

the lab tracker (ADON) has gone to lunch, so here a a stack of labs for me...is she coming back?

UTI for sure, pneumonia on another, labored breathing...several critical labs and MD won't return calls (also the medical director)

DON, says talk to ADON, see what you can come up with...and of course her way is the best...

Administrator said talk to DON.....

meanwhile...My UTI has no meds, pneumonia #1 has no meds. #2 got meds because she ended up in ER (but can't find the order to fax to pharmacy)

I have walked a least a thousand miles today. I had popcorn and reeses pieces for breakfast, sandwich from local store for lunch and boxed chow mein for super... I am dehydrated, my feet hurt.I haven't seen my children today..

and when I get up in the morning to do it all over again...It will be the same thing.

And no one is listening to me!!!!!!

What is wrong with you people!

Please help. I just don't know who much more I can take!

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    • Featured Replies

    Start filling out incident reports (in your SPARE time!). At my facility, this is the best way for these types of situations to be resolved because management are REQUIRED to review them with us individually and they're electronic, so they really can't be brushed under the rug… follow your so-called "chain of command" and see where it gets you. Also, go home and indulge! Whether it be chocolate OD or maybe an adult beverage or two… :D

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    Sounds like somebody needs either 1) a vacation or 2) a new job...take your pick.

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    Sounds like somebody needs either 1) a vacation or 2) a new job...take your pick.

    Sounds like maybe BOTH! I am so sorry! It sounds like a real cluster over there.

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    The only other thing that I can say is IF the MD will call back, explain the situation and see if you can get an order to send them to the ED so they can get the meds and the orders.

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    • Experts
    oh, what a day! It seems as though I say this every day. All of the days run together. Can't get the meds from pharmacy, can't find the order on the chart, lab results are locked in an administrative office, medical director won't return phone calls....

    and it really is every day!

    the same family member calls every hour to rant and rave about the horrible care her mother is getting, while a different family member (same resident) sits in the room with the resident and rants and raves...

    meanwhile, it's almost lunch time and I haven't finished my 9am med pass, and now I have to prioritize...finish this med pass or start accuchecks and insulin before lunch...

    oh, did I say can't find the meds...30 minutes looking for an order because pharmacy has not sent med because they don't have order...but the med shows up on the electronic MAR..no order on the chart...and no medication on the cart

    found the admission nurse that handled the new order, she can't tell me where it is either.

    accidentally found an order for accuchecks that is not on the emar...and hasn't been done since who knows when, because I can't find any documentation on eMar or paper chart either....while in the same chart found errors in some other orders...

    the lab tracker (ADON) has gone to lunch, so here a a stack of labs for me...is she coming back?

    UTI for sure, pneumonia on another, labored breathing...several critical labs and MD won't return calls (also the medical director)

    DON, says talk to ADON, see what you can come up with...and of course her way is the best...

    Administrator said talk to DON.....

    meanwhile...My UTI has no meds, pneumonia #1 has no meds. #2 got meds because she ended up in ER (but can't find the order to fax to pharmacy)

    I have walked a least a thousand miles today. I had popcorn and reeses pieces for breakfast, sandwich from local store for lunch and boxed chow mein for super... I am dehydrated, my feet hurt.I haven't seen my children today..

    and when I get up in the morning to do it all over again...It will be the same thing.

    And no one is listening to me!!!!!!

    What is wrong with you people!

    Please help. I just don't know who much more I can take!

    Sounds like a LTAC I used to work for......key word here.....USED TO WORK for....:smokin:

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    Yikes...I think just about everyone in LTC has had a few days like that. (note few days). If this is an everyday type of occurance you need to either try to fight it or help solve the problem or get out.

    If I can't find a med or order, and its not a critical med, I will flag it and look for it later. Getting behind on a med pass is a death sentance.

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    Best I can do, here's a hug... :hug:

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    • Author

    And no one is listening to me!!!!!!

    What is wrong with you people!

    Please help. I just don't know who much more I can take!

    I didn't mean YOU people, I meant THOSE people.

    Today was a better day for me. I was administrative nurse today so my responsibilities were different.

    I really feel like my hands are tied. It is hard to make progress and do things right when no one will cooperate. I pride myself on being very by the book, and it seems like this place (THOSE people) have never even seen the book.:confused:

    thanks for the comments. It is just hard to be a nurse. I love the nursing part of it, it is the rest of it that SUCKs!

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    What horrible conditions to work at and be cared for!

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    thanks for what doing what you do! LTAC is a rough world.

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    • Author
    The only other thing that I can say is IF the MD will call back, explain the situation and see if you can get an order to send them to the ED so they can get the meds and the orders.

    Really thinking that would be great...We send so many out, just because we can't get the MD to return calls!

    Some nurses just do what ever they think doc will tell them to do...But I am not comfortable with that. I did not go to medical school :nurse:.

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    I am thankful that not all LTC is like that. I am fortunate to work in one that is "pretty good". I take care of 36 residents, but I have a charge RN on my wing to handle the docs, families etc...

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