I was recently made unit manager of a 44-bed ward.
Nights, on which I have worked, have been a true disaster. This morning two brand new just-off-orientations aides left the units a disaster. People soaked throught their pads to the bed, one very frail woman in feces and urine and THREE new areas threatening to open, you get the picture. People soaked through 24 hours briefs, double-padded which is against policy and common decency, people with SIGNS saying not to use plastic with double plastic soaker pads.... the charge last night asked another unit to swap an experienced aide with one of ours and they flat-out refused. They were written up.
One aide will sail off the unit without writing witness statements to falls and I end up cat-herding to get what I need for incident investigation and reporting. The usual aides NEVER do a full three rounds and the state of the residents in the morning makes that obvious.
Today I have my weekly care planning meeting with the other disciplines. My usual charge is off and the other regularly scheduled nurse calls off. She really has been sick. The float shows up. I'm putting out fires all over, being called into multiple rooms to assess and be informed of the previous night's neglect, and at 7:20 for the 8 am med pass I say to float that I'll take med cart 2. That's the easier one but the unit mgr usually takes it because she has other duties. She tells me she's planning on taking that one. Okay.
I keep getting interrupted for valid reasons. at 9 a.m. float sails by and tells me she's gooing on break. When she returned I asked if she could finish my pass as was already late and had my meeting at 11 for which I needed to prepare. She respons that she has treatments. I tell her I will help her after the meeting. She disappears and ignores me.
I get started on my own work and the DON shows up to mention that my cast is out and unlocked with meds on it. I apologize, and say, "I'm waiting for M to finish the pass." M shows up and I hand her the keys. She says, "Why are you giving me your keys?" "To finish the meds." "They're late. They can't be given now." Now, they still need their meds. DON backs me up. She takes the cart and I thank her. She yells across the unit, "Well, I don't have a choice when the director of nursing tells me to." I said, "*I* asked you to." Challenges me. "Yeah? Where've you been the last 45 minutes?" "Where've YOU been?" "Doing my job!"
I. was. livid. When to the Don and she told me that M was mad at her because she said she couldn't leave early since we were short nurses.
I need help on: What do I do about nights? The DON is aware, and the experienced aides are in trouble and we will "educate" the newbies (who have obviously been taught by SOMEONE how to take shortcuts.).
And direct insubordination. I do NOT throw my weight around, I toilet people, assist with direct, poopy patient care, and do what needs to be done. Is she testing me? Is she just lazy?
Help!
And thanks.
And I actually love the new job. But I am developing a thick skin very quickly.
