Completely unavailable Unit Manager and DON

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I recently started a job. Of course things seemed alright at first. During floor orientation, I started to see beyond the façade --- I got a glimpse of some pretty serious problems. For instance, our Unit Manager is supposed to be on-call 24/7, but basically NEVER answers, even if one of us is calling at 7 or 8 pm. I have even tried calling her at work---never answers, even if she is there. She has now left me two text messages saying that she wants me to 'come into work 15 minutes early' on my next scheduled day so she can talk to me about some things. This would be several days away, and I have told her (via text) that she can call me at home, that would be better. You know,,,, instead of leaving me hanging about what the problem is!

I can only guess. For instance: I had to send an aide home (well, to the ER) who suddenly had all the classic symptoms of a stroke while working a particularly stressful day. It was terrible for us both. That night, I tried to call our Unit Manager THREE TIMES just to let her know per company policy that I had sent an employee home (we had a ride pick her up and take her to the ED). I acted as quickly as I could. I was shocked and scrambling around, called a family member to get this employee picked up as soon as possible. That was my #1 priority. Now, I wonder if I just should have called 911. In hindsight, probably.

It was a terrible shift. There was also this horribly demanding family that were nasty, unreasonable, demanding, etc, etc. They INSISTED that I get their loved one sent to the ER due to a bit of an increase in BLE swelling. The patient was up all day, legs not elevated (due to appointments and PT sessions), and anyways, I tried calling the Unit Manager with regards to guidance about that situation because the vitals were all WNL and the patient was in no apparent distress. Very odd family and an unusual situation because I couldn't get them to understand that a trip to the ER didn't seem necessary.

Since the Unit Manager didn't answer, I called the DON and she said I would have to go back into the patient's room and explain that what I'm seeing doesn't warrant an ER visit(again). The family was not having that, so I called the doctor and he said 'go ahead'. So, fine. All this happened nearly a week ago, and I STILL have yet to get a conversation with the Unit Manager in about it.

I even called her today, tried to reach her several times (no response) in response to her texting me and she finally picked up from her office when I called the floor and had a nurse transfer me from there. When I FINALLY got ahold of her via phone, she sounded fumbly and said she couldn't talk, she had (another) meeting...blah, blah, blah.

I could go on and on. I really, seriously feel like this is a facility full of incompetents as far as nurse managers and office personnel goes. But those are my two big complaints. Anyways, it feels unsafe. I have another job lined up. What would you do?? Would you just say 'hey, it's not working-bye'. (No notice) Or stick it out for the two weeks?

I don't think the people running this place are competent OR caring.

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Specializes in ICU.

Go to this meeting only to be sure that you are not facing a serious accusation of some sort.

Give her your badge andletter of resignation effective as of that day cc to HR and save a

copy. Say "I'm not coming back."

Celebrate, take a vacation or just be thankful it's over.

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I recently started a job. Of course things seemed alright at first. During floor orientation, I started to see beyond the façade --- I got a glimpse of some pretty serious problems. For instance, our Unit Manager is supposed to be on-call 24/7, but basically NEVER answers, even if one of us is calling at 7 or 8 pm. I have even tried calling her at work---never answers, even if she is there. She has now left me two text messages saying that she wants me to 'come into work 15 minutes early' on my next scheduled day so she can talk to me about some things. This would be several days away, and I have told her (via text) that she can call me at home, that would be better. You know,,,, instead of leaving me hanging about what the problem is!

I can only guess. For instance: I had to send an aide home (well, to the ER) who suddenly had all the classic symptoms of a stroke while working a particularly stressful day. It was terrible for us both. That night, I tried to call our Unit Manager THREE TIMES just to let her know per company policy that I had sent an employee home (we had a ride pick her up and take her to the ED). I acted as quickly as I could. I was shocked and scrambling around, called a family member to get this employee picked up as soon as possible. That was my #1 priority. Now, I wonder if I just should have called 911. In hindsight, probably.

It was a terrible shift. There was also this horribly demanding family that were nasty, unreasonable, demanding, etc, etc. They INSISTED that I get their loved one sent to the ER due to a bit of an increase in BLE swelling. The patient was up all day, legs not elevated (due to appointments and PT sessions), and anyways, I tried calling the Unit Manager with regards to guidance about that situation because the vitals were all WNL and the patient was in no apparent distress. Very odd family and an unusual situation because I couldn't get them to understand that a trip to the ER didn't seem necessary.

Since the Unit Manager didn't answer, I called the DON and she said I would have to go back into the patient's room and explain that what I'm seeing doesn't warrant an ER visit(again). The family was not having that, so I called the doctor and he said 'go ahead'. So, fine. All this happened nearly a week ago, and I STILL have yet to get a conversation with the Unit Manager in about it.

I even called her today, tried to reach her several times (no response) in response to her texting me and she finally picked up from her office when I called the floor and had a nurse transfer me from there. When I FINALLY got ahold of her via phone, she sounded fumbly and said she couldn't talk, she had (another) meeting...blah, blah, blah.

I could go on and on. I really, seriously feel like this is a facility full of incompetents as far as nurse managers and office personnel goes. But those are my two big complaints. Anyways, it feels unsafe. I have another job lined up. What would you do?? Would you just say 'hey, it's not working-bye'. (No notice) Or stick it out for the two weeks?

I don't think the people running this place are competent OR caring.

Here's a tip: Don't "argue" with family or residents about ED transfers in LTC. They have a right to abuse the system if they want; it shouldn't be allowed but that's just how it is. You have nothing to bring unto yourself but headaches and employment trouble by refusing this request.

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Here's a tip: Don't "argue" with family or residents about ED transfers in LTC. They have a right to abuse the system if they want; it shouldn't be allowed but that's just how it is. You have nothing to bring unto yourself but headaches and employment trouble by refusing this request.

I didn't "argue" or refuse... it was just that I had answered several questions for them regarding the care of their loved one, all of my answers should have let them know their loved one was in good hands... I didn't take it personally, but had never had a family be THAT unreasonable before. I can't go into too much detail, but it was kind of out of nowhere. That's why I called our unit manager.... no answer. Then I called the don, she told me to go back and say 'your loved one doesn't need to go to the ED.' But, I KNEW they were going to cause a stink, so I conferred with another nurse, and she said that she would probably call the doctor and ask. Her advice sounded right, so I did and to my surprise, the dr said 'go ahead and send them'. I have never had this issue before anywhere, and it would have been nice to have our on-call person actually take an interest in their own unit.

By the way---I think they opened themselves up to trouble at this facility. The aforementioned patient had a recent hospital stay (1 week prior to coming to us), was d/c'd to home with home health, then the family decided that they couldn't take care of the patient at home, so they brought their loved one to our skilled unit. They accepted an admission that was inappropriate for our unit.

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I didn't "argue" or refuse... it was just that I had answered several questions for them regarding the care of their loved one, all of my answers should have let them know their loved one was in good hands... I didn't take it personally, but had never had a family be THAT unreasonable before. I can't go into too much detail, but it was kind of out of nowhere. That's why I called our unit manager.... no answer. Then I called the don, she told me to go back and say 'your loved one doesn't need to go to the ED.' But, I KNEW they were going to cause a stink, so I conferred with another nurse, and she said that she would probably call the doctor and ask. Her advice sounded right, so I did and to my surprise, the dr said 'go ahead and send them'. I have never had this issue before anywhere, and it would have been nice to have our on-call person actually take an interest in their own unit.

By the way---I think they opened themselves up to trouble at this facility. The aforementioned patient had a recent hospital stay (1 week prior to coming to us), was d/c'd to home with home health, then the family decided that they couldn't take care of the patient at home, so they brought their loved one to our skilled unit. They accepted an admission that was inappropriate for our unit.

Here's another tip: the doctor is never going to say no to an ed transfer if the family is demanding it. I agree that you were in the right, but it doesn't matter! You could have saved yourself a lot of headaches by just sending them out after one education intervention.

Your unit manager is clearly an idiot, but you just have to play the game, or get out of the cesspool that is LTC.

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Specializes in Registered Nurse.

It seems like this particular Unit Manager and Don would like you to be a bit more independent and use your *good nursing judgement. It seems you should have discouraged the transfer to the ER (for the patient with the "odd" family) but, push come to shove, you need to do what the family says..and the doctor will usually back that if the family insists. After a while, you will know these things. However, I have no idea what they are wanting to talk to you about...could be nothing or something. You'll find out. And employers/higher ups seldom do things at your convenience, as a subordinate...it is usually at their convenience, in my experience.

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You put an employee, a non licensed one at that, in a car with classic stroke symptoms?

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Specializes in Dialysis.
You put an employee, a non licensed one at that, in a car with classic stroke symptoms?

I did a double take on that one too!

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I did a double take on that one too!

I did the right thing. One of those things where you had to be there, have the background knowledge I have regarding said person and assess for yourself. I don't want to divulge this person's medical hx, but she got checked out that night and she's fine.

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