Cry or scream.. venting thread

Can I rant too? If I hear one more time already this season, "You don't have kids why can't you work xmas" I am gonna shoot myself! Really! Like Idon't have a family and then for the nurse to say "Well in 15 years come talk to me" I don't care how long you have worked there your holiday is your holiday geez. ok I'm done :)

vent away...lord knows this is needed thing to stay sane!!!

is it just me, or does the number of people having really rough times at school and work seem to be really high recently???

nascar, i worked subacute/rehab/skilled LTC more 8 years. i did the transition care too. i don't know what it is about nursing homes, but the management lately (the new mgmt) is lacking basic managerial skills. they pick favorites, don't address very real problems that can and HAVE resulted in pt issues. lack of care is astounding. the documentation (if it's even done at all) is often lacking, contradictory, and will never hold up in court. i remember one month we were denied payments by the ins companies because when they reviewed the charting, it didn't cover any of the things people were there for.

i have also seem droves of experienced RN and LPN who were there for years and years, driven out by management one by one. for dumb things. the things that matter (say, a pt c/o CP, being sent to ER with EKG changes, and admitted) not charted on AT ALL. no one knew why the person left the facility. the chart was in the rack for over a day before it was realized the person was admitted in the hospital. the things that don't matter (the TED hose audit chart, for example) was missed for one day by one shift, and that nurse was disciplined. i don't know what it is. this environment is demanding and short-staffed every day (i know it prob is like that in the hospitals too...) and it's sad. these poor residents are being neglected and the care is poor. i really believe the staff that IS still left there, doesn't care. they are all buddies with the new managers, and the survey has a lot of nursing tags, lots of legit complaints from family and patients, etc. i don't know how the place stays open. it's like this all over the area right now. the new management has repeatedly LIED right to peoples faces. they've done it to me, and they've done it to a dozen other people (even their own managers!!).

i don't know how to fix it. i tried to help, but i was not liked when i spoke out about the lack of care. if i offered suggestions, they were shot down. i finally had to leave due to health issues, but a lot of my friends from there have moved on. they are all stressed to the max, having CP themselves and anxiety when at work, etc. and these were GREAT nurses. nurses i'd want taking care of me and my family, that's for sure. now, the nurses there either don't care, or don't want to work hard. they do what they gotta do to get through the shift. minimal. i truly feel for those residents, and i feel for all the nurses who have to work in such a toxic work environment.

i hope you feel better, nascar. vent away!!!

I think you have made the right decision. It will drive you crazy

going through those inspections and trying to fix everyone's

documentation. Been there. Done that. It's not worth it.

http://www.corvel.com is one of the insurance jobs that pays well

and has good benefits.........workman's compensation cases

that you work on over the phones.

Just some other things to think about - what is your charting system like? The computerized charting system we use is ridiculous - it's so time consuming and cumbersome - I know I could do a much better job documenting things if the system was more user-friendly. Do you chart by exception? Paper chart? Are the charts in the pt rooms or at the nurse's station?

Also, what else is going on there? What's your nurse to pt ratio? Do the nurses have a managable workload? Good support from CNA's etc? Are other tasks keeping them from charting? Often these problems arrise from a combination of factors. And the demands of nursing can burn you out so badly, you lose the enthusiasm you started out with. And it seems like every day managers have new demands for you.

The biggest problem between managers and staff nurses is that each group has different priorities and different things important to their lindividual world. To you, accurate charting is huge because your job focuses on that. To them, charting is yet another painstaking task, keeping them from going home on time. You have to find a way to make your priorities meaningful to them too.

It sounds like the solutions your management has come up with have been negative and punitive (writing people up, etc.) How can you positively motivate them? What's in it for them - what's their incentive? How will charting like you want improve their daily lives?

I'm not trying to make excuses for poor employees, but just some other things to consider. Before I became a nurse, I was a PR consultant. I learned if you want to motivate or persuade people, you have to first get inside their heads and find out what matters to them. Then base your interventions off of that. Forcing them to have the same passion for your agenda won't work. Maybe pass out a survey to find out what they're thinking, what the barriers are, ask for their suggestions - ask them what they care about, and what they value, and then focus on that.

Good luck!

Nascar - I can't speak for the nurses at your facility, but I wish someone would have spent some 1:1 time with me. I knew so little about LTC when I started, and only got 3 days orientation.

The charting is so different from the hospital, where we used a lot of flow sheets. I had no idea what was expected, and no one told me - until the middle of a nurses meeting a month later. A lot of the time I have felt that I'm wandering around in the dark.

Another thing I'm finding is that the residents are becoming more critical. And, frankly, some nites I have little time to chart, because I spend so much time doing direct care. And now we've been told we're not allowed to have overtime.

I know the feeling of wanting to lay down on the floor and kick and scream, but I just don't have time.

I find a lot of times it boils down to accountability. I work in staff development and I go through a lot of the same issues. For some reason the LTC facility seems to be the biggest challenge. I know there is enough paperwork but maybe you could draft an algorhythm for them to follow, or some type of check off sheet that they need to address at specific intervals to make sure that duties are carried through. I feel your pain....sometimes it seems like a thankless job where you just spin your wheels. Good luck!

It sounds like the solutions your management has come up with have been negative and punitive (writing people up, etc.) How can you positively motivate them? What's in it for them - what's their incentive? How will charting like you want improve their daily lives? "

Hello....?!?!?! How will it improve the daily lives of the staff??? Cripes! You don't come to work with the intention of improving YOUR life..you are paid to do a job and hope to improve the daily lives of the residents. In no other industry are the workers so coddled. I know it's hard...I've done it all and gave it my all no matter what the job because I was brought up that way. Seems to me some nurses think they are owed something other than a pay check. I bend over backwards to help,teach,train,and support my nurses and some of them still won't comply with the regs. The last DNS did everything for them so it would be done right. That would be the easy way, although I'd end up in a home somewhere...it's much more difficult to show them the right way and have expectations for them to do it.

Capecod - would you please come work with us!! :) I'd love to be coddled.

My goodness. You described my LTC to a tee.