Do I just care too much?

[RMNurse1]

Hi everyone,

It's my first post here but I have so much to say.

I'm a new nurse - I've been on my own for 3 months now, but I have been at my current facility for 7 years (worked as a CNA prior).

Without giving away too much, I work in a LTC and work on night shift. Needless to say, I am miserable, and there's a few reasons why:

1) The CNA's. The CNA's I work with on night shift are for the most part, awful. Except for two in particular, who are amazing, and I tell them that all the time. I help out whenever I can, answer call lights, etc. but I will not tolerate laziness. One CNA in particular spends the entire night texting, etc and this has been going on for quite some time because the other nurses who work on our shift won't speak up. Including our so called "supervisor" who would rather just be liked by everyone.

The CNA's have assignment sheets and certain residents who they are supposed to change Q2hrs. They know this. They're not stupid. I have found residents on multiple occasions who were completely soaked and total bed changes. It's obvious they (especially this one CNA) are not doing their rounds. They have around 15 people to change Q2hrs and with this particular CNA, it takes them MAYBE 10 min tops. I KNOW it takes longer than that (if they were doing their job right) because I have worked at this facility for years and it would take me at least a half hour to do rounds, if not more.

This one CNA also just gets people dressed in bed without even taking them to the bathroom or washing them up. I know, because he never uses or brings in towels to their room. It breaks my heart that these residents are getting neglected on a daily basis.

Day shift has also went to management regarding residents being soaked when they come in, and they just don't care. Whenever you go into the office about anything, you're basically told "You don't like it? Then hit the road."

Which brings me to my next point:

2) Management. Our management has been worse and worse over the past couple years, but it's coming to the point now where it's just unbearable. I have no problem writing people up who aren't doing their job and going to management about issues, but it's like talking to a wall. You get a blank stare and they keep staring at you even after you're done talking, and you end up leaving the office awkwardly wondering what the heck just happened.

My passion is working with the elderly. I thought I wanted to stay in geriatrics. I am trying to look out for these residents - I come in and try to do my best every shift, but it's just not enough anymore.

3) Night shift is really getting to me. Even with 8+ hours of sleep, I'm depressed and have no motivation to do anything anymore.

Should I look for another job or is it like this at every LTC facility?

Thank you for taking the time to read this if you made it this far.

[Ruby Vee, BSN]

much of what you describe sounds like "newnurseitis". that first year is a real challenge. most of us were absolutely miserable much of that first year. i hated my job, my colleagues, my house -- pretty much everything about my life. then, once i had some experience something "clicked" and suddenly things were different. my colleagues were nicer, management suddenly caught a clue and although night shift was still night shift, i could cope with it.

night shift may not be the real reason you're depressed and have no motivation. that could be newnurseitis as well. if you're getting sleep, that's a big plus. you won't have the same social opportunities you have on day shift, but they're there. try to make the most of them.

don't look into a new job yet. just grit your teeth and try to make it through that first year. then let us know how you're doing.

[classicdame, MSN, EdD]

Personally, I would get another job and report this facility to the State.

[RMNurse1]

So, what should I do then about this particular CNA?He's getting away with everything because none of the other nurses will speak up, and he probably knows management won't do anything about his laziness/neglect either.Sorry, but I dont think it's okay to not do all of your rounds and not wash people when you're getting them ready in the morning. I know for a fact they are not getting peri care when this aide is on.I would like to talk to this aide before going to management, but he's the type that is all talk and will say he's doing all of his rounds. So I know nothing is going to change by talking to him. I'm at the point now where I feel like I need to go in and do rounds with him, but how do I go about doing that without it looking like I don't trust him?!

[iluvivt, BSN, RN]

The RN is legally and ethically responsible for the care provided to the patients under your assignment so you have every right to make certain the care meets your high standards. The RN delegates and coordinates the nursing care provided and legally you are responsible to make certain you are meeting the standard of care. If the staffing is such that you cannot provide that care yourself you need to make certain that the CNA is doing so. Please review the Nurse practice act in your state so you know exactly what your responsibilities are and any position statement by the board in your state. . Many nurses fail to do this until it is too late.

Now as far as the CNA..yes I would go with him on rounds. I would have a brief discussion with him beforehand. I would say something like this... " Since I am a new RN I have come to realize that you may not know what my expectations are for providing quality care for our patients that I am legally responsible for seeing that it is provided. So I will be going with you today so I can I can make my expectations clear.

Once you have made those expectations clear over a day or several days then you need to make certain he is meeting your standard. So if you find a resident wet all you should have to say politely " please go see to it that Mr Jones gets cleaned up and changed". You most definitely will have to make rounds to make sure he is keeping up bc/ he will slip back into his lazy ways if allowed to to do so. Except that you will be making some waves but you will be doing this with the utmost respect for this individual b/c you ultimately have to work with him. If he keeps failing you are going to have to write him up...just remember YOU are responsible now for the nursing care provided and you should never lower your standards b/c you have a lazy co-worker. NO..you are not caring too much...your patients are lucky to have you...welcome to nursing.