Do things fall apart when you take time off?

[noc4senuf]

I took a one week vacation and planned for an extra day at home to recuperate when i got back. But, since my boss was leavign the next day for two weeks, I decided to call him for an update. Apparently things fell apart when i was gone. Two aides transferred a resident without a transfer belt(part of the uniform) and the resident gatherthered a skin tear. They were suspended for one day.

A nurse (LPN) over the weekend gave thin liquids to a resident who had specific orders for thickened liquids. She had only been admitted les than a week prior with pneumonia and had gotten an additional CXR that showed she now had pneumonia in both lobes. He gave the thin liq d/t the family member asking for them since she was not eating.

Another nurse on her very first day of orientation to the floor went home halfway through the shift in tears d/t the nurse she was with was "just awful, ignored her, and would not answer any of her quastions".

Needless to say that when the NHA called me at hoem at 8PM and was still upset, i told him to go on vacation and I would take care of it.

The next morning, i was waiting for the one nurse to come to work at 6:30 AM and terminated his employment. Reasons why.... he made the decision on his own to give the thin liquids and did not call the In-house charge or the RN on-call to discuss it and he also did not call the MD for an order for the thin liquids... and the number one reason is the woman died.

That same afternoon, I was waiting for the other nurse to come in at 4PM and terminated her employment. If she was that rude to a brand new nurse, how ruse is she to my residents.

So, I think it has all settled down now and am not going on vacation again until Feb.

[lunden]

wow was all i could say after reading that. talk about taking care of business.

[Rexie68]

yup, things fall apart when i'm off, too....but not like that. just that mds' get way behind, and care plans don't get done till i'm back. heck, just trying to keep up while taking full time classes is making my workload all but impossible.

i'm glad you take care of business, though.....'cause in my facility it takes an act of god for someone to get fired........at least you don't put up with incompetence!

[mdsmadness]

and what is time off??????????

[rukiddingme]

That was another part of my 'reasoning' for turning in my resignation - besides them telling me I had to be 'on-call'.

Nobody else in the building would do 'anything' if I were to take a vacation. Even adding a simple care plan would probably be left to me do do upon my return.

Matter of fact, the current DON admitted she 'doesn't know anything about the MDS job' -- so when someone called with an inquiry about my position, she gave the call to the Administrator.

And I believe that's part of the problem there. I think everyone believes that I don't really do anything.

[VeryberryRN]

I appaude the way you handled the situation when you returned from vacation. Too many times these kiinds of things are allowed to slip by due to short staffing, and the staff get the misguided message that it is OK not to follow the rules. So pat yourself on the bacik, you are an excellent manager. Having said that, the answer to your question is yes, when I am away, nothing gets done. Luckily, I don't manage a unit. If you are the MDS Coordinator and a Unit Manager you need your head examined. Just one of those jobs is a killer. I am the MDS Coordinator for 120 beds, 40 of which are Rehab. Recently I had knee surgery, and was out for 5 days. It was near the end of the month, and I was in a panic, because I knew that my MDS's had to be finished for billing. Pretty bad when you can't even get sick. So - I am now working with a brace on my knee, and with a walker. I look and feel like one of the residents, but my job is getting done. The only other person in my building that knows how to do an MDS is the DON, and she not about to do them. I guess it's nice to have job security, but sometimes I really would like alittle more help.,:typing

[noc4senuf]

I noticed that I originally posted this is the wrong section, as it should have been under the LTC DON slot. I apologize.

As for the MDS's, I review all the calendar schedules for both my LTC MDS coordinator, and rehab Medicare coordinator. While I was on vacation, the medicare coordinator made some errors on the dates and they were submitted before I caught them. Since my return, I have had to make two modifications and one inactiviation. Nothing seems to be simple. Both of the coordinators are great at there jobs, they just can't seem to get the whole picture of scheduling the MDS's and I am the one that actually belongs to the AANAC.

[Rexie68]

wow noc4senuf, sounds like you need a new mds coordinator! our don knows how to submit, but doesn't do so unless there's extenuating circumstances, and any modifications/inactivations are done by us. you have quite a bit on your plate! i don't belong to aanac....i'm an lpn....but regardless, it doesn't take certification to know the rules and regs....along with the tricks to high rug levels! god bless you!

[VeryberryRN]

I don't envy you being the only RN over seeing the process. In NYS you have to be an RN to be an MDS coordinator. I would suggest you get your MDS nurses certified. That will help them understand the process so much better. You can take the AANAC courses on the computer if there is not one being offered near you. Medicare is getting more complicated every day, and the feds just want us to mess up so they can take money away. You have to know your stuff to survive in this finacial climate.