Does anyone else ever get tired of "stupid" nurses?

lpnbhw · Jul 9, 2003

Im a lpn and 3-11 supervisor. I know exactly how you feel. I myself experienced a similiar occurance when I had a pt doing very poorly, decreased po intake , increased temp, tachycardia, and increase lethargy. I asked the nurse in charge of that resident to monitor the vitals , including to give apap pr to help with the temp. in return, i called the md, while waiting for the call back, i asked the nurse if he obtained the pts vitals? considering i asked almost an hour ago, his reply was no , i havent got them yet, ive been busy passing my meds and im so behind. Ok, whats more important, meds or a pt whos very poor? hmmm .. What a idiot. Needless to say i got the vitals myself, sent him to the er and finished with a res who i was admitting who just happen to be this nurses. dont get me wrong, i dont mind helping out my nurses, but if you are in charge of a critical pt, as this pts nurse, you need to know where he/she is at in the begining of your shift. but, heres the best yet, one of my other nurses reports to me a res who was on cmo has just passed, as i was on the phone with the md the other nurse was telling me i needed to do his treatments for him since he was so behind. i asked why he was so behind?? well you know i did have a new admit and we had to send the other res out. Ok, who sent the resident out and admitted the other resident. poor excuses for lazyness. what a jerk, he didnt help with anything!!!!!

Huq · Jul 9, 2003

I'm playing the devil's advocate, but here goes.

Could your problem be attitude? one

sentence jumped out at me " i dont mind helping out my nurses," They are nurses

on a shift you happen to supervise. I doubt, very much, that any would admit to belonging to you.

Just imagine how much faster everything would have gone if you HAD initiated vitals etc; yourself. You might even have pushed fluids and, maybe, resolved the whole problem. "decreased po intake , increased temp, tachycardia, and increase lethargy." sounds like dehydration to me.

An important part of supervision is ensuring that everything runs smoothly. Picking up the slack and allowing a nurse to finish a med. pass. (which has a time limit mandated by the State) is a good start.

Just imagine! The nurse might even have had enough time finish treatments

IrishCream · Jul 9, 2003

Every nurse (RN & LPN) should be more careful in charting their assessments. The other day a nurse charted "good, strong bilateral pedal pulses" on a AKA patient. I wonder how she got those pedal pulses.

lpnbhw · Jul 10, 2003

Huq,

In respose to your inquiry, first of all, im not stateing anyone belongs to me, what im stateing isthis nurse and others works under MY supervision . I am in charge of over seeing this nurse and his aides that the res are provided with good , compasionate care. This nurse im talking about was asked IN REPORT to gather vitals and stats on this res since the md was expecting a call from me within the hour to update him since, all the other interventions earlier that day was not working, includeing the iv that was running that morning that the res removed himself. why i did not gather the vitals and stats myself was because he told me he was going to take care of it immediately since i was "PICKING UP THE SLACK" and takeing care of a new admission for this nurse so he can assess this res, report back to me and finish his meds. with this nurse this is a ongoing battle. like the old saying goes, take 5 and save 20

twinmom2k · Jul 11, 2003

lpnbhw,

I totally agree with you. The whole point of my post is that nurses should learn to prioritize whether they are in the middle of passing meds or not. Being the house supervisor means that I am not only in charge of the 8 nurses and 16 CNA's but also the 170 residents. This is why the floor nurses are responsible for their own vitals etc. Especially if one of the residents is ill that should be their first priority, not passing meds. It always surprises me that I hear this stuff coming from a nurse. They more than anyone should understand that the supervisors job consists of more than what they can see. Plus even when I am not supervising and am working a cart I would never expect a supervisor to get my vitals nor would I call them before completely assessing my resident. And I would NEVER have a CNA get my vitals on an ill resident. I know they are trained to do vitals, but they are not trained to understand what those vitals may mean. So they may not think to retake a blood pressure of say 90/46 to make sure it was accurate. I have literally seen CNA's put vitals like that on the sheet and hand it in like it was nothing.

I guess maybe this is why I am supervising and not the other nurses. I don't know, it just drives me crazy.

And Huq,

those symptoms could also mean infection or a number of other illnesses. Pushing fluids would not have solved that problem. And those interventions should have been done by the nurse in charge of the resident before the supervisor was ever called, which was the whole point of my post.

angelbear · Jul 11, 2003

I am an LPN on 3rd so no supervisor other than me. We do however always have an oncall supervisor that will direct us via phone or may even at time come in. When something goes wrong with one of our residents unless they are plummeting fast I had dang well better have a full set of vitals and head to toe assessment, as well as having given any appropriate prn meds they may have, before I call the nurse supervisor. If they are going down hill fast I will usually be on the phone with the MD while the lead aid is on the phone with my nurse manager. My point is I am just an LPN but I can at leaste handle that much. I admire the fact that if things get out of hand with more than one active critical at the same time they will come in to help. It seems to me that the supervisor needs to delegate and make expectations known. My nursing supervisor is my boss the one in charge I know what they expect and I do it without question. If you are the supervisor and your nurses are not doing what is expected of them then it seems to me you are not doing your job. I certainly do not mean that in a nasty way Just trying to point out what I see as the obvious. I hope this makes sense.

Huq · Jul 11, 2003

twinmom2k

Read my post again,

I said "maybe" resolve the problem.

I am perfectly aware and do not minimze that these signs

and symptons might cover any number of more serious conditions; however, one should also keep in mind the more simple problems.

One of the many supervisory duties is to keep things running smoothly. Should a State surveyor walk in and find a med. pass way over the mandated time, things would certainly not be smooth. They would immediately want an explanation from the supervisor unless, of course, that supervisor was an LPN. In this case they would be after the luckless head of any RN that might be working in the area or, failing this, the on call RN.

Of course one would interrupt a med. pass for an emergency (if there was knowone else to take care of it, but in this case there was) I believe it is called teamwork.

bklynborn · Jul 11, 2003

Sounds to me as if some mandatory inservicing r/t procedure is needed here...............Who takes the vital signs CNA or licensed staff, when (if ever) is it appropriate to use an electronic BP monitor, what information to prepare prior to phoning the doctor and when to phone the doc to request a pt be shipped.............................. after the inservice make sure all licensec staff and NAC's are given copies, clarity in these matters will help to eliminate (hopefully) what you went through from happening again................:)

carcha · Jul 11, 2003

yeah we all have to deal with the knuckledraggers who spend an hour pouring over their pay check to ensure their paid correctly to the last cent, that they understand but who feel that assessing or reporting out of the norm vital signs is a task for their slopeheaded buddies to perform. are u all getting the point of what i think of "stupid" aka INCOMPETENT "nurses"

lpnbhw · Jul 12, 2003

twinmom2k,

THANK YOU!!!! for understanding how fustrating being a supervisor is and you cant split yourself a hundred ways come sunday. I am in charge of over seeing 2 nurses ( if im lucky) and 8 cnas. im also responsible for the kitchen staff and maint dept AAGGHH did i also mention 76 residents who should i say ALL have behavioral alzimers. 20 of them are on safety checks d/t unsteady gait, ph of falls, etc. we always had team work until this nurse started . and huq, when it comes to the state walking in, first of all, you have a time frame of when they are expected, second if your meds exceed your one hour time frame, as long as you doc the res recieved the meds late, and passed it along to next shift for example a bid med that was due at 8 and given at 10 so they can give the next dose accurately. this info i can assure you is accurate since my mom is a surveyour. and no, RNs are not in line for blame if aLPN is not doing his/her job correctly. the nurse them selves get the blame supervisor or not. lpns are not looked down upon by rns, infact, i have rns who are floor nurses who respect me for the position i am in . and in return respect them. team work does make a shift go perfectly but, all it takes is that one staff member to break the team work chain.

Huq · Jul 13, 2003

I do not recall any mention of LPN's being looked down upon by RN's. I do not have time for that nonsense. We are all nurses.

This will be my last post on the subject because I also find 'I'm right, no I'm right' counterproductive.

The only time frame for a State survey is, for example. They came last August so perhaps they will come in August again. Pretty large time frame! A State survey is always unannounced.

There is a time frame for a med. pass.(Incidentally it is not one hour) To go grossly over this during survey would be questioned.

Finally an RN would be, ultimately, held responsible. This is defined in Section 2725 of the Business and Professions Code of the Vocational Nursing Practice Act. This has also been discussed at length in other threads.

twinmom2k · Jul 14, 2003

Huq,

Your right, to go GROSSLY over the time limit (in our state it is one hour) would be questioned. But would be explained appropriately that an emergency occured and that took priority over giving a MVI at exactly 9am. I think they would more closely question why the resident was not given priority over a med pass. I also recently posted that in our facility our med pass is spread out from 8am to 10am giving the nurse from 7am until 11am to pass these meds. Honestly if your med pass takes more than 4 hours then there is a big problem with your assignment. I would also like to add that TEAM WORK does not mean "you go take care of my ill resident while I continue to pass my meds." Maybe I am niave, but I think teamwork means lets get this ill patient taken care of together and then if the med pass falls behind we will take care of that together. I also have been around for quite a few surveys and they may be un announced, but everyone in the building knows when they are there within 5 minutes of them walking in the door. And like lpnbhw said, as long as it is documented that the med was given late and corrective measures were taken it would not be questioned.

I also agree with you that it is counter productive to continue to disagree over this. Let's just agree to disagree, everyone has different view points.