DON out to get me?

[carbaminohemoglobin]

i'm a new nurse. got my pn license in january. been working at the same ltc fac since xmas eve. i feel i'm adjusting well to the job, but having major issues with the don and other nurses.

the don has only worked at this facility for 2 months. i've been working evenings, but just recently switched to weekend nights. it seems like i wake up to a very ****** voicemail from the don every monday afternoon asking about things that i've done. most of the time her information is incorrect and i wasn't even involved. well, last week she wrote me up for a transcription error and for asking the physician for a siderail order on a pt she felt was inappropriate. whatever... this scenario has kept growing from there. she's called me stating she feels i'm blowing her off... which is absolutely not the case.. she says she doesn't understand where i'm coming from, when i'm the one who really has no idea what she's talking about, because i've taken our "discussions" to heart.

i feel like she's really picking on me. i feel very bullied. she's taken my job away twice to newly employed nurses. then offered me this ft night job for fr, sa, sun, mon nights.. two days after that i was informed they hired a nurse for fr and mo nights... she's fired 2 nurses since she's been at this facility. and hired a few of her friends... one of which may be the worst nurse i've ever met. why isn't everyone else being hounded like this? i mean, i'm not lazy, i don't fake my assessments, and i actually care about these people. that's more than you can say about some of these other nurses that are getting preferential treatment.

my friends tell me to get another job. i know i probably should, but i'm scared to death about going to a new place. i doubt this don would give a good report to inquiring jobs. i'm also scared that this prize-winning **** is going to fire me. getting fired from your first nursing job? that would look real good..

any suggestions?

[NC Girl BSN]

Sadly, I think she is trying to make you quite. I think you may not have any other choice but to either find another job or go in and try to have a heart to heart with her and see if she is honest enough to let you know whats going on. Another thought, you may be Screwing up and don't even know it.Let me play devils advocate for a moment. Restraints are a big deal in the nursing home and asking a Dr. to order more is inappropriate and dangerous. That is a issue that should be discussed with the DON or ADON first. There are certain evaluations,documentation,and careplanning etc.that has to take place before something like that happens. It has to be discussed with the family and they have to give consent.You can't shrug that off as a "whatever moment". The family could come in a see it, get mad and call the State.If DON would not have caught it, it may have caused them a deficiency with the state or worse if the patient got hurt on it, it could cause the facility their medicare-medicaid funding. I think that you making poor judgement calls and she is trying her best to keep you in the facility. It would be intresting to actually know what other things she is calling you for that you state that are petty. To you, they may seem petty but it could and probably is be a good reason behind it. Sorry to throw all this at you. There are so many do's and don't in a nursing facility. Your so new, that it seem that your boss is bullying you when in fact you pose as a risk to them with some of your decision making. This job is a learning expereince for you. Just reflect on the events and learn from them. If your unsure of something, ask before you take action. It looks like she has done everything in her power to save your job. Sorry and hugs to you but sometimes thats just life. I worked in a nursing home for 10 years as CNA, 5 yrs as an Activites Director and 2 yrs as a LPN. Trust me I know about alot of this because I have been through numerous State Visits and been on several committes about this stuff. You have to be humble and willing to learn. You have less than 6 months of experience there is alot of stuff you just don't know yet. Good luck to you in the future.

[caliotter3]

Get out of there while the getting is good. This woman has problems. You were right on target when you said you don't want to get fired. Taking your days and hours away from you is tantamount to firing you without doing the dirty deed. Take the hint and go away.

[carbaminohemoglobin]

The other things she's called me for:

1) a resident wanted to file a complaint against a CNA from the evening shift b/c she had left her sitting in her own feces, urine for 5 hrs, refused to clean her 3 or 4 x's with different excuses of why she couldn't do it. I wrote a lengthy note to the DON and left it in her box. In the nurse's notes I wrote: "Res requested to file a complaint against staff member on evening shift, had concerns r/t care, felt requests were being ignored. DON notified of situation." DON said she thought I needed to put a positive spin on the situation. I told her it was a very negative situation and asked how I could possibly make it more positive.. From her response, I got the impression she wanted me to lie.

2) One time I was f/u on something another nurse should've done, but without pointing that fact out. This nurse found a skin tear and hadn't rec'd a tx order, didn't fill out the paperwork, make a nurses note, or contact the family.. And it was a pretty gnarly skin tear. So, I went behind her a cleaned up. It appeared as though I had found it. The DON left a horrible message on my voicemail, I called her back and she said she had found upon investigation that I wasn't the one who found it initially. I asked her if I had done something wrong and she painfully said "No, you're showing initiative when your fellow nurses refuse to."

3) a man fell and I did the whole shebang needed for a fall. I even double-checked my work.. She called me saying that I didn't do any of the paperwork for it.. I told her I was sure I did and asked her what I missed.. She told me, and I had definitely done those things.. She said she didn't see it when she had looked.. I told her politely to look again.. She asked if I was blowing her off and threatened to write me up again.. ***?

4) she's always calling me with blanks in the mar, tar that aren't mine. She says that charting is the most basic of nursing.. She won't listen when I say they're not mine..

She's always coming to me with the errors of other nurses assuming they are mine. She gets really upset when I point out med errors of any kind. The other day, I stumbled across a man with two scopalamine patches on, one right next to the other...

I'm not okay with walking around knowing all of these med errors going on and not reporting them. If I can fix the problem and it's not a med error then I fix it, otherwise, I do what I was taught. I try to make amends.

[caliotter3]

The complaint note probably should have been less. I would have written: Res requested to file complaint r/t concerns about care. Notified DON. The second example you gave in your last post points out that the DON definitely has problems that have nothing to do with you. She doesn't seem to be able to distinguish who is doing a good or even adequate job, from who needs to be counseled. Get a new job. Starting over in a new place can not be as bad as wondering what will happen next. A new job will be harder to get if you get fired. You need to remind yourself of that.

[NC Girl BSN]

Well from what I can see in the first scenario you were dead wrong on that one! You never write stuff like that in the chart even if you feel that way or is like that. The chart is an offical state document and if the state comes in an audit that chart, that is an automatic deficency for neglect, violiating residents right etc. You are putting the facilities neck on the choppin block for something that a CNA did. I see why the DON has a problem with that.That was bad judgement.

I really don't have a comment on the others. Maybe your tone or body language rubbed her the wrong way. Maybe she still mad about the other things you did.I would have also asked the DON to show you all the paper work that needed to have been filled out so in the future there would be no questions.

From what I see you have done 2 inappropriate things that could come back and bite the facility in the butt.Sorry to be so harsh but there is a right and a wrong way to do things and your did it the wrong way.

I think you have to understand and learn from these instances. Even if you go to another facility, you will still get in trouble if you continue to do things like this. They will look at you as being a risk to the facility.

Again, Good Luck!

[carbaminohemoglobin]

About the siderails, okay. I get that.

But the complaint note. I thought we were the pt advocate. If a pt is being abused, neglected.. Shouldn't that be brought to State's attention?

[carbaminohemoglobin]

I've already started looking for a new job. It sucks to feel like I'm being pushed out by this person who given her track record of 5 NH's in the past 3 years won't be at this facility for very long anyway.

[caliotter3]

About the siderails, okay. I get that.

But the complaint note. I thought we were the pt advocate. If a pt is being abused, neglected.. Shouldn't that be brought to State's attention?

Not in the medical record. Stuff like that is for an incident report and not to be mentioned in the medical record. And bringing things to the state's attention shouldn't be in the medical record either. If you want to deal with the state, you call them on the phone or write them a letter. You don't make negative statements in the medical record.

[NC Girl BSN]

About the siderails, okay. I get that.

But the complaint note. I thought we were the pt advocate. If a pt is being abused, neglected.. Shouldn't that be brought to State's attention?

No it shouldn't. It should be brought to the DON's attention so that she can fix it and make the situation better. If its brought to the States attention then they are going to turn that place upside down find more things and cut off their funding. You have to give the nursing home time to fix the problem. What your essentially doing is setting the nursing home up to lose its license, again your so new that your not following policies and procedures. Every facility has a protocol on how to handle abuse and your not following it. You are a big risk to the facility unless you start following the rules. Essentially your just going over thier heads.

[carbaminohemoglobin]

Well, I didn't think about it like that. I'm not trying to shut the NH down, I just want to take care of the residents. I do approach the DON often about things I see and nothing ever really comes of it. Maybe I'm acting passive aggressively since they refuse to do anything about it other than say the residents are lying and want nothing to do with any problems occurring anywhere in the facility.

[NC Girl BSN]

Well, I didn't think about it like that. I'm not trying to shut the NH down, I just want to take care of the residents. I do approach the DON often about things I see and nothing ever really comes of it. Maybe I'm acting passive aggressively since they refuse to do anything about it other than say the residents are lying and want nothing to do with any problems occurring anywhere in the facility.

Alot of times they are doing something about the things you report. They can't come back to you and give you an update because it will violate privacy of an individual. There is a process with everything. It takes time to make things happen or to fix issues. Your boss must scense your passive appressiveness and now your not on her good side. I am not sure if you can fix the relationship that you have with her.