Exhausted, need to vent, advice please!

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I am so tired after a LONG, HORRID day at work, I will try to keep this brief, but I am really needing some guidance!!

I am a new grad RN, and my first position (after a LOT of job hunting) is for RN charge/floor nurse in LTC.

Had a month of orientation, things went pretty well, and I really like our residents.

Irritations..... our supplies are a joke. Literally, I spend a good portion of the day tracking down briefs/wipes for the CNAs, desperately seeking wound care/treatment supplies, and you can forget about finding nebulizer/gtube equipment.

My 2 biggest problems.... CNA's who are rude/disrespectful and vanish like Houdini. The DON/ADON admit we have several problem CNA's, but whenever a problem is brought to their attention, the CNA's are "counseled" and returned the floor. Case and Point: A few days ago, I entered a patient room and heard a CNA being very aggressive with the patient she was tranfering. She actually said to him "if nobody was watching, I would slap you". Later, (same CNA), she heard me tell a resident "So&So is your CNA, she can assist you if you need help". She told me "Dont tell them my name!! If I do something wrong, I am gonna tell them my name is Trubie... Trubie trubie Trubie". ........ I reported her to the DON/ADON and she was called into their office to discuss it. Fast Forward to today- I hear a weekend supervisor tell another staff member that the whole issue was dismissed because it was "unfounded". We have another CNA who frequently leaves the floor without notifying the nurses and leaves the building for 90 minutes at a time!! We report this to the DON and we hear excuses about how bad his personal life is.

Big problem #2.... Nurses who dont do their jobs. After a few days off, I came back to work today and looked at the treatment book. Since the new Nov MARs, only 1 other shift had signed for any care. We have 12 hr shifts, so that is almost 4 days of AM/PM care that was not completed. I frequently find old bandages that have not been changed (that I signed/dated), and when I ask patients if other nurses give these treatments, they always tell me that I am the only one.

Please give me some advice because I just dont know what to do!!! I looked so hard to find a job and I thought I could be happy at this one, but the other staff is making me miserable. I feel like I am the only one doing my job and then I feel like a witch for reporting other staff who are slacking off. The CNA's have started to notice that I am reporting their absenses/behaviors, so now they seem resentful of me.

I want a professional, teamwork environment and right now I am knee deep in poor preformance, with no support from the managers.

The managers keep telling me what a great nurse I am, and they are so glad I am hard working and they want me to stay...... I just am feeling so unsupported right now in regards to dealing with other staff!!

What should I do?? I pride myself on being a team player, and I am willing to overlook occasional mistakes (because everybody has a bad day).... but lately all these mistakes is making MY days bad!!

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Keep writing them up. And write what you witnessed. It cannot then be determined to be unfounded. It takes a lot of time.

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The DON is the problem. A company, any company, needs to communicate clear expectations to the employees and provide adequate training so that the employee is capable of doing the job he's being asked to do. Once that happens it becomes the employee's responsibility to actually DO the job. If he does not do so then it may be that the job is not a good fit with the employee's goals/personality etc. At that point it's time for management to do what it is supposed to do i.e. management counseling and disciplinary actions up to and including termination if the employee decides that he is unwilling to do the job the way the company needs it done. This takes balls. Some people do not have them. Sounds like your DON is one of the latter.

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Specializes in Med/Surg. LTC,Homecare,Private care.

WOW!! I hope your next shift is better. I have been a nurse for 16 plus yrs. and I too am a team player. I found that I care TOO much and ended up taking up alot of the slack on my shifts also. I used to work on a med/surg flor and did the 3-11:30 shift and ended up there til 1-1:30 am! I think we are in a small group that takes our job to heart and we aren't there just for the money.

I have come across alot of CNA's in the SNF's I worked in were very disrespectful because they think the nurses don't work as hard as they do ect.- jealousy because you are "new" and they are going to push you to see how far they can get.

I have reported co-workers also and got mixed results. If the situations keep occuring -keep reporting it. Does this facility have any scheduled meetings with the staff? As charge you can write them up,report abuse and make sure it is followed up with some sort of results.

The dressing changes should be reported -that is neglect and if the health department,OSHA ect. gets wind the facility will have a lot more to deal with than you trying to be a good nurse and doing your job.

Keep your chin up and keep doing your job- you aree doing the right thing!

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Being new myself, you dont want to cause waves n what not. But unfortunately, you're going to have to write up th CNA's for leaving the floor for as long as they do, remind them of their job. You could say their leaving the floor for 90+ minutes is abandonment resulting in neglect. And if thats the case then they need to be turned into the state department. Same as the nurses who dont do precribed treatments.

Ive had some similar cases myself. CNA's being rude and not doing what is asked. I was an aide for 8yrs before becoming a nurse. I know their job and mine. We all work hard during our day even if it doesnt appear we do. There are lots of things on our shoulders and things going on that they dont see

Keep your chin up and care for you patients as best you can

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O.M.G. That is NOT right. Welcome to the world of LTC. If the DON doesn't do something about those issues, and you feel that it shouldn't go on any longer, talk to your administrator. If you catch an abuse? Then there's the Ombudsman. You're not there to make friends, if you feel that your team is not functioning towards the residents' best interest then do something to change that. You're on the RIGHT track. I want to let you know.

The "irresponsible" nurses who don't do their jobs will get what is coming to them. Remember, it is THEIR license that's on the line. You just need to do what is expected of you to do. Unchanged patient dressing for days is unethical and illegal. If it's a doctor's order (which for sure it is) to change dressing q day then they're definitely going against it. Inform your supervisors.

Always think about who will get the short end of the stick here, the poor Residents. We're patient advocates. Don't let what you learned in nursing school crumble due to a bad nursing environment. Maintain your integrity as a professional nurse! Goodluck!

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Specializes in Acute Rehab/Geriatrics.

A few days ago, I entered a patient room and heard a CNA being very aggressive with the patient she was tranfering. She actually said to him "if nobody was watching, I would slap you". Later, (same CNA), she heard me tell a resident "So&So is your CNA, she can assist you if you need help". She told me "Dont tell them my name!! If I do something wrong, I am gonna tell them my name is Trubie... Trubie trubie Trubie"

This is actually verbal/emotional abuse/intimidation and you are a mandated reporter, required by law to report this...and not just to the DON, which was a good start but you are required to fill out a SOC 341 Elder abuse form and send/fax it to the Ombudsman and Dept of Health.

You seem like a conscientious nurse, I am sure they are happy to have you there and sounds like you do a good job but you could get in trouble for not reporting this and don't let your DON intimidate you, just show her the law which is probably outlined in your facility's P&P

Good luck with it all

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Those people that were there before you started are not your team. They will not want to be your teamates unless they like the team you create. If they do not want to be on your team then it is time to cut them. I am not a nurse yet, but I speak from experience; unless they are your caliber you need to either get them to your caliber or cut them. It is your responsibility to delegate as well as your responsibility to evaluate their performance as to your delegation. If they are not up to par then it is your responsibility to write them up for failing to perform that which was delegated to them.

BTW

If things do not change, the people above you care as much as those below you. Time to move on; no need to risk what you have earned.

BTW BTW

Keep going up the chain of command, sometimes that works best.

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Specializes in ER, ICU.

Good God, sounds like you are going to have a battle on your hands, but one you can be proud of. I agree with many posters, write up what you see. This protects you if any lawsuits result. Threatening someone with slapping is called assault and illegal, might be hard to prove but don't brush off behavior like this. If after a week or two of frequent and copious writeups ask your DON for an update. If they appear to be doing nothing think about how to have your concerns address. Good luck!

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Specializes in LTC, Memory loss, PDN.

Do your job as you have been. Chances are you're not going to change things by yourself. Document(for yourself) every report you give to the DON. I know jobs are hard to come by these days, but consider this. If the facility has a bad reputation it won't look good on future resumes. Also, while you need a job you have to be able to look in the mirror. What I mean is, can you live with yourself if you stoop down to become a player in that team. I do not envy you and I can assure you I've had to pay the price for being politically incorrect, but then again I didn't wanna be in politics. Personally, I would unleash holy terror on the staff that threatened the resident. But as I said, I have paid the price. However, no regrets. I wish you well.

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Trubie, I bet you are exhausted! I'm exhausted for you and I just woke up, girl!

God bless you and the patients you care for. I would say run but it sounds like the patients really need you.:heartbeat

I guess, though, if it's affecting your overall health too, can you really help them like you want anyhow? Maybe you should run. Don't let them mess with you anymore by their lack of support. Find someplace that respects you and your nursing skills if that exists in your area.

This reminded me so much of a tech I used to work with who took so many, like 6-10 a day, :smokin:breaks, and in a cancer surgery clinic at that. I got written up for talking to her about it. :confused: Uhhh, she smelled like smoke not to mention all the lost work time. Nauseating...If you find you have a target on your back, e.g. no support from management or worse yet fake support, e.g. they say one thing but do another, run, Forrest, run. (after giving proper notice, of course) :nurse: :cool:

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Specializes in Gerontology, Med surg, Home Health.

While I am in total agreement that the CNAs statement about slapping is verbal abuse, not all states have the same method of notification. In Massachusetts, I have 48 hours to investigate and report. They don't want to get notified until you have done (or at least started) the investigation.

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