FED UP!!!!!!!!!!!!!!!!!!!

Hang in there I know that it is difficult to work with all of those different personalities. But I have to agree with you and the aide...if the other aide doesn't come in until 430pm or 5pm the all the other aide is suppose to do is answer the call lighst and make sure that the residents are clean and turned every 2 hours. Not her job to get the other aides residents up.

Administration needs to make that very clear to PT aide. I don't know what the chain of command is on that because I would say to have you explain to the part time aide.

But here is a suggestion...if they strongly insist that there be a 7th person may be you can ask them not to give the PT aide a hall or run and allow her to be a floater which would consist of her coming in at 430pm...:igtsyt:let me back up for a minute first they reallllly need to establish a consistent set time for her either 430pm or 5pm because it is unfair to those that have been there since 2pm and have done all of the hard work and she comes in and it is easy breezy for her for the next 5 hours...like I was saying as the floater she would be responsible for the VS, Ice, answering call lights of all 4 for halls. If she comes in and begins right away she can definitely get this done befor the end of shift. And that will alleviate a lot of the confusion between her and the aides because she knows what her new job title is and the other aides are able to continue with their work as though they were 6.

As far as the complaints of being loud...I would probably start writting people up for the violation of hush time. Because I know in most facilities there is a hush time policy I think after 7pm because is majority of time that residents go to bed. Just a thought! I hope this helps...Keep us posted!

I have tried to explain to the 7th one a few times that she cannot expect the others to have her end done by the time she gets there....I told her that because I noticed that when she would come in she'd go stand around at the desk....The floating idea would be wonderful IF any of them actually floated....the way its been working is the 7th one floats during supper...doesnt feed....no passing trays...they get lights and toilet people.....but this often falls through. The mgmt does not define exactly what they want xyz person to do....then comes up all this mass confusion with ?s that we dont have answers to...and it gets soooo busy during and right after supper time. I cannot keep up with what the aides are doing in that time....we are trying to get charts done and get ready for that next med pass. . Tonight though they both worked and didnt fuss. I was surprised. Seems like every time Im off certain aides cut up on other nurses who are more apt to not say a word to them vs me. I usually am very easy going, but when I need something done.....I expect it to be done and they know this. The biggest problem starts in mgmt....not enough communication, not standing by their words, and not enough clarification and actual direction on the floor. The DON/Admin. pile everything they possibly can on the nurses when we already have more than we can do in8 hours. I guess it will change when they decide to retire.

I love the "I don't want that hall" and " I don't want to work with her" part. So many possibilities. "Do you want some cheese with your whine?" or "It sucks if you have to do things you don't like, doesn't it. Now that you know how I feel, I expect you to work as hard as I do." or "It will teach you patience and integrity" I'm not usually mean, but I don't do whining unless they're under the weather or have another good reason. I don't quite understand the problem with the seventh CNA. The extra CNA is not there for staff convenience, but for safety issues. In my thinking, I'd leave six groups and have the extra CNA answer lights or do showers or whatever else may benefit the residents. If the other CNAs don't like the extra help, have the seventh CNA do safety rounds and check for call bells within reach etc. and have her ambulate and range residents. As for home health, don't let the trachs and vents scare you. Some good reading material and a good orientation is all you need. Most of my cases in home care are peds and some of them like to pull out their trachs, so be sure you get a good hands on. I've only come across a handful of different vent models and I don't mess with the settings, in fact, most of the settings are locked anyway. I think the most important thing is being prepared so you don't get caught with your pants down, e.g. power outage, leak in tubing, etc, so a good orientation on trouble shooting is important. Finally, some of my vent patients aren't even on the vent 24hours, but mostly at noc. Anyway, if you can do LTC, you can do homecare. Just don't be surprised when you go visit a trach patient and you see a family member use a sander in the same room (that really happened to me and I did have a fit )

a sander in the same room..OH MY.....

one of our new gals a couple of weeks ago tried to drown one of our guys with a trach.......i wasnt there...but i guess during the shower she forgot about the trach and started spraying the water around his upper body.....poor guys o2 went to 50.....she felt bad, all ended well......one really must not get side tracked....lesson wll learned i should say,

Wow! I agree on the 7th one to be there for safety but til the boss gets it together and makes it clear cut I think things won't change. However I switched shifts with a 3 rd shift nurse and was blown away. It was the best shift I think I've ever worked. The aides were outstanding and they only have 3 aides 2 nurses on 3rd. When I got there they had all the vitals done and hanging at the desk, coffee made, and ice done. They did their rounds helped each other got right to call bells and alarms and they were quiet! No fussing no bickering just pure smoothness. I was helping my aide clean a pt whose colostomy bag blew up everywhere and the other aide came down my hall and said "you go do what you need to do we got this" & I was dumbfounded. This same thing happened the other night on 2 nd and the cna 2 came and interrupted me during my charting and med checks and chart checks to tell me to come change the bag! She says she doesn't get paid to do it. I'll remember thY come time for her cna 2 renewal when she can't prove she's done level 2 duties. Yet I went and did it despite my eyes burning and watering and my stomach rolling from the smell. Colostomies just don't agree with me. They are the one thing aside from eye VTRs and vagi

meds that bug me. I bet I'd be unlicensed if I said "I don't get paid to do that"

Well....fellow nurses....its happened AGAIN!....Another patient of this nurses was sent out by nurses on the other units because she would NOT assess her pt in respiratory distress......moving along...pt was admitted...this is the 3rd one since Tgiving thats been in her care that she has neglected. Im thinking about having a heart to heart with the DON. Not that it would do any good but still. And she put this liability nightmare of a nurse on the upcoming schedule! What a waste. This chick needs to get gone before she kills someone and drags the rest of us into some scandalous lawsuit or something.

Wow I totally feel your pain; I've been there, done that in more facilities than I can count (I've worked agency). I cannot offer you any solutions, but I have to say your expression "As useful as tits on a boar hog" had me cracking up!!! It also indicates what a normally good-natured nurse you typically are. Be thankful that you have a sense of humor to help you through these rough patches.

I've also done home health and it actually is a really nice respite from LTC burnout, if you can find a company that is well enough organized for you to actually feel productive. You really do have to be flexible and patient with scheduling, sometimes the RN case managers have not updated care plans very well, and the driving part gets old. But the teaching and one on one part is so much nicer than having to constantly multitask.

Good luck to you, whatever you decide!

I got the prn home health job go for orientation in two weeks. I'm nervous about it because I'm used to 20 people wanting me at the same time. I've got alot on my plate right now since I'm the only income in my household now dh lost job. I'm glad you liked the bit about the boar hog . Must be a southern thing & I got plenty more where that came from . I just hate being so frustrated by this employee. Maybe it will get better but I doubt it. I just keep to myself as much as possble and hope for the best. I have always had a hard time putting up with slackers but apparently the boss doesn't mind what she's doing because it saves money.

fortunately I work in a very small facility and have never really had to deal with any disagreements or arguements that where too bad or on-going. I do have a very poor tolerance for excessive and presistant tardiness; so I came with a new rule anyone one >hour late or so late that other staff had to start getting their people up, then becomes the bath aide(because our facility doesn't actually employ one) for the day and does everyone's showers.