I am an RN, ADN working at a local nursing home/rehab ctr. During the past 3 months, I have seen everyone from the ADON's (2 of them) to the Administrator either fired or resigned. The new DON ironically was the same one who interviewed me and hired me last year, and was then fired before I even reported to work! I was kind of suspicious but decided to stick it out and give the new folks a chance, and for a while, things were looking really good. The new DON told me during the first week that she had heard a lot of good things about me from both fellow staff and family members of residents. I found myself being praised by name at the last several payday inservices, and was fortunate to be posted to a wing where I was in charge of some of the most difficult patients in terms of degrees of skilled nursing care. I had (and still have) a fine team of CNA's who getm the job done with a minimum of supervision, and I had a Medication Aide who always volunteered to stay extra hours to make both of my evening medication passes, freeing me up to do nursing work.
Then overnite, everything changed. Suddenly, and without any warning, all medication aides were prohibited from working any hours except 7-3. My shift is 3-11. My resident count was increased to one short of my hall's maximum, and suddenly I was short my med aide, forcing me to have to pass my meds myself. At our facility, the first 3-4 hours of the 3-11 shift is extremely busy, what with people returning from dialysis with new orders, family members wanting to speak with me about the care of their loved one, doctor's offices calling, and problems with individual residents requiring my immediate attention. On the first day I had to make do without a med aide, I was totally unable to start my med pass for 4 pm until well past the dinner hour. During this first day, I was approached by a resident who asked me if I would please followup on an appointment he was supposed to be having. I told him I would get back to him, and that I really needed to get my medicines passed right now before anymore time passed. Somewwhere during the next 2 hours, this resident took care of his problem himself on the upstairs phone. He approached me at that time and said "Hey thanks for NOTHING!" I told him that I had fully intended to get back to him, but I was too far behind with my medicine passes, I was short-handed, and I just wasn't able to get to it. I felt at the time that getting my meds out was a slightly higher priority than checking on an appointment.
The next day, I was called into the DON's office and presented with a Disciplinary Notice by the ADON, who told me that the angry resident had approached them that morning and told them that I refused to help him. I told them this was not the case, and that I was busy pasing my medicines, reminding them that they took away my medication aide on very short notice. I was then given a lecture on what constitutes negligence and irresposibility, and told by this ADON (an LVN by the way) that my immediate responsibility was to attend to his question. I told them that checking on an appointment was hardly a higher priority than getting the medicines out to people who needed to take them either before or while eating their dinner meal, and since I was already late by having to deal with other issues, was I now going to make them wait longer? The ADON told me that this is exactly what they expected, and from now on when this resident asks for help, my responsibility is to drop whatever I am doing and take care of him. I was also given a stern lecture on how they came from working at other facilities where they had no medication aide, were in charge of 30-odd patients, half of which were G-tube fed, 2/3rds of which were diabetic, and they got everything done including new admissions, and treatments, and did so in timely manners. I was also told that I would NOT have a med aide anymore, and I was just going to have to accept that as will all the other nurses on the evening shift, and there will be no further discussuon on that issue. When I left the office, I felt as though all the satisfaction of working there had just gone out of me. I had to try very hard to contain my anger all the rest of the night. Somewhere during the night, I found that one other nurse had been written up in quite the same manner, for "not being on top of her CNA's." This nurse had angrily told them "what do you expect? I have this, and this, and all THIS to do, and by myself all of a sudden." She got the same lecture as me, that this is how it is going to be from now on, no med aide, and she is going to just have to do her job without one.
What bothers me is that in both of thses instances, we were judged guilty before we even walked in the door. The disciplinary notices were already typed up, and our main purpose was to hear them tell us what lousy jobs we had done, sign, and rebut if we felt like it, and get back to work. No chance to air our side of the story, introduce conflicting evidence, or otherwise show that we are doing the very best with what we have been handed.
I have always prided myself on giving 110% and more to my work, but suddenly 110% is no longer enough. I feel now that I am under the gun. I have never before been accused of anything even remotely called negligence, and to suddenly be called negligent and irresposible galls me to no end. And more so, because this same resident has put me on notice that he intends to report me to the DON again because he didn't like the way I helped him change his colostomy appliance. I have also noticed too that the full-time medication aides we have now are being vastly under-used. During the last week, my former hallway med aide was only able to work 25 hours.....and she is supposed to be full-time. Most of the others have experiences the same. In addition, this same med aide is being watched by the front office, and every time she is seen conversing with a staff member other than a nurse, that staff member is called into the office to be asked what were they discussing?
I suppose that the time has come to move on to something else.........still it perplexes me as to why our facility would change so much overnight from a place where everyone wanted to be there to a place that everyone can't wait to get away from.
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
Sounds almost like they have gotten a directive from above to cut costs way down. They replace the administration, now they are trying to get the MedAides out and they have increased your patient load. This doesn't sound like anyplace I would want to work, get out as soon as you can.
I encourage you to stay the real test is "if you are a solid nurse and responsible" then wait it out, and let it happen. Medication techs are a real waste if all they do is pass medication; in short they are not doing any physical labor, and can draw out their shift hours, and currently you are going back to passing medications and not used to keeping that pace. I don't have time to go back and re-read the original text but if you have a reasonable amount of residents and can "handle" the load for now, for I am sure they do not want to pay you OT if they are cutting costs, then stand it out, and make calm, yet simple statements of your needs when your DON is not overstressed.
There are some huge takeovers going on currently in LTC and sometimes this will allow a new vision and a company takeover that will truly change your life for the better. I really do not know or care to share details that might not be public, but a lot of changes in LTC corporations is currently happening. Since LTC is now the progressive industry for acute hospitals will be closing doors rapidly for insurers just will not pay for acute care stays; we in LTC are getting new wings of sub-acute that they will pay for. Since those post op, post CVA, post anything need a level of medical care prior to going home the true marketability exists here.
Do not let panic drive you over the edge. As a DON I encourage you to ride this wave and not pick it apart. If you are doing your job as changes take place you may find the administration is also assessing the staffing needs, and regrouping and that you will soon not be doing that ward alone (or at least feeling like it). Make some simple notes, review your priority needs, and approach that DON when they are not up to their neck in messes. It might take a couple of weeks if things are in chaos right now; when it happens be prepared calm and willing to be open so that the DON knows your sincerity.
I think you might feel more secure and happier if you give it a try!
Thanks,
Karen G.
Steve - if they want to cut staff, why not cut a couple of those ADON's? Too many chiefs and not enough indians!!
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
This is simply a friendly reminder that this thread is nearly 2 years old, although the same issues remain consequential to this day.
Any advice that is being bestowed upon the original poster might not get to him, as he has not visited the forums in a while. In addition, his situation in life might have changed since he originally reached out to us.
This is simply a friendly reminder that this thread is nearly 2 years old, although the same issues remain consequential to this day.
Any advice that is being bestowed upon the original poster might not get to him, as he has not visited the forums in a while. In addition, his situation in life might have changed since he originally reached out to us.
Yes it has been a LONG time since I visited this thread. Yes, life did change a lot. For one thing, I got the h$#@! out of there, after the then-ADON's in charge (there was still no DON) had me transferred to a new wing, then saddled me with three new admissions in one night. Afer I finished that nightmare night, I went home and wrote up my letter of resignation. I took my two weeks, then took my vacation, came back and started a new job where I am presently at, and loving it. Meanwhile, I stop in at that same facility to see PT's that my provider takes care of. The situation changed very dramatically. The administrator was fired, a temp DON was found, then she too resigned, then a new DON who is still there was found, first one ADON resigned (with barely a day's notice-- seems she noticed some writing on the wall) then the other one was fired. So what goes around comes around eventually.
Sorry to hear about your troubles. It's too bad you don't have a union. I'm afraid if they continue to behave this way that it might put your license in jeopardy. I don't know that much about the system but do these negligence claims go on a permanent record to the state or anything? If that is a potential risk you should get out asap, imo.
dream'n, BSN, RN
1,162 Posts
Sounds almost like they have gotten a directive from above to cut costs way down. They replace the administration, now they are trying to get the MedAides out and they have increased your patient load. This doesn't sound like anyplace I would want to work, get out as soon as you can.