Oh my!! What a day!!!!! sigh....

[lisamcrn]

Alright, this is my first post...it wasn't intended my first post be rather cynical, but it appears that the way it goes. I'm an RN in LTC 76 bed facility working 12 hour shifts. We have about 50 beds filled right now due to recent deaths and competition from assisted living facilities.

This morning one CNA called in sick and couldn't find a replacement....but, we had a good crew on and things were going fairly well under the circumstances. Leaving me as the RN, one LPN, one CNA in the alzheimer's unit with 9 residents, and 2 CNAs on the floor with 41 residents. You know the drill, everyone runs their behinds off and all basic cares are met. By 1230 everyone is exhausted but still runnning. All residents were fed, clean, repostioned, toilted etc and their were no unexpected events.

1400....fresh crew of CNAs arrive, staffing stays as above with a 4th CNA due to come in at 1600....the nurses are praying for the day to end and thankful for the energetic, hardworking CNAs onboard.

1430...State surveyors arrive unexpectedly of course to begin the great annual review. LPN starts calling in DON, ADON, Administrator, Care PLan Nurse, and other departments heads....who all show up within 30 minutes. I silently run thru the building triple checking every little detail on the floor, warn all staff....and the LPN nicely points out.....Yeah she is in charge over there.....pointing toward me....yikes. Things are okay though.

1530...call a family regarding a res who is becoming weaker and a change in status, family wants only comfort measures...ok...nothing eminent just a decline.

Adrenaline starts pumping, have a cigarette or two and everything is going like clock work. For whatever reason the 'guests' follow my LPN thru her 1600 med pass/insulins/chemstrips...and just say hello to me a few times...whatever! Then they are in with the bigwigs visiting or whatever they do.

1700....my resident vomits....ok....no big deal...do assessment, paperwork, fax dr., call family.

1730....my resident falls...ok..not hurt...do assessment, paperwork,fax dr., family not home, surveyors busy and aren't aware of this....great!! : )

1745...Finish up 1800 med pass, help with supper, surveyors leave......yeah....great sigh from all.

1838....on overtime, whatever, finishing report and paperwork, alzheimer CNA calls LPN regarding previous res who is slowly declining "doesn't look right tell Lisa to come", LPN bless her, tells her I'm leaving and will send noc nurse

1840...CNA calls back "I think she quit breathing" I run to the unit, 2 nurses behind me and she is definetely gone....as we look at each other trying not to laugh from this surprise I state "I'm leaving and not doing the paperwork" really not attempting to be callous, just exhausted on my 3rd day in row and the wonderful noc nurse says "go home".....so I did.

So I sit thinking thank GOD I have tomorrow off...maybe I'll finally get the flu.....or get struck by lightening.

Lisa (and you should of heard about 2 weeks ago....that was a story)

[donmurray]

Lisa, you did good, and as for cynical, any nurse who isn't, occasionally, is in preparation for sainthood!

[Jenny P]

Lisa, how lucky that your patient died AFTER the state surveyors left! (Now that is a cynical remark-- sorry)

[micro, RN]

Hey, Lisa,

Sounds like you got it handled.......Sometimes cynicism is the only way to go!!!!!!!!!!!!!

Nothing like those ltc days.........

But then again there are those hc days......

and then again

sarcasm and cynicism is a great survival strategy for nurses!!!!!

micro

[PhantomRN]

Hey I think you did great. Gettng through the shift is what it is all about.

In aute care I would say "If I can leave the shift and everyone is still breathing then I have done my job." But for LTC maybe we should change it to, "If I can leave my shift and my residents are in a better place then when we started than I have done my job."

[OneChattyNurse]

Hi Lisa and welcome from a fellow Iowan!!!

I remember those LTC days well. I think it sounds like you did a GREAT job!! Hang in there and keep up the good work!!!

Shari:)

[lisamcrn]

Thanks for all your replies. I think those defesive attitudes come in handy on weeks like this one. At least the surveyors should be gone by Friday and I'll be on over-time by then!!

Lisa