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Just wanted a few opinions on this so when I get called into the DON's office on Monday, I'm prepared.

I work at a LTC which is having staffing problems right now. We have PRN nurses, but most are either unavailable this weekend, or already working. I injured my back at home, which has happened to me before, and feel that due to taking meds to control the pain, will be unable to work this weekend. I made arrangements to work a double shift Monday to make up for today (Saturday), but have basically been told by our scheduler that I can't be covered for tomorrow (Sunday), and had better make it in. I know I won't be able to push a med-cart for 6 hours tomorrow (and that is really how long it takes to do the two med-passes), and will barely be able to on Monday, but was sorta' pressured into the double to "make-up" for Saturday.

Our "on-call" is the DON, and my opinion is that she really doesn't want to come in to cover. Last time, I got stuck staying from 7 A to 8 P, 5 hours after my shift ended because she couldn't make it in when she was on call due to helping her sister, although she was aware of the staffing need before she left to help her sister. I still got stuck at work with no relief, and missed a very important family engagement because of this.

I've been told that I'd be needing a Dr's note upon return Monday if I chose to take Sunday off, although it would only be my second day calling off, which is NOT company policy. I'd usually be happy to oblige anyway, but the facility never processed my insurance, so this visit, over a weekend, would be out of pocket for me. Also, I don't want to go to the ER, as I've sufferred with this back problem for years, and already know what they'll tell me. I don't feel it's an emergency to get a DR note.

Also, I originally wanted Thursday off, because of my vehicle breaking down (fixing it was how I hurt my back), but had a co-worker come to pick me up because I couldn't get coverage,,,, only to find out that I was scheduled off Thursday, and was given Friday off to compensate. The scheduler was aware of this, but sorta' led me to believe that I had work Thursday because they were already short, and me being there would cover someone else, making both the on-call's and scheduler's life easier.

I already know some of you will tell me to look elsewhere for a job, but I can't financially afford to quit right now, and am looking forward to some of my sign-on bonus which comes due to me in less than a month.

Any suggestions on how to handle it on Monday when I go back? Am I justified in not feeling able to go to work while on vicodin and in pretty bad pain? Should I go and talk to our interim administrator? He doesn't really seem to concerned, just tries to avoid problems by letting them go and work themselves out. We just lost our old DON and Admin all in the same week, and everyone is feeling overwhelmed, but I really don't feel capable of administering meds thru a very heavy (most on at least 5 meds at one time, some as many as fourteen) med pass, not to mention a ton of tx's., and I really don't feel it's MY fault that our DON is going to have to cover, after all, she's on call this weekend. All advice and/or criticism is appreciated.

Please forgive me if this is long and rambling, I still have quite a bit of pain, and a few vic's under my belt right now. Thanks in advance guys.

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If you cn't afford to quit, don't quit, but be on the lookout for another job. In the meantime, can you have a witness of your choosing at this meeting? I'm assuming you are not union. I can understand them wanting a dr's note since you called off for the weekend, but I also understand your concern regarding the insurance. Since your insurance should have been processed, you can nicely tell the DON that if she wants you to see a doc, you would be happy to......at the facility's expense because of the insurance snafu. As for the coverage issue, what's she's doing is not fair but not much you can do about it. Document, definitely get the owners involved because that way you've gone up the chain. Make sure they're aware of the DON not following through with her on-call status. And don't be available if they need extra coverage if you can help it. They're not doing you any favors so don't do them any.

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Thanks Tazzi, I appreciate the advice, and believe me, I'm looking for another place. I offerred to see a doc at their expense already to the scheduler when she told me of this need for a note. Funny tho, that this is the first time ANYONE has needed a note for calling off over the weekend.

An older LPN once told me that all facilities are the same, just depends on how deep the crap is you have to walk thru every day.

Not to vent too much right now, because if I start, I won't stop, but I usually try to be available when they need me, and on the one other occassion I needed to call off, due to my sister, who lives with me and is 18 years younger than I, being beaten up at work and taken to a hospital unconcious, I still called work at 11P to get coverage for the 7A shift I was to work BEFORE I left for the hospital to see what happened to sis. I also always make sure my work is done before I go home, and usually cut lunch short and skip breaks to be sure I did my job as best as I know how. I had bitched about my morning med-pass taking three hours, when all the meds are set for 8A, and I'm not done until at least 10A, but that fell on deaf ears. At that time I offerred to come in on my day off and re-write orders to be signed so we can make some of these meds 9A, keeping me in compliance. I was told no, it can't be done, and have since learned to quit bitching. LOL.

Some of my co-workers like to play the martyr, or try to be supernurse, and just live with these conditions, but I am all about being in compliance, being the best nurse I can be, and being a pt advocate, as I really care for my pts. That's why I won't work while medicated. Anyway, thanks, you gave me some good advice I didn't think of, and some food for thought about my employment.

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Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

I HATE it when TPTB do this! Definitely do not be hounded/shamed/pushed into going to work tomorrow. If you give it 'the old college try' and then get there and find out that you just can't do it, you will be stuck. No coverage and no way to leave. I've learned that you won't get an E for effort from TPTB. And if, heaven forbid, you make a mistake, you will take the fall. Take care of yourself and protect your patients, do not go in. You cannot provide them good, safe care in your condition. As for their staffing issues, that is not your problem. If the company policy does not support the need for a Drs note (sounds so elementary school) after 2 days absence, they are probably just blowing smoke. If you really feel that they are forcing you to get a note from a MD, maybe you need to call in Monday also to see a much cheaper (cheaper that an ER or UC) Dr in his office. I really, really hate when companies make their staffing problems, OUR problem. I also remember once when my grandmother died her funeral was at noon and I was scheduled for 3-11. My boss told me "well if the funeral is at noon, you have time to get in for your shift." I called in. Trust me, I have so many stories.

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Thanks everyone, for the positive reinforcement of what I already decided. I'll be off today, and work the double tomorrow. I only agreed to the double because It's my relief that called in, and I woulda' been stuck there anyway. I'd rather be aware of the double shift and plan on being there than have it sprung on me at three pm, as a surprise, which is what usually happens. Believe me when I tell you tho that I'm actively looking for another place to work at! I only took this place because it's much closer to home than any of the places agency was sending me to. I'm new down here in this area, and don't really know of alot of LTC's close to home yet.

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Good morning.

If this is a chronic problem then your PCP is obviously aware? Could you get a note from your PCP regarding this as a chronic problem with flare ups without actually being seen?

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Good morning.

If this is a chronic problem then your PCP is obviously aware? Could you get a note from your PCP regarding this as a chronic problem with flare ups without actually being seen?

My PCP is in PA, I recently moved to FL, and haven't got a local Doc yet. The original accident that screwed up my back happened years ago, hasn't flared up in well over a year, except for some tightness and mild discomfort. Doesn't help that I've put on a few pounds since I've moved either. LOL

My new employer is aware of the problem tho, as I put it on my application as a pre-existing condition. Guess we'll just have to wait and see what happens tomorrow.

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I also remember once when my grandmother died her funeral was at noon and I was scheduled for 3-11. My boss told me "well if the funeral is at noon you have time to get in for your shift." I called in. Trust me, I have so many stories.[/quote']

I was scheduled to work 7p-3a one night; in the afternoon I got a call that my brother had been in an accident. When I got there I was told he was critical. I called the house supe to tell her I wouldn't be doing my shift because I needed to be with him. She actually suggested that I stay with him until he was transferred to ICU, then clock in!

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JohnBear, your work experiences are very useful to medical reviewers (insurance companies, medicare, etc)....how about treating yourself to a civil job sitting down using your talents?

Sounds like this place is going to run you into the ground.

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JohnBear, your work experiences are very useful to medical reviewers (insurance companies, medicare, etc)....how about treating yourself to a civil job sitting down using your talents?

Sounds like this place is going to run you into the ground.

Love to, but I also love the interaction of bedside care. Also, I'm an LPN, and I heard that these "sit-down-jobs" are mostly looking for RN's. After moving to FL to watch over my little sister, I really can't afford to do the LPN-to-RN thing yet. I AM planning on going the RN route before I hit 50 tho! I really can't see me pushing a med cart for the rest of my life.

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