frustrating

[fairyluv]

We have a nurse manager who seems very demanding. One of those who feels that you should drop what you are doing and run when she calls. It's getting very frustrating for some of us. I mean she even had one of the nurses cussing in the med room about all the stuff the NM had her doing. And this nurse NEVER cusses. I had never heard this nurse say "damn" let alone hear the words coming out of her mouth. She said she couldn't get through her med pass. She was still trying to pass meds from her 1 st med pass. I guess one of the res. was having some anxiety issues, and needed a prn ativan, (which the res. has q 4h) which the nurse gave, but then she was being told to call the dr. and get an order for ativan to give now if needed. And give her a pain pill to. this res is confused and occasionally has anxiety attacks and will usually respond well to alternative methods,like deep breathing exercises, refocusing and will calm down. The NM was insistent that the nurse give her all the Ativan and Norco she can get for her to calm down. When this res has an anxiety attack, she does not go wild, or get loud, she hyperventilates. So we use breathing exercises to help her calm down, most of the time, she just wants someone in there to hold her hand. I know we don't always have the time to sit and hold there hands, but with her. it really doesn;t take much. And the NM would not listen to the nurse as she was trying to tell her that she really doesn;t need to be chemically sedated. When all she needs is someone to breath with her for 5 min or so.

If the NM would listen to what the nurse was trying to tell her. It wouldn't have been so bad,if the nurse taking care of her had the opprotunity to assess the situation herself. and they could have come to that decision together, rather than being ordered to do it.

[ktwlpn, LPN]

Why didn't the NM make the call herself or let her sign out the med and give it if she really felt this resident was in such distress? She knows the med pass needs to be completed in a timely manner.I would tell her just that,too-in a very calm and professional manner. AND I would remind her that prior to admin of a prn in LTC we MUST attempt non-pharm interventions and document their effectiveness .AND I would make sure to care plan those interventions you mentioned.

I'm old and tough and not worried about speaking my mind but you do have to tread carefully or your life can be made miserable. It can be difficult to work with a unit manger who is in-experienced (sounds like this one must be) And if they are the micro managing type it's even harder. She shouldn't disregard the staff's input.It sounds like you all need a conflict resolution meeting (aka "come to jesus" meeting) She should be meeting with staff regularly anyway and I think she would appreciate if you all discussed the issues in a professional manner and leave egos out of it (hers,too-it's not "her way of the highway" when you are at the bedside) We all learn from each other and shouldn't close ourselves off to that.

[CapeCodMermaid, RN]

Yikes. Why couldn't the nurse manager go in and sit with the resident? I'm the DNS and if the nurses are busy, I always step in and help and I have nurse managers on every unit. Perhaps the nurse manager is unsure of what her role is? Maybe she has no confidence in her own skills so she is bossy?

You need to sit with her and discuss this calmly.