I'm about to crack...read this and help!!!!

Specialties Geriatric

Published

Hello, my fellow nurses. It's so good to be here. I need your opinions on this situation.

Okay, I currently work in LTC on a rehabilitation unit/skilled nursing facility. Before I came on, they used to do 12 hours shifts. Now they are doing 8 hour shifts. Anyone who has ever worked on a rehab unit in LTC knows that it is near impossible to get anything done in 8 hours. Well, when they went to 8 hours, no one made adjustments to the work load. I work 1st shift. So, therefore, all of the treatments are scheduled on 1st shift. In addition to the normal duties; 2 med pass, treatments, charting, dealing with various issues, we sometimes get 7 and 8 admissions on 1st shfit. I have 25 patients that mostly are post-surgical and need pain medication on a regular basis. And it seems that recently, we have been having to send a lot of them back to the hospital as soon as they get there. These people have been butchered and develop so many problems.

So take 25 patients, plus discharges and admits, plus treatments, 2 med passes that seem endless because you have constant interruptions, plus family member's concerns, and you barely have time to look up before the end of the shift has come. I often stay over to finish up what I couldn't on my shift. Well, as you know, I am getting the blues from management for staying over because I am going into overtime. I told my manager that I just cannot, with a clear conscience, leave without doing my treatments and my charting. It is not the patients' fault that we are inadequately staffed and overloaded. They came there for good and care and by George, they are going to get it from me. So, she said, cool, do that. But she is telling me that if I stay, i must clock out and work off of the clock. I don't think that's right, but I guess i have no choice. But it's really taking a toll on me, physically and mentally. And I have only been there for 3 weeks. I'm already burned out.

This is where I need your advice. What should I do?

My manager says that it's understood that I won't be able to do everything on my shift. But if I don't do it guys, it won't get done. The 2nd shfit nurses won't finish anyting because they feel, "Well, that's 1st shift's responsibility". And I don't want to always leave them something to do. They don't deserve that. Also, I fear for my license. If I never do my treatments and leave them everyday, I'm afraid somebody's foot may rot off. And you know that in a court of law, they aren't trying to hear that I couldn't get it done. All they will hear is that I didn't do it. So, I am sometimes leaving an hour or two past getting off time and that is without being paid. I don't know about anyone else, but my time is valuable. I have a child that needs me. If I am going to be there, I feel that I should at least be paid, right?

By the way, we have a treatment/wound care nurse, but she won't touch a patient. She never does any treatments, except when the corporation comes in or state comes for a survey. Even then, she lied about doing the treatments. And get this, management knows about her, but they want to jump on me for staying on doing my job. And the CNAs cannot be counte on. They are nowhere to be found when you need them. They all go on break at the same time They run the floor and will tell the nurse what they are and are not going to do. And they even will sometimes tell the nurse what to do. The situation seems hopeless. Besides leaving, what options do I have? What's a girl to do? I just started this job 3 weeks ago and with all humbleness, I can honestly say, i am a pretty good "floor" nurse. I have worked in the hospital setting and left acute care to "get away." But I can honestly say, I don't think the hospital is as bad as this. I am at my wit's end. I am so tired, physically and mentally. I feel like crying everyday when I finish. And they schedule you to work 6 out of 7 days sometimes 4 days in a row before you get an off day. Somebody help me before I leave the profession for good. I need some inspiration and some advice. And it will all be much appreciated. I'll be waiting to hear from you all.

Good day!!!

Specializes in Med-Surg.
I'm glad to hear you're getting a new job. On your way out the door of this place you should place a call to your state department of health which is probably the agency that licenses and inspects the place. Tell them about the situation with the treatments and why you quit. They'll be interested and might pull a surprise inspection on them.

Thank you. I would love for the State to roll up in there right now. I want them to see what I see and know. They won't be able to turn a blind eye to it. I might help them on getting there ;)

Specializes in Med-Surg.
Dont Crack, that is what they want you to do, I would stay at that job, because the next place you go to will be even worse. I work in LTC and I experience high pt loads, staying late every day, ect... A little trick I do is Flag all the priority treatments, and take the Treatment cart and the Med cart with you on your med pass. THis may seem like it takes longer, but once your done the pass your done, then all you have left is charting, and if they request prns ect.. Also Nursing is supposed to be a team effort, so dont feel bad for rolling anything over to the next shift, thats why they are there right?

You're right. Nursing is a 24 hour job, and they know this, but they won't accept it. And I guess the DON and Administrator are afraid of losing them because it's so hard to replace nurses on 2nd shift. And the patients tell me all the time that they can never get anyone to come see about them on 2nd shift. You know, I wonder what are they doing? I know that they have 2 med passes, but so do I. But they don't have treatments, and don't have to deal with as many meals, etc. What could they be doing? I worked part of 2nd Friday, and it was so quiet in contrast to the day shift. On top of that, excuse my language, there is this cow in PT that thinks she knows more than the nurses and is always coming around tellling us nurses what we need to do for our patients. I am so sick of everybody being so disrpectful toward the nurses. Do we ever get a break?

Specializes in Med-Surg.
Tell me why you are staying? And not that you love patients etc. What makes you want to stay?

I suspect that your answer is because you want a good job reference or a good evaluation. Do you honestly believe that anyone would accept what these people consider a day's work? Facilities' reputations get around.

Do not ever work, medicate, chart, pick up off the floor or anything else if you are off the clock. You can fight it in worker's comp hearings, but it's better to be either off and gone or on and getting paid.

I'm with the screen door theory. Vote with your feet and don't let the screen door hit you in the rear. Right now you are so stressed it's making you ill isn't it?

I guess besides all the other reasons, I'm staying because I want to believe in my heart that things can't be this bad all the time. I get good feedback from the patients that make me feel like I am making a true difference in the care they receive. But what they don't know is that I don't feel they are getting the best care, especially when they aren't getting all that need to be done for them. I feel that it is an underserved area that people can't tolerate to work. Now, I know why, they are not able to do all that they are required to do.

Oh, yes, i feel terrible. I have aches and pains that I've never had and it seems that my psoriasis is getting worse. I have some cruel anxiety attacks and my hair is shedding (may be seasonal) like a mangy mutt. I am definitely going to go to that interview. I think I've had enough. I feel that the Lord knows that I've done all I can do. That's why He opens these doors for me to exit. :nurse:

Specializes in Rehab.

Good luck with your interview... I'll be praying for you.

I worked in a LTC facility day shift 12 hours. There were days that it seemed like I would be staying over forever. But eventually those days subsided and I was ready to leave when the next shift came on about 95% of the time. It was extremely busy, but getting everything done in 12 hours was extremely do-able.

Now, I work in a rehab hospital/ltc that only works 8 hour shifts. I'm staying late probably 50% of the time because of my time management skills. I'm so used to having that extra 4 hours a day to catch up on everything. It's really really difficult to feel like I am on top of things. But let me tell you what I found to be the MOST defining reason why I stay late at my new job and not my old job:

Breaks.

At the 12 hour job, I took every single break that was coming to me.

At the new job, I think I'm too busy to take a break, so I don't. Many days I don't even take a lunch. So, I end up getting tired and overwhelmed, but instead of giving my mind a few minutes to relax, I over burden it with even more work. I'm going to start taking my breaks now... and you should to. You'll return to work with a fresh mind and you'll feel more organized.

Blessings,

Crystal

On top of that, excuse my language, there is this cow in PT that thinks she knows more than the nurses and is always coming around tellling us nurses what we need to do for our patients. I am so sick of everybody being so disrpectful toward the nurses. Do we ever get a break?

I'd have told her, sweetly, that anytime she thought she could do my job better, to go back to school for however many years, and give it a try!!

I understand what you mean about the lack of respect, sometimes, but we don't have to tolerate it. The incident that cemented my decision to leave my current LTC position was during a nurses meeting when the DON stated that she couldn't understand how we could ever have to have overtime on nite shift!! Now, keep in mind, this gal absolutely refuses to ever do any of the nurses jobs and has NEVER come in on an off shift.

I have myself and 1 aide at nite for 35 to 40 residents - and, I'm sorry, the residents come first. Some nites the lites are crazy, everyone is wet, they all want PRN meds, we have 5 wanderers, several skilled, I have extra paperwork to do at nite, plus a large med pass to do in the AM. So, I told her that unless she wanted to come in some nite and see how things went, she had no right to say anything.

It's not like it's often - I hate getting out late, but if it's been 'one of those nites' some of the charting gets left until the day nurse gets there.

Specializes in Med-Surg.
Good luck with your interview... I'll be praying for you.

I worked in a LTC facility day shift 12 hours. There were days that it seemed like I would be staying over forever. But eventually those days subsided and I was ready to leave when the next shift came on about 95% of the time. It was extremely busy, but getting everything done in 12 hours was extremely do-able.

Now, I work in a rehab hospital/ltc that only works 8 hour shifts. I'm staying late probably 50% of the time because of my time management skills. I'm so used to having that extra 4 hours a day to catch up on everything. It's really really difficult to feel like I am on top of things. But let me tell you what I found to be the MOST defining reason why I stay late at my new job and not my old job:

Breaks.

At the 12 hour job, I took every single break that was coming to me.

At the new job, I think I'm too busy to take a break, so I don't. Many days I don't even take a lunch. So, I end up getting tired and overwhelmed, but instead of giving my mind a few minutes to relax, I over burden it with even more work. I'm going to start taking my breaks now... and you should to. You'll return to work with a fresh mind and you'll feel more organized.

Blessings,

Crystal

Thank you very much. Please keep those prayers coming. I need all the prayers I can get. As for the interview, it went really well. Seems like the manager will be calling me in a couple of days. I sure hope and pray everything works out.

I think you're right. I definitely don't take my breaks. It just seems that I need every waking minute and don't have time for much more than anything but bathroom breaks. On a seldom good day, i take a lunch, but mostly, I don't. I believe that I am going to have to train myself to start taking those breaks. Breaks give the mind a pause. I think that would certainly help. Thanks for the much-needed advice. And God bless you, too.

Specializes in Med-Surg.
I'd have told her, sweetly, that anytime she thought she could do my job better, to go back to school for however many years, and give it a try!!

I understand what you mean about the lack of respect, sometimes, but we don't have to tolerate it. The incident that cemented my decision to leave my current LTC position was during a nurses meeting when the DON stated that she couldn't understand how we could ever have to have overtime on nite shift!! Now, keep in mind, this gal absolutely refuses to ever do any of the nurses jobs and has NEVER come in on an off shift.

I have myself and 1 aide at nite for 35 to 40 residents - and, I'm sorry, the residents come first. Some nites the lites are crazy, everyone is wet, they all want PRN meds, we have 5 wanderers, several skilled, I have extra paperwork to do at nite, plus a large med pass to do in the AM. So, I told her that unless she wanted to come in some nite and see how things went, she had no right to say anything.

It's not like it's often - I hate getting out late, but if it's been 'one of those nites' some of the charting gets left until the day nurse gets there.

LOL!!! I started to let her have it. No, but really, I don't say much to them because I'm afraid I may let my emotions take over. I guess she feels that because she went to school for 6 years, that gives her the right. But, she went to school for PT, not saying that they don't take some of the same things we take for prerequisites, but she really thinks that she is Florence Nightengale or somebody. And you know, my supervisor has a vendetta against me. She does nothing all day long. And I mean nothing. So, when I called in because I had the runs the other day, she got mad at me because she had to work the floor. Well, I told her, i can't help that my body doesn't handle stress very well. And why would i come in when I am already about broken down? Needless to say, she rolled her eyes and kept going. She is never around when we need her. I don't know where she hides out, but she definitely is not available to us. And she sometimes blatantly refuses to come when someone asks her to come for a second.

So, as you can see, we have not support from management, not one bit. I will be so thankful unto God when I get to leave this place. I fear for my health. I won't last much longer if I don't get out.

:zzzzz

All of the above posts describe LTC to a tee, bottom line, once again MONEY.Unionize!

Thank you very much. Please keep those prayers coming. I need all the prayers I can get. As for the interview, it went really well. Seems like the manager will be calling me in a couple of days. I sure hope and pray everything works out.

I think you're right. I definitely don't take my breaks. It just seems that I need every waking minute and don't have time for much more than anything but bathroom breaks. On a seldom good day, i take a lunch, but mostly, I don't. I believe that I am going to have to train myself to start taking those breaks. Breaks give the mind a pause. I think that would certainly help. Thanks for the much-needed advice. And God bless you, too.

Please take better care of your own health! How long do you think an automobile would function properly if you constantly tried to drive it when the oil level was too low, or when the fuel pump is sucking sludge out of the bottom of the gasoline tank because you can't be bothered to stop at a service station and put in the fuel and oil that automobile needs? You absolutely have to give yourself enough sleep and proper food at regular intervals to help avoid any unnecessary stress in order to meet even the ordinary challenges of everyday life. When you learn to stand up for your own rights to remain healthy, you will automatically become much more able to advocate for your patients' well being. You worked too hard to earn that nursing degree to gamble it away on a bad decision you might make because of fatigue or stress.

Whoaaaaaaaaa Nellie!!! Well number 1. You can NOT clock out and continue to work. This is against National Labors Board, or some such group. No one should ever tell you that this is okay, because it isn't. It sounds like you have management problems and those types of problems have to be solved by their higher ups. It is VITAL that the management is very supportive. You have a wound nurse who won't do txs? Um, Um, why is she there? This is not ethical in my opinion but your management is allowing this to happen, that is if they're aware of it. Does your manager's boss know? It IS very hard to get it all done in 8 hours, and when your having problems you need a person who is willing to step up and help when needed and you ask. You should be able to ask your DON for help and she should give it or find help for you. This can happen if you have a good DON/manager. SEEK DIFFERENT EMPLOYMENT!!! girl....

If you don't want this, try talking to your DON again, if no luck, talk to the administrator, if no luck, talk to your corporate human resourse person. I also value my license and I worked hard for it. On the other hand, it's only been 3 weeks, you may want to give it more time. Don't focus on what others have done or not done but focus on your job and what good things you have accomplished in those 8 hours. I realize it is hard to do your work when you feel like you don't have the support of others. But remember, keep plugging along and keep reporting what you see or hear, and remember do this in writing and keep your own log. (I do). The squeeky wheels almost always gets the oil.

Great answer!!!!!!!!!!!!! :yelclap: :yelclap: I work in a LTC and when the OP described her problem, my answer is to get out of there. That management will never change their tune!!

Reading this - and all the other posts here - plus my own experience in the past few months has shown me a whole lot - the guy that invented nursing homes should be run over by a truck!:lol2:

I remember a supervisor that I had at the hospital saying one time that she couldn't wait to retire and have some nice little low-stress job in a nursing home. That's what gave me the idea to go to work in one. Never DID like her.:uhoh3: :D

LOL!!:rotfl: :rotfl:

i know what you mean about the DON (i love her dearly). we had a med-aide call in one day so she had to pass the meds and the ADON and the MDS coordinator !!! All three of them and still the pass was out of compliance because of time. sorry just had to say it. After that for at least a week or so they appreciated all of us just a little more. :lol2:

That is great, however if one does not pass meds on a regular basis it is hard. You pick up speed with each pass. If I were to pass meds now, it would take until Christmas till I was done.:smackingf :smackingf

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