Please, someone tell me how to stay out of trouble and keep my job.

Specialties Geriatric

Published

...... that's all I want to know.

I work my butt off at my job, I have 54 residents to watch over, I try to do my best job 99 percent of the time at least... I really do try very hard to get my work done, get my charting done, plus just make sure everyone is okay.

Last night I received a write up... because one of my residents, a lady with known behavior issues, dementia, non-compliance with meds... just returned from a stay at a psychiatric facility... called her roommate a *****, and I didn't report it RIGHT AWAY, at 6 o clock in the morning while I'm doing my med pass, to the DON. Attached to the write up was a post it note that said, essentially, "I'll decide what your consequence is after I review your file".

I would understand reporting say, two men having a heated verbal altercation. Two women calling each other names.

Anyway.... I just would never have guessed that this was reportable. I feel like I don't know anything sometimes. I feel like I completely lack that CYA mentality. I have a hard time seeing details; I see big pictures. It's the kind of person I am.

I've been at this job almost six months and though I hate to, I've just got to find another job. I'd really love to go back to psych. *sigh* But as long as I'm in LTC, HOW do I stay out of trouble????????

I worked LTC for almost 8 years, and I never could find a way to stay out of trouble.

Mother Theresa wouldn't have been able to stay out of trouble working LTC.

The biggest problem I run into is that we need to make so many nursing judgments with no supervisor or management to consult be working this weekend and passed on the info to the oncoming nurse to monitor the situation but I dont know what protocal is for most things. There isnt a guidebook.

If in doubt, ever, call the provider. Let him p*ss and cry and moan, too bad, poor baby. He's getting paid a huge amount of money. And it's simply got to be done.

Specializes in Pediatrics, Geriatrics, LTC.

LTC seems to be a hotbed for 'getting in trouble' over the little things yet they ignore the big problems, like staffing ratios and lack of supplies. I can't seem to grasp that mentality nor do I have the CYA thing working for me. I am however learning to do that as I have been written up for the the most trivial things, (like giving a res ensure w/o a doctors order!) It's not easy.

Specializes in Cardiac.

LTC...where you are trained for a couple of days and off on your own. Whattya mean, there's a problem ? Oh, the DON thinks you should be ready for every situation when you're a new nurse? They CTA on you. Take your time and pass on what you don't get done because you usually can't be thorough with charting r/t census.

I feel the exact same way. I'm actually waiting to go into work now and am almost in tears because so much happened last night (Falls, Res:Res altercations etc) that I know something is going to be an issue. I feel like I can't walk in the door without there being some kind of issue or problem from the night before... from admin or other nurses. E.G, "There was a cup on the floor in soandsos room!" (Seriously, that's been on ongoing "problem" with one of my nurses I report with... as if I can somehow know the dude threw a cup on the floor after I walked out the door)

But to answer your question, My ADON gave me some good advice on a resident who said her "stomach hurt" but had no presentation of pain on palpation , bowel sounds active, normal BMs, and could not give any description of the actual pain. The ADON said, about any issue or concern, "Call the doctor and at least let him know what's going on. Document you did a good assessment and put her on acute charting and whatever else he wants. Always put it back on the doctor's orders to make sure your license stays safe"

So I do. And he usually sounds super confused and just says, "Monitor" And as much as some of them hate it, I notify the supervisor too and document who I talked to and what was said (not necessarily in the patient's chart but in our 24hour report book) I'm very new, very confused and feel like I'm at a total loss 99% of the time. But I do my best and always make sure someone else above me knows about a situation or problem.

It's all about CYA until things start to come together a little more.

Best of luck!

It might irritate them if it's something "small" but I'd rather be safe than sorry.

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