Going to be fired?

[Meridian2]

Hello I need advice I am in a terrible situation. I have been a RN for 3 years now just transitioned from hospital for a long term care position. It wasn't my choice but I am per-diem at the local hospital and couldn't get full time. I only work there one weekend a month but they keep hiring new grads instead of giving me more hours

I started skilled LTC position 2 months ago evening shift. And it is not full time but 3 days a week and no weekends yet. I only got orientation for 2 weeks and it wasn't enough im afraid. Its too busy and Never slowed down at all. I get everything done really late and I don't have time to follow up on every single thing that day shift didn't do so then I give report to the night nurses and they give me attitude because I didn't get everything done. I don't understand because night shift isn't busy at all they don't do much so should that shift be the ones to follow up on left over stuff?

They do not ever follow up on anything either. I feel like I am drowning and being a target. 2 of the night nurses went to my manager when I was just off orientation and said that I leave things out of report all the time and thats a lie. There was only one time that I left out information but I was honest. My boss said to me "even just the one time was dangerous." I think it was a honest

mistake but not dangerous. It was a patient's endo appointment changed to be the next morning and I forgot to tell the night nurse to pass onto the day nurse. So the patients transport came and no one got the patient ready so the patient did not have time to eat and they are a diabetic. They got a snack to bring with them so they were ok. I apologized to my manager.

I got a verbal warning for that and begun to do better but then a week later the same two nurses said to my manager that I always leave the cart a mess, that they find pills in the cart all the time. They told her they found 1 unused syringe with insulin in it that I signed for. I should not have signed before I gave it. I was going to give it but it got too late and I got sidetracked. and then the night nurse came and she wanted the cart keys. I said "I just have to finish something" and she insisted I give her the keys and said "last night I waited 15 minutes"

My manager asked me if I am giving all of my medication or if I am just signing that I did. I told her I am giving everything and that I must have left refused pills in there. Then yesterday my manager called me and said that a patient who is AAOx3 told her that I gave all her 5pm pills with her 10pm pills. Yes I had to do that because there's not enough time!!! I have 18 patients!!!

Maybe if they had more staff or made some of the 10pm pills to be given after 11pm the night nurses could give them and there would be more of a balance! I used to work nights as a sitter in the hospital before I was a nurse! It was so easy that it was boring. My manager is siding with the 2 other nurses and even my evening nurse coworker said its notright! These night nurses are a clique and if you make one angry they all hang up like its high school. We are going into the next schedule period and I called my manager and asked why I am not on the schedule and I am meeting with her tomorrow. I asked if I am fired and she said no so I don't know what this means. I am scared and I feel betrayed and horrified. Has anyone been through workplace bullying before?

[Wake88, BSN, RN]

And some say nurses don't eat their young.

Meridian, from my personal experiences there are nurses out there who are willing to give you advice while not, at the same time, try to cut you down. Frankly I do see it here: don't think you're that subtle.

Speak cordially with upper management at your facility. If 18 patients per nurse is too much it may be a better option to find a facility that offer 6-8 patients per nurse. A facility with a safer ratio will help you, and put your license at less risk. If I were you I would speak with people and see if there are facilities within range with safer ratios.

[enc123]

Im sry I got defensive I wrote this here cause I'm crying my eyes out I thought someone else could give me good advice and say they went trough it too

You have gotten excellent advice the problem here is you don't want to hear and except it. You only want people to agree with you but by your comments and response to others you have proved yourself to be incompetent and won't take accountability for your actions. This is really sad and I read each post and stayed quiet for a while but I can no longer continue to do so. You have come here and insulted fellow nurses and insulted those who didn't share your opinion. You have a long way to go and a lot to learn.

[NotAllWhoWandeRN, ASN, RN]

1. Take responsibility for your incompetence and inability to efficiently manage your time.

2. Stop blaming other shifts when you admit you leave work for them.

3. Learn the grave and citation/fine worthy effects of combining the 5pm and 10pm medication passes. Yes that can cause a fatal drug error. You clearly don't understand that.

4 lower nurse to patient ratio in the highest acuity patient unit is not easier. Your responsibility for those two to three critically ill lives will be tenfold of what it is for your relatively stable 18 patient load. It will easier to make a fatal drug error with a critical patient if you are inefficient and disorganized.

5. Night shift isn't easier or less work. It's different. It's no extra support. Less aides. No pharmacy. No therapists. No managers. No family. People like to have medical crises on overnights. You need to be skilled, efficient, accurate, trustworthy and organized to be successful on night shift.

6. Consider looking into books or online measures for executive functioning deficits. Poor time management and disorganization plus forgetfulness will destroy your career. You can learn to self modify and accommodate. Brain sheets, to do lists, and other tools can get you on track once you admit you need help and stop blaming the other shifts for their seemingly valid complaints filed against you.

7. Know you would be up a creek without a paddle and risk a formal BoN complaint if that patient you gave the 5 & 10 pm

Meds to because you are inefficient reported you to the state ombudsman or LTC inspectors. There is no excuse and to assume others cut corners and hide it better is a bad mindset---again refusing to accept responsibility for your own shortcomings.

8 rather than assume overnights is "easier" (very doubtful plus you need strong critical thinking skills, applied knowledge and the best time efficiency and organizational skills) Ask for a preceptor. Ask to shadow an efficient nurse on your day off. Take notes. Learn what tools the efficient nurse uses to stay on task, efficient and organized. Google LTC brain sheets and to do lists. Find what works for you.

9. calling a neurobiological condition fake to insult a person giving you a reality check is very middle school and is not only unprofessional but very juvenile. Check yourself before you start throwing stones when you don't like the answer. You owe a legitimate apology for your personal attack b

I'm trying very, very hard to bite my tongue (started out with a great deal of sympathy as my first job in LTC put me through heck, but lost that with "everybody cuts corners" followed by personal attacks and serious reading comprehension issues) so I'll just say "What she said."

[roser13, ASN, RN]

And some say nurses don't eat their young.

Meridian, from my personal experiences there are nurses out there who are willing to give you advice while not, at the same time, try to cut you down. Frankly I do see it here: don't think you're that subtle.

Speak cordially with upper management at your facility. If 18 patients per nurse is too much it may be a better option to find a facility that offer 6-8 patients per nurse. A facility with a safer ratio will help you, and put your license at less risk. If I were you I would speak with people and see if there are facilities within range with safer ratios.

Please get over the NETY gripe. It's old and vastly over-used and thus automatically makes most of us disregard anything that follows.

i did, however, read on and must question your ability to speak to "safe ratios." From what I read here, 18:1 is about the "safest" LTC ratio around. Usually we hear about 30:1 or even 50-60:1. So please respond only to issues about which you are knowledgeable.

[BuckyBadgerRN, ASN, RN]

Go away with your sad, tired cliches. Op is not a new nurse, so it doesn't even apply. I'm not sure what nursing advice you can offer op anyway.

And some say nurses don't eat their young.

Meridian, from my personal experiences there are nurses out there who are willing to give you advice while not, at the same time, try to cut you down. Frankly I do see it here: don't think you're that subtle.

Speak cordially with upper management at your facility. If 18 patients per nurse is too much it may be a better option to find a facility that offer 6-8 patients per nurse. A facility with a safer ratio will help you, and put your license at less risk. If I were you I would speak with people and see if there are facilities within range with safer ratios.

[CelticGoddess, BSN, RN]

I will ask if I can switch to someone for night shift I will have more time to get things done and learn easier things.she is going to talk to me about a plan so I'll tell her I accept the responsibility and I will do ok on a slower pace on night shift

Night shift is NOT slower paced in a lot of situations. I work nights (have for 5 years) and my shifts are very very busy. I don't work on a unit either. My last shift, I spent most of it trying to get a pts blood pressure up, while arguing with the doctor to get him off my unit, all the while caring for my other 4 patients. My other pts were not exactly easy either. 2 on IV abx, one dying, one just very needy. This is the norm for my floor. Again we are not a unit.

We have fewer resources available to us, fewer people available to help us out, no secretary (we have to put in our own orders) and guess what, pts don't always sleep at night. And there are nights I don't get my full assessments in until 7am. It's busy.

Please reconsider the unit. The only nurses I know that have only 1 patient, have a patient on the vent, with multiple drips and they don't really leave the bedside all night.

[JustBeachyNurse, LPN]

LTC does not offer 6-8 patient to nurse ratio more common is 1:30. 1:18 sounds more like subacute

This is a vulnerable population. The fact that you are pulled of the schedule but not yet terminated may need suspension, probation, training & performance improvement contract.

Giggle LTC brain sheets walk in prepared as to what support you need to improve your organization, your time management and your your efficiency. Focus on what you need to improve your nursing practice.

The nurses likely tried speaking to you but you may have inadvertently brushed them off forcing them to escalate to management for legitimate safety concerns

Of course the Goodwin law and NETY accusations in response to the much needed reality check for the OP. Nice touch. Especially since this is NOT a young nurse unless of course you are referring to the personal attacks allayed by the original poster.

[Wake88, BSN, RN]

Please get over the NETY gripe. It's old and vastly over-used and thus automatically makes most of us disregard anything that follows.

i did, however read on, and must question your ability to speak to "safe ratios." From what I read here, 18:1 is about the "safest" LTC ratio around. Usually we hear about 30:1 or even 50-60:1. So please respond only to issues about which you are knowledgeable.

Stay classy.

The saying that nurses eat their young is absolutely true for quite a few nurses. I've seen it first-hand in my experiences so I don't need someone like you trying to pretend otherwise for whatever reasons you have.

Now if you were as intelligent as you are arrogant you would know that I'm advising Meridian to find a facility that offers a safer nurse to patient ratio. Since she's a nurse she doesn't have to be confined only to LTC, which means there are non-LTC facilities that actually offer lower ratios, between 6 and 8. How do I know? I work at one. Sub-acute facility with rehabilitation is an option, and they may indeed have a better ratio.

So, before you have something to say, please respond only to issues about which you are knowledgeable.

[JustBeachyNurse, LPN]

And some say nurses don't eat their young.

Meridian, from my personal experiences there are nurses out there who are willing to give you advice while not, at the same time, try to cut you down. Frankly I do see it here: don't think you're that subtle.

Speak cordially with upper management at your facility. If 18 patients per nurse is too much it may be a better option to find a facility that offer 6-8 patients per nurse. A facility with a safer ratio will help you, and put your license at less risk. If I were you I would speak with people and see if there are facilities within range with safer ratios.

No LTC has a 6-8 patient ratio. That's acute care medical surgical.

[Meridian2]

I never said you are going to kill people.

Your words don't offend me. Go ahead and keep reading my posts if you want I dont mind, but it's not gonna help you. I hope you can realize your wrongdoings and learn from them. The things you mentioned could get your nursing license taken away. And you could seriously hurt someone. You need to seriously reflect on yourself and how you handle stress. Gettinf organized and managing your time better will help you in any situation, especially at work.

Thanks to overcoming my "make believe" ADD I learned a thing or two about that.

Its that your pity full way of saying sorry? You are a liar yes you did say I would kill icu patient. It's in writing go look. I am a lot older then you I have wisdom and critical thought you dont you dare tell me how to be a better nurse and handle my stress after the hurtful words you said. I don't need to self diagnose myself with adhd to gain sympathy

[MaxAttack, BSN, RN]

no the hospital is going to give me more hours when a position opens in icu.they only have one patient so it will be a lot easier

I never said thats being night nurse is a slice of cake. But ur not as busy as me. U have 3 meds to give.the rest seems like technical stuff with the machines and charts.

There's so much wrong in this thread, but these two nicely sum up the problem.

[Meridian2]

Op, I'm sorry things are this way.

It really sounds like the LTC thing is really not suitable for you. It is what it is. I dont think your coworkers are ever going to let anything slide ( which they shouldn't anyway). Since the job is a struggle, why would you even want to stay there? I sure wouldn't want to.

The icu thing- very very unusual to only have 1 pt, and if they are 1:1 usually they are with 8 drips going, etc. Glad some people do this for a job, but I wouldn't want that responsibility unless I was well versed in it.

Unfortunately , I hear lately 3 is the norm in icu. So not safe.

Maybe something office would be better

Good luck. Sometimes we have to accept something is just not for us.

I am on suspension a waiting to see if they give another chance. I have been drinking a little bit of wine to calm down. Thank for not being rude