Going to be fired?

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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?

Specializes in Pediatrics, Emergency, Trauma.
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

This person again, DID NOT state you would kill a patient; if anything gave sound advice and you keep attacking this person when you are WAY out of line.

Here's the original post that stated such:

Since when is ICU "easier"? You can't remember to give a diabetic their insulin but think you are cut out for ICU. Also many ICU ratios are now 2-3 patients per nurse, there's not many 1:1 left and the few left are fading fast.

For someone who supposedly has 3 years experience, you have a lot of learning to do. I pray you don't kill someone in your negligence one day. I really don't understand the thought process of someone who thinks critically ill ICU patients are "easier".

So STOP targeting this particular poster and attacking this poster that you seem to be fixated on in an unhealthy manner; stop deflecting the fact that your errors, in reality can potential kill a patient unless you modify your practice; that's not being mean nor rude, that's being honest, especially when med errors are one if the leading cause of death in the US-keep that in mind when you need to practice safely and prudently.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
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. ;)

Smaller ratios mean higher acuity. Nursing in any area requires competence and time management skills. The troubles faced by OP are not likely to be area-specific. Giving her sunshine and daisies might perk her up for 5 minutes, but she's going to keep having the crappy experience she's having now.

People have taken the time to give her well thought-out advice. Unfortunately, well thought-out advice isn't always fun to hear. We'll eventually get back to what we were doing, and those who want to pick online fights can keep trolling.

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I've worked with many cringe-worthy nurses who can be compared to the OP.

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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. ;)

i dont work in subacute right now I amlong term care. I give injections and oxygen treatment and PO pills. Mayb the rehab could be a fit forme thank you

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Specializes in LTACH/Stepdown ICU.
No LTC has a 6-8 patient ratio. That's acute care medical surgical.

Correct. However, I did not say that. Meridian does not have to work LTC. She can work in any kind of facility. Not all facilities have 18:1 ratios. Sub-Acute Med-Surg/Rehabilitation like I am in has 6-8 patients per nurse. She can try that, and it may be easier to juggle.

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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

No no she didn't! Bugya 90 is the one who said that. Care to apologize to Where'sMyPen?

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
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

Oh. OK then. Never mind. Have a nice day.

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Specializes in Complex pedi to LTC/SA & now a manager.

Your personal attacks against other members not only violate the site terms of service that you agreed to but destroy any credibility and microgram of professionalism that you may have held on to. Be prepared for more than you think if that AAO patient filed a formal complaint about your five hour medication error. Those errors are not taken lightly by state investigators and the center for Medicare and Medicaid services.

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Specializes in Med/Surg, Ortho, ASC.
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. ;)

:sarcastic: You should stop while you're kinda-sorta still ahead (not really). Anyone who puts acute-care ratios in the same category as LTC/ALF/sub-acute ratios really should not participate in this conversation.

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Specializes in Complex pedi to LTC/SA & now a manager.
Correct. However, I did not say that. Meridian does not have to work LTC. She can work in any kind of facility. Not all facilities have 18:1 ratios. Sub-Acute Med-Surg/Rehabilitation like I am in has 6-8 patients per nurse. She can try that, and it may be easier to juggle.

She has only a per diem shift in the hospital and if the hospital is affiliated with the LTC she may lose her opportunity there based on these critical errors. Sometimes I'm sorry and honesty is not good enough. If she marked that she administered 10pm medications on time but confirmed the patient complaint that she actually administered the medications at 5pm that is document fraud. Grounds for termination. So is falsely charting that she administered a high alert drug insulin and in fact "got busy and forgot" leaving a loaded syringe in the med cart to be found by the next shift. If this is a Medicare case and fraud is founded this can escalate and result in her being barred via the OIG exclusion list which means she cannot work for any facility or company that accepts Medicare or Medicaid. Is it common that two fraudulent medication documentation errors result in OIG exclusion no, but it is possible.

This is NOT eating a 3 year old nurse not suited for LTC or likely the faster pace of acute care based upon what she revealed here but a reality check so she can see what grave results (aside from patient harm) can occur from 1. Taking short cuts and 2. Not knowing what you don't know.

She may need to return to ALF.

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Specializes in Complex pedi to LTC/SA & now a manager.
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

Based on your misdirected vile unprofessional personal attacks you may want to back of wine. Wine is not a simple sedative. You continue to perseverate and attack the wrong poster.

You are suspended. You may not have another chance. If the state audited and interviewed residents as they often do prepare for the worst.

Prepare a targeted performance improvement plan if given the opportunity

If terminated for cause--documentation fraud with regard to medication administration check the BoN mandated reporting guidelines for your state.

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I work in a SNF that has a LTC side (two hallways=60 pt total) and a subacute/rehab side (also two hallways, 60 pt total). There seems to be no difference in acuity level. All of these pt have IVs, piccs and midlines, Shiley caths, wound vacs, trachs, surgical incisions and drains, IV ABT, hip fractures, neck fractures, back fx, g-tubes.. Literally no difference in workload or required skill level when I float to either side. day and evening shift has 4 floor nurses and a supervisor. That means floor nurses get 30pt each. Except at night, floor nurses get 60+ each. we also only have 4 CNAs in the whole 120bed facility at night. So rehabs and subacute are not always better than LTC, not where I am anway. Always do research before accepting a job.

18 patients is a very good ratio for just PO and injections.

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