Got written up AGAIN

[Justliving00]

So today, I get written up AGAIN!!! & for what this time....

Here's my story, I have been working at this LTC facility for 8+ yrs (3 yrs as an LPN & 5 as a CNA), so I work 80 hrs biweekly on 11-7 shift. I have 60 residents all to myself.....yes 60! But I don't let that stress me out, I have great time management skills, my meds are always passed out in a timely fashion, my notes are completed, my patients are kept safe, etc. But no matter how great of a job I do my best still isn't good enough.

When I have off a day, and then I go back to work, the nurses are always complaining about the nurse who filled in when I have off because my co-workers and patients appreciate me is what I can say. However, over the weekend, when I'm getting report from the previous shift, it's like they are always passing something on to the night shift, like I'm just sitting on my ass all night. Mind you, with 60 patients, the CNA's are always calling out, bad enough they are always working short.

So with all this being said, as I got report, it stated that 5 different resident's needed UA C&S (urine specimen)....again they're working short, plus I have a ton of high-risk fall patients.....so as the aides were doing their rounds, I delegated to them the "pee samples" I needed, and out of my 5 patients I was able to retrieve 3, 2 attempts on the other 2 residents were unsuccessful, but many attempts were made. so I had to pass it on to the next shift.

So while leaving work, the Unit-Manager called me into his office and wanted to know why I wasn't able to obtain all 5. I kindly explained to him how my night went. All in all, he started shouting and wasn't trying to hear anything I had to say. He's telling me abt my job description and how I am responsible for checking labs (which I did) and I am responsible for obtaining urine samples (no excuses!) I explained to him that a bed pan cannot side under a resident for a whole shift or a urinal between someone's legs...but every two hours my aide attempted again (and they may have wet the brief in the time between, but an attempt was made), so since I continued to explain myself instead of just agreeing with him, he then writes me up and tells me to sign the write up, I said NO, and refused to sign.

He said to him, that he's always coming to me telling me about what I DIDN'T DO, what about all the things that I DID DO, it's never good enough, he then says "Oh well, if you tell as though you aren't appreciated, then take it up with HR!" ......the thing is he has no idea how my night goes, I come into my nursing station looking a hot mess, trash filled up to the top, meds are all over the station that they didn't put away, papers everywhere, their work incomplete, then I gotta do their work and mine.

When I vented to him in the past, it went in the ear and out the other. I just have this confidence, because I know that I work harder than the other shifts that he always takes up for. When I receive report, the nurses be like, oh well, they have 30 patients each, so they didn't have time to do so and so, and just pass it along, but what about my 60 pts I had, I did the best I could.

So after I refuse to sign the paper, he just kept saying I MUST get this and that! So I kept asking him, what on the other shifts, the pt don't pee? He just said worry abt your shift. I make attempts whereas day and evening shift don't make any.

So I made a copy of the write up paper and went downstairs to speak to my DON about the situation. the DON and I spoke for abt 30 minutes, I explained to him the situation, and long story short, I feel as though he sided with the Unit Manager. the DON was explaining to me that the UM has a stressful job position (but like my position isn't stressful), I gave an example to him that on day shift that pts have toileting schedule...why wasn't the urine obtained then or on evening shift, they have toileting times, why wasn't it obtained then? They don't make any attempts that's why, they just pass everything on to night shift, I was so upset that I cried in front of the DON (and it takes a lot to make me cry) but I was pissed, especially when I go above and beyond!

I normally don't take my problems home, but I thought about it all day that I only slept for one hour after working night shift, and it's now evening, still haven't slept, I just feel as though right is right and wrong is wrong, they have their picks with coworkers (when I know who the horrible nurses are - sorry to say) but since I'm not in the IN crowd, oh lets write her up again!

Someone told me along time ago that "A Piece of Mind has No Price!" - so with that being said, I just finished writing my 2 week notice (it's really a month notice)....since my best isn't BEST enough, I'm going to step down from my full-time position and go part-time (I be missing my bed anyway).... I'm the best nurse to ever run that floor! but lets see how that floor runs without me....

Sorry to vent for so long, just had to get this off my chest.... this just gives me more motivation to focus on my studies and be well rested while doing so.

[VANurse2010]

Does anyone else think that crappy staffing is leading to the need for FIVE UA's for possible UTI's all at once? How can proper peri care be provided to 60 residents with not enough CNA's/nurses?!

You are correct. While 5 UA's may not seem all that much, imagine all the attention that limited CNA staff was giving trying to collect those instead of keeping people turned and clean q2H. That's an example of how dumping your work for the next shift can negatively impact care.

[hppygr8ful, ASN, RN, EMT-I]

You are correct. While 5 UA's may not seem all that much, imagine all the attention that limited CNA staff was giving trying to collect those instead of keeping people turned and clean q2H. That's an example of how dumping your work for the next shift can negatively impact care.

That's why we went to the straight cath and our manager advocated to the docs that this was the best way to get that sample. It's fast and easy and doesn't put an undue burden on already overworked CNA's.

[NurseBulldog]

It's clear you need more help and it's you who needs to take this up with the powers that be I would say.

Also don't you use the urine collection pads? They're not the best but it's better having a result than none.

[brandiep1982]

Ok, first let me say I have had managers and bosses that were nasty, that yelled, that were unfair... you name it. Your manager sounds like an unsavory person... to put it kindly. Even if you had been blatantly disrespectful, a person in a managerial position should have the capability to not yell at his/her subordinates. Period. That being said, as I read your post a few things popped out at me. The first was how many times you emphasized how great you are and how terrible everyone else is, and the second was all the assumptions you seem to be making about other shifts.

In my 15 years of work experience, one of the most important things I have learned is that no matter how hard I work and how little others may "seem" to work, I am not there with everyone to see all they do (you mentioned that your boss seems to harp on what you don't do rather than focus on what you do get done... maybe he isn't the only one who does this). Even if I had hard evidence that I was much better than anyone else, how would it make everyone around me feel to make sure people know just how much better I am? I mean, would you like the coworker that had that attitude? I don't think so. And people can say "well, I don't say anything, it's just how I feel"... but how people feel is expressed in how we talk to one another, how we carry ourselves. So even if you aren't "saying" you are better than everyone else, it is very likely you actually are, just not verbally.

Any challenge I come across, no matter how unfair it may seem to me, I always try to see what I can learn or how I can grow. Placing blame on everyone else stunts growth. In the end we cannot change other people, we can only change ourselves. It is likely you are being targeted, not because you are a poor nurse, but because people don't like your attitude of superiority and judgement on them.

[MissM.RN, BSN, RN]

I have two thoughts about your situation:

1. nursing is a "24 hour role". no one nurse can be expected to do every possible ordered thing within 8 hours. i mean, if the patient doesn't have a productive cough, how are you supposed to collect a sputum for culture? :)

2. urine culture and sensitivity on incontinent patients cannot be collected via urinal or bedpan. This order must be accompanied by a "straight cath x 1 for sterile sample" order. there is no way to collect a worthwhile, non-contaminated sample without it.

[ritit123]

so you are saying call and wake up the doctor for an order for a straight cath at 4am? the other shifts could have AT LEAST called and gotten an order. I worked 11-7 at a LTC facility and the RN/LPN was in charge of 98 patients. rediculous. id quit too!

I guess each faculty is different but when I get an order to collect a urine sample I clarify if they want a clean catch or a straight cath. If a doc ordered a sample on an incontinent patient I would get a cath order right away but i guess that goes back to the person who got the order being responsible for getting the sample