I love my job as a hospice nurse. I usually get to go to patient's private homes and treat them there. Within the last couple of months I've been asked to work in our local LTC facility and team-treat patients there in addition to my home patients. Our hospice is not affiliated with the LTC other than we have a contract to also be able to come in and treat patients in their facility. From the beginning the social worker, the DON, and the nursing staff have been adamant that they neither need nor want hospice to set foot in there. They claim that they are doing the same things we do, so what's the point? NOT the case, by the way, but I degress. Every time I see a patient, many of the CNAs, nurses, etc. have been outright hostile and harrassing. I have had my patient records I've brought in mysteriously 'disappear' (found them again, thank God, but had a heartattack). I've had nurses point blank refuse to help me find anything, waste meds with me, or give me access to medications stored in the facility. I've had the DON tell a physician that I didn't write down any of her telephone orders when I had written them AND taped them in the facility's chart. And physician told me "I can't give the orders to you, you don't write them down." So I had to track down the DON to take the orders. I've had the DON tell me that orders from our hospice medical director are not 'valid' in their facility. I've had the assistant DON call my boss and say I told a family to pull oxygen from a patient, when it was the daughter who got it into her head that it needed to be done, and she was POA, AND physician tried to talk her out of it, too. RNs have refused to give PRN morphine because mostly unresponsive patient didn't 'look' like he was in pain (with a BP of 130/75 and grimacing).....and DON directed the nurses not to give the morphine AT ALL, period, the list goes on.
Today was my personal last straw when I had one of the RNs call me to ream me out because she had to call a physician to get an order for one of our patients and I wasn't 'doing' my job as that was not HER job. Excuse me? Who sees the patient 12 hours a day? If patient has a pain crisis at 0700, when I am not yet at work, then it IS YOUR job to call the physician, especially when physician WILL call back the LTC but not the NURSE from hospice......(have left numerous pages for said doctor, nada...zip...zero). My hand hurts from all the documenting I've been doing, but I am at a loss how else to handle this. I spend 3-5 hours of my day dealing with the documentation and crap from this facility, almost daily at this point. So what else should I do? I'm about to have a heart attack from the stress of it all. Any suggestions would be appreciated.
kcochrane
1,465 Posts
Same here.