help me KEEP my license plz?...

[rickysyfee]

Hi all!

I work at a nursing home and the work load is really heavy and the job sucks (to put it lightly)

The DON has posted signs that say we MUST clock out within 5 min of the end of our shift and whatever is left to do we should leave for the next shift. I say--- but I still need to chart!

She has also said that the nurses should stop passing meds to pass trays at meal times

and basically do anything that keeps the pts quiet

The dilemma to me is LEGALLY

I believe I am responsible for the safe administration of the meds NOT THE FOOD -I think the food is the facility's responsibility or it is HERS.

If I stop passing the meds to pass trays and feed and they are all late LEGALLY I should be filling out 50 or 60 med error sheets right?

I also feel that they (management)will verbalize this stuff but wont put it in writing to cover themselves and if something happened I WOULD BE ON MY OWN...right?

I also feel that charting is a priority to cover myself so despite what she says what should be a priority for ME?

I know I gotta get another job.....workin on it

[caroladybelle, BSN, RN]

Been there, done that.

Change jobs!!!!!

[ohmeowzer RN, RN]

you need to quit.. get out...

[helikias]

You can't change your employer -- I tried that, and it does not work. You must find a new job or you'll be miserable! Good luck to you!!!

[Batman25]

Give your meds and keep charting until you find another job which you need to do pronto. tthey will hang you out to dry if something happens and someone sues. Protect your license.

[nursinger]

Where is dietary that they can't be passing their trays? No. You do your meds and your charting and let the DON have a hissy fit. You need to protect your license. If something happens, do you think the DON will back you up??? Heck no! Don't worry about the DON, you CYA!

[lindarn]

If you have any documents from the DON, where she states the above riduculous demands, make sure you save them. It is called evidence.

Complete your work, don't punch out, and keep track of your hours. If you are not paid for them, report them to the Labor Board Pronto! JMHO and my $0.02.

Lindarn, RN, BSN,CCRN

Spokane, Washington

[dannyc12]

My facility pulls the same nonsense. CNAs and floor nurses pass and collect food trays, room trays and drinks while residents are ignored in their rooms.

A while back we had a state inspection focused on charting and documentation - and the facility got reamed. Pain med charting, skin checks, turning and positioning logs, weights, and other items were not being charted. However, nurses were punching out on time.

So they had their BS "staff education" as a way to clear the tags. They "trained" the CNAs and the nurses at the same time. The Staff Education drone, "Carol," went through all the stuff that had to be charted "before the nurse left for that shift."

An astute LPN asked, "Carol, what happens if I need to stay late to get this charting done?"

"Then you have to stay longer - this HAS to be done or you will be breaking the Vulnerable Adult Laws," Carol replied.

I'm pretty sure I visibly rolled my eyes at that one because I knew what was coming. Within two weeks, the Assistant Director of Nursing was writing up every single nurse on the TCU floor for punching out late so they could do their charting. Meanwhile they keep bringing in more acute patients while RNs and LPNs continue to be forced to do the work of dietary aides.

What a freaking joke. Truly.

This is going to catch up to my facility. There was recently a death on another floor that stemmed directly from them bringing in patients who need a lot of care and then purposefully NOT staffing for them. A guy in his 20's with traumatic brain injury and a documented history of yanking on his trach. I'm not even sure when they finally figured out he was dead. The family is incensed and the facility is going to have a hard time getting away with letting him die.

I see how they are trying to though. Suddenly, a whole bunch of ambulatory and independent residents began showing up on the TCU. Where before all we got was total care quadraplegics, hemiplegics, and TBI residents we all of sudden started getting chronic drunks, addicts, and leg fractures. Many of the total care patients somehow found other places to be (if they weren't miraculously so acute they got shipped to the ER with no real change in status that anyone can recall.) Apparently, the DON and ADN found their stethoscopes or something a mysterious breakout of pneumonia occurred.

They are going to keep the semi-independent and ambulatory lower care residents around until the state gives them another green light for medicare reimbursement and then bring back the total cares.

I am so glad I am out of there.

All you can do is stick it out until you can find another job.

[diane227, LPN, RN]

You need to complete your work on the clock because it is your legal and professional obligation to do so. In addition, it is your responsibility to administer medications on time and in a safe manner. Were I in your place, until I could find another job I would write her a letter stating the following

DATE:

TO:____________

Re:_____________

I understand from your (memo, meeting, or what ever it was) that you want us to make the meal pass a priority. However as a professional nurse I feel that it is my obligation to assure that patients get their medications on time and in a safe manner. This unfortunately is in direct conflict with your expectations. As I will be held accountable for the administration of these medications under the nurse practice act for the State of ______ I am informing you know that I will not be able to comply with your request regarding the meal pass.

In addition, as you are aware, the patient load is quite heavy and I am also legally responsible for assuring that documentation entered into the medical record is correct and documented in a timely manner. This work cannot be left to the next day. Given the nature of our work here, there is little time to complete the required documentation during the shift. The end of the shift is the only time that I can complete my charts which results in some overtime. At this point there is no way to avoid this. I understand that this results as an additional expense for the facility but until another system can be implemented that will provide me with time during the shift to complete my documentation, I cannot see another way to accomplish this task.

Please contact me should you have questions or need additional information.

Sign with your name and professional title

ALWAYS KEEP A COPY OF EVERYTHING YOU SEND TO ANYONE.

DO NOT CLOCK OUT AND CONTINUE TO WORK. THIS IS ILLEGAL.

If she has a conversation with you regarding this, take notes and note the date. If she gives you a memo, keep it.

Remember, you are taking a chance here. But you have the labor law and the nurse practice act on your side. Your responsibilities are clearly defined in the nurse practice act. If you do not have a copy of your states nurse practice act, go to the web site for your state and you should be able to download this document.

Good Luck

[gladiola]

Diane, thank you so much for taking the time to share that sample letter with us! I hope I may never need it, but if I do, I'll know where to go!

[diane227, LPN, RN]

Your welcome. You gotta stand up for yourself.

[skittlebear]

Great letter Diane, I will save this just in case. Hopefully I will never have to use it.