I need to blow off some steam

[Hondamom24]

and hopefully this is the right place..

I work at an ECF for MRDD. Love the people, can't stand my co-worker. She's been there longer than I have, and feels she owns the place. Whatever. I'm just there to do my work, and get along.

We are having a ******* war over, of all things, the med cabinets.

She does not read the MAR (has all of the meds memorized, and just punches from the cards without looking) so it doesn't matter to her if the cards are in alphabetical order. Those of us who do follow the MAR (because we're supposed to? because med orders change?) have to pull out cards and re-alphabetize them continually.

When the new meds come, we both have different ways of restocking the cabinets. Since she never gets this done, I do it myself. I don't mind. I check the invoice, make sure it's correct, sign/fax to the pharmacy and stock the cabinet. She doesn't like the way I do it, and redoes it.

I put all of the new meds at the end of the resident's cards, and pull out the new meds as needed. She puts the new meds right behind the old meds, turned backwards, so the bubbles jam up with each other when you pull out the cards. Since she doesn't pull out cards, or look at what she's giving, it doesn't matter to her. Since I pull out cards and look at them, it's a pain to have the meds stuffed in the drawer and have 4 cards come out at one time because the cards catch on each other.

Whatever. It's her time she's wasting, and I don't care. Until this month.

We got the new meds, and I restocked the cabinets. She decided she didn't like the way I did it, and TOOK ALL OF THE MEDS OUT OF THE CABINETS. Not only did she take them out, she put them in boxes, and hid the boxes. She will, apparently, stock the cabinet her way when she feels like it.

However, I am running out of meds on my shift. Aside from taking them from AM meds, or taking meds from another resident, I am out of at least 1/4 of the meds I need for people with seizures, heart disease, schizophrenia, bipolar disorder - you know, the little things in life.

There are only the two of us who pass meds. This is childish and ridiculous. She has made comments about me to all of the staff members, and the supervisor, and never said anything to me. Our supervisor just told me to not waste my time stocking the cabinets, but had no answer on what to do when I run out of meds and they're hidden in a box somewhere. As it stands, I'm circling meds I am missing and noting that there are none in the cabinet, but in the end, the residents suffer, and I am the one who appears to not be doing her job.

I know, short of her quitting, there is no way to work this out, but I had to get this off my chest. Thank you for understanding.

[mama_d, BSN, RN]

Can you take it any higher? Since you're not getting any support from the management you've spoken with already?

This is something which has the potential to seriously impact patient outcomes. What if someone seizes and has a permanent increase in disability due to hypoxic brain damage? What if someone strokes because they haven't been getting their BP meds? If, God forbid, something like that did happen, I'd be afraid of being included in the lawsuit. Family would be wanting to know why you didn't do more to ensure that meds were given, especially if it's all over a personality conflict.

What about doing an incident report for every missing med? Not even where you cast blame her way, but just documentation that they were missed to raise flags for someone to officially investigate? Oh, and I'd be sure to call the MD to let him know about missing meds. Once he/she finds out multiple residents are missing multiple meds, it may be enough to force a change.

Not to scare you unnecessarily, but there was a case recently in our BON newsletter where multiple nurses got their licenses put on multi-year probations due to unadministered meds at a nursing home. One of the patients involved had a MI and died, which appeared to be the trigger for the investigation by the state BON. You want to do as much as humanly possible, leaving a paper trail to back you up, so that when the crap hits the fan your license will be protected.

[Ginger45]

Oh Geezz......why do these people go into nursing? Do they not care that they are putting lives at stake??? I was just recently in a situation where I didn't get along with the DON. I was the Director of QA. She was a witch. I hated the way she treated people. Power was all she cared about. The day after thanksgiving I came in and the nurses were in tears. On Thanksgiving there were 4-5 3-11 positions that she didn't even attempt to fill. They had to stay over. I was sick. I did my best to fill the blanks for that day, made sure they had supplies and I did talk to the asst administrator. Monday, she came in ranting and raving at me that I was undermining her. I hadn't said anything about her. I just covered. She got really nasty verbally with me, coperate was coming down, so I walked out. I couldn't be a part of that. There was no solution, I had already gone over her head.

I know this situation is different then yours but I if your boss will not do anything, I would go higher. Be prepared though to look for another job. It might get worse. You can't be in a position where you can't take care of your pts. I hope for your sake that it works out. Hugs. ginger

[Lovetobenurse]

I taught for a second,do we work at the same facility? no, but my story and yous are similar and I can't even think about where to start. I feel your pain.MY DON tells me that it is the way I appraoch people that make them not want to be part of the team.I wonder who's got in midle? the patient.My DON also tells that we are human and we make mistakes.Just do your best for your patients sake. I am glad to know that I am not alone.

[Ginger45]

I have alot of experience in long term care facilities. I have only worked in a few that really cared. Thats one reason I am doing something different this time. I can't do it anymore. I am also trying to go back to being a surveyor. It's really a matter of protecting your license. If you are not giving medications because they are not available you are putting yourself at risk. There is really no amount of documentation that can save you if you are knowingly not giving the medications. I have worked as an LPN in these facilities before I was an RN. Unfortunately, you have to push the issue to protect your license. I could not in good conscience stay there, knowing what was going on. There was alot more to it. There were other things that she did that I was shocked by. Yes, the poor patients are caught in the middle. That is why you have to stand up for them at all costs. They are the only reason we work there. I became aware that day of other issues that were going on that I could not ignore.

We are all human but making a mistake and knowingly making a mistake are two different issues.