I'm just venting so please do not feel obligated to read this booklength post.
I had the worst 16 hours yesterday.
I was off on Thursday and as soon as I walked in on Friday (3-11pm) the DNS said she wanted to speak with me. I was a little confused because she started talking about how when a new admission comes in we have to pick up orders etc. So I was like "We have a new admit?" I'm new but that's nursing 101 new admit...pick up orders....it's not rocket science. Anyway, I told her I was off on Thurs and then she proceeds to tell me about the new resident. She closes the conversation by telling me that if I needed any medications they have an emergency box in the office so I should just call the supervisor. I'm thinking why would I need medication from the office? I should have dug deeper but like a dummy I let it go at that.
Next before I left the office she asked me if I would work 11-7am on another floor and I (stupidly) agreed even though I did a double 2 days ago. There is a lot of pressure to pick up extra shifts, typically I am asked 4-5 times per week and I say no a lot but this time I said yes because I was a little intimidated that the DNS was asking and I feel guilty for always saying no.
Big mistake.
Anyway I get to my floor where total and utter chaos are in progress. The nurse manager was off and the regular day shift nurse called in. Would you believe that before they left on the Thursday (my day off) that those two characters (I would really like to use another name) did not bother to pick up the orders for new admit? They didn't even bother to fax them to the pharmacy...they did nothing and this admit came in before 2pm. The NM works from 8-4pm and the day nurse usually stays until that time or later because she comes in late every single day.
My thinking is that they thought I was coming in and they planned to just leave it all to me to do which they have done before. It was my day off though and the nurse that came on was agency. She refused to pick up those orders and then when the night nurse came in (also agency) she also refused to pick up those orders. So our new admit had NO medications, and she has COPD and is supposed to be receiving regularly scheduled treatments, she is also on percocet and she had NO pain medication until I CAME IN ON FRIDAY!!!! *&$*&@!!
They got two staff people from another floor to work the day shift (Friday) and they "supposedly" cleaned up the mess but trust me it was far from cleaned up when I got there. The lying good for nothing SOBs claimed that they did everything dressing changes etc. Ha! dressings were caked on with tons of all kinds of drainage, obviously they hadn't been changed since the day staff left on Thurs more than 24 hours ago. The off-going nurse was so bold as to ask if I could do a 10am dressing for her because that was "only one" she didn't get a chance to do. They also only bothered to do half the admission (just the med stuff) and left all of the consults for me to do.
The incontinent residents were soaked in urine and feces. The lunch trays were not picked up and the CNAs just piled them into the 1 working water fountain. The new admit is sharing with my most difficult resident who was OOB in her WC screaming for a nurse at the top of her lungs. They swapped out Ms. Difficult's bed for the new admits (I don't know why they did this) and housekeeping had no mattress for her. Then the supervisor (lazy wench) tries to come onto the floor and push some more work on me...the pharmacy is having issues with the triplicate RXs (I have more narcs than any other floor in the building) and she is so busy maybe I could take care of it? (NO!) Also they are having problems getting the lab results (due on my day off btw another thing blown off by the Thursday people) for a Vanco trough for a resident with MRSA....if the lab doesn't call back would I be so kind as to call them and then call the doc? They took the nebulizer away from my sickest COPD resident's (who is confused and non-verbal) and gave it to the new residents cuz they were too dang lazy to get another one so they just take from those who cannot complain and give to those who might be able to get on their Cell and call the family. So that poor resident had no treatments all day shift and goodness knows for how long before that. I could hear her wheezing from all the way down the hall as soon as I got off the elevator.
The porters get me a new bed and all seems well until a CNA points out that we have no siderails. The porters try to blow me off cuz it's Friday and after 5pm but I know that if I don't get this done it will not get done by the skeleton crew we have on weekends. They bring us siderails but they don't fit the new bed and there are no more working beds in the place. They would have to bring one in from another facility and in the meantime just push the bed against the wall and use gym mats.
The drama went on and on with the bed and the screaming resident....I thought my head was going to explode. Not to mention that my back ached from changing her dressings while bending over her non-working bed while she was screaming and carrying on about everything that was wrong. To top it all off I had another shift to work? I know I wasn't duped into it but damned if I didn't feel that way last night.
I managed to survive and headed to another floor for my second shift. My goodness! I thought my floor had more than it's share of psych residents but it was nothing to what I had to deal with on the floor I did my extra shift on. Each and every single person on that floor is a psych patient....no lie and there is one registered sex offender who the CNAs advised me to watch because he might try to get touchy feely. I had the creepiest night....the overwhelming majority of the residents on the floor are male.
I was stared at all night by one male resident who pulled up a chair across from the nurses station and just stared at me without speaking. In the AM when I was doing my med pass another followed me all through the halls and kept getting so close he pressed up against me a few times and I had to keep chasing him off.
I was actually in fear for my safety on that floor and I am truly P.O'd to the point of wanting to snatch someone bald for not giving me a heads up about that floor.
I got home at 7:30am and at 8:30am I called in.
Right now I don't care if my calling in is just making things worse. I cannot face another shift in that hell hole on less than 8 hours sleep. Especially when I know that this is the day nurse's weekend off and the agency nurse who is coming in will do nothing so I
will be in the same predicament I was in last night. I cannot deal with that screaming difficult resident (of all the people who this had to happen to why THIS particular resident?) who is still lying in a broken bed with no side rails screaming, "NURSE! NURSE! Where's the NURSE? This is abuse!" when I have just left her room and haven't even made it down the corridor yet. I cannot deal with another shift with our incompetent new supervisor who is a friend of the DNS and was brought in to replace the old competent supervisor who was let go because of "nursing politics."
If you read this far thanks for letting me vent, because non-nurses (like my spouse) just don't get it.
If you DO call state, call from home. DO NOT use the facility's line. There was an incident some years back where the DON demanded that the extension used be provided to her and the (now disgraced and fired) CEO ordered IT to provide her with the records.
Remember, no good deed goes unpunished. Did I learn that on the floor!
I don't know where I am going to find another job that will work with my school schedule but I am sincerely praying that there is something else out there for me. I cannot stand working at this place anymore. I had the best day off yesterday but today I dread going back to work.
I feel for you dear! I started in LTC and remember many shifts and double shifts that were completely exhausting to say the least! Get some well deserved R and R and hopefully today will be a better day. Kudos to you for taking care of the patients that were neglected from the other staff and feel good for that! They needed you and you came through for them! That shows you care and what you did equals a great nurse! Keep your head up and feel good for what YOU have done for them!
Specializes in Jack of all trades, and still learning.
Don't do them any favors, document document document to cover your own behind with things not being done for days, and start looking for a new job!
And you may even consider filling out incident forms...
Everything you were doing was for the essential safety and care of your patient (not to mention all the others). You had to have these things done. You were not trying to be 'difficult'. I really think this should be brought to the attention of the powers that be - in a written format, so that something would have to be done now
Look for that job. They don't respect you, so they don't respect their other staff. And they don't seem to care for their patients. End result: they don't deserve you...
I hope you had a good rest and a darn good day off! I'm with you all the way for doing it under the circumstances...
Gosh, Falon, my heart goes out to you! There is NO excuse on earth for those nurses to have NOT taken care of taking off the orders, neglecting the caked-on dressings, etc on that admit!! I'd be reporting them to the BON. That's neglect and abuse. I don't blame you in the least for calling in for the next scheduled shift.
BTDT...got the t shirt. No....not all places are like this, but there are enought of them that gives all of LTC the bad name.
Is this corporate or a independant facility? DO they have a compliance hotline? I would call the state on this.....these are not isolated incidents. What are the families and pts doing or saying? Maybe pointing those state numbers out to them and nudge them to call too (all of those # should be listed for them to see).
Yeah...if you weren't putting out all of those fires, you prob could fill out incident reports on all of those issues, but I'm willing to bet the form is at least 3 pages long. A lot of those would qualify for med errors and I would call the doc and tell him that xyz pt has been here for 2 days and hasn't received his meds....I'm willing to be the doc isn't gonna be happy.
As far as the double...if you ever do it again...I would tell them you need the next day off. I always try to do that if I'm getting someone to double out. That or at least offer to have them come in late and do part of a shift.
I cannot deal with that screaming difficult resident (of all the people who this had to happen to why THIS particular resident?) who is still lying in a broken bed with no side rails screaming, "NURSE! NURSE! Where's the NURSE? This is abuse!" when I have just left her room and haven't even made it down the corridor yet. I cannot deal with another shift with our incompetent new supervisor who is a friend of the DNS and was brought in to replace the old competent supervisor who was let go because of "nursing politics."
If you read this far thanks for letting me vent, because non-nurses (like my spouse) just don't get it.
1) Thank god someone else has a significant other who DOES NOT understand nursing bullcrap. I just want to knock him up side the head sometimes.
2)Um... maybe you need another job?
3)I really dislike 'melodramatic' patients who can't understand that you've done EVERYTHING you can for them, but you cannot personally make everyone do what that patient wants right that second.
4) I wonder if this is why my facility doesn't want to use agency. I hate when people leave orders for me, but I do them so the patient doesn't suffer. I could never leave work for someone else - espically once I knew the shift before had done so. The agency your facility used - kinda sucks...
Oh my! It sounds like a horrible place to work! You better start looking for something else ASAP with much better management. I am a supervisor in LTC. I work 8p-6a. Most of our admissions come between 5p and 11p. We can get 3-7 admissions on any given eve. The floor nurses are so busy it is hard for them to complete and admission right away, but if they can just do the initial assessment, verify the orders and get a few papers signed, I do the rest as soon as I get there. They are all done within a few hours. I can't imagine working in a place like you are working. You sound like a very good nurse and need to be working with other nurses who have a similar work ethic.
They also only bothered to do half the admission (just the med stuff) and left all of the consults for me to do. 
I'm with you all the way for doing it under the circumstances...
SuesquatchRN, BSN, RN
10,263 Posts
Falon, you poor thing.
If you DO call state, call from home. DO NOT use the facility's line. There was an incident some years back where the DON demanded that the extension used be provided to her and the (now disgraced and fired) CEO ordered IT to provide her with the records.
Remember, no good deed goes unpunished. Did I learn that on the floor!