Is this new nurse culture shock or is this plain out blasphemy?

[Marie.rn]

Okay, I am totally taken aback by what I experienced today at work.

I am at the end of my orientation and I was with a float filling in on the floor who was supposed to be the desk nurse for 4 hours to have me learn the paperwork side of the new admissions (which we had an admission) and how to enter the orders. This is an experienced nurse at the facility and both times now that I was with her she did everything saying we had way too much to do? I asked about the admission who came at 6p and we had to go out on the floor at 7p, but we could not do that. The point of the assistant DON putting me there in the first place. So, again I learn nothing and figure everything out for myself because no one lets me do anything but treatments, suction, trach care, meds, head to toes, basically all one on one patient care.

Trying to sum this up.

I tell assistant DON that I need to know the paperwork side of an admission, discharge, send out to the hospital etc. I am orienting with a float that supposidly works my floor often, idk. I have been with her twice, and with a float nurse on another day. I basically was orienting them to my area, and doing all the patient care and whatever else they needed.

So, long time nurse gives me bogus excuse why I can't do anything. Oh, BTW she enters orders totally different than the 1st nurse who showed me? Confused? She says we have way too much to do, there are like 15 orders and we have 3-7. I am supposed to learn the paperwork side of an admission, discharge, and other paperwork aspects. We had an admission at 6p, but we couldn't do that for some reason or another. So, I can't get anyone to teach me anything here.

My weekend RN supervisor had our area from 3-7p, he oriented orginally to my unit and area but somehow took longer to complete the med pass than I do and he forgot a lot of things in the process. He has been a nurse all of 4-5 months, he can't do my job but he is going to supervise my job? So, I came on the floor at 7p. I noticed he never came to nurses station to get any tube feed stuff. I was suspicious. I found my patient whose tube feed goes up at 6p to 6a not hung at 830p. I ask long time nurse, he signed off how do we handle. She said he got confused because my patient asked him to suction? Well, he never got the bag, the feed, or anything yet he signed it off so it seems like he just signed off stuff he didn't do because none of the feeds he needs is on the cart. All of my gravity people are unhooked, I do not think anyone got their feeds but know 1 did not. I asked if we tell next shift to go for 2 1/2 extra hours, or do we let someone know, what do we do. Going along I had to suction my patient with a trach and he was just suctioned by my Sup. who said what an ordeal it is to suction the patient. I suction him all the time, just suctioning and cleaning a cannula. He said he didnt get his breathing treatment so his secreations were worse. No one on trachs were hooked up to the nebulizers and they dont take themself off. One family that sits with their mother all day, said she was missing her breathing treatment? I ask long time nurse, ignore? So, idk. He had stuff signed off, he stuff that he didnt sign off, idk what he did. However, he is going to supervise me doing my job and he can't do my job? Plus, with how he operates Im scared to have him sup me.

So, long time nurse says you finish meds and treatments with one hour to go I have to send patient to hospital. Hello, I am not here to do everyone's job for them I am here to learn. So, I say I don't know how to send anyone to the hospital can I go with you. No you need to do this, here's my badge and the keys to meds and narc's. So, I finish med pass.

A patient of mine asks about a patch s/he had on friday that had not been applied again. Its for pain and s/he is in pain. Very high cognitive functioning, this person knows if his stuff is applied or not. So, I ask long time nurse s/he says its not being applied. She talks about falling off or aides take the patches off. Umm, okay if aides take them off they are d/c ing a med and hello!!!! So, thats bogus. The order for the patch is in the cpu, its being clicked as administered and not being administered. Then there is a order for verify placement Q shift, and guess what all signed off. So, long time nurse says falls off again. They don't fall off. Then she says probably don't have, umm what from an order 4 days ago that was already given once. I find med in med cart unopened, I say see could not have been given bcuz not open. How do I handle this situation? Nothing, nothing, nothing. I said could you leave a note on report to have her admin in the morning, nurse says yes, doesnt put it on report, is this stuff the REAL WORLD i was told all about or is this beyond the real world.

So, then she tells me I can go and I said we have treatments that have to be done and its a specified treatment day there are others that need to be done. She said of the ones i know pick the most important and do it? Umm, so I used my 1 week and 3 day nursing experience to judge which of all the important wound care to be done I would do? I went to sign off that treatment, and found Sup RN signed off all the dressing changes and treatments..........maybe he should have been putting up tube feed instead of signing off everything he didnt do.

Is this reality? When do I speak up?

[CrunchRN, ADN, RN]

What a tough situation. I have always heard this goes on in some facilities. Signing stuff that wasn't done. Ideally there would be more staff so that long time nurse would have the time to do all that is required. However, that doesn't excuse long time nurses unethical behavior.

You are new and if they take sides they may dump you like a hot potato. On the other hand this info needs to come to light and the practice needs to change so patients are properly cared for.

So, do you hang in there and just do the best you can or do you possibly jeapordize yourself on behalf of the paitents?

I need to think on that one. I am leaning towards report it if you have actual proof. You do not have so much time invested that you cannot just move on and leave it off an employment app.

[netglow, ASN, RN]

Leave. Give notice and then pray that you get out in one piece.

[Old.Timer]

No, this is not just new nurse culture shock. The only thing I would need to think about is whether I would just leave or give notice and leave. I honestly think in this case, I would probably just leave without notice. Side Note: This is why I will not leave a family member unattended while hospitalized.

[brandy1017, ASN, RN]

Sign of a bad facility, can't keep staff so is using brand new RN's and floats and the poor staffing and lack of a conscious is causing people to chart meds, treatments that weren't given. This does happen in at least some nursing homes. This could cost you your license! Falsification of records! NY state has charged some nurses at nursing homes for this because things were charted that weren't done and they had gotten families to put in hidden cameras so they could prove this and then the nurses were charged. I don't know what happened from there, but you can be sure nothing good!

So if your conscious doesn't stop you from doing or not doing your job right, just remember there could be hidden cameras! Sounds like you need to get out of that facility and report them to the state board. Talk with the state ombudsman, but I would get out of there ASAP!

[caliotter3]

Sounds like the facilities where I worked. Way I see it, it is simple. You do your job to the best of your ability the way you think it should be done, until you find another job, or you resign immediately. That is about it. If you decide to stay, start, and keep a detailed personal log. Don't tell anyone that you are keeping a diary. Write it when you are at home. Just so you have something to fall back on, if, or when, the doo doo hits the fan. Make certain that you put dates, times, and general info about who you report things to. If you think this is too much extra work to protect your own back, then you should reconsider quitting sooner, rather than later. This place does not look as if it holds much promise as a place for long term employment.

[Morainey, BSN, RN]

Sounds pretty terrifying

[PintheD]

Marie, please know what you are experiencing is an awful introduction to nursing.

Reminds me of the joke: What do you call a medical student who graduates top of his class? Doctor. What do you call a medical student who graduates at the bottom of his class? Doctor. Same applies to nursing. Some "bad" nurses find facilities where they can hide out and still collect a pay check. Generally this attitude is top down.

Get out of there. You deserve better. In the meantime tell the powers-that-be that you need orientation on the paperwork aspect of your job. Do it repeatedly until you get what you need! This will make your life easier. Document patient findings as appropriate to cover yourself and look for another job.

You can't fix this. If your supervisor is sloppy then just assume it's a top down mentality.

Having said that, I am sure there are valuable clinical learning experiences to be had where you are currently. Soak those up, don't compromise yourself as a professional and reach out to more experienced nurses (here or face-to-face) for support and feedback. This is a temporary blip in your career and bigger, better things are waiting for you.

Good luck and keep us posted.

[CorrectionsNurseSup]

You should take this to the DON/Administrator or whoever is in charge of that facility immediately. I'd report the facility to the State for neglect. Once you saw the Supervisor had signed off on wound care treatment that you knew was not done, I hope you didn't go do them anyhow. Most facilities I have ever worked in required you to date, time and initial all dressing changes.

[DookieMeisterRN]

I'm sorry I can't give any advice you're post is really difficult to follow with text/abbreviations.

[atlan]

I am a travel nurse with a number of hospital experience to share with you. I had the best time of my life in Standford University Hospital. The best time in my nursing career in fact. It happened to be a very welcoming, loving and respectful place to work. It is a non profit establishment.

Then came a certain Medical facility in Anaheim, California. There, because it is a for profit establishment, the benefits of course is poor so people who work there either cannot get a job in a better facility or use this facility as a part time hangout because the benefit portion of the job is paid adding more money to their other job at a better facility with better benefits. As a result, the place is staffed with a lot of transients like travel nurse, per diem nurse and part time staff. In this unit of 30 patients, therefore 5 staff, there were 2 obese female Caucasian LPNs who continuously ate and nibbled throughout the shift, tells the patients "don't bother me, can't you tell we are talking? go ask the nurse." Even though all they had to do was get up, walk a few steps to open the laundry room door for the patients. So 2 out of the 5 staff were useless for most of the work. This then leaves 3 nurses. I happened to have one young recently graduated Filipino nurse as a charge nurse. She looked after the paper work, admin stuff and is hardly outside the office. When she was out in the unit, she caused more problem with the mental patients then she solve necessitating my putting down the flame! Then besides myself, there is this great big per diem black nurse who of course did not know any of the patients and so she never got out of the office either. I had to handle all the admission, transfers and discharges while she nurse the chip on her shoulders. At the end of the shift, I would be charting from 10pm till 11pm. I would go home with a kink in my next and went to sleep with the kink only to get relief in the morning. That was the worse 3 months assignment I have ever endured.

My advice to travel nurses is to ask if the facility is a for profit organization or not. Then you make your choice.

[RNTwin]

welcome to nursing... it's the illusion of great care, I know it's sad....