DON on cart

[arainh20]

I've the ADON at my facility for just a week and the DON just walked out because she refused to work the cart! Is this unheard of? DON ON CART? Should I except the position?

[Nascar nurse, ASN, RN]

It's sad that "filling it the normal way" includes mandating, and that "calling the agency" is not mentioned...

Do you work LTC? Besides the cost of an agency nurse, it's a disaster to think any stranger could come in and pass medications to 25-35 residents-all of which are total strangers that likely aren't wearing arm bands to identify them. You're lucky if there is a picture of them that's less than 3 years old. I can't imagine it wouldn't be a huge liability to both the facility as well as the agency nurse.

[Kooky Korky, BSN, RN]

Please excuse my ignorance as I've only worked critical care and ER. What does "work the cart" mean?

passing meds

What does LNHA mean?

[Kooky Korky, BSN, RN]

Do you work LTC? Besides the cost of an agency nurse, it's a disaster to think any stranger could come in and pass medications to 25-35 residents-all of which are total strangers that likely aren't wearing arm bands to identify them. You're lucky if there is a picture of them that's less than 3 years old. I can't imagine it wouldn't be a huge liability to both the facility as well as the agency nurse.

An Agency nurse can do the job by asking regular staff which patient is which? I've done it several times, I have seen other Agency staff do it, too. Not really a problem, as Agency staff are generally resourceful and expect to have a hard time the first time, as they don't know the patients, the facility routine, where things are kept, which of a patient's doctors to call when needed, etc. Don't even get me started about electronic charting with no orientation.

[middleagednurse]

Please excuse my ignorance as I've only worked critical care and ER. What does "work the cart" mean?

The med carts are large and heavy. It's like pushing a stove. The cart contains all the resident's meds.

[middleagednurse]

The med carts are large and heavy. It's like pushing a stove. The cart contains all the resident's meds.

Passing meds in LTC is a hard job. You often need to crush multiple meds, mix with applesauce, and convince an unwilling person to swallow it.Add liquid meds, eye drops, and a nebulizer, times 30 patients

[Have Nurse, ADN, RN]

They are just short staffed and would want me to occasionally work cart if i take DON

Be careful.. You never get the complete truth.

[Tenebrae, BSN, RN]

Never encountered having the DON work the cart.

I only once asked for help, when I had a patient crashing who I couldnt leave and still had 30 plus meds to pass, rang my DON and explained the situation and she organised one of the other nurses to come and help

I'd be wary of a place that expected the DON to do this.

[CapeCodMermaid, RN]

LNHA=licensed nursing home administrator.

We call agency. They very rarely have anyone who can help or come at a moment's notice.

I know people get sick but I also know that the work ethic of many of the younger nurses isn't what I'd call stellar or even acceptable....but then again, I've gone to work with a PICC line in my arm infusing IV antibiotics. In my career which spans more than 30 years, I think I've called out for a total of 14 days.

[mander]

ADON here. My DON and I area often coming in when staffing is critical. We've taken carts and done CNA shifts. Of course we're not going to be as fast and as organized but you gotta do what you gotta do. As long as it's not a weekly occurrence and you're not working 40+ as DON and shifts on top of that. Then I would have a discussion with your admin.

[kdsnyder]

I find taking the cart refreshing but I will admit that I am slow going and I quietly fret about it becoming a regular occurrence as we too have ongoing staffing issues. I’m new to a directorship and I still don’t have my footing in that position, even though I’ve been a nurse almost 25 years. I need a mentor!

[LesMonsterRN, ADN, RN]

I am very fortunate that my nurses rarely call in. And when it does occasionally happen on day shift, the remaining nurses will divide their duties differently to help each other out and make the situation work. For night shift call ins (we have only one night shift nurse at the moment) or days off that can't be covered with agency, we cover the absence as a management team - DON, MDS Coordinator and administrator (who is also an RN). We will often split those shifts into equitable time frames and all do part of it so that we can still get our own work done. One of the biggest benefits of that is that the floor nurses see us as willing to roll up our shirtsleeves and dig in. That said, I'm not at all in favor of any of us managers on a med cart if it can be avoided. I'd rather it be someone who does meds routinely. It's too important.

[TwoLayi, ADN, BSN, RN]

I realize this is an old topic but I felt I needed to add my two cents

I was a RN floor nurse at an SNF and I really admire all the DON's who said they work the cart. I am not saying it should happen on the regular, but it shows real teamwork.

In fact, I just quit my recent job because I was constantly mandated to stay overtime and some weeks I was forced to work 72 hrs, or lose my job. I was stressed, burned out and very unhappy. I could never make plans after work and constantly had to cancel appointments

And it really pissed me off when our DON, would come in at 9 am and leave at 4 pm, when I had been there since 7 am and would probably be staying until 9 pm.

If my DON had taken the med cart, even if for a few hours, I would've seen her in a different light. I would have felt we were in it together. But she didn't, that is why I am leaving and the other RN's have left. And this facility will lose a star(s)